Basic Levels of UK Healthcare

Real heroes and heroines stopped wearing capes. They wear uninspiring scrubs and dangle stethoscopes from their oversized pockets.

The time is 1430hours. I have been checking the world clock on my screen every minute. Partly because I can’t sleep and partly because I have no headphones. I left mine at home and the airline is not providing any.

The couple next to me are having a beautiful moment together watching whatever it is they are watching. The man is American and the lady is Spanish. I have become a connoisseur at telling accents. Before, all whites were ‘mzungu’ but nowadays I appreciate their different backgrounds.

They look so sweet together and I suddenly miss being in a situationship of some sort. It is a fleeting thought and I banish it as soon as it appears. Because it is liberating to not have to share my bed, yes? Yes I’m joking Karen.

I am aboard KQ Flight 0390 to Heathrow, London. We taxied off at Jomo Kenyatta International Airport (JKIA) at 0930hrs. I have no idea where we are but I see clouds outside my window seat. Fat clouds. Wispy, feathery clouds. Clouds that look like a hybrid of a cat and an eagle. Small clustered clouds. Undecided clouds.

This is the second time I’m leaving Kenya for UK. The difference is that this felt like an actual goodbye. This time, I could taste the colours of my light face powder in the tears that streamed down my flushed cheeks. I still could smell my elder sister’s love on my shoulder when she embraced me that morning inside Paul Caffe Coffee shop at JKIA.

My sister has always looked out for me. She is older by two years or thereabouts but we grew up together. Fraternal twins of some sort. She is the brains where I am the muscle. She strategizes, I execute. She thinks before leaping, I leap then think later. We are complete opposites of each other and maybe that is why we are so intertwined.

Shii (my sister) is not one to show emotions. She cries and laughs in silence. The ultimate prim and proper EnglishLady. I display my emotions. All barrels out. That is until I jeed a recharge where I withdraw into my cocoon of silence. Shii is witty as a housewife’s bucket and takes a backseat wherever I’m involved. Allowing me to rush ahead and knock my head off.

It came as a shocker then when I came from the lavatories at the said coffee shop and found her in tears. That is the first time I saw my elder sister unashamedly break down in my presence.

At first I thought it was her eyes. Her eyes have recently decided to be wee devils and they tear up. It wasn’t. I pushed away my suitcase, crossed over the hard, cold table and sat next to her. I am the queen of public display of affection. She loathes it. Ha ha.

Nestling her dreadlocked head on my left shoulder, she cooed up amidst sobs,” I will miss you.”

I may have heard many warm things in life but those words chewed me up raw. My insides trembled and the pieces came out as hot tears that soaked onto her white and red-striped cardigan. “Me too Toto, me too.”

Father calls all his children Toto. It is a contraction of Mtoto meaning Child in Swahili. We have adopted it as a family.

I would miss her. I do. I always will. But I had to leave Kenya and fast. My Endocrinology appointment awaited and I had a follow up interview with a Trust in the National Health Service(NHS).

This departure was emphatic because I had finally tied all the loose ends in Kenya and I was ready to settle down in Edinburgh, United Kingdom.

Even as I formed shapely images of the clouds that rose invitingly in the skies, I knew I had made a definite decision. That decision involved me missing my elder sister more than anything in this world.

The NHS is a government funded public medical and health service anyone living in the United Kingdom can access. This is without being asked to pay upfront. What they don’t tell you however is that as an immigrant worker, you pay an Initial Health Surcharge (IHS) of about 500 Sterling Pounds for every year you’ll be in the UK. This is at the Visa application stage. Last I checked the current government plans to increase that fee.

It baffled me the first time I came here. My appointment with the endocrinologist had been occasioned by a referral from my general practitioner.

Health systems in UK are tiered up into different levels. At the most primary one is the community. That is equivalent of community health nursing in Kenya. It however is very formal and organised unlike anything I’ve ever witnessed.

In hot pursuit are the health centres. Only that they are not called health centres. They are know as General Practitioner’s (GP) medical practice or GP surgery. Why someone in Britain thought it is cute to call a health centre a ‘surgery,’ I will never comprehend. Just like I’ll never understand people who don’t eat avocados. What is your problem guys?

