What Shallom Hospital concertina-like incidences ought to remind us

Shallom Hospitals concertina-like incidences ought to remind us of how far we could have fallen as a profession.  When I first wrote about this a couple of weeks ago little did I know that this was going to be a space to watch.  There comes a time when systems can collapse on us.  WHEN THE SYSTEMS COLLAPSE ON AN INDIVIDUAL INSTITUTION IT IS NOT ENOUGH TO SAY THAT … ENOUGH TO SAY THAT THE INDIVIDUAL IS MAD ENOUGH TO SAY THAT HE IS NOT.  It was unfortunate that Shallom Hospitals had become the epitome of all that could go wrong in a health care system.

To me, closing down the facility is denying the public access to health care in a place of their choice. The public know the truth that things may not be any much different anywhere around and that was why they continued to flock into the facility inspite of previous negative reports.  As a medical fraternity, we have failed to protect the public but instead we are busy fire fighting and doing damage control.  Supposing it was a public hospital, could we have closed it?

Like an accordion, if one were to unfold each of the incidences including the St. Teresa Kiambu, three tunes could carry the day – one: laisez’ faire supervision, inept regulation and carefree attitude among some medical staff (including nurses).  But like we have seen these things are all over.

I will be quick to also put across a valid point to those county officials rushing to do damage control in response to each social media expose of our health care system.

About Baby Ethan’s (R.I.P) case it was pure incompetence on those involved if it is true that they gave Morphine x20 the dose as a first line pain reliever without observing due diligence.  A sheer lack of professionalism on the clinician, the pharmacist and the one who administered the drug.  But then we need to do a background check of those staff. Today we have the eight zero-five-staff (report at 8 am, do nothing the whole day and leave at 5pm) but we also have 8-Zero-five students who are not in touch with what is going on in class.  I want to believe those three staff came from these two categories. They have had absolutely no exposure to learning what their job entails and did not care to.

Concerning the earlier case. First and foremost labour and delivery is a natural process for all beings. Delivering unassisted, unattended could happen and unfortunately does happen in instances of poor nurse to mothers ratios, limited facilities and in precipitate labour, or in instances when the mother comes in too late with the presenting part crowning.  Labour being the natural process it is, too late could mean the delivery taking place in the odd, awkward and the out-of-place to a 4-star birthing suite on the other extreme.  For such a noble event in the life of the mother and baby, Our Lord Jesus Christ was born in a manger.

Coming back to ratios, if 10 mothers were to start pushing at the same time and there were only two midwives and two delivery couches then the staffing is outstretched and patient safety is at risk.

Let me begin with an analogy:-

Image result for concertinas picThe analogy of an accordion has many tunes depending on which cord – depicting some of the horror incidences that play out from time to time in the health system. But how loud, how frequent? It could also be that the  orchestra was playing in our backyard all the time but may be no one was paying attention, but worse no one was pointing it out. Social media was like having its’ ears on the ground for any sort of vibrations.

 

(Photo courtesy of Citizen digital)

If peer reporting was encouraged among the staff then Machakos Governor H.E Mutua could realize that the cord that was struck is indeed an orchestra playing in his backyard, but no one is listening.  Threats of Watajua Hawajui reassures no one, least of all the  residents of Machakos.

[Photo courtesy of pulselive.co.ke]
How many such or worse go unreported?  Especially in public hospitals.  Thank God we now have citizen journalism in the name of social media.  All the more reason we need to be extra vigilant.  There are a lot of good things happening in health care but bad news travels fast. Nurses must note that social media is invincible, unforgiving and not a respecter of persons; let us learn to use it to our advantage.  We did a paper on some health sciences students in relation to social media online safety.

But more importantly when did the rain start beating us? This is what I feel and I could be completely wrong at that, but would be happy to hear a counterargument.

The day when those running our regulatory bodies, unions, hospitals, colleges and universities saw that papers were more relevant than skills and attitude is the day we lost it.

Many of those in the portfolios mentioned above have some common characteristics:

One _ they hold positions e.g. Nurse leaders, Nurse managers, Tutors and Lecturers in nursing;
Two_ they loathe direct patient care at the bedside/operational level;
Three_ these are the people driving the nursing agenda in Kenya.

For a good number nursing was about positions of influence (mis) using others as a ladder, it’s not in the heart. You can only expect the same or worse of the generations they mentor.

I will use  this to advance my copyrighted mid-range theory postulates that: Nursing was now less of who was  the nurse, why they became nurses or, where one was trained, but had much to do with where one would work – by Compleat Nurse©

Consider this example: The same individual will practice on the same day two different standards of care depending on where (e.g. when alternating full time in the public hospital with a locum in amenity wing or a private hospital).  If this theory stands we can start to imagine of an individual who is practicing at any given time in the ‘perceived wrong’ place’.  Place here can mean being in a Kenyan hospital – public or otherwise. But it could also be a misplaced person in the nursing profession (wrong place-wrong person).  If this was so then we are likely to be having have several misfits here, but once they get ‘well’ placed, you can hardly imagine it is the same person.

That is nursing for you, and this paradigm was unlikely to shift any time soon.

I have always advocated for nurse autonomy and my stand has not changed but we cannot afford to fire-fight Shallom-like incidences all the time.  Mark you these are the reported cases that the public take up.  If we were to do peer reporting we could mitigate on some …, or prevent others.  Could this be possible here?

 

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