Tuesday, September 06, 2011

A hectic Tuesday...

Whereas yesterday was nice and quiet, and very productive, today was very noisy and hectic. Yes, I was at the hospital again and even though our new office is further removed from the wards, people still come in and out. That is of course absolutely fine, but just means it’s hard to get a lot done.

First of all, I sent our driver to town to buy some NPA (national power) credit and find out our bank balance. Then a colleague came to create and discuss his work plan. During our meeting a lab technician came to report that the hemocue is reading an error. I took the opportunity to teach him how to dismantle and clean it. Then someone from Mercy Ships called about a team of engineers arriving today to do a full assessment of the hospital’s infrastructure. After my meeting I went to Special Care to check on progress there. The work seems to be completed. There are 14 beds for the mothers and they seem very happy. Unfortunately in the neonatal bit, I only saw 2 nurses instead of 6, which meant a trip up to matron’s office to find out what is going on. I then returned to the office to do some printing for a survey we’re conducting. After that I met with the head of the hospital to talk about a few of the SLICH projects that have been delayed. I am not sure if we actually came to any conclusions! From there I went to the head of maintenance to let him know that the engineers are arriving today. On my way, I found a father in tears, who had thrown himself to the ground. He just lost his child. Soon the mother came out and in floods of tears they tried to console each other. I had to try hard to fight back the tears. I then went up to ER and ICU to see how things were. ER was so full and only a house officer; a few medical students, a few nurses and many student nurses could be seen. I am not sure how they will cope today. ICU was a bit calmer, but still there were some very sick children there. I wanted the nurses to check a blood sugar but they told me the glucose strips are done. I asked for them to go and get a new supply. From there I went back to the office. It’s not even noon yet. There’s still a lot to do.

The afternoon ended up being a primarily clinical afternoon, which is sometimes welcome, but definitely not something I planned for today. I was passing through the ER and overhead a conversation about a patient. Meanwhile I noticed that said patient was gasping and so started ventilating with a bag and mask while others were deciding on a plan for fluids. After 40 minutes of ventilating we were a bit stuck: there was still a heart beat but the pupils were fixed and dilated, telling us that the brain has been starved of oxygen and continuing was futile. After another five minutes of bagging, we stopped and within a minute the heart stopped beating. I explained to the mom what had just happened and watched as tears streamed down her face. I was ready to get out, but two more admissions showed up, and no one else was around. While stabilizing the first one, one of my colleagues walked in. I left soon afterwards; back to the office. Later in the afternoon I had to go back to Special Care to see how many nurses were on late shift and walked right in on resuscitation. I helped where I could. Unfortunately it was another failed attempt.

On my way back to the office at 4 pm I ran into the Engineering team. It was good to chat with them a bit and attempt to explain the complicated water system we have here at the hospital! It’s taken Welbodi 3 years to try and figure it out, so hopefully they’ll be much more successful in the week they’re spending here. I’m looking forward to the recommendations they’ll make. Just after 5, we decided to head home. Another day come and gone. Lots done, but very little crossed off of my to-do list! C’est la vie…

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