In response to the looming strike, the Ministry of Health has reportedly directed all public health facilities in Ghana to activate their contingency plans without delay. Sources reveal that hospital managers—particularly Directors of Nursing Services and their Deputies—have been instructed to remain on duty throughout the strike duration.
It was also disclosed that unit heads must ensure maternity and emergency services continue uninterrupted in all hospitals, while the Ambulance Service has been placed on high alert across all districts to respond swiftly to emergencies.
Reports further indicate that emergency coordinating structures are to be established to maintain a constant link with ambulance services, and that the Director-General of the Ghana Health Service, alongside CEOs and Medical Directors of Teaching Hospitals, will be submitting daily updates on service delivery to the Acting Chief Director of the Ministry.
In a bid to cope with the expected patient surge, the Ministry is said to be engaging quasi-government health facilities for support. Additionally, rotational nurses and those undergoing mandatory clinicals have reportedly been advised to abstain from joining the industrial action.
According to the Ministry, every effort is being made to ensure that logistics and support systems are in place to cushion the health sector against the strike’s disruption. While commending nurses and midwives who have chosen not to participate, the Ministry has once again appealed to the Ghana Registered Nurses and Midwives Association (GRNMA) to reconsider its stance, assuring that dialogue remains ongoing to resolve all outstanding issues.
A nephrostomy is a procedure where a catheter (tube) is inserted through the skin into the kidney to drain urine directly from the renal pelvis. It bypasses the ureter, which may be blocked due to:
Kidney stones
Tumours
Infections
Trauma
Congenital abnormalities
The tube exits through the back and connects to an external drainage bag.
2. Comprehensive Nursing Care in the Ward
Initial Post-Procedure Care
Monitor vital signs: Especially in the first 24 hours for signs of bleeding or infection.
Observe the nephrostomy site:
Check for redness, swelling, discharge, or leakage.
Ensure dressing is clean and secure.
Urine output:
Measure and record output hourly initially, then per shift.
Monitor for changes in colour, clarity, or presence of clots.
Ongoing Nursing Care
Site care:
Clean the insertion site daily or as per hospital protocol using aseptic technique.
Change dressing if wet, soiled, or loose.
Drainage bag management:
Keep below the level of the kidney to prevent backflow.
Empty when 2/3 full, using clean technique.
Maintain accurate intake/output charting.
Prevent dislodgment:
Secure the tube with tape or fixation device.
Educate the patient to avoid pulling or tugging.
Infection control:
Watch for fever, chills, increased WBCs.
Report cloudy or foul-smelling urine.
Pain management:
Administer analgesics as prescribed.
Monitor for signs of discomfort, especially during movement or dressing changes.
Patient education:
Explain the purpose and care of the nephrostomy.
Involve them in simple care if appropriate (e.g., emptying the bag).
3. Dietary Management
Hydration: Encourage fluid intake (unless contraindicated) to flush the kidneys.
Low-sodium diet: Reduces kidney strain and manages blood pressure.
Protein moderation (especially in renal impairment): Prevents further kidney burden.
Avoid oxalate-rich foods (if stones are a cause): Spinach, nuts, chocolate.
Monitor electrolytes:
Adjust diet based on lab results (e.g., potassium or phosphate levels).
Consult a renal dietitian for individualized dietary planning.
4. Physiotherapy Management
Mobilization:
Early ambulation if stable to prevent complications like DVT or pneumonia.
Encourage movement while securing nephrostomy tubing to prevent dislodgement.
Breathing exercises:
Especially post-op or if patient is bedridden.
Postural care:
Ensure the patient maintains good posture during bed rest to avoid pressure ulcers.
Pelvic floor or core strengthening (if appropriate):
Improves overall abdominal and back support for long-term nephrostomy patients.
Conclusion
Managing a patient with a nephrostomy requires a holistic, multidisciplinary approach. Nurses play a key role in monitoring, maintaining site hygiene, educating patients, and coordinating care. With support from dietitians and physiotherapists, patients can maintain quality of life and reduce the risk of complications.
