It was 2 pm in Ukraine and Moldova when Prof Sergeii Moskovko and Angels consultants Maria Sheverdina and Lev Prystupyuk delivered opening remarks at the virtual School of Nursing for Stroke Care.
It was already teatime in Armenia and Georgia, and the end of the workday in Uzbekistan.
In Kazakhstan and Kyrgyzstan, even further to the east, the sun had already gone done when, at 6 pm, nurses in these neighbouring Central Asian republics dialled in to a Zoom meeting that kicked off a four-day training workshop for stroke nurses.
On four consecutive Thursdays between 9 February and 2 March, they would share their virtual classroom with nurses from 117 hospitals in six countries, receiving instruction on topics that ranged from the proper insertion of probes and catheters, nutrition, positioning and the FeSS protocol, to mitigating the psychological impact of stroke on patients and their families, and on the nurses who care for them.
Although you probably couldn’t tell from their calm demeanour, Ukrainian Angels consultants Lev and Maria, the organisers of the event, had spent a frenzied morning. In the three weeks since registration opened, around 500 nurses had signed up for training, a number they considered a great success. But as the morning wore on, they noticed something extraordinary was taking place.
Lev and Maria watched their screens in astonishment as the number of registrations grew from 500 to 600 in the space of 10 minutes. In the next 10 minutes, it soared to 700. Thirty minutes before the start of the workshop, they were making urgent calls to their technical support team and each other. Nine-hundred nurses had by now registered for the event, and the number kept growing.
By 2 pm, they were all set to broadcast the webinar to 1,000 participants, and the School of Nursing for Stroke Care was off to a flying start.
Nurses play a crucial role in all phases of stroke care, Lev and Maria say. Indeed, a 2016 study on stroke survival by researchers at the University of Aberdeen found that an optimal number of nurses to provide patient care was the best predictor of survival. An increase of just one trained nurse per 10 beds could reduce 30-day mortality by up to 28%, and one-year mortality by up to 12%.
There can be no doubt that providing stroke-specific training to nurses saves lives, particularly if trained nurses become stroke champions themselves and share their knowledge with their colleagues. This exponential impact on stroke care quality and survival makes an unassailable argument for remote training initiatives like those of the Ukrainian Angels team who in November 2022 also held a webinar for over 200 Ukrainian nurses.
Technological tools for sharing information with remote audiences came into their own during the pandemic and have turned out to be invaluable in wartime. In addition, Lev and Maria can count on the expert participation of some of the main drivers of stroke care improvement in Ukraine, including Prof Moskovko, Drs Dmytro and Pavlo Lebedynets, 2023 Spirit of Excellence nominee Dr Mykhailo Tonchev, the acclaimed combat healthcare specialist Dr Yuri Vorokhta, and leading stroke nurse, Olga Yarmak.
But internet-based information sharing tools are also good for crossing borders, which was how February’s online School of Nursing came about. It was an opportunity to positively impact stroke care in six more countries, spearheaded by Angels consultants who were, respectively, displaced by the war and in the thick of it, and supported by the same generous line-up of Ukrainian stroke experts.
At the start of their planning Lev and Maria shared the workshop concept with the national stroke coordinators of the respective countries who in their turn spread the word to current and potential stroke-ready hospitals in their territories. As well as equipping nurses at these hospitals with stroke-specific skills, the aim was to shift perceptions of the role of nurses, empower them to implement their new knowledge in their hospitals, and facilitate experience sharing between nurses from different countries.
Levels of care vary between countries, Maria and Lev say. But although the standard of nursing education is generally low, the interest in skills acquisition is high. The same appetite for learning that sent registration numbers soaring ahead of the event, also manifested itself during the question time that concluded each day’s session.
Each day’s workshop had been planned to last 2 hours, but as presenters fielded a barrage of questions, everyone soon lost track of time. When each session wound down, it was after 6 pm in Ukraine and Moldova, heading for 9 pm in Armenia and Georgia, and nearing 10 pm in Uzbekistan.
And in Kazakhstan and Kyrgyzstan it was way past bedtime for newly empowered nurses who had the morning shift.