The final day of the conference was well received by an energized audience of doctors and nurses. The moderator was Dr. Vincent Hewitt, Head of the Radiology Dept. Beginning with an expert presentation on neuro-imaging and its impact on clinical care by Dr. Jocelyne Lapointe, Dr. Chris Honey followed with a riveting talk on functional neurosurgery and its impact on individuals suffering from essential tremors, Multiple Sclerosis, Parkinson, and other debilitating conditions. Dawn MacDonald discussed Palliative Care as a positive term, with quality of life the optimal outcome. Danny Moe resumed his Heart Power presentation, talking about greatness requiring us to “water the camels” – concluding the first day’s session.
In the afternoon, I discussed the management of behaviourally challenged neuro patients and Lisa presented the neuroscience research graduate program developments. Lisa also conducted an energized reflection session, where the participants got into groups of eight and discussed three questions. 1. What are the most critical health care issues in Ghana and West Africa at the moment? 2. What are the two most valuable concepts provided over the past two days? 3. What are the topics desired for next year?
A review of the answers by each group was quite revealing. Emergency transport needs were raised by almost every group as a top priority in West Africa. Deficiencies in resources including working equipment, education and training were also identified. One group raised the priority need for change of “attitude” among the health care team.
The second question revealed that the components of Heart Power took the prize! Each group singled out various concepts within Heart Power, including Solomon’s cap, going the extra mile, watering your “camels,” romancing every situation, giving out blessings to one another and to patients. They also appreciated Chris Honey’s discussion on Brain is Time (accepting the primary injury is complete however the secondary injury can be prevented with swift intervention), and Right Patient / Right Procedure / Right Time to improve quality of living. Discussion of the immediacy of intervention to preserve brain and choosing the right patient at the right time for the right reasons were valuable.
The topics desired included spinal cord care, management of spina bifida, emergency nursing, etc. Textbooks were gifted to four groups in attendance – ECG Manual to Dr. Rene Wulff, Neuro-anesthesiologist for the KBTH Recovery / ICU nurses; ACLS Manual to the Critical Care Nurses Association of Ghana; Critical Care Nursing textbook to the University of Benin Teaching Hospital neurosurgery nurses; and The Anatomy and Physiology Diagram textbook to a physician’s assistance school in Tema. We extend appreciation to Bruce Forrest for his generosity in providing the nursing textbooks. These resources will be used.
Danny wrapped up the conference, speaking on Heart Power’s – Dream maker’s help others fulfill THEIR dreams and by helping others, they fulfill their own dreams! Nii Otu Nartey, KBTH CEO Administrator and Mrs. Victoria Quaye, Director of Nursing joined the afternoon team as we wrapped up a very inspiring and successful conference. Prof Nartey shared that he is very excited by the wonderful response and wants to continue to build these neuroscience conferences at KBTH inviting the staff of all the hospitals around Ghana.
Evaluations have been submitted by each correspondent. We’re awaiting the formal results. Certificates were handed out for both days’ attendance. We brought 200 and we ran out at the end, having to combine two days onto one certificate. So over the two days, we enjoyed 100+ in attendance both days!! What a blessing.
I had a wonderful meeting with the KBTH Director of Nursing as the conference closed, discussing how my teaching in how to approach challenging situations hit a big chord with the attendees and this needs to be expanded and presented to the nursing administrators and staff throughout the hospital. As well, the chart documentation system is eagerly anticipated and we’ll be moving ahead on this Monday, using neurosurgery as a pilot unit.
The CME Conference continued in full force through Friday afternoon. KBNF team members including the nurses attended a luncheon on the Friday and we were eagerly received by the facilitator, Dr. Elijah Paintsil, Yale University. Our contributions in the neuroscience field were very much appreciated and Chris Honey received many calls to return to teach additional sessions. So you can imagine, we’re encouraging Chris to join us in future conferences. He’s very open. Paul King is also eager to continue to expand his role in Ghana and is pursuing various avenues to raise funds and meet critical needs. He was busy reviewing urgent pediatric cases that need neurosurgical intervention and determining if they could be managed at Korle-Bu or if they required transport to his Atlanta hospital in the U.S. for advanced care.
Jocelyne worked on education and training as well as radiology department assessment preparations during the day, as she prepares for next week’s programs.
Lisa met with Dr. Adjei, Deputy Provost, CHS, UG and they had a very rewarding discussion on research developments and student exchange program development. Lisa and Fred Addai, Chair of Anatomy, worked on the next steps for the research program and managed to connect with the collaborators. Regular international monthly meetings will now commence. The initial research into chart documentation development questionnaire has been prepared by Lisa and we will begin to implement this in the next few days.
I met with Head Sister Charity, KBTH Neurosurgery Unit, and she has conducted meetings with her staff determining what they would like to hear from me in the next couple of weeks. The priority for Monday and Tuesday will be Glasgow Coma Scale reviews and practice sessions. I met briefly with George Wepeba and Patrick Banka, KBTH neurosurgeons. They were delighted to hear of the automated doctors orders that I am preparing for their review, revisions and acceptance.
Chris and his son Michael toured the neurosurgery unit and the operating and recovery rooms, escorted by Thomas Dakurah, Head of the Neurosurgery Dept. Chris was so pleased to visit the various areas.
Our team headed to the Fair and Marketplace to purchase gifts for family at home. Bartering was vastly conducted by Justina, our Nigerian neuro nurse. Dr. Honey watched Justina’s skills in amazement, as she bartered for each item. Most of the team purchased beautiful quality cloth so their families could make outfits or in Chris’s case, a tablecloth, at home.
Our day concluded with a relaxing dinner and reflection over the past week’s visit and activities. It was spirited, encouraging and rewarding, as we heard of the wonderful impact of the teaching conferences and the quality time together as a neuroscience family. Chris mentioned that the twice daily visits on the bus, sometimes taking two hours, was a wonderful time of getting to know each other. We challenged each other in neurosurgery management issues and dug deeper and deeper into the challenges of decision-making and confidence to make right choices. We discussed issues of life and death, the challenges of patients with a GCS of three and ventilated for weeks and months with no appearance of improvement and yet other patients are denied ventilator support because there are no other mechanical resources available. We discussed reducing length of patient stay, thereby freeing up beds for the eight patients in emergency or clinic urgently awaiting a bed in neurosurgery.
Our practice in Canada of preoperative patients arriving the day of surgery does not appear to be an option at this time with the Nigerian team. Why? Because patients would not likely be able to fulfill the preop instructions independent of the nurses. As for discharge, they would like to try to achieve reducing their postop stay. Mobilizing day one postop is being practiced now, where it is feasible. Having a subacute unit for patients that need supervision, but are almost ready for discharge was another concept that may work.
Our KBNF family continues to grow and deepen. We are indeed blessed.