Nursing and Makeni Government Hospital

The Makeni Government Hospital is unbelievable!! They basically have nothing. They don’t even have running water to wash their hands. The few registered nurses that are “employed” by the hospital actually have to volunteer for the first 2 years of their career because the government says it doesn’t have enough money to pay them! Some of these registered nurses don’t show up to work at the hospital because they work at other jobs (mostly with international NGO’s) where they can actually make money. There’s a Sierra Leone Nursing Board, which licences nurses, but there is absolutely no regulation or anyone to hold the nurses accountable!! The standards of nursing are nonexistent! The hospital I work in has no policies or protocols! The majority of the staff is health care aids who have had no training. They do the job of nurses because there aren’t enough trained nurses. The nursing aids pretty much do anything they want to, which is mostly nothing at all. The nurse manager strolls around the hospital and does nothing that she’s supposed to do. There is no documentation! The nurses/aids perform patient care without recording what has been completed. Many things that the doctor has ordered do not get transcribed properly, if at all, and many things are not carried out, or they are done far too slowly (sometimes a day or two later). The nursing aids are transcribing orders and administering medications without having any training.I am working with a wonderful nurse from England, Suzie. She has been here since May and has spent most of her time trying to fix the problems that exist due to lack of management.... absenteeism, stealing hospital supplies, scheduling, etc. She’s also developed and implemented various tools for the nurses and aids to use (eg. admission assessment form). She’s started doing teaching sessions on how to measure vital signs and other basic nursing care. Together, we are going to develop some nursing protocols for the hospital. We are also going to develop a number of practical nursing care teaching sessions and deliver them to the nurses and aids in the hospital. We really have our work cut out for us but I’m excited about the challenge!