The interesting thing about health centres, is that they have a GP (a medical doctor) in charge as opposed to the health centres I was used to back home. There are imaging services and specialist services like physiotherapy and podiatry. Some clinics are run entirely by Nurse Practitioners.

This is the first place I interacted with a Nurse Practitioner. I always heard of them but I never knew it was a real thing. Stella Donohor (name changed) was her name. She was a Reproductive health nurse practitioner. When I booked an appointment, the medical receptionist sweetly informed me that Nurse Donohor would be the one to see me.

Raised up in a culture where a nurse isn’t really appreciated or viewed as someone who knows her or his trade, I was mesmerized. Coming from a tribe that sees nurses get short changed at the table of opportunities, I was impressed.

She let me call her Stella and because I accused her speculum of being too tight in my lady parts as she did my Pap smear,I tricked her into answering some of my burning questions. Ha ha. Yes I know how to strike up conversations in the middle of uncomfortable procedures.

A nurse practitioner, she told me, had to have a Bachelor’s of Science degree in whatever field of nursing she chose. She also had to undergo a Prescribing Course. I will revisit this topic some day in the near future.

The doctor handles all other cases. Doctors are few (so are nurses) hence the nurse practitioners help the entire citizenry by handling some cases and referring the rest appropriately. The teamwork between the Nurse practitioners and the doctors is to die for.

My GP had handled my other cases and referred me to the endocrinologist. I remember chatting with a nurse friend back home who told me it cost her an arm, a leg and a slice of her liver to afford the services of this highly trained specialist of glands and hormones of the body.

Therefore when I waltzed to The Royal Infirmary of Edinburgh hospital to see my specialist, I was sceptical if I was to cough up some Queen’s pounds. I did not.

As you’ve noted, we have graduated to the hospital. Hospitals are grouped into private and public ones. Private hospitals are not popular in the UK. They are mushrooming like bushfires because the NHS is overwhelmed but still, they are playing catch up. Worthy to mention is a branch of NHS that is the social care. This is where Care homes and home based care fall. They are either privately or run by the government. Majority are privately owned but regulated by the differed Health Care Inspectors of the government.

The inspection and regulation is a serious business and I’m full of praises for the way the UK as a whole has decided to take care of her geriatric population. That and the terminally ill.

NHS hospitals are then clustered into groups depending on the locality they are in. These many hospitals form a TRUST. Why the name Trust you ask me? I’m asking the same thank you very much. Perhaps the most famous one being St. Guy’s and Thomas Trust in London. One of its hospitals, St.Thomas, is where the good Prime Minister Boris Johnson got admitted with and recovered from Covid-19.

My hospital, The Royal as it is colloquially known falls under NHS Lothian Trust. The different Trusts across the UK run under different managements but all subscribe to the guidelines of the UK government. We could classify all these further based on the four countries that make up the UK. I feel doing so would be belaboring the point and akin to a broken record.

After a chat with Dr. Graham the Endocrinologist, I left for home feeling much better. I wished my sister was here. To hear what the good doctor had to say about me and to also accompany me home. She wasn’t. It was just me and my hopes and dreams strapped in a light backpack.

I did follow up with my interview and got the job I desperately needed. It keeps opening my vistas of healthcare in this country. I get to fall in love with a government funded, public owned healthcare without a cheap private option. Ranked as one of the top ten healthcare system by World Health Organisation, the NHS offers so much for a greenhorn like myself.

Chronic diseases are managed at the health centres only being sent to the hospital if and when acute. Community health is the heartthrob of United Kingdom’s healthcare. Without it, all patients end up in the hospital and cripple it. I have had a beautiful opportunity to be part of a community dialysis team. Accompanying renal nurses to deliver services in patients’ houses. This couldn’t get better.

Any emergency warrants a visit to the hospital while a minor concern sees you at the health centre. I can’t bring myself to say ‘surgery,’ sorry Your Majesty. Emergency services work. They are not a suggestion. The ambulance, fire, police departments are not flimsy afterthoughts. They are stark naked realities and I am mesmerized as a nurse.

When I asked Google to show me hospitals in the UK, he didn’t tell me about the mystery of Trusts. Now that it makes sense, it is prudent to think about the area you want to settle in then look for Trusts near that locality. Afterwards you can apply for a job in any of the hospitals mentioned. I think this is where you raise a glass to that.

