Tenwek is a fairly
well equipedhospital and we can do a lot. We have a total of 13 ICU beds, a
CT scanner, a well-equipped OR with talented surgeons, an inpatient and
outpatient medical service that also boast wonderful physicians. However, we
also have challenges that are unique to mission hospitals. We are one of a handful
of ICU’s in the country: the next closest CT scanner is a two hour drive. We
don’t have STARS air ambulance to fly patients to another critical care site.
When patients come to our door they are ours and we have to treat them the best
as we can. We can occasionally transfer patients out for dialysis or other care
but these cases are few and far between.
I
mentioned that we have 13 ICU beds but for these beds we only have four ventilators, and five fully functioning monitors (more monitors are coming –
Praise the Lord). Doing care in this setting has its challenges. We have many
sick patients, and not all will recover. So we ask ourselves: can we intubate and ventilate the 70
year old with a stroke who may not recover? Probably not. What about the young
man with meningitis and brain abscesses? The man with meningitis might not
recover and if he is on a ventilator does that mean I can’t ventilate the young lady
who tried to commit suicide because she found out she is pregnant and has no
support? The suicide attempt has a high chance of recovery and finding the Lord and hopefully a support network when she recovers. These are questions I am asking every day. As well as the
question: is this patient getting better – does he need a ICU bed? What about
that young man he has not improved, will he recover? Should we send him to the normal
floor. As I work with every service (medicine, OB, Peds, & Surgery) I am
facing the pressure of the resource crunch every day. When a Doctor/Resident
needs a ventilator they turn to me. Sometimes I can say yes; other times the answer is
not now but I will see what I can do. I walk away thinking, what am I supposed
to do, make a ventilator out of thin air (there is some irony in that statement). Every time I have received that request, by the grace of the Lord, we
make something work. The patient who has been on the ventilator for about two weeks and was
recently trached as he was a difficult wean breathed on his own all day. So at
3 am, we try him again on trach cradle and he does well. Another time I was able
to get a new ventilator working just before another one broke keeping the census at
4. (Our machines are old and it does not take much for one to quit working).
These are just some of the challenges I face regularly. It does not cover the
other problems we face such as an inconsistent supply of blood for our blood bank,
lack of certain labs, lack of beds, lack of pillows etc.
Don’t get me wrong, I love working here and the challenges
keep life more interesting, however, there are times when I envy my life back in
Canada where I had a storage room full of machines, extra ICU beds across the
city and the ability to safely transport patients to such ICU beds. Please pray
for wisdom and patience as the staff and I deal with these problems on a
regular basis. Also praise the lord, as I have a few new (to us) ventilators
that have been donated and will hopefully arrive here within the next six months. As a side note if anyone has a BEAR 1000 ventilator sitting around that
they are willing to give me some parts for let me know.
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