|This is the entrance to the ICU, the stuff you see hanging over the ledge (which is outside) is Vent circuits, nasal cannulas, oxygen masks, baggers etc. it is all sitting here to dry. so when you need something you look for it here|
|This is our elevator, these ramps connect the ER, OR, and X-ray to the rest of the hospital. to transfer a patient from 1st floor (medicine) to second floor (ICU) we run pushing the bed up the ramps (we have to run because the Oxygen tanks are either MIA, we can't find a regulator or the tanks are empty)|
An evening earlier this week I was called to help out in ICU (as long as my pager is on I am on call, so far it has been OK, only 1 or 2 calls a week outside of normal working hours). When I arrived in ICU I saw a severe asthmatic on lots of Oxygen and sitting leaning forward so she could breathe better. The doctor on call was concerned we might need to put a breathing tube in. (Ventilating an asthmatic is hard anywhere and would be 10 times harder here at Tenwek). I shared his concern, the patient was following asleep while struggling to breathe she was so tired from breathing all day. We did a blood gas on the patient and it was normal - this was good. I went home to go to bed and told the Doctor to give lots of Ventolin and other drugs. I left praying for this lady and hoping I would not be called out of bed a midnight because she was getting worse. I slept well and in the morning she was doing great. In reviewing the nurses note I read this line “she is doing much better this morning thanks be to God”. Working in healthcare it is easy to look at what you have done for the patient and take the credit. This is not the case as those in healthcare know we can do everything right and the patient still dies or we do everything wrong and the patient still lives. Who is this but God.
Being at the right place at the right time. I think my time here is best spent educating, but how do you educate so many nurses and doctors if they do not understand where you come from. This week I have been at the right place at the right time I was in ICU when they asked them to help out in a code in ER, I was in recovery room when a newborn needed more aggressive resuscitation, I was walking through paediatrics when a child went unresponsive. These were all times when I was able to help out and see how things are normally done. Either God had me in the right place at the right time or there is always something going on. I would say it is both.
A smile. In Canada we routinely have patients who come in sick we treat them and fix what we can but these patients still need oxygen due to chronic lung disease. This is not a problem we do a blood test call a home care company and they set them up with a home oxygen system, some of which is paid for by the government. Patients dependent on oxygen is not so common here but exists and there option is to stay in the hospital. Fortunately we do not have as many as these patients as in North America. I met a lady this morning who is about 30 years old with 3 young children (Probably has pulmonary hypertension). She has been an oxygen prisoner since April. Her home does not have power for a concentrator and tanks would not last long enough. Her blood oxygen levels are low and a simple nasal cannula does not fix it. This means that she has been wearing a mask since April. Today I made her smile, and this was very encouraging I placed her on an oxymizer (a large nasal cannula). Finally her mouth is not covered by a mask and she can eat, drink and talk much easier. She is still an Oxygen prisoner but at least she has a little more freedom.
These were my highlights at the hospital from the week.