Nursed Differently

Nursing is not about pills and potions, charting and call bells. It is about being able to love people when they least expect it, when they most need it, at their lowest.

Pain is a great motivator. Towards making great decisions or dumb ones, or both. Therefore, when I willingly chose to leave the Renal Unit, it came as no surprise.

Huntly is a rural town in the middle of Aberdeenshire County in the City of Aberdeen, Scotland. There is United Kingdom weather and then there is Scotland. Scotland’s weather is so beautiful that it breaks my heart again and again. That is actually a joke.

It is wet in Summer and wet in Winter. Wet in Spring and it badly wants to be wet in Autumn. Even the sun here rains; too intimidated to shine.

I arrived in Huntly in late summer and I was fascinated by the long daylight hours. Sunset at 9pm was marvelously beautiful. My web of intrigues was to be woven further by the system I found myself in at work.

Having left a specialised unit, it was difficult to adjust to a carehome. This is a home for the elderly. United Kingdom gives a damn about her elderly citizens. The closest I had been to this was Bethany House in Sagana, Kenya. This was several decades ago when I was still young, fresh and juicy.

I was wowed. Several tens of residents all comfortable in what I’d call a retirement home. If this was explained to me at the interview stage, I conveniently forgot about it. All I remembered was someone saying nurses get paid more in a carehome as opposed to a hospital and money was a motivation. A jolly good one.

I settled gingerly. It is not easy being black in a sea of white. It is a tiny drop in an ocean which is constantly in motion. To many colleagues, I was the first black nurse they had ever seen. Worse, the first ever Overseas Nurse to ever be sent to their rustic carehome. To some of them (read most) , Africa is a tiny village and we all live in even tinier huts and we sing with monkeys and lions.

We also wear silky loin cloths and speak Zulu and Xhosa. Well, The gods Must Be Crazy is a famous film and it looks like that is all these my colleagues knew. Talk of excellent acting. However the ignorance tasted like fermented bitterness.

I marveled at the disproportion between technological advancements and the level of ignorance about the rest of the world. Fast and furiously came the questions. Did I train as a nurse in Africa? I kept correcting them to say Kenya, not Africa. It was futile. Did we have hospitals in Africa? Did we wear clothes in Africa? How did I speak such good English? How long have I spoken English?

Then came the nursing team. Am I really a registered Nurse? Do they have hospitals in Africa? ( Side note: Do we? Do we have hospitals when our leaders keep running them down and rush to London or India for treatment, do we?)

Would I know what I’m doing at the OSCE exam? And the cherry on the cake, am I REALLY a nurse? It was too hilarious as to be dumb.

I worked under the registered nurses but mostly as a health care assistant. That was before I passed my OSCE exam and joined the register of UKRNs. I shadowed nurses as they did hand over reports and shadowed carers as they helped residents with various activities of daily living.

It was a normal Tuesday morning when I listened to Tracy the night nurse complain about a resident’s urinary catheter that kept falling out. Tracy was as white as snow. True story. She spoke through her chiseled long nose. She gestured a lot too with her perfectly manicured hands. Her short cropped silky hair had a fringe which she kept pushing away from her face. A modern day Snow White–with a nursing uniform.

While she described the catheter problem, I counted the number of tattoos on her arms. There was a baby elephant that was blowing bubbles on her left wrist, those bubbles were being eaten by a tiny dragon that was three centimetres or so below her elbow. I was just getting to a match of an eagle and a lion tattoo when Juan, my mentor interrupted my fascination.

“Catherine I want you to observe as Amber inserts the catheter then you can join the carers in serving breakfast, ” she sweetly chimed.

Amber happened to be the most qualified nurse of the day. After gaining consent from Betty, the resident, Juan, another nurse whose name I can’t recall, Amber and I went into the resident’s bedroom.

Betty was a big girl. At 68 years she oozed folds of confidence and chunks of hope. She had divorced exercise many years before her car crash which injured the lower segment of her spinal cord. She was doubly incontinent. Betty adored her snacks and even as Amber explained the procedure, Betty munched on a delicious-looking piece of Maltese chocolate bar.

She gave me one look and winked. Oh sweet soul! Trying to make me feel at home. I immediately took a liking to her. Amber confidently aimed the tip of the catheter into Betty’s private parts. I looked on as Juan and the other nurse kept me company.

