Pro-life Vs Pro-Choice: Impact on Nurses Role: Value Clarification, Service Delivery Versus Personal Dispositions.

Abortion is defined as the termination of pregnancy before the age of viability (WHO,2015). It could be spontaneous or induced. An induced abortion is characterized by deliberate interference with pregnancy, with the aim of terminating it.

The Pro-choice group supports the right of any woman to make decisions about her reproductive functions based on her own moral and ethical beliefs. Christianity particularly Catholicism, orthodox Judaism and Islam, are opposed to abortion on the understanding that the fetus is an individual created by God for a purpose. Pope Francis describes abortion as the highest form of thuggery against the defenseless, which leaves the women with emotional turmoil. He stated that “Abortion compounds the grief of many women who now carry with them deep physical and spiritual wounds after succumbing to the pressures of a secular culture which devalues God’s gift of sexuality and the right to life of the unborn”.

Induced abortion is  associated with long term psychological consequences both  for the healthcare provider and the client, thus the need for "value clarification".

According to Turner, Pearson, George & Andersen (2017), Value clarification is a process in which individuals engage in honest, open-minded and critical reflection and evaluation of new or re-framed information and situations, challenge deeply-held assumptions and myths and discover or potentially transform their values. It entails examining one’s basic moral reasoning to identify the values that one finds most meaningful and important. Healthcare providers utilize value clarification tools to examine factors affecting the health personnel or client decision to have an abortion (National Abortion Federation, 2005).

In personal value clarification, exercises are provided, intended to help the health care provider clarify present personal values about pregnancy options, abortion, and abortion training, and also to help them think about those values in the context of professional judgments called upon to make. The Royal college of nursing (2017), opined that preregistration midwives go through a facilitated value clarification process because they will inevitably encounter clients seeking termination of pregnancy services. Values clarification is, therefore, a valuable tool which can help people refine their value systems in a low-risk environment, as opposed to having to refine one’s value system in a high-risk situations such as when being faced with a moral dilemma in real life choices and behavior.

According to National Abortion Federation (2015), value clarification include examination of:
1. External influences like family and social groups, spiritual beliefs and life stage.
2. Personal or Internal influences e.g personal experiences with sex, Abortion, pregnancy, parenting, Adoption etcetera.
3. Circumstances of decision like Gestational age, individual or societal factors, comfort level with circumstances of decision of each woman’s abortion decision etcetera.
4. Professional Obligations and conflicts.

In client value clarification,  it is important for a health care provider to evaluate  a client choice along with her in order to provide objective and respectful professional care. Health personnel  will begin by looking at the option of abortion and  personal responses to issues such as gestational age, and then follow with the circumstances of the individual woman who is making this decision. Client value clarification helps the abortion seeker to understand issues about abortion. After value clarification, client may identify other better alternatives to resolve unwanted pregnancy issues and may decide to keep the pregnancy.

Regarding Conscientious Objection and the provision ofAbortion services or post abortion care, Section 4 of the Abortion Act, 1967 (as amended by the Human Fertilisation and Embryology Act, 1990) provides a right of conscientious objection (CO) which allows healthcare professionals to decline to participate in a termination of pregnancy. This right is limited only to the active participation in the termination of pregnancy where there is no emergency with regard to the physical or mental health of the pregnant woman. Supporting, Delegating and supervising is not covered by CO thus  it is recommended that  if this is in conflict  with the providers moral belief, there is need to find another job. Some countries do not discuss CO in their abortion laws. This has been interpreted to mean that providers lack a legal right to object (Fiala, Danielsson & Keikinheimo, 2016).

In Nigeria abortion is illegal and CO was not discussed in the abortion law. CO cannot be invoked in the provision of post abortion care. Delivery of post-abortion care to professional standards is legitimate, necessary, and does not in itself implicate providers in another’s prior illegality or professional misconduct. Second and third trimester abortion may result to life birth. In the event of the neonate showing signs of life, the neonate should be kept warm and comfortable and offered oral nutrition for both prolife and prochoice advocates. A neonate born alive must be registered as such by law (RCON, 2017)

Regarding Conscientious objections and the use of contraceptives, Increasing numbers of pharmacists, physicians and nurses are refusing to dispense, prescribe or administer these forms of pregnancy prevention, citing moral objections to hormonal contraceptives. The objections are based on the belief that hormonal methods of contraception are abortifacients; that is, that the use of these methods will result in the destruction of a fertilized egg.

