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January 2009 - Volume 3,
Issue 1
Nursing
in Saudi Arabia: A personal Perspective of A Female Nursing
Student
Shortage
of nurses is a world-wide problem. In the USA it has been
estimated that the nursing deficit will be 1.5 Million RNs
by year 2020 (1). In Saudi Arabia (SA) a shortage of national
nurses is a major problem due to many factors: social, educational,
system and individual. These factors are often food for discussion
among the Saudi nursing community albeit established nurses
or students. Indeed some nurses consider these factors as
barriers to the development of nursing in Saudi Arabia.
In this paper,
I will use my personal perspective and feelings as a nurse
student to talk about each factor (or barrier as we used to
call it when talking to nursing colleagues). I acknowledge
that it is a personal perspective that may not be generalized.
However, my aim is to share this perspective and feelings
with bodies and organizations interested in nursing in S.A.
in particular and Middle East in general. At the same time
to encourage student colleagues and established nurses to
share their experiences for better understanding of nursing
as a profession in this part of the world.
People in Saudi Arabia are generally
generous, friendly and kind but very conservative and affected
greatly by certain ideas about women and their work. These
ideas are manipulated by a small fraction of the community
to their benefits and distort the image of nursing as if it
is purely Western tradition which does not fit Muslim women.
This is despite the fact that Muslim women work side by side
with the Prophet Mohammed (peace be upon him) and his companions
and are used to nursing injured and sick men during war and
peace time. Society looks at nurses with some suspicion and
disrespect so that girls are afraid of joining nursing even
if they like it. I know a friend who had to terminate her
study in order to get married because her husband and his
family do not accept her as a nurse! This is just an example
of social barriers.
Although, lack of respect has been
reported in USA nursing literature (1), it has been recently
changed to more respect where public perceptions of nurses
are associated with "care", "compassion",
"professional" and "help"(2). I just wonder
what sort of perception our public is holding about female
Saudi nurses? High public regard of nursing should help in
increasing the supply of nurses. Media has to play a role
in educating society about the importance of national nurses
while professionals should do more research on this important
aspect to have more objective data on the public's perception
of nurses.
Education in primary, intermediate
and secondary school fails to produce open-minded and creative
students. It concentrates on ability of memorizing a lot of
subjects with little understanding and analysis. Moreover,
there is a dichotomy between education at these levels and
education in colleges and universities. This is not to suggest
that undergraduate education is better but rather to highlight
the dichotomy between undergraduate and previous levels of
education (primary, intermediate and secondary). To give an
example to clarify this issue:
English is not included in primary
school and not emphasized in intermediate and secondary school.
But when it comes to nursing in colleges and universities
they ask me to have good command of English! Indeed I was
denied joining a well-known nursing college because my English
at that time was not good. I had to do more in learning English
before I was accepted as a nursing student. In this way English
becomes an obstacle for me and many other girls who want to
join nursing.
I believe English is a must in nursing
education but I believe also that it must not be an obstacle
to interested girls who love nursing as a career. There should
be a way to help interested students to compensate for the
failure of education. I wish that nursing colleges using English
as the language of teaching give more chance for students
who join with little English but who have much interest in
nursing. English takes time to master, similar to any other
language. It appears unfair to jeopardize interested nursing
students because they did not have the chance to learn English.
Nursing in S.A needs motivated nurses not linguistics. Giving
intensive English courses as well as teaching in English would
be sufficient for nursing students to command English by the
time of graduation. Most of our patients, if not all, speak
Arabic and we will not have problems with communication with
them. Most of the nurses in our hospitals and clinics are
from the East and Far East countries and their English is
not perfect because it is not their mother language but they
are doing great jobs as nurses even if they do not speak Arabic.
Why then do Saudi nurses have to command English to be accepted
into our nursing colleges? What evidence do we have to prove
that high quality nursing is associated with fluency in English?
Nurses from India, Korea, Philippines, and Malaysia prove
themselves in our community and they are not English or Arabic.
Having said that again, I strongly
believe that Saudi nurses must learn English and if possible
command it, but there must be an educational system to enable
them to do so. English in primary, intermediate and secondary
schools will help preparing the ground for undergraduates
to study nursing in English without much difficulty. In the
meantime nursing colleges should give more intensive English
courses to students all through their study. The current situation
of asking new students to command English while their background
education does not support them, means we penalize motivated
students for the failure of the educational system.
Health care systems and educational
systems fail drastically to prepare the ground for interested
girls to join nursing in many aspects: lack of opportunities
and motivation, lack of a coherent strategy to compensate
for the social barriers and lack of clear vision of what and
how and when to utilize Saudi nurses. Consequently, individual's
visions of nursing as a career is blurred. Adding to this
problem is the fact that colleges of nursing in S.A cannot
differentiate between a high quality nursing student and fluent
English speaking girls who acquired their language in the
USA or England because they had the chance to stay there for
a reason or another! The majority of Saudi girls do not have
the chance to travel abroad to learn English and it is not
fair to judge their professional quality on the basis of their
English language: if they cannot master English in two semesters,
students lose their chance in completing the college course.
I think this needs a complete rethink. English is important
but it should not be the only factor determining the suitability
of nursing students.
There must be a system by which we
judge quality on sound professional objectives. Moreover,
the healthcare system and educational system must work together
and formulate a common vision on how to ensure enough supply
of Saudi nurses.
Individual Barriers:
Individual here means me as an individual student and similar
colleagues who are interested in nursing but afraid and hesitant.
Afraid of our society and its perception, afraid of failure
and regrets, afraid of the unseen!;; hesitant to take risks;
hesitant to experience difficulties and setbacks; hesitant
to talk loudly about our feelings, worries and expectations.
While I am thinking and writing this paper I realized that
expressing my view and admitting that I am afraid and worried
about nursing as career is not bad thing. It helps me to think
deeply about sources of these worries and look for strategies
to cope with barriers mentioned above.
More importantly it enables me to
realize my shortcomings: I tend to blame others for my failure;
not critical enough of myself; not utilizing available resources
efficiently (for example internet and English courses). Above
all I must see the above-mentioned barriers as challenges
to strengthen me more!
I must admit I passed through a painful
and frustrated experience in joining nursing with very little
English and it is easy for me to blame other but this will
not solve my problem. I feel proud and happy that in two years
I made good progress in English. It takes time but it is worth
the trouble! What is more important is that I do not lose
interest in nursing because of my English. I strongly believe
that being a Saudi female I can make a difference for my patients
who are mostly Saudi and speak the same language and share
the same culture. Once we lose sight of our purpose we go
astray: my main purpose of joining nursing is to care for
my patients professionally and compassionately. I believe
I can do it, believing in oneself helps in coping with challenges
facing female Saudi nurses.
Factors contributing
to the shortage of Saudi nurses must be explored, studied
and eliminated. In this article I share my personal perspective
and feelings about the social, and educational system, and
individual factors as I see them, with the aim of encouraging
colleagues to share theirs for better understanding of a nursing
career in Saudi Arabia.
- Barney,S.
.M. The Nursing Shortage: Why Is It Happening? Journal of
Healthcare Management. May/June2002: 153-155.
- www.medscape.com/
view article/576956-3
- www.accessmylibrary.com/
coms2/ Summary 0286-34710162- ITM
- Robb, A.J.P & Murray,R. Medical
Humanities in Nursing: thought provoking? Journal of Advanced
Nursing, 1992(17) :1182-1187.
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