Nurses let go after competency tests

More than 100 nurses from Al Mafraq hospital are told their contracts will not be renewed after they failed basic exams.

Al Mafraq Hospital says it is raising its standards.

ABU DHABI // More than 100 nurses from Al Mafraq hospital - one in nine of the total - have been told their contracts will not be renewed after they failed rudimentary competency examinations. "The nurses weren't very good and couldn't pass a basic test," said Gail Smith, the hospital's chief nurse officer. All of the nurses at the hospital were evaluated on their elementary skills, clinical work, customer service and work ethic.

Those with the best test results received wage increases, while those with the lowest scores did not have their contracts renewed. The nurses, most of whom were seasoned staff members, were tested on routine subjects, such as how to dress a wound, administer oral medications and do a physical assessment on a patient. "This is stuff that they do every single day - one would have thought that they know how to do that," Ms Smith said. In the "eight, nine months that I've been here, I've been trying to give them the basics - like wash your hands".

Twenty per cent of the nurses passed all of the tests and the hospital was working with those who had failed some portions of the evaluation to improve their skills. "This is not advanced stuff," said Ms Smith. "The advanced stuff is coming and we will teach them, but how do I teach the advanced stuff if they don't have the basics? It was just the right thing to do for the patients and the community."

Ms Smith said that she did not know the exact number of nurses who would be leaving the hospital, but that it was more than 100. Some nurses, however, said as many as 300 would lose their jobs - a claim denied by Ms Smith. The hospital's administrators said all vacated positions would be filled. Dr Mohammed Yaman, the chief medical officer at Al Mafraq, said those who had failed to meet the hospital's standards had shown little enthusiasm for improvement.

"Their deficiencies were discussed with them and they were given the chance to improve themselves. People who didn't, we said, 'If your contract comes up, we are not renewing it'." Some nurses claim, however, that they were not given sufficient notice to prepare for the exams. "They did not give us any time for review," said one nurse, who broke down in tears. "They said there is no need to read because it is basic knowledge. They only gave us a week to prepare."

The woman was the head of her unit. "Even doctors said she was good," said another nurse. "They would go to her for advice. It was just done by lottery. No one knows why." Dr Yaman and Ms Smith said the hospital had given staff ample time and training in advance of the evaluations and that nurses had known about the process since last December. Some nurses say that their contracts end on Dec 9, leaving them little time to find new jobs, let alone housing and schooling for their children.

However, Ms Smith said the notice periods varied and some nurses had been given up to six months and that the hospital would be flexible about termination dates. Not all nurses at the hospital were upset at the move. "We are sad for them," said Nawal Awad, a staff nurse at the hospital. "But there are lots of changes that we have to keep abreast with. It's not like if you've worked 20 years there is nothing new to learn. There are new technologies and new procedures."

Irine De Souza, a staff nurse at the hospital, said: "The system was in sleep mode and we had to wake up and move with the changes. Medicine is not stagnant. As a nurse, I have to be updated with my knowledge. "If nurses cannot do this stuff, which is so basic, I cannot trust to give my patients to that nurse." Aman Hasan, a nurse unit manager for paediatrics, agreed. "I would not give my baby to a nurse that I know has failed two tests. She might give the wrong medicine to my baby. I don't want to face this situation."

Doctors at the hospital had been advised not to speak to the media, but those who did speak, on condition of anonymity, said they were not happy with the decision to let the nurses go. One doctor suggested the move was financially motivated and said many of those whose contracts had not been renewed were exemplary employees. "Some of the nurses who were terminated were some of the best nurses, I can tell you. The nurses who were terminated, we had experience with them, we have been working with them for a long time. They were very good nurses."

Many of the departing nurses have worked at the hospital for more than a decade and are now worried about their futures. "We have children," said one nurse. "We have family. They are just throwing us out. All my life was in this country. I don't know my own country." Another said: "You can tell us to go, and that we don't need you, but not like this. Not you have failed and you don't know the skills. This is not the way to remove us."

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