Vol 1. Issue 3
June 2nd, 2020 Call to Action
THE NURSE AND MIDWIFE LEADERS’ THINK TANK THE NURSE & MIDWIFE LETTER
MESSAGE FROM CHAIR NMLTT Commissioner Hajati Kisu Museene to the Students. To all nursing and midwifery students in Uganda By now all us are aware that on the 18th of March 2020, H.E. the President of the Republic of Uganda directed that all education institutions in Uganda including those for nursing and midwifery be closed for a period of thirty days. This was a response to prevent the fast spread of COVID-19 within Uganda. The thirty days have now morphed into months, with additional guidelines issued. In the last Presidential Address, the President communicated on the possibility of allowing finalist students back to into school. The Ministry of Education and Sport through its Task Force and Political leadership in consultation with the Ministry of Health is working out contingency plans for resumption and continuity of education services in the country. In this respect, on 4th April 2020, the First Lady and Hon. The Minister of Education and Sports delivered a statement to the public indicating the plans of the Ministry of Education in response to the COVID 19 crisis. Students in Universities and tertiary institutions were encouraged to conduct self-study relying on internet and other home-based strategies. Nursing and midwifery skills development – the associated challenges Training of nurses and midwives requires provision of theoretical nursing principles in the classroom and libraries under the guidance of tutors. It also requires clinical instructors, tutors and principles to conduct hands on training through clinical rotation in hospital wards, clinics and health centres. (Ali, 2012; Chisengantambu, Penman, & White, 2005; McCarthy & Murphy, 2010; Nyoni & Barnard, 2016; Museene, 2018). Provision of theoretical nursing principles is done to ensure proper preparation of the student before he/she is placed in the real-life environment which has risks of contracting disease. In addition to the preparation, before students are attached to the clinical settings and basing on the fact that these places are considered to be high risk infectious places, provision of qualified personnel to supervise such students is a must action for clinical rotation. Nguyen, L., Ropers, S., Nderitu, E., Zuyderduin, A., Luboga, S., & Hagopian, A. (2008) in their study of Intent to migrate among nursing students in Uganda: measures of the brain drain in the next generation of health professionals, they reported that the Ugandan health care workers encounter challenges of
# StudyAtHome
#MentalHealthMatters
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conflict between provision of care and conducting clinical teaching. This conflict was reported to be a result of shortage of human resources and high demand for provision of nursing care to the fewer health workers. Subsequent studies have similar findings. In their study Museene & Mayers (2018), found that fifty three percent of the studied population reported a gap between what is taught and practice scenarios especially in relation to severity of sickness as one of the limitations of conducting and supervision of clinical teaching and learning. The need for close supervision is even greater than before with COVID-19. This calls for deliberate planning and reallocation of resources to support clinical rotations. I empathize with you, I know all of you made plans and you had visualized the day of completion of your studies, your earlier plans more and more impossible to accomplish. The UNMEB June 2020 examinations have now become mission impossible, however that does not mean that life has stopped, the right time for the examinations will be communicated. As you follow the guidelines provided by our Minister of Education, Hon. Janet Museveni, which include studying at home using the resources available to you, please do not be tempted to allocate yourselves to hospitals because this action may result into disciplinary action that could destabilise your studies and chosen career.. The provision of close supervision, prompt provision of Personal Protective Equipment (PPE) and ensuring a safe learning environment is needed now more than before, which is why all your training institutions are being consulted by MoES. Going forward, it is crucial that the training institutions and hospitals) foster a close working environment in order to effectively plan for proper implementation of clinical teaching. Stay safe, wash your hands regularly with soap and water, avoid crowded places, use masks, and avoid touching your eyes, nose and mouth. Practice basic skills like communication at home. Covid19 is a novel virus, high infectious and the various treatments are still being widely protested. Scientists are still understanding the characteristics of this virus and therefore call for you to be more careful and also comply with instructions provided to you by your seniors. If in doubt call your Principal/tutors for clarity. An official position will be communicated to you in due course. Source: ncaa.org
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NURSING NOW CAMPAIGN (NNC) UPDATES Interview with Sr. Catherine Odeke, National Coordinator, NNC—Uganda Nursing Now Campaign (NNC) is a three-year global campaign that aims to uplift the status and profile of Nursing. It is run in collaboration with the International Council of Nurses (ICN) and the World Health Organization (WHO) and is a programme of the Burdett Trust for Nursing, UK. NNC was launched in 2018 and as of January 2020, there were 528 active groups in over 112 countries, Uganda inclusive. NNC has been running successfully in Uganda, we would like to know what has worked: E.g. systems, procedures or special set-ups Photograph by Agha Khan University Uganda Collaboration and Partnerships with organisations and various bodies - the pillars of nursing working together to make Nursing Now a success. Notably, the Clinical Practice departments, the Nursing Department at Ministry of Health, nursing education organisations, and arm of regulation, as well as other associations have been able to harmonise activities under the nursing now campaign. This has worked so well. The creation of a national steering committee to drive the activities in the country, and as such, the appointment of the Permanent Secretary of Health Dr. Diana Atwine as Country Patron for the campaign; has worked out well. Meaningful partnerships with persons such as collaboration across professions, for example we have Professor Francis Omaswa as a member of our advisory committee. He is also a board member of this Global campaign. These individuals have been instrumental in shaping the success of the campaign here and in building the momentum. Involvement of many stakeholders outside inside and outside the nursing fraternity: We have the full support of the District Health Officers, Clinical Officers and In-charges, Resident District Commissioners, and CAOs at District level. Media houses have also offered free airtime on radio, TV and invited NNC leaders to tackle various topics in the profession.
