Hello to anybody who still reads this blog. I'm currently in Mexico City with 8 nursing students. We have been out in the mountains in Oaxaca for the last few days doing free medical clinics. We've finally made it back into Mexico City tonight and are hoping to get some sleep before we hit the ground running tomorrow.
I'm hoping to be able to post some pictures soon and to share more specifics about the trip but I have very limited internet at the moment. More to come...
Friday, August 12, 2011
Monday, June 20, 2011
Lorazepam
During the first few nights in Rwanda I was suffering from jet lag and was unable to sleep. Lisa so kindly offered me her ipad so I could listen to her "sleepy time" play list to see if some soothing music might help. As I scrolled through the playlists on her ipad I cam across one title "Lorazepam." For all you non medical folks, lorazepam is a sedative and is also used to treat anxiety. Of course I found the very idea of a lorazepam playlist quite amusing so I took a listen. It didn't take long before I was hooked, it really worked! The power of music is pretty amazing. When I got home I made my own "alprazolam" playlist.
I love this idea and I think I might suggest it for some of the new grad nurses I'm mentoring when they work their first year in practice. Here is one of my songs from Lisa's lorazepam list: http://www.youtube.com/watch?v=yXywFuTf65I&feature=related
I love this idea and I think I might suggest it for some of the new grad nurses I'm mentoring when they work their first year in practice. Here is one of my songs from Lisa's lorazepam list: http://www.youtube.com/watch?v=yXywFuTf65I&feature=related
Sunday, June 19, 2011
The Finished Product
One of the main reasons for my most recent trip to Rwanda (although, who needs an excuse)was to deliver the complete and final version of the trauma curriculum. It only took me four years to do it, but I finally finished the entirety of basic trauma curriculum that I wrote specifically for the resources available at Kibogora Hospital. The lectures are all recorded on video complete with skills demonstrations. Each module has a case study, assignments and a unit exam. It felt pretty good to hand the whole thing over to Sheila. I even took a photo as proof!
Now maybe I can start concentrating on that dissertation...
Tuesday, June 14, 2011
To Hell and Back
It was the weekend before Easter Sunday and I was scheduled to work at the hospital for a 12 hour shift. The assignment I got was a single patient, a woman with stage four cancer and aspiration pneumonia on a ventilator. She didn't sound too terribly complex in comparison to some patients I have had, but I would soon find out why she was singled.
As I walked into her room that morning the first thing I noticed was the number 666 tattooed on her forehead. Though she was on a fair dose of IV sedatives, she was still quite agitated and thrashing about in the bed. As I proceeded with my routine assessment I noticed two other satanic tattoos on each of her arms, additionally I found one that said "Property of ______" (fill in the blank with a name).
Upon the neurological assessment I found her to be able to respond to yes and no questions by nodding her head, she was also able to follow basic commands.
As I was charting I felt God prompt me to approach her and ask "Do you know there is a God who loves you?" When I asked her this, she began to cry. I spoke with her about it a little more and asked if I could pray for her. She nodded (or maybe she was just getting restless) so I did.
Because she was so restless and thrashed about, I couldn't leave the room as she ran the risk of extubating herself and pulling out all of her IVs. In between medications, dressings and charting I did my best to find out the story behind this woman's tattoos.
Long story short, her mother had died shortly after she was born. She was hospitalized with a head injury at age 4 which resulted in her being labeled as developmentally delayed and having almost weekly seizures. She was molested as a school aged girl and homeless by high school. She showed up in a different state several years later as homeless with a drug and alcohol problem. She had a history of multiple suicide attempts.
Later I looked up the name written on her arm and found that he was a convicted sex offender who had been imprisoned for kidnapping young girls and prostituting them at truck stops around the country. I saw a photo of the man who was also, ironically, covered with satanic tattoos.
When I got home from work, I continued to think about this women and the interaction that we had. What was it like for her to find herself restrained to a hospital bed with people hovering around her giving her interventions that she likely didn't want and probably couldn't understand? My stuggles can't even begin to compare with many of the things she has gone though. Did anything I had to say to her mean anything?
