Rachel Vickers, an A&E nurse from the NHS, has been working in Connaught Hospital, Sierra Leone’s main adult teaching hospital – for almost a year.

She is working on a 3-year project funded by the Burdett Trust for Nursing and the King’s College Hospital Nurses League that is working with the matron’s office at Connaught Hospital to develop a Continuing Professional Development structure for nurses. Rachel is part of our volunteering scheme: connecting health professionals in Somaliland, Sierra Leone, the Democratic Republic of Congo and Zambia with staff in the NHS. Here she shares some of her experiences.

Since arriving in Sierra Leone last year, I have really enjoyed getting to know the nurses at Connaught Hospital and have had a lot of fun working alongside them. I have been able to share my experience from working in the NHS as we work together to improve knowledge and skills, raise standards of clinical practice and sustain good quality care throughout the hospital.

Early warning to detect deteriorating patients

The main focus of the Continuing Professional Development framework has centred around the care of acutely unwell patients in all departments of the hospital. The Sierra Leone Early Warning Score (SLEWS) system, introduced by previous nurse volunteers, is in operation at Connaught, which has been key to patient monitoring. We have been running regular SLEWS training sessions as a ‘refresher’ for the nurses throughout the hospital, as well as a course on the Recognition and Treatment of Emergencies (RATES) for nurses. Our aim is to work alongside the nurses and give them the understanding and the tools to be able to care for unwell patients – especially when faced with a lack of resources and sometimes even in the absence of doctors.

I have really enjoyed being part of the training sessions and seeing how the nurses love to participate in simulation and scenarios – something that does not feature very heavily in nurse training at Connaught at present. We often have very interesting discussions about real patient cases that nurses have been involved in and it is so interesting to hear how they managed the situation and also to bring other ideas to the table around how practice can be improved.

My project co-lead, Rhoda (a nurse who has worked at Connaught for over 10 years) and I are also proud of our team of nurse facilitators who we have recruited to help us to deliver the training sessions. They are also passionate about training and education and have a wealth of experience to share with the nurses and I am confident they will support the Nurse Education team for a long time to come!

My favourite aspect of our training though is when we follow up with our participants on the ward with mentorship. We meet them in their clinical area and perform vital signs, or conduct an ABCDE assessment, depending on which training they have attended. We have found that practical application has been such an important way to consolidate learning and the nurses feel really happy that we are supporting them in the clinical setting too.

Working in partnership to identify equipment needs

Whilst we were spending time on the wards with the nurses, we noticed that even though they were now equipped with knowledge, they were facing challenges with the availability of equipment. Blood pressure machines were often faulty or not available at all, making regular and comprehensive monitoring of patients almost impossible. Therefore, we have been able to provide blood pressure machines and thermometers to all wards and departments at Connaught. We have also been able to provide the Accident and Emergency department with standing monitors.

Our nurse ‘champions’ ensuring training is cascaded

The aspect of this equipment rollout that was most exciting for Rhoda and I was that we called on our education link nurses to help us! The education link nurses are a team of nurses embedded within each of the wards in Connaught who have been trained to cascade training to their peers and so were able to deliver a bedside training to their colleagues to ensure correct operation and care of the devices. Since the rollout, we have been visiting the wards regularly to offer support and it has been great to see nurses motivated by the equipment as well as seeing our education champions teaching and training their peers.

Supporting Continuing Professional Development

Moving forward, we are continuing with our SLEWS and RATES trainings as well as working with Matron’s Team to conduct trainings on learning needs they identify, such as burns management, nurse care-planning and care of the stroke patient. We are monitoring the effects of our training and provision of equipment through audit on the implementation of the SLEWS tool in clinical practice and are hopeful that we will see an improvement that reflects the nurses’ motivation and enthusiasm we see on the wards!

Volunteering with KGHP

Reflecting on my time in Sierra Leone so far, volunteering with KGHP in Sierra Leone has given me the chance to develop professional skills I wouldn’t have had exposure to in my role in the NHS, such as project management, procurement, budget planning and cross-cultural communication skills. Not to mention the experience I have had in teaching and mentoring nurses. I am looking forward to bringing these skills back to the NHS and sharing my experience with my colleagues.

The highlight for me has definitely been the nurses I get to work with! They have been very supportive of me, engaged with our trainings, willing to facilitate and even teaching me Krio, the local language! I have sometimes found it a challenge to reconcile the stark contrast between the health system here in Sierra Leone with the NHS, but my nurse friends and colleagues here, who continue to work hard for their patients and to contribute to their professional development are a huge encouragement. So, as my colleague Rhoda always tells me, “We move”!

Through our long-term partnerships and volunteering scheme at KGHP, we promote skills and knowledge exchange, and mutual learning that contribute to building a stronger health workforce and improved quality of healthcare both internationally and back in the UK.