The Nurses and Midwives Letter Issue 5
THE NURSE & MIDWIVES LEADERS’ THINK TANK 2020 Lead
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Introductory remarks from Sr. Angelah Ilakut, Vice Chairperson, Nurses and Midwives Leaders Think Tank and Registrar, Uganda Nurses and Midwives Council REGULATION OF NURSING AND MIDWIFERY IN THE ERA OF COVID-19 PANDEMIC I believe the Covid-19 pandemic has been one of the most stressful seasons in the life of Nurses and Midwives. You have worked tirelessly at the frontline to ensure that the coronavirus does not spread; and more importantly that Uganda has registered less deaths than other countries. You have shown your passion amidst the global shortage of personal protective equipment (PPE) and overwhelming numbers of cases. We have seen your selfless levels of overwork, especially those of you in the direct management of covid-19 cases, in the treatment centers, or involvement in the response to the covid-19 pandemic. Oftentimes, you have not had sufficient time to rest or recover from the stressful experiences and have continued with minimal support and assistance. To make matters worse, on June 8th, 2020, the Ministry of Health declared 22 health workers in Uganda were infected with the coronavirus. These numbers have since increased to date. With two health worker deaths due to the virus per now, we can imagine the impact this has had on your mental health and wellbeing, as well as the effect it has had on your families and loved ones. Today, we are more than ever deeply grateful to all of you, as you work, round the clock, putting yourselves at risk, to fight the effects of this pandemic. We are safe because you have made it! The covid-19 pandemic has not only affected the front liners but has also affected the effective regulation of nursing and midwifery services, and provision of services to the public. We recognize that you may be anxious during this time about the renewal of your practicing license; registration with the Uganda Nurses and Midwives Council (UNMC); certification of your professional documents; as well as registration and renewal for your clinics. We empathize with you and that is why we are working round the clock to ensure continuity of service delivery at the UNMC. Following the public service circular letter No. 3 issued on March 25th, 2020, the Council remained open with skeleton staff working behind closed doors with no access to the public. We are however happy to inform you that since June 2020, the council premises have been open to the public following the public service circular letter No. 7 issued on June 5th 2020 that allowed 30% of the total workforce to be on ground to provide critical services promptly. The critical services being offered to the public are: 1)
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Picking of registration/enrollment certificates, 2) Renewal of practicing licenses, 3) Registration and renewal for private clinics, 4) Certification of professional documents, and 5) Professional consultations. Nonetheless, to enable us to apply the Ministry of Health covid-19 standard operating procedures, we encourage you to access the renewal of practicing license and certification services from our regional satellite centers that are closer to you. The centers are located within the Regional Referral Hospitals (RRH) of Arua, Gulu, Lira, Kabale, Mbarara, Fort Portal, Hoima, Masaka, Mubende, Jinja, Mbale, Soroti and Moroto. We further encourage those of you intending to pick your registration/enrollment certificates to visit our website to ascertain the actual date when you will be expected to pick them. These measures have been put in place to avoid overcrowding at the council premises. Since a safe environment is still paramount in any service delivery, the Council is in close consultation with relevant stakeholders before the registration and enrollment processes can resume as the online registration development process continues. You remain our esteemed customers and we pledge to keep you updated from time to time, knowing that you are our crucial allies in transforming council services to meet your needs, mostly in this era of covid-19.
“Please…stay safe. Wash hands regularly with soap and water. Apply PPE whenever providing services”
Please continue to stay safe, wash hands regularly with soap and water, apply the personal protective equipment (PPE) whenever providing nursing and midwifery services to the public; and do not hesitate to speak up to the relevant authorities whenever you notice unsafe working conditions. Engage in continuing professional development provided through our CPD app/platform on https://www.wcea.education/unmc so as to keep your knowledge and skills up to date for provision of quality nursing and midwifery care. Whenever in need of further information/sharing of grievances, do not hesitate to contact us using our email: info@unmc.ug or
unmcouncil@yahoo.com. To Love and Serve, Yours Sincerely, Tel: 0782836159, Email: Ilakut.angelah@unmc.ug
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Feature Article by Dan Muramuzi, @omuhiinda1 Association of graduate Nurses and Midwives of Uganda and Young Researcher. The hidden joy Ugandan parents demand from educating their children as Nurses.