That is when it struck me that Amber was not inserting the urinary catheter into the urethra. Juan and her pal were dutifully observing and encouraging her as I stood there flabbergasted. My mouth took over my mind.

“Nurse Amber please remove that catheter and insert a new one. Here,” I said as I suddenly took a new silicone catheter from the lower shelf of her working trolley and opened it for her. ” I will use my phone’s flashlight to give you more lighting. That is not the urethra. “

Uh-oh. I forgot the rules of engagement. I was to watch not talk. I was to be seen and not heard. All I wanted was the catheter in the urinary bladder. We weren’t going to achieve that if we inserted the catheter into the vagina. No wonder the nursing team was complaining about the catheter falling out. It definitely would fall out if what we were targeting was an opening bigger than a female urethra.

Amber silently allowed me to use my light to help her maneuver through Betty’s folds to locate the urethra. The female urethra is one canal that confuses many a healthcare workers if not the public themselves.

Located just below the clitoral fold and atop the vaginal orifice, it is easy to miss. Many may be forgiven to think urine is expelled through the birth canal. It is not. It is expelled through the urethra. It is what leads up to the urinary bladder,where urine is stored.

A urinary catheter is a tube used to access the urinary bladder so as to remove urine. Many reasons make the use of a catheter vital. Betty had had an injury which had severed the nerves that tell the bladder to release urine. The nerves that tell the brain that it is time to pee.

After leaving that room and washing hands, the atmosphere was ripe with palpable tension. Like slimy okra the team was unsure what to do with me. To love or hate? They decided to make independent decisions to be indifferent. How exhausting.

Betty was so appreciative and she would later joke with me about me being the first black nurse she was seeing. She however was to ask me if I trained in Africa as a nurse. If Africa had catheters. Ah, here we go again…

Juan my mentor didn’t chide me for talking during the procedure and she did not acknowledge my helping save the day. It was like nothing had happened. However, the nursing team gave me a wide berth. The hours I would shadow a nurse were greatly reduced. I was also not allowed to attend the handing over reports until I qualified as a UKRN. Amber also stopped talking to me.

It would later therefore come as no shock when I was on shift with her when a resident called me a few racist terms and Amber was silent about it. It happened twice. And twice in her presence, she didn’t intervene.

That was the straw that broke the camel’s back and I was the camel. I wrote to the powers that be and gave an ultimatum that if I wasn’t transferred from that carehome, either of the following two things would happen. A) I would lose my mind or B) I would book my next flight to Nairobi. Where skyscrapers and cars do exist,to everyone’s surprise.

Nursing in a carehome is different because it demands autonomy. The hospital will always have a team of fellow nurses but more often than not, carehomes are run by a single nurse on each unit. Every decision is made by that nurse and therefore accountability starts and stops with the nurse.

That experience horned my leadership skills and increased my problem solving capabilities. Geriatric Nursing is a broad area and I was able to integrate my theory into practice.

I consider myself very lucky to have begun in a carehome and as a care assistant. It helped me learn different things I only saw in textbooks. For instance mobility assistive devices. Take a Zimmer Frame for example, I had never used one or seen a patient use one. I know they are there in Kenya but for the chosen few. Money talks, doesn’t it?

I learnt the basics of moving and handling residents and patients. I appreciated how utterly incapacitating old age, frailty and dementia are.

I remember calling my best friend and sharing how one day I’d run a carehome in Kenya. That our elderly parents and grandparents have been left to fend for themselves in the rural areas while we could do with a formal system of care for their needs.

There is a desperate need for such as well as home based nursing care services in Kenya. The gap between hospital admissions and rehabilitation in the community for the elderly and terminally ill is valley-wide. A dry expanse of nothingness. It smells of loneliness, memories and anxiety for our grandparents and the terminally ill.

Perhaps this pool of silence on how we take care of our elderly needs to be poked. Maybe then it will cough into life.

One Exam in Belfast

Bangor is a coastal town in the Southern side of Belfast City, Northern Ireland. My hotel room overlooked the sandy Marina Beach. If it wasn’t the silly seagulls calling out, it was the whispering breeze from the salty waters.

Belfast is the capital city of Northern Ireland, one of the Four countries that make up the United Kingdom. She houses the Titanic Museum and the now all too famous setting for the Game of Thrones.

