So I have started my orientation in the ER.
The last two days have been interesting to say the least.
I got to the ER and a nurse name Catherine was still on duty.
She had been working since 4:30 pm the day before, she did not get to leave until noon.
So she was not super friendly (I would have told and orientee to eff off so I did not blame her).
She told me to sit in the corner while she saw patients.
I did not want to be annoying so I did what I was told.
I am not even sure how to describe the ER.
There is one waiting room with benches around the wall.
An open treatment room, with stained room dividers, and stretchers which are rusted.
Everything needs to be cleaned and pretty much thrown in the trash.
But they make do with what they have.
I ended up being with Lawrence (or at least I think that is what his name is, every time I say it to people I get a different reaction.)
Lawrence is a clinical officer, he said there are health assistants, clinical officers, nurses, then doctors.
Well he is amazing.
He is very compassionate, intelligent, kind, and skilled.
I first walked into the treatment room and two people were on the table.
One man had stab wounds in his head and the other woman had been scalped in a biking accident.
I was called over to help wash the debris off of her skull.
I could not believe that she was not in an operating room, her laceration was equal to that of an FOA.
They were pretty much able to just pull the scalp down over her face.
Then they asked me to suture the stabbed man.
I said no I do not know how to suture.
I would need to watch more, I think at this point I have seen enough that I could successfully do it.
After those patients were seen we drained a lot of abscesses.
I helped hold a seven year old down for a huge abscess on his elbow.
I hate that I cannot talk to the kids, I feel that at home this is what I rely on.
I think that you empower a child so much by giving them little choices and telling them what to expect.
I have no idea if they did this with him or not.
I was shoving my boob in the poor kid's face to stop him from seeing because I thought it was freaking him out more.
The nurse finally said, he is saying he wants to see.
I felt really bad.
But it was drained and wrapped and he was sent out on his way, sobbing the whole time.
The afternoons always seem to be the worse.
We got a woman who came in on a stretcher.
She would not talk or cooperate.
She had a fever of 40.1.
I took her blood pressure, it was very low.
An IV was started and no blood would come back.
Lawrence thought he was against a valve.
I told him no, she was just so dehydrated that she would not bleed.
We desperately needed fluids.
Guess what?
We are out.
No fluids.
How the hell do you run an ER with no fluids?!
They said hopefully the wards would have a few bags and we sent her there as quick as possible.
Shortly after that a man came in.
He could not sit up.
His face was sunken and he was very short of breath.
His pulse was high, bp fine, but was shaking.
We suspected he was going into shock.
He was also extremely dehydrated and in dire need of fluids.
Once again there was nothing we could do.
Have I mentioned that Mzuzu Central Hospital is the highest level of care in the region?
He was suffering so much.
I hated that there was nothing I could do.
I just laid my hand on his shoulder and prayed.
What else can be done?
Today was not a super exciting day in the morning.
We had another stab victim.
More suturing.
I was basically falling asleep.
Then after lunch Lawrence said there is a lady with bad burns.
Yes they were bad.
I would estimate that she was at least 30-40 percent.
The burns were the result of a fire.
She was burnt on her face, chest, arms, and legs.
There was already eschar.
An outside hospital had done some debriding and wrapping and had also put in an EJ.
There was still so much more debriding to be done.
I got to work.
The poor woman had absolutely no pain medication.
She was so tough for the thirty minutes I worked on her.
I felt terrible, I could see that her husband had tears in his eyes, as did I.
There was still so much debriding that needed to be done.
But we just wrapped her and sent her off to a ward.
Some of the things that shocked me are the lack of equipment and supplies.
I asked about a oxygen monitor.
He said they do not have one.
I also suspect there is no working oxygen.
I saw a portable suction machine, I am not confident it works.
I just cannot believe this is the highest level of care.
I really am hoping I never get sick here.
I am also impressed by the people.
Lawrence works hard and you can tell he cares.
I do not know how that is possible after seeing what he sees every day.
Also the patients are amazing.
There is never a complaint.
I am so used to dealing with angry, demanding parents at home, it is so strange that you can just leave a patient waiting in a room for countless hours and they will not complain.
They just wait.
The woman held her arm out for me to debride even though she is in agony.
The families all help, they feed patients, transport them, and do anything that is needed.
This is because they are grateful.
I'm back in the ER for one more day.
It will be interesting to see what tomorrow will bring.
It is not easy being in the learning role again, but I am doing my best.
It is also difficult to see so many people suffer without the help that is needed.
But I know this is why I came here.
I am constantly looking for a way to make a change.
Hopefully I will be somewhat successful after these two years.
Well I better head back and take off my only pair of pants I have to wear for these next four weeks.
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