Report from Lira 2017 Antoinette McAulay Background
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- Bu səhifədəki naviqasiya:
- Lira Referral Hospital
- Lira Comprehensive School of Nursing
- Achievements
- Suggestions for next visit
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Report from Lira 2017 Antoinette McAulay Background This was the fourth team teaching visit to Lira. The entire visit was carried out over 4 weeks, but I led the first team over the initial two weeks of October. The team taught both the University students in Lira University, and clinical teaching to the the doctors, nurses and nursing students at Lira Regional Referral Hospital (LRRH). Logistics Flight and transport to and from Lira went extremely smoothly this year. We had the services of our usual driver who was always prompt and helpful. The team stayed again at the Kanberra Hotel and had a comfortable stay. There were problems with plumbing for the last two days, and water had to brought in for washing. Several members of the team had short-lived gastroenteritis. University The first year of students have now graduated and are working as “Interns”. We had very positive feedback about the performance of one of the 4th year’s ability in managing neonatal resuscitation and eclampsia; which had been the focus of previous PAL teaching. Clinical work at the hospital has still not started apart from some antenatal clinic work, due to procurement issues over drugs and equipment. The building work is continuing including both more university lecture theatres and hospital facilities. We had contacted the University team prior to the visit to try and establish a timetable for the PAL teams, but still had to liaise with the senior lecturer Anna Agnes Arach on the first day to arrange a teaching timetable. We felt there was less opportunity for university based teaching on this occasion, and there were some problems with students not being informed of teaching slots initially and tutors running over-time. At times we were frustrated that are teaching skills were not being put to full benefit. We were also frustrated by lack of power-point facilities and that the two lap-top computers left by previous PAL team were not available to us (one finally materialised on our last day, and we bought an excellent second hand one). We arranged a Saturday study day which was extremely well attended and as previously the students and tutors were very enthusiastic about our educational input as indeed were the University and Peace Corps tutors. We had excellent support from Anna Agnes, her team and the two Peace Corp tutors, and were also welcomed by Dr Otim and Professor Jasper. Lira Referral Hospital On our first day we had a meeting with the new Medical Director Dr Odu Bernard who was happy for us to continue our teaching support. The Hospital was very short of doctors. For instance during our entire stay, medical input for paediatrics was mainly from volunteer medical staff, and on one day, no doctor arrived for the ward round. As in 2016 the Interns were on strike as many had not been given a hospital placement. Sadly we were therefore not able to assist with their education. Team members were sometimes under pressure to get involved with medical care due to the staff shortages. As previously there were numerous student nurses from different institutions and there was plenty of opportunity for clinical education on the wards during the mornings and early afternoon. Year 3 and 4 University students were predominately at the hospital, so we were able to arrange some lecture based teaching as well during the early afternoon. The hospital has beautifully kept grounds and is cleaned on a daily basis, but most of the wards are cramped and in need of significant decor. The electricity supply and running water were intermittent but there is now an oxygen plant, so oxygen is more easily available. Lira Comprehensive School of Nursing This school of nursing is just by Lira Referral Hospital, and trains nurses to certificate level in 2.5 years. He students are very evident in all areas of the hospital, and we have frequently taught them alongside the Lira University students. Sarah Currell and I made a visit to see Etaka Norah the principal and offered a few more formal teaching sessions e.g. on resuscitation. However we did not receive any e-mail or phone contact and did not have sufficient time to follow up this visit. Paediatrics The paediatric ward was largely unchanged since my last visit one year ago, in terms of décor, and staffing. Every day there was at least one experienced nursing sister, occasionally two but the main staffing was from numerous students. Paediatric medical input was lacking due to the intern strike and I did not see the Consultant Paediatrician on the ward as he is currently Deputy Medical Director. There was better access to oxygen, but until I brought small saturation monitors, now no equipment for saturation or heart rate monitoring. It was possible to get X-rays and ultrasounds, but there was no change in the limited laboratory tests. Basic drugs such as antibiotics, anti-malarials, steroids, rehydration salts and zinc supplements were available; but often parents had to go to local pharmacist to obtain other drugs Paediatric teaching to nursing students was on the ward was mainly directed to the following:
Paediatric teaching to the paediatric medical staff both on the ward and clinic consisted of discussing management plans. Numerous topics were covered including management of the acute abdomen, sickle cell crises, the wheezy child, reducing use of antibiotics for viral illnesses, psychosomatic disorders. Achievements
Suggestions for next visit Teaching
Equipment
Teaching Aids
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