Is it already February? Am I just getting older, or is time really going faster?
My time at St. Francis is drawing to a close and, after a year of living in Zambia, it is hard to “wrap things up” without a huge nshima pot of emotions sticking to everything.
I told my nursing class this morning that I only have two more weeks left with them. It appeared as if I had told them the sky wasn’t blue, it was purple, and that it was falling. People actually gasped, and the puppy-dog eyes made me almost tear up, so I quickly made a joke, which changed the mood and they laughed and applauded.
Now that people know I’m leaving, I get the ‘sorry-to-see-you-go’ and all that, but I also get the “what are you leaving me in remembrance of you?” I’m told by everyone from slight acquaintances to very close friends that I should leave them my stethoscope, my uniforms, camera, refrigerator… They mean well.
I’m looking forward to coming home, there are plenty of things I miss and plenty of things I want to do in Canada. But I will miss this place and these people very much, and already I feel it pulling me back.
I can’t explain what it’s like to be here for a year, it’s something you can only experience. I can try to explain the symphony of insects at night, some sounding like bubbles popping, other like floating glasses tinkling into each other, I can try to describe the peacefulness of thunderstorms or the smells of the market, but all this will just end up as poetry. These things have created their own special place in my heart, and pictures and words can never express them fully. That’s the goodness of it, as we say.
What I can do is write never-ending lists of things I’ve realized, things I love, and things I’ll miss. Not included will be ‘things I’m frustrated with’, though I feel I have written enough of that, and will save it for a more productive use.
Here’s a list of “Things I’ve Realized”. Many (but not all) are also “things I love” and things I’ll miss”; so think of it more as a compiled list, save me the typing.
Things I’ve realized:
1. You can never eat too many mangoes.
2. There is no such thing as too many greetings, even if you say them all in a row “How are you? How is your family? How is work? How is the day going? How is your husband? How is his work? How are you finding Zambia?...Otherwise, you’re okay?”
3. Not all ants bite.
4. Those small black ants that like to live in your house are among the worst, and will make your finger swell up and itch like crazy for 3 days.
5. You have not eaten unless you’ve had nshima. Even if you have had rice, potatoes, pumpkin, etc, you have yet to have your meal of nshima.
6. The Zambian concept of time is different from Canadian/Western time.
7. Earplugs are a necessity on 6 hour bus rides.
8. 6 hours of continuous Celine Dion is worse than super loud wrestling footage. Her songs just ‘go on and onnnn’.
9. You don’t need an alarm clock to wake up at 5am on a Monday. The crows landing heavy-footedly on your tin roof serve the same purpose, and are just as reliable.
10. Cheese-flavoured Jiggies actually taste pretty good.
11. Ask a yes-or-no question, and you will always get a ‘yes’ response.
12. Ask a non-yes-or-no question, and you will always get a ‘yes’ response.
13. Flying ants kind of taste like bacon.
14. You have an 80% chance of being peed on if you hold a baby.
15. Never ever count on having power at any time of the day, especially during supper time.
16. Always accept any gifts given to you, even if you already have three bags of groundnuts. Even if you’re allergic to groundnuts.
17. “Sorry, but I’m married” is not a deterrent, and is taken more like a challenge…
18. Mini-bus drivers could win “World’s Worst Driver” every time. Hands down.
19. You don’t need an invitation, even an excuse, to visit someone or have dinner with them, and they will gladly welcome you every time.
20. Wherever you go, you will eventually find a family, feel loved, and have support.
21. Laughter is the best medicine. Panadol comes a close second.
22. Two lumps of nshima twice a day will make you fat. Apparently, it will also help you to have twins.
23. The only thing worse than getting stuck in the back of an overcrowded, 6 hour long bus ride without earplugs or proper ventilation is having intestinal issues at the same time. Or… listening to Celine Dion for the entire trip.
24. Zambian nursing students will write down EVERYTHING you put on a powerpoint, even “Do not write this sentence in your book”…
25. Visiting “big shots” from the donor community bring out a whole new level of butt-kissing.
26. Nothing can kill a cockroach.
27. African babies and children have more patience than the average Canadian adult.
28. A man holding hands with another man is normal, but a man holding hands with his wife is offensive.
29. You can fit 9 people into a taxi, and 7 plus at least one child is standard.
30. It's not rude for a man to scratch or hold his crotch while talking to someone, or even while shaking hands with them… provided it's the other hand.