Substance abuse is a growing concern in our world today, affecting individuals, families, and entire communities. Whether it’s alcohol, tobacco, or illegal drugs, substance abuse damages lives in ways that many fail to realize until it’s too late. It is crucial to understand the causes, recognize the effects, and find ways to prevent or overcome addiction.
What Causes Substance Abuse?
Many factors contribute to substance abuse. Some of the most common include:
Peer Pressure – Young people often start using drugs or alcohol due to influence from friends or social groups.
Curiosity and Experimentation – Some individuals, especially teenagers, want to experience what it feels like.
Stress and Mental Health Issues – Anxiety, depression, and other mental health struggles can lead people to use substances as a way to escape reality.
Family Influence – Growing up in a household where drug or alcohol use is common increases the likelihood of substance abuse.
Availability of Drugs and Alcohol – Easy access to substances makes it easier for people to fall into addiction.
Trauma and Abuse – Past traumatic experiences, such as physical or emotional abuse, often lead individuals to seek relief through drugs or alcohol.
Effects of Substance Abuse on Health and Society
Substance abuse does not only affect the person using drugs or alcohol—it impacts society as a whole.
Health Effects
Brain Damage – Prolonged drug use alters brain function, affecting memory, judgment, and emotions.
Heart and Liver Problems – Alcohol and drugs can cause severe damage to the heart, liver, and other organs.
Mental Disorders – Substance abuse can trigger depression, anxiety, and even psychosis.
Weakened Immune System – Drug use lowers immunity, making the body more prone to infections and diseases.
Risk of Overdose and Death – Many people underestimate the power of drugs, leading to overdose and even fatalities.
Effects on Society
Crime Increase – Many criminal activities, including theft and violence, are linked to drug abuse.
Broken Families – Addiction destroys relationships, leading to divorce, child neglect, and domestic violence.
Unemployment and Poverty – Many drug users lose jobs due to poor performance or criminal activities.
Health System Burden – Hospitals and rehabilitation centres are overwhelmed by cases of drug-related health issues.
How to Prevent Substance Abuse
The best way to fight substance abuse is by stopping it before it starts. Here are some effective prevention methods:
Education and Awareness – Schools, communities, and families should educate people on the dangers of substance abuse.
Strong Family Support – Parents should communicate openly with their children, guide them, and provide a safe environment.
Healthy Friendships – Choosing the right friends can help avoid peer pressure and bad influences.
Engagement in Positive Activities – Sports, music, and hobbies can keep young people busy and away from drugs.
Strict Laws and Policies – Governments should enforce laws that regulate drug use and sales.
How to Stop Substance Abuse if You Are Already Addicted
If you or someone you know is struggling with addiction, there is hope. Here’s how to overcome substance abuse:
Admit the Problem – The first step to recovery is acknowledging that you need help.
Seek Professional Help – Doctors, counsellors, and rehabilitation centres can provide the necessary treatment and support.
Surround Yourself with Supportive People – Being around loved ones who encourage sobriety is crucial.
Develop Healthy Habits – Exercise, good nutrition, and positive activities can help replace bad habits.
Avoid Triggers – Stay away from people and places that encourage substance use.
Stay Committed – Recovery is a journey. Stay strong, be patient, and never give up.
A Warning to Children and Youth
Dear young ones, your future is bright, and you have so much to achieve. Do not let drugs or alcohol ruin your dreams. Substance abuse is a trap that many fall into, but you have the power to say NO. Surround yourself with positive influences, focus on your education, and seek help when you face difficulties. Your life is too precious to waste on drugs.
Conclusion
Substance abuse is a serious issue, but with education, awareness, and strong community support, we can fight against it. Whether you are trying to prevent it, help someone struggling, or recover from addiction, remember—there is always hope, and change is possible. Say YES to life and NO to drugs!
