interview with Ms. Merry Mwangi
Kenya’s nursing system is unique. Over the past decade, it has been reported that there are over 7,000 unemployed nurses. (Rakuom. C, 2010) Over 1,300 new nurses graduate annually from colleges. At the same time, many functional health facilities are understaffed, with over 500 nurses retiring, which means there is a shortage of manpower and nurses are overloaded with work. Rakuom (2010) noted in his article Kenyan nursing case study, Kenyan nurses working conditions are poor, and there is a lack of resources and poor education. (Rakuom, 2010). “Most of Kenya’s dispensaries throughout the country do not have qualified nurses. In addition, key factors responsible for the shortage of nurses at service delivery points include a fast-expanding health care delivery network that also experiences inadequate recruitment and misdistribution of staff. Contributing to the shortage are an aging nursing workforce, and a lack of proper workforce planning that includes nursing skills analysis and distribution of medication (Rakuom, 2010, pg 1).”
Kenya’s nursing system is unique. Over the past decade, it has been reported that there are over 7,000 unemployed nurses. (Rakuom. C, 2010) Over 1,300 new nurses graduate annually from colleges. At the same time, many functional health facilities are understaffed, with over 500 nurses retiring, which means there is a shortage of manpower and nurses are overloaded with work. Rakuom (2010) noted in his article Kenyan nursing case study, Kenyan nurses working conditions are poor, and there is a lack of resources and poor education. (Rakuom, 2010). “Most of Kenya’s dispensaries throughout the country do not have qualified nurses. In addition, key factors responsible for the shortage of nurses at service delivery points include a fast-expanding health care delivery network that also experiences inadequate recruitment and misdistribution of staff. Contributing to the shortage are an aging nursing workforce, and a lack of proper workforce planning that includes nursing skills analysis and distribution of medication (Rakuom, 2010, pg 1).”
The
reason for doing an interview is that I wanted to know the roles of a Kenyan
nurse and problems that they are facing and their working conditions. I
also wanted to learn more about their goals and values and their future plans.
My
interview took place on January 10, 2012, at 11 o’clock in the morning in
Burnsville, Minneapolis, Minnesota. I was up early, dressed smartly, and waited
in the living room taking a drink while waiting for Ms. Merry. I took a last
look at my notes to see if there was any question which was unsuitable for the
interview. When she arrived, I introduced myself to Ms. Mwangi. I shook her
hands firmly and I asked my questions with confident.
I
chose to interview Ms. Merry Mwangi, who currently works as a Director of
Nursing in Kenya, and 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. Merry 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
Merry has served as Clinical Director, Director of Nursing in Kisii, Kenya. In
these leadership roles Merry has been supervising office support, student clinical,
and representing these organizations on several boards and committees. Merry
currently works as a Clinical Manager of Nursing in Nairobi, Kenya.
During
our meeting, the first question I asked was, “what kind of leader do you
perceive yourself to be?” The response to my question regarding background and the
roles she has today was that she has "grown up" as
a nurse manager and as an assistant nurse manager. She stated that, “An
effective leader knows his or her strengths and weaknesses and therefore it
makes it easier for them to delegate appropriately. A nurse leader or any
leader devotes his or her time to develop individual skills for staff and to
deal with any issues within the unit. By doing this an effective leader is able
to form teams who are responsible for various duties… If a leader is able to
motivate staff members personally, staff members' duties will be carried out
more effectively” (Merry, 2011). A good
leader should be an advocate for their staff who advocate for patients. A
leader should be someone who has the big picture and makes decisions based on
the needs of the hospital. Important qualities or characteristics of leaders
include flexibility, good communication and organization, presence/availability
to their staff, critical thinking, and definitely common sense.