31. Picking your nose is acceptable, even while flirting with someone or cooking for them.
32. Swearing is NOT acceptable.
33. Asking direct questions is a bit rude and giving direct/clear answers is never expected.
34. Praying lots and being thankful to God and humble is ordinary.
35. If you avoid Zambians that are involved in public transport, you'll almost always like them.
36. If you're friendly to the ladies selling produce in the market you will get an extra fruit or vegetable.
37. When someone makes a joke, they expect you to slap their hand and then hold it for a while, and it's actually nice and makes perfect sense.
38. Everyone wants to do more schooling, regardless of how educated they are and whether or not they're employed.
39. Helping others is not optional.
40. There is an entire new dimension to what I thought of the words ‘suffering’, ‘love’, ‘forgiveness’, and ‘faith’; and I have learned so much from and am so humbled by these incredible people.
41. No matter how long I practice, I will never be able to shake my butt like a Zambian woman.
Thursday, February 3, 2011
Monday, January 31, 2011
Gender Violence
Tuesdays are clinical meeting days at the hospital, and various departments present a topic to the rest of the staff.
Last week, our social worker and security head talked to us about gender violence. At home, I’d often go to discussions on topics like this; professors and guest speakers would talk about Africa and poverty and AIDS and human rights, and I’d be there, taking it in, blood boiling from all the injustices throughout the world, wondering why these things are still happening, why it seems like even worse things continue to happen. Aren’t we supposed to learn from our mistakes? Isn’t it common sense and only human to think of all people equally, be they women, children, black, white, rich, poor?
The thing about common sense is that it’s not so common.
Here’s the thing about gender violence. It’s everywhere, it affects everyone, and it is going to take huge shifts in all aspects of society to change it.
In Zambia, gender violence is very real. Come spend some time at the hospital and see for yourself. After a few assault and rape cases, impressed with these women for coming forward, even contacting the police, I am left wondering just how many more are in the community, afraid to come for help, afraid of losing everything.
Gender violence, and I’m not just talking about physical assaults, seems to be “built into society and culture” (words from our social worker). I’ll give you some examples of the male dominance of Zambian society.
Education: Exam standards and requirements are higher for boys than girls. This reinforces a stereotype that boys are more intelligent and work harder, and more is expected of them. They will expect more of themselves, and push themselves to reach that set point, whereas girls are expected to do less well, and don’t expect to reach high results, and won’t push themselves as hard. I see this in our nursing school – the number of boys is higher or equal to that of girls (even though national guidelines say to favour girls). More boys apply, and with higher marks. I asked one of the tutors about this and his reply? “Boys just have that drive, they try harder.”
Bride Price: When a man wants to marry a woman, he goes to the woman’s family and negotiates a fair ‘price’. Typically, this has been in terms of cattle, but has more recently moved to a cash payment. Though this is traditionally to be viewed as an exchange for the family's loss of the bride's labour, etc, it has the effect as labelling women as 'commodities', a good owned by the husband.
Polygamy is common. Here, there is a discrepancy between national and ‘traditional’ law. More than one wife is okay by traditional law, whereas it is considered bigamy by national law. This is one of many discrepancies between national and traditional law, and these inconsistencies lead to a lot of bureaucracy, which pretty much makes both laws pointless. Anyways, men will often look for a second wife (“to help the first wife” they say), and this new wife becomes the spoiled one, whereas the first wife is basically a slave. If you are poor and unemployed and have the chance to marry someone who can support you while another woman does most of the work, why not?
Reporting assaults and rapes: Will it change anything? Better question: will it make things worse?
1. Police and victim services are often ineffective in these areas. There is an example of a mother who terminated a pregnancy and died. Lots of people came forth to testify, saying they knew the one (healer) who does this (it’s happened before), where he stays, etc. The police were told, but nobody followed up; the excuse from the police being that the woman is dead and cannot be a witness, so there is no evidence…
2. If a woman is poor and unemployed, and she reports her husband (and something is actually done about it), who will look after her and the children? She is in a very subservient position, with little power and no voice.
There was a situation in which a 14 year old girl came to the hospital to deliver. She was married. After the baby was born, the question came up – should the husband be charged? She isn’t of legal age, this is considered “defilement”, yet the girl told them not to arrest him, they were happy. I don’t know the outcome of this one, but I do know how it would have ended if this weren’t Zambia. A 14 year old mother!
