PE R IOPE RAT IVE PRACT ICE
Sharing experiences: 20 years of FOAN
Kate Woodhead RGN DMS reflects on 20 years of sharing knowledge with African nurses as part of an educational charity, established to enhance practice and exchange experiences.
Unbelievably it is twenty years since my colleague Lesley and I sat in a hotel in Uganda contemplating the fact that we had, by lucky chance, been born and worked in the United Kingdom. Both being perioperative nurses and managers in the NHS, we had much to share and contribute to enhance nursing practice in Africa. What developed was a charity called Friends of African Nursing (FOAN) and it has been sharing knowledge to save lives with many different healthcare workers, but mostly theatre nurses, in a variety of countries in sub-Saharan Africa since that day. Many others have contributed to the rich seam of education, delivered in eleven countries by volunteers almost all whom have been perioperative practitioners in UK. I thank them all for their collegiality, contributions and for being an essential part of making a difference. I hope that what they learned has enriched their professional lives, as it has mine. This is a two-way process. It seems an appropriate moment to review those last twenty years and to
identify what I have learned, that may be useful to me in future and to others taking a similar path. Reflective practice in nursing demonstrates the thought process where individuals consider their experiences to gain insights about their whole practice. Reflection supports individuals to continually improve the way they work or the quality of care they give to people. It is a familiar, continuous and routine part of the work of health and care professionals.1 It does not need to be a formal process, nor does it need to be written, but the latter does ensure that it remains to be further analysed and considered. It requires, however, a structured approach which has learning outcomes. It should include both positive and negative insights.
It should be noted that reflection on the success or otherwise of a week of teaching is always undertaken while the team is together at the end of the course. The team of facilitators sits together and debriefs on what went well and what could be better next time. The individual evaluation
forms from the delegates are reviewed and discussed. Since the team gathers for the course alone and then goes back to their day job, that is the only opportunity to gain the insights necessary to improve for the next opportunity. The reflection also forms the basis of the report back to colleagues in the charity who were not present and to justify the expenditure of charitable funds, but mostly it is to ensure that the teaching we deliver gets better each time. The facilitators would try to make a visit to the Health Ministry towards the end of the week to review with the Chief Nursing Officer (CNO) some observations of the surgical service that we had heard about during the week. Learning to make insightful comments, which were largely positive or issues that could be solved were part of the planning process that the team who made the visit worked up carefully. They were generally very formal visits but an important element of making a mark and getting permission from the CNO for a future visit to the country.
Clinical context From the outset, Lesley and I determined that we would set each course delivered, into the nation’s local clinical context, so that we had some insight into the strengths and weaknesses of the local healthcare system. We made a visit to the local hospital and its operating theatres on Monday morning while the delegates travelled to the training venue. From country to country there are many differences in the investment that governments have made into their healthcare infrastructure. What we did not discover, until we met the delegates, is that the variation extends to the rural versus the capital city hospitals relating to equipment, pharmaceuticals, bed numbers and the number of on-site medics. We discovered many operating theatres with holes in the plaster of the walls, some with no air conditioning and many with extraordinary practices such as using what I
MARCH 2021
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