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Maxwell Kpeem

Maxwell Kpeem

OPD, Ward, General Nursing Practice
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Maxwell Kpeem has 4 years experience and specializes in OPD, Ward, General Nursing Practice.

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  1. Maxwell Kpeem

    What Would Florence Nightingale Say Today?

    Florence Nightingale, the lady with the lamp, the best in her days, this generation and perhaps in the generation yet unborn. There might have been nurses before her days but none could conceptualise nursing during her time and even for the future as Florence Nightingale did. She laid the ground work for how nursing should be visualised, considered and developed in the future. She equally created a pathway that, eventually, made nursing to be considered as a profession hence, making it one of the largest and fastest growing professions, in terms of creating new fields or venturing into newer territories in the health care sector today. As with every situation in this world, Florence Nightingale will be both happy and sad with developments in the nursing field because, although, the profession has evolved a lot with significant changes, there are still lots of cracks that needs to be sealed. Below are some of the areas of concern identified and what Florence Nightingale’s reaction will be about these issues. Nursing as a Profession Florence Nightingale will be glad that nursing is now recognised as a discipline to be studied and a profession to be respected. She would be pleased that systems and structures are being put in place to train would-be nurses and to initiate them into the profession upon successful completion of their training. This upgrade has made nurses have a sense of independence, that is, not to feel they are under anyone but to have a sense of belonging in a team of staff who work together for the betterment of the clients in their care. To add to that many specialties have been developed in the nursing sector over the years to, primarily, support some sections of the health sector and to give nurses a variety of options to choose from. Florence Nightingale will also be happy with this development because nurses now have a feeling that they don’t only belong to the ward but can do more to help push the goal and agenda of bringing quality care to all and sundry in almost every department. However, are nurses embracing these challenges? Are they constantly improving and updating on the new chapters that are being flipped every now and then? Though increased stress levels may make this task a bit difficult to accomplish, it is a challenge that we must take upon ourselves to ensure we reduce work place errors that may lead to unnecessary deaths and disabilities. For instance, in 2018, a study concerning medication administration errors at tertiary hospitals in Addis Ababa, Ethiopia in which 298 nurses participated; 203 (68.1%) nurses reported to have committed medication administration errors. Some of these errors were attributed to inadequate training and unavailability of guidelines for medication administration. Nurses can do more to improve their knowledge especially in this age of information technology where every form of training seems to be available on the internet if the right source is sought. The Numbers Florence Nightingale would say kudos to the sort of attention that nursing, as a profession, is getting nowadays. She would be happy about the number of compassionate hearts that have joined this noble profession with a noble cause. As a field that is ever growing and ever expanding to infiltrate more areas of the health care sector, there is the need for more and extra hands to care for the sick and comfort the dying and it seems the world is responding to this need by heeding the call to come and sacrifice their time, efforts and hearts to the cause of this profession. At the center of the Crimean war where Florence Nightingale rose to fame, there were just a few of them at that time caring for the wounded soldiers. Some books about her heroics even identified the fact that in the middle of the night she had to pick up her lamp and make rounds in the ward to care for those who needed help. I believe, in those days and even several years after the Crimean war, there were sick and wounded people who needed this kind of help but could not due to the number of nurses or carers that existed at that time. So, of course, she would be happy about the current population of about 20.7 million nurses which accounts for nearly 50% of the health workforce in the world today (according to WHO). However, she would also want more room for improvement with the numbers because there is a severe shortage of nursing staff across the globe at the moment which is likely to get worse is no action is taken. According to the National Center for biotechnology information, there are lots of factors that are fast dictating the falling numbers and shortages plaguing the nursing field. These factors include; projected ageing of the baby boom generation which means the need for more carers, ageing staff which also means majority of the workforce nearing retirement, nurses’ burnout and violence at the work place which are factors forcing lots of nurses out of the nursing field. These are all factors that are affecting the growing nursing shortages in the world today. When you flip the other side of the coin, thus, into the situation in the developing countries such as in Africa, there is currently a mass exodus of nurses, in search of greener pastures, into the Americas and other European countries largely due to poor working conditions and low remuneration of nurses. The COVID-19 pandemic equally added insult to injury by scooping a part of the nursing population. According to the international Community of Nurses, about 1500 nurses succumbed to COVID 19 in 44 countries. Obviously, Florence Nightingale will not be happy about this looming danger that is about to send her cherished creation (the nursing profession) into a state of oblivion or into a similar situation like the type which existed in her day and will want something to be done about it as soon as possible. Fortunately, authorities are doing their best to tackle this looming danger by instituting interventions such as the use of technology, staff empowerment through motivation and measures to tackle high stress levels, are being put in place to help solve these staffing deficit issues. Service Delivery When it comes to service delivery, nurses have and will always make a statement because, though nurses are most of the times seen as a nuisance by some client’s and their relations, they remain resilient in discharging their duties as they should. It is not easy dealing with some humans as some patients will just try their very hardest to make life for their nurses uncomfortable. This, in my own