Nursing In Zimbabwe And Now Lecturing Nursing In Australia

Meet Patience Moyo, a Lecturer in Nursing with a wealth of experience nursing in Zimbabwe prior to coming to Australia. She shares in this article what the differences are between Zimbabwe and Australian nursing, her experience and thoughts as a lecturer in nursing, tips and advice to junior nurses and much more! Since being a Lecturer in Nursing, she has contributed to four textbook chapters and also published a research study in an international journal.

Introduction

Thank you for this great opportunity to showcase the value of being a nurse. I have been a Registered nurse for nineteen years.  I am from Zimbabwe, born in Gwanda but grew up in Hwange and Bulawayo.

My specialities are currently in acute surgical nursing, theatre nursing and academia; however, I have experience in various specialities. In Zimbabwe, I have worked at Hwange Colliery Hospital and amassed wide nursing experience in the following specialities: medical/surgical nursing, paediatric nursing, critical care nursing, emergency care nursing, midwifery, and nursing education.  I worked in Zimbabwe until 2008 and then migrated to Australia.

Having migrated to Australia in 2008, I have gained great nursing expertise in surgical nursing, theatre nursing and academia. In Australia, I have worked at Dubbo Base Hospital, Lourdes Hospital, Holy Spirit Catholic Aged Care Facility and Charles Sturt University.  I am very passionate about nursing to which during the time I worked at Dubbo Base hospital, I was awarded the 2013 Best Nurse of the Year award.

My current specialities are surgical nursing, theatre nursing and academia. In my nursing career, I have worked in various capacities which includes Registered Nurse, Clinical Nurse Instructor (CNE), Clinical Nurse Specialist, Acting Nurse Unit Manager and Lecturer in Nursing. Since 2016, I have worked as a Lecturer in Nursing and worked on a casual basis as a Registered Nurse in various acute health care contexts such as surgical, Intensive Care Unit, Emergency Department, Paediatric Unit and Post Anaesthetic Care Unit.

Working as a Registered Nurse, my focus is to provide the best nursing care possible using evidence-based practice for optimal health outcomes. Working as a Lecturer in Nursing, my academic focus is to empower students to be equipped with excellent clinical reasoning skills and clinical professional capabilities to be able to apply evidence-based practice to work safely within the dynamic health care context.

Tell us about your journey nursing in Zimbabwe and then the journey to Australia.

My nursing journey in Zimbabwe and here in Australia have been very much enjoyable and interesting as well. Most of the aspects of nursing in Zimbabwe are like the nursing here in Australia with the difference being that Australia is more advanced in technology which is something which I had to learn quickly.

One of the things which I had to learn quickly was the use of equipment such as the infusion pumps, syringe drivers, Patient-controlled analgesia (PCA) machines e.t.c. as I had limited experience utilising these, thankfully with the support from my fellow colleagues and with me being a quick learner this was not much of a big challenge.

In Zimbabwe, Registered nurses are able to independently do most of the things by the time they graduate such as diagnosing and prescribing most medications and intravenous fluids, inserting an intravenous cannula, performing venepuncture, ordering some of the blood investigations, sputum and urine tests, inserting an indwelling catheter to both males and females, insert a Nasogastric tube without needing a doctor’s order,  removing an Underwater seal drain(with a doctor’s order).

This presented a big challenge as despite being competent and able to do most of these things, I was unable to do so once I got to Australia with a requirement to gain additional accreditation for most of these things and with some of these things completely not considered to be within the scope of practice for a Registered Nurse unless there are standing orders or one has received a special accreditation for the same.

I remember, situations in which I would feel very challenged when there was a patient who required intravenous antibiotics but had no intravenous cannula and while I had the knowledge and skills to insert one, I could not do so as I had not received the new accreditation at the time and this was very frustrating as it meant the patient would miss a number of antibiotics while waiting for the only Junior medical officer who would also be overloaded with work taking care of several other patients on various wards.

I also found it very challenging when I was limited as to what I can do during an emergency situation while waiting for the medical team to arrive and yet I had the know-how and competency to undertake some of the things and yet, could not do so due to those aspects of health care being considered to be outside my scope of practice.

Another aspect which I found different was that at the time of arrival, there was a recorded handover, to which this was a stark difference as in Zimbabwe we had a bedside clinical handover, however, I am grateful with the ever-changing nursing practice, as there is now bedside clinical handover utilising the ISBAR (Identify, Situation, Background, Assessment and Recommendation) approach and even better still Safety Huddles take place prior to the bedside handover which I find very valuable for patient safety and continuity of care.

You’ve worked in many roles,  can you tell us about each of these?

Clinical Nurse Educator

Working as a Clinical Nurse Instructor/Clinical Nurse Educator, my role was to support professional development for the nursing students and nursing staff; provide support to ensure appropriate levels of competencies are achieved by all for effective, safe nursing care; provide support in resolving clinical issues, develop policy and procedure directives or help dissemination and implementation of newly developed policies or any other organisational changes, maintain appropriate communication with all stakeholders as well as documentation.

Clinical Nurse Specialist

As a Clinical Nurse Specialist, my roles involved, using my specialised knowledge in the Surgical area to lead and empower other nurses within the ward I worked in, I supported other nursing colleagues to problem solve, I was involved in continuous evaluation and improvement of the quality of surgical nursing practice for optimal health outcomes, I also engaged in root cause analysis, I helped to develop new policy and procedure directives while also supporting with acting as an organisational change agent.