Merry
said that to become a registered nurse in Kenya, one can
attend a technical school, a two-year college to earn an Associate’s degree, or
attend a four-year college to earn a Bachelor’s degree in nursing. The last
step to becoming a registered nurse is to take and pass the Kenya National
Council Licensing Exam. Once this exam is passed, the student can officially be
registered as a nurse in Kenya. Merry also told me how one can make a good Kenyan
nurse by saying, “Nursing is a good career choice for
people who want to make a difference in the lives of other people and who want
a stable career that pays well. People, who enjoy science, want a flexible
schedule and the opportunity for advancement will find that nursing meets all
of these criteria” (Merry, 2012).
She
stated that the hardest part about being a nurse in Kenya is treating people
with limited access to health care. She also quoted that, she has seen people
who have mistreated their health for a long time, not because they didn’t care
or didn’t know there was something wrong, but because they couldn’t afford the
care they needed because of poverty. I
find that very sad. I try to be very cognizant of the costs of the
prescriptions I write” (Merry, 2011).
Kenyan
nurses are facing challenges. She said that, “In Kenya there is manpower
shortage in all health facilities. There is one nurse in almost half the dispensaries,
and nearly half the health centers are staffed by less than three nurses and
they serve almost 3000 people a day and yet the payments are low” (Merry,
2011).
She
also talked about the working environment of a Kenyan nurses. She stated that “The
working environment of a Kenyan nurse varies, depending on the type of nurse
and the place of employment. However, it is very typical of a nurse to work long
hours at odd times. It isn't uncommon for a nurse to work a 12hour shift, have
a day off, and then back on for another long day/night. The environment can be
hectic and high-pressure, as nurses are depended on to make quick decisions,
and care for the sick and injured. Sometimes when caring for someone with an
infectious disease, the nurse's work environment can be dangerous” (Merry,
2011).
I
asked her what types of nursing specialties they have in Kenya. She “In Kenya we
actually have Emergency Room, Pediatrics, Forensics, and Mental Health. These
are just a few of the many specialties open to nurses. Nursing specialties
exist for nearly every major illness, population group and life situation
requiring medical care” (Merry, 2011).
Most
Kenyan nurses work in poor conditions and uncomfortable healthcare facilities.
Home health and public health nurses travel to patients’ homes, schools,
community centers, and other sites. Nurses may spend considerable time walking
and standing. Patients in hospitals and nursing care facilities require 24-hour
care; consequently, nurses in these institutions may work nights, weekends, and
holidays.
“Kenyan
Nursing has its hazards, especially in hospitals, nursing care facilities, and
clinics. In all three, nurses may care for individuals with infectious
diseases. Nurses must observe rigid standardized guidelines to guard against
disease and other dangers, such as those posed by radiation, accidental
punctures from needle sticks, and chemicals used to sterilize instruments. In
addition, they are vulnerable to back injury when moving patients, shocks from
electrical equipment, and hazards posed by compressed gases,” says Merry (Merry,
2011).
Mwangi’s
comments and experiences actually match up with my research that I did three
weeks ago. Merry say that Kenyan nurses are overworked and they are not paid as
health professionals. Working facilities
are not good compared to western countries. The salary is less (Wanambisi, 2012.
pg. 1). In one, article it explains that 25000 striking 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
in 2011” (Wanambisi, 2012). The Kenyan nurses also are striking for better
working facilities and they want improved facilities in the Kenyan hospitals.
The sacked nurses have been told to reapply for their jobs in order to be
considered to retain their previous jobs.
This
interview means a lot to my project. It has actually given me the clear picture
of the roles of a Kenyan nurse and what kinds of problems they are going
through. It also raised several questions in my mind. Some of them I couldn’t
find the answer to. Those questions include: why does the Kenyan government
make the nurses and patients in the hospital suffer? Don’t they have compassion
for people? How long will these problems keep on going? And is there any other
way that they can train enough nurses? How long are they going to depend on world
organizations such as the World Health Organization (WHO) for help with health
care?
These
questions will be useful in possible future research. They will guide me to
where I will do my research and how I should conduct it. Now I know where there
is a problem in Kenyan nurses and what trends they should follow to make the
health care good and a decrease the problems.