7th April 2011 (0720)
How wonderful and awesome are God's ways and plans. I don't know why we give so much praise to mens plans that don't nearly match up. You always know the who-what-when-where-why. We don't always need to know. We had a good-bye party for Sharrie. She's called back to a job in the U.S. I know it will be hard for her and Randy to be apart for 8 months.
8th April 2011 (0716)
How often I fail to just rely on God for my strength and courage. When things seem out of control, I need to stop to pray & let God's words come to mind. Everyday there is something frustrating about this job whether it's dealing with people not doing their job; having to remind admissions of the same thing over & over; the cleaning staff getting annoyed anytime I ask her to clean a bed (she'll clean all the beds we don't need before she'll clean the ones I ask for) or giving me a hard time about giving me sheets; administration deciding to implement a fee for our patients without telling us. Basically, our orthopedic service is stuck in an odd position because it's being run in a private hospital that has decided to up to this keep it free. But I do believe the workers know they are not paying, so they don't feel like they need to give them the same care. And then trying to balance the clashes between our doctor and administration. Sometimes I just feel overwhelmed and don't know how to handle these situations. After this, I'm not sure what is more frustrating. This or floor nursing. I think floor nursing was definitely crazier...but it was only 3 times a week. This I'm constantly here so I don't get a good break.
But regardless of these frustrations, I do love Haiti and the Haitian people. I love speaking Kreyol and I'm glad to help with whatever is needed.
11th April 2011 (0830)
How often we work and try to plan out every detail or our lives. How we try to please men to win their approval. Lord, how fruitless is all of this. Help me to show faith in, character like, and trust in You. I can trust that God will work out the problems in the hospital; He will help me to learn and memorize the songs for Gospel Kreyol; You will show me the right time to marry. So I don't need to worry or do things on my own. I pray for the hospital for to being seeking Your help when making decisions. I pray for collaboration and teamwork. I pray for the upcoming vacation to give us the rest & rejuvenation we need.
Lord, how often we take things for granted, even here in this hospital. The generators are going bad (and Haiti power is not reliable) so we are losing electricity a couple hours a day (which means no running water). Can you imagine a hospital that didn't have electricity 24/7 on a regular in the states? It is what it is here. We make do with what we have. (As I'm writing right now...28th April....the generators are going crazy....it's flashy in & out...and only some parts of the hospital have electricity).
12th April 2011 (1805)
I am a people person (well, maybe not as much as I used to be) but I love talking to people and sharing frustrations & joys. But, sometimes God (well all the time) I need to come before God first. Because other wards I am only getting mere man's opinion & judgment. At times, You will speak to us through others, but I really have to work on coming to You first before man. This is difficult for me!! Not saying I can't go to friends at all, just need to start with God. I am still need of refining from God.
Many people from back home ask me what it's like on a regular basis to work here. Of course there are many comforts I've given up- 24 hour reliable electricity; a variety in food, easy (and comfortable) transportation; all the supplies needed to do my job; family & friends; a well-paying job; etc. But truly, I don't have it bad at all. I'm getting a stipend to pay my bills & pay for all that I need; free room & board (even if it is dry rice & beans everyday); and a job. There are joys & frustrations like every job- such as a I love speaking Kreyol with the patients & nurses. I'm learning a lot of random skills & ways to make do and character building. It's the usual as a nurse job- super busy in the morning & have to deal with the same issues of people not doing their job. We start with rounds- then I'm balancing admitting patients & discharging patients; writing orders for the doctors; dressing changes & other patient issues (I act more like a Physicians Assistant than a nurse, but do some floor nursing work too). As of now, I don't have a translator. Most of the time I can get my point across by myself. Trying to keep things smooth between the ortho team and administration. I guess they've deemed my title as orthopedic coordinator. Some weeks I'm so busy I don't think I can handle it and others are a normal pace. ZJ (the social service year doctor) is working on improving policy & procedure to get things running smoother.
Work hours vary, but tend to be 40-60 hours a week. Occasionally, I get woken up in the middle of the night. In the evenings, we try to exercise & cook. I try to fit in talking to Wilshaw (not enough, I'll admit). Now, that I'm in Gospel Kreyol Choir, I also try to practice my songs every night (I have to memorize about 30 songs in French & Kreyol). Wednesday we are trying to make bible study. And then, at night now I'm trying to read a couple verses in the Kreyol Bible and look things up in the dictionary. Practice praying in Kreyol (because I want to be able to pray with people and talk about my faith).
