The Anglo-Ethiopian Society
Your Chairman's Spare Time!
Author - Jean Bailey
The NHS has been encouraging UK NHS trusts and medical and nursing schools to develop links with partner organisations in less developed countries. Leicester medical school and university hospital trust have had such a link with Gondar medical school and hospital for about 7 years.
Sandra Kemp, the co-ordinator of the nursing part of this link, reviewed the nursing elements link two years ago. Until that time it had consisted of training around specific clinical topics such as resuscitation of small babies etc. She approached me to help with the leadership development needs of the nursing staff - from Matron and head of the nursing school to the staff nurses and students. Quite a tall order!
During my many visits to my late husband’s family and my Aysanew Kassa charity work in Azezo I had witnessed the enormous challenges facing the nurses of delivering high quality nursing care to the ever growing number of patients. Whilst I am a nurse, midwife and health visitor I felt that I never had the time to do anything constructive there as my fulltime job with the Royal College of Nursing in the UK and the charity work kept me fully occupied - or so I thought! So when Sandra approached me for help I was torn but as they say ‘give a busy person a job to do and it will get done’. So I found myself putting together a proposal to undertake a baseline assessment of the leadership needs of nurses with a view to a longer term commitment to meeting them!
After a few false starts, May of 2006 found me returning for the second time this year to Gondar with Sandra. Normally when I am in Ethiopia I stay with my family in Azezo; but because of the need to work in the evenings, and as I know that it would be impossible to do this in Azezo, as I always seem to attract a lot of uninvited guests to my mother-in-law’s house that I would have to entertain, we lived for two weeks in the Fogera hotel. Our experiences there could fill this article!
The work with the nurses involved many challenges not least two public holidays whilst we were there (we had not chosen the dates of the trip), interruptions in the electricity supply, plugs falling off the wall and a classroom that needed a great deal of detergent and elbow grease before it could be remotely possible to use. I was keen to demonstrate that nurses who are caring for really sick people in ever increasingly cramped and overcrowded situations should be respected and have at least a reasonable environment with good refreshments for their time out. On top of this we landed in the middle of a pay dispute!
However, with lots of flexibility and daily changes to our plans we managed to facilitate the nurses to develop their mission for the next 5 to 10 years. Many of these nurses had not had any professional updating for a long time and soaked up all that we could offer. In all 45 participated out of 120 using small focus groups - though Gondar hospital should have 150 registered nurses. It was interesting to find that the long list of issues that affected the nurses were similar to the ones that I would expect from groups of nurses in the UK and had also found during recent work in Poland - what was totally different was the environment and context. The importance of gaining an understanding of the environment and context for anyone before attempting such work in the future cannot be over emphasised. But with the challenges also came lots of fun and laughs each day and we relaxed each night with a G and T as we typed up the day’s flipcharts. We ended the ten days activities with a celebratory lunch at the Fogera hotel which was a great success.
Over the next 5 to 10 years the vision for nursing is to see a substantial improvement to patient care and clinical outcomes in Gondar university hospital through the development of effective leadership and management of nurses and nursing. The anticipated outcomes are:
1. Improved patient care and hospital environment
- Patient mortality will decrease
- Maternal mortality will decrease
- Decreased length of inpatient stay
- Improved patient satisfaction
2. Strong management and leadership of nurses and nursing
- Overall increase and retention of nurses and midwives
- Better educated and trained nurses and midwives
- Improved morale
A plan of action was agreed with everyone. Sandra and I, together with the nurses in the Leicester link scheme, will be working in partnership with the nurses of Gondar over the next 5 to 10 years. This is subject to funding from many different sources and the British embassy in Addis Ababa giving visitor’s visas to the very few individual nurses that we know would benefit from a short experience with nurses in the UK.
During our trip we also met up with other UK folk who were working at the hospital for 1 to 2 years and this proved invaluable in helping to understand how things happen or don’t! On returning to Addis Ababa we met with an awe inspiring president of the Ethiopian Nurses Association who shared her knowledge so freely with us that it has provided us with a deeper understanding of the whole healthcare and regulatory systems.
We have just received the first progress report from the Matron so the next challenge will be keeping the momentum going. I will be returning with Sandra in October 2006 to run some workshops for the senior nurses as well as planning for clinical nurses from the UK to partner with different departments early next year.