February 19th, 2010 - 4:15am
It’s quiet this time of night in the hospital's adult tent. I am working the night shift (this is my first of four 12 hour shifts in a row). The hospital complex has a Big sleeping tent for workers, command center tent, wound supply tent, ortho tent, adult/xray tent, peds/ICU/OR tent. The ER is outside under a tarp. We have porta potties & only hand sanitizer. There’s a bush to brush your teeth. The whole place is surrounded by a fence & watched by military & Haitian security guards.
Last night it down-poured and my tent got soaked, as well as myself. Luckily, I got an empty cot inside the big tent so I could catch some dry sleep.
My first day, I woke up early thinking I might be working day shift. So I stayed up for awhile. I donated my supplies. I met the chaplain. We went around passing out Dum-Dums I brought for the children. Almost all the kids had a smile to their face. They are so strong for going what they have gone through. One child had his arm amputated with a pocket-knife. We met a beautiful baby boy that was born yesterday. We then went to the adult tent and prayed with the patients. We even had one guy sing us a hymn (in French Creole of course). I noticed that the patients sing at times, which is so beautiful to see that in the midst of tragedy.
This type of nursing is very different. I spent a lot of time just trying to get a flow of what to do. It starts with very basic assessment, passing meds, and making sure all the orders were done for the day; and then make sure people are breathing, IV bags are dripping, & people are medicated for pain. Our patients are lined up side to side with no privacy (no curtains) and no gender separation. The family members do all the aide type work and stay over night. Co-workers are great because we are all volunteers and want to work. Even the doctors are laid-back and easy to get along with. We are making do with the supplies we have and we were laughing together to keep the mood good.
I have 11 patients with diagnoses that range from: pneumothorax from a stabbing, malaria, a pressure ulcer on a paralyed patient, broken bones, and severe malnutrition. One patient was stuck under the rubble 22 days. His H & H is 5.1 and 13%...crazy! There are no blood transfusions. I also have wound vacs, foleys, external fixators, dressings, and a chest tube. There’s no real charting except for meds and if something significant happens. We have no heplocks for IV’s. We just have to leave the IV bags attached, so I’ve gotten good at pulling air out of IV tubing.
Luckily, we have plenty of Haitian translators & transporters. There’s one stretcher with wheels, but they don’t use it. Instead a couple Haitian men carry the stretcher by hand. The Haitians are hard-working and want to get their country back to functioning.