Healthcare reforms gives nurses a new opportunity to deliver care and play an integral role in leading change. Understanding these opportunities is just the first step, we need to know how we can be part of the solution to achieve better patients outcomes at a more reasonable cost. We need to do more to prevent disease; provide chronic care management to an aging, sicker and more diverse population; and offer end of life care that emphasize comfort and compassion across all settings- especially geriatrics- we must do more to prepare ourselves for the future. I will outline nine challenges that individual nurses and our profession MUST address if we are to help lead our country to a healthcare system that is more equitable and provides a higher quality of care.
- USE NURSE-LED INNOVATIONS
I believe that we Nurses know how to expand access to care and improve
quality at lower cost. There are many innovative care models developed
by nurses worldwide to prove it, including nurse-managed health clinics
and home visit programs for low income mothers. by emphasizing the use
of master's-prepared nurse to oversee care from the hospitals to within
the homes, this model has been effective in many countries and has
reduced re-hospitalization of elderly patients with multiple chronic
conditions. We need more nurses to develop innovations that will help
lead our country to a healthcare system that is more equitable and
provides a higher quality of care.
- GENERATE EVIDENCE AND ENGAGE IN RESEARCH
Nurse play an important role as innovators who help shape quality and safety. successful models aren't born, implemented, or sustained without solid effectiveness data. Its up to all Nurses to collect and track data to improve their own practice as part of broader efforts to improve care. Nursing research helps build the scientific foundation for clinical practice, prevention and improved patient outcomes. We must support nurse researchers through adequate funding. There are a few organizations here in Kenya and worldwide that will help fund a nursing quality research especially research that links evidenced-based nursing care to improved patients outcomes
- REDESIGN NURSING EDUCATION
ALL NURSES need to possess basic competence to meet the demands of an aging and diverse society, with an emphasis on clinical training in multiple setting across the lifespan. The emphasis should be on quality and safety, evidenced-based practice, research, and leadership. All this concepts should be incorporated in to nursing education including quality and safety in Nursing Education. A standardized program that will incorporate all level of nursing to be able to juggle between practice and school achieved by establishing e-learning modules and also shorter period for diploma holders to upgrade to degree e.g 2.5 yrs.
A standardized program would give nurses on-the-job learning and would better prepare them for clinical practice. Certification and continuous learning opportunities are essential to a profession that's responsible for others' lives.
Degree nurses in Kenya must be allowed to practice to full extent of their education and licensure. working with doctors, they can provide cost-effective care and help address the primary care shortage. However, statutory and regulatory barriers prevent them from practicing to the full extent of their licensure. there are many who can't take insurance due to the high healthcare cost. Nurses should be allowed to provide primary care they are trained to give.
To reduce health disparities, greater efforts must be made to ensure that the nursing workforce reflects the patients' diverse background and cultural values. Furthermore, all nurses should be educated to provide culturally competent care. Finally we need to have more men into the profession, provide scholarships to students from diverse background to attain a baccalaureate and masters degrees.
We must learn to use the newest medical technology and electronic documentation system to improve quality. Nursing schools should use simulation labs and take advantage of online classes to educate more students. Nurses worldwide are frequent technology users and so should we. more of us need to be at the table to help make decisions about designing and purchasing the technologies that help patients the most. There should be programs that provides a process that enables nurses to identify and apply technology solution to improve patient care
.
- FOSTER INTER-PROFESSIONAL RELATIONSHIPS AND COLLABORATIONS
Teamwork and collaboration are CRITICAL to seamless high quality care. The process begins with understanding the roles and responsibility of each healthcare discipline. Understanding- and the trust it fosters- must start in joint nursing and medical school training programs and continue as a cultural norm in practice settings. NOTE:
for quality health care the unity between doctors must exist. and if we are not doing our part of the reforms don't expect a doctor to do it for you. "mkono mtupu haulambwi" if you don't bring anything tangible to the table no one will praise you and if you don't participate in reforms doctors won't make them for you and that's how the musymi report was drafted.
- DEVELOP LEADERSHIP AT EVERY LEVEL
Nurses should have the opportunity to take on leadership activities whether they practice at the bedside or sit in the boardroom. They must believe they are capable and fully empowered to provide excellent care and make the changes necessary to improve ineffectual systems. I believe that doctors and administrators must support nurses in their effort. Most of all, nurses need to help each other through mentoring, educational and skills development opportunities and support networks, here is where we fail instead of supporting each other we fight whenever one of us want to compete for a leadership position with the doctors, we see our colleagues as competitors and that's we will remain stagnated and move in circle until we create order out of the chaos.
As the health care professionals most actively engaged in direct patient care, nurses are positioned to provide leadership in a;; healthcare areas, including developing systems to reduce medical errors, improving quality, providing better care, coordinating, increasing access to care and averting. We have left the doctors to do this for us and its quite a shame. Doctors are the ones drafting proposals to increase access to care, coordinating what is to be done in most hospitals and also proposal for providing cheap accessible and quality healthcare. Let us also draft our proposals and develop our own policies. I am a believer of good work never goes unrewarded thus if your proposal is the best no one will shoot it down without it fighting for itself.
TEAMWORK AND COLLABORATIONS ARE CRITICAL TO SEAMLESS HIGH QUALITY CARE
In the health sector in Kenya their is an enormous shortage of health care workers yet clinical experience isn't enough, some of us must serve as board members and chair committees. To be a successful and knowledgeable board or committee members, nurses must be familiar with GOVERNANCE, STRATEGY, FUNDRAISING, FINANCIAL SYSTEMS, HEALTH LAW AND POLICY. Always say "YES" when asked to be at the table. If you believe you are ready but haven't been asked, then ask to be involved in a board or committee of interest. There should be programs that should be working to bring more nurses into leadership position at the local, county and national levels. At the end of her life, Florence Nightingale said
" May we hope that when we are all dead and gone, leaders will rise who have been personally experienced in the hard, practical work, the difficulties and the joys of organizing nursing reforms, and who will lead far beyond anything we have done." Take her words to heart and prepare your self to contribute to the reforms that will take place in our lifetime. WE HAVE MUCH TO CONTRIBUTE
The author of this document is a finalist Nursing student of the University of Nairobi.
