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The carers caring so far from home in west Suffolk

The contribution being made by people who have come to this country to work in the NHS has recently been applauded both by the Prime Minister and Health Secretary Matthew Hancock. The West Suffolk NHS Foundation Trust (WSFT) workforce includes 146 nurses who have joined from the Philippines since the Trust took its recruitment campaign overseas in 2018 to tackle a significant number of vacancies.

Among them is Napoleon Manaog, known as Nap, one of those recruited in the Philippines and now a staff nurse on F1 (Rainbow Ward), which cares for children. Nap was among those recruited by a team which went to the Philippines to meet nurses who would be prepared to move to the UK and take the Objective Structured Clinical Examination (OSCE). This has to be passed by any nurse from outside the EU who wishes to register with the Nursing and Midwifery Council (NMC).

Nap is used to caring for patients – especially children – far from home, as his career has taken him to many places. The experiences Nap gained in the developing countries in which he has worked have given him unique insight into nursing during challenging times, which is standing him in good stead in this current COVID-19 crisis.

Clinical education lead at WSFT, Diane Last, said: “So far we have supported 124 students to pass the OSCE, and all 146 we recruited are working with us. They are a great asset to the Trust. Quite apart from helping us to manage our vacancies, they are all registered nurses in the Philippines and bring lots of experience. In finding them posts in the hospital, we have tried to match vacancies to experience. The programme has been a great success, benefiting both our patients and colleagues.”

A 13-strong WSFT education team developed a training programme linked to national guidance including proficiency in English, nursing theory and practical skill tests, such as observations, drug rounds and wound care. As well as the classroom skills, the students worked on the wards as nursing assistants.

Nap was born and brought up in the United Arab Emirates, but his family is from the Philippines, and he completed a BSc nursing degree at the University of Perpetual Help System Dalta in the capital, Manila. After a first job in general nursing, he took up a post as a ward manager. “It was pioneering work and a huge weight on my shoulders,” he remembered. “I had to establish the ward, caring mostly for children. I feel blessed to work with children, it is sometimes difficult managing all their complexities, but it is an amazing thing and I have learned so much from them, and their parents.”

Wanting new challenges, Nap moved on to working with a number of NGOs (non-governmental organisations). He started as a paediatric nurse in Ethiopia. “I was sustaining neonatal and paediatric units as well as teaching and training,” he explained, roles he continued when he moved to a post in Sierra Leone. “I was nurse educator and manager, leading local staff nurses in a brilliant unit. This was after the Ebola outbreak, and we were also caring for many children with malaria, and facing cultural challenges as well as the lack of resources and malnutrition. There were deaths every day.”

Nap’s next move was to the war-ravaged nation of Afghanistan. “People asked me if I had a death wish,” he says. “But I wanted to experience it, I was just there to help, and you only live once. I was based in a rural area, away from the bombings in Kabul, with a team of 15 international staff. A hospital had been opened for victims of the conflict, and I worked closely with children, establishing a paediatric unit.”

He was recommended to consider opportunities in the UK, which brought Nap to the WSFT when the team was recruiting in the Philippines. “I completed the English tests in a month,” he said, “the general competencies and the interview, and got through the whole application journey, which was strenuous.” He began the process in June 2018 and by October was living at the Hardwick Lane site.

“I had been on holiday to the UK as a teenager, I felt I knew it and fell in love with the country. What I like about Suffolk is that it is really quiet and safe – especially after the hustle and bustle of Manila. There is a real community spirit, I feel at home and am never lonely.”

Nap embarked on the OSCE programme, while also working on the children’s ward, juggling work and study. “OSCE was mind-boggling,” he said, “like going back to university, developing my knowledge within UK guidelines, a real refresher course. The team at WSFT and my ward colleagues were immensely supportive.”

WSFT ward manager, Jo Rackham, said: “Nap has come so far, he has developed personally and professionally and is a valued and well respected member of our team. Nap has embraced the challenges that have come with his role and is advancing his knowledge on a high dependency unit course. We are very lucky to have him, he brings so much to the team.”

Nap lives on Moreton Hall and enjoys living in Bury. “I am sometimes homesick, and I do worry about my family at this time. But my OSCE cohort are my family here.” While things he enjoys such as visiting heritage sites and travelling are currently unavailable, Nap is busy with further training, and looks forward to staying at the Trust to develop his career.

“I have been welcomed here and supported, people have confidence in me. Nurses and doctors work closely together, we communicate well and are given opportunities. The team effort is appreciated. Parents have respect for the nurses and confidence that we will be able to take care of their children. The UK takes care of its staff and I don’t have to worry about resources – people will be looked after,” he said.

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Napoleon Manaog, a staff nurse on our Rainbow Ward.

Napoleon Manaog, a staff nurse on our Rainbow Ward.