The Surgical Patient and Nursing Care in a Low-Income Setting: Challenges and Way Forward

Abstract

Background: The newly developed Nigerian addition to the universal health coverage has surgery, obstetrics, anesthesia, and nursing as components of the plan. This study evaluated the challenges in the nursing care of the surgical patient in two public Teaching Hospitals in Port Harcourt, Nigeria. Materials and Methods: A cross sectional descriptive study was conducted among total population of consenting Nurses and Medical Doctors at the Surgery Departments two public Teaching Hospitals, using semi-structured selfadministered questionnaire. Data obtained was entered into Microsoft Excel Spreadsheet / Statistical Package for the Social Sciences, and formed into tables. Results: There were 67(26.1%) male and 190 (73.9%) female respondents. The mean age of respondents was 37.63 ± 10.22 years. The mean years in practice was 11.05 ± 9.26 years. One hundred and forty-nine (58.0%) of the respondents were nurses. Most challenging nursing issues were giving intravenous fluids according to schedule (75 = 29.2%), wound dressing (73 = 28.4%), inadequate equipment and manpower (51 = 19.8%), administration and charting of intravenous fluids (26 = 10.1%), and drug administration (26 = 10.1%). The most challenging surgeon / doctor-related issues was poor staff interpersonal relationship (103 = 40.1%) followed by poor supervision of the surgical team (97 = 37.7%). Conclusion: The challenges of nursing the surgical patient in our setting are of multiple origin. Administrative issues of inadequate employment of manpower and its multiplier effects are reported along with patient-related and health professional issues.