“Every child and every family leave a mark on me. It is difficult to say which one is most rewarding. When I see mothers’ tears of happiness feeding their babies, this is priceless. One of my families phones me every Christmas just to say that on their table, there is a candle which burns for me and my children. Is that not rewarding?” – Kostadinka Bojikova, Cleft Specialist Nurse at Smile Train Partner Medical University of Plovdiv
The World Health Organisation has declared 2020 the Year of the Nurse and the Midwife. Across the globe, midwives and nurses play a vital role in healthcare — and delivering care to those with clefts is no exception.
Midwives play an instrumental role in introducing women to the health system and ensuring that women and their babies receive care throughout pregnancy, childbirth, and in the critical time after birth. This is especially important when babies are born with clefts, where early action and referral are key the best health outcomes.
For families, nurses are invaluable sources of knowledge, comfort, guidance, and medical expertise throughout their child’s care journey. When babies are born with clefts, nurses are commonly the first medical providers that can provide life-saving support on feeding strategies. They often guide families through the fears and anxieties that can accompany the birth of a baby with cleft in regions where stigma is pervasive.
For surgical teams, nurses are essential to provide the safest and highest quality of care to patients. They are commonly the first to interact with patients, recording their vital signs, weight, and allergies. They work with the families to minimise anxiety and answer questions, comforting patients and their loved ones alike. During surgery, nurses complete the operating theatre checklist with the surgical team, ensuring that team members are prepared and in sync. After surgery, as they monitor recovering patients closely, nurses are best placed to see early changes in a patient's condition that could indicate complications, and to respond with treatment. Nurses also provide guidance to families on post-operative care and the subsequent treatments their loved one might need.
Despite the importance of their role in delivering high-quality healthcare, nurses are too often under-recognised and under-compensated. In large part, this is tied to gender inequity — while nursing is of course not an exclusively female profession, the vast majority of nurses are women, and though women comprise more than 75% of the global health and social workforce, they hold less than 25% of the leadership positions in health systems. In a 2019 report on nurse leadership by IntraHealth International, NursingNow, and Johnson & Johnson, researchers found that nurses encounter many social, cultural, structural, political, and personal barriers that bar their road to leadership positions. This dire shortage of trained nurses worldwide, as well as the chronic under-recognition of the nurses that work on the frontlines of care, is a threat to health systems around the world.
Recognising that nurses are essential to cleft care, surgical care, and achieving universal health coverage by 2030, Smile Train has developed the Safe Nursing Care Saves Lives Workshop, a training course that empowers nurses with essential skills to administer high-quality nursing care for children undergoing cleft surgery. The skills the nurses learn in these workshops benefit all patients in need of surgical care, building health worker capacity around the globe.
Nurses are leaders. Alongside the WHO and the many global health organisations championing nursing care, Smile Train will continue to empower the nurses who change the lives of patients with clefts every day — and we will work to raise their voices, sharing their stories, their challenges, and their triumphs.