Week 4

9/26/10 (0911)

     Something about the simplicity of my room, not knowing anyone, and not having internet gives me quality time to focus on God, to reflect on myself, and change what is not right. I am thankful to have God as my rock because I could be nervous and overwhelmed right now not knowing anyone who can speak fluent English. But, I know that God is with me so I am not going to feel lonely.

     It's funny because back home I always felt like I had a never ending to do list, but here I do not. I guess since I do not have to cook, grocery shop, pay bills, do the laundry, clean, etc that frees up a lot of time during the week. I am very thankful and fortunate to have such giving parents that are willing to manage my bills while I am here. I don't think I could have done this trip without that. There are so many wonderful people in my life that have made this trip possible and I thank you all. I hope you know that I am making the best out of this missions trip as I can.

     One side note (OK, I know I have a lot of side notes): I have been told that the men are more domineering and forward here. Apparently most male doctors will not take suggestions from female nurses, but I have not encountered this yet (except the men have been extra complimentary). Also, I have noticed that it's only the males that ride on top of buses & hang off the side. They let the women have the safer seats.

     Well, I am going to venture out to see when and where I am eating. I suppose I'll spend the day reading and practicing Creole. I am actually comfortable today (not sweating up a storm). I was told it is slightly cooler up here. There does seem to be more trees.

     Oh, I think I forgot to mention when we were driving to the airport in PaP, that there were lots of metal signs fallen. Apparently there really was a tornado and a couple people died (5 is the number I heard) in PaP. I'm not sure if there is a storm watcher in Haiti like in America, so I don't think people have time to prepare their houses and get somewhere safe.


9/26/10 (2120)

     I do not know why I was so worried that I would not fit in here. I know You, Lord, taught me yesterday to trust You and that's what I need to continue to do. I'll admit, I was frustrated at lunch because there was no translation to what everyone was saying. I got myself discouraged. Talking to my family, Emmy, & Wilshaw did lift my spirits.
  
     But, You have already answered my prayers. The two Haitian female doctors want to practice their English and help me with Creole every night, which is what I wanted. They have a book with Creole, English, french phrases with an Audio CD. It has everyday phrases & words.

     I went to dinner with them- it was a delicious oatmeal drink and bread/butter. We hung out and watched music videos. It is a little crazy how much American entertainment is listened to and watched in other countries. We really do influence the world. We listened to a little of everything- gospel, R&B, French songs, & contemporary Christian music. I almost felt like I was back home tonight. All the 3 doctors I have met are under 30. They are all doing their social service year to the government. I haven't met a Haitian Doctor over the age of 32 yet, but we'll see what tomorrow brings.

9/27/10 (2210)

     Our lives are just a tiny speak compared to what God has created, history, present & future. May that help me to put my life in perspective. This morning started with not knowing when breakfast was again and not knowing when and what I was supposed to be doing. The lady, Sandra, was supposed to give me an orientation but instead just put me with the translator nurse Jonas in the clinic. I started a dressing change with him, but in the middle of that he took me to work with the clinic Doctor Karry Felix.

     So I'm not sure exactly what I'll be doing here but I'm taking it as a week of orientation. Karry is 26 years old and doing his year of social service after medical school before he can do his surgery residency. He taught me a lot today- medically and helping with the language. I helped him place a cast, which I've never done before. He told me his mom is a nurse so he has a lot of respect for nurses. You could tell because we talked about patient's cases on an equal level and he actually took some of my advice.

     At dinner, it was all in Creole! Well, everyone says the best way to learn the language is immersion in the culture, even though for awhile it is going to be frustrating & taxing on my brain. I like all the doctors and nurses so I enjoyed myself. It seems there are 4 or 5 doctors doing their social service; one OB/GYN Doctor, and 2 other general practitioner doctors that run the hospital & clinic. (I still think they are all under 35 years old). There is a maternity ward, adult medical ward, & pediatric ward as well as the day-time clinic. There are surgery teams that come 4 or 5 times per year to do major surgeries.

     Sandra told me I'd work in the clinic until my Creole is sufficient to do it on my own; but I'll have to talk to Shawn (the American director) when he gets here because that could take the entire 5 months. I don't expect to advance medically here, but I just want to feel useful. Living in another country and learning another language is something I've always wanted to do. It didn't work out during nursing school, so I'm doing it now using my nursing and love for God.

     I spent 1 hour tonight practicing my Creole. I'm enjoying eating Haitian food. I'm the only American on the compound right now, but I'm making friends so it doesn't bother me. Well, it's time for a good nights rest to get rid of this cold!

