Bitter complaints of the Nurse-Anaesthetists

Dear Editor,
Allow us the opportunity to highlight a few concerns that have been facing us as Registered Nurse Anaesthetists and Student Nurse-Anaesthetists, since the commencement of the above mentioned training program in 2008. Registered Nurses  have been selected from various regions across Guyana to be trained as Registered Nurse- for a total of 2.5 yrs. The training is facilitated thorough the Georgetown Public Hospital Corporation and Institute of Health Science Education. On completion of the program, the newly trained Registered Nurse Anaesthetists[RNA] return to their respective hospitals with the hope of administering anaesthesia.
Our areas of concern are as follows:
1-    Since the commencement of the program in 2008, we are still awaiting the Ministry of Public Service to create the post for a Registered Nurse Anesthetist. Hence, persons except those at Georgetown Public Hospital have returned to their respective hospitals and are awaiting appointments. The Nurse Anesthetist in Bartica is in the 5th year of her five year contract and awaits her appointment. She functions in the capacity whenever there is a medical team sent to perform surgeries at the hospital. The NurseAnaesthetist at New Amsterdam Hospital [who is in the 4th year of her 5 year contract]was sent by the region to be trained and upon return was told that no vacancy exists for RNA, thusshe cannot be appointed. She is still receiving the same salary of a Registered Nurse but functions in the capacity of RNA. The Nurse Anesthetist at Mahaicony Cottage Hospital returned to a non- functional theater and was tasked with bed-side nursing duties until whenever.  He travels to Georgetown to maintain his skills on his off duties at Georgetown Public Hospital. He too, awaits appointment and salary increase.  There are three Nurse Anaesthetists at West Demerara Regional Hospital. Two of the persons are still awaiting appointments and salary increases.  The newly trained person at Lethem Hospital is facing a similar plight, i.e. no salary increase, no appointment. He was also informed that he had additional training and would not be paid for same. In the meantime, he will perform bedside nursing duties too, until a medical team is sent to Lethem to perform surgeries where he will be given the opportunity to administer anaesthesia. On organizational chart, no post exists for a Registered Nurse Anesthetist.
2-    There isn’t a fixed salary for RNA’s except those employed at GPHC. Over the years, Cuban RNA’s / technicians have been brought and tasked with the same responsibility or less. They have been paid almost twice our salary  with allowances i.e. housing
3-    Some of the RNA’s have been asked to do ‘’on-call’ duties for Guy $ 450 .00 /24 hrs.  E.g. Linden Hospital Complex.
4-    Government of Guyana contracts are being given to us during the early stages of the program to be signed. We weren’t given the opportunity to take the copies to a legal advisor. Two students were told by staff at the Ministry of Public Health, that if they didn’t sign the contract their salaries would be withheld. They reluctantly signed same, and were subsequently told that a copy would be made available when their passports were stamped.  The persons sent to Cuba to be trained as Medical Doctors are given 5 year contracts for a 7 year training program. We are given 5 year contracts for a 2.5 year training program.
5-    There are no opportunities for us to upgrade in the field on Anaesthesia. The training program should be offered by the University of Guyana since it is a specialty of Nursing. We all have Diplomas in General Nursing and at the end of the Nurse- Anaesthesia Training Program, we are given another Diploma, this time in Nurse -Anaesthesia. This Diploma is unrecognized by our local university and overseas.
6-    No additional allowances are being given to Nurse Anaesthetists accept those who are employed at GPHC, who receive a telephone allowance.
Here are a few suggestions that we would like to offer to those who will read this article and are in the position to assist us
Suggestions:
1- Creation of a policy regarding training and appointments in order to address national  needs
2- Creation of a post at the Ministry Of Public Service.
3- Acceleration of appointments.
4- Revision of benefits   e.g.  On – call, housing, uniform allowance.
5- Revision of salary scales and standardization of salary for Registered Nurse- Anaesthetists across the country.
6- Creation of additional allowances such as risk and transportation allowances, inconvenience allowance.
7- A policy for Duty Free Concession should be created for certain categories of Nurses.
8- Persons should be paid for additional training and in order of seniority.
9- Nurse- Anaesthetists should be appointed as soon as they return after training with a vacancy waiting to be filled. Those who are still awaiting appointments should have a retroactive salary dating back to the commencement of duty.
10- Upgrading of theaters at the district and regional levels. Theaters are inadequate and needs to be to be fully functional with necessary staff and equipment. Regions with no theaters should not send Registered Nurses to be trained as Nurse- Anaesthetists e.g. the case of Kumaka District Hospital in Moruca. When they return there is no anaesthetic related work to be done. As such skills are lost.
11- There should be a clear policy at the national   level   for training of Nurse -Anaesthetists and doctors. [Especially at GPHC].
 Nurse-Anaesthetists (names supplied)