PROBLEMS FACING KENYA NURSING

Kenya’s nursing system is unique. Over the past decade, it has been reported that there are over 7,000 unemployed nurses. 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. Working conditions are poor, and there is a lack of resources and low education. 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 skills analysis and distribution.

In my interview I chose to interview Ms. Merry Mwangi who currently works as a Director of Nursing in Kenya, and has an interesting background in management. Merry 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, 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 role 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 strength and weakness 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”. 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 and important qualities or characteristics of leaders include flexibility, good communication, and organization, presence/availability to their staff, critical thinking, and definitely common sense.

To become a successful in a leadership role the leader must have enthusiasm, energy, and commitment, be able to inspire, and listen to others. I have always been a “leader” more than a follower. I enjoy decision making and advocacy as well as owning processes.

She said that to become a registered Kenyan nurse, 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 is officially being registered as a Kenya nurse. She 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”.

She stated that the hardest part about being a nurse in Kenya is treating people with limited access to health care is the hardest part in Kenya. I see 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.

Kenyan nurses are facing, 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”.

She also talked about the working environment of a Kenyan nurse she said 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”.

I asked her what types of nursing specialties they have in Kenya. “In Kenya we actually have Emergency room, Pediatrics, Forensics, and Mental Health. This 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”.

Most of Kenyan nurses work in poor conditions, 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 of which 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 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.