Burnout

The burnout syndrome frequently occurs in people-work settings where staff spend enormous time directly involving themselves with other people (Maslach and Jackson, 1981). Job burnout, a syndrome of exhaustion, depersonalisation and inefficacy, is a term used to capture nurses´ prolonged response to emotional experiences in the work place that are chronically stressful. Nurses in the clinical area take on responsibilities which have “long been regarded as stress-filled based upon the physical labour, human suffering, work hours, staffing, and interpersonal relationships that are central to the work nurses do” (Jennings, 2008). Worth to note, is a popular quotation in many burnout texts that accentuates the ability of nursing work to expose nurses to chronic emotional stress:

Everyday the nurse confronts stark suffering, grief, and death as few other people do. Many nursing tasks are mundane and unrewarding. Many are, by normal standards, distasteful and disgusting. Others are often degrading; some are simply frightening. (Hingley, 1984: 19)

The nurses´ experience continues to be described as demanding and overwhelming (Maslach, Shaufeli and Leiter, 2001; Harrowing, 2011). The ethical dilemmas posed in caring for terminally-ill patients are stressful (Martin, 1990). Nurses working in Ugandan public health facilities describe the events at work as “the irreversible maelstrom of events and circumstances that both culminates in a healthcare system in chaos and also leaves their professional values and assumptions in tatters” (Harrowing, 2011). Though nurses love their work, they feel powerless and seem not to avoid burnout (Billeter-Koponen and Freden, 2005).

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Musawo, yes I am!

Graduate still on holiday, waiting for internship!!

Transition from student to professional

The good Lord has brought me this far … The feeling that I amgraduating soon is exhilarating. I am thankful … 

I am glad to be joining the nursing workforce. This year 2012, the nurse-patient ratio in Uganda is 1: 3,000. I, just a student nurse near the completion of my course, would seem insignificant in making a difference. However, I feel I am now empowered to make a remarkable contribution to healthcare in Uganda; this is what I long for, and it is the path toward which am treading.

That is the response I gave to a friend who asked me about how I felt about the fact that I would be graduating soon. I doubt I will be feeling that way in the near future if uncertainties continue to display their ugly face … 

DREAMS OF A STRANDED STUDENT

DREAMS OF A STRANDED STUDENT.

My colleague in our soon-to-graduate nursing class …

Nursing …

RANDOM THOUGHTS

I serve in a hospital. Health systems worldwide leave a lot to be desired even in the so-called developed countries. There is always that one something missing. Something missing in the touch of a skilled physician or in the eyes of an empathetic nurse. Something Florence Nightingale did not see coming. Probably then when she saw the wounded men of war she had thought that she could bring them a glimpse of hope or just prepare them for a decent death. She had thought that her compassion for the sick and dying would be carried on by the young women…..and later men she had mentored so gracefully. She must have had a big dream and for several years that dream had almost come to pass. The health system had been the delight of the world. Great physicians, amazing nurses and all those who make the big bubble of health…

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Reducing patient waiting time in Kisenyi Health Centre III…

I have been working in Kisenyi health centre III for the last three weeks. It works on out patient basis. The encounters with the patients have been so interesting because the place is more community based compared to the settings I have previously been in.

As it is with every government facility, the patients flood the place, the cues are long and waiting times are overwhelming. I have to confess that at most times I was in Kisenyi, I have not looked at patients holistically but have instead been looking at and addressing specific medical needs so as to reduce on the patient waiting time. As we were being oriented, the nurses seemingly communicated to us that the less time you spend with a patient, the less the waiting time for other patients who are in the cue. Emphasis was that at the end of the day everyone goes home attended to, a small share of what the government has to offer. Sounds interesting, doesn´t it? But this experience made me feel very ineffective…

I worked at the triage station for the start. One at the starting point has to be very fast, and this time it was me. As the pressure piled on me for being slow (actively listening to patients), before I knew it I was already adapting to what the staff there were doing. There is no time to listen to what seems irrelevant, in fact, at one point I found myself hurling the same questions to patients: name? age? village?…as I registered them, and after some reflection it did not make sense. But I had registered and may be triaged 80 patients in one hour.

I left that station and went to the young child clinic, the  routine continued, and there it was about asking: child´s card? child´s age? breast feeding well? diarrhoea? measles?, then I would record vaccines and immunisation shots to give. After administering I would tell the mother the return date for the next immunisation. And ask the next mother for her child´s card and so on and so forth. I would also give measles vaccine to all infants above six months because there was an epidemic in Kampala district. There was not a single genuine conversation with a patient

To be continued…

The humane face of nursing… but nurses love their work

Previously, I shared a typical day of a Ugandan nurse from an objective perspective. This quotation, found in most nursing literature accentuates nursing more:

 

“Everyday the nurse confronts stark suffering, grief, and death as few other people do. Many nursing tasks are mundane and unrewarding. Many are, by normal standards, distasteful and disgusting. Others are often degrading; some are simply frightening.” Hingley, P. “The humane face of nursing,” Nursing Mirror, No. 159, 1984, pg 19-22.

 

But Harrowing argues that Ugandan nurses reiterate that burnout, and the departure from nursing that often follows burnout, is not an option because of the life-threatening risk that their leaving nursing represents for patients who will be “left to die.” Despite all this, nurses their work…

I will be finishing my 4-year course in June. I am looking forward to joining the workforce that is the backbone of Uganda´s health system


Mulago is the national referal hospital of Uganda.

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