‘Useless at the bedside’

The lack of standardisation in the allied health sector is resulting in graduates leaving institutions being unable to carry out vital checks or recall information critical to ensuring patient safety.

President of the Practical Nurses Association of Jamaica, Stephanie Powell, said the ability of graduates to recall and recognise important abbreviations is among the areas where the concern is greatest.

To highlight her point, she shared that NPO – from the Latin nil per os, which means ‘nothing by mouth’ – is a common abbreviation that is at times placed above patients’ beds.

“The practical nurse went in that room and gave that patient water, and I said to her, ‘Do you know what the meaning of NPO is?’ and she was like ‘Miss, me nuh memba,’ and I was really mad because this young lady had just graduated maybe about six months before and was in a private hospital with a patient who just had surgery and was not to take anything by mouth,” the PNAJ president shared during Wednesday’s Gleaner Editors’ Forum on the export potential of allied health workers.

Powell lamented that many of the schools are operating under an “eat-a-food mentality” and are failing to recognise that they are training people to literally handle life and death situations.

Former head of the UWI School of Nursing (UWISON), Dr Steve Weaver, said that following assessments, he had to recommend further training for many students who had graduated from various allied health institutions.

“They came with an attitude of knowledge, power, and authority, but they didn’t know how to find the radial artery, they don’t know how to put on a sphygmomanometer to take the blood pressure, they don’t know how to walk a patient or deal with a patient who has fainted and has fallen … . That’s a danger to the local population because these are the people who are in homes out there and taking care of patients,” Weaver pointed out, adding that the sector is in need of serious regulatory attention.

With an attractive employment market overseas and even locally for mental health patients who come from the Cayman Islands for short-term treatment, Weaver proposed that a fix be found to the competency issues.

He told The Gleaner that UWISON has the capacity to offer training in allied health and to build a career path for those who begin at that level.

Weaver explained that many of the students who apply for allied health programmes have five or more Caribbean Secondary Education Certificate subjects while a few have associate or undergraduate degrees.

“This would be a good addition to at least start a process, and then when we have the standardisation of the others, then we could look to have them join in with the programme. The way I perceive this thing happening is that if we have an allied school attached to the UWI School of Nursing, there will be some courses that are taught to the nurses that they could do – basic skills and first-year courses. If they want to move forward along that career path, they would have already done these basic courses,” Weaver suggested.

He reasoned that nurses, no matter what level, must be both trained and educated to be able to interpret and report unusual activities with patients.

“We really need to have this group of professionals properly trained and certified so that we can have this pathway that will take them forward. When we do that, we would have completed nursing education in Jamaica from top to bottom – PhD here, allied workers here and a career path that can take them straight up to the top,” the former UWISON head said.

Weave added that the health and safety of Jamaicans would be safeguarded as the best care would be guaranteed and the country’s reputation would also be protected when allied health graduates are sent overseas.

Weaver found support in registered nurse and nursing instructor Sophia Kelly Davis, who argued that enrolled nursing assistants who train for two years are unable to transition to a four-year registered nursing programme.

“They would need to go back to school for four years to be a registered nurse. If it is done in the way as Dr Weaver has proposed, we will have a better workforce,” she said.

Weaver added that there is also a cost benefit when allied workers are properly trained as it reduces the number of senior nurses required to supervise junior members on a session.

“The burnout will also be less,” Kelly Davis chimed in as she explained that oftentimes due to their lack of practical knowledge and experience, they are “useless at the bedside”.

judana.murphy@gleanerjm.com