Bangor is half an hour from the Capital and less that via train from the George Best Airport in Belfast.

Funny how one Country can be split and give birth to two. Sudan, you weren’t the first one. Ireland did it for us ages ago. We now have Ireland the Republic which is different from Northern Ireland. Welcome to Europe.

I was here for the sole purpose of training for Objective Structured Clinical Examination (OSCE). This is the final exam towards Registration as a Nurse in the United Kingdom. My employer, for some humorous reason, found it fulfilling to have me transverse the Irish and Northern seas in search of knowledge and skills at handling this exam.

There are numerous testing centres in the entire UK but my employer had booked our test at Ulster University in Londonderry. Londonderry is where you visit the Game of Thrones sites and moments. You are welcome.

I owe it to them for allowing me to tour a slice of beauty from the heavenly pie that is Belfast and particularly Bangor. Coupled with sights at the vintage museum, my mind was pacified and ready to handle my reality.

Visiting the beach was one thing but practising for the exam was another. I have always been horrible at practical Nursing exams. Not horrible in the sense that I don’t pass ; horrible in the sense that I can’t think when I have someone hovering over my shoulders.

I feel imbued with disparaging anxiety and my examiner can touch my disorganized thought bubbles; hold them in his defty hands and drop them like the hot mess they become. What made OSCE even less attractive to me is the fact that one is required to talk through their actions. There is audiovisual recording of every step and somehow time runs out before you can say OSCE.

In retrospect, this employer knew what lay ahead and decided to entice me with beautiful scenaries and free flights to and from Huntly in Aberdeen City, Scotland.

Talking of which, Huntly is the Turkana of Scotland. Why they sent me there is still a mystery to me. Why I accepted remains a parable of Biblical proportions.

I without a doubt believe that pain obscures one’s judgement. It also leads to sinister decisions. My settling for that tiny town in the middle of civilisation’s desert was a quintessential example. Let us go back to the exam.

Nursing process encompasses four or five steps depending on who you’re asking. If you ask the United Kingdom’s Nursing and Midwifery Council, they tell you four steps are enough. These include Assessment, Planning, Interventions and Evaluation. Do not ask me where Diagnosing went because I was as perplexed as you are.

OSCE therefore, seeks to determine your ability as a registered nurse to safely practice within these steps.

Each step is acted out either by real patients (patient actors) or by mannequins. Fair enough, right? Wrong!

You’re required to speak. Suppose you’re washing hands, naturally you just do it and dont bother explaining the steps. Even in my basic Nursing exams in Kenya, not once did I have to talk through the entire process of handwashing. I had only been required to say I’m washing my hands.

OSCE expects you to say something akin to the following:

“I have opened the tap now I’m checking to see if the water is at the right temperature for my hands as I wet my hands. Now I’m putting soap onto my hands to cover enough surface. I am now rubbing palm to palm,now back of each hand with fingers interlaced. Now washing in between the fingers with fingers interlaced, washing my thumb and web of each hand,knuckles of each hand. I am now rubbing my fingers onto the palms of each hand, washing my wrists. I am rinsing my hands then drying with disposable tissues. Now I’m closing the tap with my elbows. “

All these is said as you do it and also as the clock ticks and tocks down from either 15 or 8 minutes depending on the particular situation presented to you.

That is not all, there must be Skillset stations where the examiners and their camcorders watch you save life or quash it. To practice as a nurse we must ensure you’re a safe nurse. Safety is only measured in practice not on paper.

From Basic Life Support to Aseptic-Non- Touch-Techniques, one must demonstrate ability to deliver quality care and do so efficiently. That informs the timing of these actions. You must be nimble in thought and fingers.

Practice therefore, is paramount. Many nurses I’ve talked to cite the English exam as the hardest part of the entire process. For me, it was certainly the OSCE.

I excelled in it much to my own amazement. Perhaps the promise by my employer that they’d transfer me to the city if I passed on first attempt added to my zeal.

There are unfathomable pressures that come with training for an exam in a far flung place. They didn’t matter though because I met lovely souls from every corner of the world. I made friends from the Philippines, Botswana, Zimbabwe, Israel and my country of the day– Grenada.

I didn’t know Grenada was a country. Heck, vicarious travel makes one think they know squat about the world they live in while they don’t. We shared different values but our love for nursing was universal. That plus Filipinos are excellent cooks. Yes I had to write it here somewhere. Food and I are in a stable relationship. Ha ha.

