Welcome to the wards!

Yesterday was my first shift on the ward! To be honest, I have been a bit nervous to begin working here. I haven’t had to use my nursing skills for almost a month and a half, and I have NEVER had to be a pediatric nurse. (Kids and sick kids are very different in my opinion) I was told that nursing here is very different from home, but me--the worrier, decided that maybe it would be difficult. Maybe I would be bad at it, or maybe I wouldn’t like it.  Turns out that everyone was completely correct, and that yes in fact nursing is VERY different than what I am used to at home, and really fun (in a chaotic 40 people in a small space, playing a game of language charades kind of way.) Due to being a surgical specialty hospital, we select patients who do not have a large number of medical problems, so our patients come basically with their only issue being what we are about to fix. In addition to their health, our patients are very grateful, humble people who honestly don’t want or require much attention. A few times my patient said, “but what would I possibly need?” after my asking for the 50th time if they were okay.

For my first shift I had a very light load, just two patients. Yes, for all my SLU Hospital friends, that is t-w-o patients who are healthy! Definitely a change of pace! On the ship, there are a total of 4 different wards with about 70 beds between them all and a 5 bed ICU. For now we only have 2 wards open, and the one I am working in only has 12 patients filling our 15 possible beds. Once things pick up we will have a typical load of 4-6 patients, and if I am needed in the ICU it will be a one nurse to one patient ratio. (a super light load!)  My assignment for the evening shift was to admit one patient, and take one patient back from his surgery---It was so fantastically easy and joyful! 

A typical admission goes like this: An admission nurse brings them down to the ward from the dock, shows them to their bed and assembles their chart. With the help of our AMAZING dayworkers/translators we introduce ourselves, orient them briefly to the ward and then help them to look through their bag that they are given on arrival. The bag contains some brand spanking new GREAT stuff! It has a towel, handheld mirror, soap, lotion, toothbrush, toothpaste, balloons and crayons for playing, and a shower sponge (aka a “loufa” as we call them in the US --which every child and adult has thus far decided must be some kind of a toy, because what need would you have for that while bathing?!?!). The looks they have given them are priceless!    

All patients, caregivers and siblings must shower before they are allowed to sit on the beds. (This is required to basically get rid of any bugs they bring in before they begin living so closely to open wounds, and the 30 other people in the ward.) After showering we do a quick set of vitals, feed them dinner, and then they just hang out until the next day. During this down time we are trying to prepare them on what to expect after surgery, the importance of washing their hands, what kind of diet they will be on, what kind of surgical drains they might have, and how long they will be expected to stay on the ship to heal. Then we begin playtime!! There are kiddos running around, the mommas are talking with one another, the dayworkers translating, the nurses doing their tasks, and it is ONE BIG BEAUTIFUL MESS in a small small space. Let me give you a mental image of what is typical--At one point during the shift the cutest most mischievous little toddler was running around stark naked, squealing in laughter bouncing a ballon and peeing on the floor. He was scolded by his mamma for that one, but it really was truly hysterical at the time. (He is here for his cleft lip to be repaired)  His momma and little brother are staying on the ship with him and sleeping under his bed at night so she is a great extra hand for him. Later in the shift, my other patient came back from surgery for a massive tumor removed from his forehead. Within 10 minutes of arriving he was walking to the bathroom, chatting up a storm, and later even graced us with a few jokes. He got a little jealous watching the little ones playing a game of balloon volleyball, so he joined in. He was by far the best balloon spiker that I have ever played against! His smile was contagious, and he was possibly having more fun than the 6 year olds, instead of his feeling his 68years. By the end of the shift we had them all tucked into their beds sleepy from playing, and handed off to the oncoming night nurses.  

Something I love so much about our ship is that we literally put a mattress on the floor under the beds for the caregivers to sleep on. In addition to sleeping arrangements, while their child or parent is in the wards, they are provided all of their meals and showers. It’s a great set up and the best family centered care I have ever been a part of!We are able to teach them about the surgery, wound care, what to expect, and from day one they are involved. They are avidly watching, listening, practicing, and taking notes so that when they take their little ones go home they can continue to care for them. In addition to surgery specific teaching from the nurses, the dayworkers are educated on Malaria, cholera, hand washing, and other health topics. During downtime they can teach their own people and have pride in “taking charge” of some of our impact here. It’s really great to see them raising up their own people, and truly they LOVE doing it!

 As all good nurses do, we needed a “wind down period” so we headed up to the top deck to relax. We ended up sitting for about an hour and a half, listening to Pat strum the guitar, chatting, and watching the stars. It was truly an excellent end to a day that I had built up so much anxiety over. I think that nursing here will be great and that I will learn so much from our wonderful Guinean hosts! It seems that I will have the time to do all the teaching I want, will be able to really connect with my patients, and will just receive so much joy from them in return. I’ll keep you all posted as more happens, and I’m sure I’ll have great stories as I begin working my 4-5 shifts a week. 

One last tidbit of info before I head to dinner. -- Today, because we are low on patients at the beginning of the field service, I was assigned to a “special project” instead of a nursing shift. Turns out that myself and one of my bunkmates got to be Starbucks Baristas for a day! My working knowledge of coffee was definitely a huge help, but we got a quick 15 minute inservice before the morning rush came. As a corporation Starbucks donates thousands of dollars in syrups and coffee to Mercy Ships each year. Because of their generosity, coffee is DIRT CHEAP on the ship. Let me tell you, $1.00 for a latte brings out the masses! It seems that during the 2 time slots that it is opened during the day almost every person on board stops by for a drink. It was a ton of fun, a great way to meet new faces, and it turns out I don’t make it too terribly. So my dream job of hanging around and working at a coffee shop might just come true! 

I really hope all of you are well, feel free to ask if you want more information on a specific thing, and thanks for taking the time to read what’s going on with me!!! Have an excellent weekend!