President of the Guyana Nurses Association Cleopatra Barkoye believes there has been not much movement forward in the profession at the local level since she joined it over 30 years ago and as the world observed International Nurses and Midwives Day last Wednesday, instead of celebrating she grieved for the practicing nurses in Guyana.
“My feelings today [are] mixed because… for me in Guyana we have not made as much strides as I would have liked to see… We have been stagnated somewhat. So today I feel for my colleagues. I feel for those who are still in the profession, and who still have some of the issues that we were faced with, that I was faced with, over 30 years ago,” Barkoye told Sunday Stabroek in an interview last week.
International Nurses and Midwives Day is observed every year on May 12, which is also the birth anniversary of Florence Nightingale, the English founder of modern nursing.
Barkoye, who has been president of the 93-year-old association for some years, joined the profession as a nurse’s aide and retired last year having spent more than the last ten years of her career imparting knowledge as a member of staff of the nursing school.
When Barkoye joined the profession nurses were migrating and then there was a period when they remained to serve their country but now they are migrating even more. Because many good nurses have left over the years, the profession, in her estimation, has suffered in terms of knowledge being passed on to the young generation. “That is one part that has really grieved me,” she said reflectively.
As a young nurse, she recalled, they grappled with material resources and “we are still in that position, it is a shame. Nurses long ago had to make some difficult choices. And you know what? It is almost the same thing today.”
Expounding on this issue Barkoye gave the example of nurses at times having to make the difficult decision as to which patient would receive medication because there was just not enough to give to all who required that specific medication.
“You have to make a choice and that is not right, that is not ethical for nurses… nurses shouldn’t be called upon to make those choices,” she said.
She said those are some of the challenges that made her emotional as she observed the special day and she said nurses across the world deserve a standing ovation, but more so in Guyana because they have done an excellent job.
According to the association’s president, there are over 3,000 nurses, midwives and nursing assistants in Guyana, and they continue to face the challenge of not having enough resources to work with at all levels, including larger hospitals, health centres and health posts.
Often, policymakers do not listen to nurses and so there are times when buildings are built and they are not equipped with all that is needed by nurses.
“We want the policymakers to hear us, to listen to us, to pay attention to us. We have knowledge and information. Nurses don’t just practice like that,” she said.
There have been times at some of the institutions where a simple thing, such as a screen to maintain the privacy of a patient, is not provided.
Nurses are also faced with the challenge of transportation and Barkoye noted that when she joined the profession there was a bus that transported nurses but after a while this service became unavailable and it remains unavailable today.
This is especially grievous in areas such as Linden, she said, when the nurses have to work in the evening. She believes this is a cause the Guyana Public Service Union (GPSU), which represents nurses, should take on, perhaps in terms of a transportation allowance. She noted as well that nurses are at risk everyday wherever they are and as such they should also be given risk allowances, especially in light of the COVID-19 pandemic. The allowance should not just be given to those who work directly with COVID-19 patients, as was initially done but is now no longer available, but to all nurses as they are all at risk being on the front line.
“That would be something good that we can get our union to represent us and get something more added to the salaries,” she said.
‘Never had that experience’
Over the years, some nurses, particularly those at the major hospitals, have faced severe criticism as regards how they treat patients. When this was put to the association’s president, she said she “personally never had that experience”.
However, she said, she has heard the complaints and she has no reasonable excuse to give for such actions although at the same time she called for the media to be “more kind to nurses and don’t always highlight our negatives”.
Barkoye also believes that a psychologist should be made available to nurses as they are humans and face psychological issues; the association has been asking for assistance with this over the years.
“Nurses come to work every day, they have to grapple with patients who are in pain, we may or may not have the appropriate medication to give that patient, we don’t have enough hands on board to take care of that patient. Relatives are there and they need answers and we have to be able to give them, sometimes they are not always kind to us,” she said.