As I prayed and pondered these questions that evening this scripture came to mind: Isaiah 55:11 "So will My word be which goes forth from My mouth; It will not return to Me empty, Without accomplishing what I desire, And without succeeding in the matter for which I sent it."
If the words I said truly came from God, then they are His words and He gives them meaning and purpose. He then reminded that aside from being God, He had been to hell and back for her and for me. What a wonderful reminder of the redeeming power of God, I am humbled.
As I walked into her room that morning the first thing I noticed was the number 666 tattooed on her forehead. Though she was on a fair dose of IV sedatives, she was still quite agitated and thrashing about in the bed. As I proceeded with my routine assessment I noticed two other satanic tattoos on each of her arms, additionally I found one that said "Property of ______" (fill in the blank with a name).
Upon the neurological assessment I found her to be able to respond to yes and no questions by nodding her head, she was also able to follow basic commands.
As I was charting I felt God prompt me to approach her and ask "Do you know there is a God who loves you?" When I asked her this, she began to cry. I spoke with her about it a little more and asked if I could pray for her. She nodded (or maybe she was just getting restless) so I did.
Because she was so restless and thrashed about, I couldn't leave the room as she ran the risk of extubating herself and pulling out all of her IVs. In between medications, dressings and charting I did my best to find out the story behind this woman's tattoos.
Long story short, her mother had died shortly after she was born. She was hospitalized with a head injury at age 4 which resulted in her being labeled as developmentally delayed and having almost weekly seizures. She was molested as a school aged girl and homeless by high school. She showed up in a different state several years later as homeless with a drug and alcohol problem. She had a history of multiple suicide attempts.
Later I looked up the name written on her arm and found that he was a convicted sex offender who had been imprisoned for kidnapping young girls and prostituting them at truck stops around the country. I saw a photo of the man who was also, ironically, covered with satanic tattoos.
When I got home from work, I continued to think about this women and the interaction that we had. What was it like for her to find herself restrained to a hospital bed with people hovering around her giving her interventions that she likely didn't want and probably couldn't understand? My stuggles can't even begin to compare with many of the things she has gone though. Did anything I had to say to her mean anything?
As I prayed and pondered these questions that evening this scripture came to mind: Isaiah 55:11 "So will My word be which goes forth from My mouth; It will not return to Me empty, Without accomplishing what I desire, And without succeeding in the matter for which I sent it."
If the words I said truly came from God, then they are His words and He gives them meaning and purpose. He then reminded that aside from being God, He had been to hell and back for her and for me. What a wonderful reminder of the redeeming power of God, I am humbled.
Friday, May 27, 2011
Muzungu Moments '11-4
Sorry I've been a little slow with my updates. It's been a busy week with a lot of things to do so I'll just give a short recap.
Yesterday Dorothy and Melba went to visit the Batwah Pygmie village with the hospital chaplian. Apparently it was quite the amazing experience but I have yet to see their pictures as yesterday afternoon and last night were so full.
Lisa and I finally got the 12 lead EKG machine working properly. The radiology tech is the one who does the EKGs here so we spent some time with Xavier showing him how to use the new machine. It will be interesting to do some follow up and see how often it is used and what kinds of patients are getting EKGs ordered.
I also had the opportunity to go out with the ambulance. We went to a nearby health center to pick a woman in labor with possible fetal distress. I don't really know much about OB so I couldn't really offer much in that department, but I was able to learn more about the actual ambulance, it's equipment and the transport system.
In the afternoon, my class did some ambulance drills. I think it's safe to say that everyone had a lot of fun. Our assigned pretent patients did a great job acting sick or injured and there was a lot of laughter involved. We drew quite the crowd!
It's now time to start heading out to Kigali where we will visit the Bourbon (Rwanda's Starbucks with the most wonderful Rwandan coffee ever!) and perhaps visit the genocide museum. We fly out to Kenya tomorrow afternoon. It's hard to believe that the trip is almost over.