There are many other smaller things that demonstrate and promote female inferiority -distribution of household chores and farm work, men eat first and inside at the table while women and children eat last and outside in the kitchen, a woman is expected to follow her husband in every way, and is taught at a very young age how to please and serve him. A nursing officer just spoke to me today about which church I attend. When I mentioned that my husband’s family is Anglican, she said, “Then you should also be Anglican, you should follow your husband.” I explained that we have found our own church together – she seemed okay with that, though a bit confused.
Included in the entrance forms for the Midwifery School here is permission slip – to be signed by the student’s husband, granting her permission to pursue higher education.
A Zambian work permit has provision for the bearer’s wife (not ‘spouse’ or ‘husband’), and even has extra pages for additional ‘wives’.
There are many things that need to change to bring about gender equality and an end to gender discrimination and violence, the issue is very big. A lot of changes need to happen in term of policy, and unfortunately, most governments throughout the world only care about making their voters happy… and Zambians go to the polls later this year.
As with everything, it all begins with a shift in thinking and a shift in attitudes. And, as Mrs. Seya keeps telling me, “Attitudes are the hardest thing to change”.
Last week, our social worker and security head talked to us about gender violence. At home, I’d often go to discussions on topics like this; professors and guest speakers would talk about Africa and poverty and AIDS and human rights, and I’d be there, taking it in, blood boiling from all the injustices throughout the world, wondering why these things are still happening, why it seems like even worse things continue to happen. Aren’t we supposed to learn from our mistakes? Isn’t it common sense and only human to think of all people equally, be they women, children, black, white, rich, poor?
The thing about common sense is that it’s not so common.
Here’s the thing about gender violence. It’s everywhere, it affects everyone, and it is going to take huge shifts in all aspects of society to change it.
In Zambia, gender violence is very real. Come spend some time at the hospital and see for yourself. After a few assault and rape cases, impressed with these women for coming forward, even contacting the police, I am left wondering just how many more are in the community, afraid to come for help, afraid of losing everything.
Gender violence, and I’m not just talking about physical assaults, seems to be “built into society and culture” (words from our social worker). I’ll give you some examples of the male dominance of Zambian society.
Education: Exam standards and requirements are higher for boys than girls. This reinforces a stereotype that boys are more intelligent and work harder, and more is expected of them. They will expect more of themselves, and push themselves to reach that set point, whereas girls are expected to do less well, and don’t expect to reach high results, and won’t push themselves as hard. I see this in our nursing school – the number of boys is higher or equal to that of girls (even though national guidelines say to favour girls). More boys apply, and with higher marks. I asked one of the tutors about this and his reply? “Boys just have that drive, they try harder.”
Bride Price: When a man wants to marry a woman, he goes to the woman’s family and negotiates a fair ‘price’. Typically, this has been in terms of cattle, but has more recently moved to a cash payment. Though this is traditionally to be viewed as an exchange for the family's loss of the bride's labour, etc, it has the effect as labelling women as 'commodities', a good owned by the husband.
Polygamy is common. Here, there is a discrepancy between national and ‘traditional’ law. More than one wife is okay by traditional law, whereas it is considered bigamy by national law. This is one of many discrepancies between national and traditional law, and these inconsistencies lead to a lot of bureaucracy, which pretty much makes both laws pointless. Anyways, men will often look for a second wife (“to help the first wife” they say), and this new wife becomes the spoiled one, whereas the first wife is basically a slave. If you are poor and unemployed and have the chance to marry someone who can support you while another woman does most of the work, why not?
Reporting assaults and rapes: Will it change anything? Better question: will it make things worse?
1. Police and victim services are often ineffective in these areas. There is an example of a mother who terminated a pregnancy and died. Lots of people came forth to testify, saying they knew the one (healer) who does this (it’s happened before), where he stays, etc. The police were told, but nobody followed up; the excuse from the police being that the woman is dead and cannot be a witness, so there is no evidence…
2. If a woman is poor and unemployed, and she reports her husband (and something is actually done about it), who will look after her and the children? She is in a very subservient position, with little power and no voice.
There was a situation in which a 14 year old girl came to the hospital to deliver. She was married. After the baby was born, the question came up – should the husband be charged? She isn’t of legal age, this is considered “defilement”, yet the girl told them not to arrest him, they were happy. I don’t know the outcome of this one, but I do know how it would have ended if this weren’t Zambia. A 14 year old mother!
