Volunteering on a Surgical Mission: An Insight from Lead Nurse, Raj Mashiana

Where do I start? So much to say and so much to come back home to and process after three weeks in Ethiopia.

Let me start by telling you about my role in the Project Harar Complex Mission 2019. I was so happy and honoured when Project Harar asked me to be Lead Nurse for the Mission and excited about what this responsibility would bring. I was also a little worried as I wanted to do my very best for the team. I have been volunteering for Project Harar for six years now and being a part of the charity has not only been the highlight of my nursing career, but it has been the highlight of my life.

My Lead Nurse role involved planning several months in advance for the Mission together with the team at Project Harar. I was charged with recruiting and scheduling the nurse volunteers appropriately for the three stages of the mission – pre-operative, surgical and post-operative – ensuring that there was the right skill-mix and experience to provide the highest quality care to our patients over eight weeks. It was also vital that we had a mix of returning volunteers and new volunteers across the Mission, to ensure not only that we provided high quality care for patients, but also that our nurses were learning and being supported at all times.

In addition, I supported the events for our nurses’ fundraising campaign, leading and motivating them in their efforts. I had a fantastic partner nurse who led the Mission with me – Nurse Lara Tang. She had the huge task of planning and managing our stock requirements before we left – ensuring we had the right medical equipment for the Mission. I also worked with the Mission’s Lead Doctor to plan and arrange teaching of the Ethiopian staff each morning, on topics such as tracheostomy care and nasogastric feeding.

I landed in Ethiopia during the second week of the pre-operative stage and stayed for the two following surgical weeks. It was so exciting once again to be part of the team, meeting all the new patients as well as some past patients from previous missions. I arrived at a pre-op centre that was well set up. The team in the first week had done a fantastic job, registering and assessing all the patients, taking histories of their conditions and the impact it had had on their lives. Our wonderful dieticians had also worked hard to build up the strength and physical well-being of our patients. Now, in the second week, patients were ready for the doctors’ medical clerking and examinations as well as the investigations they needed, such as scans, X-rays and blood tests.

My role as Lead Nurse involved many more responsibilities than in previous years. Working together with the Project Harar team during pre-op, I co-ordinated patient logistics – organising visits to external clinics for tests, following up test results, vetting new patient referrals with the doctors, escalating any issues, and reviewing and making changes to our routine on a daily basis as patient care demanded.  I also planned and co-ordinated the Ethiopian nursing staff rota across pre-op, surgery and post-op.

During the two surgery weeks, I talked through theatre lists with our surgeons and anaesthetists, and provided the surgeons with nursing feedback on a daily basis of what things had gone well and what needed to change on the surgical ward. I worked closely with the Project Harar team, reviewing stock daily and ensuring stock was being purchased as needed, planning ahead on the admission and discharge of patients, co-ordinating their transport. I managed the nursing staff to carry out their work on the ward and monitored and supported the nursing staff at all 3 sites to ensure things were always running smoothly. I also supported our ward doctor with numerous daily tasks, kept patients up to date with plans and changes to their treatment and provided moral support to them and to their parents or guardians. I never forgot to ensure that the nursing staff were well and looking after themselves, particularly in such a busy and sometimes stressful situation.

This just touches the surface of what my role entailed but I hope it gives you an insight into the Lead Nurse’s role, and the invaluable support provided to and received by each and every individual. There is so much more I did during the three weeks but I am struggling to put it all down on paper. My role was not as hands-on or clinical as in previous years, which I found hard at first as I was not able to spend as much time on the ward or do as much one-to-one nursing care. Thinking about my role back home in the NHS, I had to remember that being a lead/senior nurse can take you away from direct nursing care. I also had to remind myself that all the tasks that I did – chasing, escalating, having conversations with other healthcare professionals, organising of transfers, liaising with families, sorting out problems – was ALL for the patients. All the decisions I had to make were for the benefit of our patients. It took me a little while to take this in and realise that I was still supporting and making a difference to these patients’ lives.

I would not have been able to do this without the support of my co-lead partner Nurse Lara Tang! She was my gem and was by my side each step of the way. She also made me realise that I couldn’t do it all myself and we came to an agreement that I would support the Project Harar team in the organising, logistics and the follow-up of the patient cases and she would manage and support the clinical side on the ward. The nurses throughout the mission were a fantastic team and absolutely brilliant at their roles! They took on the daily challenges of nursing in Ethiopia yet always had a spring in their step and a smile on their faces!

I was also not able to fulfil my role as Lead Nurse without the fantastic working relationship and support from Biniyam (Project Harar Ethiopia) and Emily (Project Harar UK). We were the Trio! The support, communication and constant catch-ups throughout the day kept us all going and ensured team decisions were made! Even with the challenges, stresses, busy days and constant phone calls at times, I would not change it for the world…. AND I would do it all again in a heartbeat!