Uganda`s education system comprises preprimary, primary, secondary, and tertiary institutions. The system is so complex that both the learner and the parent/guardian struggle to ensure there is commensurate outcome despite the difficulty that everyone must incur in order to acquire the desirable outcome, which is academic excellence and financial freedom. A report by National Private Educational Institutions Association indicated that their membership by 2020 September, was 18,000, out of which 7,211 were kindergarten/nursery schools, 8,430 were primary schools and 2,196 were secondary schools. A total of 161 were tertiary institutions while twenty-three were international schools. The country had over 13,000 private schools; the figures are bound to increase further because the country works on an open market principle where an investor can consider starting up a school/institution provided s/he meets the basic requirements. This is good for any state, but also merits the country because of the revenue collected from taxes and the jobs it opens in the education sector, partly solving the unemployment problem which is at its peak in Uganda. And this is likely to double in post Covid19 era. Whereas the Ministry of Education and Sports is always involved in setting up working guidelines, once the process of establishing an institution is done, the investor is left to independently cost his/her service.
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This is where everything goes wrong; an infant in baby class can pay up to UGX2m per term this comes to 6 M per year, while at primary level, school tuition ranges between UGX 600,000 to UGX2M per term this would come to around UGX 10.5M for a period of seven years. In addition to these exorbitant payments, the cost of living is also too high. Worse still, the cost of secondary school tuition is sky rocketing each and every year with tuition ranging between UGX 700,000 to UGX 3 M. This therefore requires approximately UGX 11M to complete the six years of secondary school. Using simple arithmetic, for an individual to become a professional majoring in sciences and for a course at the university for a period of four years, you might need close to UGX 15 M to graduate from a program. In a lump sum, you need approximately UGX 81,600,000 to finally graduate with a certificate for example in Nursing Science. This is however, on assumption that you will not incur other costs such as hospital bills in case you of sickness. For someone to become a professional nurse, the minimum educational entry level one must have is ordinary level training with credits in science subjects such as Biology, chemistry, food science then a must is a pass in English and Mathematics. At this level, an individual can join a nursing school. If not awarded with a government appointment, then s/he will search for a vacancy in a private institution whose salary policy is determined by the economic scales of demand and supply. To note is that entrepreneurs are usually happy to exploit desperate people who cannot easily demand for accommodative remuneration no matter how resourceful they maybe. Let our emphasis be towards Nursing education. Because of the traditional prestige we put on medical programs such as medicine and nursing education, it’s always every family’s desire to have medical personnel in their family, and this is the major factor that always blinds most parents. Many reach the extent of selling their property in hopes that their children shall recover the sold property after completing their education. Hope is also set on the dream that they will automatically have well-paying jobs. It should also be noted that while we are at school, our education system and curriculum does not expose us to life after school. It is only read, read, and read. By the time, a student graduates from school, majority do not understand their value in terms of remuneration (salary and other benefits). This therefore leaves many nurses being under paid, mostly in the private sector because of their poor financial literacy and negotiation power. This is never taught in schools and it has a direct impact on our families because one cannot fulfil their long-term dreams or hope. Direct consequences. The education system of Uganda has contributed to the average Ugandan’s poverty because the outcome, doesn’t have any relationship with the input that includes fourteen years in class after which one is paid UGX250, 000 per month in a private facility. This is from my expert opinion. The government counterparts would earn UGX 600,000; while this is a bit more, it is nowhere near adequate. A nurse who is being paid that money per month may need approximately twenty-three years to recover what s/he spent in school, assuming s/he has no other responsibilities.