Their scrumptious chicken curry and chicken SomethingSomethingElse is to die for. I ate unreservedly. It allowed me a great chance to learn about the difference between Nursing education in the Philippines and in Kenya.

Being a sucker for Education, it marveled me that the Philippines abolished any other level of Nursing education less than a Bachelor’s degree. That to me is classical of a people interested in career development.

It explains the seamless transition of Filipino nurses into Western and Eastern healthcare systems. They have the papers to prove their qualifications. I nostalgically wished Kenya would one day get there. Where students upon graduating high school confidently approach University for a Bachelor’s degree in nursing.

The presence of Diplomas and Certificates in Nursing waters down the very profession we keep trying to herald forward. We will get there someday.

As the train galloped to George Best Airport in Belfast, I soaked in the earth-red houses adorning the shoreline of the city.

What a contrast to the humourless grey houses of Aberdeen! Aberdeen is famous for oil and granite. Granite therefore is the very mineral that coats the building bricks. In summer it sparkles in the sun. However, if you’re not looking, and I wasn’t, it is all backwater. Nothing ever happens there and it happens all the time.

For the purposes of information, there was a total of three examinations before I could finally call myself a UKRN. It started with the English Exam, a Competence Based Exam and finally the OSCE.

The first two are done in Kenya. They are easily available and unnecessarily expensive by my metrics. Lately, the Nursing And Midwifery Council subsidized the cost of the Competence based exam. It is cheaper today than it was when I did it.

YouTube offers great tutorials on the International English Language Testing System (IELTS) Exam. I prefer that to lecturers who will more often than not take your money and not deliver. Have confidence in yourself.

The difference between the English exam and OSCE is that the former seeks to prove that you don’t know a thing while the latter seeks to demonstrate that you know more than you give yourself credit for.

As I pulled the covers over my tired body in that shared apartment in Huntly, I envisioned myself passing the OSCE. The feeling of listlessness warmed my duvet and allowed me to have a fitful sleep. I needed to get out of that living death.

In Search Of A god called Peace

Not all who wander are lost. ~Lord of the Rings

I spat out the second bite of my lunch. It was potatoes and rice. Again. I keep telling mother that I hate this mishmash of ineptitude and discouragement. She doesn’t care. We come from Central Kenya and a meal without potatoes is a crown-less princess; she is just any other girl. Mum had packed this for me as I headed out for work in the Ward as a registered nurse.

I gave up on this meal and attended to one dialysis machine which had decided to burst my eardrums. I disliked the blaring alarms. The water plant had run out of water — third time this week. Julieta,my colleague and a damn great nurse, hurried out to refill the water tanks.

The other nurse was helping me circulate the blood manually by turning the machine pump to prevent blood from clotting.

We should not have been going through that but this is Kenya and here we do with what we have. We got tired of complaining.

After this ordeal bland as my lunch, the Nursing manager sent me a text that my transfer request had been accepted. I was finally going to Garissa County!

I had pushed this request to the recesses of my mind just like I had many other alternative versions of my reality. This was a wake up call. I had wanted to transfer to Garissa county but now I had a choice not to. A choice beyond Garissa. Beyond Kenya.

See, I had always wanted to leave my country. For better terms and conditions of employment. For betterment of my career and to see what else a nurse can be apart from a clinical nurse.

I knew I am an old school wannabe writer trapped in the body of a modern day Renal nurse. I have been very curious as to what opportunities the world has to offer a nurse who holds a pen. Kenya, understandably, limited that into clinical work and teaching if not research and marketing. I have no idea how the seed of a mysterious MORE was planted in my head but I sure watered it.

Going to the famously loved Nurse destination–United States of America. was out of the question. The process would take at least an year to immigrate. I had many things with me but time was not one of them. I needed out. My world was collapsing and the walls that held it were belly up.

The kitchen of my personal life was melting and I needed some ice on my tongue. I just wanted to go. To. Go. Anywhere. The god of peace, I needed him. If he couldn’t come to me, then I would go to him.

United Kingdom was floated to me by a former colleague. The problem was that I didn’t know what to do about UK. How did nurses immigrate to the UK?

