The Updates are a-comin’
Posted By Sika on January 16, 2009
I haven’t really talked much about what I’m doing at work. I was getting ready to write about South Africa, and I realized that I should probably write about a little more than my holidays.
I’ve actually gotten quite busy with work at work. Sometimes I don’t even have time to read Mike’s missives of mockery regarding my internet access and use.
Most Malawians love having their picture snapped. Malawians who you’ve never met before and will never meet again sometimes ask you to “snap them”. For months I tried to figure out how much and what kind of compensation I need to give students to snap them for my additions to the skills manual. One tutor told me I’d need to pay them, and that the fair rate would depend on how much money I had in my budget.* Another told me that I didn’t need to give them anything because they’re students. And then it turned out that all I had to do was make a sign up sheet. When I told them that I’m going to make a contributor page with portrait photos of each of them, that was a happy bonus none of them were expecting. Happiness only slightly marred by my insistence on smiles for the photos.
So, I’ve taken photos for the first four skills in my list and will be figuring out the rationale and then plugging them into the webpage templates I worked up (in notepad) ages ago.
A couple of months ago, David and I started taking the students into the practical room to work on skills. We took one group each day from 5pm-6:30 (really 6:45 or 7 by the time we actually get out of the room) and gave the students a chance to practice their skills.
One of the problems we run into in teaching skills in the practical room** is a total lack of time. For instance, when I was in nursing school, health assessment was an independent class. Over 14 weeks, we had a couple of hours of lecture and an hour or so to practice per week. There were about 15 students when I was practicing. For my students, Health Assessment was a 3-hour lecture and practical would have been 2 hours for all 68 of them except for this project David and I are doing. So they got an hour and a half total for each group of 11 or 12. And this took us a week and a half, plus lunches and breaks getting students caught up or letting them practice again.
We are told repeatedly that we need to level the education (This means that diploma students are taught at a different level of thoroughness than degree students). Our students will not be RNs when they are done. They will be nurse-midwife technicians. Of their three year degree, only two of them are spent becoming a nurse the way we think of it (the remaining year is spent training in midwifery). So our students aren’t meant to have the same level of education as Bachelor’s trained nurses. The problem is, many of our nurses are going to be in charge of entire health centers or the only nurse on staff. And how do you level down the education of someone who will be independently in charge of so many people’s lives? And yet the time and the resources are not there to train them properly. Our after hours times only make it clear how woefully short our time is.
Right now we’re trying to teach IV administration and IM injections. Every session we’ve had so far has gone over by about half an hour while we only get through about half of the students in the group. We can’t even catch up by bringing them in at lunch because it’s still not enough time. The only thing I can think of doing is begging*** the students to be better prepared.
One of the nice things is how excited the students are to practice. It would be nice if they were also excited to study before coming into the practical room It would also be nice if they did accurately assess the skills they need the most practice doing, like we were told they would in our Problem Based Learning training. They’re all shaky on health assessment, but they only want to practice bed-making and vital signs. But, they do come and snag as many lunches as we allow. And they asked us to come in on Chilembwe day so they could practice giving medications. And they come in when class lets out early to see if they can get a bit of time in the practical room. Their enthusiasm makes up for a lot of the frustration that comes when they do things like wave bare needles around and try to swab off the part of the IV inside the vein.
*The answers to this statement are, “bullshit” (said diplomatically, of course. Well, mostly diplomatically, given that it’s me and diplomacy isn’t my strong suit) and “What money?”
**besides the lack of a good stock of disposable supplies like IV bags, syringes, tubing, dressing supplies, catheters
***Begging is another Malawianism I’ve picked up. When you want something, you beg for it. We beg for supplies from the hospital. We beg for someone to borrow us something.
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