Wednesday, April 15, 2015

Nursey Stuff

Well... we have had a very busy 3 surgical days at the hospital.  Monday we had 2 sweet ladies with open cholecystectomies (gall bladders), a bilateral inguinal hernia repair,  and something else I can't remember already.  There is another nurse and I that work the pre-op/recovery room/post-op area.   We basically get the patient from off the OR table, take him to our room, and look after them til they go home or stay overnight.  Today we moved 2 more beds into an already full 4 bed ward.  At one point we had 7 VERY FRESH post-op patients in there.  We started out with a 2 year old circumcision who screamed for pretty much 3 hours, then 4 year old Maria-- inguinal hernia repair who was the sweetest girl ever!  She cried for about 20 seconds once, and while they were putting her under.  Then we moved onto Fabricio, the brave 6 year old with an undescended testicle.  I got a kiss from him when he went home.  Then we also did 2 more inguinal hernia repairs, 2 more gallbladders, and an umbilical hernia repair. I don't know where they are all getting these hernias, but they all seem to want to ride home on a motorbike on 4x4 roads.

All this with a manual BP cuff, since our automatic vitals machine died half way through the day.  No ECG monitoring and one patient who came to us with an airway still in place.  Made for busy times. 3 spinals and 5 general anaesthetics.

My feet are tired, but my heart is full.

Other interesting nursing moments for you nurse types:
- one pair of nasal prongs is all that exists for O2 which comes in a big tank that we haul to whichever bedside needs it (nothing piped in, no suction equipment at the bedside).  I guess everyone has to share nasal germs or go without.  Rewashed our one oxygen mask today.
- the post-op infection rate is really low here considering all that goes on, and MRSA- what's that?
- tomorrow we are doing a colonostomy reversal.  I don't know if it's this guy or someone from last year, but ostomy supplies aren't in abundant supply here, and he basically carries around a Walmart plastic bag to drain his ostomy into.  You can imagine how life changing this surgery could be for someone like this!!
- We made a deal with the anaesthetist to give us some vials of Morphina because 60mg of Ketorolac (ouch kidneys!) and Tylenol are what they basically use post-op for even big hernia repairs. At home they could be on a epidural or PCA for a few days.  So I carry some ampoules in my pocket all day for when we need to use it.  No saline to dilute anything so we just pull it out of the IV "bags"/boxes that we have to cut the tip off to open.
- no handwashing audits here, none of the sinks, if you can find one, have soap.  Hand sanitizer!!
- Privacy?
- the patients can get surgery here but it costs about $1000 and no one can afford it, so they are living with these things often for years.  We charge $40 or something like that so that they can feel responsible but also respected and cared for.  Some will wait til next year when the team returns.
- the first day when we asked for new sheets to change the bed it seemed like we were asking for their first born.  There was visible blood on the bed.

Today was a more calm pace and I ended being trucked home early this afternoon due to a wonderful case of Montezuma's.  I got to nap and enjoy the pool briefly which was much needed.

We had a potential ruptured appendix that came last night and we hydrated and antibiotic-ed overnight so he could be operated on today.  Giving 3 hours in the OR, in case of complications, possible resection or whatever, they went in found an abscess that popped pus everywhere, no appendix in sight, put in a drain and closed him up in 45 minutes (sorry Dawn and Erin if you are reading).  He is lucky 19 year old!!  The family has a lot of spiritual stuff going on, witch doctors etc. that they have tried for the last 2 weeks before bringing him to us.  Our "chaplain" shared the Gospel with him and he gave his life to Jesus this morning and went into the OR with peace on his face, much different than last night.

Thanks for thinking and praying with me!  It's really rewarding to give care to people who are so grateful, hug you when they go home, and being able to pray with patients and love on them is a great experience! So thankful for our awesome translators that we will turn into nurses yet!

Prayer requests:
- they are showing the Jesus movie tonight in a nearby neighborhood and then next Wednesday we will show it in the town square so that will be cool
- to top off my day, I had a filling fall out today, so pray I don't get some mouth infection and die in South America. I was able to Skype Kevin and Erin and he phoned our dentist who said it should be OK.
- Doing more kids tomorrow, so that worries me since my peds. experience is so rusty
- some of the team changes on the weekend, some go home and a bunch of OB/Gyn types are coming next week.  Hysterectomies, fibroids, fistulas here we come.  And I really want to see some births!!
- my partner Cindy gets some relief from her allergies and some much needed sleep!

Quote of the day: "No worries about the neighbors trying to steal wifi, when they are crocodilias"

No comments: