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An Egyptian Nursing Institute Redefines the Profession

EL GOUNA, Egypt—Ahmed Gamal’s younger brother might not have survived a hard fall down the stairs without the attentive care of a male nurse in an ambulance.

“After we arrived at the hospital, the doctor told us that the nurse saved my brother’s life,” Gamal said many months after the accident. “The doctor said the nurse intervened using knowledge as if he was a doctor. My father went to thank him and he said, ‘This is my role and I always seek to do the best that I can.’”

Praise for a nurse’s leadership is rare in Egypt, where nursing is viewed as a lowly profession for those who don’t have good enough grades to get into university. Private hospitals often hire nurses from outside Egypt as they cannot find trained and interested Egyptians. But it only took one critical incident for Gamal to respect the profession, prompting him to enroll at the Gouna Technical Nursing Institute, which is working to set a higher standard for nurses and to more broadly promote the profession.

“The institute gives you a chance to be a professional nurse, which isn’t common in Egypt,” Gamal said on a recent morning.

Established just over three years ago in a coastal city on the Red Sea, the Gouna Technical Nursing Institute produces well-trained graduates.

Institute classroom (Photo by Sarah Lynch)

“When our students come here and they see role models—teachers within the school—who really have a love for nursing and enjoy what they do, they can see this can be a rewarding career and I think they feel really empowered that nursing is a meaningful and rewarding job,” said Linda Gorman, an assistant lecturer from Glasgow, Scotland. “That is where you can see in our graduates that they are enthusiastic.”

Under the Ministry of Higher Education, the institute offers a two-year degree and teaches a curriculum developed by the Lawrence Memorial/Regis College Nursing Program, which is located in Massachusetts, in the United States, and sent a team to Egypt numerous times to help build and develop the institute. Students attend on full scholarships from the Sawiris Foundation for Social Development, a non-governmental organization in Egypt.

“The curriculum is excellent,” said Lawrence Memorial/Regis College’s Marie B. McCarthy, the lead consultant working with the institute. “They are using U.S. standards and even though they aren’t [U.S.] accredited or seeking U.S. accreditation, everything we put in place was with that in mind. So they are meeting standards above and beyond those that are required in Egypt.”

Given that, it certainly could be a model for other nursing schools in Egypt or in the broader region, she said.

Through a rigorous English-language education that—unusual in the Arab world—promotes principles of self-evaluation, communication and critical thinking, the institute tries to answer challenges that plague the nursing sector.

If educators can replicate the work of the nursing institute elsewhere in the country and make it a national standard, “it will change everything about nursing in Egypt,” said Hassanat Naguib, dean of the institute. “One of our missions is to… have everyone see how we succeeded in improving the nursing profession.”

Nursing shortages are common in many countries but Egypt seems to face it in the extreme. In 2008, Egypt needed 44,000 nurses it didn’t have, according to a working paper by Marwa Farag, then a research fellow at the Dubai School of Government and a Dubai Initiative fellow at the Harvard Kennedy School. Of those nurses who are in the field, almost 90 percent are trained only at a high-school level. That “is considered to be inadequate/inefficient quality nurse education not only internationally but even by the region’s standard,” Farag wrote in the working paper.

Naguib said lack of proper training is a symptom of a broader system that neglects the role of nurses. In hospitals, they are treated like assistants and not even given feedback on their work performance, she said.

In Egyptian society, nurses are viewed as lacking knowledge and needed only for basic tasks such as giving injections,Gamal said. “It’s a stereotype of nursing in Egypt,” he said.

It is within that atmosphere that the institute is trying to have an impact. And with eight faculty members, 32 students and 30 graduates so far, its efforts—even if on a minute scale—seem to be successful.

Christina Karam, a 2013 graduate of the institute who now works at a psychiatric hospital in Cairo, said that while other nurses she works with are good at what they do, it is a result of experience rather than training. “My studies gave me the opportunity to communicate more effectively,” she said.

Practice patient (Photo by Sarah Lynch)

Some employers can see the difference. Bernadette Bishop, director of nursing at the Aswan Heart Center, where some of the institute’s nurses have interned after completing the two-year program, said she has been very impressed by the institute’s graduates. They think critically and are professional and disciplined, she said.

“I’ve had to wade through hundreds to find the right ones and the Gouna nurses are completely different than others in Egypt,” Bishop said. “They’re completely differently trained from the rest of Egyptian nurses… It’s a much higher level.”

Behira Mohammed, a current student from the Nile Delta region, said the institute, which she discovered online, taught her how to assess her strengths and weaknesses. “I also learned how to communicate better with people as well as think critically,” she said.

But educating the next generation of nurses to the highest criteria is no easy task in a developing nation that struggles with a crumbling school system, political instability and marginalization of rural regions.

“All students are coming from public schools and I have to tell you the outcome is miserable,” Naguib said.

Moreover, most students come from poor families, said Mohamed A. Rahman, head of the institute’s English-language department, which offers 15 hours of English instruction a week to students in their first term. “They don’t have much experience in life to the extent that some of them have never been to a mall.”

Yet the students, who mostly come from the Nile Delta region, a sprawling patch of land north of the country’s capital, have been receptive and are improving, Rahman said.And graduates are thankful for the institute.

Karam, the graduate from the Upper Egyptian city of Sohag, said the institute changed her life. “If I didn’t join the institute I’d probably be sitting at home without a job, so thank god,” she said.

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