My job

My job: an emergency response nurse in war-torn areas

Medical emergency response team nurse Ivy Muya describes how her work without doctors in Africa puts her skills to the test.

Medical emergency response team nurse Ivy Muya describes how her work without doctors in Africa puts her skills to the test.

Ivy Muya

What is your job?

I am a Kenyan-born emergency nurse in the medical emergency response team in Galkayo, Somalia. My role is to provide mobile and rapid medical emergency response capacity, advanced life support intervention and evacuation to humanitarian workers and the local community on a case-by-case basis.

Why did you become an emergency nurse?

I love the adrenaline rush and realised that I was getting bored by bedside nursing. I was curious and fascinated by the notion of saving lives because this definitely is not what bedside nursing is about. It is also one of the fields of care where a nurse can think independently, autonomously and innovatively, especially in most developing countries where there tend to be no doctors.

What might you have done otherwise?

The alternative would have been to continue to work in the surgical ward as a bedside nurse.

How and where have you developed your emergency care skills?

I began developing my emergency care skills in the emergency department (ED) of a private hospital in Nairobi, Kenya. From there, I became interested in doing short courses such basic life support and then advanced cardiac life support and advanced trauma life supportand it took off from there. After looking for courses that would enable me to better my skills in emergency care, I branched out and took a peek at the pre-hospital industry.  

The paramedic qualification does not exist in Kenya so I trained as an intermediate emergency medical technician before working as a paramedic for a humanitarian organisation. This was definitely an emergency care skill builder, although I also practised my skills in remote and sometime conflict-stricken areas in Sudan.

I returned home and practised in the north eastern Kenya, in Dadaab and Wajir, before joining a medical emergency response team set up by a non-governmental organisation in Somalia. The response team has worked in areas such as Bosaso, Dolow, Garowe, Hargeisa, and Galkayo, where I currently practise emergency care.

How does your current job make use of these?

As civil unrest is the order of the day in my part of the world, injuries such as gunshot wounds, road traffic accidents, stab wounds, falls and burns are common. All these require life-saving measures, which are encompassed in the skillset of an emergency nurse.

What do you enjoy most about your job?

The ability to work under pressure, improvise and use innovation.

What achievement makes you most proud?

Local capacity building of the emergency nurses working in the public hospitals.

What is the greatest challenge you have faced, and how have you overcome it?

As I am a lone worker, I am faced with situations where I need help. I have overcome this by training my colleagues who are not healthcare professionals and those working in local hospitals in basic first-aid procedures so they can assist me in emergency situations.

What makes a good emergency nurse?

One who is willing to learn on a continuous basis and able to improvise when resources are limited.

What keeps you awake at night?

The possibility of a ground attack and I am unable to reach the stabilisation centre to care for victims of war.

What advice would you give a nurse who’s starting out in emergency care?

You’ve got to put your back into it and be prepared for anything. Be confident in you skill and practice – the rest will come naturally.

What is likely to affect emergency nurses most over the next 12 months?

More and more nurses are emigrating from developing to developed countries. The resulting staff shortages arecreating a gap in basic nursing care, which then has a knock-on effect on nurses working in emergency care.

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