Tuesday, October 23, 2007

A Day of Nursing

October 5

James has moved me to work in the Adult ward all week so that I will learn more French with the Chadian nurses. I don't know if I actually learned more French yet, but I've moved to doing more and more nursing as I learn from observing. It has probably been the most challenging week so far and today was crazy!

As I arrived at work this morning, I spent forever organizing all the paperwork that is always a complete mess. They don't see the value in writing things down, but anybody who knows me, knows that I have to have everything just right and organized. So after entering in all the new patients and getting the #s to add up right in all the wards, I headed off to take vitals on all the patients.

My coworker for the day was David, a nurse that I'd never worked with before. He grabbed all the patients' papers from me and started walking around randomly, snapping his fingers at me to take blood pressures of certain patients. By the time James arrived to do rounds, we hadn't even done half of the vitals and all the papers were in a jumbled mess again in David's hands. I used the distraction of James yelling at a patient who didn't buy meds. to take the papers and put them in order again. As we went around, I tried to work on my humbleness as David kept grabbing my pen, stethoscope, clipboard... snapping his fingers in my face and yelling, "Come!" "This patient needs this...!" I already wanted to say that I already knew since I'd been taking care of these patients for 5 days now and probably knew more than he did about them! But thankfully, sometimes the language barrier is a blessing so my anger doesn't pour out. It is teaching me to bite my tongue and calm down before speaking since it'll take me 10 min. to figure out a sentence to say.

After I finished with all the discharges and set out all the papers for 12:00 meds, I went over to the American house to try & send/receive my email. It hadn't been working for a week, so when it actually went through, I decided to wait for it to finish even though it was 12. I'm still just, supposedly in training, helping wherever James puts me. So I figured it wouldn't be a problem to let David do the meds by himself, which he would be doing anyway if I wasn't there.

I went back over to the hospital a little after 12. David was nowhere to by found with nothing done. I ran around crazily trying to find patients to give them their meds. Many of them go outside to lay around with their family. I tried to do everything like I'd watched others do it.
The last med. I went to give was for a TB patient in the isolation ward. Just as I walked up, I heard the wailing start. She had just died a minute ago.

Four new surgery patients poured in one after another. I finally found each of them an empty bed and started their paperwork. Lab reports came in for many patients, diagnosing them with malaria so I was prescribing Quinine and Doxy, left and right, trying to explain the importance of buying meds, otherwise they won't buy it. I just tell them they'll die without treatment and it usually works with adult patients. With pediatrics, it's harder because the parents have to decide if their kid's life is worth more than the meds cost, which half the time it isn't, according to them. We don't treat or give anything until they pay, which may seem harsh, but it is really possible for most anybody to pay. The hospital allows donations so they just have to give a bike or even just a cooking pot to be put in the garage until they pay their debt.

Anyways, I finally started 1:00 meds a little late, but Dr. Bond came in interrupting me. Dr. James Bond is a volunteer surgeon here for a while...a very interesting, eccentric man. I don't know how anyone so obsessive-compulsive could end up in Africa! :) He checked on all his surgery patients and barked out orders for me, handing me meds to give them and special instructions. I was so overwhelmed and nervous giving meds I'd never heard of before. Somehow I finished everything by the time work ended at 3. David came around ever once in a while. He'd see me giving an injection and run over to grab it from me, yelling "What are you doing?" I'd explain and show him what was supposed to be given. He'd grudgingly say ok and then leave again.

At least, after today, I have much more confidence in being able to take over and do things instead of just sitting back and watching. And patience is a virtue...to keep working on...
I can't help still wondering about the woman that died. If I had been there to give her meds an hour earlier when it was supposed to be given, would it had made a difference? Or if I had been around to attempt resuscitation?...She probably still would have died, but I can't help wondering...

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