“Work as you earn, nurse” is a familiar saying among nurses in Zambia. It means “Don't work so hard or go an extra mile; it is not worth it! Our paycheck is too little for the work we do.” This is a normal attitude among some nurses due to limited resources and increased daily workload.
As a bedside nurse, imagine caring for 60 clients in a shift. Imagine working with inadequate essential basic equipment such as thermometers, a functioning blood pressure machine, fluid stands, and beds while lacking medicines such as analgesics. I have experienced high patient loads on an admission unit where four clients shared one intravenous fluid stand, and at a pediatric section where one cot bed simultaneously held three babies. Under such conditions, where the nurse–patient ratio is so high, we face the challenges of not being able to provide effective patient care. The lack of care from the nurses means that most of our clients have at least one relative at the bedside; however, some have up to three to help provide care, depending on the weight and condition of the client. For nonbelieving nurses, it sounds justifiable to “work as you earn” and not put in effort to provide quality care with a good attitude.
As a Christian nurse and a member of Zambia Nurses Christian Fellowship, I have opted to practice and do unusual things because I view nursing as a calling. I recall the vow I made during my graduation: to save lives. I remember ending my vow with the words “Help me, God.” Over time I have discovered that there are consequences of not keeping a vow (Deuteronomy 23:21-23) and I do not want to be found wanting.
In my professional life, I always have believed God would make a way for me, no matter how difficult the situation. When I haven't had certain medical supplies, I've had other provisions that are never out of stock—a smile, a comforting touch, a gentle response to a patient's call, and being able to explain to my clients what I was doing and what was being awaited. This has been fulfilling. I have seen clients show confidence in me and sometimes gratitude. I have tried to do my best with whatever was available within my job jurisdiction and I have left what I could not do to God.
While working in an orthopedic ward, my shift started with praying, either individually or with my patients whenever feasible and appropriate. These prayers provided unexplainable inner strength and peace. Being a Christian nurse has resulted in unpopular nursing duties such as giving bed pans to additional patients. Most Zambian healthcare workers provide bed baths to clients in the mornings; I found myself providing bed baths on the afternoon or night shift because the client did not receive this care in the morning. This invariably increased my workload as others took advantage, being confident that I would provide the care. Even with this situation, God granted me special strength to manage the extra workload. These words from Scripture have shaped and continue to guide my practice and conduct as a nursing professional: “Do not withhold good from those to whom it is due, when it is in your power to act” (Proverbs 3:27, NIV). Good care includes providing counsel, care, comfort, or a nursing intervention that makes my clients comfortable or shows compassion.
I have often imagined what nursing would have looked like if we had everything needed to provide quality care. I have opted to put efforts toward what is possible and within my power. Having that kind of attitude makes me enjoy my work and I am able to put a smile on most of my clients compared with my colleagues under the same working conditions.
My plea to my fellow nurses working in settings with limited resources is for you to join me and choose to do unusual business by relying on God for unseen resources and strength beyond measure. God's provisions and blessing are abundant. A day is coming when we will be required to give an account to our Maker for the work of our hands. Let us be ready for that day.