This year’s World Health Day, held on April 7 (2020), has the tagline “Support nurses and midwives”.
As the world deals with the Covid-19 pandemic, it is an opportune time to remember and recognise the key role nurses and midwives play in the provision of healthcare.
Nursing has been around since time immemorial.
The foundation of nursing as a profession was due to Florence Nightingale’s involvement in the Crimean War (1853-1856).
She associated health with cleanliness, fresh air, light, clean water and efficient drainage, the lack of which led to illness.
Nightingale established the first school of nursing linked to a hospital.
The word midwife meanwhile, means “with women”.
Midwifery is concerned with the assistance and care of women in pregnancy, childbirth and the immediate period after delivery.
Nurses and midwives comprise about three-quarters of the healthcare workforce globally.
While nurses and midwives have traditionally been females, there are increasing numbers of males in both professions.
According to the Health Ministry’s Health Facts 2019, there were 106,373 nurses in Malaysia in 2018, with 65,153 in the ministry, 34,874 in the private sector and 6,346 in non-governmental organisations (NGOs).
All nurses follow a time-honoured scientific process designed to deliver good patient care, involving:
- A detailed assessment of the patient’s medical, psychological and social state.
- Formulating a diagnosis of the patient’s condition and behaviour.
- Using their expertise to establish realistic goals for the patient’s recovery
- Implementing the care plan consistently
- Documenting the patient’s progress
- Analysing the effectiveness of the care plan and the patient’s response, and
- Modifying the care plan if necessary, to ensure that the best patient outcomes are achieved.
Nurses and midwives utilise their clinical judgment to incorporate objective data with the subjective experience of the patient.
This approach ensures that every patient, irrespective of their station in life or wherever they are, receives the best possible care.
Like medicine, nursing and midwifery is an art and a science.
Their core is a fundamental respect for human dignity and an appreciation for a patient’s needs.
Each care process is implemented with the compassion and dedication that nurses and midwives are well known for.
Each nurse has specific strengths, skills and expertise in accordance with her specialty or job function.
For example, a nurse in the intensive care unit (ICU) will have different skill sets compared with a nurse in the accident and emergency department.
Ask any doctor and there will be near unanimous agreement that nurses and midwives are the eyes and the ears of doctors.
Nurses and midwives do not only play a direct role in patient care.
They are also involved in the development and implementation of nursing standards, quality assurance programmes, and the management of nursing services, as well as of healthcare facilities and organisations.
The relationship between nurses and midwives, and patients, is based on trust, just like the doctor-patient relationship.
Many patients divulge their innermost secrets to their nurses and midwives.
Knowledge about the patient’s preferences and other issues can impact on their healthcare facility, and may even lead to prudent financial expenditure.
Nurses and midwives are familiar with the cultures, traditions and practices of the communities within which they practise.
As such, they are essential during any emergency, whether national or local, like the current Covid-19 outbreak or the resurgence of poliomyelitis in Sabah at the end of 2019.
Midwives are vital for maternal and newborn health, including family planning. Most of the deliveries in Malaysia are done by midwives.
The relationship developed during the course of their relationship with women during pregnancy, childbirth and the immediate period after delivery, enables them to provide health education in a way no other health professional can emulate.
According to the World Health Organization (WHO), more investment in midwives could avert more than 80% of all daily maternal deaths, stillbirths and neonatal deaths, as well as prevent almost one-quarter of pre-term births, i.e. before 37 weeks of pregnancy.
WHO states that many countries need to ensure that nurses and midwives work in environments that are safe from harm, that they are respected by doctors and the public; and that their work is integrated with that of other healthcare professionals.
The organisation has called on its members to invest in five areas of nursing and midwifery:
- Accelerating investment in nursing and midwifery education
- Employing more specialist nurses
- Investing in the leadership skills of nurses and midwives
- Making midwives and nurses the heart of primary care, and
- Supporting nurses and midwives in delivering health promotion and disease prevention.
Patients all over the world and in Malaysia are treated and cared for daily, even on public holidays, by dedicated nurses, midwives and their medical colleagues, whose frontline jobs entail lots of sacrifices, e.g. health, sleep, family time, and sometimes, their lives.
There is rarely any public acknowledgement and recognition, let alone accolades, of their dedication and hard work, although that is changing during this Covid-19 outbreak.
However, there has been no lack of complaints about the services provided by public and private healthcare nurses, midwives and their medical colleagues.
While some of these complaints are justifiable, the vast majority are not.
The Covid-19 outbreak is a reminder of the dedication of the nurses, midwives and their medical colleagues.
All nurses, midwives and their medical colleagues in the frontline of healthcare provision, particularly during the Covid-19 outbreak, deserve everyone’s gratitude and admiration.
Theirs was, and is, an example of the core values of the nursing and medical professions, i.e. to cure sometimes, to relieve often and to comfort always.
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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