I had a week earlier received a Skype interview invitation with a potential employer in the UK. I knew I’d ace it. My former colleague had said it was easy peasy.

I therefore wrote to the County Secretary to suspend my transfer to Garissa County. I would stay. I would stay long enough to eat my lustre less lunches and refill the water tanks in the water treatment plant.

A few days after my 28th birthday, I bade farewell to Kenya. This was done in complete secrecy. Only a handful of people were made aware. It felt like I was leaving for some vacation. Like I would be back soon.

Being conspicuous on social media, I continued a charade of someone who was still in the country but having some time off work. It worked. I never made it to the Broadway so social media can as well be my God-given stage!

There is nothing as testing as being alone in a new country and a different continent. Now I know. Now, I surely know. I however had too much pain back home that a change of scenery was welcome.

Offered a choice between drinking my own blood and going home to the embers of a dying personal life, I’d gladly have slit my wrists open.

Starting out where nobody knew me or my story was a plus. Because time is the great equalizer, the reality of the mistakes I made in accepting the job offer I received started showing.

The half-hearted explanations and witty exploitations from coworkers started manifesting themselves. It did not help that I was yet to get my Personal Identification Number (PIN/LICENSE) as a UK nurse. It was exasperating.

The United Kingdom became icy for me. But if I went back to Kenya it would be icy inside for the rest of my life.

As the days bled into nights,I spent some on the floor of my shared apartment crying and rocking myself to sleep. I longed for mum and her craftly uninspired packed lunches. I needed someone to talk to and I was in terrible shape. Home sickness they called it. It was more.

It was the feeling of worthlessness. The fangs of hopelessness dug into my flesh and ate away at my very core. It took me a minimum of three months to fully settle my mind and get my bearing . It took an even longer period of time for me to know my space as a nurse and fully exercise the authority enshrined in the Nursing Code of Conduct.

I used what I’ll call backwards strategizing. I was so encapsulated in my own misery that I failed to research well about Nursing in UK while I was still in Kenya. Emotionally fraught with all the things happening in my life then.

There are gaps that I did not identify and fill. There are potholes as sharp as any double-edged sword in the scanty information regarding migrating to the United Kingdom as a Kenyan Nurse.

It has been long but I love this country of the Queen. I have hopelessly fallen in love with Nursing here. I love the autonomy. I love everything that a nurse symbolizes here. I have had to learn and unlearn a few things but all in a day’s work!

My lessons I’ll share and more. We will laugh and discuss different aspects of this journey going forward. Every Wednesday will see a snippet of this process surface on this blog.

About my god of peace, he had always been in a cage in my heart and I finally broke the lock and set him free. I’m bathed in his iridescent golden rays of serenity.


Even when you are not nursing, you are nursing.


Thank you for walking with me when I’ve been stumbling over my words. I have had a beautiful run. Bumpy yes but indeed magnificent.

I have chosen to refocus and fine tune my blog towards health issues and medico-nursing matters. Time is ripe for me to give back to the medical and specifically nursing world as a Kenya and United Kingdom registered nurse.

I have shelved my personal anecdotes for future references. I believe time will come too for me to take a deep dive into that. This is a transition for me where I need to focus on one issue and commit to it. I couldn’t be happier that I’m finding my voice as a scribe.

Thank you for always being here and reading what I have to write. I promise to be annoying as always. Every Wednesday will see a new blogpost. Some will be equal to chewing my own teeth but at least we will have some words every week to keep us going.

I will take a journey from Kenya to the United Kingdom of Great Britain and Northern Ireland and eventually we shall compare and contrast or simply laugh at the experiences of nursing. We shall together laugh and learn from different diseases. I will try my best to break down the sombre medical language into lay terms for all to understand.

I must reiterate that my target audience is not medics or aspiring medics primarily. My target audience is people like my mother who have never seen the inside of a college, my neighbor who still believes washing hands is a waste of time and finally, my renal patients who have to live with a disease they barely comprehend.

The caregivers who have to take care of patients without knowing what to do or not do. Students graduating high school and not knowing any other thing apart from they want to be medics. Student nurses choked by the system such that they feel all they will be is a clinical nurse. My audience, friends, is as diverse as it is wide.

In a world where everyone is trying to be technical and appear more educated than the next Jack or Jill, I want to be simple. I hope to be (wink).

Welcome to my renovated site.