This past week I had the privilege of working in the Out Patient Department (OPD) at Lewanika General Hospital. The OPD is equivalent to the Canadian version of the Emergency Room. I am so thankful for the many Medical Officers, Nurses, and Doctors that taught me so much about the journey of a patient from entering the OPD to being admitted on a floor.
The first thing that I noticed about the OPD is that the morning starts slow. However, as I learned Monday morning the "slow start" is really not an accurate picture at all. Once patients are allowed to enter the hospital they must get their medical card, and vitals before waiting to enter the treatment/screening room. First thing in the morning everyone is still getting their vitals done but by about 9:30 -10:00 you get an influx of patients that take over the OPD like a tidal wave.
The majority of patients do not pay the extra cost to be seen faster and therefore it is very challenging to see and treat all patients out of the one small main room. Patients that are severely sick will be rushed to the front of the line after having their vitals taken. In my experiences, patients that had a decreased level of consciousness were rushed to the front of the line. Despite being placed at the front of the line, the health care workers would address their "urgent" patient in an unhurried manner, sometimes waiting to have treatment started or to be reassessed.
But the Medical Officers and Doctors were so knowledgeable about the conditions seen routinely in the OPD. My one colleague taught me how to read and diagnose x-rays as they are one of the staple diagnostic tools available. I learned that symptoms and history are the key to diagnoses in Lewanika. I was given the challenge by one colleague to diagnose a client based on their symptoms alone and it took me most of an hour to finally provide them with my diagnosis. My colleague had diagnosed them in fifteen minutes and had sent the patient home with treatment in that time. The staff there are so gifted at developing differential diagnosis, and the amount of critical thinking involved in that was truly challenging but rewarding to learn.
Despite having limited resources and space the nurses are able to accomplish a variety of tasks such as cannulation, catherization, and giving medications to patients. The teamwork between the Doctors, Medical officers, and Nurses was evident as they worked in such close proximity to each other. I really enjoyed my time in the OPD and look forward to my week at Lilimunga.