view, could be attributed to the fact that nurses spend more time with the client than any other member of the health care team and secondly, to the fact that the law seems to focus largely on what the client goes through in the hands of the nurse than what the nurse goes through in the hands of the client. Nurses suffer varying degrees of abuses ranging from physical, verbal and sometimes emotional and even if the statistics don’t show, we can testify to the fact that there were lots of times where nurses had tears behind those beautiful smiles they showed while caring for their clients. Those smiles are not forced as some may think. They are smiles that say, "though you hurt me, I will still give you my best". Some may claim this is what we signed up for when we took the oath of this profession but anyone who experiences a quarter of what nurses go through will surely not think twice about going against the very oath they swore, on the day they decided to accept the call of this profession, by bowing out. This is not what Florence Nightingale would have wished for her nurses. The show of gratitude alone pushes one to give his or her best in terms of service delivery. Nurses have blood running through their veins too but unlike ordinary men and women, nurses are moved by the suffering of their clients and are ready give their all to ensure the speedy recovery and safety of their clients and sometimes journey through with the client to his or her life’s end to ensure that he or she has a peaceful death and rest. This gesture will be boosted if they can be treated with respect by their clients and relations. If this COVID-19 pandemic didn’t prove to the world the big role nurses play in the health care sector, then I don’t know what else will. Nurses who have families had to heed to the call of duty and some, in so doing, never returned, not even to bid their loved one’s goodbye. While other workers were safe and out of danger during lockdown, nurses laid down their lives to fight this pandemic and some did actually lay down their lives to rise no more. So as more is being done to help nurses contain themselves, that is, not to issue the same treatment their clients mete out to them, more can be done to give attention to the stress that nurses go through in the midst of these inhumane treatments that tends to threaten the very existence of this profession. Conclusion Nursing is an ever growing profession which will see changes year in and year out. Of course as I said earlier, Florence nightingale will be impressed with the sort of recognition given to nursing by making it a profession and the numbers that are currently in the profession but she would want more to be done in terms of the attention nurses receive while in the line of duty. She would also want nurses not to give up on their call. As the saying goes, "every cloud has a silver lining"; the silver lining of nurses’ efforts in the midst of all the difficulties they face is to see their clients get well. Despite the difficulties nurses go through, either in the hands of clients or the management, nothing can be more satisfying than the joy of seeing that you have accomplished your task, as a nurse, of seeing your clients get well and having another go at life. As we celebrate the year of the nurse and midwife yearly, let’s be reminded of the vision of Florence Nightingale for the nursing fraternity. As she rightly puts it: She constantly put her feelings and her visions into actions and through her works the world can boast of a close companion; one that can connect more than family in sickness and, though, the time of interaction may be for a limited time, will facilitate the healing process and leave a lasting impression which may be unbeatable for years to come. This companion is none other than the Nurse that cares so much for the sick and the dying. Happy year of the Nurse and Midwife celebration to all colleague nurses and midwifes around the globe. References/Resources 1. Wondmieneh et al, 2018, Medication administration errors and contributing factors among nurses: a cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia, BMC Nursing, accessed 4th June, 202, https://bmcnurs.biomedcentral.com 2. ICN, 2020, ICN confirms 1,500 nurses have died from COVID-19 in 44 countries and estimates that healthcare worker COVID-19 fatalities worldwide could be more than 20,000, International Council of Nurses, accessed 4th June, 2021, https://icn.ch 3. WHO, Nursing and Midwifery- WHO Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020, accessed 4th June, 2021, https://who.int. 4. Haddad et al, 2020, Nursing Shortage, accessed 4th June, 2021, https://ncbi.nlm.nih.gov.
  2. Working in the health sector can be so demanding and as such very stressful in this 21st century. No matter the category (Doctor, nurse, lab technician, etc.) in which you find yourself, you will most likely sail through some moments to forget. It is even more stressful for nurses because we form the majority of the health care profession and spend more time with the clients. Stress Nurses are often faced with two main stressors which include emotional or psychological stress and physical stress. Emotional / Psychological Stress The emotional or psychological stress, mostly, comes in the form of suffering or empathising with the client. There are times that nurses have to soak themselves in the very pool of pain and distress their clients are going through in other to understand the sort of care they need. This can be sometimes refreshing when you are dealing with simple clients or emotionally draining when dealing with a complicated client. Another thing that can make this encounter stressful is when you have to consider each patient individually and deal with them as such. It’s just like having different personalities at a time. Physical Stress The second type of stress nurses suffer is the physical stress which often occurs when nurses are overwhelmed by the sheer number of clients they care for in a day due to either a shortage in the number of staff or an increase in the number of clients which may be as a result of a pandemic, the like of which we are facing in the world today. There are other times, too, when too much improvisation makes the work tedious to deal with. Working with the right tools and equipment, on the other hand makes the work much less stressful physically. Medical-Legal Issues Present day enlightenment has made medico-legal issues, which are now on the rise, add its weight to these stresses. A nurse will have to judge well before taking a particular action since he or she may not want to be found in the middle of any legal issues. With modern day nursing, nurses perform their duties with caution while paying attention to the slightest of details even in an event of being tired and extremely stressed because the legal structures that exists seems to protect the client’s rights more than