9/29/10 (2215)

     It's been a rough couple days. I know Your hand, Lord, is on this trip, so speak to me. Let me know what I am supposed to be doing. I like Haiti and the people here, but I don't see how I'm supposed to go about what they want me to do. Shawn came today and told me I would be on the medical ward, but I won't have a translator. Jonas will give me lessons two times a week that should be sufficient for me to work on the wards. They want me to improve their nursing care by working on the medical ward. But, there are a couple problems: The chart is in french and most of the nurses do not speak any English. So I don't know how this is going to work out. He wants me to fill in the gaps- things that aren't being done. But if I can't ask the nurses or read the charts, how do I know what gaps to fill in?

     I guess the doctors complain because the nursing care is not very good- orders are not being done; medications are not given when they are supposed to be given; nurses are not working the hours they are supposed to. So there are a couple hours each day that no nurse is watching the patients. Which is a little crazy- if this happened back home that hospital would be shut down in a heartbeat.

     I'm just frustrated because I don't understand how they want to help when I can't read the doctors notes & I can't communicate with the nurses or patients. I see what the problem & goal is, but I'm not sure how to go about it and if I'm the right person for the job. It's hard to ask someone from another country to take a role like this without a translator. He told me not to tell the nurses my reason for being there (to improve the nursing care) because they will make my stay miserable. But they're not dumb. They'll figure it out. Shawn said this is what they do with all nurse volunteers, so I'm driving myself crazy wondering if there is something wrong with me that I feel incapable.

     It's hard Lord, because I want to trust You. I'm just so confused and frustrated that I don't know how to go about doing my job. I feel useless. So, Lord, please guide me with all aspects- the where/what/when/how. I feel completely out of control so I need You to take complete control.

     The Haitian doctors are very nice (and they all speak some English), so that's not the problem. Shawn, the director, said you have to win the Haitians respect by knowing what you're doing. They don't care what certificates you have. How's that's going to happen because I don't know what I'm doing. It's been a long 3 days.

     I'm trying to stay open to this being where you want me to be. I'd feel bad if it doesn't work out here, but I can't stay if it is like this for 5 months. So, I did email the Adventist Hospital in PaP to see if they would still need a nurse.

     So this place has a clinic, medical ward, pediatric ward, and maternity ward. Each wards holds 10-20 patients and there is supposed to be 1-2 nurses per ward. There are 10 doctors on staff (5 full time staff and 5 social service doctors). They take turns on call to the wards and they all work in the clinic (except the OB-GYN). The patients have to pay for everything (medications, lab tests, etc) before it can be done. They even send the family with the slip of supplies needed (such as IV's) to pay for the IV's before we can put them in. They occasionally do credit for emergencies when the patient cannot pay at that time.

     They have an orphanage of disabled children that came about because of Haitians leaving their unwanted disabled children at the clinic. It's taboo to have disabled children, and there are no programs for special needs children in Haiti.

     Nurse Jonas does things nurses can't do back home- suture; drain large abscess, remove cast, etc. It's probably not the best that I don't have experience in putting IV's in. But I don't how I would have fit that into my nursing day back at my other job! There are 2 surgery rooms for when the surgery teams come in. That part of the hospital is protected by a big dog. There are lots of small & medium size dogs in Haiti, but no big dogs. The dogs on the compound are friendly and they like when I pet them. Even the big dog was friendly, but apparently the Haitians are scared of him. He was attacked once with a machete and has a huge scar down his face & neck. Poor dog!

     I'm finally getting over my cold so that has been nice. I am slowly getting a better orientation. My Haiti phone ran out of minutes, so I will have to add more tomorrow. I'm still learning how to use it. You add money and it's about 5 goudes/minute (that's about 10 cents/minute). There's no free nights & weekends!

09/30/10 (0742)

     I am so thankful for a peaceful nights rest and waking up feeling refreshed. I am refusing to start the day frustrated, but just rely on God today. There is no other way to get through the day. None of the phones and internet is working today (maybe the monthly allowance has been used up), so You are all that I have right now. That is good because You are the one I should be seeking first.

     It's so funny when you ask God for something, because He may do it and then you realize it's not what you thought it would be. I thought 6C (my nursing job in Pittsburgh) was overwhelmingly busy at times, and now I feel like I have nothing to contribute/it's not busy enough; and it's just as frustrating. I wanted to be around more of the Haitian culture, food, & language. I do like being around it, but it is taxing at times not to understand the conversations at meal times and during the day.

      The female doctors are still working with me to learn Creole in the evenings and next week I start lessons 2 nights per week with Nurse Jonas. Well, it's time to start the day. Jesus, be my driver.

10/1/10 (0800)

     I gave it my best yesterday working with the  Haitian nurses in the medical ward, even though they don't speak any English. I helped with the vital signs and a dressing change. I rounded on one patient with the doctor (all the doctors speak some English), so I felt like I could care for this patient well. She was in congestive heart failure and needed more lasix. I still felt like I didn't do much, but so it will have to be for now. I'm doing what I can under the circumstances.

