Just Do It

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Well today (day 2) was really something. I was the primary nurse for an ICU patient who didn't have a lot going on. During my slow morning, I discover that a neighboring ICU patient has a central line! *oncology nurse perks up* I didn't expect to find any central lines, but my sweet patient in Portland donated a lot of extra central line dressing kits to me last week and I had the chance to use it! The hospital is mega short on biopatches and I had brought tons! The charge nurse graciously let me change the dressing, possibly the one nursing task in which I am truly experienced. 

Cue the afternoon excitement. I was informed that I was getting an admission from the ED (which totally terrified me! I don't know what to do!). So I just walked over to ED and started pitching in on his care right away by running to the pharmacy for meds. He had a gun shot wound to the head and had lost consciousness and was now intubated and very agitated. He needed a CT scan. I wish I had a video of the colossal process it is to GET the patient to the CT scanner. It took 4 of us to roll the rickety stretcher over to the scanner's location, then LIFT the stretcher onto this motorized lift that takes you to the level of the scanner, then maneuver past trash cans and chairs to the table. Get patient on the table, all while manually ventilating patient and keep him from thrashing off the stretcher and giving sedating medications I've never given before. Once that is done, the power goes out. It comes back on but the scanner is not working. No CT scan. All that work for nothing. Meanwhile the patient is aspirating his copious secretions and still thrashing. Now to get him back DOWN from the scanner. This all makes sense when you can see what we are dealing with here. 

We do a similar process to get an X-ray and discover that the bullet is lodged far back in his brain with fragments scattered throughout. His prognosis is not good. He is 21. The doctor (Dave) brought his dad in to see him after he is back in ICU. After he explains everything, Dave says "Are you okay," and puts his arm over his shoulders. The dad says in French, "no, but I will try to be." 

Today was crazy. I think I did my best jumping into a completely new, uncomfortable situation. I was definitely challenged! I wish I had more pictures to show. I'm not allowed to take photos of patients without consent so I have to be careful who is in my photos. 

I'm learning that if I can't get someone to understand me, I'll say the English word in a French accent and SOMETIMES it's better understood! I call this a victory. 

Initiation

First full day here at the hospital in Haiti. I spent it following Pamela around in the ICU. She is a Canadian nurse who has been here for 2 weeks. She was so awesome. We had one patient who was in a moto accident and is still unconscious, intubated, and unresponsive 1.5 weeks after a craniotomy surgery. He didn't require a lot of care throughout the day so Pamela and I visited and joked around a lot, took breaks and chatted with the Haitian staff. 

The patient's family plays a crucial role in the care of the patient. NOT in the way I expected. The family must provide food and linens for the patient. If they don't, the patient goes without, unless the hospital has extra; they often don't. All of our ICU patients had urinary catheters. When we emptied them into buckets, someone had to go yell the family's name out at the door of the unit and wait for the family member to come and take the bucket away (apparently to some unknown human waste river). They bring the bucket back to us and then go back to waiting in the courtyard of the hospital. So strange. Another thing, when the doctor orders any tests or lab work, the family has to pay for it first, then bring the nurse the receipt. Only then can the nurse draw blood or take the patient for a test. This happened to me today. Pamela and I got all the supplies out to start and IV and draw blood, but the family couldn't pay for the labs so we potentially wasted supplies by opening them too early. Crazy. 

 

Alvers and Pamela, my ICU buds for the day. Alvers is Haitian staff. He's 26 and lives in a sketchy neighborhood. He stays at the hospital if it's not safe to get home.  

Alvers and Pamela, my ICU buds for the day. Alvers is Haitian staff. He's 26 and lives in a sketchy neighborhood. He stays at the hospital if it's not safe to get home.  

The only empty ICU bed.  

The only empty ICU bed.  

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This code cart is actually stocked!  

This code cart is actually stocked!  

Arrival

Port-au-Prince, Haiti.  

