The Pulse | Tuesday, August 28, 2018

Helping Nurses Globally By Sharing Knowledge

Agnes Gaber, MSN RN ANP

For the past 10 years, Debbie den Boer and I have traveled in Africa and the Middle East to speak to GI nurses at workshops, and biannually at the African Middle East Gastroenterology Congress (AMAGE). It all began with an invitation by Dr. Ziad Sharaiha, a gastroenterologist from Jordan who was the founding president of AMAGE. He got Debbie and I involved in bringing improved standards, safety guidelines and infection control measures to the nurses in the developing world.

In 2017, he was awarded by ASGE for his exceptional work and contribution to improving standards, safety and networks between gastroenterologists in the Middle East and Africa.

We met Sharaiha in 2005 at a UEGW European Gastroenterology Conference that he, his nurse Lilishor Poponea and a gastroenterologist from Iraq asked if we would come and teach their GI nurses. “We need help,” he said. We both agreed we would be willing to share our gastroenterology nursing knowledge. When the invitation came to come to Amman, Jordan for their biannual Gastroenterology Conference and their first GI nursing workshop, I remember Debbie reluctantly asking me, “Will you go?” I replied, “Yes, if you go.”

They had established a Jordanian Association of Gastroenterology and Endoscopy Nurses and Associates (JAGENA) with the support of their physicians in 2006. The JAGENA story was becoming a model story for us to suggest to other countries in the future. A focus group of endoscopy nurses in Amman visited as many endoscopy units as possible, observed their practices and needs and worked on improving conditions and formulate guidelines and standards. As decades-long members of SGNA, we could share this knowledge with them and help implement especially the cleaning and disinfecting guidelines. Hands-on demonstrations were the best ways for them to visualize a process that is of utmost importance. We were happily surprised by GI nurses who spoke English and were eager to learn and interact.

Photo: GI Nurses from Sudan attending GI workshop in Amman, Jordan.

It is incredible how nurses who lack barriers can connect with ease. We observed this is in each country we visited in the Middle East and in Africa. Although resources were lacking in some the countries, we found their nursing education is of high standard. Because physicians from all over Africa and the Middle East would attend these meetings, many came to us for educational material for their nurses. What was, and still is, very popular is the endoscope cleaning and disinfection charts!

This is where the networking really started and we were invited to present at the first GI Endoscopy workshop of the Sudanese GI nurses, in Khartoum, Sudan. This inspired group of endoscopy nurses, who also formed their own society with great support from their gastroenterologists.  We were able to donate SGNA Core Curriculums and GI and Pulmonary Manuals to both their president and physicians. The Sudanese GI nurses organize frequent workshops and seminars for their nurses.  

The World Gastroenterology Organization (WGO) has training centers in many local hospitals in the developing world where local physicians are trained by specialist from all over the world. Because the local nurses are involved in assisting during these training sessions, it is so important that they have in-depth knowledge of endoscopy equipment, emergency procedures, endoscope reprocessing, infection control, etc. This is why Debbie and I feel so passionate about education and sharing knowledge and expertise and providing resources.

While attending the conference in Khartoum, Sudan in February 2012, we met two physicians from Nigeria. They invited us to do a program for their GI nurses during the sixth Congress of African Middle East Association of Gastroenterolgy in Calabar, Nigeria, their very first GI Nurses Workshop! The ability to communicate via email made it possible to prepare a two-day program for the GI and surgical nurses. We also presented a general session on endoscope management for physicians and nurses. The nurses and physicians were open to our suggestions of organizing an endoscopy group, and we were able to assist them with forming an endoscopy nursing society called Society of Gastroenterology and Endoscopy Nurses of Nigeria (SOGENON.)

Photo: Noel Yunusa, founding committee of Society of Gastroenterology and Endoscopic Nurses of Nigeria (SOGENON) and the organization's first president.

The following year we assisted one GI nurse from Jordan and one from Nigeria to attend the SGNA Annual Course. The next year, 11 GI nurses from Nigeria, (the whole SOGENON Board) came to the SGNA Annual Course in Baltimore, Maryland.

Our two trips to Egypt, where we spoke at GI nursing workshops, made it possible to interact with the Egyptian GI nurses. This is a field where we feel a lot of work still has to be done. Promoting and sharing SGNA standards and guidelines is done via email, but implementing these standards may be somewhat problematic. We hope that in the future more doors will be opened.

In Saudi Arabia, we were invited to present at their first endoscopy workshop “Scope Talk,” which was a great success. In their endoscopy unit, their staff represented nurses from 27 different countries—a very diverse group. Standardization of procedures is very important there, and their manager promoted strict adherence to proper endoscope reprocessing.

SGNA publications have been donated to GI nurses in Nigeria, Sudan, Ethiopia and Egypt. We have also provided books and materials for GI nurses through their endoscopists in Ghana, Chad, Kenya, Malawi, Cameroon. and Zambia.

In the Middle East SGNA publications have been distributed in Jordan, Saudi Arabia, Lebanon and to those attending the GI workshops from Syria, Iraq, Palestine and some smaller European countries like Croatia, Slovenia and Macedonia. We’ve even presented a set of SGNA publications to GI nurses in Argentina.

We are so grateful to SGNA for providing us with publications when new additions are available, if any remain. As Dr. Kathy Baker, RN ACNS-BC FAAN, so pointedly emphasized in her recent Gastroenterology Nursing editorial (Vol 41, # 3, May/June 2018 pg. 187-188) there is a campaign “Nursing Now 2020” to support global nursing. Because of the anticipated global nursing shortage in the future, it is of the greatest importance that our current and future nurses are well trained, especially in the developing world, and that they have access to resources promoting best practices in healthcare.

Thank you SGNA members for mailing your used additions of SGNA publications.

We would welcome your contribution for GI nurses around the globe, eager to improve their practice.

For more information about this program, please contact Agnes Gaber nezka3377@gmail.com.