17 December 2023
Written by Katie Croom, a registered nurse from New Zealand currently on assignment with Volunteer Services Abroad (VSA) at the National Referral Hospital in Honiara, Solomon Islands.
Edited by Belle George, IDYP Co-Chair.
On entering the newly constructed High Dependency Unit (HDU) at the Solomon Island’s National Referral Hospital, Serah Pitavolomo’s face will be one of the first you see. The unit functions smoothly under her watchful eye — the chaotic symphony of monitor alarms somehow more harmonious. The HDU has only been open a few months, and her involvement has been key in ensuring a smooth transition. The HDU is the first of its kind in the country, an important milestone, providing care for the sickest of patients. Pitavolomo is a Clinical Nurse Consultant, a role that varies from assisting in a cardiac resuscitation to troubleshooting any problems that nurses on the floor may face.
Pitavolomo undertook two years of study and clinical placement in Australia, completing a Graduate Diploma in Nursing Science (Acute Care) from the University of Adelaide while on practicum at Saint Andrew’s Hospital. Since returning home to the Solomon Islands, she has put her international experience to good use. Pitavolomo delivers regular nursing education sessions, mentoring nurses in the HDU and writes new hospital policies and guidelines. She discusses at length the many differences between the Australian and Solomon Islands healthcare system, namely technology and infrastructure. Her passion is palpable and contagious, as she lays out her many ideas to empower her colleagues and improve the nursing standards at the National Referral Hospital. Pitavolomo states that her experience in Australia has increased her confidence significantly.
“I used to be shy but now I have come back to the Solomons and taken on a leadership role. Studying in Australia has helped build both my personal and professional confidence. It broadened my knowledge and skills to look after acute and critical patients. Now I can share that knowledge and skills with my colleagues.”
Why is professional development important?
The evidence is clear — Investing in nurses’ professional development leads to better health outcomes and an improved health system. According to the International Council of Nurses, professional development significantly reduces patient mortality. Nurses are the backbone of health institutions, being the largest occupational group in the health sector and delivering almost 80% of hands-on care worldwide. Given the substantial role nurses play in delivering health services, it is crucial to have a highly-skilled workforce. Professional development enables nurses to stay up-to-date on the latest advances in science and technology and reduces the likelihood of errors or adverse patient outcomes. Continuous education is important in any profession, but especially in healthcare where best practice is continuously changing. Pitavolomo is a strong advocate for professional development to improve the standards of nursing care:
“Professional development helps to enhance nurses’ knowledge and skills with the latest evidence- based practice. It helps nurses to know how to recognize the signs and symptoms of someone becoming unwell. Not just through observations, but by clinical assessment skills. Nurses can then escalate care to implement early interventions and maybe save the patient’s life.”
What are the challenges to nurses’ professional development in the Solomon Islands?
There are no postgraduate nursing qualifications offered in the Solomon Islands, meaning nurses must look elsewhere for professional development opportunities. Pitavolomo explains the obstacles to professional development:
“It is hard to get study options locally. You can study health leadership and management but there are no specialized nursing courses at Solomon Islands National University (SINU). We can do online courses, but a lot of nurses don’t have the funds. Some nurses get scholarships to go overseas but it is very competitive, and you have to spend a long time away from home.”
There are limited opportunities for nurses in the Solomon Islands to apply for international scholarships. Pitavolomo is grateful to the Australian Department of Foreign Affairs for the opportunity to be selected as an Australian Awards scholarship recipient. However, such scholarships are competitive and not without challenges. Studying internationally requires a substantial commitment and personal sacrifice — usually consisting of at least one year abroad, often more. Embarking on postgraduate study overseas requires nurses to separate from their family and community and can be difficult financially, even with a scholarship. Additionally, they may have limited social support overseas and must navigate the challenges of adapting to a new culture. Pitavolomo elaborates on these difficulties based on her Australian experience, explaining that there were significant language barriers that made her studies challenging.
“The lectures were all in English and the lecturer spoke so fast. It was hard to understand. Every class I had to take a video, and then go home and re-watch to make my notes pressing pause and re-play.”
Postgraduate courses in Australia teach based on the Australian healthcare system. The Pacific Islands have considerably different health infrastructure and access to technology and resources. Whilst such Australian qualifications teach international best practice, they may not be applicable to the clinical situations that nurses in the Solomon Islands will find themselves in. Online postgraduate study offers a potential solution, however, as Pitavolomo highlights this also brings challenges. The lack of necessary technology such as computers can hinder nurses’ participation. Additionally, the Solomon Islands has one of the highest electricity prices in the world, with only 15 to 20 percent of the population having access to power. Not only is electricity expensive, but internet connectivity is unreliable, making consistent engagement in online learning difficult.
So, where to from here?
Pitavolomo believes that the solution lies in offering nurses local postgraduate study options.
Previously, the SINU Faculty of Nursing has collaborated with the Auckland University of Technology (AUT) in New Zealand to develop the country’s first Bachelor of Nursing degree. Similar work could be explored with the faculty to develop a locally delivered Postgraduate Certificate or even Masters in Nursing. Investment in such a course would be a valuable contribution from any international development partner wanting to provide support to the Solomon Islands health system. This will move the Solomon Islands one step closer to a sustainable healthcare model, empowering future generations of change-maker nurses such as Pitavolomo.
Image description: Serah Pitavolomo, a Clinical Nurse Consultant smiles while talking to her colleagues in the Solomon Islands’ National Referral Hospital in Honiara. Serah is delivering training to two nurses in the High Dependency Unit on how to use an intravenous infusion pump.
Image credit: Katie Croom
