Mission: Survive one clinical week on the Male Ward.
Details: In the face of lacking supplies, extreme nursing workload, a language barrier, an unknown hospital political process, discouraged critical thinking and an evil doctor, you must care for patients in every way you can, and come out of it with your head still perched upon your sweat soaked neck.
With so many things stacked against them, it is a wonder that patients, family and nurses alike make it out of there in one piece. The “supply room” is a spacious room, but only because there is next to nothing in it. It contains just a few boxes of IV fluid and some catheters on the floor along one wall. Even clean linen is scarce. The number of patients fluctuates, but you can be assured that there will be at least 40 patients (medical and surgical combined) on the ward with only 3 nurses to attend to them. There are often many students on the floor though, so they seem to manage in their own way. One of the most difficult things to work with is the fact that the nurses here are not taught critical thinking skills. These skills actually seem to be discouraged, and the only purposes the nurses have are to clean and to follow doctors’ orders. Following orders isn’t necessarily a bad thing, but there are often times when a patient becomes quite sick suddenly and the nurses do not act because they do not have a doctor there to give the orders they need. And no, they do not call the doctor for help regularly. It was during these times that Nicole M and I were really able to kick butt and get things done, using our critical thinking to do what we could with what we had.
My stand out moment this week was the care for a particular patient on the floor. We noticed that his mattress had been moved to the floor overnight, so we went to check on him. He was semi-conscious, naked and covered, from head to toe, in his own feces. After a quick assessment we went to work cleaning him up and trying to talk with him as he became more alert. The nurse we were with though didn’t seem to want to come and help us even to just translate what he was trying to say. After scrounging up some linen we were able to clean and cover him, and we sat him up by leaning his mattress against his bed post, as he was too weak to sit by himself. His mouth was also covered in sores and muck, so we cleaned out his mouth with some of our supplies. It was then that he smiled at us. That single moment has made my trip here so worth everything in so many ways. Later that day when his guards came in they went to talk with the nurse. We heard them talking, laughing and saying “makuwa” (white person) a few times. We asked the nurse what they were talking about once the guards had left and though she didn’t really answer that question she did tell us that he hadn’t eaten in 5 days. You see, it is up to the family members to feed the patients, and he didn’t have anyone in the hospital to see him. He also was unable to get food for himself. The hospital provides one meal a day however, so we made sure to feed him when they came around with the food. We also asked her to tell the nurses to feed him when food comes, but who knows what will happen with that. I was really disgusted at how much the stigma of being a prisoner affected the ability of the nurses to care for this patient, but I hope that our actions were watched closely by the nurses (as I believe they were) and that they may take even just a moment to think about us and why we acted the way we did. Hopefully, these small thoughts will eventually turn into something a little more that can help the patients of the future.
Clinical week 3 of 5: Completed.