There are many other smaller things that demonstrate and promote female inferiority -distribution of household chores and farm work, men eat first and inside at the table while women and children eat last and outside in the kitchen, a woman is expected to follow her husband in every way, and is taught at a very young age how to please and serve him. A nursing officer just spoke to me today about which church I attend. When I mentioned that my husband’s family is Anglican, she said, “Then you should also be Anglican, you should follow your husband.” I explained that we have found our own church together – she seemed okay with that, though a bit confused.
Included in the entrance forms for the Midwifery School here is permission slip – to be signed by the student’s husband, granting her permission to pursue higher education.
A Zambian work permit has provision for the bearer’s wife (not ‘spouse’ or ‘husband’), and even has extra pages for additional ‘wives’.
There are many things that need to change to bring about gender equality and an end to gender discrimination and violence, the issue is very big. A lot of changes need to happen in term of policy, and unfortunately, most governments throughout the world only care about making their voters happy… and Zambians go to the polls later this year.
As with everything, it all begins with a shift in thinking and a shift in attitudes. And, as Mrs. Seya keeps telling me, “Attitudes are the hardest thing to change”.
Tuesday, January 18, 2011
Depression in Africa
It’s Monday morning, and I hear the faintest knock at my door. It’s one of the first-year nursing students, I happily invite her in, and she sits down for a chat with me.
"Sorry to disturb you, I won’t be long, it’s not very important.
What could be the reason for feeling sad all the time?
I wake up and have no energy, all I feel is weakness.
I’ve tried to talk to my roommate about this, but she just tells me I’m being moody. The problem is, this has been continuous; it doesn’t go away.
*tears come*
I can’t talk to anyone about this, we’re not that free, not even my aunty, and I call her mom. I only have one good friend, she’s also in nursing school, but she’s in Kitwe, so we don’t see each other.
Even when I go home I feel this way, I don’t know what it is that’s making me feel like this…
Is there anything that can help me? What can I do?"
I give her a hug as she leaves my office, tell her to come back again so we can talk about this some more, and give her some options and words of encouragement in the meantime.
This poor girl. She’s far from home, doesn’t have many close friends, and is struggling with this sadness in a culture where depression is seen as a weakness and not a disease. I’m glad she can talk to me, but I can’t imagine how alone she must feel.
How many other young women feel this way? How many feel free enough to talk about it, and with whom? What support is there for them?
Perhaps things are changing in Africa with regard to how we look at mental illness, but there are many firm-rooted beliefs that involve demons, curses, or just the notion that becoming depressed is the way that people with poor stamina deal with life's challenges. This way of thinking prevents us from treating any form of mental illness, since some higher power has caused this condition. Of course, I don't want to fiercly oppose traditional healers or argue over the power of prayer, I'm just saying, as with everything, we need to find the right balance.
"Sorry to disturb you, I won’t be long, it’s not very important.
What could be the reason for feeling sad all the time?
I wake up and have no energy, all I feel is weakness.
I’ve tried to talk to my roommate about this, but she just tells me I’m being moody. The problem is, this has been continuous; it doesn’t go away.
*tears come*
I can’t talk to anyone about this, we’re not that free, not even my aunty, and I call her mom. I only have one good friend, she’s also in nursing school, but she’s in Kitwe, so we don’t see each other.
Even when I go home I feel this way, I don’t know what it is that’s making me feel like this…
Is there anything that can help me? What can I do?"
I give her a hug as she leaves my office, tell her to come back again so we can talk about this some more, and give her some options and words of encouragement in the meantime.
This poor girl. She’s far from home, doesn’t have many close friends, and is struggling with this sadness in a culture where depression is seen as a weakness and not a disease. I’m glad she can talk to me, but I can’t imagine how alone she must feel.
How many other young women feel this way? How many feel free enough to talk about it, and with whom? What support is there for them?
Perhaps things are changing in Africa with regard to how we look at mental illness, but there are many firm-rooted beliefs that involve demons, curses, or just the notion that becoming depressed is the way that people with poor stamina deal with life's challenges. This way of thinking prevents us from treating any form of mental illness, since some higher power has caused this condition. Of course, I don't want to fiercly oppose traditional healers or argue over the power of prayer, I'm just saying, as with everything, we need to find the right balance.
Monday, December 27, 2010
Merry Christmas
This month, instead of telling you all how much I miss you, how different the weather is, or how it is impossible to find a turkey in Zambia, I’ll instead share with you some Christmas cheer – things that have/are making us happy, and why this year has been so important and amazing for us.
