My shift was in the wodi na wanamume (female ward). Normally
we start out with rounds by the doctors, but there was an emergency surgery
this morning so all we could do was wait. The nurse’s cannot begin their duties
until the doctors make rounds. Anna and I changed a few sheets and visited with
the patients, many of which we were familiar with from the previous day. Every
two days we switch wards. Something smelt askew in the ward this morning, and a
patient asked for the nurse. This language barrier thing is very frustrating at
times, and I wish I would have brought a Swahili-English dictionary and
practiced more prior to the trip. We checked her tumbo (stomach) because she
complained of maumivu (pain). She was admitted with a diagnosis of threatened
abortion. We then removed the sheet and found her sitting in a pool of blood,
with the cord of the placenta protruding from her vagina. I immediately went
and briskly walked throughout the corridor to find the first doctor I could.
Dr. Mahangay came with me and he immediately asked me and Anna to find a
stretcher because she needed to go to minor theatre (minor surgery). I got to
scrub in to surgery, and use my knowledge of aseptic technique. I assisted with
the removal of the rest of the contents of the uterus. There was no way to save
the baby because part of the contents had already been expelled prior to
beginning surgery. My heart broke as I knew that this woman had lost her baby
at the age of 17. The doctor’s words did make me feel better though, because he
said that I saved her life by coming to find him. If she did not get immediate
medical attention then she would have bled to death. Later in the day I got to
hang blood for her and monitor her vitals throughout the transfusion, which
went well until a few hours ago. She spiked a fever of 103 and so I sought out
more medical attention. Sometimes when you get a transfusion, even if the type
and crossmatch are the same you can still have a reaction. Many times in
America people are premedicated with Benadryl and Tylenol to prevent adverse
reactions. Unfortunately we do not have all of the resources here. There is no
pyxis or room with dawa (medicine). The medicine sits in a cabinet and you have
to get a prescription to go pick it up from the pharmacy nearby.
I believe that the highlight of my day was working with a
woman who has stephens-johnson syndrome, which is a skin reaction in response
to AIDS drugs. Her mouth is covered with sores and appears as a large bleeding
scab that might fall off soon. Her entire body is covered with sores, and the sores
are not limited to external surfaces. She has sores in her mouth, down her
throat, and in her eyes. I got the privilege of being able to clean her up. We
mixed half hydrogen peroxide with half water and gently padded her face, and
let the liquid drip on her lips and cleanse the surface. Then we would take a
tongue blade and wrap a small cloth around the top. This device would be dipped
in the liquid and then gently put further into the womans mouth to cleanse
deeper. She frequently would have to spit out bloody mucous into the basin, and
the pain was written all over her face. I cannot imagine how it would feel to
have sores on every inch of my body, intern and external. And as if this is not
enough, part of stephens Johnson also causes swelling in the feet. Bilateral
feet are filled with so much liquid they are translucent when shining a light
on them. In better terms, her feet are large blisters covering the entire
surface of the padding of her feet. She can hardly walk to use the bathroom,
and stays in bed for the rest of the day. I have not seen any family come and
visit her and she has been here since we arrived. Yesterday Anna and I got the
opportunity to pray with her and we just held her hands and brought our
requests to the Lord.
There
were many blessings today, and I find myself very excited about
the little things. The ability of the stevens Johnson syndrome had the ability
to spit today, the precious little girl with malaria got to return home, I
successfully started an IV, Anna successfully started an IV, Ashli successfully
started an IV, Erin helped deliver four babies, a woman’s temperature of 103 dropped
to 98 today, another woman stopped vomiting halfway through the day, we made an
arm board to keep a vein open and readily able to infuse, the joy of poprocks,
and way too many other things to mention in one small post. The Lord is alive
and his work is very vivid in action. I love seeing my fellow nursing students
interact with patients and watch faces of small children, men,and women light
up with laughter as we say words wrong, show them fun new toys, paint nails,
use balloons, poprocks, beach balls, wall crawlers and many other fun things. I
can’t believe I only get to stay here for four weeks. Each day I wake up with
new possibilities, and new opportunities to touch people’s lives. I want God to
use my hands for his glory, and to paint new pictures with each action I
perform whether it be taking a temperature, hanging meds, sponge bathing, IV
starting, stretcher rolling, surgery assisting… and list goes on and on. God
please paint people’s lives with our actions and give us the strength as we
face fatigue and disappointment.
Thank you again for all of your prayers. Please pray for the
woman with stephens Johnson, the woman with the blood transfusion reaction, and
for all of those who have lost someone the last few days.
Tomorrow I will be in male ward.
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