Careers
Paediatric critical care in Ethiopia Patricia Doyle is a children’s nurse from Newcastle upon Tyne. She took a career break from the Great North Hospital to volunteer in Ethiopia for a year. The challenges have been great but then so have been the rewards, as she explains WHEN I first arrived at the Nigist Eleni Mohammed Memorial General Hospital, I used to do a quick sweep around the ward to ensure all the children were stable and none was near to death. There is a lack of critical care units, and the paediatric ward was badly resourced, with only nine staff for 50 beds, little monitoring equipment and no access to emergency care. We had one thermometer, one saturation monitor and three oxygen concentrators for the entire ward. The hospital, where I worked last year with Voluntary Service Overseas (VSO), serves about 1.5 million people and is in the Hadiya region of southern Ethiopia. There are high rates of communicable diseases, such as tuberculosis, malaria and pneumonia, and the hospital also deals with many problems similar to those found in the UK, such as respiratory distress and meningitis. By the time people present themselves, they are often critically ill due to lengthy travelling times and an inability to pay hospital fees. There is also a shortage of essential drugs and medical supplies. In 2012, two VSO volunteers working at the hospital set up a neonatal intensive care unit (NICU). This has proved to be hugely successful, even though it is more like a high dependency unit (HDU) area because there is no ventilation or invasive monitoring capability. The unit has reduced the neonatal death rates by nearly 50%. With the support of VSO, the NICU project is being disseminated across other hospitals in the country. 38 February 2015 | Volume 27 | Number 1
It was the success of the NICU that led the hospital to ask for a children’s nurse to support the paediatric ward, with children ranging in age from one month up to 18 years. When I arrived, it was obvious early on that we needed to provide better care to the most critical of children, so a proposal was written and funding secured to open the first paediatric HDU in an Ethiopian government hospital. New resources A functioning HDU properly stocked with medications and oxygen is now in place following months of setting standards, developing policies, protocols and training packages. There is also access to a reliable power supply. We have one patient monitor, which gives us electrocardiogram trace, arterial oxygen saturation, and non-invasive blood pressure, heart rate and respiratory rate. Crucially, there is a suction machine and oxygen concentrators for each bed space and an emergency cupboard that holds airway devices, intravenous
access equipment and blood glucose monitoring machines. A nurse works in the HDU 24 hours a day and an emergency paediatrician is on-call overnight. The nursing staff took part in a four-day introduction course on HDU care and have reached competency skills in the care of the critically ill child. The hospital agreed to pay them on a slightly higher pay scale, in recognition of their extra skills. VSO and Ethiopia’s Ministry of Health are interested in looking at this model of care with a view to disseminating it to other hospitals. We need more children’s nurses to volunteer and support the work going on in Ethiopia and other countries. An HDU audit has shown promising early figures for reduced death rates, suggesting that a higher level of care than was expected has been achieved. It has been the most challenging thing I have ever done, but it has also been my most rewarding professional achievement. Patricia Doyle is a children’s nurse who is now back working in the UK after volunteering in Ethiopia with Voluntary Service Overseas
Find out more VOLUNTARY SERVICE Overseas (VSO) is recruiting children’s nurses to work in maternal health care in Ethiopia and other countries across Africa and Asia. Volunteers generally need two to six years of relevant experience, a professional qualification and some experience of supervising, mentoring or project
management. VSO supports volunteers by providing them with training, the costs of flights, accommodation and a basic living allowance. It is not recruiting for Sierra Leone, where it works with local volunteers, but is running an Ebola appeal fund. To find out more visit www.vso.org.uk/ volunteer NURSING CHILDREN AND YOUNG PEOPLE
Nursing Children and Young People 2015.27:38-38. Downloaded from journals.rcni.com by FLINDERS UNIVERSITY on 12/05/15. For personal use only.
Paediatric critical care in Ethiopia Patricia Doyle is a children’s nurse from Newcastle upon Tyne. She took a career break from the Great North Hospital to volunteer in Ethiopia for a year. The challenges have been great but then so have been the rewards, as she explains WHEN I first arrived at the Nigist Eleni Mohammed Memorial General Hospital, I used to do a quick sweep around the ward to ensure all the children were stable and none was near to death. There is a lack of critical care units, and the paediatric ward was badly resourced, with only nine staff for 50 beds, little monitoring equipment and no access to emergency care. We had one thermometer, one saturation monitor and three oxygen concentrators for the entire ward. The hospital, where I worked last year with Voluntary Service Overseas (VSO), serves about 1.5 million people and is in the Hadiya region of southern Ethiopia. There are high rates of communicable diseases, such as tuberculosis, malaria and pneumonia, and the hospital also deals with many problems similar to those found in the UK, such as respiratory distress and meningitis. By the time people present themselves, they are often critically ill due to lengthy travelling times and an inability to pay hospital fees. There is also a shortage of essential drugs and medical supplies. In 2012, two VSO volunteers working at the hospital set up a neonatal intensive care unit (NICU). This has proved to be hugely successful, even though it is more like a high dependency unit (HDU) area because there is no ventilation or invasive monitoring capability. The unit has reduced the neonatal death rates by nearly 50%. With the support of VSO, the NICU project is being disseminated across other hospitals in the country. 38 February 2015 | Volume 27 | Number 1
It was the success of the NICU that led the hospital to ask for a children’s nurse to support the paediatric ward, with children ranging in age from one month up to 18 years. When I arrived, it was obvious early on that we needed to provide better care to the most critical of children, so a proposal was written and funding secured to open the first paediatric HDU in an Ethiopian government hospital. New resources A functioning HDU properly stocked with medications and oxygen is now in place following months of setting standards, developing policies, protocols and training packages. There is also access to a reliable power supply. We have one patient monitor, which gives us electrocardiogram trace, arterial oxygen saturation, and non-invasive blood pressure, heart rate and respiratory rate. Crucially, there is a suction machine and oxygen concentrators for each bed space and an emergency cupboard that holds airway devices, intravenous
access equipment and blood glucose monitoring machines. A nurse works in the HDU 24 hours a day and an emergency paediatrician is on-call overnight. The nursing staff took part in a four-day introduction course on HDU care and have reached competency skills in the care of the critically ill child. The hospital agreed to pay them on a slightly higher pay scale, in recognition of their extra skills. VSO and Ethiopia’s Ministry of Health are interested in looking at this model of care with a view to disseminating it to other hospitals. We need more children’s nurses to volunteer and support the work going on in Ethiopia and other countries. An HDU audit has shown promising early figures for reduced death rates, suggesting that a higher level of care than was expected has been achieved. It has been the most challenging thing I have ever done, but it has also been my most rewarding professional achievement. Patricia Doyle is a children’s nurse who is now back working in the UK after volunteering in Ethiopia with Voluntary Service Overseas
Find out more VOLUNTARY SERVICE Overseas (VSO) is recruiting children’s nurses to work in maternal health care in Ethiopia and other countries across Africa and Asia. Volunteers generally need two to six years of relevant experience, a professional qualification and some experience of supervising, mentoring or project
management. VSO supports volunteers by providing them with training, the costs of flights, accommodation and a basic living allowance. It is not recruiting for Sierra Leone, where it works with local volunteers, but is running an Ebola appeal fund. To find out more visit www.vso.org.uk/ volunteer NURSING CHILDREN AND YOUNG PEOPLE
Nursing Children and Young People 2015.27:38-38. Downloaded from journals.rcni.com by FLINDERS UNIVERSITY on 12/05/15. For personal use only.