that of the nurse and the judge will not hesitate to whack the gavel that will collapse the nurse’s entire career and to add insult to injury, pile a jail term on his or her life. Nursing Profession is Demanding With all the above submissions, which are just the little of the lot that nurses face, it will be fitting to say that this profession is one of the most holistically demanding in the world today and here are a few statistics to prove why: According to a study in 2017 by Kronos Incorporated involving 257 RNs working in US hospitals, 98% of nurses said their work is physically and mentally demanding, 85% reported that their nursing job makes them fatigued overall and 44% worry that their patient care will suffer because they were so tired. Another research carried out by Baye et al in government hospitals in Harar, Eastern Ethiopia showed that, out of 398 nurses who participated in the study, two-thirds of those nurses had work related stress. Reduce Stress Establish Good Working Relationships In the midst of all these storms, which are most of the times out of our control, there is actually one area that nurses can do well to excel in and that’s the area of establishing a good working relationship amongst themselves. Good working relationships amongst nurses can actually reduce stress levels to some extent and we will see why by the end of this article. We are all humans coming from different walks of life. We are different in terms of how we behave towards people, how we approach people who have wronged or offended us and how we accept other people’s approach towards us when we wrong them; this can actually affect our relationship with other nurses or staff at work. First of all, we need to put workplace relationship into comprehension. Workplace relationship is a valuable, positive and interpersonal relationship that enables colleagues to work in harmony for a better end results with regards to productivity. A good workplace relationship prides itself in the following values; trust and respect. Trust and Respect As Phil Jackson rightly puts it, "Good teams become great ones when the members trust each other enough to surrender the me for the we," and so for there to be a good working relationship, trust must be developed amongst the working staff. Then comes respect which is another key motivational factor to building a healthy working relationship amongst staff. There is the factor of good and open communication that also serves a catalyst for growing a good working relationship at the workplace. Increased Productivity Good working relationships can lead to a happy working environment and a happy working environment means happy workers which in turn leads to increased productivity, all of which occurs through the following means: 1 - Improvement in team work - When there is a good working relationship, teamwork becomes the norm. Workers are able to brainstorm on critical issues, help each other when stuck, move together in one direction and have a common understanding on issues. The nature of a nurse’s work does not give room for individual thinking and solving of issues. Any nurse who tries to do it all alone may end up losing it if care is not taken. However, when there is that tendency to allow other nurses or members of the health care team extend a helping hand, then stress levels are reduced because you go from carrying everything on your shoulder to sharing the responsibility on other team members’ shoulders. 2 - Better customer engagement - Good working relationship results in a better customer engagement, in that, when workers are in good talking terms and are more of friends than enemies, there is an accepted way of approaching and engaging clients instead of everyone using his or her own way to engage the client. For instance, when nurse Apollonia and nurse Olivia are not in good talking terms, nurse Apollonia tries to win the client's trust by saying bad things about nurse Olivia to the client but unfortunately nurse Apollonia has got that completely wrong because that’s not how to win a client’s trust. You don’t win a client’s trust by spreading negative things about your colleague to the client. You win his or her trust by giving the best of care; the sort of care that will result in a quick recovery. Even recommending that your colleague can do a great job as well in your absence can go a long way to win the client’s trust since that gesture will show the client that the staff is united and winning the very heart of the client. And, who wouldn’t want to join a winning team of nurses full of smiles and togetherness? Even the patient being cared for would love to, at least for the moment, be a part of that success story. Now let’s see how this can also reduce stress levels. With the above scenario, it means nurse Apollonia will always be called upon by the clients if they need anything done because she appears to be the better nurse in their eyes. This would be physically stressful to her and emotionally draining to nurse Olivia because nothing she does for the clients will be appreciated since she is seen as the bad nurse. However, when all the nurses are considered good and their work is always being appreciated in the clients’ eyes, the work is shared, meaning no physical stress for anyone, no emotions are called into play and hence no emotional stress on any nurse as well. Improved Employee Retention Rates Last but not least, a good working relationship also leads to freedom that comes with responsibility, and hence improves employee retention rates. Nurses get the freedom to explore but with the utmost caution when there is that good working relationship amongst staff. There is that freedom to want to learn new things and experiment with procedures that the nurse wouldn’t have gotten the chance to exercise in an otherwise tense working environment; a tense working environment that is as a result of a poor working relationship amongst staff. This makes it easy for workers to want to stay at that post for as long as possible. After all, it is every nurse’s dream to be in a place where he or she feels loved, welcomed and is free to explore his or her potentials. In Conclusion There are a lot of issues that the health sector is battling with. Some are wholly administrative problems or none of the workers’ business where as the others are issues that workers can deal with. This article shows that a good working relationship, which is majorly the responsibility of the individual workers to develop, can reduce psychological stress levels and to some extent physical stress ... even in the most tense of working environments. References Well-being index team 2021, Is burnout on the rise? Startling statistics on Nurse Well-being, accessed 20th May, 2021. Baye et al 2020, Nurses’ work related stress and associated factors in government hospitals in Harar, Eastern Ethiopia: A cross section study, accessed 20th May 2021.