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Letter from Zambia 4: The students are ready to return to critical care

The team teaching critical care nurses in Zambia have to think quickly to create meaningful practice scenarios.
Zambian students

The team teaching critical care nurses in Zambia have to think quickly to create meaningful practice scenarios.

The students are becoming more confident of their knowledge and abilities and much more relaxed with us. Our teaching sessions with them are now very interactive, with shared experiences of the critical care environment often creating much laughter.

The skills sessions have been particularly successful and have allowed us to explore a theme which we introduced on day one that of the students fears and expectations for their new role on return to their own units.

Todays afternoon session had the students revising their defibrillation and tracheostomy care skills. Not surprisingly, the basic manikins and simulation equipment to undertake critical care skills in practice are in short supply in Zambia.

It took us some

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The team teaching critical care nurses in Zambia have to think quickly to create meaningful practice scenarios.

The students are becoming more confident of their knowledge and abilities and much more relaxed with us.  Our teaching sessions with them are now very interactive, with shared experiences of the critical care environment often creating much laughter.

The skills sessions have been particularly successful and have allowed us to explore a theme which we introduced on day one – that of the students’ fears and expectations for their new role on return to their own units.

Today’s afternoon session had the students revising their defibrillation and tracheostomy care skills. Not surprisingly, the basic manikins and simulation equipment to undertake critical care skills in practice are in short supply in Zambia.


The students were unfazed by the lack of teaching resources

It took us some time at the School of Nursing to assemble enough working equipment, including power leads and batteries, to be able to run a basic skills session. The contrast with our well-stocked skills facility back at Birmingham City University (BCU) was painfully apparent.

However, the students appear unfazed by the lack of teaching resources and were very eager to practice their skills ahead of November’s critical care course final examinations, taking turns and encouraging each other to ‘have a go’ with lots of laughter and gentle encouragement.

Whilst these sessions put the students under pressure, they appear to have little opportunity to practice skills away from the clinical areas; it’s also a stiff test for us as educators.  We have to work quickly to pull together scenarios that are meaningful to the students, reflecting their current practice environments and expectations for the delivery of critical care in their home base units rather than ours.

In addition, this has to be achieved using old-style equipment that we may have used at the beginning of our careers, but have not used in practice for some considerable time.

However, we really believe that we are having a positive impact and have broken down some barriers in communication and this was confirmed to us in the final session of the week.

On day one we had asked the students to tell us their fears and expectations of returning to their own units. Politely they told us that they had no fears and they indicated that with the knowledge they had gained from the course they felt that they would be able to manage all the challenges ahead.


The interactive teaching sessions encouraged students to voice their fears and expectations

In the final session of the week we got them to return to this question by asking them to consider the findings of their peers; the qualified critical care nurses currently working throughout the hospitals and health centres in Zambia.

This information was gathered from the tour of critical care facilities undertaken by Chris and Kevin in conjunction with the Ministry of Health earlier this year. These were as follows:

  1. Staffing levels – critical ratios
  2. Lack of understanding of role by other team members
  3. Inappropriate admissions
  4. Limited professional development opportunities

It appeared that the words and feelings of their colleagues gave the students the confidence to express their fears and hopes in an open forum and begin to develop personal and professional tools and mechanisms to manage the challenges ahead.


About the authors

   

Major Chris Carter (pictured) is a critical care nurse and nurse educator at the Defence School of Healthcare Education, Department of Healthcare Education, which is co-located at Birmingham City University, UK

Kevin Crimmons is an Associate Professor, Head of Adult Nursing, Birmingham City University, UK

Major Sue Viveash is a Nurse Educator at the Defence School of Healthcare Education, Department of Healthcare Education, which is co-located at Birmingham City University, UK.

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