Teaching Nursing Leadership in Liberia

Teaching nursing in a global context necessitates an understanding of the material being taught, as well as an understanding of the cultural context.  Liberia’s civil war ended 10 years ago, but the impact is still felt in the challenges in the healthcare infrastructure (Varpilah, Safer, Frenkel, Baba, Massaquoi, Barrow, 2011).  Liberia's health care and nursing infrastructure was woefully understaffed and new nursing educational institutions are continually opening to meet these needs (Flomo-Jones, n.d.).  The nursing educators in Liberia are typically diploma or bachelor’s prepared, with a lack of master’s prepared nursing faculty and no doctorally prepared faculty (Flomo-Jones, n.d.). 

The Master's in Nursing Education (MSN) program at Mother Patern College of Health Sciences in Liberia was developed to increase the educational foundation of nurse educators in Liberia.  The Master's program began in 2012 with the first of three cohorts, the most recent finished in June, 2014.  Approximately 50 nurse educators have completed the MSN program and returned to their nursing schools to improve education in the country.   

The MSN curriculum was developed by doctorally prepared nurses in the US who adapted their courses to the Liberian context.  The leadership and management in nursing course entailed significant adaptation based on the Liberian nursing leadership context to assure the development of strong culturally appropriate leadership skills (Rowe, Brillant, Cleveland, Dahn, Ramanadhan, Podesta and Bradley, 2010).  Though nurses provide a significant amount of the healthcare in Liberia, it is still seen as a low ranking profession.  Nurses are mostly female, though the numbers of men in the profession is growing.  Nurses do not hold Ministry of Health and Social Welfare positions, nor county health positions, these are all held by medical doctors.  Leadership for nurses in Liberia needs to come from cohesion and support of those in the profession.  The leadership and management course was tailored to facilitate learning to work together.  Evaluating the cultural context relevant to each course was critical to creating a transculturally appropriate curriculum.

A variety of leadership theories were taught through lecture, powerpoint as well as group activities.  The group activities were created to foster cohesion among the cohort that could be transferred into their workplace on their return (Rowe, Brillant, Cleveland, Dahn, Ramanadhan, Podesta and Bradley, 2010).  Examples of activities included developing criteria for nursing school accreditation; expanding the role of the Liberian Nurse and Midwifery Association; advancing nursing school programs from diploma to bachelor’s degree and improving the role of the Chief Nurse of Liberia to a position on the cabinet of the Ministry of Health and Social Welfare.  Subsequent to the completion of their coursework, graduates have taken up roles in the President’s Task Force for Ebola, the Ministry of Health and Social Welfare Ebola Education and Training, as well as within the Ebola Treatment Units.  With the loss of healthcare workers to Ebola, the leadership role of the nurse has become even more critical.