Amara Okoye stood on the veranda of her small family home in Lagos, her hands trembling as she clutched her plane ticket to London. Her heart felt torn. Her husband, Emeka, stood silently beside her, holding their youngest child. Their two children, Ada and Chukwuma, clung to her legs, their innocent faces looking up at her with confusion and sadness.
“Amara, are you sure about this?” Emeka asked softly, his voice heavy with worry.
She nodded, wiping a tear from her cheek. “It’s for all of us. I’ll work hard, save, and bring you and the kids over as soon as I can. We deserve a better life, Emeka.”
With a final embrace, Amara said goodbye to her family, friends, and the life she had always known. As the plane ascended into the sky, she prayed for strength and a brighter future.
Chapter 2: A Harsh Welcome
Arriving at Heathrow Airport, Amara’s excitement quickly turned into anxiety. She waited for hours, scanning the crowd for the agent who was supposed to pick her up. No one came. Her calls went unanswered. Exhausted, hungry, and unfamiliar with the cold London weather, she sat on a bench, her suitcase by her side. Tears blurred her vision as she realized she had no plan B.
By chance, a kind woman named Mirabelle Konadu approached her. Mirabelle, a Ghanaian nurse, listened to Amara’s story and offered her a place to stay.
“Don’t worry, my sister,” Mirabelle said warmly. “You’re not alone. God brought you to me for a reason.”
Amara moved into Mirabelle’s small flat, sharing space with Mirabelle and her husband, Kofi. Despite the initial relief, life in London was far from easy. With Mirabelle’s help, Amara found work as a support worker, earning enough to send some money home to her family.
Chapter 3: Strained Bonds
Months passed, and tension grew in Mirabelle’s home. Kofi’s patience wore thin, and he eventually demanded Amara leave. Heartbroken but determined, Amara began searching for her own place.
One day, a British colleague named Bred overheard her struggles. “I live alone in a two-bedroom apartment,” he offered. “If you’re comfortable, you can stay with me for a while and save up for your own place.”
Desperate, Amara agreed. Bred proved to be kind and supportive, treating her with respect. He did the grocery shopping, and Amara cooked for them both. For the first time in months, she felt a sense of stability.
Chapter 4: A Forbidden Night
One evening, Bred invited Amara out to dinner. The night was filled with laughter and a sense of freedom Amara hadn’t felt in a long time. Bred drank more than he should have, and by the time they returned home, he was mildly intoxicated.
Amara helped him to his room, but as she turned to leave, he pulled her into an unexpected kiss. She tried to resist, but his grip was strong, and in a moment of weakness, they crossed a line. That night, Amara’s guilt consumed her, but the act repeated itself in the days that followed. Their bond deepened, despite Amara’s efforts to maintain her loyalty to her husband.
Chapter 5: The Consequences
Weeks later, Amara discovered she was pregnant. The revelation shattered her. When she told Bred, he was overjoyed.
“Amara, this child means the world to me,” he said. “You don’t have to stay, but please, let me raise this baby. You’ll still have your family, and I’ll make sure you have everything you need.”
Conflicted, Amara wrestled with the decision. She thought of Emeka and her children back in Nigeria. How could she betray their trust? But Bred’s unwavering support during her pregnancy softened her resolve. He fulfilled his promise, helping her secure British citizenship and ensuring she could eventually bring her family to the UK.
Chapter 6: A New Chapter
After giving birth to a healthy baby boy, Ted, Amara weaned him and moved to Manchester. She rented her own apartment and worked tirelessly to bring Emeka and their children to the UK. When they finally reunited, tears of joy filled their eyes. Her husband’s love and trust made her question whether she should reveal the truth about Ted’s existence.
Amara is torn between two seas. She is so confused and disturbed. She could not completely detach herself from her UK family, not to mention the pain of not seeing her own child for months. Therefore, she visits every two months to see Ted. Bred had told Ted that his mother goes away because of work. Ted loves her deeply and always wants to see her on video calls when she is away. Sometimes, Amara hides in the toilet or finds a secret place to talk to her own son. She is silently dying and weeping every day.
