Walking into the Emergency Department at the Tamale Teaching
Hospital, our senses were assaulted. The air hung heavy and still, the smells
were overpowering and a heart rate monitor was pinging loudly. However, we were
immediately oriented to the floor with a warm and welcoming nurse named Doris,
who guided us through the triaging system. As soon as we introduced ourselves, the
heart rate monitor began to alarm noisily behind us and a couple of us
gravitated towards the noise to see if we could help. A male nurse, David,
began to work on the male patient and allowed us to assist him. He quizzed us
right off the bat and would later become our primary mentor. We even managed to
teach him a thing or two, despite his high level of skill and knowledge.
The hospital is reserved only for the sickest patients. According
to nursing staff and students, Ghanaians use the hospital as their last resort.
This can be due to a preference for traditional healing, inability to cover medical
costs, lack of family support, and fear of hospitals. Some of the common
limitations to care were the inability to provide medications until the patient
or family paid for them, lack of equipment and language barriers. However, family
support in the emergency department was commonplace and frankly, essential.
Almost every patient had a loved one at their bedside, washing them up,
providing food, paying for medications, going to get the medication, and even arranging
diagnostic tests such as running the blood samples to the lab. Where we have
auxiliary staff at home, such as porters, dietary and care aids, they have
family. At home in Canada, family is discouraged from gathering in the
Emergency Department and we are quick to ask loved ones to leave when
procedures are being done. There is still much work to be done at home in terms
of family centered care. Here at the ED in Ghana, nurses recognize that they
could not do their jobs without the support of families.
Although the conditions in the ED were less than ideal,
nurses here show amazing resilience and collaboration. We now have a greater
appreciation for the resources and systems established at home. We will take
what we have learned here at the Tamale Teaching Hospital and incorporate it
into our practice back home in Canada.
Posted by: Jade Geddes, Emma Miller, Carolyn Grinham and
Jessica Sherbinin
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