Female Genital Mutilation
Introduction
The practise of female genital mutilation is a tradition that is deeply rooted in sub-Saharan and middle east countries. Women and girls have been affected by this tradition because the consequences are quite devastating on health and quality of life in both long and short-terms (Ortensi and Menonna, 2017). The globalization process has seen an increase in FGM cases in the world which are represented to the healthcare professionals like nurses; thus, posing a challenge on the approach that can be adopted in a transcultural, respectful, and ethical manner. FGM is a present problem in populations seeking healthcare services, unfortunately, the healthcare professionals have shown a lack of knowledge around the concept, typology and countries where the practice is prevalent and the existence of protocols of action that would lead to appropriate referral of the women and girls to appropriate professionals and services that fit their needs. To improve the knowledge, attitude and skills of adult nurses in the UK, a multidisciplinary approach should be adopted to provide transcultural care to the women and girls who have been through female genital mutilation (Curtis et al., 2019). The nurses need to understand that sometimes it is not the wish of women and girls to undergo the process, but their cultures and families force them to take the process which is rather more traumatizing. Equipping nurses with the right attitudes, knowledge and skills is a great milestone because the women and girls who are already mutilated would feel accepted in society.
It is estimated that close to two million women undergo some form of female genital mutilation every year. The rise in the number of immigrants to the United Kingdom is a cause of alarm because adult nurses have encountered several incidences of women who have been mutilated seeking their healthcare services. Lack of knowledge and skills of handling mutilated women has led to the recommendation of alternative ways of helping women, especially during childbirth. It is a gamble that should be stopped by ensuring that the nurses further their knowledge and skills through training to manage or adopt measures that would eliminate stereotypes like a caesarean section can manage FGM in cases where the vaginal examination is impossible. It is a gap that has been identified among adult nurses and it is significant in practice and theoretical knowledge because culturally, the United Kingdom’s traditions do not practice female genital mutilation. Lack of technical skills and knowledge in adult nurses has led to inconsistency in the way care is provided to women with FGM. The roles that the adult nurses played unclear regarding clinical care and referral to women with FGM. Many adult nurses have encountered women with FGM and given them care with little or no knowledge about the condition. Studies conducted in Eat London indicate that formal training is needed not only the nurses but also for other healthcare professionals such as doctors to boost their confidence in diagnosing women with FGM. Knowledge and skills concerning female genital mutilation are essential because they can easily identify different forms of FGM that women have been exposed to depending on their countries of origin. Adult nurses and other healthcare professionals would know the correct procedures to use when de-infibulating women during labour. It has been previously noted that the methods applied in the past were poor as they could lead to short- or long-term complications and sometimes women with FGM would not identify any effect of the procedures adopted. Communication is also an essential tool that the adult nurses in the UK should be equipped with for them to educate women with FGM on the impact it has caused in their lives and encourage them to speak to their children because children are at a high risk of FGM especially during holidays when families embark to their countries where FGM is practised. Acquisition of knowledge and skills among adult nurses would enable them to empower women with FGM; thus, protecting their girls from going through the stigmatizing process.
Critical Review
Intersectoral coordination
Education sector
The consideration of coordinating schools and healthcare care services to provide education to families from countries where female genital mutilation is prevalent is a measure of ensuring that they learn the risk that the family may face in the UK (Curtis et al., 2019). Provision of this information to the paediatrics’ office or a healthcare centre would be helpful (Truglio-Londrigan and Lewenson, 2018). Adult nurses can gain knowledge and skills in schools and in return use them as a tool of educating families that come to the UK from countries where FGM is prevalent.
Awareness in schools should be advocated for especially from the adult nurses who are assigned school duties. The school nurses are required to encourage the girls to open up on the situations that they encounter in their lives, about their friends, or their sister. The nurse uses the opportunity to gain knowledge about how the girl’s life has been affected by life experiences. As an adult nurse, it is not easy to divulge imminent FGM as there is always a dilemma experienced when a child involved the family in abuse like FGM. If the school nurse realizes that FGM has occurred, or a significant risk of the experience occurring maybe to the siblings, an adult nurse should take the responsibility of protecting the child by reporting the case to the children’s social services or in a local multiagency to seek an urgent action for any imminent suspected by involving people like police, social services, and education authorities. Such an action would lead to child protection because the adult nurse took the necessary measures of reporting. Knowledge and skills and the right attitudes would help the school girls to get counselling and medica attention to incase they have already undergone mutilation and those who have not yet been cut to be protected at all costs. Information should be shared across all agencies to ensure adult nurses are equipped with knowledge and skills to help protect young girls from FGM.