On Sabbaths, after service, we usually eat together. Then rest or reading. Now I have choir practice or programs at 3pm. Sunday is a light work day, chore day, or visiting friends. Friday afternoon is my food shopping day. There are days I go to bed to late and days I don't want to get up for work. But I do love my co-workers so that helps.
So, do I think I'm a "better person" for working in Haiti? NOT AT ALL!! Lol, it's just a passion God gave me. Living in Haiti actually feels like home now. We all have our own callings & places to live & work. For now, mine just happens to be here. I'm not scared walking down the street & I go shopping by myself (well always with another person...but they don't have to be Haitian b/c I can purchase things on my own). I think I might at times be a little hardened to all the suffering and hardship. I will admit, in a lot of places in America, we are sheltered to extreme poverty. Here, it's in your face more and sometimes you just want to take a break from it. But of course, these people never take a break...they have to learn to make the best of it. The hard part is the people who have enough but lie to try to get more. It makes you hardened a little at times, because sometimes it's hard to tell who is faking it and who is really in need.
There are many things you see here (in terms of medical), that you rarely see in the states. We had a 28-year old motorcycle accident from 2 months ago come in. He was in another hospital (being seen by an American doctor) in Cap Haitien. He had a femur, hip & tibia fx. He had ex-fixs to hold the broken bones in place, but the tibia fx was still an open wound for the last 2 months. I went to take down the dressing over the tibia fx (didn't know it was an open wound), and saw his tibia bone broken in half still sticking out of his skin. I don't know what the plan was at the other hospital, but it wasn't working so I guess that's why they sent him here. And unfortunately I've seen lots of complications that I never saw in the states (or not often)- compartment syndrome 2 times, 2 people die from pulmonary embolism, and a probable death from anesthesia.We ran out of all our meds for DVT/PE prophylaxis currently (which really isn't the best for big fx).
When I sing with the choir, it feels like the choir back home except a different language and less personal space (the car rides are always nice & personal, lol). So, anyway, that's the normal as of now. We're off to get some donated supplies now!
15th April 2011 (0830)
I am so glad for this week of vacation. You know our needs God, however I do pray for those who do not get paid vacation either by choice or necessity. I'm glad to be here, but I will miss speaking Kreyol for a week. Yesterday we went to pick up supplies at J/P HRO, and while we were waiting for Richard to reutrn I was surrounded by a group of young Haitian men. I called my friend, Yonie, who speaks no english, and after one of them told the group "She speaks Kreyol", I guess as a warning to not say anything that don't want me to hear. I love that!
I think Beatrice, our 14 year old patient who had surgery to correct her blouts disease on March 13th (but developed compartment syndrome), was sad to see me leave. I spent 29 minutes listening to gospel kreyol music with her last night. I reminded her to call on Jesus in prayer for anything. 14 is still an age where they look up to people my age. I hope she chooses God as first in her life.
16th April 2011 (1950)
As the sun sets and another Sabbath day end, I have nothing but thanksgiving and praise to You, O God. As I read in Your word, it is so mighty and worthy of life. It refreshes and restores me. It helps me confess and repent to move towards doing what is better. I'm reading a fiction book about 5 women in the bible (well it is based off their stories, but expands it in a historical context) and a book about marriage. Marriage is hard, and I want to be as prepared as I can (I know it's a life long learning experience). Marriages are falling apart and it really affects the family so I want to be serious about it. I want my marriage to bring us closer and others to know Christ.
I am so thankful for wonderful friends that week after Your way and word. We can pray, study, laugh, implement God's word, and have fun together. I am thankful for quietness and peace as well as not all the dust and dirt in the air. The ease of transportation. A warm, comfy bed and no mosquitoes overnight. A warm shower. A break from living and working in the same spot.
I was just thinking about Spendie telling us when she was on the tap-tap about an illegal prescription drug seller selling lisinopril (a blood pressure medicine) as a vitamin. Oh my...lol, that's a disaster!! He didn't know what it was, but as a doctor she knew what it was. Oh, I do love Haiti...even the quirks. I've been told most Haitians would prefer to live in Haiti, but come to America because of better jobs in order to support family in Haiti. I do miss things in America. I guess you're naturally going to miss things you grew up around.
20th April 2011 (0835)
We got to go to Animal Kingdom for free. That was fun! I enjoyed Disney when I went at age 14. It's expensive, so I am very thankful for my dad spending his hard earned money to provide us a memorable trip together as a family.