Nursing Now: Raising the profile of Nurses and Midwives
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NGOs such as JHPIEGO, who gave us practical support and is hosting our secretariat office space at their premises in Kampala. We were unable to secure the appropriate office space at the Ministry of Health HQ. We have unlimited access to their boardroom to hold our quarterly meetings. They also have supported and continue to host our webinars. Seed Global Health has also contributed tremendously to the success of this campaign. They are supporting the Nurses & Midwives Leadership Think Tank (NMLTT) in various ways in addition to hosting the NMLTT meetings. An achievement through the support given to the NMLTT, is that a Nurses and Midwives Newsletter/bulletin has been birthed. This is a good achievement as it is raising the profile of the Nurses and Midwives and this new development has brought the Nurse Leaders to work closer to the Nurses and Midwives. Florence Nightingale challenge - A program on leadership development for the young Nurses. Mulago National Referral Hospital (MNRH) is one of the early adopters of this initiative and has made many achievements with support of Aga Khan University Uganda. Two groups each of 20 young Nurses and Midwives were nominated as requested by UUKHA with 2 facilitators -Nurse and Midwife Leaders; for each group. The final report of all countries that have participated; Uganda inclusive, is underway. Continued training: - Before Covid 19 pandemic, Aga Khan University had started a CPD program on leadership and advocacy of 90 young Nurses and Midwives 30 in each group.
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Reception from Nurses NNC has been very well received and embraced by Nurses and Midwives in Uganda. The fact that we have a young nurse leader on the committee helps us remain in touch with the issues affecting the young nurses and share challenges and mentorship gaps for us to address. Some nurses have also carried out different activities for the betterment of the campaign like the National Health Care Conferences.
What has not worked well? Like any other campaign or project, there are things that work well and those that don’t. Funding of the activities under the campaign remains a major hurdle. The steering committee and I developed a concept for activities under the NNC, but implementation has been slowed due to insufficient funding. There are also issues of sensitisation, awareness creation, and follow up at the district levels. All these require some level of financial input. Unfortunately, we have also had many partners failing to fulfil their initial commitments. What are the potential ways in which the above can be resolved? In hindsight, personally as the Coordinator, if we had a National Nursing and Midwifery Association, the issue about funding could be resolved because as an association, funding opportunities are easily realised. We do have smaller associations that are working with us, but they are still fairly new and also just establishing their operations e.g. the association of critical care nurses, graduate nurses and midwives, the association of midwives and the association of public health nurses. Current status We have sensitised nurses in different fora and worked with the department of nursing at the Ministry to travel to various regions in the country. There are still some nurses who do not fully comprehend what NNC is all about. The onus is also on the leaders who do fully understand it, to share with their teams so that everyone is aware that the campaign is here to uplift the Nurse, raise our profile and raise our voices collectively. There is also a song composed by Nurses here in Uganda - an anthem for NNC that the Global Board members: including the Chair have listened to. They love it! Going forward
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A Voice to Lead: Nursing the World to Health
We are advocating for all nurses to have a place at the decision-making table and be included in developing policies and encouraging all to specialise. It is important for us all to work together. On Behalf of the PS, the NNC team, and NMLTT, let us continue to lift the nursing profile. The onus is now on you to join us.
