Nursing a Dream: RN Takes Can-Do Attitude to Haiti
Ruth Barnard, PhD, RN, was about as far away from Haiti as a person could get in her cold, blustery hometown of Ann Arbor, Michigan. Newly retired from her professorship at the University of Michigan School of Nursing in 2000, she was ripe for a new challenge. But she didn't choose it -- it chose her.
Barnard explains, "The senior pastor at First Presbyterian Church of Ann Arbor asked me if a school of nursing could be built in Haiti. I said, ‘Sure.' He asked a question, I answered it. That simple. Then he asked me to lead the effort. I decided yes, I'd try. I knew nothing about Haiti. It's been a real eye opener."
Indeed. Barnard is something of a go-to authority on the state of nursing education in Haiti. She says there are several nursing schools on the island, but the quality of education "varies greatly -- generally, they're not very good."
Time Stood Still
When she started her newfound project in earnest, in about 2001, she found healthcare in Haiti to be equivalent to US healthcare circa 1940.
Barnard says the first nursing school in Haiti opened in 1915 when the U.S. Navy occupied the island. Navy nurses kept things going until the early '40s. "That's when World War II got in the way," quips Barnard. "They had gotten off to a good start, but that's where it was left. Textbooks, when I got there, were still from that distant time. It was a living time warp. Medical capabilities were not keeping pace with rest of the world.
"Hospitals didn't have much equipment -- they had to lock up their mattresses because they would be stolen," recalls Barnard. "Empty beds were just old metal frames, hand-cranked style. There were no electric beds because often there was no electricity!
"Central supplies were a mish-mash. Patients' families had to supply their own food, basic care. They had to go to a pharmacy to get medications, IV supplies. So the hospital I saw at that time was a shell of a building -- a dirty shell at that. Each time I went, my eyes opened wider."
A Few Rich, Many Poor
A further frustration, says Barnard, was the social and professional stratification of Haitians, "...bright, charming, wonderful people." With no middle class, Haitians are either the minority select elite, or the poor. Very poor. And nursing, it seems, has always fallen to the lower strata.
Haitian nurses-in-training typically struggled to get a real feel for their chosen profession. "Clinical training consisted of taking students and dumping them in a hospital and hoping the staff would teach them what they needed to know to be a nurse in the clinical areas. That didn't always happen," says Barnard. She remembers when one of her associates traveled to Haiti to visit a hospital. "One nursing student was found hiding in fright in a closet because she simply didn't know what to do. Because of poor preparation, the trend has been for nurses to remove themselves from hands-on care."
Barnard offers an example. On one hospital visit Barnard's associate saw a stretcher coming from an emergency room, carrying a male patient writhing in pain from a blocked catheter in his bladder. "The hospital nurses couldn't -- didn't know how to -- unblock him, so they were going to send him home," tells Barnard. Her associate showed them how to remove the catheter and put in a new one. "That patient went home and had a life. If he'd gone home with a blocked catheter he would have died -- and not in a nice way."
She pauses, then pleads, "Please don't make these wonderful people sound bad, please don't put them in any bad light. These are open, warm, brilliant people. They simply had no opportunity to learn."
But all of that is changing and hands-off, haphazard nursing is disappearing in Haiti. The winds of hope have already started to blow through island palms.
"It is really a miracle to see what has happened," says Barnard. "God wanted this. I don't usually say things like that." "This" is a sturdy growth with flowering branches. It is all rooted in The Haiti Nursing Foundation (HNF), incorporated in Michigan in February, 2005, to support the advancement of nursing in the Republic of Haiti... especially on Faculté des Sciences Infirmières de l'Université Episcopale d'Haïti (Faculty of Nursing Science of the Episcopal University of Haiti - or FSIL), located in Léogâne, Haiti. It is, indeed, the first BSN degree-granting nursing program on the island of Haiti. The foundation also lends help to Haiti's Hôpital Ste. Croix and provides tuition for one of the hospital's nurses to gain advanced study at Haiti School of Public Health. It would seem Nightingale arrives in the form of education, and nests in a burgeoning tree.
Next time: Hurdles are jumped, miracles are counted, and the first class graduates.
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