I've been enjoying the hot tub and talking to Wilshaw on the phone and being able to understand everything clearly. And I've been getting lots of practice on our songs.
25th April 2011 (2219)
We have arrived back to what I call home sweet home. Thank You, Jesus, for providing a week away to get some sleep, an opportunity to read, visit Orlando, shop for things we can't get in Haiti, water park, enjoy the Sabbaths in a new environment, and talk to lot sof friends and family. But mostly, it was a time to not have to stress about the daily routine of work and be away from living in the hospital.
At first, I was cringing about going back to the stresses again, but when you get back here and greeted with excitement, it feels good to be back. The one nurse told me she could sense that my presence was not there. How sweet- never had anyone say that at my other job. Beatrice discovered I arrived back today and called me to come visit.
I pray for Elisabath as it appears she is going into labor.
27th April 2011 (0703)
How glad and joyous I am be up today. I have many joys & praises- they decided orthopedic surgeries would still be free; a fan to keep me cool overnight; a mind to choose (free will); filling food; ability to sing, work, do my laundry by hand; a beautiful view of your nature in the middle of the city to study Your word; Elisabeth giving birth to a healthy daughter!
I'm getting back to the swing of things here. Enjoying speaking Kreyol again- it comes back easily and my goal is 5 new words each day. And now I'm working with Amy to organize the outside storage supply room. It's got so many random boxes everywhere. But if we can go at it, a couple times a week for 2-3 hours, it will get there. I mean there is an overabundance of some things we rarely use, but the things we use often are running out. We got about a garage full of hydrogen peroxide!! The hospital is starting to buy IV fluids and medicine.
29th April 2011 (0722)
The faith of others inspires me. My one patient that I was trying to get an IV in (unsuccessfully) would just tell me to try this spot after I missed one. And then he said "God is blessing You." Haha- how many people would say that when you've just stuck them 2 or 3 times and missed, lol! And the other evening (after sunset), the electricity went out for a couple moments (but you never know how long it will be off), and it was pitch black trying to provide nursing care. I was holding a flashlight for the nurse when the light came back on and she said "Thank You Jesus." Such pure and simple faith.
1st May 2011 (0751)
I am thankful for genuine for fellow sisters & brothers in Christ. I appreciate the gentle way Ossee & Coran approached me about my earring yesterday. They weren't judgmental but just respectfully asked me to remove it because in Haiti, they said people in the Adventist Church make it a big deal and they will talk about you (and then hence talk about the choir). Ossee said he's been in the states so he knows it's not a big deal and he has no problem with it. Coran asked about how it was seen in the states (tried to understand instead of judge). I appreciated their approach. And I'm very willing to respect cultural things.
I took my 2 female patients to divine service yesterday. I love girls around the age 11-14. There is a 18-month old girl that is slowly getting used to me. She used to always cry and hide in her mom's lap when I entered the room. Everyone else said she likes you, she's just afraid. She's adorable! Slowly, she's letting me come closer (especially singing songs with Beatrice, she's getting used to me). And then there's Maxi, the 28 year old guy I described before with all the leg fractures that were never properly dealt with and sent to us 2 months later. His bone is still sticking out, but the wound is shrinking in size! It hurt him a lot to change the wound, so I helped just to keep him calm. The whole time he was yelling my name (even though I wasn't changing it) so I told him to call on the name of Jesus. He had told me earlier I was patient and never got mad (well I guess I don't show it when I do). I told him I try because that's what God asks of us. That was a powerful example to how our attitude and interactions really will be noticed by others and can be used as witness tool. I truly pray for my attitude, interactions, and reactions to be refined to be like Jesus (no matter what comes on my plate). The best way to do that is staying in God's word and praying.
I was so happy I knew the songs at Gospel Kreyol practice. Although I had a cough and running nose, so it made it difficult to sing at times. I am so thankful for some friends I've made in the choir. I pray for each individual walk with You so that we are truly glorifying You and preaching to lost souls.
I'm happy my family gave my mom a special birthday yesterday! I pray that we continue to serve one another, be kind, and have patience. Let love (God's type) guide our interactions!
3th May 2011 (0712)
How sweet it is to get a good nights rest and then have lots of time for devotional in the morning. I rested very well last night, I need to cut out what is not necessary every night so I can go to bed earlie
I got to see Elisabeth's baby girl Donna. How precious is life! It could never have happened by chance or continue happening without an active involved God. I enjoyed being around Elisabeth's mom as well. I slept in the room with all 3 though, so I didn't sleep well that night. But I was glad to share the day with them. I am going to try to visit them more often. I want to cook for her. It was fun watching Elisabeth's mom teach her things of motherhood and it made giggle when they disagreed on the cloth diapers.