Monday, May 23, 2011
Muzungu Moments '11-3 Ambulances in Africa
This morning after I finished my class I went down to the ER just to see what was going on. Communication is starting to get a bit better and I managed to get the point across that I needed to look at/in the ambulances. When I went out to the first ambulance I was pleasantly surprised to find a nearly full oxygen cylander, a working portable suction unit and a fully functional transport monitor complete with EKG cable and and SPO2 monitor, score!!!
Nobody seemed to know what the oxygen tank was or what to do with it so I'm assuming that is how it remains full. I found a few electrodes for the EKG monitor and we tested it out on John, the driver, who had never before seen an EKG. It was like Christmas for all of us! We couldn't stop smiling and laughing all over a simple EKG tracing. I must have spent about an hour in the back of just one of the rigs showing John and Dr. Bora how to turn off and on the O2 tank and what to do with all of the other exciting finds of the day.
The next time the rig goes out when I'm not teaching, I'm supposed to tag along. I guess I'm teaching an ambulance class at the end of the week.
Melba is having a good time with her quality improvement group and Lisa taught a clas about heart failure to the doctors today. Dorothy's got the backboard strap situation almost completely covered. We've been keeping busy here, I just wish there more hours to the day.
Saturday, May 21, 2011
Muzungu Moments '11-2
Lightening is Striking Again...
Last night after my class session I went down to the emergency room to track down Lisa and to see what was going on. As I was walking down the hill, two ambulances went speeding past me. As I got down to the ER entry there was a lot of commotion. All of the ER beds were full and there were crying babies, and people moaning on stretchers all over. I couldn’t find anyone in the ER who spoke English and Lisa was nowhere to be found so I ran back up to house to see if I could find her and we could all go to the ER to help.
As it turns out,5 people who had just been stricken by lightening had been brought in from a village clinic; two little boys and three women. One of the women had a baby strapped to her back at the time of the strike and had been thrown to the ground baby and all. We examined all the patients for signs of arrhythmias and burns, looking for entries and exits of electricity. One of the boys had burns on his neck while another women was found to have burns on her back and yet another with burns on her legs. The infant was assessed for potential injuries from the mother’s fall but checked out as normal.
All of the patients were admitted for observation overnight. Lisa was able to do a little education about rhabdomyolysis and the importance of administering fluids and assessing labs. This morning when we went to round on the patients, no labs were available. We also had difficulty even finding the patients as nobody seemed to know where they got transferred to. Fortunately, when we found them, all of the patients appeared stable but the overall experience of watching how this situation was handled was quite interesting. The doctor we were working with had never seen lightening strike victims before and I had only seen one under very different circumstances. What an interesting day!
Last night after my class session I went down to the emergency room to track down Lisa and to see what was going on. As I was walking down the hill, two ambulances went speeding past me. As I got down to the ER entry there was a lot of commotion. All of the ER beds were full and there were crying babies, and people moaning on stretchers all over. I couldn’t find anyone in the ER who spoke English and Lisa was nowhere to be found so I ran back up to house to see if I could find her and we could all go to the ER to help.
As it turns out,5 people who had just been stricken by lightening had been brought in from a village clinic; two little boys and three women. One of the women had a baby strapped to her back at the time of the strike and had been thrown to the ground baby and all. We examined all the patients for signs of arrhythmias and burns, looking for entries and exits of electricity. One of the boys had burns on his neck while another women was found to have burns on her back and yet another with burns on her legs. The infant was assessed for potential injuries from the mother’s fall but checked out as normal.
All of the patients were admitted for observation overnight. Lisa was able to do a little education about rhabdomyolysis and the importance of administering fluids and assessing labs. This morning when we went to round on the patients, no labs were available. We also had difficulty even finding the patients as nobody seemed to know where they got transferred to. Fortunately, when we found them, all of the patients appeared stable but the overall experience of watching how this situation was handled was quite interesting. The doctor we were working with had never seen lightening strike victims before and I had only seen one under very different circumstances. What an interesting day!
Subscribe to:
Posts (Atom)
