The Anchor, Eldoret, Kenya
As month of July came to an end, I realized that few months were remaining to renew my practicing license to remain as a legitimate and registered nurse (RN). Being a worst crisis manager, I braced myself to complete continuous professional development (CPD) courses early enough. I recalled how I had been able to renew my license from thousand miles away. It was a triumphant experience as Nursing Council of Kenya (NCK) had made tremendous improvements which I gladly embraced and celebrated. Fascinated by this experience, I enthusiastically got in the mood of doing the courses. The excitement however was short-lived upon revisiting the email communication from my regulatory body.
I was first offended by being addressed wrongly. I wondered how everyone could addressed as Halima and how Halima had been overwhelmed by carrying entire Kenyan nurses’ burdens. I imagined how many CPD courses Halima had done as a sacrificial lamb and if I was further required to do any of the courses! Then I quickly shifted and snapshots of messages and emails from my bank, school and even network provider addressed me with my correct names played in front of me. I asked myself many questions how NCK could not identify me as an individual despite my annual requirement to renew license at a fee and I am continually expected to give individualized patient care! A monologue immediately transpired “After paying your license renewal fee, what value are you getting from NCK? “This was interrupted when I flashbacked my encounter with immigration officer who openly demanded a bribe to renew my passport after I had embraced a transparent system in Rwanda; it was an awkward moment for the first time after many years accustomed to “kitu kidogo/ chai ” culture. “Give NCK benefit of doubt, they must have done due diligence and are working to transform nurses.” I encouraged myself not knowing what awaited me.
As I commenced to register on the platform, I was fascinated by the message,” NCK is providing all members CPD online and mobile application.” What caught my eyes was “education offered is from Royal college of Nursing and Midwives and other respected educators”. To ice the cake, the courses are free. I tried hard to register but with numerous efforts with high speed internet and ample time, still my efforts were fruitless. I then realized free is not free after all, I paid with my time. I immediately empathized with my fellow rural nurses who are poorly remunerated, experiencing irregular electricity, poor network connectivity and are the only staff in the health facility. To remain connected, these nurses opt to use mulika mwizi phone to stay connected but here our regulatory body expects them to complete and earn the required 40 points!
Upon successfully creating an account and logging in the system, I navigated through the courses. Being an avid scholar, I was thrilled but only for few seconds. The courses are tailored to developed countries with developed and robust health systems. I looked back at my beloved country and began to wonder if the courses fitted into our setting. I struggled to find courses that are of interest, relevance and applicable to me as an individual. At this juncture, many questions deluged my mind, thanks to Prof Wong who mentored me to be strategic-problem solver. Were nurses consulted on these programs as the major stakeholders? Are nurses acquiring these courses to merely acquire points or are they gaining skills that they will implement? Do NCK have information of impact these courses are creating? What are possible unintended consequences that may arise from the CPD courses? I thought of the funny weight points of some courses that crushed my morale. Moreover, what happens in subsequent years, shall nurses recycle the courses? And being health equity advocate, I perceived that the platform is discriminating nurses especially those living in areas with poor internet connectivity rather than building their capacity. That begs the question, what factors did NCK consider in settling on the CPD courses for her clients?
Without solid answers, I logged out from platform disheartened. I continued to ask myself whether Kenyans are lazy/incapable of creating courses that suit her needs, or do we love one size fit all courses in the name of keeping abreast with global world. I recalled how I had spent several months interacting with rural communities as I designed health programs that could strengthen university-community relationship in a foreign land where I had to work with translators. The outcome was successful and sustainable programs running as I pen this article. Do not mistake me, nurses must be updated but first address educational needs based on our priority areas. We cannot go to advanced levels without mastering the basics. NCK can do better than this, CPD courses need not to be punitive but user-friendly and relevant. We always cry of lack of public participation in many public sectors or policies, yet we cannot handle our own issues as nursing fraternity. What happened to previous continuous medical education (CMEs), why were they abolished? If there were gaps, couldn’t we address them? Or does it mean we trust other systems than our own system? NCK, we need value of our time and money and not doing CPD courses to merely satisfy license renewal requirements. Is it too hard to offer nurses courses that make practical sense to them? As for now, voiceless nurses especially in rural Kenya, I included need to be rescued not only to continue to be in the register but also build our capacity. Is that too much ask for NCK?
About Chepkirui Hildah
She is a nurse’s watchwoman. She is currently pursuing MSc Health Economics and Policy (University of Birmingham), holds MSc Global Health (University of Global Health Equity) and BScN and Public Health (Kenyatta University). She is a Chevening scholar, 120 under 40 global family planning leader, Ashoka changemaker fellow, YALI alumni, community leader. Connect with her on www.linkedin.com/in/chepkiruihildah