6th May 2011 (0716)
How lovely is God's name in all the earth. No matter what is going on here, that doesn't change the fact that You are an amazing and never changing God. How beautiful it is to sing songs of praise to You with my patients. I'm thankful for the choir to learn words of faith and then share singing with my patients because that is a huge part of their culture. And even the 18-month old baby allowed me to give her a kiss on the cheek! We have come a far way from when she used to cry everytime I entered the room.
I thank you for providing safety on the road! Amy went out to St. Marc today and ran into 2 issues on the road. They ran into a demonstration that was monitored by armed U.N. Soliders...they found a back road around it. Then, later, they were driving through Cite Soliel (the most dangerous part in Haiti), which we've driven through many times, but this time the car in front of them got robbed at gunpoint. It was a nice looking car apparently (filled with Haitians)- they don't particarly target Americans here...just people showing off their wealth. It's better to be in a ratty car.
Lord, life is uncertain here, so let us be prepared at anytime to die or that You may come back. And this applies to everyone- no matter if you live in the "safest" area of have lots of money. No one is immune to death. But we all have been the wonderful gift of salvation and eternal life (a place void of evil) through Jesus Christ.
8th May 2011 (0925)
I'm having a "uh-huh" moment for what marriage is about. While yes they are meant to be our lover and friend, ultimately marriage is supposed to be a metaphor of our relationship with Jesus Christ as to the church. Love and respect and honoring who has authority. So whether our spouse is doing the right things or not, we are asked to not to change, get even, or get them to try to treat us better but to please God in our reactions. So whether you choose a believer or not, we need to, as professing believers, obey God. I am glad for this time to prepare my heart for marriage. You know we needed more time to prepare us to be husband and wife. In the meantime, we have callings that have called us apart for awhile.
12th May 2011 (1300)
I'm so glad for another year of life. While God has prepared a better life ahead for us, there are still many joys and blessings in this life. 25 years, that's a pretty good age. It's funny how make every new stage of your life into the best. How time flies! This is my first birthday ever away from home. I miss spending it with my close family and friends, as well as my mom's TLC (Tender Loving Care). I had to make my own breakfast.
No, but a couple people knew it was birthday and have been telling others so lots of people gave me a birthday wish and kiss. It was also nurses day, so after the program today they sang happy birthday to me. So I did some work, but relaxing and reading in the cool now. Napping, practicing some Kreyol.
This week has been busy with surgeries, but thankfully a lot have been same day surgery. Only 1 generator works right now....just need to have a bucket of water for the morning in case. Electricity is supposed to go off early morning (5-7:30 am) so then surgeries can happen all day.
I've been trying to fight off the feelings of depression. I think it hit me in all my business, that I've made lots of amazing friends but haven't made a close girlfriend. I struggle without that, but I want to find my refuge in God's wings. I can make it and take it with Jesus. My life is in God's hands. Sometimes I get frustrated that I'm not better at Kreyol than I am, but I just have to keep it keep at it and keeping a learning a couple new words every day.
Yesterday it was nice to finish at a decent time (5:30pm) so I could sit on the roof to watch the sunset and practice my songs. It's so peaceful. If it wasn't so hot, I would sit up there now.
It's such a reality check when you hear of others stories- it gets your mind out of your own bubble. It's hard not to be hardened to things here sometimes because there are times when people truly have nothing, but other times people can afford it but think they can get things out of you. It's hard because all in all, I know that a lot of people I interact with have significantly less than me (even if they have enough to make it by each day). I guess this is called getting out of your "comfort" zone. It's going to be uncomfortable...but I guess it's better to be deal with uncomfort than live a whole life of comfort but never reached anyone else's need. Sometimes it's hard to be compassionate when you're tired and you have to deal with lots of people who can't pay for things in the hospital. I've never had to get involved with those aspects as a nurse in the U.S., but here I do.
Surgeries and beds are still free, but clinic, labs, & meds are costing now. So a lot of times, people can actually pay for those things. I have had to buy some things though. We put 2 of our patients in a building outside because they need daily rehab only. Apparently it was built for that reason (long term rehab needed for those who live too far to come everyday) by Project Hope, but now they're not sure if they want it for that. But Jamo decided it's just sitting there so we put our 2 pre-teen girls in there. It's always fun seeing post-op patient's back in clinic. Although they all think I can get them in sooner to be seen by the doctor. Everyone gets a number and has to wait in line (up to 8 hours...it's a full day even to go to the doctors in Haiti).
