By Valerie King

Today is my first day at Margret Marquat Hospital. For those that know me this is not my area of
expertise. I am a community based nurse.
I am much more comfortable going from hut to hut than to try to serve a purpose
in an acute care hospital. I had hinted
at my desire to stay at the outpatient health center but Maura thought my
assessment of the nursing care at the hospital would be helpful.

We have been asked by the new medical
director, Dr. Lucy, to do an evaluation of our experience at the hospital. She wants to make some changes so our input
is solicited. We are treated very kindly
by the nurses but there are significant deficiencies in the nursing care that
goes against everything that we have been taught as an American Nurse. The contents of our report are too lengthy to
go into in this Blog but suffice to say patient safety, infection control and
issues related to competent and compassionate nursing care were some of our
biggest observations.

Later on this
evening I created with Maura and the students, a 4 page document that we will
use to present our findings to Dr. Lucy.
I am reminded of the comments of my teacher and friend Dr. Geoff
McEnany-Phillips when he taught me about evaluation. It is important to be truthful but we have to
be mindful of the stakeholders in this situation and try to present our
findings in a thoughtful and professional manner. We create the document over a
bottle of wine and with very insightful comments from the students. I am not sure how Dr. Lucy will use the
information but we felt it was our duty to be advocates for the patient but
also to help promote professional development of the nurses in Ghana.

To help
with our goal of professional development I gave a 2 hour lecture today at the
Kpando Health Center on a few topics. I
presented a lecture on the assessment of the geriatric patient and also
diabetes mellitus. The audience of
mostly nurses but some other staff seemed to be very much engaged with the
lecture. I had to slow my rate of
talking and to try to use appropriate and understandable terminology. I tried to lose my New England accent.

The time flew by and I was encouraged by the
thoughtful questions that were asked by the participants. I have truly come to respect these Ghanaian
nurses. They work with such limited
resources but have such potential for improved care if only they are given the
education. Throughout my lecture I keep
repeating that they have incredible power as nurses to make a difference in
their patient’s lives. I think the
nurses could play a larger role in the care of the patients but am limited in
their knowledge and sense of responsibility when it comes to patient outcomes. I pretty much told them that they are much
more important than the doctors (my apologies to my physician colleagues). I think there is a vast difference in the way
that Ghanaian nurses and American nurses are educated based on my
observations.

I would like to see these
nurses claim their autonomy and professionalism. Change comes slowly. I think having the UML nurses work with them
opens the door to comparisons, questions and emulation of behaviors. We have witnessed an obvious change in the
demeanor of the patients when the UML nurses address them with respect, touch
them and provide the level of compassionate care that is the trademark of the
American nurse. I have such personal pride in the accomplishments of the
student nurses from UML. We have had
many thoughtful conversations at night about the comparisons of the two
countries and their ideas for improvement.
I am proud to be a graduate of UML and I am equally proud to be a nurse
educator who will have a role in creating the future American nurses. I will end now on that positive note. There are still many more stories to tell but
again I am burning the midnight oil and tomorrow is another busy day.