Yemeni nurses under stress (Part 2) [Archives:2007/1024/Reportage]
By: Fatima Al-Ajel
For Yemen Times
Female Yemeni employees are always under scrutiny. They continuously must account for everything and invariably face prejudice against women in the workforce.
In Yemen, nursing is the symbol of disparagement against women and some negative societal views cause many native nurses to seriously consider leaving their careers, regardless of the consequences. A look into various circumstances from both the nurse's and the patient's point of view reinforces this opinion.
Abeer Hazam, a nurse at Al-Thawra Hospital, says there's no respect for the nursing profession. Degradingly, many believe that nurses aren't merciful angels, but rather menial servants who are there to help relieve a sick patient's discomfort. Yemenis don't understand the importance of the nursing profession, which exists to supplement and enhance the work of doctors.
However, considering the social environment, Hazam states, “It's difficult to work far from home or travel to work in villages, so why don't nursing administrations train people in these villages to help alleviate nursing staff shortages?” Yet such won't help the fact that nursing is no ordinary technical career and the field's level of sophistication is beyond rural Yemeni schools.
H. H., another nurse at Al-Thawra Hospital, daily suffers societal views and the pressure they create. Her family especially considers nursing a low-ranking career. “At first, my father was against my studying at the nursing institute because we are from a higher social class. My father believes my work as a nurse is more like a servant to patients,” she says. “Because my job requires dealing with different people, especially men, my father tried unsuccessfully to stop me from completing my studies.”
H. H. also experiences society's negativity toward nursing. “If they need me to help, I'll go, even working the midnight shift. They'll thank me and pray for me, but afterward, they'll say nursing is bad, especially for girls, because it forces them to go out in difficult situations and it's dangerous anyway.”
A nurse at Saba'een Hospital since 1991, Salimah Al-Jonied says, “I hate working nights at the hospital due to negative social views, as well as the difficulties of working at night. I only worked the night shift during the war.”
Regarding working in rural areas, she comments that many other nurses will accept and be willing to work there; however, “I absolutely refuse to work outside Sana'a, even if there are many persuasive circumstances to the contrary,” she emphasizes.
While nursing is a wonderful profession, it can be bothersome when some patients' attendants, usually family members, want nurses to do whatever they say, even if it hurts the patient. This is based on such individuals' attitude that a nurse isn't so much a medical professional as a mere servant. The difficulty lies in convincing families and society at large that nurses are doing what's best for patients because they're following solid orders by the attending doctors.
Amat Al-Wahab Al-Saragei has taught at Al-Thawra Hospital's Nursing Institute since 1983; however, she isn't exempt from the problems and inconveniences caused by her family and her community's views, nor from the job itself.
“My mother wouldn't agree to let me work as a nurse, but the need for additional income forced her to accept the matter. Unfortunately, our traditions and customs play a major role in constructing and perpetuating negative images of nursing,” Al-Saragei says.
Reminiscing, she adds, “At the beginning of my career, I went to work in Sanhan, where area citizens had low awareness and understanding of what nurses are and what they're supposed to do. Many didn't understand or appreciate the importance of nursing or how women are the best contributors to this field.”
In the end, it was the lack of basic necessities like clean water, safe housing for female nurses in the villages that led her to “never accept work outside major cities.”
A 2006 student-run study involving 207 patients at Al-Thawra Hospital on the perceived levels of Yemeni and foreign nursing staff found that approximately 70 percent of those surveyed said Yemeni nurses are better than foreign staff in a variety of aspects. Yet, foreign nursing staff were said to give better care and had higher salaries.
Asked about the treatment and care they received from nurses, the patients replied as follows:
Mohammed Ali Darem said Yemeni nurses are better and more merciful than foreign nurses. Mohammed Al-Jabal added that he prefers Yemeni nurses due to the common language, which makes it easier to communicate with them.
Some foreign nurses were good, but differing languages and customs cause misunderstandings between patients and nurses. Yemeni nurses also were said to realize the importance of their responsibilities and duties toward patients, as well as their country.
However, other Yemeni patients found foreign nurse more practical than Yemeni ones because they were honest in their treatment and most didn't neglect their duties.
Homadia Salah remained neutral, believing that positive or negative aspects never relate to a nurse's nationality, but rather to his or her personality. If nurses like their jobs, they'll do well regardless of their nationality or place of employment.
Because the majority of Yemenis are uneducated, it's difficult dealing with foreign nurses, so patients tend to overlook their efforts. Amar Sarhan Al-Hatami and Jamil Al-Matri feel nurses with less experience “know how to deal with us and know our traditions.” Does this mean experience is viewed as negative? Wouldn't experienced nurses be preferable to those right out of school, since the latter group could jeopardize patient care?
Abud Al-Moniem, deputy chief manager of Al-Thawra Hospital's nursing department, believes that there's been observable improvement in Yemeni nurses in recent years, especially after changing the system of accepting new graduates from either institutes or universities.
“The outcome from nursing institutes is higher than before and reflects on the nursing performance, both at the hospital level and within society. This brings more attention to them, giving them better ranking positions and increasing their income. All of this may change the negative view society has about nursing,” he says.
It's been said that, “We need to improve both public and private Yemeni institutes, which invariably will lead to increasing qualified of Yemeni nurses.” Nursing plays an important role in treatment because they are closer to patients than doctors or even a patient's family. It's important for a nurse to be knowledgeable, have enough career experience and always follow any new developments in the nursing field, which ultimately provides patients better care.
According to Al-Moniem, “We now have very good nursing staff and many countries surrounding Yemen are looking for these qualified staff to work in their hospitals at higher positions and salaries. Hospital management has lists of names needing courses in a variety of fields and a system of selecting the names.”
Because many nurses are leaving their careers, many hospitals constantly are finding it difficult to find employees, train new staff or fill recently vacated posts. This then indirectly becomes a self-perpetuating problem on its own, thus slowing the process of developing the nursing career.
As previously noted, the departure of nurses is attributed to women due to low salaries, familial circumstances and the desire to work in a more comfortable and fulfilling career. Disorganization within nursing administrations magnifies the problem, pushing more experienced nurses out of the field and into privately-based careers or no work at all.