In Nigeria, there is no known laws protecting health personnel from prescribing or administering contraceptives on moral or ethical grounds. Decision to provide contraceptive services are based on a framework which focuses on principle-based ethics. This utilizes four principles to objectively analyze a given clinical situation: respect for patient or providers autonomy, beneficence, non maleficence and justice.

By Ijeoma Kelechi-Duruh,
Department  of Nursing Sciences University Of Nigeria, Enugu Campus.

Anthonia u. Chiweuba (PhD),
Department of Nursing Sciences University Of Nigeria, Enugu Campus.

The views expressed in this article are the views of the authours and published with their consent. Any questions or enquiries arising from the article can be addressed directly to: Kelechiduruhijeoma@gmail.com

Tetanus - a.k.a Lock jaw.

Tetanus is a condition caused by the release of toxins, by the microorganism called Clostridium tetani.

This microbe is so well distributed in the environment and especially in the soil, that once we get deep traumatic wounds, we're advised to go get a shot of the vaccine called  "tetanus toxoid".

Know why? I'm about to tell you!

Clostridium tetani, the causative organism of tetanus, is:
1) anaerobic - meaning it does very well in places without a lot of oxygen like your deep traumatic wounds.

2) spore-forming - meaning it is remarkably resilient. It can convert to a dormant energy-saving form during harsh conditions and revert to the energy-spending form when conditions are favourable, like when it gets into that wound.

I know right? Evillll!!!

This condition is so significant that pregnant women have to get vaccinated to protect their babies when they are born before they can get their routine vaccines - thankfully free in Nigeria.

There are classic symptoms that characterise this condition.

These symptoms stem from severe spasms caused by the toxin released; spasms so severe, "bones break"!

They include:
Opisthotonus (the back curves forward), lockjaw aka trismus, the person can't swallow, the abdominal wall becomes very rigid, sometimes the severity can even cause some persons to stop breathing... Andddd the rest you know!

The toxoid is prepared from a component of the toxin that causes tetanus. When injected into your body (for cases of deep wounds), it helps you immediately neutralise any circulating toxin produced by the microbe, while giving your body time to produce it's own naturally, in order to carry on the process.

Stay safe!!! Get vaccinated, Get booster vaccine doses!!!

HALITOSIS A.K.A MOUTH ODOUR - SWAGS SPOILER!

My people my people!! Ha.. Just imagine this scenario:
Someone totally ignorant of his/her bad breath, continually leaning in to say something to you and how you helpless you are, deciding if to hold your breath, turn away, or simply scream at him/her to "shuttttt it" and stop talking to you!.. Halitosis is a "funkilized" way of  referring
bad breath - A very embarrassing condition I must add.
The causes of bad breath are many.. bad breath can be of oral origin - bacterial build up in the mouth, infections of the throat, dry mouth  and gum disease. Bad breath can also come to be, as a result of medical conditions including - diabetes, stomach conditions and acid reflux..
For young adults in this part of the world, I dare say the leading cause of bad breath is poor oral hygiene, leading to bacterial build up.. Just imagine downloading santa(fufu or akpu) one hot afternoon only to skip brushing at night(as is usual with the majority of us Nigerians), then doing sharp sharp brushing in the morning cos you are late for lectures or work. You'll now "goan" sit beside one innocent person with your "church mind" and be causing him/her havoc.. Respect yourselves!! Get good flouride containing pastes to prevent cavities (holes) in the teeth and also to prevent gum disease. Brush your teeth using correct strokes. Spend good time brushing your tongue too. Last but not the least, drink lots and lots of water. Remember fresh breath gets you a "maybe" in the least, when you go chyking - guys! But with bad breath, trust me, you'll get not just a "no". 'Mba', you get somthing that sounds more like  "neverrr! Get away from me".

THE MOST SIGNIFICANT FACT ABOUT STRETCH MARKS-DO NOT BE DECIEVED BY CREAM, OIL AND SOAP SELLERS..

Hi everyone! I apologize for the "no post" last week. Network issues. Decided to make it up to you all by discussing somthing very interesting this week - "stretch marks".
Surely, we are all aware what Stretch marks are, so it needs no re -introduction.The skin is made up of 3 layers: the outer layer we see called the epidermis - containing dead cells, a middle layer which lies beneath the epidermis called dermis - made up of living cells that contain collagen and elastic fibres (these give the skin its characteristic elasticity.) And the innermost hypodermis -containing mostly fat And connective tissue. The skin can distend/stretch considerably to accommodate gradual increase in body size. So, stretch marks result when a body (or a part of it), gains too much weight too fast. By this, i mean weight gain that takes the skin by surprise, giving it insufficient time to distend gradually as it should normally, thereby destroying the collagen and elastic fibres Present in that area of the body. At first we see bands of lighter, wrinkled skin which get darker after a while. Stretch marks MAY fade over time, ON THEIR OWN but never completely. Some scientists have discovered that stretch marks may also be hereditary. So If you are my friend or acquaintance, and I catch a flash of any stretch mark removal cream, oil, or soap, on your shelf, ...
Happy Valentine's day to you in advance!