Acting Nurse Unit Manager

My role as the Acting Nurse Unit Manager involved supervising all staff within the ward, recruiting staff as required, developing and coordinating staff rosters to ensure safe staffing levels during each shift, taking care of the ward budget to ensure the funds are used within the allocation, managing staff performances and providing support accordingly, working within the interdisciplinary teams to ensure professional relationships are maintained for positive patient health outcomes, keeping up to date and implementing policies while ensuring that the ward staff adhered to these as well, organising and attending various meetings, addressing any issues within the ward which included the Incident reports and maintaining appropriate communication as well as documentation.

Lecturer in Nursing

While working as Lecturer in Nursing, my role has included teaching both on campus and online tutorials/lectures, developing/reviewing learning content, participating in the review of the Bachelor of Nursing Curriculum, working as a Subject Coordinator for various subjects across various campuses.

How do you manage lecturing/academia and staying clinically relevant?

I have continued to work on a casual basis to remain clinically relevant until last year, to which, I took some time off to care for my daughter while only continuing to work in a single job, however, I intend to return to working in the clinical areas shortly when my daughter is at least two years old.

What experiences should nurses get before they become lecturers/educators?

For nurses to become a lecturer/educator, one needs to gain practical nursing experience and advance oneself theoretically by undertaking a Post Graduate course and master’s degree. In some cases, a PhD places one at an advantage for securing a job in academia. Experience in clinical teaching is also valuable. Certificate IV in Training and Assessment is also helpful in helping one to develop skills of adult learning and teaching.

Why are you so passionate about education and what makes a great nursing educator?

I am very passionate about being a lecturer as I am a lifelong learner and have a strong desire to share knowledge, skills, and values as this helps me to empower others to reach their maximum potentials and achieve their career dreams which adds value to the communities we live in as more people become experienced in providing evidence-based nursing.

Another reason why I am passionate about teaching is that learning is reciprocal as I also learn a lot from those that I teach which enables me to broaden my knowledge and skills. What makes me a great teacher is that I view each person as an individual and can mentor, support and inspire others.

What are your top pieces of advice for nurses to support their staff/students in reaching their potential?

My advice for nurses to support their staff/students in reaching their potential is to foster mentorships as this helps in recognising one’s strengths/weaknesses and creates a platform for reinforcing one’s strengths while also building on one’s weaknesses.

What are some of the most common themes you find students struggle with learning from your experience as a lecturer?

I find that students most times struggle with the scientific aspects of nursing such as anatomy and physiology and pathophysiology as well as research. I find, that when one tells themselves that these aspects are very challenging, they often struggle in those areas and as such a positive attitude always works in one’s favour which I always encourage.

What are the most challenging aspects of your day to day role?

The most challenging aspect in my day-to-day role as a lecturer is the time factor as at times students require more time for practice and there just is not enough of this. Another challenging aspect of my job is that at times students do not perform so well despite the effort they would have put and as an academic I cannot just make the students pass based on effort as I must maintain integrity while also ensuring the safety of the community, trying to help students realise that effort does not always equate to quality can be a great challenge.

Another challenge is that students have certain expectations which may not be in line with the university’s expectations, and this can tend to have a negative influence on the students’ learning experience and overall satisfaction.

What do you wish you knew before you started educating?

Before I started educating, I wish, I had known that there is more to academia than teaching. I came to the realisation that there was leadership, management, administrative, community and professional engagement requirements as well, something which I had to learn very fast while also learning to manage to navigate several University systems and processes.

What are some common misconceptions about lecturing?

The most common misconception about lecturing is that anyone who has undergone nurse training can be a lecturer, and since being in the field, I have realised that lecturing is not about the nursing professional expertise but certainly is beyond this as one also needs to acquire skills in teaching, administration, and research.

 How has COVID19 impacted on yourself and your colleagues, students?

Covid-19 is the worst thief which has stolen people’s well-being, lives and more. Covid-19 has negatively impacted the way we teach as we have had to move from on-campus to online teaching which has presented a challenge for those students who prefer/thrive on on-campus learning. There has been increased workload for us as we had to adapt to the online teaching, with increased administrative requirements as most students required extensions for assessment tasks due to the impacts of Covid-19 such as home schooling or increased working hours.

 In some cases, students have been forced to withdraw from their university courses as they could not cope with the increased working hours while also studying at the same time. Covid-19 has also resulted in job losses, which is very sad as any job loss most often does not only negatively impact the individual, but, however, the impacts could also extend to the family/lies the individual normally fends for. Due to Covid-19, staff have been working from home which can be a challenge internet wise, disruption wise etc.

Covid-19 has also seen several people losing their beloved ones. Due to lockdown and border closures, people have been working without taking leave and this can have an impact on physical and psychological health.

What are the biggest lessons you’ve learnt on your nursing journey so far?

• The biggest lessons I have learnt in my nursing journey so far includes the following:
• Evidence-based nursing practice is the best way to go to ensure safety and positive health outcomes.
• It is okay to acknowledge that you are not sure about something and simply ask others or look up information, bearing in mind that our errors can be detrimental to one’s health. We learn every day and we can never know everything.
• Listening to the patient is always best as they are the expert to their own health. When patients and their families feel that their input is being valued, I often see positive therapeutic relationships.
• A smile during appropriate times always goes a long way to provide warmth and comfort in patients and families alike.
• Supporting others has reciprocal benefits, as per adage from an unknown Author, TEAM (Together Everyone Achieves More), from the most reserved person that I use to be, I quickly learnt this in my early nursing career journey.
• Reflection is key to developing oneself both professionally and personally.