The price of compassion: Pauline Kawira turns painful nursing ordeal into a book

Facing hospital management over an allegation of theft was embarrassing. Her attempts to explain herself were unsuccessful, and the nurse was suspended for two weeks. [Benard Orwongo, Standard]

Pauline Kawira had been in the hospital for 15 hours, attending to sick babies. She was exhausted.

When she finally stepped out of the ward to head home, still wearing her nursing apron, all she wanted was to rest.

At the hospital gate, she was stopped by a security guard for a routine check. As she went through the checks, a vial fell from the pocket of her apron. Kawira was shocked.

She had not even realised she was still carrying it or that she was still wearing her apron. The vial, a small glass or plastic container used to hold medication, was supposed to be kept in the patient’s cabinet.

“It was at the security check that I came to my senses. I realised I was still wearing my apron, which I was supposed to have left in the dressing room,” recalls Kawira.

Her explanation did not convince the security guard. He reported her to the management, which concluded that she had intended to sell the medical commodity.

“How much would I sell a vial for? Maybe Sh50. I was supposed to return it to the patient’s drawer for the next injection,” says Kawira.

Facing hospital management over an allegation of theft was embarrassing. Her attempts to explain herself were unsuccessful, and the nurse was suspended for two weeks.

At the time, she had worked at the private hospital for four years. The incident denied her an opportunity to receive sponsorship for further training in intensive nursing care and left her deeply disappointed.

In May 2019, she resigned.

“In everyone’s eyes, I had stolen a vial. Being suspended and denied an opportunity to go and study was one of my lowest moments as a nurse. I felt nobody appreciated or valued my work, so I resigned,” says Kawira.

“I felt disrespected, despite having served with passion. Stealing was the worst accusation I could have been linked to,” adds the nurse.

Gradually, she healed from the humiliation after securing another job at a private hospital.

Years later, Kawira is using her writing to draw attention to the sacrifices, struggles and often overlooked contributions of nurses, the very people entrusted with caring for patients when they are at their most vulnerable.

Her book, titled Hands That Heal: Cry of a Kenyan Nurse, is a tribute to nurses whose work often goes unnoticed, even as hospitals depend on them to keep services running.

“Nurses are the engine of the hospital, but ironically, they are not valued at all,” says Kawira.

However, according to Kawira, the problem is not simply about recognition, but also about understanding what nurses do, the conditions under which they work and the personal sacrifices that come with caring for patients.

Her inspiration to pursue a nursing career began in childhood. Growing up in a farming community in Meru County, Kawira saw people struggle to access healthcare.

Some of those who came to work on farms needed medical attention, but getting help was a challenge.

Some suffered injuries but could only tie pieces of cloth around their wounds to stop the bleeding. Without proper care, their conditions would deteriorate.

This prompted her to lend a helping hand, even without medical training. Her first exposure to basic care came through first-aid training offered on large farms, where workers learnt how to respond to medical emergencies.

“I really loved serving people. At times, I would see people struggling in the neighbourhood and help them without being asked,” she says.

After completing Form Four, she pursued her interest in healthcare, joining nursing school in 2012 and graduating in 2015.

She secured a job at a private health facility, where she became a team leader.

The work gave her an opportunity to care for patients, but it also exposed her to the demands of the profession, including long shifts and the physical and emotional toll of caring for people who are unwell.

The alleged theft incident in 2019 revealed to her how little the nursing role was respected.

After resigning, she sought other opportunities, including locum work, but struggled to find placements.

In 2020, when the Covid-19 pandemic disrupted healthcare services, she applied for a position under the Universal Health Coverage (UHC) programme and was posted to Kajiado.

There, she felt that the importance of nurses was not fully appreciated. Nurses are often the first healthcare workers patients encounter, particularly in dispensaries and health centres.

They spend hours monitoring patients’ conditions, administering medication, responding to changes in their health and reassuring anxious families. In maternity and newborn care, their role can be particularly demanding.

They must remain alert to changes in a patient’s condition, sometimes making critical observations that require immediate intervention.

According to Kawira, the work can be physically exhausting, emotionally draining and, at times, financially unrewarding.

The recently concluded nurses’ strike exposed how much hospitals depend on nurses, as services were disrupted and patients and their families struggled to access care.

As the strike intensified, doctors, parliamentarians, human rights activists and Kenyans at large called on the nurses to return to work. This followed mounting concerns about the impact of the industrial action.

Mothers in need of maternity services faced difficulties accessing care, while concerns were raised about newborns who did not survive.

At Mbagathi Hospital, a doctor broke down while recounting the struggles newborn babies were experiencing as the strike continued.

The disruption exposed how heavily hospitals depend on nurses, even when doctors and other cadres of healthcare workers remain at their workstations.

It also renewed questions about the conditions that drive healthcare workers to seek opportunities abroad and what Kenya must do to retain skilled nurses.

These experiences underline the message in Hands That Heal, which was published in August. The book’s opening chapter explores nursing as more than a job. Kawira describes it as a calling rooted in compassion, courage and a desire to serve humanity.

But she also acknowledges the difficult realities behind that calling.

Her writing explores the exhaustion of long shifts, the sacrifices made by nurses and the financial pressures they may face while continuing to care for patients.

Some nurses report for duty despite months of unpaid salaries.

Others skip meals but continue to fulfil their responsibilities, standing for hours on aching feet while tending to patients and putting aside their own discomfort.

These are stories that deserve to be told because the people who care for patients also need care, support and recognition.

One passage in the book captures the emotional weight of the work. “There is something profoundly holy about holding a patient’s hand and whispering, ‘You will be okay,’ even when you are unsure yourself,” she writes.

She also reflects on the responsibility of sitting beside a dying patient and ensuring that their final moments are marked by dignity and peace. “There are things money cannot measure. The trembling of a patient who finds peace in yours. The first breath of a newborn, marking the miracle of life. The silent nod of a family whose loved one survives because of your presence,” reads the book.

These, she notes, are treasures beyond value. But there is a harsh reality: “Humanity does not pay rent, compassion does not feed hungry children, and calling does not settle bills.”

Through the book, she hopes readers and stakeholders will look beyond the uniform and recognise the people behind the profession.

Kawira hopes to give a voice to nurses whose sacrifices are rarely acknowledged and whose challenges may remain hidden behind hospital doors.

With the support of her husband, Simon Ngatia, Kawira has printed a few copies of the book but hopes to have it published more widely and distributed across the country.

“I will one day be able to stand as a voice for many nurses and advocate for them to be recognised in our community and beyond,” says the nurse.