She added that while they are trained to handle such situations they also have to face the reality of patients dying and they have to go “home with all of that baggage, nobody to talk to or to listen to us [and] that is challenging for us to carry”.
While she made it clear that none of the above is an excuse for nurses not to do the right thing when at work, Barkoye said one of the things the association believes is that if there is a psychologist available to nurses, “lots of things that you see nurses manifesting out would not occur”. She believes the public would receive better service from the nurses.
Congratulating the nurses across Guyana, the president of the association singled out those in Region Ten who unfortunately had none of their programmes to observe the day approved by management. “They are having a down day…,” she said of those nurses who did not receive funding or permission to have any of their submitted programmes become a reality.
And “when a nurse hurts we all do, we all feel it,” she added when asked about the recent protest actions taken by nurses in Linden over comments made by Chief Executive Officer (CEO) of the Linden Hospital Complex, Rudy Small. The CEO, who was removed and then reinstated after the comments, had told a journalist that some nurses leave their posts at night to visit their “sweet man”.
Weeks of protest to have him removed proved futile and in the end the nurses had to end the industrial action which resulted in salary cuts.
Barkoye said the association had taken steps to represent those nurses for them to have a fair hearing at the level of Ministry of Health and in the media but unfortunately they were not heard or even acknowledged. “We know what it is like… It is a terrible thing to talk down nurses and it is sad because it happened during the year designated for nurses and midwives,” Barkoye said.
‘I will do it all over again’
Barkoye decided to join the nursing profession at a very early age and she said this desire may have been birthed since she was around 14 when she became Christian. Her church’s population back then comprised largely of elderly persons and some did not have persons to care for them and she gravitated towards them. Some of them were in a home and she used to go there to help care for them.
She was still in secondary school at that time but she realised that it was her calling as she was getting much satisfaction from caring for the elderly and while initially she worked at the General Register Office she always knew where she wanted to be.
She later applied and was granted the opportunity to join the noble profession and has worked in several regions.
Over the years, she said, there might have been “instances in a blur” after a long or frustrating day when she might have regretted becoming a nurse, but they were usually not when she attended to patients but after she became a tutor at the nursing school.
She recalled that when her students did not perform well “it was down time for me and I asked myself I am I doing the right thing? But sitting here speaking to you, I would say to you if I had to do it all over again I would do nursing”.
All of her years were given to Guyana and while there were times she wondered what it would be like to work abroad in well-equipped hospitals where she may not have been forced to improvise, she never left.
Barkoye wants laptops to be provided to nurse educators along with internet access which will also serve students and the libraries for the schools. She called for updated libraries at the schools, whether physical or online. With COVID-19 the educators have been asked to remain at home and teach, but Barkoye said there is need for a platform to be provided to facilitate this as Zoom may not always be appropriate.
The Nurses Association, she said, is a professional body with a mandate of assisting nurses with professional development, and has done excellently in this area. She said that since the pandemic the association was unable to continue its work, but the International Council of Nurses and the Caribbean Nursing Organisation assisted with an app which members could use to access information online.
The association is now looking to move some of its services online to make classes and presentations virtual for its members. However, one of the challenges is that most of those on the executive body are retired people who are somewhat technologically challenged.
Should some of the younger nurses join, they could assist the association in that area as the world has changed and the association needs to stay abreast. While there are over 3,000 nurses in the country, only about 1,000 are members of the association. She called on nurses to join the association — the dues are $500 a month — and to work with the association’s research, social and welfare committees and to represent it at national and international conferences.
The older nurses, she noted, “are going off and we need to pass the baton successfully”.
Told that some of the younger nurses may question the benefit of joining, Barkoye said that over the years the association has awarded its members across the country and recently bursaries have been given to the children of nurses. Importantly, as well, the association assist its members with continuing education, which is required for promotion and this is done free of cost. Members are also given an opportunity to rub shoulders with their regional and international counterparts and learn from them.
