Anywhere in the world, nursing is a challenging profession. But in some resource-constrained settings, such as the sprawling peri-urban estate of Githurai just south of Jacaranda’s Kahawa West facility, the challenges are even greater. “Here, sometimes we don’t have enough gloves or we’ll run out of syntocinon (a drug used to help stop bleeding after delivery)”, says nurse Leah Marija, who works at a public facility. “We are also short of staff, which is a challenge because sometimes you are working two stations at once. You’ll be working the child wellness clinic (CWC) while also trying to monitor the maternity ward.” But, Leah emphasized, despite the challenges the people at her facility try as hard as possible to get what is needed to patients. One of the ways this public facility maternity unit, in particular, is strengthening their skills is through a partnership with Jacaranda’s Nurse Champion program, funded by Pfizer Foundation.
Leah Marija is one of the two Nurse Champions at Githurai-Langata Health Centre. She and her colleague, Joyce, came to Jacaranda for training on EmONC skills (emergency obstetric and newborn care), followed by a week of mini-residency at Jacaranda, and a course to be a PRONTO simulation drill facilitator. As a leader in the Nurse Champion program, Leah has been working with her team to debrief deliveries, improve skills for emergency obstetric and newborn situations, and run simulations. “Through these drills we are pursuing zero maternal and newborn deaths,” she says. Between September and November alone, the use of proper active management of the third stage of labor (AMTSL) techniques tripled during the simulation drills, and the self-reported team communication improved.
But perhaps even more important are the applications the team has found in real life. Just one week prior to our visit, Leah’s colleague described a night delivery which turned into an emergency situation– a baby was born not breathing and the mother started hemorrhaging. The nurse called for help with the mother and quickly began resuscitating the baby. She said she felt confident she knew how to respond because she’d practiced this scenario in drills through the champion program. Leah agreed, “After the drills, the nurses have courage to take the proper steps. I’ve seen very positive feedback.”
Leah says she became a nurse out of passion. “The job is fulfilling, especially maternity. When I see a mother with her baby, I get such satisfaction. Then, sometimes I see the child coming back for the child wellness clinic here and it makes me so happy. Seeing the smile on the client’s face makes it all worthwhile.” It is undoubtedly related to her passion that her facility chose her as a Nurse Champion. As for the future, Leah sees the potential for positive impact all around Githurai-Langata. While many of the challenges public facilities face are out of the control of individual nurses, champions like Leah are impacting the quality of care and environment in their facilities. “One of the key things I learned from Jacaranda was communication skills to use with my team,” she says. “If we continue working on these skills, I think we’ll really be able to serve our mothers and kids better.”