Lorraine

Lorraine is an Advanced Clinical Practioner and Emergency Department Nurse with nearly 40 years-experience. She works at the Countess of Chester Hospital in Cheshire.

She spent a week in Sierra Leone in December 2019 with UK-Med on an observational training exercise, and spent three weeks in Malawi as part of the UK Emergency Medical Team’s response to COVID-19 last year, returning on Christmas Eve 2021.

In Malawi, she joined seven weeks into the ten-week response, supporting a group of 10-15 student nurses in the small emergency medical ward at Kamuzu Hospital, the main hospital in Lilongwe, Malawi’s capital.

New experiences

Being in Sierra Leone was both amazing and horrifying at the same time. It was quite traumatic to see how they managed with such little resources. We went to remote clinics to observe.

It was polar opposite to the NHS. But the staff were so friendly and welcoming. They showed us how they adapted to the resources they had. It was a fabulous week, especially due to the team I travelled with.

In Malawi, I followed the nurses and doctors during the working day to see any gaps in clinical areas or knowledge that I could help with. I assisted with catheters, medication and showed them how to use the ECG machine and interpret the results.

The doctors were interested in my half-doctor, half-nurse status as an Advanced Clinical Practitioner, so I’d support then looking at chest x-rays. I was asked to continue the work started by Harriet (a previous UK EMT Emergency Department Nurse) on an assessment form for patients on ABCDE (airway, breathing, circulation, disability, exposure). They found this beneficial when assessing unwell patients.

A new-found appreciation for the NHS

During my time in Malawi, patients sadly passed away and at a young age. One 14 year old girl who had been with us for three days, another 23 year old woman came in with seizures, she tested positive for COVID-19, but also sadly died. The resuscitation or complex care of such patients was not possible in Malawi due to the lack of appropriate equipment. The trips taking patients to the morgue was extremely sad.

It changed my perspective, the student nurses worked hard and as in the UK it was very busy, but they seemed more relaxed and didn’t have the same angst. The patients were very deferential to the staff and happy to wait without complaints.

I very much appreciated the students and staff in the Emergency Medical Department I worked in. They took me under their wing and tried to teach me the local Chiwewa. We had many chats about their own lives in Malawi in comparison to mine in the UK and the differences in nursing. I have kept in touch with one girl Mercy, a fabulous student who was enthusiastic to learn and made sure I was doing clinical work the Malawian way. 

Addressing burn out

Before going to Malawi, work in my UK Emergency Department had been stressful and very busy. The two years of COVID-19 had left staff including myself, feeling the pressure of work commitments and long hours. And as with most hospitals, we were overwhelmed by patient volume and complex COVID-19 patients.

I found the experience in Malawi extremely rewarding, helping me to refocus on what’s good. Since I’ve been back at work, I feel more relaxed, not as stressed and very appreciative of the resources we have here in the NHS.

I’m proud I’ve done it. I feel a huge sense of achievement and despite the long waiting lists in A&E, I’ve really enjoyed being back of work, with a renewed sense of purpose and motivation.