MAY 2020- THE INTERNATIONAL MONTH OF THE NURSES AND MIDWIVES Even Covid-19 couldn’t stop nurses and midwives across the country and the globe to celebrate both the International Nurses and Midwives Day. In pictorial, we share with you a few images of various events showcasing the solidarity and importance of nurses and midwives. The Nurse of the Year: Doris Akudinia receives the Nurse of the Year Award!
Congratulations to Doris for her courage and for reminding us all that caring is not a crime; and that our patients expect us to think on our feet, lean into leadership, overcome barriers and provide solutions.
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Jinja Regional Referral Hospital: IMD
International Midwives Day: Midwives at work (Photos NNC-Ug)
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SALUTE TO A FALLEN LEADER ADHO/MCHN Adjumani, Sr. Adunia Anne Mary, who died on Tuesday 26th May 2020. A tremendous loss to the Nursing Fraternity. May her candle keep burning and May her Soul Rest in Peace.
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“5 MINUTES WITH OUR NURSE AND MIDWIVES LEADERS”
Avoid using the Yellow Pages…Update your knowledge
Ms Kabanyoro Annet, DEAN School of Nursing Kampala International University (KIU) I greet all nurses and midwives and thank you for the great job you are doing. We are the topmost heroes of the world and I wonder where communities would be without us! As a nurse educator, the challenge my team and I have taken up is support our students during this difficult time. Personally, the pandemic has taught me many lessons, and among them is to at least save 10% of our salaries every month or find a business and invest in it so that you have some reserve to lean on whenever challenges such as these arise. I am sure that many of my colleagues have had challenges too, but the only hope is that every challenge has a solution floating around somewhere. It is upon us to dive into the deeper waters and fish out these solutions especially through sharing our experiences and challenges with colleagues and friends. So, how are we at KIU helping our students during this pandemic? We are working to introduce an e-learning platform for the students to continue their studies remotely. However, we have realized that there is a Digital Divide challenge among our learners. Some students do not have personal computers or smart phones, have poor or no internet connections and are therefore are cut off from the continued e-learning. We have realized that e-learning is not an equitable solution. inequitable for students and yet we had no quick solutions. Future planning Covid-19 has changed our seasons as Nurses/Midwife educators, we need to reshape nursing education and adopt innovative pedagogies that will help us meet the new seasons’ demands. Flipping our classrooms might be of great help when we resume. We might have to encourage every student to acquire electronic devices before being admitted into institutions of learning. We need to develop resilience to better manage challenges we face as educators. Let us think critically, be innovative and collaborate more than ever before. NCHE has a policy on e-learning. We will be reviewing this and evaluating how to develop the policy specifically for the Nurses and Midwives. We hope that this will enhance the process for the diploma in nursing extension and Bachelor completion programs to adopt e-learning. It has been done elsewhere and has worked. We need to embrace it! Readiness to Re-Open: As we start thinking of our readiness to resume, and wait for guidelines from
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MoES, let us try to think through the best practices in the prevention of Covid-19 and get organized accordingly. Students who are able to return to school post-lock down might return with newly acquired challenges from the lock down, these could be financial constraints or others that affect at them at an individual level, how shall we support them? We need to develop strategies now to use later. We are designing CPDS for nurse educators because. We know that CPDs are emphasized in clinical practice i.e. hospitals & may be less emphasised in education. We are more aware of the changing trends and directions in our profession and in the education sector. CPDs will help to ensure that you and your knowledge stay relevant and up to date.
Soroti Regional Referral Hospital: Internal Nurses Day
Avoid using the “yellow pages”. This is referring to very old notes whose pages have already turned yellow. Let us use this time to update our knowledge and our notes. Let us advance the profession, develop curricula that involve different specializations at master’s level to help us cope with the increasing society demands. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory and to cover practice gaps. Utilizing the best nursing practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward. We need strong and vibrant professional organizations that will take forward our agenda. Finally, let us love our colleagues, love our students, support one another and have a positive mind towards nursing education and the profession. For God and My Country.
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Daily, I’ m motivated by the team work of the nurses here...