Discovery. Entering a different culture is exciting. Sharing knowledge and experiences is so rewarding, and eventually, after a LOT of learning, you reach a point where you can finally relax and (almost) fit in with the people around you. Things aren’t as hard as they were, and little things like not hesitating to greet everyone you pass on your way to work, and drawing water every day for your bath are just another great part of your day. Yesternight (a Zambian saying), a co-worker told me how impressed he was with my language, and said, “you even speak like a Zambian now”. That made my day. You also discover things about a different prace and people (like constantly mixing up ‘l’s and ‘r’s), that are hirarious, and you eventually do the same things without lealizing it, only until someone from home catches you.
Patience. Is a common name here. But also, it really IS a virtue, and no one knows it better than Africans. Take it easy, relax, things will be okay. Though I do think this can be a bit detrimental in some situations, Ben and I have learned a lot about this word. I waited months and months to finally be registered with the nursing council. As I write this, we’re waiting for our neighbours to come by so we can go help them buy school uniforms. They’re already an hour late. Nothing comes on time, and you just deal with it. If things don’t fall into place like you have planned, it will still be okay. Maybe even “better than okay” (another Zambian saying).
Laughter. Say something remotely funny, and you’ll get roaring laughter and hand slaps, especially from old women. Show any sort of interest in a group of kids, and you’ll have an entourage of under-10’s wherever you go, ready to turn and run screaming if you give in and play with them.
Community. Walk anywhere at any time of the day, and you’ll see people sitting in the shade on their reed mats, chatting as their hands busily shell groundnuts or maize. Walk past a church group practicing their music, with drums and shakers and dancers – and they gladly welcome you to join or just listen. Visit anyone, anytime, and always receive the warmest welcome. Have 40 neighbour kids know your name as Uncle/Aunty Stephan, every elderly person is grandma/grandpa, and your closest neighbours treat you like a brother and sister. It’s more than community, it’s family.
Hope. Another common name here, along with Mercy, Gift, Joy, Peace, …Fatness (not kidding). There is poverty and malnourished babies, young people die from AIDS, and things really are stacked against people who want to have a better life than this. Despite all the obstacles and adversity, there is a lot of hope. A lot of determination and tenacity as people try to overcome corruption, disease, financial hardship, gender inequalities, and traditional expectations. People have innovative ideas, ambition, and a lot of optimism about the future of their country, despite the struggles of their past/present. It’s so encouraging and wonderful.
We’re both so lucky and happy to be here, words and pictures aren’t enough to tell you what it’s like for us. Thank you for all your support and thoughts and prayers while we’ve been in Zambia, we both really appreciate it and always look forward to even the smallest email or facebook message.
This Christmas, we’re celebrating in Lusaka. A friend has graciously let us stay in their house and look after their dog and cat and pool while they are traveling. So we’ve been “out on the town” here, going to the movie theatre to see Harry Potter, eating ice cream and muzungu food, and enjoying the sun by the pool. On Christmas Eve, Ben and I and a friend had a nice lamb dinner here, then joined two friends and went midnight mass (at 9pm) at a huge Catholic church with 500+ other people. It was so great, we sang carols, there were 2 choirs, and we danced our way out of the church 2.5 hours later. Ben and I came home and watched a bit of The Polar Express and opened one gift. On Christmas day, we were happy to see that Santa had come, then we relaxed by the pool. We had 9 people over for Christmas dinner, and we ate and ate and ate and played games and drank wine. It was nice to celebrate with friends and have a traditional Christmas. Zambians do celebrate Christmas, but there aren’t any big traditions, and to most people, especially in rural areas, it’s not a big celebration at all. Only when you get to Lusaka and enter the big new fancy mall will you see decorations and hear Christmas music. It’s nice if you don’t like the commercial part of Christmas, even though you lose some of that Christmas-y feeling. The tropical surroundings don’t help that either, but I’m not complaining!
MERRY CHRISTMAS!!
Sunday, December 5, 2010
Flying Ants!
It’s the first big rain of the season, and I try (unsuccessfully) to stay dry on my walk home, jumping over puddles like a not-so-graceful kangaroo mouse. I arrive home completely drenched and muddy, but entirely happy. I was the kid who had to be pulled out of her rubber boots in the middle of the biggest puddle on the farm.
Later that evening, I’m called from my house by my neighbor, Katie. “Staphy!! Come and see the ants!” I’m puzzled as to why she sounds so excited – ants are everywhere, always, and there are plenty of fascinating insects to take your attention away from an ordinary ant.
