Must All Facilities Run 24 Hours OPD Service In The Days Of Health Workers Exodus? -Ebenezer Agyenim-Boateng.

A thought that keeps running through my mind, as stated above. Currently countries like Ghana, Nigeria and the likes keep losing Nurses , Doctors and some other health care workers to the West in search of a better future for themselves and their loved ones.

Most District and Municipal hospitals currently run a 24 hours OPD Service on already burden few health care workers of which some facilities are pushed to the point of allocating Nurses to the consulting room to practice as Doctors and Physician Assistant during afternoon and night shifts respectively. I ask again’ Must all facilities run 24 hours OPD Service in the days of health workers exodus?

Most OPD cases (Patient) are believed to be cases that can wait for sometime which may not cause harm to the patient, OPD cases are not considered as emergencies or urgent. Most Teaching hospitals do not run OPD service after 3pm but only see emergency cases. In this event, it allows the facility to allocate more staff to the emergency and wards where their services are really needed.

In cases where some District and Municipal hospitals run 24 hour OPD services and use Nurses as prescribers, it puts extra burden on the few Nurses on the ward who are overly stressed already by the huge exodus of their colleagues to the West. I will ask again, Must all facilities run 24 hours OPD Service in the days of health workers exodus?

The other danger that arises with the use of Nurses as prescribers is, the issue of legalities;

1. Does their job description allow them to play that role?

Do these facilities heads have any legal written documents to protect these Nurses in the event of any unforeseen circumstances (mistakes).
I ask this because the level of training of a Nurse is not the same as a Doctor – even with Doctors, there are cases which are left in the hands of specialists. An example is the management of a patient who has had 2/3 previous Caesarean Sections.
Are these Nurses given the necessary remuneration for their extra services they provide ?
Are these Nurses not needed in the wards to provide quality nursing care for patients other than to be prescribers when their certificate does not allow them?
Finally, do Nurse Managers in such facilities follow up on these Nurses playing the role of Doctors and Physician Assistant to review their work output?

Can facility managers look for other alternatives other than using our few Nurses left in these hospitals as prescribers? If we want to run 24 hours OPD services, must it only be Nurses that run the facility when there are Doctors to do their part of the work?
I don’t intend to point hands to anybody’s duty but I ask, must our Nurses be the ones to run the facility while having fewer benefits?

The sad and most painful part of this situation is, these Nurses acting as prescribers are mostly the ones that struggle to even get study leave to upgrade their knowledge. It is also surprising to note that most of them have not had any training to upgrade themselves in the position they are currently in. Can’t we have other alternatives to this?

I will finally ask again, Must all facilities run 24 hour OPD Service in the days of health workers exodus?

Dear Nurse please think about it, dear Nurse Manager please think of the safety and improvement of your Nurse. Together can we find a better solution for our facilities?

Your ideas are welcome, please feel free to contact for further discussion.
Thank you.

Source:

Ebenezer Agyenim-Boateng
MSc Advanced Nursing Practice
agyenimboatengebenezer@gmail.com

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