KOKOR MAGDALENE
SPNO MBALE REGIONAL REFERRAL HOSPITAL What has worked well for you as SPNO of Mbale RRH? What has worked well for you as SPNO of Mbale RRH? Being a Leader - I have learned a lot from being a nurse leader. I have witnessed my staff adapt a strong positive organizational culture. Organizational culture is when people in an organization behave similarly. When I joined the family of Mbale Regional Referral Hospital, I met nurses and midwives who were self-motivated, hardworking, cooperative and above all smart in full uniform (according to different cadres). I’m happy that I have been able to maintain the candle burning. Daily, I’m motivated by the teamwork of the nurses here, their mutual respect for each other. When I delegate duties to perform a task, that person is given the respect as though it was the SPNO herself, and it is done well. I do encourage the staff to learn from what I do, and always push them to perform better. In matters concerning nurses and midwives in my region, I have been involved in decision making, hiring and interviewing, as well as counselling of students. The plus has been the high-level cooperation from the hospital director in matters related to nurses and our students. To ensure a safe working environment, I assigned a team whose main role is to observe infection prevention and control, leading in quality improvement. At the hospital, there is also a team at managerial level that conducts training and orientation of staff in performance management and leadership. They also prepare staff due for retirement and some for further training. We have sent staff for further training. Mbale Regional Referral Hospital: International Nurses Day
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We call upon nurses to therefore embrace research
What is not working well There is still a poor attitude among some of the nurses towards patient care. Some nurses and midwives are rude to patients which is demoralizing. Hospital administrators take a long time to attend to requests sent to them, most times these are essential needs that could improve the health outcome of patients and health services as a whole. An example of these is unmet oxygen requests or repairs on the ward. What can I do to improve? I recognize the need for continuous advocacy for improvement. I am motivated to always show a good example to the young nurses and midwives so as to create a good working environment. Counselling of nurses and encouraging them to change their attitudes, Supervision, mentorship and recommending nurses for upgrading through training. We also need to create safe spaces for addressing grievances and to revise the code of conduct for nurses and midwives. Stay safe and follow MOH Guidelines!! Magdalene
“FEATURE ARTICLE - NURSING RESEARCH” Moving the Research Agenda for Nurses and Midwives in Uganda by Elizabeth Namukombe Ekong and Dr. Rose Nabirye Chalo All professions employ a systematic inquiry that uses disciplined methods to answer questions or solve problems and generate new knowledge that inform and advance the practice of the professionals. In the same way, Nurses and Midwives ought to continuously engage in research that helps to solve issues in nursing practice, education, administration, & informatics (Polit, D.F and Beck, C.T, 2008). This is nursing research. As a general reminder to us Ugandan Nurses and Midwives, we have to engage in Nursing research so that: • We determine effective best practices. • Whatever nurses do, has a rationale and we need to know it. To discover the rationale, it is important to ask questions such as: • Why is it done this way? • What is the best evidence? • Is there a more efficient way? We have to engage in Nursing research to be able to respond to changes in the healthcare environment, patient populations and government regulations. This is because health care practice is super dynamic. Environmental changes result in an eruption of new diseases and change in human behaviour. This calls for an inquiry to understand what the best response would be. Secondly, changes in patient
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population require effective responses. Therefore, nurses have to carry out research in order to acquire new care models that are evidence-based, patient-centred, affordable, and accessible to diverse populations for quality health services. Currently in Uganda, there are changes in government regulations in education. This calls for research. Nursing research also helps to enhance and update nursing Knowledge. All professions evolve. No evolution takes place without new discoveries. Usually, people look at nursing as a caregiver responsibility that follows other professional’s orders. The public should know that Nursing is an independent profession and nurses have the ability to think, weigh options and carry out independent actions based on education, evidence, and experience. Are Nurses and Midwives in Uganda conducting research? “Yes” and “No”. This is mainly because many nurses carry out research to fulfil their academic requirements. It is unfortunate that even some of those that have done the academic research have not been able to fully disseminate or publish their findings! Hence there are relevant findings lying either in academic institutions' libraries or in their archives. Some nurses also conduct research using designs that do not generate evidence to improve practice. Therefore, most of the evidence being used in Uganda is from research done by other nurses abroad. Some of the challenges faced by nurses in relation to conducting research include the following; Lack of Resources – these include policy, human resources, financial support and time. There is no specific fund for Nursing research. Nurses struggle to get funds to carry out research, even though currently it is which is mainly for academic purposes The lack of a National Nursing Research Policy or Agenda which would guide the professionals on the areas of focus in their identified research fields. Leadership/Human resources where there are sufficient numbers of nurses at policy making level. There are very few nurses at this level to advocate for Nursing and Midwifery issues despite the evidence available. This demotivates the few researchers. The shortage of nurses at the workstations makes the available nurses get absorbed in the day-to-day care activities, leaving no appropriate time for them to reflect and analyse the data they generate. As stated by Polit, D.F and Beck, C.T, (2008), evidence is measured using “The Gold” standard for research designs: From highest level: Meta-Analysis, Systematic Reviews, Randomized Controlled Studies (RCT), to the lowest like Cohort studies, Case Control Studies, Case studies and Case reports. However, there are limited numbers of Nurses and Midwives who have the knowledge and skills to conduct research which generates this kind of evidence.