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Recommendation There is an urgent need to put financial education training in nursing schools and other medical schools to ensure that they can get relevant skills of bargaining for their worth. Otherwise parents will continue wasting a lot of money that cannot be recovered. References https://www.international-schools-database.com/in/kampala/vienna-college-namugongo-kampala/fees https://www.newvision.co.ug/news/1521587/300-private-schools-risk-closure
“THE FRONLINE VOICES” Exclusive Interview with Ronald Jokindu (RN, BsN.), Arua Regional Referral Hospital Please tell us a little bit about yourself: I am a nurse , working in the emergency unit at Arua Regional Referral Hospital and I have 10 years of dedicated service as a frontline health worker and a mentor .I hold a bachelor’s degree in Nursing Science from International Health sciences university, previously trained as a registered nurse and currently pursuing a postgraduate diploma in Hospital and Health management at Uganda Management institute (UMI). Having been trained by SEED Global Health as a regional trainer in basic emergency care, I serve as the focal point person for Emergency care services and a trainer for infection prevention for the hospital. At the district level, I serve as the planned secretary for the Uganda Nurses and Midwives Union. What inspired you to become a nurse? A painful experience that my mother went through more than 10 years ago drew me to become a nurse. She accidentally fell into an animal trap that had been set up by hunters and severely injured her leg. There was no quick means to get her to hospital immediately for emergency care. Finally, when she got to the Arua hospital, she was unable to access X-ray services as the machine was broken. The pain was unbearable, the suffering was immense and after two days we decided to transfer her to a Private Not
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for Profit (PNFP) where her injured leg was put in a Plaster of Paris (POP) and was discharged after 24 hours. While in the hospital, I was saddened by the condition of many other patients and I wished I could help. After five days, my Mother expressed that she was having pain. It became extremely unbearable leading to sleepless nights. Wondering what the cause was, my elder siblings decided to open the POP one night and guess what it was, pressurized with oozing pus. There was a temporary relief immediately and she managed to sleep that night. The following day she was taken to another PNFP hospital in hope of better services. This transfer of facilities reminded me that both my parents had always dreamt of becoming health workers. It was this that helped me make up my mind and do everything it takes to make their dream come true. What has been your most memorable moment as a nurse? In August this year, I saved a life of a 38-Year-old gentleman who was brought in by police and initially labelled as an unknown drunkard. According to police, he was found lying helplessly in a trench on a cold night with multiple bruises all over his body and was restless. On a quick examination, vital observations were unrecordable, blood sugar was 3.1mmls, (low)GSC 7/15 (low) the patient was very cold, and his circulation was not good. I tried to keep him warm with blankets, but this seemed not to be helpful. I wheeled him to direct sunlight and after 30minutes, his temperature was 34.5 degrees centigrade, later after 1 hour, the temp was now 35 degrees centigrade. His orientation of time, place and date recovered, and I decided to transfer him to his admission ward. The following day, I went by the medical ward where he had been admitted to check on his progress and surprisingly he had been discharged. I felt good about this rare innovation of warming a patient using direct sunlight more so for us working in resource limited setting where patient warmers are not readily available. What is your biggest achievement to date – personal or professional? I have several achievements both professional and personal. •Completion of a bachelor’s degree in Nursing. I am still aiming higher and I wish I could be supported to achieve higher qualifications. •I was nominated among the top 6 outstanding intern nurses for 2017/2018 by the Ass commissioner for nurses and midwives -Mulago currently the Commissioner for Nurses and Midwives at the Ministry of Health. I am proud of this achievement.
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It is the International Year of the Nurse and the Midwife. What do you wish other people knew about Nurses & Midwives? •Everywhere, Nurses and midwives form the foundation and wall of health care. Other health care professions occupy the roof because by the time they interface with the patients, nurses will have already provided the initial lifesaving interventions. •Nursing and Midwifery are independent professions. Nurses and Midwives are not anybody’s assistants in direct patient care. The public needs to be educated and understand this. •All players interested in delivery of quality healthcare are called upon to invest in the foundation and wall of health care and this is because nurses have longer contact time with patients than all other professionals.
