بسم الله الرحمن الرحيم
Assalamu`alaikum and greetings to all…
If I have a super power, here are some changes that I will do to make nursing in Malaysia much better. This is based on my personal opinion and experience working in three different institution, at two different country. Honestly, I can rant about all the negative issues I encountered when I was a Jururawat U41 but let just put it aside.
The Road Not Taken in KSA
Nursing Education
We all know that knowledge is power. The qualification of all nurses in Malaysia should be at least Bachelor of Nursing a.k.a Degree. When all the nurses have same basic education background, their knowledge can be reflected on the nursing practice and hopefully they can provide a quality nursing care.
What is going to happen to Jururawat U29? At certain point in their years of service, I think they should upgrade their education level and this requirement must be put as compulsory. Otherwise, the old-school-unwilling-to-change-nurses should be removed from the system. Their presence is just like a parasite. As time goes by, their grade will goes up by default and until now we did not see any different because they just counting days for retirement.
Moreover, all Degree nurses should be encourage to further study. The Institut Latihan Kementerian Kesihatan Malaysia (ILKKM) should stop producing Diploma nurses and focus on training specialized nurses in Intensive Care, Hemodialysis, Labour and Delivery etc. There are numbers of experience nurses out there who can become a very good Clinical Instructor and Lecturer but unfortunately we do not have enough post for Pengajar U41.
Those who are working in specialized area must complete and renew their privileges every 3 years. It begin with attending a class, sit for exam (if applicable), get a check-off during the class and after that hands-on in the clinical setting. This is to ensure that their knowledge and skill is up-to-date with evidence based practice.
Nursing Development
Since most of us graduate from different nursing school, the standardization of nursing practice is very important when we come to the clinical area a.k.a hospital. Here, the management level of nursing play a major role by ensuring all appointed nurses in the government passed the Lembaga Jururawat Malaysia test and passed all subject covered in the nursing syllabus. Failed in English and Mathematics is not acceptable as later on we will be dealing with a real patient. Patient’s safety should not be compromised just because of incompetency of the nurses.
The nursing management team should come out with Internal Policy and Procedure (IPP) for all nursing practices that is going to be applied in all hospital under Ministry of Health (MoH). In the IPP, there must be a Title/Description, Index Number, Effective Date, Replaces Number, Applies To, Approved By and complete details on how the procedure must be done.
Honestly, I did not know what are the job scope of the Dark-Blue-Nurses working in MoH. For me, those nurses working office hours and sitting in front of the computer most of the time should review, update and sometimes drop the IPP from the system based on current research findings. Continuous search, read and appraise the research article is the main task and it is time consuming. A lot of thinking and writing involved here. Therefore, they should have access to all reliable databases which I don’t think we have at the moment.
I always wondering what happen to all the Final Year Project or research done by nursing students? Where we can get access to their paper? Does the management have effort to publish the papers in any database? You tell me the answer.
Nurses in the clinical area should only become the end-user of the IPP and not the one who have to do both management and clinical responsibilities at the same time. This is one of the reason why I happily resign from the MoH because of the unclear and unfair job distribution.
Nursing Practice
Sooner or later, we have to work towards a paperless hospital. Everything should be computerized and system generated. At first, it is going to be complicated but once we get used to the system, our work will be much easier.
Should we changed to 12-hours shift? Personally, I do not think it is a good idea because our nurse-patient ratio is not ideal and our huge Bed-Occupancy-Rate (BOR). No matter how much working hours we have, it will never get enough. Everybody should aware about this and that’s why we have continuity of care.
Furthermore, the National Nursing Audit (NNA) should stop focusing on the 5 procedures only: Administration of Oral Medication, Administration of Intravenous Infusion, Aseptic Wound Dressing, Blood/Blood Component Transfusion, and Pain as 5th Vital Signs. Please move on and cover other procedures also.
Nursing Payment
Once we manage to improve on our nursing model and development with a clear career pathway, that’s the only time we can ask to increase our basic salary. When this happen, all nurses working abroad will faithfully come back and serve for people of Malaysia.
“Berubahlah. Bila kita anti-perubahan, kita sebenarnya tidak berfikiran terbuka.”
(Azizul Azli Ahmad – Otak Power)
Until we meet again.
May peace be upon you.
Hera Syahirah ヅ 