Monday, October 3, 2011

So proud!!! :)

Two days ago I probably had one of my favorite moments since moving to Sierra Leone. A few weeks ago, our doctors returned from their leave in the US. This has been a huge blessing! Since we now have doctors to do the rounds on patients, I’ve been spending some more time working in the peds ward with the junior staff. The junior staff are technically supposed to have the role of a nursing assistant in the States, but since we’re so short staffed, they pretty much act like nurses- giving meds, assessing patients, etc. Unfortunately though, their training has not adequately prepared them for the fire that they’ve been thrown into, so there are lots of teaching opportunities.

One of the areas that I’ve been trying to work on with the staff is assessment- picking out those kids that are really sick. This week it was myself and a junior staff person taking care of 34 kids, so being able to figure out which ones are the really sick ones is really important. Unfortunately I’ve done rounds before and been in the ward for an hour before stumbling upon a kid that was barely breathing—but nobody who had been working in the ward for hours before had bothered to tell anyone. So assessment is key.

I try really really hard not to be preachy, so the way I tend to try to teach is that when I decide to do something (give a certain med, add an extension to the IV etc) I explain to the person I’m working with what I’m doing and why.
Two days ago I was working the evening shift, so that morning I was lounging around, reading. At 8:30am one of the junior staff at the hospital called me at home. The conversation went like this.
Junior Staff: “Emily, I have a child here who is very sick. I checked his blood sugar and it just says “low.” (Note: This made me proud in itself because we’d been practicing taking blood sugars all that week. The quinine that we give the critically ill kids tends to drop the sugar and since they usually haven’t been eating much in a few days when they come in, their blood sugar is often critically low. So the fact that he’d checked it made me really excited!)
Me: “Ok, that means it’s too low for the meter to read. Has the child been breastfeeding?”
JS: I don’t know. The mother has left, said that the child is dead already.
Me: Ok, does the kid have an IV?
JS: Yes.
Me: Ok, we want to give some D50 through his IV. Do you know where it is?
JS: Yes, I’m looking at the D50 right now, I just don’t know what to do with it.
Me: Ok, give him 5ml’s of the D50 and then check his blood sugar again in 15 minutes.
15 min later he called me back

JS: Emily, the blood sugar is now 101.
Me: That’s good! Ok, check it again in 30 minutes.

About 30 minutes later I went down to the hospital to check on the kiddo myself. When I went to the bed, the kid was wide awake and was eating. I went and got the junior staff and clarified, “Is this the kid you called me about?” He was beaming. Yup, that’s the one. I jumped up and down and gave him a HUGE hug and said, DUDE (I really said his name) YOU SAVED THIS KID’S LIFE!!! He got a huge smile on his face and just nodded.

I found out later that the child’s father came back a couple hours later and asked for the child’s body. The Junior Staff said, “Look, there is your child in the bed.” The father had already gone and dug the grave and prepared everything for the funeral. The junior staffer started explaining all about how the blood sugar works, etc. Not sure if the father understood but he got a lesson anyway. J Love it!

1 comment:

  1. That is amazing! You SHOULD be proud....I am sure that I would be continually amazed by the lack of "knowledge" people in other parts of the world experience.