Regardless, I am intrigued, and dash outside to see what the excitement is all about. I’m met with millions of flying ants zipping through the air, and Katie in the middle of them, a huge smile across her face. All you can see is flying ants, all you can hear is flying ants, all you can feel is flying ants! I nervously venture out my door to join her in this amazing flying frenzy, and feel as though these insects could at any moment coordinate an organized attack and lift the both of us right off the ground. I resist the urge to run inside and hide under my net. Katie explains to me that this happens once a year, after the first big rain, and everyone is so happy to see these little creatures. I ask if she eats them. “No, these are just the small ones, but I’m still happy to see them!” “Do they bite?” I ask. She assures me they don’t. We chat a bit more then go back to preparing supper.
A few minutes later, Katie calls again, this time not really making any words because she is running and laughing. I run outside, and she is awkwardly trying to catch some flying thing outside my door. She is successful, and brings her trophy to show me. “This is the one you eat”, she explains breathlessly as she shows me the inch-long flying ant (termite) in her hand. She tells me that she personally doesn’t like them, but makes them for her husband (it’s his favourite). This is followed by a sharp yelp, as the “non-biting” flying ant bites her thumb. She throws it on the ground, and we both burst out laughing.
Later that evening, I’m called from my house by my neighbor, Katie. “Staphy!! Come and see the ants!” I’m puzzled as to why she sounds so excited – ants are everywhere, always, and there are plenty of fascinating insects to take your attention away from an ordinary ant.
Regardless, I am intrigued, and dash outside to see what the excitement is all about. I’m met with millions of flying ants zipping through the air, and Katie in the middle of them, a huge smile across her face. All you can see is flying ants, all you can hear is flying ants, all you can feel is flying ants! I nervously venture out my door to join her in this amazing flying frenzy, and feel as though these insects could at any moment coordinate an organized attack and lift the both of us right off the ground. I resist the urge to run inside and hide under my net. Katie explains to me that this happens once a year, after the first big rain, and everyone is so happy to see these little creatures. I ask if she eats them. “No, these are just the small ones, but I’m still happy to see them!” “Do they bite?” I ask. She assures me they don’t. We chat a bit more then go back to preparing supper.
A few minutes later, Katie calls again, this time not really making any words because she is running and laughing. I run outside, and she is awkwardly trying to catch some flying thing outside my door. She is successful, and brings her trophy to show me. “This is the one you eat”, she explains breathlessly as she shows me the inch-long flying ant (termite) in her hand. She tells me that she personally doesn’t like them, but makes them for her husband (it’s his favourite). This is followed by a sharp yelp, as the “non-biting” flying ant bites her thumb. She throws it on the ground, and we both burst out laughing.
Saturday, December 4, 2010
Attitudes
I often start my morning at 0730 on St. Monica, the female medical ward, helping out the nurses and tagging along on the ward rounds with the doctors to ask questions, learn, and offer any input I may have on patients. Mornings are usually quite busy until 11, which can be a great way to start a day if you are efficient and have a good team working with you. Sometimes, it can be a bit overwhelming, if you’re short-staffed, or have staff that would rather sit at the desk and watch things not happen.
Often in the mornings I come across things that have been missed from the previous shifts, so I try to organize a bit and bring everyone up to speed. It may be a diabetic patient who has not had any glucose checks since admission, and is now nearly unconscious after her morning insulin, it may be a young woman in renal failure who is hugely edematous and currently receiving her third liter of fluid, it may be a gasping pneumonia patient lying flat on her back with no oxygen in sight; any of these situations (and more) are possible when you report for the early shift. So you quickly prioritize and send for the oxygen concentrator, draw up some IV dextrose, and stop the fluids, then survey the ward again to see if there’s anything else you missed. After/during this, I pull the first year students aside, drag them with me, and quiz them on nursing care, and help them out with some lacking information. ‘What do you think is our top priority here?’ ‘Tell me about diabetic management’ ‘Why is fluid balance important in renal failure?’ Really, some days I just want to yell at them and the night nurse for missing such obvious, basic things, and failing to call for help when a patient is deathly sick…
Which brings me to a question. What motivates us? I’m asking this because I’d really like to know the answer. I’m not sure how many people read this, but please offer any insights you have on this.
Why do we do things the way we do? What makes us want to do things well; what drives our pursuit of excellence? Why do some of us always strive for more, while some of us are more than happy to settle with ‘enough’ or average’?
Are our motivations based solely on incentives, or is there some greater, more noble reason? Or perhaps some balance of the two?
