Hola de nuevo!
This has been another super busy week! This time in the “sala respiratoria”- the respiratory ward, which consists of two rooms, one with 14 kids and one with 9 kids, mostly with pneumonia, asthma, and bronchiolitis. Because of the number of kids admitted with these diagnoses, usually both rooms are completely full and there are a few patients in beds lining the hallway. The residents there really work their tails off all day, and I hope that I was able to be at least somewhat helpful to them, although the management of disease and administrative process were both really different from what we do in the states so I spent a lot of time asking “where is this?” “How do I do that?” and things of that nature.
The residents continue to be amazing and welcoming here. Monday was a day off for “Heath Care Workers Day” (we need to get one of those in the States!), and so I went with a couple of other residents to a beach about 20 minutes here; I hope to have those pics up soon. It was really fun and relaxing to get away from the hospital to hang out for a while!
So, the paint… the hospital is being painted, which is good because it needs it, but bad because there isn’t enough room to rope anything off. Also unfortunate is the bright teal color of the paint, especially given that no one seems to feel the need to post signs in the places that were just painted! I don’t think that there is a white coat on the Pediatrics ward that has escaped! I never realized how often I lean against walls until I started having to clean my skirts with paint thinner!!
Boogers- wow there are some serious boogers going around in that respiratory ward! I mean, imagine 14 kids crammed into one room with their moms, all of them crying and hacking up a storm. Then throw in the heat and it is one fun time! Interestingly, there is an AC unit in that room which works, but the mothers don’t like it when we turn it on because they think that kids with respiratory symptoms will get worse if they are in an air conditioned room. Needless to say, my white coats have needed frequent laundering!!
The moms in the hospital are really in large part the care coordinators for their own children. The medical team, of course, prescribes treatment and medications are administered mostly by nursing staff, but due to the extreme shortage of nurses (try ratios around 15-20 patients to each nurse) and the complete lack of respiratory therapists, the mothers have to remember the timing of the nebulizations that their child needs, squirt the indicated amount of solution into the machine, and fire it up. They also do chest PT, remind the extremely busy nurses when the IV isn’t dripping anymore or there is another problem, and even bring their child’s urine sample down 3 flights of stairs to the lab. If a mom isn’t on top of things, it can really affect her child’s care. Sometimes there are dads or grandparents, but mostly it is moms, as most of the kids are breastfed. They stay all night sitting in chairs next to their child’s crib in this crowded room. It must be so incredibly stressful for them! I have seen some real gestures of solidarity- on Wednesday some of the moms were walking around the other wards taking up a collection to buy pulmicort for a child because her family couldn’t afford it (costs a bit under 5 bucks, which is a chunk of change here). Pulmicort, an extremely common medication in the States, is one of the many medications that the hospital is unable to provide. Any care that is provided in the hospital is free, but if we need to give a medication that isn’t available, we give a prescription to the parent, who goes out of the hospital to buy it at a private pharmacy. Obviously, we try to avoid this situation so I have made and effort to learn what is available on site.
On a lighter note, onions. I was walking with a couple of the residents and we came across a couple of nurses holding very fragrant plastic bags- fragrant good or fragrant bad depending on how you feel about the smell of raw onions. The resident asked why everyone seemed to be carrying one of these around, and the nurse replied that the hospital worker’s union was handing out onions that day. No one seemed surprised except me. As they explained, a few weeks ago everyone got some bananas!
Well that’s it for now- tomorrow will be a big day- I am climbing Volcano Momotombo and then there is a huge town fesitval! I will write all about it soon!
Best- Dra MV
PS Here is a picture of the famous “mystery bucket” from the last post:
