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Shaun D Bowden has been involved with nursing education and organisational wide training for over a decade in hospitals and tertiary institutes of education. He currently works as Head of Nursing Education at Mafraq Hospital in Abu Dhabi, UAE and as the Programme Director for CME activities for the Dept of Nursing GAHS Abu Dhabi. In 1997 he was conferred his Masters of Nursing degree in Advanced Practice in Australia, and holds further qualifications in teaching and management.

Excerpts from an Exclusive Interview with Shaun D Bowden RN Cert-TESOL DipFlMan BN MN(AdvPrac) by Ms. Priya Nambiar, Gulfmd Medical Correspondent.

Nurses make up the majority of healthcare professionals in any hospital. Nurses are on duty in hospitals twenty-four hours a day, seven days a week, every day of the year. Patients are admitted to hospital to receive the care offered by nurses. A simple way to explain what nurses do is that 'nurses care and doctors cure'. Nurses care for the whole person and view illness and treatments as particular sets of needs for patients to be helped with.

Shaun D Bowden: No, certainly not. Hospitals sometimes put all nurses in the same uniform, which can be confusing for patients as they see all nurses as the same. Basically, there are four different types of nurses working in the gulf region. It is important for patients to understand the difference, as this will help them in distinguishing the professional nurse and who to turn to for professional nursing advice.

The first level nurse is a professional nurse or 'RN', this nurse has had a minimum of three years education at a university and can work in general areas of the hospital undertaking and supervising direct care of patients.

The second level nurse is the practical nurse or 'enrolled', this nurse has a basic education for a minimum of one year in an institute and can carry out basic care instructions of a professional nurse.

Another level are the specialist professional nurses who have continued and advanced their education with a minimum of five years university education. This group of nurses work in specialised areas and in many countries are becoming practitioners in their own right, ordering tests, drugs and undertaking some relevant medical procedures. Some of these nurses have even gone on to complete a Doctorate specialising in nursing which can take up to ten years of education.

There is one other level that can be found in the gulf region, the "helper" or "nurse's aid", this individual has had no or little formal education and unfortunately are still called a nurse in many hospitals.

A: If you don't know then the best way is to ask. If a patient needed brain surgery, he or she wouldn't see a kidney doctor. Hospitals are complex organisations that check the credentials of those who are working for them and assign people to various jobs, roles and sections. The brain surgeon you go and visit in the clinic has had their credentials checked by the hospital to ensure he or she is a practicing neurosurgeon. Hospitals also check where a professional gained their qualifications and experience because unfortunately not all universities and hospitals are the same and standards differ around the world. Nurses are assigned to various areas within a hospital based on their qualifications and experience. The important lesson is not to assume you have the best, you should ask; a professional surgeon or physician is quite happy to tell you about their experience and qualifications and so too will a professional nurse.

A: Globally there is a real shortage of nurses. Internationally there is a body that sets the standard for nursing, known as the ICN (International Council of Nurses). The council has done a great deal of work in helping individual countries develop excellence in nursing care and protect the public from harm. Each country sets up it's own internal regulation of nurses, and within the gulf region different countries are a different stages in setting up these systems. Bahrain for example has really moved ahead in this area and Oman has made great inroads into encouraging their nationals into the profession. In the UAE, where the majority of nurses are imported from other countries, there have been significant steps made by the Ministry of Health towards regulation and local health bodies such as the Dept of Health in Dubai, the Authority in Abu Dhabi and regional Medical Districts to encourage the Emiratization of Nursing with an increase in undergraduate nursing education available. Progress is being made through the efforts of the president of the UAE, His Highness Sheikh Zayed bin Sultan Al Nahyan, throughout his consistent stance on improved education for nationals, there have been many great changes in the country and with each passing year a new group of graduate nurses will have a significant impact on healthcare in the UAE.

A: Hospitals are frightening places; it is a whole new, sometimes difficult, world of rules, procedures, drugs, tests and surgeries. Nurses are there to care for, help and guide patients through these complex things that happen to patients in hospital, they can be seen as primary patient educators.

Healthcare is a rapidly changing field of work. There are new diseases and technologies coming almost every day. Therefore, education for nurses can't stop when they graduate. Just like our medical colleagues, nurses have to be up to date on the latest information.

Just imagine a patient sought out the best surgeon to undertake a latest procedure that could cure him or her, the nurse who works in the operating theatre has to know all about the new instruments, the nurse post operatively has to know what complications to watch out for, and the nurse on the ward has to know the particular follow up care that could be required. For every doctor that learns about a new procedure, there are at least three nurses that have to know all about it too.

In the Emirate of Abu Dhabi, the local Authority sees this as essential for the continued development of the healthcare system and have put nursing into the Continuing Medical Education (CME) programme along side our medical colleagues, you can even see examples the programme on this website http://www.gulfmd.com/cme/abucme.asp

A: Generally, nurses are the forefront of patient care, and so are at the bedside when a patient needs information. Nurses are there to explain what is happening in hospital and how the treatments will effect the patient. Some specialist nurses have particular roles that are direct patient educators; there are lactation consultants, diabetes educators, renal educators etc… indeed that is the primary job for these nurses to teach patients how to manage their illness and treatments.

A: Indeed, some specialist professional nurses have set up their own practices in some countries. Nurses in the gulf also work in a variety of settings outside of a hospital. They work in the community, in preventative health - teaching people how to avoid and manage illness, they work in schools - monitoring health of pupils and even specialist nurses work in patients homes - visiting and attending to needs after discharge from hospital, these are just to name a few. Wherever a patient needs care, you should find a nurse.

Q: Nurses certainly play an important role in the healthcare system, but what sort of things can you help patients with through a web site like gulfMD.com?

A: To many healthcare professionals the world of healthcare is filled with regular, almost mundane routine procedures and treatments, but to patients this is all part of a new world that can be quite frightening. For example, talking of something simple like intravenous hydration or 'a drip' is routine to the healthcare professional; the professional nurse caring for the patient views the 'drip' as part of the whole person and understands that a patient needs to know what is taking place and how they can help in preventing complications. Through sharing information about a procedure a patient can assist in getting the best out of it and preventing any complications.

Nursing in Gulf Hospitals - A major contribution to healthcare