During my sophomore year in high school, I had no plans on going to college or university. All of that changed during my junior year when I took biology class and chemistry and biology. I became self-confident and I started believing in myself. I saw a lot of improvement in my grades and I became interested in these sciences. In the fall of 2011 I became the first person from my family to go to college and now am majoring in nursing.
I originally got interested in the health care field at a very early age because my mother was an assistant nurse in Kenya and I spent considerable time in my childhood observing her at work. I was attracted to the idea of helping people with physical problems, although I had no thought about any specific specialty. However, in time physical therapy became the logical focus of my attention for a number of reasons. For one, I have memories from a very young age of my grandfather in Kenya, disabled by a stroke, his problems unmitigated by any attempts at physical therapy. I will never forget the devastating consequences of this; I have heard of hundreds of deaths that occur daily due to lack of medical resources in Kenyan hospitals.
There are many questions in my mind about poor nursing in Kenya. I want to know why Kenyan nurses are leaving the country. First I begin with education. Why do we have to hire nurses in Kenya who are not qualified to work in health facilities? Second is the health environment. In Kenyan hospitals we have a poor working environment for nurses and even patients and nothing has been done about it. Who is responsible for this and why don’t we improve the working environment for both nurses and patients? How does one qualify to become a Kenyan nurse? I also want to know the major problems facing the Kenyan nurses themselves.
A few weeks ago I chose to interview Ms. Mwangi, who currently works as a Director of Nursing in Kenya, and she has an interesting background in management. Ms. Mwangi is someone I consider a strong leader and mentor. She is very positive and genuinely enjoys her job. She has 13 years of nursing experience in medical surgical nursing, research nursing, as well as public health and community health nursing. For the past four years Ms. Mwangi has served as Clinical Director, Director of Nursing in Kisii, Kenya. In these leadership roles, Ms. Mwangi has been supervising office support, nursing student clinical, and representing these organizations on several boards and committees. Ms. Mwangi currently works as a Clinical Manager of Nursing in Nairobi, Kenya. As a Kenyan nurse, Ms. Mwangi has been through a lot of problems in the Kenyan nursing system and now she knows the solutions and steps to be taken to solve those problems. Ms. Mwangi says that “Key factors responsible for shortage of nurses at service delivery points include fast-expanding health care delivery network that also experiences inadequate recruitment and misdistribution of staff. Contributing to the shortage are an aging nursing workforce, lack of proper workforce planning that includes skills analysis and distribution, and lack of up-to-date, accurate and comprehensive data sets to assist in remedying the workforce planning situation” (Mwangi, 2012). The Kenya government should build more health facilities because the number of patients is increasing. They should provide education to nurses to improve their skill in planning situations.
By providing more money, equipment, and training, the future of nursing in Kenya will change. I want the future Kenyan nurses to be able to follow principles of ethics. They have to practice to be faithful to the patient in order to have a good relationship with the patient. They should learn to be fair at the same time they should prevent harm to patients. If they follow the right procedures, then we will have great care in Kenya.
I came to America to gain more education than the one provided in Kenya to be a good skilled nurse so that I can go back and provide proper nursing care. My duty as a nurse is to assist individuals in performing activities that contribute to health, recovery, or peaceful death, activities which the patients would perform if they had the strength, will, or knowledge required. I want to prevent cases like my grandfather’s death, because he didn’t have good nursing care. I will also strive to achieve the best possible quality of life for the patients, regardless of disease or disability. I will use proper clinical judgment to protect, promote, and optimize health, prevent illness and injury, alleviate suffering, and advocate in health care for individuals, families, communities, and populations.
There are many things we can do to have better nursing care in Kenya. We need to focus mostly on education. Kenyan nursing education is really not of high quality. We want to see that every registered nurse in Kenya knows all the procedures of a nurse. They should not be hired as nurses if they don’t have qualifications.
Previously Kenyan nurses have been having strike crises of low payments and instead the government holding talks with the nurse union, they end up threatening them with a sacking the entire work force. It really doesn’t make sense in any way and it is not possible to dismiss such a large part of the workforce. This is not the best way to handle such crises and the best way is by holding meetings and to implement a salary increase. The article “Sacked Nurses Receive Termination Letters” says that “250000 nurses have been fired because they went on a strike. The reason for this strike is because the government has failed to implement a salary increase agreed upon some time back 2011” (Wanambisi, 2011, pg. 3). Nurses have been fired because they are demanding what belongs to them and the government takes a step of firing them. For how long are they going to keep on striking and how many times will they be firing nurses who go on strike in demand of their money? The government needs to solve these problems.
Nurses should improve skills and knowledge throughout their nursing career. Nursing skills must be maintained and improved through training, continuing education, professional conferences, work experience and mentors. These will contribute to high quality health care for patients and is necessary to improve upon nursing skills in order to keep up with new technologies and procedures. They can learn these skills by going to school. In the article “Nurses and Doctors Go Back to School”, it says that “most of Kenyan doctors and nurses have left the country to go for further studies in western countries. Most of them have gone back to school because they are aiming the highest payment” (Situma, 2012 pg. 2). Nurses have taken a step ahead of going back to school to improve their skills to save people’s lives and at the same time to be paid good wages. Most of the nurses have left the country to other countries for education and job opportunities.
The government should let nurses continue with education coursework in which interactive simulations and scenarios for skills development provides an excellent opportunity for improvement in nursing practices. This continuing education coursework will provide training in nursing practices and procedures so Kenyan nurses should keep nursing skills up to date. The government should also pay for continuing education coursework which will be an added way nurses skills up to date. The article, “Nurses and Doctors Go Back to School, also says that “nurses have gone back to school to improve their working skills because the education they have is old. So they are going back mostly for needle handling” (Situma, 2012 pg. 1). Going back to school for Kenyan nurses is really a good thing that they are doing. The old education they have doesn’t help a lot at this time. They need to improve their skills to care for patients in a good way.
I really think another great way to improve nursing skills in Kenya is to find a mentor in a nursing organization that can guide all the nurses and help them to improve their knowledge and skills. All hospitals should offer mentorship programs. Senior level nurses in the health workplace should be able to mentor other nurses and provide some individual training. In the article “Developing a Nursing Database System in Kenya”, it says that “All Kenyan hospitals are soon going to offer mentorship programs and we expect that all nurses will attend this program, they will gain more knowledge and they will pass to other new recruits in the facilities” (Rakuom, 2011, pg. 5). When nurses attend such mentorship meetings and classes they share ideas and advance the old ones. This is a nice thing that they need to do. They can solve many problems that could not be solved in years and I prefer all the nurses to attend these programs to gain more knowledge so that they can pass the same knowledge to new recruits.
The health sector in Kenya should make it mandatory for Kenyan nurses to attend professional conferences in nursing field. This is an important way for them to improve their skills. By doing attending these conferences, it will provide an opportunity for social networking with other professionals, educating each other with new care techniques and providing an opportunity for cross-disciplinary learning. These conferences will also provide workshops and individualized training sessions that can help with keeping up to date on new technologies and the improvement of nursing skills. In “Developing a Nursing Database System in Kenya” says that “All the Kenyan nurses need to attend international conferences that are taking place in our country because they will learn more from attending and what they will learn, they will also go and offer the same mentor to the new recruits” (Rakuom, 2011). I think it’s a good thing that will do by attending conferences. They will gain more than not attending them. They will interact with other nurses from other countries and share their stories and come up with solutions to solve the nursing sector problems.
Another problem is nurses leaving the country. The numbers of Kenyan qualified nurses who graduate annually are many and because they are not hired, they decide to travel to western countries where they will be hired. The Kenyan government should be capable of attracting and retaining their nurses. If no, then they will not be able to solve the nursing shortage they have. The number of nurses that are on the move every year continues to increase. It really doesn’t sound that good when Kenya keeps losing the best nurses. They should try to retain their nurses by doing well for them by helping them financially and giving them grants to go back to school because many nurses who move from the country end up going back to school for more education. In the article “African nurses head to U.S. for better pay”, it says that “nurses have left the country to seek better payment in western countries because there is too much work in Kenya, too little payment” (associated press. 2011).” Too much work and less payment is not enough for nurses’ life. If they are paid good money it’s not easy for them to leave the country. Well educated nurse are paid less and now they have decided to leave the country. This is the biggest challenges the government need to solve before it’s too late.
Kenyan nurses play a big role not only by giving medical care to patients, but also by giving comfort and support to the patient and his or her family. When the patient cannot recover, the nurse helps to make sure that the death is peaceful. When a person becomes ill or is injured, he goes through the nurse to see the doctor and then the doctor only deals with the main problem after the nurse has admitted the patient and managed their care. Kenyan nurses carry out many of the treatments prescribed to the patient. For example, the nurse helps the doctor during surgery in the operation room. The nurse might inject the patient with the drugs prescribed to the patient. The nurse changes the patient’s dressing and monitors the healing of the wound. The nurse also should administer medication for the pain. In the case study, the article gives the basic understanding of the roles of Kenyan nurse and how they work with patients. “Kenyan nursing case study,” says that “Kenyan nurses deliver care within the boundaries of their role, focusing upon supporting patients to be healthy, monitoring of long-term conditions, health prevention and screening activities” (Rakuom, 2010, pg. 1). Nurses should do their best to see that every patient has received a proper care. They should not go beyond their boundaries of knowledge to care because they may course injury on the patient or death. So nurse should do what they only know.
