Supporting Nursing in Macedonia

I have been volunteering in Macedonia for the past two weeks helping to support Project HOPE’s Strategic Medical Resupply Program. The goal of this program is to provide medications, equipment and training to hospitals in Skopje. Currently, the hospital that we are working with is the University Pediatric Clinic (their word for hospital is clinic) in Skopje. This pediatric clinic is in the public sector of the health care system in Macedonia. It is the most advanced pediatric clinic in Macedonia. The hospital receives many patient referrals from all over the country.

For the past week, I have teamed up with another volunteer, Dr. Janet Kinney, a practicing pediatrician and retired Neonatologist who has had training in Infection Control and has also worked for the Centers for Disease Control. We have been visiting each department in the clinic to learn about what they do, and what they need for equipment and health education.

We have found that health education varies for the different medical professionals. Physicians in Macedonia go through six years of general medical school and then they have another four years of specialized training to become a pediatric doctor. Physicians are required to participate in continuing education to keep their licenses.

Nurses, on the other hand, go through nursing school in high school and then they have three years of training in college (which technically is optional).  After that, there is no continuing education. Because of this, most of the nurses have not had any training in a very long time.

Continuing education for nurses seems like the ideal way for Project HOPE to help.

After meeting with each department, Dr. Kinney and I have come up with three different ideas to help the nurses improve their education.

• Implement a Nurse Mentoring Program to bring in general or specialized nurses that would work alongside the clinic nurses providing a resource of new knowledge and a way for nurses at the clinic to gain new expertise.
• Design a continuing education course based off of the Pediatric Advanced Life Support curriculum. This course, required for all medical professionals in the United States who work in a pediatric hospital, teaches resuscitation, drug administration, identification of respiratory distress/arrest, identification and treatment of shock, identification and treatment for cardiac arrest and more. A required course for clinic nurses in Skopje would help unify the nurses’ abilities and make a stronger nursing staff. In order to help the sustainability of the program, we would design the course around Project HOPE’s trademark “Train the Trainer” philosophy meaning we would teach the course to a few nurses who would then teach it to other nurses and so on.
• Elevate the nursing profession by helping the nursing staff establish a database where they can record what infections occur, where they come from, how serious they are, etc. The database will help support infection control and enable the nurses to implement simple protocols that can help save lives.

Our inventory of equipment also revealed the need for very standard equipment like bedside monitors, portable suctions, nebulizers, medical pumps, and ultrasound transducers. It really is amazing how the staff is able to operate and save so many lives when they lack basic equipment.

In general, everyone at the clinic is very excited to have our help. We are excited to work with them and learn from their system and knowledge.