Position: Orthopaedic/ Trauma Nurse Location: Libya Reporting to: Health Coordinator Technically supported: Orthopaedic Surgeon Working with: Surgical team Duration: Two weeks to three months Start date: ASAP Salary: £22,100 - £22,850 per annum pro-rata (dependant on relevant experience) inclusive of annual Cost of Living allowance Benefits: Insurance cover, accommodation, return flights, and annual leave pro rata Closing Date: Ongoing
Please note that offer of post is subject to funding confirmation
Only short-listed applicants will be contacted. Due to the urgency of this position, applications will be short listed on a regular basis and we may offer this post before the closing date.
Please note that this is an unaccompanied position.
Merlin International Profile Merlin specialises in health, saving lives in times of crisis and helping to rebuild
shattered health services. Each year, Merlin helps more than 15 million people in up to 20 countries.
Context and Background
Merlin has set up a trauma orthopaedic surgical programme in Western Libya and adjacent Tunisian border in order to support the treatment of casualties occurring in Western Libya as a consequence of the Libyan civil war.
The programme is established in a referral hospital. A considerable proportion of the staff is expatriate and although some of these have left the majority remains in their posts with no stated intention of leaving. The majority of the Libyan staff also appear to have remained in post although specific deficits do exist; for example at present there are no radiographers.
Given the relative depopulation of the surrounding areas the hospital is very quiet, with virtually the only admissions being combatants injured in war fighting. In the absence of aerial bombardment and with a paucity of heavy armour or heavy weapons on either side of the conflict, the majority of injuries are high energy transfer bullet wounds. Protocols are already in place for transfer of orthopaedic injuries from the frontline once life saving abdominal surgery has been undertaken, if required. The number of bullet wounds being admitted is estimated to be around 10-20 per week currently. The level of conflict in the area is estimated as low.
There are six clean theatres, one of which is for orthopaedics. The orthopaedic theatre has a draw-over anaesthetic machine, good lighting and an orthopaedic traction table. Although there are currently adequate supplies of plaster, sutures, pharmaceuticals and other consumables the formal logistic chain via the Libyan Ministry of Health has now ceased and these items will need to be supplied by donors in future. Orthopaedic surgical equipment is in very short supply although Merlin is providing external fixators and other equipment. There is a 4 bed ITU which was fully occupied at the time of Merlin assessment visit, the patients all having suffered a combination of gunshot wounds to the trunk and to limbs. Ventilatory support is possible.
It is possible to transfer select patients over the border into Tunisia following treatment or if their clinical needs cannot be met. Merlin concluded that, at present, the supported Hospital is having difficulty managing the influx of patients with war related orthopaedic injuries. Although most of the civilian population has fled as refugees across the border into Tunisia there is a steady stream of orthopaedic war injuries presenting to the hospital is the orthopaedic referral centre from the surrounding hospitals and health centres. Although there is the potential to transfer some cases to Tunisia, for some patients this is not possible and definitive care must thus be provided in Libya.
Key services required on this line to date are:
Support to orthopedic and trauma surgery through the provision of a Merlin orthopaedic surgeon, an senior theatre OT nurse and logistician based in Libya
Provision of orthopaedic equipment and general surgical supplies. Training for management casualty (A&E) and surgical staff on trauma care, mass casualty management and support to develop an MCM plan for admission of additional 20, 50 and 100 patients.
For this programme Merlin requires the presence of a registered theatre nurse (staff level, with scrub orthopaedic experience) for a period of three months and is willing to take nurses who will rotate and can remain in country for a two – three week period. The registered nurse will work within a team (logistician/security, orthopaedic surgeon and the nurse) and will follow Merlin security rules and procedures.
Main purpose of the role The orthopaedic nurse will work with the expatriate orthopaedic surgeon seconded by Merlin to provide surgical care as part of the team and relieve the pressure of work. To provide technical support and advice and training on orthopaedic and trauma care as required. To work with the orthopaedic surgeon to review and support the hospital mass casualty plans and provide training to hospital managers and staff on mass casualty management and trauma management in issues related to theatre management and anaesthesia. To advise the Merlin health coordinator on resources required to improve patient care in this specific circumstance.
The nurse will work in compliance with the policies and guidelines of Libya, WHO and Merlin.
Overall Objectives (scope) • To work in a Libyan referral hospital (OT and orthopaedic male ward) as part of the national team supporting the care of all patients to relieve the pressure of caring for trauma and orthopaedic cases on an overburdened team. To support surgical services, admitting patients, preparing for theatre, taking to theatre, recovering immediately postoperatively in theatre and on the ward as part of the orthopaedic team.
• To provide technical support for the nursing care for specific orthopaedic and trauma cases as required. • To provide training for key medical staff on trauma management. • To support Merlin training activities and support for mass casualty management and specific emergency admissions with the expatriate orthopaedic surgeon. • To be available to assist in other hospitals and border reception centres as required for specific technical assistance for cases or sudden influx of patients. • To support the provision of regular reports on patient caseload and patient outcome to ensure Merlin remains accountable to donors.
• To assist the health coordinator in ordering additional drugs and equipment as required. • To ensure debriefing with the health coordinator and provide specific recommendations for Merlin emergency staff as to how to improve future programme.
Coordination/representation • Ensure coordination of Merlin activities among the different units within the hospital with a focus on establishing linkages and harmonisation of services Other • Carry out any other related responsibilities as requested by the Health Coordinator or the Project Manager
Person Specification Essential
• Registered nurse with orthopaedic and trauma experience (at least staff level) and scrub experience • Extensive clinical skills and ability to work independently with different materials and levels of support staff. • Willing to support staff with practical training on trauma management and mass casualty management. • Experience of establishing professional relationships with colleagues and patients from different functions and cultures • Experience of team work/team building with a proven ability to provide leadership and build capacity of staff • Strong communication skills, with excellent written and spoken English, French and/or Arabic. • Experience of a flexible approach to managing and prioritising a fluctuating unpredictable workload. Experience of proactively identifying and addressing issues • Ability to live and work in rural environment. • An understanding of and commitment to Merlin’s mission and values
Desirable • Previous field work experience with an International NGO in a developing country context • Previous experience of working in conflict areas • Previous experience of working in middle income countries
How to Apply
To apply for this job, please email your CV stating your availability to applications@merlin.org.uk
Please state in the email subject line “Nurse, Libya”
Data Protection In accordance with the 1998 Data Protection Act Merlin will hold and use personal information that you have given for the purposes of recruitment and employment should an offer of employment be made. This information will be stored in manual and/or computer form. This information may also be disclosed to third parties in accordance with the Data Protection Act. In cases where a job offer is conditional on ensuring that potential employees’ names do not appear on counter terrorism lists generated by the United Nations, European Union or the United States due to donor funding requirements, Merlin will use the information that you have given for checking that your name does not appear on these lists
