Freetown’s College of Medicine and Allied Health Sciences (COMAHS) was forced to shut its doors for nine months during the Ebola outbreak. Finally reopening in June 2015, COMAHS is critical for rebuilding Sierra Leone’s health workforce, despite its limited training capacity, poor learning facilities, and a major shortage of teaching staff in most areas. This essay tells the story of the partnership between COMAHS and KSLP, formed with the goal of building capacity and resilience in post-graduate education in Sierra Leone.
Today we are in the Intensive Care Unit (ICU) at Connaught Hospital where the nurses are conducting their afternoon handover. Alongside Sister Elizabeth Kamara, the ICU sister-in-charge, KSLP’s Dr Ruth is leading today’s handover.
It’s is a quiet day in ICU so Dr Ruth is taking time to test everyone’s knowledge on the importance of fluids and how to provide oxygen. Her energy is contagious as she asks about each patient:
“Ok, so why might this patient’s condition have changed?”
“Reaction to the blood?”
“Exactly, it could be any of those things, so if there is a change in the patient condition, we need to think about what might be the cause and what you need to tell the doctor in charge.”
Such on the job learning is highly valued in this unit. The daily handover is appreciated as much for ensuring the consistency of patient care, as it is for the opportunity to receive further training.
“Mentoring other nurses is the best part of this job,” said Sister Elizabeth. “It’s great to be able to share my knowledge and understanding with others.”
A close relationship builds between the nurses and their patients. In ICU, they provide ‘complete nursing,’ which includes everything the patient like feeding, fluids, and pain management. Any and every change in the patient’s condition must be recorded. This is a major responsibility, but all of the nurses shoulder it professionally.
Each provides a detailed history of every patient at the end of the shift. Histories include details of why the patient was admitted, when he or she was last seen, and the critical points in his/her care and management. Despite seeing some tragic cases, optimism abounds in the unit. After all, “ICU is where we treat critically ill patients,” said Sister Elizabeth. They are the ones we know we can revive again and bring back to life.”