“Everywhere, Nurses and midwives form the foundation and wall of health care”.
Despite their contributions, even here in Uganda everyone knows that they are poorly remunerated, and this makes them live very miserable lives e.g. most of them retire when they still have incomplete houses or nothing at all just to mention a few. What would you tell someone who is thinking about getting into the nursing profession regarding emerging trends and changes in this profession? •I wish to state that the future is bright for nurses and midwives especially for those pursuing vertical career progression and I would encourage all nurses and midwives to pursue this path as it places them at high levels of policy and decision making in healthcare. •Medical care has become more complex so Nurses and Midwives should familiarize with information technology and modern equipment use. •Social Capital has become an asset. Nurses and Midwives need to make use of wide networking opportunities and inter professional networks e.g. engineers, lawyers, teachers, and business experts to share productive ideas such that they keep Updated where opportunities exist. •Nursing and Midwifery is a priceless service, and this should be noted seriously. This is because no amount of money is enough to make a patient recover from a life-threatening health problem. Aspiring nurses and midwives should therefore prepare their minds to avoid frustrations when in the field.
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TRAINING OPPORTUNITIES
Scholarships for Academic Training Scholarships under support of every woman every child (GFF) - implementing Uganda reproductive maternal and child health service improvement project URMCHIP have been announced. The scholarships are being offered by the Government of Uganda.
Scholarships of Masters in Nursing (Critical Care) at MUST are open. The deadline for application has been extended from June 2020 to 30th September 2020. Interested applicants should pick their admission forms from Mbarara University of Science and Technology. Upon admission into the program, they are advised to present their letters of admission to Ministry of Health – Training Division to be guided on how to apply for the scholarship. We encourage all nurses and midwives to apply (the target number is 400). Note: The first cohort of nurses for the short course training in ICU is almost complete and the applicants will be notified soon.
Additional Academic Resources Access to Health Care journals (Discounted at 30%) In partnership with UGANDA NURSES and MIDWIVES ASSOCIATION UK (UNMA-UK), Markallen group UK (https://www.markallengroup.com/ma-healthcare/) has offered a 30% discount on their online subscriptions (MA Healthcare titles only) for UNMA-UK members. This has also been extended to Nurses and Midwives in Uganda as per UNMA-UK mission. You may use the confirmed discount code [UNBA30] to access a range of their healthcare journals.
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NURSING NOW CORNER
The Nursing Now National Coordinator (NNC) is Mrs. Catherine Odeke. If you have been involved in any activity that raises the profile and status of Nurses and midwives, send your photos and activities to the National Coordinator at odeke2@yahoo.com or at nursingnowuganda@gmail.com In the previous three months, NNC Coordinator and some of the Nurses and Midwives Leaders participated in a series of Webinars as panelists hosted by Uganda UK Health Alliance (UUKHA), Jhpiego among others. We also participated in a meeting with nursing colleagues at the invitation of the head of Nursing Department College of Health Sciences Makerere University. There were among others, to discuss and to chart a way forward to improvement of the nursing and midwifery services in the year 2020 year of the Nurse and Midwife and to share experiences from the Nursing Now Campaign. The NNC coordinator, the Commissioner Nursing and Midwifery services among other nurses participated in the Development of a concept Paper on Capacity Building of Nurses and Midwives on Leadership, Management and Governance chaired by the Commissioner Health Services Nursing and Midwifery. One of the ways to promote Unity of nurses and midwives is to have one umbrella organization “The Nurses and Midwives Federation”. This is in progress and with support from partners, the final copy of the constitution for the federation has been signed for the lawyer to present to registry for approval.
