Unqualified nurses in schools

Hala Khalaf and Mitya Underwood

• Last Updated: November 14. 2009 12:07PM UAE / November 14. 2009 8:07AM GMT

ABU DHABI // Four schools have been given official warnings for staffing their medical clinics with administrative personnel instead of qualified nurses.

A quality audit team from Health Authority-Abu Dhabi (HAAD) found the staff working as school nurses without permits or licences.

The schools, all in the capital, were warned by health and education officials, and the workers were “removed from the school clinics immediately”, the authority said. It did not name the schools. It was the second time this year that inspectors from HAAD had found school medical clinics employing non-licensed staff. In April, an administrative worker was found posing as a nurse.

Zaid al Siksek, the chief executive of the authority, said every health institution and professional should “adhere to the systems and policies laid down by Health Authority-Abu Dhabi”. Advice and technical help would be provided to facilities that needed improvement, he added.

This week, Mr al Siksek disclosed that inspections by the authority had trebled in recent years in an effort to stop unlicensed people working in health care.

His comments came on Wednesday following a court case in which an unlicensed doctor was jailed for one year after delivering a baby at a private hospital in Abu Dhabi, leaving the girl profoundly disabled due to inadequate care. The doctor, a Ukrainian woman, had previously been caught practising without a licence but was allowed by the hospital to continue working.

Lina Abu Shalbak, a nurse who works at Al Rawafid Private School, said the job carried a responsibility to both pupils and parents.

“Parents should not have to worry that an impostor is pretending to be a qualified nurse at their children’s school – they are trusting this impostor with their children’s lives and safety. The thought is terrifying,” she said.

“How will an unqualified nurse, who doesn’t know what she is doing, act if a student’s blood glucose drops suddenly or that student has an allergic reaction?

“Knowing how to put a Band-Aid on just isn’t going to do it.”

According to the Licensing Requirements for a School Clinic checklist issued by HAAD, a full-time registered nurse, with a current licence, must be available. It also says that, if the nurse is absent, there should be a replacement.

There are about 100 requirements a clinic needs to meet for it to be registered. They fall under the headings of: medical equipment and furniture; medical consumables; medical records; complaint management; physical requirement; manpower; fire and safety; infection control; first aid; medications; and clinical practice.

Rihab Hamdan is a nurse at Al Ittihad National Private School in Khalifa City, with 800 children in her care. She said all qualified school nurses were aware of HAAD’s requirements and should abide by the regulations. “Working in school health is not just about applying a Band-Aid or bandaging a sprained ankle. The gym teacher who knows first aid can do that,” she said.

“You need a qualified nurse because you are going to have kids with asthma, with severe food allergies, with diabetes, sometimes even kids with epilepsy. You have to know how to respond quickly and correctly, in a way that will gain the trust of the students and their parents. When the school opened in 2006 and we set up our school clinic, we made sure all of the health authority’s requirements were in place because caring for children’s health is a huge responsibility.”

If the number of pupils at Al Ittihad were to exceed 1,000, another nurse would be hired and the clinic might be expanded.

On a quiet day, Ms Hamdan sees up to 15 pupils, although the average is usually double that.

Fatima al Murshid, the principal of Al Ittihad, said the role of the nurse was not simply to deal with minor ailments or emergencies, but also to educate and raise awareness. She said: “The school nurse teaches children how to be healthy, and understands students enough to be able to provide them with continuous care when needed. For example, she has to follow up on vaccines, or check up on diabetic students, or talk to parents who are against vaccines and educate them on the importance of vaccinations.”

It was crucial for parents to have open communication with the nurse, who had to be seen as trustworthy by parents, pupils and staff, said Mrs al Murshid.

Saleena Majid, whose seven-year-old daughter, Dima, is a pupil at Manarat al Ilm Private English School in Madinat Zayed, said the idea of having no nurse in school, or one who was not qualified, was terrifying for a parent. “The nurse at Dima’s school knows what she is doing and I don’t have to worry about my daughter,” she said. “That is a comfort every parent should have.”

Mrs Majid said a nurse’s role was not just to be there when a child scraped a knee: “If they develop any health problems, there needs to be someone aware keeping an eye on them and trained to point things out to parents when needed.”



hkhalaf@thenational.ae

munderwood@thenational.ae