Elly taking nursing off the sidelines

Elly taking nursing off the sidelines

Ratih Sayidun and Santi W.E. Soekanto, Contributors/Jakarta

Countless parents want their children to become doctors, but they
would be less than enthusiastic -- probably downright angry -- if
the latter wished to become a nurse.

Maybe they should meet Elly Nurachmah, the first Indonesian
nurse to become professor of medical surgery nursing at the
School of Nursing, University of Indonesia, of which she is now
the dean.

She acknowledged recently that people often look down on the
nursing profession, believing that it is of lesser status than
doctors. Her speech when she was made professor last May clearly
defined the problem of nursing in Indonesia, in that the
profession has yet to develop the way its "colleague" (the
medical profession) has developed.

"Nurses are so often sidelined among health professionals ...
the government has yet to allow nursing professionals to
significantly contribute to health development of the nation,"
she said.

"The prevailing image of the nurse in the public is that of an
assistant or merely the servant of doctors. Evidence of this can
be found in the kind of appreciation and financial compensation
for nurses, the poor esteem that the public holds for them."

Part of the problem carries over into training of nurses,
which remains focused on having them do the bidding of others.

"Many nurses have not been given adequate training and
understanding about patients as human beings," she explained.
"Nurses are often trained to just carry out tasks given by
doctors, (and this is one of the reasons why) they tend to
disregard patients' feelings."

Historically, nursing in this country was a profession that
developed from a low level of education. Nursing training here
was first initiated in the 1890s by nuns, so the discipline was
at first not as scientifically rigorous in nature and mostly took
less than a year to complete.

In 1962, Indonesia established the first nursing academy,
offering a three-year training course for high school graduates,
and the profession began to have regulations and organizations.
The development of the profession was strengthened in 1983 during
a national nursing seminar that declared nurses to be health
professionals, just as doctors are.

Higher studies in nursing began when the University of
Indonesia set up a five-year nursing studies program, and then
the D3, or three years of training, for high school graduates.
Elly was the first D3 graduate who went on to further her
studies.

The higher level of education is therefore expected to polish
the nurses' bedside manner, she said, so they would be more
sensitive to patients' feelings.

"It's very often the case that patients who are already
anxious about their ill health become even more anxious because
of the nurses' unfriendly manner," she said.

"What we need now are nurses who are critical and rational
about their profession. Nurses used to work only by instinct,
intuition, but now they really know what they are doing."

Even today, more than 60 percent of the approximately 250,000
nurses and midwives in Indonesia are graduates of the nursing
academy. Less than 2 percent are graduates of university schools
of nursing; many of the latter choose to work as academics rather
in hospitals, where they would be able to give the best quality
nursing to patients.

"This is a fact because health care facilities such as
hospitals do not appreciate the graduates enough, while other
nurses with lower education in the hospitals often feel
threatened by them," Elly said.

"It's regrettable but if more nursing graduates go to work in
the universities and education centers, rather than go to work in
hospitals, they will end up as poor educators with no experience
in the field."

One of the ways to overcome the various obstacles facing the
nursing profession is to develop criteria of nursing education.
State-run Cipto Mangunkusumo Hospital in Jakarta and other
hospitals have developed programs where graduates of university-
level nursing schools can apply their knowledge in facilities
while undergoing training.

Born in Bogor, West Java, on Aug. 17, 1948, Elly is the
daughter of a housewife who did not believe in education for
girls, because they would have to spend their life in the kitchen
anyway.

Upon graduating from high school, Elly pleaded with her father
to allow her to continue to university. He relented, and she
applied to the University of Indonesia's School of Medicine.

On the day that she learned she did not pass the medical
school entrance test, she wandered sadly around the Cipto
Mangunkusumo Hospital and chanced upon its nurses' dormitory.

"I thought, this is it, the right school for me so I could be
independent from my parents," she told d'Maestro magazine. "So I
took its entrance examination, with confidence."

Elly found independence and her true calling.

"Many people do look down upon us nurses, but personally I am
happy to be a nurse because it makes me feel I can do something
good for other people," she said. "I am happy every time I see a
patient leave the hospital in good health."

Elly began her career as a nurse in the Intensive Coronary
Care Unit (ICCU) of Cipto Mangunkusumo Hospital in 1971. Four
years later, she won a Colombo Plan scholarship to a coronary
care course at the Royal Melbourne Hospital in Australia.

In 1988, when she was working and studying for her master's
degree in Sydney, Australia, she had her first experience in
caring for AIDS patients.

"The disease had been first revealed in 1983, but not many
Indonesian nurses knew about it or how to care for the patients,
because the government was not forthcoming on the subject."

None of her colleagues in Sydney were willing to care for the
AIDS patients then, but Elly came forward.

"I took double precautions, including putting on two sets of
gloves and put one gown over the other, but that was all right. I
was sure that God wouldn't allow bad things to happen to me
because I had only good intentions," she said.

She took part in the Leadership Training for HIV/AIDS in
Chicago last year. Upon her return, Elly established the AIDS
Team of University of Indonesia's School of Medicine, which, in
cooperation with the College of Nursing of the University of
Illinois in Chicago, regularly disseminates information on
HIV/AIDS.