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Lack of publication strategies. Currently, there is no Journal of Nursing and Midwifery Research in Uganda. Strategies for moving the research agenda for nurses and midwives in Uganda forward a. Develop a Nursing Research Policy to guide formulation of our National Research Agenda b. Formulate research teams at facility, regional and national level where each team includes members at policy level, education and practice. c. Strengthen nurses’ knowledge and skills in research methods that generate appropriate evidence through work-based training and use of mentors (Kelly, et al, 2016). d. Have more nurses and midwives at the table of policy formulation e. Nurses and midwives conducting research should engage the end users of the research findings to inform and guide the writing of specific practice recommendations that may implemented in health care service delivery (Titler, p. 117, 2008). f. Partner with professional opinion leaders and health care organizations so that dissemination of research findings forms a basis of action (Titler, p.118, 2008). We call upon nurses to therefore embrace research in order to enhance our profession. References: Kelly, K. P., Medical, N., Speroni, K. G., Mclaughlin, M., & Guzzetta, C. E. (2016). National Survey of Hospital Nursing Research, Part 2. (January). https://doi.org/10.1097/NNA.0b013e3182786029 Titler, M. (2008). Section II: Evidence-Based Practice. Patient Safety and Quality: An EvidenceBased Handbook for Nurses, pp 113–132. Polit, D.F. and Beck, C.T (2008) Nursing Research: Generating and assessing evidence for nursing research. 8th edn. Philadelphia, Lippincott Williams & Wilkins. Titler M.G. (2008). “The evidence for evidence-based practice implementation” in Rhonda G (ed.) Patient safety and quality: An evidence-based handbook for nurses, U.S Agency for Healthcare Research and Quality, pp.117-118. https://www.ncbi.nlm.nih.gov/books/NBK2659/pdf/Bookshelf_NBK2659.pdf
Publish or perish: Why it matters to you. Source: Clancycross
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UPDATES NEW COMMISSIONER FOR NURSING AND MIDWIFERY
#PPENOW #ProtectHealthCareProviders
One of Our most notable achievements as indicated in our objectives includes advocating for leadership in the fraternity. We congratulate the newly appointed Commissioner for Nursing and Midwife at Ministry of Health, Comm. Beatrice Amuge formerly Act Comm. Mulago National Referral Hospital (MNRH). Watch out for her interview in the next edition where she shares what her first priority in the role is going to be. PROVISION OF PPE June 1st, 2020: Seven healthcare providers were reported to have been infected by Covid-19. Three nurses, two doctors and two healthcare officials. These are probably the first of many who will be affected if robust measures to protect all those on the frontline are not taken. We continue to lobby and advocate for more funds in order to meet this objective. For $19.50 (UGX 70,000) only, you can sponsor a nurse/midwife to receive a pack of PPE for her shift. This pack includes an apron (reusable), two pairs of gloves, a hair net, N95 mask (with instructions on how to sterilize), and soap. Please feel free to contact us via our email Uganursemidwife.leaders@gmail.com for further inquiries. TRAINING CPD TRAINING FROM UNMC If you have not yet registered with WCEA, please use this link:- http://wcea.education/new-councilsonline-platform/ to register. The CPD credits will automatically be captured by UNMC. Any queries or problems, please see email list on the contacts section on page 11. The World Continuing Education Alliance (WCEA) works in partnership with the World Medical Association, the International Council of Nurses and other key partners to provide professional health care workers access to education through online systems and mobile technology. In doing so they work with respected educators to make their content available around the world. In response to the global pandemic the WCEA has made available Coronavirus courses from some of the world’s leading education providers. The content is provided free of charge to all registered health care professionals. To access go to: https://wcea.education/covid/ CPD is important as it helps to ensure that further learning is accessed in a structured, regulated way to guarantee that there are applied efficiencies in learning. CPD allows an individual to focus on
