The day before the Storm

October 9, 2016

The Day before the storm – Tuesday, August 2nd, 2016

I arrived at the hospital this morning expecting to go out into the community with Ms. Jemma, since Ms. Emma is still out sick with chikungunya, which is an illness similar to Malaria that is contracted from an infected mosquito. Anyway, the hospital was a twitter with the tropical storm approaching, and Ms. Jemma said she would have to go to the police department for a 12 hour shift coordinating emergency services, and there would be nothing for me to do. So, I went back to the Emergency Room to spend the day there.
There wasn’t much happening today. Four patients were discharged to home, one of them was the first trimester pregnancy suffering with a UTI from Sunday night. Five people were transferred to Belmopan. These included a patient who suffered a partial abortion, an elderly man with cardiac arrhythmias and a history of CAD, another elderly man with a T wave and U wave depression (he had come in Sunday night with a very high blood pressure and chest pain), the man who sustained multiple machete wounds who was experiencing a hematoma over the left jugular vein, and a child who had unknown abdominal fluid.
The child was the most interesting to me, because it seems as though 2 large adolescents had fallen on the small thin boy last Friday. On Saturday he began to experience vomiting and diarrhea. This subsided by Sunday, but then he began suffering with abdominal pain on Sunday. By Monday, the diarrhea came back, and the abdominal pain was only felt when he walked. His mother took him to a private Doctor, who said that his kidneys had shrunken and she needed to take him to the hospital to have IV fluids administered. The Doctor on duty said she would not blindly follow the orders of another Doctor, she would have to examine the boy herself. With the limited diagnostics available at the hospital, she deduced that he had fluid in his abdomen, but was unable to determine what sort of fluid, and sent him out to the bigger hospital.
There were few that came into Accident and Emergency today. There was a child with a laceration to the posterior side of his head, and the poor little guy wailed unmercifully as his wound was sutured! There was an older man who had a laceration to the front of his head, and I got to assist the Doctor, and clean and dress the wound. There was a young man who came in with torticollis, and was in quite an amount of pain. He was given a muscle relaxer, and some Ativan to help calm him. And finally, there was a 15 day old baby who was having trouble breathing, was given a nebulizer treatment. She was a very sweet baby.
Another thing this trip has shown me is that I do like children. I also understand that sometimes it is necessary, although uncomfortable to cause them pain to help them heal. Before coming here, I was adamant about not working with children, but here, I don’t find it so bad.
As far as tomorrow goes, I plan on arriving at work in the morning. I am fully expecting to be working a 12 hour shift, which is what they move to in times of emergency. If the weather is bad, I will stay overnight at the hospital and work a 12 hour shift on Thursday as well. Nrs. Madrid was going to have me stay home, but I said that if I were already a registered nurse and worked here, it would be my duty to come to work. Besides, I don’t mind, and would rather be at the hospital than sitting at home. So, I have packed clothes, food, and toiletries and will be happy to help serve this community. The hospital is a safe place to be to weather the storm, and I might actually see something more exciting.

Going Steady – Wednesday, August 3rd, 2016

Today we expect the hurricane to hit. It was supposed to come sooner, but slowed down. We are now told that it should arrive around midnight in our area. With this information in my mind, I packed enough food and clothing to go to the hospital with the intention of riding the storm out there. The day proceeded almost as any other day.
As I walked to work, I noticed men digging out the drainage ditches in preparation for the storm. I was eager to get to work to see what the day had for me. Wednesday is the diabetes clinic. This is offered once per week, with appointments in the morning and the afternoon. The patient has a basic triage of height, weight, blood pressure, finger blood glucose stick, pulse oximeter, and pulse. Then they wait their turn to see the Doctor to see how things are going and if they need their medication increased. Normally, if things are progressing well, the patient comes back in 3 months. If there are problems, they come back in 2 weeks to 1 month. Normally the clinic is packed to capacity, but today because of the storm coming, only half of the AM patients showed up. In the afternoon, less than half came to clinic.
Around 3pm a little boy was brought in who slipped and fell off a roof. Fortunately he had no breaks or fractures, although he was very full of stool in his bowels. The Doctor kept him to observe him, and made plans to discharge him in the morning.
About 6pm, a young lady came in who had just had her foot run over by a truck, she also did not sustain any breaks or fractures, just some bruising.
I was given a ride home at 7pm, and was told that I would be picked up in the AM.
The storm hit us about midnight, with the standard high winds and heavy rains. It was quite loud and strong, and woke me up several times. I did manage to get some sleep and was up, ready, and waiting for my ride at 6:30am. They arrived to get me at 10:15am, and boy was I anxious to get out of the house and back to the hospital!

A truly Memorable Experience – Friday, August 5th, 2016

Today was my last day at the hospital. I was anxious to return, so I skipped breakfast and went straight in. I enjoyed my walk, looking at all of the places along the way, and admiring the countryside. I chose to walk up the dirt road that I warned against traveling after it rained, and found out why. I arrived at the front door with mud caked to the bottom of my shoes! I respectfully removed them and walked in to wash them off before I began work!
Today I got to work in the Out Patient Department with Nrs. Figaroa again. I did enjoy this day as well, as it is always steady with things to do. I smiled, laughed, and talked with the patients as I gathered blood pressures, pulses, oxygen saturation, heights, and weights. I enjoyed all of the kids, talking with them as well about school time coming soon. I really enjoyed holding the babies. Children are so much more relaxed here, and an honest pleasure to work with. The Mom’s and Dad’s are also very pleasant, and love to show off their kids.
After signing the patients in, we went to the next room to change dressings, and give injections. I was able to change all of the dressings, and give all the injections, with Nrs. Figaroa watching over me, making sure I did everything correctly, and filling in the Spanish language, when I could not! I actually got to remove sutures from a cesarean section too!. Two of the dressings were ones that I got to see last week, and it was so great to see how well they were healing. It was also nice to start to see familiar faces, and chat with people who remembered me from last week.
I was sad as I came to the end of the day. I knew that tomorrow I will have to leave to go back to the States. I find myself wanting to stay. I would love to stay and build relationships with these patients, and watch their kids grow. I would love to continue my time at this hospital, working along side gifted, kind, compassionate Nurses and Doctors. This is truly a community hospital and that is something that I have never experienced before. Even for the draw backs of lack of supplies and equipment, this hospital makes it happen. They do everything they can, and transfer the patient if necessary. They care about their community, and the community appreciates everything they do. This to me is what healthcare and community should be.