Thursday, 17 January 2008
Need a presciption... or something?
I've spent the last few morning in a clinic that services Banaii, a slum area of about 10 000 people. Though I was origonally assigned to visit HIV patients, I was swapped out after the discovery that I am a "nurse". Origonally, I protested this title and tried emphatically to explain the difference (several times). But how do I get introduced? - the "nurse". I am so underqualified for the expectations of this place, yet have the most education and experience in this field at this time. It has been amazing... the first patient had undiagnosed abdominal pain, and without an assessment I was asked to write him a prescription. I have since understood that it is totally expected that I write a prescription for just about every patient. I can put anything from pepto bismol (his) to morphine (I still can't imagine circumstances that would have me write this on a paper and sign it). It is so bizarre to have that authority and expectation. The next stories may not be for everyone, so if you don't like gross, you may want to stop... A little girl came yesterday, about 5 years old, her hands covered with pus sores and blisters and filled with dirt and filth. I'm not sure exactly what she has. I do know there were no gloves available as I took a needle and popped the pustuals, cleaning them as best I could with what was available. Then we bandaged up her hands and told her mother she must apply antibiotic cream and come back tomorrow to have the dressings changed as the infection is spreading. Today they didn't come. The 4 year old boy who came in today cut his inside ankle 5 days ago... today it is open, deep, and the outside tissue is beginning to die. We cleaned and flushed for half an hour but it was still dirty. I cut away the folds of his skin where it was still pushed inside the cut with dirty dull scissors we cleaned with alcohol - no freezing... He just watched and his only tears were when we attempted to pop the large bulge of pus under his skin with a needle. I hope he will return tomorrow so that we can use a scalpel to get rid of the rest. With the dead tissue still attatched, healing will be difficult. There isn't another place for him to go... I have so much to learn. So that's a peice of my day - would love to hear about yours:)