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what specific skills and knowledge they require or need by offering many modules to choose from The Think-tank encourages all Colleagues to take part in this exercise. WHO ACADEMY COVID-19 MOBILE LEARNING APP The WHO Academy has launched its mobile COVID-19 learning app for health workers. The app gives access to a wealth of COVID-19 knowledge resources developed by WHO, including guidance, tools, training, and virtual workshops to support health workers in caring for patients infected by COVID-19 and to protect themselves. Resources include maintaining essential health services, IPC and occupational health, case management, community engagement and many others. • Apple app store: - https://apps.apple.com/us/app/who-academy/id1506019873?ls=1 • Android: https://play.google.com/store/apps/details?id=org.who.WHOA For more information on the WHO Academy, visit: - https://www.who.int/about/who-academy WEBINARS Two successful webinars have been held so far. These will now run monthly from June 2020 to enhance continued knowledge sharing and learning. Invitations and information about the next webinar will be sent out two weeks before the set date. Watch out for the next webinar! APPLIED RESEARCH The rapid national Nursing and Midwifery survey to assess the impact of covid-19 on the workforce ended on 30th May 2020 at midnight. Although the survey might not be able to cater for those who are not employed, have challenges to access the internet due to various factors, we encourage all who have not yet participated in this short survey to please do so here In order for the analysis of the data to commence in a timely manner, a report of the findings will aim to be ready by 30/07/2020. The findings so far have been used to inform and guide our planning and advocacy and will continue to be used for the same. RESOURCES: LIST OF USEFUL CONTACTS Please find below a list of useful contacts to forward your concerns appropriately. • UNMC queries: - info@unmc.ug • UNMU: - info@unmu.ug • CPD APP concerns: martin@unmc.ug National organisations Education and training Standards: - Department of Nursing at Ministry of Health BTVET (Min of Education and sports) QUESTIONS? CALL: 0417 893600 (PRO) Mobile 0777108170 Benevolent fund: - Department of Nursing at Ministry of Health, Uganda Some of the associations. (Find out more information about their membership and activities) • AGNMU: graduates@agnmu.org • Critical Care Association:president@ccnau.org
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Midwifery Association: nationalmidwivesassociationug@gmail.com Nursing and Midwives Society: info@nursesandmidwivessociety.org Emergency Care society of Uganda: - admin@ecsuganda.org Palliative care Association of Uganda: - pxau.admin@pcau.org.ug
Others • NMLTT (Think - Tank Leaders): - Uganursemidwife.leaders@gmail.com • Writing articles for publication on NHCC Uganda website: - editors.nhccuganda@gmail.com Global networking • Nursing Now Campaign Uganda: - nursingnowuganda@gmail.com ON GOING NMLTT continues to work in collaboration with the National task force in the Management of Covid-19 & the Nursing Now campaign to uplift the status & profile of nurses and midwives. The Think tank continues to meet every week to check on progress against our objectives and formulate strategies to support and advocate for Nurses and Midwives. We would like to thank Seed global Health for their continued support for hosting our zoom meetings and webinars. Our faith in you is steadfast. May you continue to rise up to the challenge in this International year of the Nurse and Midwife - 2020. More than ever, this nation needs you. We thank you and May God bless you. Please feel free to contact us with your concerns. If you find this Nurse & Midwife Letter useful, we would really like to hear from you. We continually evaluate and assess the progress of our communication channels with you. Please email us atUganursemidwife.leaders@gmail.com. For God and My Country. Yours sincerely,
Dr. (Hajat) Safinah Kisu Museene Chairperson Nurses and Midwives Leaders Think Tank Commissioner BTVET, MoES Tel: +256 774 46 3085, Email: safinahm2002@hotmail.com Copy to: • The Hon Minister for Health • The Permanent Secretary- Ministry of Health • The Registrar, Uganda Nurses and Midwives Council • The Chairperson- NATIONAL TASK FORCE COVID 19 • The President of Uganda Medical Association • The Commissioner- Nursing Services Ministry of Health • All Nurses and Midwives in Uganda