“What should I do, Lord? What kind of situation have I found myself in?” Amara whispered in despair.
During her visits, she prepares different kinds of soups, stews, and assorted dishes, keeping them in the fridge for Bred and Ted. She takes Ted to playgrounds, buys him ice cream, and showers him with motherly love. Her room in Bred’s house remains untouched, kept as she left it, serving as a memory of their time together.
Emeka senses that something is eating away at his wife, but he cannot unravel the truth. The secret is that Emeka does not know he is on a visiting visa that will soon expire. Amara had divorced him before marrying Bred to gain UK citizenship. Now, five months since her family’s arrival, the moment of sadness and guilt has reached its peak.
Amara, after buying a test strip from the pharmacy, tests positive. She is pregnant again. Who is responsible? As the saying goes, only the pregnant woman knows the father of her unborn child.
Now, Emeka has agreed to return to Nigeria to bring African food and herbs for their new baby. But will he come back? Amara’s mother is the only one who knows all her secrets. Will Emeka return to the UK, or is this the beginning of a tragic unravelling?
Moral Lessons
Resilience and Determination: Amara’s story highlights the sacrifices and challenges faced when striving for a better life. Her determination to succeed, despite setbacks, inspires perseverance.
The Weight of Secrets: Secrets can erode trust and relationships. Honesty, though difficult, often paves the way for healing and growth.
Kindness and Humanity: Mirabelle and Bred’s generosity remind us of the importance of helping others in their time of need.
The Consequences of Actions: Every decision has consequences. Amara’s choices, though made under challenging circumstances, illustrate the complexities of human emotions and the importance of accountability.
Epilogue: The Ultimate Question
Should Amara tell Emeka the truth? Should her children know they have a brother somewhere? What should she do now that she is pregnant again?
Menstrual pain, or dysmenorrhea, is a common condition that many women experience during their menstrual cycles. Here’s a breakdown of medical treatments, home remedies, and signs for when you should see a doctor.
Home Remedies for Menstrual Pain
Heat Therapy:
Use a heating pad, hot water bottle, or warm compress on the lower abdomen. Heat relaxes the muscles and improves blood flow, reducing cramps.
Stay Hydrated:
Drink plenty of water to avoid bloating and cramping. Warm water or herbal teas like ginger or chamomile are particularly soothing.
Exercise:
Light exercises like walking, yoga, or stretching release endorphins, which act as natural painkillers.
Dietary Changes:
Eat anti-inflammatory foods like fruits, vegetables, nuts, seeds, and fatty fish. Avoid caffeine, alcohol, and salty foods during your period.
Eat Magnesium-rich foods (e.g., spinach, bananas, dark chocolate) can also help.
Essential Oils:
Massage the abdomen with diluted essential oils like lavender, clary sage, or peppermint to ease cramps.
Ginger and Turmeric:
Ginger tea or adding turmeric to meals can help reduce inflammation and pain.
Rest and Relaxation:
Stress can worsen menstrual pain, so practices like meditation, deep breathing, and adequate sleep are helpful.
Herbal Supplements:
Some women find relief with supplements like evening primrose oil, fennel seeds, or vitamin B1. Always consult a doctor before starting any supplement.
Medical Treatments for Menstrual Pain
Over-the-Counter Pain Relievers:
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are highly effective. They work by reducing the production of prostaglandins, which cause cramping.
Acetaminophen (paracetamol) can also help but is less effective than NSAIDs.
Birth Control Pills:
Hormonal contraceptives can regulate or lighten periods and reduce cramping. They prevent ovulation, which decreases prostaglandin production.
Prescription Medications:
If OTC pain relievers are ineffective, a doctor may prescribe stronger NSAIDs or hormonal treatments like a progestin IUD (e.g., Mirena).
Muscle Relaxants:
In some cases, muscle relaxants can help alleviate severe cramps.
Surgical Options:
If underlying conditions like endometriosis or fibroids cause severe pain, surgery (e.g., laparoscopy) may be necessary.
When to See a Doctor
It’s important to consult a healthcare professional if:
Pain Is Severe or Debilitating:
If cramps prevent you from performing daily activities, it may indicate a more serious issue like endometriosis or adenomyosis.
Pain Lasts Longer Than Normal:
Menstrual cramps should typically last no more than 2–3 days. Prolonged pain could signal an underlying condition.
Symptoms Are Unusual:
Heavy bleeding (changing pads/tampons every 1–2 hours), large blood clots, or irregular periods should be evaluated.
Pain Is Unresponsive to Medications:
If OTC medications and home remedies don’t help, a doctor may need to investigate further.
Other Symptoms Are Present:
Pain accompanied by fever, nausea, vomiting, diarrhoea, dizziness, or pelvic pain outside of menstruation requires medical attention.
You’ve Recently Had Changes in Your Menstrual Cycle:
Significant changes in flow, cycle length, or pain level should not be ignored.
You Have a Known Condition:
If you’ve been diagnosed with PCOS (Polycystic ovary syndrome), endometriosis, or fibroids, worsening symptoms may need treatment.
Red Flags Requiring Immediate Attention
Sudden and severe pelvic pain.
Signs of infection, such as foul-smelling discharge, high fever, or chills.
Pain following an intrauterine device (IUD) insertion that doesn’t subside.
Wear the Right PPE: Always wear gloves and any other necessary protective equipment before handling the catheter to maintain hygiene and prevent infection.
Remove the Balloon Water First: Ensure the water in the catheter’s balloon is completely removed before attempting to take out the catheter.
Non-Traumatic Clamp Use: If you use a clamp to minimize discomfort, don’t forget to remove it at the end of the procedure.
Common Mistakes to Avoid:
Not Wearing Gloves: Many candidates fail to wear gloves when cleaning the sampling port or handling the catheter, which is a serious infection control breach.
Incorrect Balloon Water Removal: Some candidates do not withdraw the correct amount of water from the balloon, which can cause issues during removal.
Improper Technique: A common error is attempting to remove the catheter without fully deflating the balloon, which can cause pain and tissue damage.
Simplified Process:
Wear gloves and other PPE for protection.
Clean the catheter port before starting.
Use a syringe to carefully withdraw all the water from the balloon.
Gently remove the catheter, ensuring the balloon is deflated.
If you used a clamp, make sure to remove it before finishing the procedure.
Practicing these steps helps ensure patient safety and prevents complications during catheter removal.
Planning involves creating a detailed care plan based on the person’s needs and the issues identified during the assessment. Here’s how to approach it effectively:
Top Tips:
Identify Key Problems:
Focus on the most important issues the person is experiencing, such as pain, anxiety, difficulty moving, or trouble breathing.
If they have recently had surgery, think about common post-operative problems they might face, like pain, nausea, or risk of infection.
Document Self-Care Abilities:
Record what the person can do for themselves. For example, can they eat, dress, or move independently? This goes in the “self-care” section.
Set Review Times:
Decide how often to check on the problems you’ve identified. For example, if they’re in pain, you should review them much sooner than 24 hours later.
Stay Focused:
Only include information that directly relates to the issues you’ve identified. Avoid irrelevant details.
Complete All Sections:
Make sure all parts of the planning documentation are filled out properly. Don’t skip anything!
Common Mistakes to Avoid:
Missing Self-Care Details: Forgetting to document what the person can manage on their own.
Lack of Specific Nursing Actions: Not including detailed, evidence-based interventions to address the identified problems.
Identifying Irrelevant Problems: Missing key issues and focusing on unrelated information, like equipment use, without addressing the care priorities.
Omitting Review Times: Failing to specify when the problems will be reassessed.
Documentation Errors: Not signing, dating, or printing your name on the care plan.