     I spoke with Amy at the Adventist Hospital in PaP and she is going to get back to me about a need for me in their hospital. So I've decided not to worry about it, but let You work it out in the right time.

     I really enjoyed my evening last night with Stella. We spent 45 minutes practicing creole; we spoke in English for an hour getting to know each other better (they want the practice too); and then we watched the Spanish channel with English subtitles. The evenings make up for the confusing days. It's always nice to talk to Wilshaw at the end of the day too.

     There is one male doctor (Dwight) who would say good morning/good evening to me but nothing else; so I wasn't sure what to make of it. Well then I was sitting in the nurses lounge yesterday and he came in and spoke to me in English for about 20 minutes! I knew all the doctors have to speak some English (they need to speak English to go to medical school is what I was told), but I wasn't sure why he never spoke to me (all the other doctors have). He was nice and spoke English well. I guess he was just sizing me up before letting on the fact that he speaks & understands English well. The other doctors said he is a quiet person anyway. He told me he spends time reading English books. Well time for breakfast...I'm trying to be timely because Shawn asked me too. The Haitian culture is not timely (man I would fit in here well because I am not a timely person either ;)


10/1/10 (1305)

     I went to bed way too late last night! I wish I had time for a nap. It is a good thing that I love rice & beans because that is what we have everyday for lunch. In Haiti, they eat a big breakfast (usually soup or pasta) and lunch (rice & beans, meat dish, & veggies). And then for dinner, it is a small meal (an oatmeal drink & bread). So our dinners in America are like their breakfast & our breakfast in America is like their dinner. Maybe that is better though?

     I also think that my clothes are cleaned a lot better here by hand than back home using the washing machine. The laundry ladies are good and very friendly.

     I rounded on all 5 patients this morning (vital signs, assessment & I gave the one medication that I knew needed to be given). And then I charted (I really do only chart by exception here.) I hope the doctors can understand it. Medical abbreviations are different here. Like TA is blood pressure (tansyon) and they don't measure it in mmHG. So a blood pressure back home of 110/90 mmHg is written 11/9 cmHg. I had to get used to that because it's different!

    There were 3 nurses for 5 patients so I knew they didn't need my help. Back home I take care of 5 or 6 patients by myself and that's all they need here too, so I helped in the clinic doing dressing changes and I assisted the doctor with a thoracentesis (draining fluid out of the lung by sticking a needle through the rib cage into the lung and aspirating it out). So, I'm not sure what to do with myself this afternoon because there are only 3 patients in the ward, so we don't need 3 nurses. It's so crazy but I realized I'd rather be steady busy at work. I can't stand not having anything to do for long periods of time. It's good to have breaks, but not such long ones.

10/1/10 (1745)

     Well, Lord, I always say that everything happens for a reason. Some reasons we may never know or understand. Jonas was teaching me to suture a guys scalp laceration today. I couldn't get the licodaine to go in, so I stood back and let him do it. Out of a true mishap (and I wasn't even leaning over the patient), when he was pushing the lidocaine into the bloody tissue, it sprayed on my face. It happened so fast that I'm not sure if it got in my eyes. So I washed my eyes out well, but I still wanted to have the guy tested for HIV.

     Let me tell you, it was probably one of the worst feelings as I stood over the lab technician doing the test when he told me the patient was positive for HIV (and he checked it two times). I didn't really know how to feel- but I wasn't mad. It was a mishap, not an intentional mistake, so there was no reason to be mad. I don't even know if this young man knows he has HIV, probably not. And, I guess they don't bother telling him. Although looking back I think he should have been told so he can learn about the disease & learn what he has to do so not to spread it. But of course I wasn't thinking the mostly clearly after being told he was HIV positive.

     Earlier this week I was told by a doctor that one of the patients was admitted for lethargy and infection. He ended testing positive for HIV, but they did not tell the patient or family. They were going to send the patient to a nearby hospital that has a HIV clinic. They said sometimes the patients do not respond well when they are told they have HIV, so they decided not to tell him yet.

     After consulting 2 trusted medical professionals, I was told the transmission rate is only about 01.% for an eye splash so it is not recommended to take the HIV prophylactic medications. I'll just get HIV testing at 6 weeks, 3 months, & 6 months. And I've decided that I can't worry about it because I could drive myself crazy worrying about it. I just have to continue doing what I'm here to do- and maybe go above and beyond the standard precautions since the HIV rate is so high.

    So, I'm glad for this weekend to have off (and though I don't felt I did too much). I'm thankful for God's protection, wisdom, and strength.