What a graduate nurse does

Hi, this is Nancy Schoofs speaking. I had a chance to talk to a graduate nurse who is doing her one year of service in a hospital in Accra, the capital city of Ghana. She went to the University of Ghana. She'll be taking her Nursing and Midwifery Council of Ghana skills exam and written essay exam next month. She showed me the booklet with all of the skills written out step by step and the scoring scale used for each skills testout. There was a long list of skills and the graduate nurses have to be ready to perform two of them for their exam. Everything from inserting a foley catheter to readying a dead patient for burial to preparing a child for an examination were included. Nurses are not allowed to draw blood or start IVs--only the doctors can. Day shift nurses work 6-2 or 8-4 and night nurses work 8p-8a for three nights a week. They get a fixed monthly fee no matter which shift they work. She said she wants to be a patient advocate, but does see a lot of nurses who don't care and wear artificial nails (her words, not mine!)
I asked her about the essay exam and she said the graduate nurses might get a question such as: You are in the market place and a woman is in labor. You must provide for her privacy and then examine her. How do you do that? Then, after you examine her, you find that the baby's head is in the birth canal. How do you care for her?
I asked her about any patients with cardiovascular disease. She said they see congenital heart disease, some CAD, but not much heart failure. Considering that the life expectancy is 60, this is not surprising. There are no heart procedures, so heart disease patients are just treated with medication.
They're seeing more diabetic patients due to the starchy diet (no desserts and not too many sweets except pop), but lots of bread and a starchy powder made from the manioc root that they cook. She said renal failure patients can have dialysis if they can afford it, butmost can't and just die.