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AUGUST THINK TANK HIGHLIGHTS THE THINK TANK REACHING OUT TO FELLOW HEALTH WORKERS AT ARUA REGIONAL REFERRAL HOSPITAL (ARRH) – 28th AUGUST 2020 Since the covid19 global pandemic hit the world early this year, many countries have been grappling with the challenge of ensuring health workers have access to quality PPE in time to protect them from cross infections from covid19 patients who report to the health facilities for treatment. Uganda is no different, and over the past six months the Ministry of Health Uganda has procured and supplied PPE to Health Facilities across the country. One of the objectives of the Think Tank is to contribute to the efforts of the Ministry of Health MoH, the National Task force and all other stakeholders’ response in the fight against the Covid19 pandemic in Uganda and since the outbreak in March this year, Think Tank has sought to compliment the efforts of the Ministry of Health by running a PPE fundraising drive in early May 2020. At the end of the drive, TT handed over 19million worth of PPE to the Ministry of Health for use by Health Workers in Mulago National referral Hospital and Entebbe Grade B Hospital. Recently, after Arua District was identified as a hotspot for covid19, on August 28, 2020, the Think Tank (NMLTT), followed up with support to the health workers at Arua Regional Referral Hospital (RRH). The Think Tank, handed over assorted Personal Protective Equipment (PPE) which included Surgical Masks, K95 Masks, Face shields, Theatre Gowns, Scrubs, among others. These items were chosen after thorough consultation with the hospital leadership including the PNO to identify the most critical needs of the hospital. The Think Tank was represented by Ms. Emily Bako and Mr. Isaac Wonyima who handed over these items to the leadership of Arua Regional Referral Hospital.
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This story was reported in the Daily Monitor Newspaper of 1st September 2020. In case you would like to know more about this fundraising effort to support nurses and midwives at the frontline, contact uganursemidwife.leaders@gmail.com To send your contribution; Emily Baako at 0772692777
INTERPROFESSIONAL COLLABORATIONS NMLTT COLLABORATES WITH THE LEGAL FRATERNITY The Think-tank leadership was hosted by the Cymbell advocates on 14th August and hosted a webinar titled “The future of the Nursing profession and health care”. It was streamed live on Facebook and the discussion was very insightful. The panelists included Dr. Safina Musene (Chair Thinktank), Ms. Angela Ilakut (cochair), Ms. Anita Nuwasima, Ms Rhoda Tugumye, Mr. Cliff Aliga (association head). The moderators were Dr. Rose Clarke Nanyonga (Thinktank mobilizer) and Ms Joyce Katende. These kinds of collaborations are very important as advocacy tools because they provide an avenue for us (nurses and midwives) to not only speak to ourselves but reach out to other professionals to networking and to educate them on the role of Nurses in health care. 2nd NATIONAL HEALTH CARE CONFERENCE We are delighted to learn that the National Health Care Conference team was a successful event with over 400 participants. With support from various stakeholders such as UUKHA, Seed Global Health, JHPEIGO, Nursing Now among others. In a special way, we were excited to learn that the conference had participation from Nursing leaders from ten regional hospitals
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including Arua, Lira, Mbarara, Mbale, Mulago Iganga, and Hoima. They joined the conference with clusters of colleagues and were able to share knowledge with both national and international experts and colleagues in various fields. Following the successful two-day virtual conference, where many Nurses and Midwives had an opportunity to showcase their research, look out for the NHCC 2020 conference booklet and for the YouTube channel to catch up and watch the two days presentations. Upcoming webinars: 1. Follow up HR and Pharmacy 2. Young Nurses & Midwives webinar 3. Communication and interpersonal skills for nurses and midwives
ONGOING ACTIVITIES
The Think tank meets twice a month to check on progress and formulate strategies to support and advocate for Nurses and Midwives. Our faith in you is steadfast. May you continue to rise 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.
Copy to: The Hon Minister for Health The Permanent Secretary- Ministry of Health The Chairperson- NATIONAL TASK FORCE COVID 19 The President of Uganda Medical Association The Commissioner Health Services- Nursing and Midwifery, Ministry of Health All Nurses and Midwives in Uganda Compiled and Edited by Think Tank Debrief team on behalf of the NMLTT: Dr Rose Clarke Nanyonga, Elizabeth Pearson, Irene Atuhairwe, Tracy kobukindo, Judith Hope Kiconco