Here are some observations I’ve made, and I have to stress that these are personal opinions, and you are more than free to disagree with me, as I realize that I still have a lot to learn.
a) 49 first-year nursing students. On the whole, this group shows a lot of ambition and enthusiasm for the nursing profession. They are eager to learn, always looking for opportunities to apply theory in practice, asking questions constantly, and studying in their spare time. They are super inquisitive and absorb as much as they can in this short time they have of being students. When the students are in the hospital, the wards are spotless, the patients are bathed, and treatments and orders are done (usually) on time. They are starting to think outside their procedure manual, asking me thoughtful ‘why’ questions, showing that they are beginning to think critically.
b) Staff Nurses. Although there are wonderful shining exceptions to this, on the whole staff nurses couldn’t be any more opposite. They trudge through their shift, taking 2 hour breaks, falling asleep with head in hands at the nursing station, getting up to give medications or take a couple blood tests. I hear a lot of complaints about nursing care (from other hospital staff), lack of clinical judgment and reasoning. It seems as though once you have completed school, once you are a qualified nurse and have your white uniform, you don’t have to learn anymore (after all, you already know everything), you don’t really have to try anymore. You’ve landed a government job, and even if you occasionally miss something (even if that something is BIG), you won’t suffer any major consequences, and you definitely won’t get fired.
I asked a student about this, after she finished telling me how she wakes up at 3 or 4am to study every day, then works a full shift and comes back later to do extra procedures. “Maybe nursing isn’t their calling,” she told me, “maybe they just don’t have a passion for it.”
Okay, that makes a bit of sense to me, though I still struggle with the fact that human lives are in play here. But maybe that’s because I care about my job, I have a passion for it. Maybe if I was stuck in an office typing Excel spreadsheets all day, I’d do the absolute minimum I had to, because I really don’t care about Excel spreadsheets, even if the success of your business depended on it.
As Mrs. Seya, our nursing administrator, keeps telling me while we hammer out an Action Plan for nursing workshops and try to overcome the incentive obstacle, “Attitudes are hard to change.” Hard to change, hard to understand.
Often in the mornings I come across things that have been missed from the previous shifts, so I try to organize a bit and bring everyone up to speed. It may be a diabetic patient who has not had any glucose checks since admission, and is now nearly unconscious after her morning insulin, it may be a young woman in renal failure who is hugely edematous and currently receiving her third liter of fluid, it may be a gasping pneumonia patient lying flat on her back with no oxygen in sight; any of these situations (and more) are possible when you report for the early shift. So you quickly prioritize and send for the oxygen concentrator, draw up some IV dextrose, and stop the fluids, then survey the ward again to see if there’s anything else you missed. After/during this, I pull the first year students aside, drag them with me, and quiz them on nursing care, and help them out with some lacking information. ‘What do you think is our top priority here?’ ‘Tell me about diabetic management’ ‘Why is fluid balance important in renal failure?’ Really, some days I just want to yell at them and the night nurse for missing such obvious, basic things, and failing to call for help when a patient is deathly sick…
Which brings me to a question. What motivates us? I’m asking this because I’d really like to know the answer. I’m not sure how many people read this, but please offer any insights you have on this.
Why do we do things the way we do? What makes us want to do things well; what drives our pursuit of excellence? Why do some of us always strive for more, while some of us are more than happy to settle with ‘enough’ or average’?
Are our motivations based solely on incentives, or is there some greater, more noble reason? Or perhaps some balance of the two?
Here are some observations I’ve made, and I have to stress that these are personal opinions, and you are more than free to disagree with me, as I realize that I still have a lot to learn.
a) 49 first-year nursing students. On the whole, this group shows a lot of ambition and enthusiasm for the nursing profession. They are eager to learn, always looking for opportunities to apply theory in practice, asking questions constantly, and studying in their spare time. They are super inquisitive and absorb as much as they can in this short time they have of being students. When the students are in the hospital, the wards are spotless, the patients are bathed, and treatments and orders are done (usually) on time. They are starting to think outside their procedure manual, asking me thoughtful ‘why’ questions, showing that they are beginning to think critically.
b) Staff Nurses. Although there are wonderful shining exceptions to this, on the whole staff nurses couldn’t be any more opposite. They trudge through their shift, taking 2 hour breaks, falling asleep with head in hands at the nursing station, getting up to give medications or take a couple blood tests. I hear a lot of complaints about nursing care (from other hospital staff), lack of clinical judgment and reasoning. It seems as though once you have completed school, once you are a qualified nurse and have your white uniform, you don’t have to learn anymore (after all, you already know everything), you don’t really have to try anymore. You’ve landed a government job, and even if you occasionally miss something (even if that something is BIG), you won’t suffer any major consequences, and you definitely won’t get fired.
