BEING a nurse is not the easiest of things. You spend several hours standing while on duty, miss important events at home, and have to deal with a lot of difficult situations at the hospital.
Yet, there are people who have chosen to be nurses and are happy to save lives.
Georgina Chipowe is the chief nursing officer of the Accidents and Emergency Department of the University Teaching Hospital (UTH) in Lusaka.
She talks about her department and how she and her team leave the hospital with beaming smiles when they have saved lives.
Without prior appointment; either by their own means or by that of an ambulance, scores of patients pour into Zambia’s largest hospital, the UTH from all parts of the country.
Their first stop is the Accidents and Emergency Department that is armed with an ever ready medical team of nurses, paramedics and doctors in wait for them. As chief nursing officer of the department, Chipowe’s role is to supervise nurses and coordinate their activities in the department.
She explains that the Accidents and Emergency Department is part of the Adult and Emergency Hospital – one of the five hospitals established after its decentralisation. Others are the Women and Newborn Hospital, the Eye Hospital, the Cancer Diseases Hospital and the Children’s Hospital.
“So the role of the accidents and emergency department is to receive patients, both the stable and the critically-ill. When they come, they are sorted out. Surgical cases are seen on the surgical side, those who are ambulant and stable are seen on the outpatient,” Chipowe explains.
She explains that due to the unplanned nature of patient attendance, the department provides initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention.
According to Chipowe, the most a patient should stay in her department is 24 hours.
From the time a critically ill patient arrives, her team works around-the-clock to stabilise them before passing them to other wards for further treatment.
She says the department receives patients from all over the country either as private cases or by reference from other health facilities.
“Once patients arrive, they are received by our porters and the security guard that is always there. They are brought at the triage or what we call the sorting area. So, there the doctors and nurses are there 24 hours and they will screen the patients and sort them out according to the urgency of the case,” she explains.
“There are colour codes that we follow; we don’t go by first come first serve. But we go by colour codes of how critical your case is. When the patient is very critical, they are regarded as a red patient and the red patients are seen first, immediately.”
Chipowe adds that for patients falling in yellow code, it means they are a bit stable and that they can wait for a minimum of an hour.
“But since the doctors and nurses are just there, they don’t go that far. They are seen within 20 or 10 minutes and those that are stable are seen last,” Chipowe notes.
The critical patients are straight away wheeled into the emergency room, which Chipowe says is equipped with pulsoximeters ventilators, suction machines, cardiac monitors for stabilisation.
After a patient is stabilised, they are evacuated either to the intensive Care Unit (ICU) or to the admission wards.
Chipowe observes that her department is critical to the hospital, little wonder staff levels are a little higher than other departments.
Since supervising such a busy department is not the easiest of duties, Chipowe considers the location of her office, situated near the entrance and wards, ideal so as to monitor and coordinate her team.
“We don’t have the luxury of remaining in our offices; you come in the office for 30 minutes, handle the administrative work but the fact that we are located close to the wards helps us as supervisors because every time, almost every hour, you pass through just to see what is happening,” she says.
Chipowe says the situation is not always stable in her department.
“It’s an emergency situation. So, any time, any minute you find that the people get overwhelmed. So, what we do is we redistribute the staff, we alarm each other when we receive alarm or suddenly we have a mass casualty or anything that is overwhelming we call for help from other departments,” Chipowe says.
“We are giving high standard care in a standard set-up because this is not high cost, it’s free for all. Those issues of high cost come in after we have stabilised the patients. We ask the patient where they want to be but before that, we just have to save the life of the patient and stabilise them.”
Chipowe points out the job of her profession and department, stressing that it: “calls for a lot of commitment, it calls for a lot of team work and sacrifice.”
“Sometimes we want to knock off even at 13:00 hours but when the place is overwhelmed, we go even up to 17:00 or 18: 00 hours it goes like that,” she explains.
She adds that many other times, nurses are called from their homes to return to duty, even when they are off.
Despite the load of work on her shoulders and the department, Chipowe is happy with support from the UTH management and the public.
She said only a fortnight ago, the Road Traffic and Safety Agency (RTSA) donated wheelchairs to the department which was then followed by a donation from first lady Esther Lungu.
Chipowe says her best moments of work are when her department saves a life that initially seemed lost.
“When you save a life, it just makes you knock off with a smile because you look at this person who looked they would die and then they survive. It is nice to see the smiles on the relatives’ faces, all panic going away all because of you; you feel good,” Chipowe shares.
The other thing that makes Chipowe smile is the fact that the place has been renovated.
She says her and workmates work in a clean environment and that they have achieved a lot, in terms of re-organising their systems.
“Previously it was like one bunch of service being provided but we have become a bit more organised,” Chipowe indicates.
For 2020, Chipowe looks forward to even improved services in her department, that is earmarked to receive 12 nurses who have been undergoing a trauma and emergency nursing course at Lusaka College of Nursing, within the precincts of the UTH.
“We have realised that this is the place where you are receiving people that are very critical and if we have to save lives, our skills should be very high, So, I’m glad to say that the first intake of those that we sent last year, the first ever in Zambia, have finished their training this December,” Chipowe explains.
“In January we are having them on board. So, our triage and emergency room will be manned by specialised trauma and emergency nurses.”
To motivate her team, Chipowe says the management is always monitoring and recognising hardworking nurses, promoting them and putting them in the forefront to enhance the image of the hospital and the nursing profession.
On attitudes, relating with the public, Chipowe observes that nurses are human who also have different personalities, pointing out that some are smiley while others are serious.
“What we mind about is ‘how is their attitude towards patients?’ Are they able to attend to them in a respectful manner and provide a respectful service at the end of the day? Of course, there may be bad eggs here and there,” concludes Chipowe.
“But all in all, what I would like to say is we mentor where we need to. We discipline where people go out of hand and we encourage. But as of now, most of our nurses are on track; they are enjoying their job, they are providing respectful care to patients and even if they don’t smile physically, some are smiling in their hearts.”
Story and pictures by Salim Dawood