Night Shift- Athens

June 2, 2012: Saturday

 It’s our first shift at the hospital and it’s on nights and I’m on the maternity and Surgical units. Oh may what have we got ourselves into. I’ve never liked maternity so I don’t know why I agreed to this unit. I guess I was trying to be helpful and expand my horizon, but right now I’m thinking that probably wasn’t the best idea. Right away there is a lady in the delivery room and it’s her first child so I know it’s going to be a long night. The Chadian nurse is so excited to see me and wants me to help assess the patients and motions for me to assess her progress and I cringe at the thought of what I’m about to do. I look around for sterile gloves and some lubrication and then I remember that I’m in Africa and I reach to a box of clean gloves and as I stuck my fist up this woman’s vagina all I can think is INFECTION!!! I try hard to remember everything that I’ve learned about dilation and effacement and I move my fingers around trying to measure what I can’t see but I’m struggling. When I remove my hand and smile at the nurse and we switch places I almost gag at the thought of what I just did.  Suck it up Athens! You’re a nurse and you’re in Africa! After my pep talk I exit the room hoping I never have to do that again.

                The local nurse still hasn’t showed up yet and the other day shift nurses are ready to leave but I know they can see the fear in my expression at the thought of being along all night with a women in labor and 25 patient to man all by myself. They graciously stay late to help me. Note: I have not had any orientation to the unit besides 3 days of shadowing on the day shift and It wasn’t in English. I’ve had to learn routines by watching and asking people that speak English whenever I see them. I don’t know where to find anything. I’m really stressing out and the only thing I can think of to do is pray, and oh man do I ever!

                The women laboring isn’t making much progress so someone called the doctor and I’m so grateful cause she an American and speaks English! (Fist pump) As I finish helping pass medication to the patients I get to the last one and I so excited then all of a sudden the short African nurse passing meds with me starts yelling at me so fast that it takes me a minute to realize what is going on and I kind of want to laugh cause she sounds like a crazy person and apparently I did something out of order. I just stare at her with my dumb face and I watch as she shows me what I did wrong and I laugh because it was a pointless mistake but I just make note to self not to do it again. Why am I in Africa? The other night shift nurse finally shows us 2 ½ hours late and I’m a little annoyed and the doctor is to and sends him away.

                I make it back to the delivery room just in time to see the doctor give the lady an episiotomy and I’m reminded why I don’t like Maternity. Carlie and I watch as the baby is born trying to soak up all the information that we can on how things are done. (Soon we will have to do this on our own.)  I am given the task of cleaning up the baby and cutting the cord. I spend the next 30 minutes with baby playing with it and making it cry- it’s the only way I know it’s still breathing.

                Because we work at the best hospital in Tchad, Africa they like there staff to be well rounded so we also double as the night janitors. After the baby and mother are stable we have the honor of cleaning up all the blood off the floor. Since the traditional foot attire here at Bere Adventist hospital is flip flops Carlie are not really excited about blood splashed all over my feet and the other nurse can tell by our expression because she hands us a pair of tall rubber rain boots and I grin in relief. We spend the next 20 minutes scrubbing, squeegeeing, rinsing and repeating the process of cleaning the floor. And where does the dirty, bloody, amniotic fluid go? Well out the front door of course and down the side walk till it hits the dirt. We had to ask a couple of people that were sleeping on the ground outside to move because they were right in the line of fire… too bad we its already soaked part of their sleeping mat…only in Africa. 

                We finish cleaning up just in time to pass 12 am meds and hour late, but I’m just glad that they are getting passed at all. A lot of the night staff here would rather sleep then to do their jobs. There is only a couple and after their finished we have till 5 am till we have to pass meds again and take vitals (Vitals are only done once a day in the morning or on admission. Assessments aren’t done at all L we hope to change this.) The nurse I’m working with decides to take a nap and sprawls out on the wood table that is located in the nurses’ station. This table also doubles as an exam table and a desk and is about to snap in half judging by the huge crack in the middle and the way it bows.

