Emory nursing professor Linda Spencer PhD, MPH, knows what war can do to a community. She saw it first-hand while assessing and training Kurdish nurses in war-torn Iraq. Now, on the heels Iraq's first democratic elections in more than 50 years, the nurses she helped train could play a major role in the development of an Iraqi health system, thanks to Spencer's work with them.
In August 2003, just after the war in Iraq began, Dr. Spencer joined a program sponsored by the Washington Kurdish Institute, and traveled to hospitals in Dohuk, Erbil and Suleimaniyah, three villages northeast of Mosul and Kirkuk. While there she worked to enhance the clinical practice of the Kurdish nurses and helped them develop a continuing education program.
Dr. Spencer's team assessed the Kurdish nurses' situation by asking three basic questions: "What are the challenges you face? What are your duties? What new skills do you want to learn?" The team found a bright, eager group of caregivers who had little organization and inconsistent training and standards.
Dr. Spencer, an associate professor with Emory University's Nell Hodgson Woodruff School of Nursing, says "We discovered that there are no specific standards of care, no nursing leadership organization, no job descriptions and that the nurses' education varied from a six-month program after sixth grade to a three-year college program after high school."
To address the nurses' needs and ultimately save lives, program participants like Spencer focused on the basics of care -- physical assessment and body systems, hand washing and hygiene, CPR training, the Heimlich maneuver, choking and body mechanics and preventing decubitus ulcers or "bed sores." They combined classroom training with hospital practicing skills and role-playing in a collegial and supportive atmosphere that provided the Kurdish nurses with skills and empowerment.
"These nurses are amazing and inspiring," says Dr. Spencer. "I was humbled to see their dedication and determination in providing care for the Kurds in what many western nurses would consider very bleak conditions. The nurses each have 35-40 patients to take care of at a time, many of whom are burn victims or have birth defects, which are both huge problems in northern Iraq."
In addition, each patient's family must provide most of the non-medical patient care in the hospitals -- bringing blankets and sheets for the hospital bed and providing meals for the patient.
Even though it has been 18 months since Dr. Spencer traveled to Iraq, the Washington Kurdish Institute program continues to send American nurses to support the Kurdish nurses for up to three months at a time. Dr. Spencer also still helps with training by keeping in touch with both the American and Kurdish nurses via email.
She recently presented her experiences at the American Public Health Association meeting in Washington, DC.