Many ask us, "What types of medical specialists do we send?" We send all types of specialists, including Certified Nursing Assistants.
The Shortage of Medical Professionals
The shortage of medical professionals - all types of medical professionals - is a daily reality in low- and middle-income countries, which are affected on an ongoing basis by the numerous manifestations of having limited resources. Global health organizations and researchers have been reporting for years about a global shortage of available workers in the medical field, which includes medical doctors, nurses, and nursing assistants. Additionally, countries that receive help from the International Monetary Fund often are required to reduce government spending and required to place caps on the public sector wage bill, thus further handicapping countries’ abilities to hire or adequately pay doctors, nurses, and other health-care workers. Thirdly, low and middle income countries and nongovernmental organizations must choose where to delegate their limited funds in hiring decisions. They do not have the luxury of staffing resources at their disposal as affluent countries do to be able to hire fully-staffed interdisciplinary teams, and so medical workers are often overworked and unable to get all the patient care needs met. Fourthly, many funding organizations fund the cost of antiretroviral medicines but do not delegate funds to cover the cost of medical workers or to provide rehabilitative treatment for those who develop AIDS, further contributing to a situation where there is a shortage of medical workers and a lack of rehabilitative services for patients. It is in the light of these worker shortages that LoveAIDS must make its decisions regarding who to send to the field. Each location that we work with has differing worker shortages, and each international project and country relationship is arranged to best meet those needs.
We Send All Medical Specialists - Including Certified Nursing Assistants
In the light of the worker shortages that we have witnessed so far, we have witnessed a surprise from our public regarding what types of workers we need to send. Yes, LoveAIDS sends all types of medical workers, depending on the need, but LoveAIDS has witnessed that there is pronounced need for nursing assistants, something that our public has shown us they don’t expect to hear. In affluent countries, nursing assistants far more often than nurses provide the bulk of the direct care to HIV/AIDS patients in skilled nursing/rehabilitative/palliative care situations. However, in lower resource settings, there is a shortage of workers, and nurses must provide most or almost all of the direct care to the patients themselves, creating the situation where nursing staff are overworked and unable to meet all the patient care needs. This results in high rates of depersonalization, emotional exhaustion, and depression among those in the nursing profession who care for people living with HIV/AIDS (PLWH) and is the subject of ongoing research by global health and medical professionals. It is in this context that LoveAIDS sends whichever types of workers are needed, including Certified Nursing Assistants.
What Do The Differing Specialists Do?
For those who are not so familiar with the daily tasks of certain medical professionals who are working with HIV/AIDS patients, we provide a rough breakdown of a few roles to help explain what goes on in the field:
Medical doctors diagnose, prescribe drugs, and refer the patients to other medical specialists as needed. The interaction between medical doctor and patient lasts for 5-45 minutes every couple months or once a week for an in-house medical doctor in the rare cases a facility is able to have a doctor come weekly.
Nurses administer drugs to patients, complete nurse-specific wound care, schedule medical appointments for patients, and correspond with medical doctors. This includes preparation of medications and extensive patient charting. The interaction between the nurse and the patient lasts for 5 minutes – 30 total minutes daily.
Certified Nursing Assistants
Change their briefs,
Rotate patients in their beds every two hours,
Wash patients' faces/brush their teeth multiple times a day,
Help clothe the patient,
Assist the patients in walking,
Help transfer the patients to/from their beds, to/from their wheelchairs, to/from the toilet,
Push the patients in their wheelchairs to different locations in the facility so they are not trapped in their rooms,
Pull the blankets over them so they are not cold,
Assist the nurse as she/he provides the wound care,
Massage the patients' hardened muscles and backs,
Help clean the patients' room,
Change the bedsheets,
And work as physical therapy aides carrying out the exercises that the physical therapist assigns in the patient care plan. The work alone as a physical therapy aide is a full-time position that needs to be staffed.
The interaction between the nursing assistant and each patient lasts for 30 minutes to 3 hours daily.
What Happens When There is a Shortage of Nursing Staff - Specifically the Common Shortage of Nursing Assistants?
In a situation where there is adequate staffing, as is common in affluent countries, nursing assistants provide a significantly larger amount of the direct care to patients so that nurses can focus on nurse-specific tasks. But in situations where there is not adequate staffing, as is common in most low- and middle-income countries and particularly with HIV/AIDS patient care in those countries, the nursing assistant’s work defaults to the nurse, who cannot possibly get everything done, resulting in the depersonalization, emotional exhaustion, and depression so common among nursing staff who care for people living with HIV/AIDS. This results in situations where patient recovery is handicapped and often stunted at best, but at worst can be blocked and often, unfortunately, is.
More specifically, a shortage of nursing assistants mean dying patients do not receive the attention and time needed during their last days. It also means patients whose immune systems have recovered so that they can continue living are not able to receive the care they need. When they do not receive the care they need, they are not able to gain their mobility back and as a result are not able to provide for themselves, crippling them financially as a result of their illness, and also severely affecting their quality of life. LoveAIDS acknowledges that while sending doctors to diagnose and nurses to dole out antiretroviral medication and other medications is important, there is a huge hole that is left due to funding and other restrictions by organizations and governments which results in extreme suffering for HIV/AIDS patients.
Yes, We Send All Specialists - Including Certified Nursing Assistants
It is very clear then, when we at LoveAIDS ask, “How can we go about accomplishing the most good in the most tangible and life-transforming way possible for these HIV/AIDS patients?” that Certified Nursing Assistants are important specialists we need to send out to the field.
If LoveAIDS can consistently send an army of medical specialists, including the Certified Nursing Assistants which are needed so desperately, to humbly and effectively provide qualified medical care, we will accomplish tremendous work. It is a powerful and effective way for us to love HIV and AIDS patients for Christ in ways that are tangible and life-altering for our patients.