Tuesday, January 25, 2011

Back to Work

The last few blogs have been filled with a lot of excitement. For a few weeks in a row I don’t think I had put in any five day weeks - with Mom and Dad coming, Christmas, Nairobi Visa trip and Kenyan Holidays. All that is over now and it is time to get back to work.

When we returned from safari I had thought of taking the rest of the day off as it was the last evening with my parents however, it was so busy that I could not just sit by. Mom and I took off to the hospital and Dad was content with his book in hand. Mom had a great experience as we intubated a fellow in casualty (ER) we almost coded a patient in ICU – I made Mom bag. There was also the desaturation of another ICU patient to the 60-70s, mom got to see me in action as I lectured the student nurse (he had written down the low vitals for the last hour and did not do anything about it) and as I turned down the new packaged non-rebreather mask for the one that had been bleached multiple times – this was all in less than two hours. I managed to escape the hospital for a few hours and chat with them a bit until the pager went off and I went up to set up a previously unused ventilator on a patient. The page came just as I had invited a friend to join the three of us for supper. The three of them did enjoy supper, I joined in late. All in a afternoon at Tenwek.

I feel like there are trends at Tenwek just like there are back home. I have noticed a few different trends recently, I had bagging afternoon where after a quiet morning I spent the afternoon bagging various patients: one with decreased SpO2 and three others who had coded. Sadly none of the codes survived, especially difficult as two of the codes where pediatric patients.
Bagging afternoon led to fixing bagger day. Tenwek reuses almost all their respiratory equipment. This includes baggers (ambu baggers as we like to call them here regardless of brand) that are designed for single patient use. As they are single patient use they are not made to last as long but stand up remarkably well, however there are a few styles that have a port on the patient side designed for a pressure manometer or delivering medications – this makes sense as long as you have the cap however after the tenth time something is cleaned the cap disappears giving us a leak when we bag. I realized this problem soon after I came to Tenwek and would remedy it with putting my finger there or plugging it with the cap off a sharp. However, I was the only one doing this meaning patients were only bagged effectively if I was around – as there is only one of me and I am not always around a permanent solution was in order. I asked the electrician who functions as biomed for something to fill the hole with that would with stand up to multiple jikings (jik is our word for bleach). I was given a 2 part epoxy and off I went finding every bagger I could and filling the holes. I am pleased to say that it has worked well, we no longer have a leak. I am still walking around with epoxy in my lab coat pocket so that I can catch the ones I have missed – one more thing to carry, lab coats do come in handy.

I have been busy with multiple lectures, as well new interns have started at Tenwek and after three years of medical school with minimal practicum they are quite green. This is in addition to the other teaching I am doing. Last week was busy with a lecture to the nurses about high flow cold nebs and venturis on Monday, Tuesday was a lecture to the interns on low flow oxygen, followed by a Wednesday lecture to the nurse anesthetists on ventilation by pathophysiology.  A busy week. The lecture to the nurses was the hardest as venturi and entrainment are difficult concepts and there is a lot of room for error but overall I think it went well.

Besides new interns at the hospital January has brought a lot of visiting staff to the hospital as well. This makes me busier in two ways, the first is visiting staff are not familiar with our (ancient) ventilators and need education as well they are used to having a RT around. I also am more willing to help out the short term visiting staff as they leave before I do meaning they will not be left in a lurch when I am gone, in comparison to the long term staff who need to get by without me in a few month. All in all I end up helping out a little more – but that is fine. The other part of having visiting staff here is a lot more (young single) people to hang out with. I have spent evenings hanging out, learning how to play racquetball, playing settlers and going for walks. Weekends have been games of ultimate Frisbee and hikes up Motigo. This had been wonderful I am enjoying getting to know everyone and the games are a lot of fun – I think I need to keep at it as I am out of shape. Racquetball was right before bagging day and my forearm was sore.

            Being busy both socially and at work has taught me to prioritize things. This has changed up my routine and it has been great. I now have to schedule time to take for God – this has been wonderful and I should have made myself do it years ago instead of leaving what time I have left at the end of the day, making time for God and setting it aside for him had brought so much more meaning and insight into my walk with God. Please pray for me as I take this time to get to know God better and inquire his plan for my life

Ultimate Frisbee - Waiting for the next play

I am gonna say I caught this one and then we scored (really I have no clue)

everyone laughing after the Frisbee hit "A" in the head
Still laughing - see even the Kenyan kids are laughing


  1. It is so neat to read how you are able to share your gifts with the staff and newbies. And I love hearing your ability to make-do, solving problems with a creative solution that ultimately saves time and a life! God is certainly working through your highs and lows, A. Strength to you.


  2. Thanks Annette, I love reading your stories. Thank you for posting for us!