 I arrived safe and sound! It's been a long day of travel and orientation and I am SO TIRED. I got my schedule for the week and am luckily working day shift all week. I volunteered myself to work in ICU and pediatrics...both dreams are coming true....YIKES! More to come on that... 

My first thought on Port-au-Prince is that is reminds me so much of Navotas in the Philippines. The same faces, smells, roadside thrift stores, pain, desperation, heat...the list goes one. I feel like I've been here before. 

Welcoming crew (not mine) at the airport  

Welcoming crew (not mine) at the airport  

I don't know what this is but it seems important.  

I don't know what this is but it seems important.  

Street.  

Street.  

View over the hospital. The square footage is small but there are so many units and clinics inside it. The tour of it took a long time. 

View over the hospital. The square footage is small but there are so many units and clinics inside it. The tour of it took a long time. 

Fifteen minute walk past this house is one of the worst slums in the Western Hemisphere (per the UN) 

Fifteen minute walk past this house is one of the worst slums in the Western Hemisphere (per the UN) 

MORE TO COME!  

Navotas

I'm sure there are parts of the Philippines that resemble paradise or whatever beach/resort/dream vacation one could imagine. Navotas isn't quite that. Not really. Its about an hour ish drive outside the capitol Manila (with traffic--which is another thing to behold, once you get past the nausea). It's basically a slum. Poverty, prostitution, all that. 

Once I got there and saw all the pain and suffering, it easily has the power to crush the spirit. But somehow it doesn't. The joy of the Filopinos transcends the destitution.  They have smiles and laughs and skips in the step despite ratty clothes, rotting teeth, failing health, and hungry bellies. I smile and laugh with them and the joy on all their faces only increases. To me, this is a different kind of paradise. One where, there is no doubt that the Lord lives here. 

The river that runs through Navotas. It's more sludge than water if you look closely. Best to plug your nose if you do!

Filipinos waiting in line to see the doctor at the medical clinic.

My own little paradise in Navotas--best mangos in the world.

This baby was born blind and then abandoned. The family that brought her in had adopted her even though they already couldn't feed their own kids.  

Many makeshift homes along the river banks.

Playing with girls on the street late at night. Parents were not around and were most likely "working."

Vanessa fell out of a jeepney (Filipino public transpo) and cut her head pretty good. The infection was looking pretty gnarly. She got a thorough head scrub and several dressing changes and looked much better by the end of the week. 

A home next to the river. 

Most babies did not wear diapers--too expensive. 

The sludge...

Location 2016

When you first start a blog, you want to have all the right words in all the right order, to impress your online audience. Well I don't have any of that. I am not a writer. I keep a journal, and this is not it. Everyone has things to say, I suppose. I have thoughts, I have experiences. Why not write them down?

2016 is going to be a very big year for me personally. Nine months ago, I became a travel nurse after spending the first four years of my nursing career in Boise, Idaho. I spent 5 months in Seattle working at a cancer care institute, then the last 4 months working in Portland at a center for hematological malignancies (leukemia/lymphoma). I will continue working in Portland over the next few months, but I am very excitedly preparing for 2 upcoming trips.

On February 5, I will be leaving for Port-au-Prince, Haiti to work at a critical care hospital for one week. I have never been to Haiti before so I DO NOT know what to expect. More to come on that...

On February 22, I will be going to the Philippines for the second time! I went with a small team from my church in Boise, Revolution22, in January 2015 for 2 weeks and 5 of last year's team is returning this year! This is the second medical mission trip for us. The team will be setting up a clinic and treating patients in a church in the slums of Manila. This trip is 12 days long.

I could go on and on about the Philippines and I probably will. All in good time. 

Entrance to the infamous Walking Street in Angeles City, Philippines, known for prostitution

Entrance to the infamous Walking Street in Angeles City, Philippines, known for prostitution

Epic roofless church down the street from Walking Street

Epic roofless church down the street from Walking Street