last day in the ward

19 Jul

Today was our last day to round on our patients in the pediatrics ward.  The ward was beyond full with 59 patients (remember, only 37 beds).  Moms and children were sleeping on the floor in the middle of the room and between beds, and there were two children per bed along one side of the ward.  IV poles were everywhere with fluids and blood transfusions hanging.

The nurses lined up the kids in the middle of the room who weren’t connected to an IV pole for us to start seeing.  We essentially start at opposite ends and the moms carry their children down the line of stools until they get to us to be seen.  We then round on the children with IV’s connected – they stay in their beds and we come to them – though the ward has been so busy lately that Dr. Hewitt, Dr. Wilson, and Dr. Dickens usually make it through the rest of the hospital before we finish and come to help us with the kids.

We were able to send many home today – a lot of the admissions from last night just needed some extra fluids or a transfusion.  It’s crazy how much our concept of an acceptable hematocrit has changed since being here in the middle of malaria season – we pretty much only transfuse for hematocrits below 19% (in the U.S., we typically transfuse for anything below 24%, sometimes higher).  We have also become experts at feeling large spleens and livers in kids when examining them – a skill we were excited to master.  We feel ready to be senior residents in charge of many patients, and are not as scared to be the one to run a code in the hospital when we get back home.  It has been such an amazing experience.

Rachel’s translator for today is named Ralph.  He is a fabulous translator and is so interested in learning – he always asks questions and does such a good job explaining things to the moms of our patients.  He told Rachel at the end of rounds that if he had the power, he would give her an award for the hard work she has done here.  He said that it “is better” with us in the pediatrics ward and he wishes we could stay longer.  All of the nurses have been telling us how sad it is we have to leave and that we must return some day.  It has been so encouraging to hear these words from them.

This afternoon, we held an in-service for some of the nurses on treatment of seizures (see previous post, “all for good”).  We discussed the physiology of seizures, the potential complications of having seizures, the mechanisms and indications for valium and phenobarbital, and the proper doses of each.  We were surprised by their enthusiasm to learn – they participated actively and asked great questions throughout the presentation.  We went over several cases at the end to illustrate the concepts we covered and they had clearly been listening as they were able to answer all of our questions correctly.  We then spent some time answering their questions and discussing some scenarios they had seen on the wards.  It was encouraging to see how interested they were in learning and how appreciative they were for the in-service.  Unfortunately, the pediatrics ward was so busy that none of the pediatrics nurses could come.  However, those that attended agreed to teach others and we are planning to type up our presentation and provide it as a handout for all the wards to review.  We have also re-designed the protocol of standing orders for the pediatrics ward – it will be hung in the pediatrics ward.  You can see the new protocol under the documents section on our blog.

We then distributed all the left over supplies to various wards – blankets, onesies, diapers, and bulb syringes to the maternity ward, surgical supplies to the theater, medications to the pharmacy, and band-aids, medications, medication syringes, pediatric nasal cannula, and the glucometer to the pediatrics ward.  The nurses in the maternity ward were so sweet – they thanked us and expressed their sadness that we were leaving “just as we were getting to know each other.”  Everyone was appreciative and wished their blessings on us – it was like Christmas.  So fun.

Tonight, we are apparently having pizza for dinner – they must have read our minds!  We are then going to the Nyhus’ house for dessert (ice cream sandwiches made with chocolate chip cookies!!  so excited) before heading to the village streets to pass out glow bracelets and necklaces as our last hoorah with the kids.  We leave at 3 a.m. tomorrow to drive back to Tamale to catch our flight into Accra.  We are sad to be leaving, but so thankful to have gotten to come.  We have been so deeply blessed by the people here – by their hospitality, bravery, sense of community and willingness to accept us into it, joy, and faith.  Our God is so, so good.

– Courtney & Rachel

3 Responses to “last day in the ward”

  1. John Dickinson July 20, 2011 at 2:49 pm #

    Thanks for letting us join you in your journey thought this blog. However, you should have included a warning at the beginning, “Reading beyond this point will require Kleenex!”

  2. Jen July 21, 2011 at 11:54 am #

    I have no doubt that the hospital, the pt’s, and nurses, the other physicians… they are all going to miss your presence dearly. Isn’t God so good to involve us in His work and allow us to touch the lives of others? What a blessing you two have been the children and families there. Can’t wait to hear more stories!!

  3. Karen Tucker July 23, 2011 at 1:03 pm #

    What a wonderful experience for all of you; I’m so happy that you were able to go together. The blog has been something we’ve looked forward to every day – being able to share your adventure through words and pictures has been such fun. Made me smile to hear of you passing out glow bracelets to the kids.

    You leave behind God’s work – he will bless that.

    Love, love, love, love (that’s one for each of you),
    Mamasita

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