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Where There is No Doctor: A Clarion Call to All Nigerian Nurses By Williams M - Articles - Nursesarena Forum

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Where There is No Doctor: A Clarion Call to All Nigerian Nurses By Williams M by katty : November 14, 2018, 05:25:25 AM
It was a very hot afternoon in one the communities sited in the creeks of Bayelsa state. I just stepped out of the health center in hunt of a chilled drink to quench my thirst. Surprisingly, one of the community members who recognized me as a “corper nurse” posted there, ran towards me alerting me of a friend in the neighboring community who already notified her of their coming to the health center for an emergency. I hurriedly aborted my mission and rushed back.

While still at the entrance, I sensed danger on my sight of drips of blood littered along the entrance of the health centre. It was a case of matchet injury to the hand. The patient reportedly mistakenly cut deep through his hand on an attempt to carry out his routine farming work. The client already laid on a couch, was bleeding profusely as some arteries were affected. The environment was already tensed as the client was obviously anxious and humbly pleading with us to help save his dear life; relatives and well-wishers who accompanied the client were heard calling on their gods and God to intervene. A battle between life and death!

Unfortunately, the doctor on call was temporarily unavoidably absent. Decision-making automatically shifted to we; the nurses on ground. It was a tough choice between “promptly referring the client to a decent hospital in town for expert management by speed boat” which would take about 50 minutes and “instituting emergency treatment to the best of our abilities”. We chose the latter option as it was apparent that the client would give up the ghost from hypovolaemic shock if treatment wasn’t commenced immediately as he has lost so much extracellular fluid. A choice between a greater and lesser evil! We swung into action.

As God may have it, the health center was quite equipped with emergency drugs and supplies. While applying pressure at the bleeding site to control the bleeding, intravenous line was secured and infusion set to boost the fast depleting plasma volume. Within few minutes of attempt to irrigate and suture the injury site, client ran into hypovolaemic shock. Client became unresponsive and pulse rate difficult to palpate. The environment was thrown into chaos as the cry from the relatives tripled which attracted a large crowd which was difficult to disperse. At that point, for the first time in my life I felt helpless and overwhelmed but I struggled to remind myself as I was thought in school, “to always remain calm in an emergency to be able to deliver effectively”.

With the help of my able colleagues, Cardio-pulmonary resuscitation (CPR) was initiated, artificial oxygen apparatus set and emergency drugs administered. To God be the glory, within few seconds, client was revived and was stabilized after some minutes of battling to suture the bleeding site. Client was afterwards, referred for further expert management. Theories learnt from the fore walls of college were put into practice. What would have been a life-time nightmare and post-traumatic stress to me turned out to be a good feeling of accomplishment and source of encouragement to go deeper and learn more.

TO MY DEAR NIGERIAN COLLEAGUES


While waiting for any slightest opportunity to fly out and join our colleagues in the Western world; where the society and government appreciate well our good works; where everyone is recognized and respected for the vital role they play in the society; where the hospital working conditions are health-workers friendly; where there are abundant opportunities for personal and professional growth and advancement, it is pertinent we have these at the back of our minds that:
 You may not always be lucky to have a doctor who by the Nigerian bureaucratic system, is responsible for leading the health team in the medical management of clients. Hence, the need to equip ourselves with the necessary practical skills and knowledge to deliver effectively mostly in an emergency as such. In such situations, your actions and inactions will mean so much in saving a client’s life who may be your loved one, relative, friend etc.

 There is gap between theory and practice and should be bridged. Having being exposed to the theories in courses like Anatomy, Physiology, Med-Surg, Biochemistry, Pharmacology etc. in the course of our training as students, the onus is on us to practice and build on these to boost our competence.

In Nigeria, mortality rate is already very high and life expectancy is low. Your competence and emergency readiness can help checkmate this. As I was taught in “Medical Jurisprudence”, life is sacrosanct and as such, should be conserved and protected at all cost.
I will be quick to suffix that I am victim of Nigerian system but won’t continue to let it negatively affect me in the practice of my vocation and passion.

BY Williams Maduka

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