                The lights are flickering; there are bats flying above my head, babies crying and topless Chadian women walking around mean while a giant coca roach is playing chicken with me. But I’m just so thankful that I’ve made it this far. Seven a.m. couldn’t come soon enough.

 June 3 2012: Sunday

Mark 10:27 “With man this is impossible but not with God; all things are possible with God.”

                As soon as I walk into the maternity ward the stench of sweaty bodies and urine plagues my nose and as I slowly open the door to the delivery room I pray that it is empty….. and alas my prayers are answered.

                The first task of the evening is putting in a new IV on a 7 day old baby. I’ve never done an IV on a baby so I don’t feel to confident in my abilities to try so I pass at the try and just watch and learn so I can be prepared next time. It took 2 nurses and 7 trying with the SAME needle to get a good stick. All the supplies and medications that the patients need here at the hospital have to be paid for right away. This family only had enough for one IV so that’s what the nurses had to use. Though I was appalled when they dropped it on the floor twice, but when you have nothing you take anything you can get.

               

 June 4 2012: Monday

                Not much going on in the hospital no babies were born which made the night go by really slow. It had rain earlier today so it was cooler then it’s been in a while. Not really thinking about how cold it could actually get in Africa we both went to work without any warm clothes. Bad choice. We spent most of the night spooning on top of a small desk in the urgency ward trying to stay warm.

                A boy that had come in the morning with a viper bite died in the night. There is no cure for snake bites here and the bite itself was 5 days old. A lot of people here don’t seek help right away they wait till they can take it anymore then they come in when it’s too late.

I got electrocuted AGAIN!! I went to unplug my computer cord and right when I seen the little blue bolt I knew it was coming and there was nothing I could do about it. I felt the shock go up through my arm and into my jaw. I’m pretty sure that my eyes were twitching. I jerked back my hand as soon as I could but not before I felt the horrible pain of the arm and jaw being fried. But I’m Ok and everything is functioning as it should. :)

 June 5: Tuesday

                Bronwyn is a girl out here from the UK who we have become close friends with and who we spend most of our time with. While we were sitting around wait to go to work a voice can out of the dark and it was Bronwyn in the bathroom “Umm… Did one of you finish the toilet paper?” There was a moment of silence where both Carlie and I looked at each other and just burst out laughing. Like can’t breathe, crying/ chocking kind of laugh. The door to the bathroom doesn’t have a knob on the outside so there was no way for us to take the TP to her…she had to come to us. There are no light except for the head lamps that we have so out of the darkness of the bathroom came a hand. Just at the sight of it we started laughing even harder. Probably the best part of our night!!

                I thought delivering one baby was stressful oh no! We had two women at the same time in the delivery room. Thankfully another nurse came over to help and it took 10 minutes for one lady to deliver. She literally came in and laid there for about 8 minutes and in the time it look for me to walk over and check on the other womens IV she pushed her baby out. As soon as I turned around Carlie was yelling “Baby! There’s a baby!” We race to put gloves on as fast as we can and grabbed the baby from Jo and start suctioning out the nose and mouth and drying her. Another successful delivery. YAY! I think I might be starting to get the hang of this.

 June 6 2012: Wednesday

                Always check your patient!!! Always! Always! Even when your best friend who is a nurse as well is telling you that a patient 2 beds over is dead. Never take their word, always check.

Working in nothing but Darkness.

  I was doing a dressing change on a patient and Carlie leans over and wispers in my ear “the patient in bed 16 is dead.” I look over and the family has covered the patients face and wrapped then with cloth and appeared to be lifting them up out of bed. SO as soon as I finish my dressing change I race to find Jo (the local night nurse that does not speak English) and we try to tell him in as much body language as we can that a patient is dead. He finally gets it and he follows us out. When we get there and walk up to the bed the whole family is surrounding the bed and we walk up slowly and Jo leans over the foot of the bed and starts shaking his head. I follow and as I get closer I can hear the patient snoring and I feel so stupid. I turn around and look at Carlie who still has a scared look on her face and say “Their not dead, their snoring.” Jo starts to laugh and tells the family and they start to laugh and then other patients and family member all over the ward laugh. I am so embarrassed. Moral of the story don’t listen to Carlie!