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The new nurse:

By Ann-Margaret Lim Observer staff reporter

Sunday, January 11, 2004    

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The image of nursing that most adult Jamaicans have is that of textbook heroines, Florence Nightingale and Mary Seacole - selfless in caring for the sick, toiling through gruelling and sleepless nights to ease the pain of their suffering patients.

That image is steadily being eroded as nurses face a barrage of criticisms as being insensitive workers, hardened by the tough conditions under which they work and concerned more about getting better remuneration.

Most complaints emerge out of the maternity wards of public hospitals, especially the main Victoria Jubilee Hospital (VJH) in Kingston, the largest maternity facility in the English-speaking Caribbean.

"The nurses said that they treat the younger mothers differently because they are vulgar and careless," said one man who gave his name only as Wayne, speaking on behalf of his girlfriend who had her first born at VJH.

Wayne told the Sunday Observer his baby-mother was, fortunately, well cared for but said he understood the nurses' reason for callousness in some instances.

A 33-year-old vendor who had her last child at Victoria Jubilee, recalled being left unattended during child-birth and that a nurse only came 10 minutes after she gave birth.

"She was upset that I complained about the time and said that it was people like me who go on talk shows and complain," she said.

Maternity wards were not the only subjects of complaint. Tina, who lost her 76-year-old mother last year, was still bitter because of what she said was neglect at the public hospital where her ailing loved one was admitted.

"I would go to look for her and she would be lying in her urine, even though the nurses say they cleaned her. I had to beg people I knew there to keep an eye on her when I wasn't there, because I didn't feel comfortable that they were caring for her," Tina said tearfully.

She vowed that she would never send anyone she knows to that or any other public hospital.

Jennifer, whose adopted mother died at the Kingston Public Hospital, said she too was unhappy with the level of care and had to pay a woman to watch over her mother. She didn't blame the hospital for her mother's death, but said she noticed the insensitivity of nurses while she visited the ward.

Male interviewees who stayed at public hospitals, on the other hand, were satisfied with their care, stating that they even shared jokes with the nurses whom they found to be very attentive. Women were generally found to be harsher critics of the nurses.

Nursing tutors and medical practitioners who must work closely with nurses, blamed the coarsening of nurses on the general hardening of society and the shortage of nurses due to mass migration to higher paying opportunities.

In the first week of January, 117 new nurses joined the service, boosting the number of registered nurses employed by the Government to 1,754. The regional University Hospital of the West Indies employs another 502 nurses.

But hospitals islandwide complain that the number is woefully short, forcing nurses to work long hours under difficult conditions.

In respect of pay, a chief staff nurse grosses about $1.6 million a year and a level one nurse is paid $523,000 per annum, salaries which can't compete with similar jobs overseas where they are in great demand.

Dr Hermi Hewitt, senior lecturer at the Advanced Nursing Education Unit of the University of the West Indies (UWI), said she was aware of the "growing public perception that nurses are becoming insensitive".

Noting that nurses were created by society to provide care, she emphasised that patients should be seen as the real reasons for nurses' work and not as hindrances to it.

"There are too many public reports about nurses' non-caring attitudes, while caring is supposed to be the essence of nursing," said Hewitt, who noted that the grimacing faces of nurses too often betrayed the fact that they inadequately managed pain.

Heather Fletcher, head of the Northern Caribbean University (NCU) nursing school, traced the different calibre of students to the current moral fabric of Jamaican society. "Today's students come with more baggage than before. Their perception of nursing is different from 20-odd years back and our society does not have good mentors now as before, because many of them have migrated," Fletcher argued.

She said she hoped more nurses would stay to mentor the younger ones, who are now, upon graduation, being given the responsibility of manning a ward and were overworked mainly because of the low numbers of nurses.

Agreeing, Merl Rochester-Riley, matron at the Bellevue Hospital in east Kingston, noted that some nurses were inept and mainly in transit, using the profession primarily as a vehicle to go overseas. Some of them, she added, had not bargained for their huge workload.

But in defence of her charges, president of the Nurses Association of Jamaica (NAJ), Valda Lawrence-Campbell, insisted that the fraternity still emphasised caring, but was affected by low numbers, which bred overworked nurses.

The NAJ president appeared to get support from private medical practitioner, Dr Richard Gomes, who argued that every profession was affected by a growing insensitivity induced by decreasing purchasing power.

"People are less happy than before because our earning power has decreased significantly over time and so it will seem that money is more important than caring," Gomes said. "When compared to doctors, this may be more obvious in the nurses because they earn much less."

Gomes said that newer nurses and interns approached their profession as just jobs and hated working in the wee hours, pointing out that both nurses and doctors were now more stressed than before.

Opthalmalogist Kevin Scarlett added: "Nursing is a profession like any other, where you have bad and good, but generally they are still caring."

He emphasised that nurses had "financial and domestic problems, like everyone else".

But Antoinette Davis is one nursing student, determined to stay true to the old image of the caring nurse. Now in her third year, the 21-year-old switched from biological science to nursing at the end of her first year, after deciding that she wanted to be an "evangelical nurse".

"After the September 11th fiasco and the release of SARS, the respiratory disease discovered in Asia, I realised that more nurses are needed and I wanted to spread hope," Davis said.

She said that she wanted to open a nursing home for the elderly who are generally abused in nursing homes.

Pauline Atkins, a senior nurse at Bellevue Hospital said for her nursing was about saving lives. "Money is secondary and although we are short-staffed, we still concentrate on giving quality service," she insisted.

Retired nurse and registrar of the Nursing Council, Thelma Deer-Anderson, also saw the vocation as a ministry. She advised those approaching it as a job to "step back, because money is not the priority".

Apparently concerned about the state of nursing in the region, PAHO, the Pan American Health Organisation, has declared 2004 The Year of the Caribbean Nurse. PAHO communications advisor, Clare Forrester, noted, however, that Jamaica had not yet submitted activities to mark the year.

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