An informal anonymous survey of 22 students in MS 150 Statistics found that :
Students from Lewis and Clark College. Dr. Don Buden was able to provide special assistance to Eva Dubey.
On Tuesday 19 February 2002 the Honorable Secretary for Health, Education and Social Affairs Dr. Eliuel Pretrick, Director of the Department of Health Services Simao Nanpei, Dr. Yaingeluo, VPIA Spensin James, DAP Joe Habuchmai, Greg Myers, Patty Grandos, Mike Dema, and Dana Lee Ling met at the Pohnpei campus to discuss a variety of issues related to the Title III grant, health care needs of the FSM, nursing program matters, and to share information on the work of the Asian Development Bank (ADB) and the potential impact of the Basic Social Services Program (BSSP).
Secretary Eliuel opened the meeting by noting that training must take into account whether a student produced by the training can be hired into the system.
He indicated that a student should be useful to the health care system whether or not they graduate. The implication was a desire for a curriculum that would allow a student who dropped out after one year to be useful to the local health care system.
The Secretary noted that the training needs of the nation include both the training of new nurses and the ongoing training and refreshing of current nurses, nurse practitioners, and health assistants. At present many of our nurses were trained in Majuro, Guam, and Saipan.
The Secretary noted that while nurse practitioners worked under the supervision of a graduate nurse in the hospital, the health assistants worked in the dispensaries. [This use of terminology is not necessarily consistent with the use of these terms in other nations - ed.] The health assistants and nurse practititioners are locally trained and are in need of refresher courses.
The FSM still looks to the program in Majuro as a major source of nurses. A World Health Organization consultant has said that a population base of 100,000 is sufficient to support a nursing school.
The nation needs at least eight nurses per year. We are not meeting that goal. Every hospital is short of staff. A nursing program in the FSM rather than the Marshalls is seen as the best way to remedy these shortages.
The College was asked to designate a teaching hospital with which the College could work cooperatively to start the program.
A student in the program should be guaranteed a job as a result of the program. The program should be designed in a way that a nurse practitioner [as defined within the FSM] is produced at the end of the first year. That is, a student who leaves the program after a year should also be useful to the local health system. Since we are already producing nurse practitioners with a one year certificate program designed in Kosrae, this is seen as a starting point for the program. It was noted during the meeting that programs such as the COM-FSM national campus Health Career Opportunities Program is seen as useless by leadership because the graduates cannot immediately go to work in the hospital or dispensaries. Given that an academic approach has resulted in the loss of all students from the pre-nursing major at the national campus, this approach is also considered a non-starter.
The program that is needed by the nation should mix practicum with coursework from day one.
Students who graduate from the program should be considered not a new hire but as one stepping in the fill the many existing vacancies.
The health assistants are functionally a front-line doctor triaging patients in the village. They handle basic diagnosis, refering those cases that are more complex. Chuuk state has the most dispensaries.
The ADB/BSSP monies are targeted at infrastructure, current employees, capacity building, and other areas. There is no direct targeting of training and education. There may be set-aside funding in the BSSP that could be directed at training and education if the leadership decides to do use the money in this way.
VPIA Spensin James noted that there are 20 Chuukese and 10 Kosraen students in the nursing school in Majuro. At present few students at the national campus of COM-FSM view Majuro as an attractive post Associate's degree destination. The VPIA asked that COM-FSM personnel be included on the ADB's list of approved consultants for the BSSP.
A decision was made that a task force needed to be formed consisting of, among other people, representatives from the FSM national government in health services, state directors of health, and COMFSM. There must be a sense of ownership in the resulting health and nursing program or the program will not succeed.
After the meeting Greg, Patty, Dana, and Mike met to discuss Title III issues and other matters related to the above meeting. During this and other conversations a model began to evolve which would entail a first year practical nursing program with a practicum component in the teaching hospital by day coupled with evening or day classes on the national campus. The national campus has the necessary laboratory facilities. The program will require specialized faculty and hence a single main delivery facility.
There may be, however, due to the acute nature of the nursing shortages in Kosrae and Chuuk, the need to run a one year practical nursing certificate program in the state campuses. At the end of the one year program those deemed most likely to succeed in more advanced courses would come to the national campus for advanced work. Those students who do not appear likely to succeed in advanced studies could then work as a nurse practitioner in the local hospital.
Other discussions have included that looming need to run another medical officer's program. The Pacific Basin Medical Officers training program is the core of the medical staff at Pohnpei hospital, if not elsewhere as well. Personnel move on into other things in life and there is an ongoing need to replace these people.
Information online provided to Dana by Mike Dema:
2001 WHO FSM country health profile:
http://www.who.org.ph/chips/chip01/mic.htm
Information on the structure of nursing in the FSM:
http://www.who.org.ph/themes_focuses/theme3/focus2/mic%202000.html
Mid-level and nurse practitioners in the Pacific: Models and Issues
http://www.wpro.who.int/themes_focuses/theme3/focus2/nursescoverall.pdf
The above document notes that nurse practitioners are generally the result of one year of training in the Pacific while a Medex can be produced in three years.
Other online information:
SPC Public Health Section
http://www.spc.org.nc/phs/
including distance education in health initiative Telehealth:
http://www.spc.org.nc/Health/DistanceEducation/Index.html
No arrivals, departures, births, marriages, or death occurred during February.
The Division Chair's official self-portrait: