Shortage in nurses, lack in respiratory therapy specialty

By Ashley Skinner

In Guyana, specialties in almost every other area of the medical field can be found in the hospitals, except respiratory therapy.

The lack in the specialty stems from two major areas: a nursing shortage and the absence of the curriculum at the university level, according to Sheik Amir, the director of medical and professional services at Georgetown Public Hospital Complex.

During a training day at Georgetown Public Hospital, Sharon Armstead speaks to a group of nursing assistant students about the importance of respiratory care.

“Getting respiratory care to Guyana rests on the arms of the Ministry of Public Health,” Amir said. “It has to start at the university level.”

The University of Guyana is responsible for introducing students to the curriculum specialties. Once the students go to nursing school, they are taught basic respiratory care techniques.

However, the experience the students receive in the hospitals is mostly the traditional duties of a nurse like taking blood, checking temperatures, cleaning up the patients and all about the body, according to nurse Natasha Cameron at the Linden Hospital Complex.

“Since we don’t have the specialty, we do check the ventilators and listen to the patient’s lungs,” Cameron said. “But we weren’t really taught to do much else. In school, I learned the respiratory tract and what causes lung diseases, but the rest I am still learning as we get new patients who need different treatments.”

Through a series of collaborations with universities around the world, the most prominent including the U.S., Canada and China, the country has been introduced to and adapted many specialties like neurology, radiology and mental health.

Yet, while a Canadian university is collaborating with some hospitals in the country, few have specific respiratory care units. Linden Hospital Complex is an exception.

“We recently got a spirometry unit to help diagnose asthma,” Gerald Thompson said, general practitioner and spirometry unit assistant. “We really need respiratory therapy in the country though, especially this mining town because bauxite produces a lot of contaminating things.”

Bauxite is a sedimentary rock that is used in making aluminum, as it has iron oxide in it. While the rock itself is not toxic the red mud that is created when the bauxite is being mined for is very harmful. The dust that is made from the dried red mud can cause chronic illnesses and asthma, a driving force in Linden.

After a press conference at Georgetown Public Hospital, Sharon Armstead exchanges contact information with Emanuel Cummings, the Dean of Health Science at the University of Guyana.

“Respiratory therapy is a specialty for a reason: because putting our job on nurses in its totality is overwhelming,” Sharon Armstead said, respiratory therapist and Professor at Texas State University. “You have to know causes for the illnesses in your area and everything there is to know about them and the machines that go with them. If a human cannot function without lungs, why would you let a hospital function without respiratory therapist?”

Armstead also said the country needs to look into curriculum for the specialty and installing spirometry units in all of the hospitals.

However, the nurse retention problem must be solved before the curriculum can be instated to the university.

“We don’t have shortage in people who want to be a nurse,” Amir said. “We have a shortage of nurses coming back to the country once they’ve left for training.”

Once nurses become certified, some are given the opportunity to do their training abroad. Many of the nurses do not come back to the developing country once they have been in a more developed one.

“It’s not unusual that they never come back,” Amir said. “The top neurosurgeons in Jamaica are Guyanese. There is not just a need for specialist in this country, there is a need for employees since some leave and never come back.”

Many of the doctors in the country are from other places around the world. Between Georgetown and Linden, 10 doctors are from China alone. Other major specialists include doctors and nurses from Cuba, Brazil, the U.S., Canada and Japan.

Elizabeth Gonsalves, deputy CEO of the Georgetown hospital, said she is aware there is room for improvement in the curriculum, nurse retention rate and the hospital overall.

“I want our hospital to be first-world-like,” Gonsalves said. “We are doing pretty good with what we have but I know we can do better once we get these issues solved. We definitely need to improve the education of our nurses because they don’t get all the attention they deserve.”

Cleopatra Barkoye, principal of the Georgetown School of Nursing, said in press release on the University of Guyana’s website that the system has failed the nurses who are in training. This statement is in regards to the 2016 Professional Nurses State Final Examinations, where the school has a 90 percent fail rate.

“We don’t have enough lecturers in the classroom, in none of the schools,” Barkoye said. “We don’t have enough materials. The curriculum specifies that you must have a clinical instructor, we don’t have any clinical instructors in Georgetown and New Amsterdam, what we have are clinical supervisors.”

The professional system requires one tutor for every 20 nursing students. In the Georgetown School of Nursing alone, there are 343 students, but only seven tutors.

“Due to the shortage of tutors across the three nursing schools – the Georgetown School of Nursing, the Charles Roza School of Nursing in Linden and the New Amsterdam School of Nursing – there is no room for specialization.”

 

Photos by Ashley Skinner/Global News Team

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