HERE'S WHY YOU SHOULDN'T WEAR TOO TIGHT SHOES..

For all the beauties and blokes who have plus sized feet, Here's to you all! I'm sure I speak the mind of everyone when I say the prettiest/cutest pairs of shoes ever, come in "minus" sizes. So there is always the temptation to get "that pair", which you know is a size or two smaller than your feet, but would definitely go with that: exquisite gown, accessory bead/custume, or lovely suit jacket. "Biko", here is why not! According to the "Ortho info" of the American Association of Orthopaedic Surgeons (AAOS), wearing shoes with too tight toe boxes would lead to the following:
Bunions - an enlargement of bone at the base of the big toe, which may also rub against the sides of the shoe, causing wearing and bruising.
Corn - a callus or hardening that occurs when tight shoes put constant pressure on/between the toes of the feet.
Hammer toe - a condition where toes curl (tip facing downward), instead of lying flat on the floor of foot wear.
Ingrown toe nail - condition where abnormal and constant pressure is felt at the tip of the big toe nail, by the toe box of tight shoes, resulting in inflammation and associated nail pain.
Images have been included for emphasis. So "antees" and "onkus", resist that temptation to buy shoes "just" one size smaller, in the name of love for your toes.. Stop squeezing your feet into shoes that do not fit!

"SHOT PUTTING" THE FAVORITE BONDING SPORT OF HOSTEL GUYS..

Last week we exposed ladies' hostel "anti toilet infection" invention and guys were busy giving us sanitary tips abi?. Today na una day. Guyssssss, you people are not ordinary! Of all activities to bond with, y'all chose "shot putting". And the crazy part of this act, is that it is a secondry school invention, almost always carried onto higher learning institutions mostly by males. "Shot putting" - the act of defaecating into waterproof bags, while gisting with fellow culprits of the act, without the decency of even using toilet paper but sheets of paper. What you all didn't find out during the invention is that, tryin to clean youself with hard sheets often gets faeces under parts of the finger nails where simple washing can't reach - then imagine eating "agege" bread with those same fingers. Now tell me, how can we not be concerned?.. The WHO frowns greatly at surface defecation because it is the quickest means through which potential faeco-oral (faeces to mouth) infections are spread. And there is just an endless list of micro organisms which can be spread, when such surface dumped faeces are washed onto fruits and vegetables by "run off". Especially when people who have poor access to adequate water supply can't wash these food produce well enough. This microbial list includes Polio. So please if you are part of the "shot putters" don't ever come out in public to air your views, we don't want to hear such water proof "pooping", "paper wiping", "poop swinging" views. Heal our world!

"PEE BUCKETS" - SAVING NIGERIAN FEMALE STUDENTS BAD TOILET TALES SINCE "FOREVER".

If you obtained or are still in the process of obtaining your Bachelors Degree here in naija, and you are a female, I see you nodding and concurring right now. Chai! terrible to imagine if our wise hostel predecessors didn't come up with the 'itch saving' and 'oh so welcome' idea of "pee buckets". No forming o biko. As long as you didn't attend a private school, you are a 'sister'!. Just remember arriving your hostels in first year, and your roomate (in a higher level, of course ) showing you the specific type of bucket you should add to your 'plastics list', and how she told you she would show you what its used for when you returned. Hmmm.. memories!! Well, "pee buckets" like we fondly call them save females who live in hostels, from contracting toilet infections, from the endless list there is. Since inadequate water supply is also one of the nagging issues most higher institutions face, feacal matter has and will always be found in the water closests there. Here, I'd like to proffer a single sanitary tip those ladies who like to take "allowance" when "pee buckets" have given us "allow" : 'biko', 'abeg', 'jor', do not store urine in pee buckets for any reason whatsoever. Aside from the offensive odour, it can be the perfect culture medium for microbes and can infect you the 'sole user' and tha totally kills the whole aim. I now declare the floor open for smart "pee bucket sanitary tips", especially from the "brothers" who often fall victim of tipping the semi full buckets with their large and often unaware large feet. Tell us what you think we dont know!