Promises to keep and miles to go: Shared Communities of Practice

The Ministry of Health (Zambia) and Birmingham City University (BCU) Health Partnership was established nearly a decade ago. A continuous programme of research, education and capacity-building projects have enhanced emergency, trauma, and critical care nursing provision nationally and regionally.  

To coordinate partnership activities, a ‘hub and spoke’ model is used, in which BCU acts as the hub. The spokes of the model are made up of emergency, trauma and critical care nurses working in acute NHS hospitals who provide their Zambian peers with virtual and in-country expertise, as requested. This provides a forum through which nurses can volunteer on different levels both virtually and/or in-country.  

With NHS hospitals under pressure, this volunteering model maximises effectiveness by increasing the pool of volunteers available. During our Global Placement Health Partnership Bursaries project to establish the virtual volunteering element of this project, a national call for emergency and critical care nurses via the British Association of Critical Care Nurses (BACCN) successfully recruited 18 volunteers across all four countries of the UK. From our forum, during the Nursing Now Challenge Fellowship, we created a virtual community of practice. Mentors supported our emerging leaders, as they completed their quality improvement projects in emergency, trauma, critical care and operating theatre nursing in five hospitals in Zambia. This comment piece highlights two of our NHS volunteers and illustrates how the model supports bi-directional learning and exchanges. 

Jen Harris, Neonatal Intensive Care Nurse Manchester 

I have worked in neonatal care for over 16 years and have experience in intensive care, surgical care, transport of sick infants and working alongside the postnatal team. I first got involved in partnership work in 2018, when I volunteered as part of a study for infants born with Gastroschisis in Sub-Saharan Africa and had the opportunity of working in Ghana and Zambia. My role was teaching nurses and doctors how to care for infants born with this condition.  I have always had a passion for travelling, so welcomed the opportunity to work again in Zambia.  

I stayed in contact with many of the staff, including a Neonatologist, who put me in touch with the MOH-BCU partnership as they wanted a long-term volunteer. The partnership was keen to have input from a neonatal nurse as this is part of the critical care nursing curriculum. I was excited to get involved and work with people who had the same interests as me within the Zambia healthcare system. 

While in Zambia, I worked alongside many different people from different areas of the hospital. Part of my time was spent in the neonatal unit, with the nurses, observing and supporting them within their roles. I was keen to go back to see what had been carried on since I left and I expected a bit more than I found and if anything it had got worse, this seemed to me to be mainly due to COVID-19 (I was there in mid-2021) and they were very short staffed. They have so few trained neonatal nurses and that was a big problem and why a lot of these babies weren't surviving. It was hard, emotionally and physically draining, to find a baby dead in their cot, it was so very sad.   

During my visit, I spent time teaching the student nurses the basic neonatal care they needed for their training. I was also asked to help support nurses from the unit who were currently completing a Master’s in neonatal nursing.  We met a few times on the unit, assessing many of the infants and focusing on their care, as they would come to each meeting prepared with questions and areas they wanted to go through. Working with these nurses who had such different experiences and knowledge was a privilege and it was so nice to see them putting what they had learnt into practice. 

Marc Robinson is a Critical Care Nurse and currently a Student Midwife in London 

I have spent the last 20 years trying to balance all three nursing passions of mine, working in the NHS as an emergency and critical care nurse, and working as a nurse in the humanitarian sector, deploying to a range of disease outbreaks, conflict zones or natural disasters. Working in all these sectors requires a dynamic nursing approach; therefore, I have served both adults and children.  

I wanted to work on the MOH (Zambia) / BCU partnership as I enjoy capacity-building projects in resource-limited settings trying to support and elevate nursing and an international safety-critical role. I wanted to get involved in this project as I was impressed by the long-term relationship that had been established and the use of home-grown educators. I chose to undertake virtual volunteering as I am studying to be a midwife, so I could not travel.  

During the project, I delivered a series of virtual lectures to emergency and critical care nurses in Zambia and Malawi. Currently, I cannot travel therefore, I was delighted to be offered the opportunity to participate while remaining in the UK. Drawing on my previous international experiences I used a case-based approach to link theory to practice and bring alive the role of the nurse in the care of these complex patients. Once I have completed my studies, I would consider becoming an in-country volunteer. I found the discussions and reflections on practice really useful to consider a different perspective in both my work in the NHS and overseas.  

Educational Exchanges  

An added benefit of having a forum of nurses and NHS organisations is that it facilitates exchange visits. Recently our partnership hosted two nurses, an Emergency and Trauma and Critical Care Nurse from Zambia. During the visit they were able to meet with emergency nurses and practice development nurses at the Royal Wolverhampton NHS Trust, Royal Free NHS Foundation Trust, Guys and St Thomas’s NHS Trust and University Hospital Lewisham in London. The UK visits help to make the partnership real, providing an opportunity for face-to-face contact and discussion of shared and differing practice. This gives context and increases understanding on both sides.   

Given our long-standing relationship with partners, we are increasingly seeing the virtual volunteering becoming a route to in-country volunteering and then nurses becoming mentors and guides (virtually) for different projects. These examples provide an insight into the breadth and depth of our UK Community of Emergency and Critical Care Nursing Practice. We would like to say a huge thank you to all our volunteers who have supported activities over the years on all levels.