To make Kenyan nurses better, they must care for patients well in order for patients to have trust them. Patients must feel safe and confident about their nurse. In the beginning the patient and nurse relationship can be difficult to establish due to lack of confidence because they are new to each other. The nurse has to establish trust with the patient by building a rapport. The nurse has to listen to what the patient has to say and learn to respect the patient’s wishes. This approach is extremely important as a new nurse.
Every Kenyan nurse should be able to face ethical problems, but they should also be ready to handle the issues. Kenyan nursing case study, says “Kenyan nurse, truth telling versus deception is really on important issue that they have to deal with, especially when families want to deny telling the patient the truth about the medical condition because the patient has the right to know his or her diagnosis” (Rakuom, 2010, pg.3). Nurses must be faithful to patients and must respect their culture. A patient has rights to know his or her diagnosis any time that he or she has gone through any medical checkup.
According to Ms. Mwangi, when I interviewed her she said that “the government also needs to provide a good working environment in hospitals. Kenyan nurses should care for patients as they could care for themselves. Kenyan nurses should take of patients, making sure they can breathe property, help them sleep, and making sure that they are comfortable. They should take care of their elimination of waste and each nurse should know each patient diseases and how to treat them. Nurses should get enough resources to protect patients and themselves from diseases and germs. Hospital facilities in Kenya are very sanitary, but nurses still come in contact with germs and bacteria and so do other staff working in the nursing facility” (M. Mwangi, personal communication, January 10, 2012). Ms. Mwang says “Rules should be passed out to all nurses so that anyone feeling sick should not come in to work if they feel any symptoms, no matter how minor. Working with residents all day, germs and bacteria can easily be spread from person to person, and when working with the elderly it can be dangerous to their health. Visitors who are sick should be discouraged from entering the hospital facility for the health protection of the residents; this is an absolutely necessary precaution. During flu season especially, residents are vulnerable to catching illnesses and are not as capable of fighting them off because of their weakened immune systems. Visitors should come in when they are healthy. Staff and visitors should also be cautious while in the nursing facility” (M. Mwangi, personal communication, January 10, 2012).
Kenyan nurses should know that keeping patients healthy should be of the highest priority. Certain measures will have to be taken for the actual facility, such as ensuring proper ventilation, and monitoring that only healthy visitors and staff are entering into the nursing facility to make sure illnesses are not brought into the building.
In order to achieve these Kenyan nursing goals, both the government and the health sectors including nursing organizations should come together to solve the problems. The government should take the biggest responsibility to cater for the nurses’ problem. They should stop the striking crises that are increasing the death rates in Kenyan hospital. Human rights activist should also intervene to protect both nurses and patients. By solving all the problems, then I think nurses will play their major roles with quality. We can even prevent some deaths and spread of diseases. Even the World Health Organization (WHO) will be ready to provide more help to the country.
This project hasn’t been that easy for me. It has been a mountain to climb. I began with choosing the right topic for my research which actually took me two to three days. At the end of the third day I came up with one title which I felt is really good. The title was “Roles of a Kenyan Nurse.” The reason why I wanted to explore this topic is because I wanted to know more about my country and the field I want to go into. Previously I had heard that Kenyan nurses are not treated with dignity. They have low wages, poor working condition, and high employment of unqualified nurses.
I have been working hard for this project in order to pass the class. I have been working with my tutors for help where I don’t understand. I really a had hard time understanding the project and following the instructions but since there are student tutors, my project is becoming easier for me. I also spent plenty of time working in these projects although I had some other classes and homework to do. Since the beginning of day one of project one to project four I have been trying my best to do an excellent job. The reason why I have been spending more time on this project is because at the end there is a good result. The wise men didn’t go astray when they said “no hard work goes unpaid.”
From my further research I would like to know more about the Kenyan nursing education. What kind of post basic training do they offer? What are the main minimum entry requirements, post diploma programs, minimum entry requirements, and degree programs? I would like to know the Kenyan feature plans for the faculty and job opportunities.
I would like to be granted the internship to keep doing the research for countries like Kenya to check the problems that they are going through so that we can make a change. Want an internship from organization like the African Medical and Research Foundation (AMREF).
Reference
. African nurses head to U.S. for better pay. (2012) Associated press.
http://www.hrhresourcecenter.org/node/1534
Rakuom, V. (2011). Developing a Nursing Database System in Kenya
http://www.ichrn.com/publications/casestudies/ICHRN_Kenya_CaseStudy.pdf
http://allafrica.com/stories/201203100433.html
Wanambisi, L. (2012). Kenya: Sacked Nurses Receive Termination Letters. YallAfrica
http://health.newsplurk.com/2012/03/kenya-says-sacks-25000-striking-health.html
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