We started off our practicum on the postnatal ward at Lewanika General Hospital. The postnatal ward is an area of the hospital that cares for women and babies after delivery, readmission of sick infants under 28 days old, and a neonatal intensive care unit.
During rounds with the doctor, we noticed how sick many of these babies were on this ward. We were particularly concerned about two babies this week, both presenting with neonatal sepsis and severe dehydration. Our nursing intuitions told us all that these babies required nursing support and care from us. When we assessed the first baby, we noticed his skin was very dehydrated-it was scale-like and tented when pinched. The heart rate and breathing was very fast, and a pulse could barely be felt, the baby was very sleepy, did not cry or arouse when handled. It was then that we knew that this baby required fluids in order to survive. We tried to assist the mother with breastfeeding, this was challenging for several reasons. First, the mother did not speak english and required her neighbour to translate for us. Second, the baby was so tired and weak, he could not breastfeed. As an attempt to hydrate this baby, we fed expressed breast milk with a syringe- and even this was not very successful. Out of concern, we got our instructor to also come assess. Unfortunately, as we left the hospital for the day we found the mother of the baby wailing outside (in Mongu wailing is a common grieving action when a love one passes). It was then that we knew that the baby had passed away shortly after our efforts.
We were very discouraged and frustrated, we would not see dehydration in an infant go this far without treatment and intervention in Canada. It got us thinking about how resourceful and plentiful the specialized health care team members are available to sick children in Canada. Here in Mongu, these resources are not always available and this prevents quick and effective treatment. Because of this experience we were determined to ensure that other baby remained hydrated and healthy. The next morning in rounds, we shared our assessment findings, concerns, and advocated for routine IV fluids. An IV was started on the baby, and we gave fluids through this. We also spent time with the mother, teaching her about formula feeding. The next day we noticed huge improvement in this infant! This was so exciting! His skin was not as dry, he was alert, and crying loudly.
Rebekah, Rebecca, and Nicole