Community health resources
The nurses are required to draw or collect the discourses related to the aspects that deal with the existing or absent coordination between various healthcare levels and between different healthcare professionals regarding their profiles on how they can address FGM. The nurses are required to seek coordination with other medical professionals in the situation that involve the mutilated women, for example, interventions in healthcare process such as pregnancy (Murray and Mckinney, 2018). Such professionalism will enable a doctor to assess the women and know the appropriate actions to take and respect her for that because he does not know the situations that made her go through the process. Enhancing communication between the nurses and the mutilated women is also essential because it would make it easy for the healthcare practitioner to understand one’s problems. Sometimes the mutilated women may not be willing to speak up because of their past experiences; thus, it is recommended that a mediator be available to help her through the communication process (Curtis et al., 2019).
Female mutilation is a major issue affecting the world, UK is among the countries where women affected by the challenge has kept on growing. FGM is an illegal process and it causes a lasting impact both physically and psychologically. Unfortunately, healthcare facilities have lacked a robust response until recently when the government policy had to intervene and develop clear policies and procedures to enable detection and reporting of cases of genitally mutilated women. Adult nurses in the United Kingdom were equipped with the task of protecting the community and giving care to women who have already been affected by the process. It is when it was realized that utilizing the available resources to give care to the genitally mutilated women was a challenge because they had not recognized their prime position in handling the situation of women with FGM. Nurses handle patients frequently; therefore, the acquisition of knowledge and skills by interacting with community members in their work environment would enable them to get information on the kind of FGM that women are exposed to because it will trigger the urge to seek further evidence on how the process occurs.
Adult nurses in the UK may be aware of the problem that women with FGM are facing. The leaders in the government urge adult nurses to be proactive by identifying women in communities who have undergone the procedure so that they can help prevent potential victims such as young girls in the future from the same practice. The commissioning agencies, the local safeguarding childrens board and other regulatory authorities in the United Kingdom can work together with adult nurses by providing them with policies and procedures on how they can deal with women who have been mutilated.
There are set recommendations that nurses should focus on reporting FGM as a statutory duty; therefore, the adult nurses should not wait for a new system to be introduced for them to acquire skills and knowledge on handling women with FGM. The nurses’ professional code requires them to be liable for omission as a commission and ensuring they support women and girls by collating evidence on the extent of FGM practices, consequences and causes of practice and developing a process of advocacy in the community among those who have experienced FGM.
Adult nurses who have observed cases of mutilation in communities should encourage record-keeping in communities to know the sample that is affected. The opportunity to conduct an examination is done especially when women are in maternity care. Keeping records by adult nurses would enhance the protection of girls from FGM. The midwives should also take the role of talking to the communities where the practice is prevalent by emphasizing the impact it contributes to during the childbearing process. The adult nurses acquisition of knowledge and skills should enable them not to necessarily advocate for physical examination, but rather observe the directly on symptoms such as difficulty in passing urine or conducting an imminent conversation with the patient or family member. Women and girls who have gone through the experience may feel that their privacy is being invaded, as a nurse, alternative ways should be sought to protect the patients autonomy which is according to nursing ethics. Knowledge and skills among adult nurses will enable them to know the kind of cases they can handle and the ones that professionals like gynaecologists and paediatricians can deal with; thus, recommend for a referral.
Training of the nurses regarding FGM
There has been a deficiency in the training of nurses on female genital mutilation because generally, the United Kingdom does not practice such a culture. Due to globalization and settlement of immigrants in the country with people from nations that practice FGM, the nurses are required to get the necessary skills, knowledge, and develop the right attitudes on how they will deal with mutilated women who come to the healthcare facilities to seek their services ((Ortensi and Menonna, 2017). There has been a notion that the practice is associated with cultural traditions which makes it feel like addressing it is beyond the remit of healthcare professionals. It has come to the attention of nurses that lack of training makes them fail to discover that a woman is mutilated. The outcome among the nurses is that they have lacked confidence on how they will address the issue or just leave it. Lack of training among nurses makes some cases go unnoticed because there are different ways in which cultures dictate the form of mutilation that women undergo (Homer, Brodie, Leap & Sandall, 2019).
References
Curtis, K., Ramsden, C., Shaban, R. Z., Fry, M., & Considine, J. (2019). Emergency and
Trauma Care for Nurses and Paramedics.
Homer, C., Brodie, P., Leap, N., & Sandall, J. (2019).Midwifery continuity of care.
Murray, S. S., & Mckinney, E. S. (2018).Foundations of Maternal-Newborn and
Women’s Health Nursing – E-Book.
Ortensi, L., & Menonna, A. (2017). Migrating with Special Needs? Projections of Flows of
Migrant Women with Female Genital Mutilation/Cutting Toward Europe 2016-2030.
European Journal of Population / Revue Europenne De Dmographie, 33(4), 559
Truglio-Londrigan, M., & Lewenson, S. (2018).Public health nursing: practicing
population-based care.
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