Wednesday, April 9, 2014

Maternity Week 3 :)

       This week Shawnel and I were paired together again on the Maternity + Post-Natal units. The week was a good learning experience, especially in preparation for our upcoming CRNE (the BIG exam). Though the week was not as eventful as a couple of the other girls who have done maternity, we were still able to get the full experience of maternity nursing in Zambia. 
       A challenging and different thing we noticed from Canada to Zambia is the length of time and overall nature of the labour and delivery process. It was very different for us to see that sometimes multiple women will be giving birth at the same time, in the same room. Then, not  30min-1hr later (sometimes sooner if more women need to give birth), they will be moved back out to the ward and then transfered to the post-natal unit. In Canada, women have an entire delivery room to themselves and after birth, are able to relax in that room for a longer period of time before having to be moved. Obviously, it is of no use to make comparisons between Canada and Zambia due to a variety of different factors influencing circumstances, however, the “having a baby” process here seems much less special than it’s made to be in Canada. Again, this is likely due to the increased number of births here, less resources, less manpower etc. etc. etc. Its just such a different culture here, a different mentality, and a different lifestyle. 
       One situation that really was particularly shocking surrounded one of the post-natal patients on the ward with a severely infected c-section incision. This woman’s infection caused her incision to dehisce (open all the way up) and then she developed a fistula (hole) between her bladder and the bottom of the incision causing her urine to leak through her incision, as well as a vaginal fistula. In Canada this would call for an IMMEDIATE surgery! Here in Zambia, she is on the top of the list to go in for surgery, but the constraint to this was the hospital had no blood bags that matched the patient. Therefore, no surgery until there is blood for the patient which can take days to come, and it took more than a week. Luckily the patient was generally stable, except having a unnervingly low blood pressure on average of 80/60 (normal is 120/80). The patient is still on the ward and has not received surgery. There is question as to whether they will be sending her to the capital, Lusaka, to fix both her fistulas, or if they will do one here and then another there because they do not have a ObGYN here to fix the vaginal fistula. 
This has been a common theme and difficult one to see that some patients are delayed necessary treatment because of the lack of resources and staff. It just makes us feel so thankful and grateful to live in Canada where we have any and almost every possible technology and medical device at out disposal if needed. It just blows my mind, no words can describe it. I can honestly say, I don’t think I will be complaining about a lab result taking to long at home anymore, or having to prep my patient for a CT during a busy shift because at least we have them and my patients will be getting the care they need, when they need it!
        Overall, maternity was a great learning experience and a chance to really step back and see the bigger picture. I learned to truly appreciate the life I live and the health care I have available. As frustrating as it can be here when there is such inequity and resources lacking, my biggest lesson from this week has been to always do everything I can with what I have here in Zambia. This is the key to really absorbing this experience and making the most out of it for us and our patients :) 

Until next week!! :)
- Caitlan S.
Some Extras from this week!
  • We got to go into the OR and watch a c-section of TWINS :) 
  • Shawnel got to see an abnormally great vaginal delivery!
  • Working with the 3 Quintuplets from Caitlin, Leah, and Savannah’s week on maternity! They are doing better and slowly growing and getting stronger! 
  • Recognizing that a baby’s nasogastric was not placed correctly and likely in the baby’s lungs. With a pH strip test confirming this, we inserted a new nasogastric tube and confirmed correct placement with another pH strip! 
  • Teaching a mother who had a premature baby about proper feeding as we noticed she was not feeding the baby as frequently as should be for a premature baby.

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