I have recently returned from my first visit to Haiti. I have worked in Rwanda mentoring nurses in a hospital and teaching at a nursing school. Last January I traveled to Malawi where I visited hospitals and health centers to listen and learn from the nurses. After each visit I always leave inspired and humbled by my nursing colleagues. The themes are usually similar. They face similar challenges: lack of human resources, lack of materials and equipment, high attrition rates, the desire for more education, and limited clinical mentorship or preceptorship opportunities to help translate didactic trainings into clinical practice. They work long shifts, often working and living away from their families, and yet they keep their morale. They are eager for knowledge and to improve nursing in their countries. Last September I began working with Partners In Health to support our cross-site nursing programs. This has led to my most recent visit to Haiti where I was joined by Manzi Anatole, a nurse colleague from Rwanda.
Manzi has had incredible success developing a nurse mentoring program in Rwanda that started as a small pilot program at local health centers and has now expanded to the entire country. His visit brought a wealth of experience and inspiration to the nurses in Haiti. He was able to share how he overcame similar challenges including lack of equipment, poor infection control, and sub-standard clinical care. By developing and implementing a nurse mentorship and quality improvement program he was able to be a catalyst for change to improve patient care despite these challenges. The nurses speak more openly with him about their challenges. I quickly realized that this cross-site sharing of experiences is invaluable. Nurses are managers, caregivers, educators, innovators, and advocates. On a daily basis we are forced to think creatively to problem solve and provide optimal patient care despite the obstacles we may face. Sharing challenges and identifying solutions that have been successful in Rwanda, Haiti, Malawi, Mexico, Lesotho and other similar settings is an invaluable resource, inspiration, and source of empowerment for the nurses. I saw nurses’ eyes light up and ideas start to flow as we spoke and discussed ways to overcome what can at times feel like impossible challenges.
Later in the week Manzi facilitated a workshop for nurse leadership from our sister organization in Haiti Zanmi Lasante (ZL). ZL supports 12 different sites in Haiti to deliver optimal patient care to the community. The workshop focused on nurse mentorship as a tool to improve health care delivery. Manzi brings his unique experience using nurse mentorship and nurse led quality improvement as a tool to instigate change and measure the impact of nurses. ZL nurse leadership has developed an impressive nurse mentoring and education program over the past 2 years and are now interested in measuring the impact of nurse mentorship at their sites.
As I got on the plane to return to Boston I too was left thinking about ways we can continue to develop and support this type of cross site, cross cultural collaboration for nurses. The idea that nurses are stronger together has been instilled in me since I was a new nurse. Uniting nurses to troubleshoot together, to share in their excitement and in their despair, and to lead quality improvement initiatives is critical to advancing nursing at the global level. Technology makes it easier and easier to stay connected despite large distances. However these type of site visits are really invaluable to inspire new ideas and empower the nurses. Manzi and the nurse leadership team left me thinking about how we can continue to develop and provide opportunities for this type of collaboration to allow nurses from different countries and cultures to share common struggles and identify new collaborations for innovative solutions. I’m looking forward to seeing how this new collaboration will continue to evolve and be a catalyst for change.