I asked a student about this, after she finished telling me how she wakes up at 3 or 4am to study every day, then works a full shift and comes back later to do extra procedures. “Maybe nursing isn’t their calling,” she told me, “maybe they just don’t have a passion for it.”
Okay, that makes a bit of sense to me, though I still struggle with the fact that human lives are in play here. But maybe that’s because I care about my job, I have a passion for it. Maybe if I was stuck in an office typing Excel spreadsheets all day, I’d do the absolute minimum I had to, because I really don’t care about Excel spreadsheets, even if the success of your business depended on it.
As Mrs. Seya, our nursing administrator, keeps telling me while we hammer out an Action Plan for nursing workshops and try to overcome the incentive obstacle, “Attitudes are hard to change.” Hard to change, hard to understand.
Tuesday, November 23, 2010
Bike Taxis
How is it that I always seem to get the drunk bicycle taxis?
I sometimes take a bicycle taxi (jinga) home from work if I miss the hospital transport, or if I’m traveling somewhere far enough to dissuade walking but close enough not to need a vehicle. It’s a great way to get around. Usually…
Most of the time, the drivers are not too bad – they work hard for their 50 cents and get you to your destination safely. The interesting bit comes some afternoons, especially on the weekends (Sundays are the worst), when your bicycle guy has had too much Shake-Shake. A usually calm, scenic 2 km bike ride becomes a harrowing near-death experience as you dodge and dive dogs, goats, women carrying water or produce on their heads, other cyclists, and the dreaded passenger buses careering by at 120 km/h. The bicycle that is normally a rickety old contraption is even more shaky as you swerve and hit potholes and bumps, and your stomach is sore at the end of the trip from keeping your balance for the past 30 minutes.
Sometimes, however, the opposite can be true. Instead of an exhilarating trip, your driver can be as slow as the old women carrying their goods to the market. You are being passed by kids, women, men, even oxcarts, and this doesn’t bother your driver in the least. I now take these moments in stride, forget about why I’m in a hurry (usually doesn’t matter anyway), and take a good look at the scenery around me. I see Mphangwe mountain in the distance, the setting sun reflecting bright oranges and pinks and reds off distant rain clouds. Beside me is a heron fishing in a puddle in the middle of a wide open field of tall grass. Six small kids are running at me from a village on the other side of the road, huge smiles on their beautiful faces, shouting “How are you?!” at the top of their lungs. All these things are part of this beautiful country, this beautiful town – and though there is poverty and death and suffering, it is good to be here. Life is simpler in many ways, happiness is easier to find.
I sometimes take a bicycle taxi (jinga) home from work if I miss the hospital transport, or if I’m traveling somewhere far enough to dissuade walking but close enough not to need a vehicle. It’s a great way to get around. Usually…
Most of the time, the drivers are not too bad – they work hard for their 50 cents and get you to your destination safely. The interesting bit comes some afternoons, especially on the weekends (Sundays are the worst), when your bicycle guy has had too much Shake-Shake. A usually calm, scenic 2 km bike ride becomes a harrowing near-death experience as you dodge and dive dogs, goats, women carrying water or produce on their heads, other cyclists, and the dreaded passenger buses careering by at 120 km/h. The bicycle that is normally a rickety old contraption is even more shaky as you swerve and hit potholes and bumps, and your stomach is sore at the end of the trip from keeping your balance for the past 30 minutes.
Sometimes, however, the opposite can be true. Instead of an exhilarating trip, your driver can be as slow as the old women carrying their goods to the market. You are being passed by kids, women, men, even oxcarts, and this doesn’t bother your driver in the least. I now take these moments in stride, forget about why I’m in a hurry (usually doesn’t matter anyway), and take a good look at the scenery around me. I see Mphangwe mountain in the distance, the setting sun reflecting bright oranges and pinks and reds off distant rain clouds. Beside me is a heron fishing in a puddle in the middle of a wide open field of tall grass. Six small kids are running at me from a village on the other side of the road, huge smiles on their beautiful faces, shouting “How are you?!” at the top of their lungs. All these things are part of this beautiful country, this beautiful town – and though there is poverty and death and suffering, it is good to be here. Life is simpler in many ways, happiness is easier to find.
Subscribe to:
Posts (Atom)