17th May 2011 (0720)
How sweet and wonderful it is to sit in a quiet spot overlooking the mountains and ocean, hear the birds and silence, and get away from the business of life. What a beautiful spot to do devotions in the morning. Saturday morning, the recognized all the nurses of the hospital for nurses week. I have to appreciate the measures the medical director and doctors went to to make the nurses feel appreciated. Because apparently the nurses were getting tired of getting told all they are doing wrong and not getting appreciation every once in awhile. They mentioned good nursing attributes about all the nurses. They even included me. They said I work a lot and I can speak with the patients. Then, they prepared a wonderful meal.
Saturday evening, we sang at a program in one of the biggest churches I've seen so far. It was across from the palace. There were hundreds of people inside, and about another 100 outside because there was no room inside. Just standing there there to hear. Never seen people do that in the states. If there's not a comfy seat, forget it!
Sunday, the medical director paid for us all (about 15 people) to go to a beach resort. I think the tickets were about 40 USD. That's extreme generosity and wanting to show that she cares and appreciates the nurses. It was a nice time to relax, play, and speak Kreyol. I realized I think I learn the most Kreyol with Beatrice and her family. When a returned, a 41-year old male with a 2-week old pelvis fracture threw a suspected pulmonary embolism (clot in the lung) after they finished manipulating his hip to put in traction. His oxygen sats were ranging 70-85%. They started him on a heparin drip and the sats came up. But, since the Haitian nurses don't know how heparin drips work (or maybe they do, but I couldn't guarantee he would get watched well enough overnight) and we weren't sure how stable he was, ZJ & I split the night staying up watching him. He is still doing fine, and with all that heparin his PTT Level is normal. Which mean he normally probably clotted very fast (heparin was given before the PTT was checked) which means he was probably very high risk for clots. Especially not being on DVT prophylaxis for 2 weeks after a pelvis fracture. Unfortunately, the PTT solution ran out, so I have to figure out what to do because it's really important to check it every 6 hours until therapeutic and then every day to prevent it being too high or too low. We still do have to do the actual internal surgery to fix the fracture. Now, as Amy said, we need to make sure he knows Jesus.
20th of May 2011 (0715)
So glad it is Friday! This week has been somewhat mentally exhausting. I've been busy, but half of the time I'm not sure what I was doing. But, I'm here to serve no matter what it is. I can truly say I enjoy serving my patients here. The hard part comes when you don't have everything you need. For example, this guy with the pulmonary embolism has never been therapeutic on heparin after the first day.We haven't been able to get him therapeutic again. Now ZJ and Terry are gone, so I'm left here trying to figure out what to do. I'll just have to ask Dr. Spendie, but I always feel bad because she works for free all the time for our patients. And I know this patient can't afford it.
And having professionals do their job poorly because they wanted to leave (and I don't think it's because they didn't know, but that they didn't care). Hanging ice cold blood after 30 minutes when it's not an emergency. I found him with elevated blood pressure and shivering. I got him warmed up and apparently he doesn't have any major heart problems. That was basically a stress test on the heart. He is fine, but I didn't appreciate the unprofessionalism from the Haitian anesthesiologist.
But, I really enjoy hanging out with Beatrice and any other long term patient with her at the time. They brought me new fruits last night, but I worked too late so I didn't see them. I'm exhausted from waking up in the middle of the night and working long hours. I guess it's hard when you feel responsible for the patient's overall care. In the states, I have to stress about it when their, but then I go home and rest assured someone else is taking care of them.
22 May 2011 (1135)
Medishare CMO (chief medical officer) got my telephone number and has starting calling about transfers almost every week now. I'm accepting the fact that I truly never get one day off that I don't have to do something medical. That's why they give us vacation every 3 months, and let me tell you I need it. I worked 2 years with only 2 weeks of vacation a year, but I don't think I could survive 6 months without a vacation here.
To me, my biggest ministry is connecting to the patients. Especially kids between the ages of 11-16. Divegline (a 13-year old girl with a femur fracture) said she didn't want to come to church again, but she decided to come. The message was given from a genuine follower of Christ and the speaker spoke to both my girls afterwards. The one guy even helped me bring them back down to the long term house and spoke to the girls. Then, Brittany and I went back later to sing with them and read a bible passage. They both believe in God, but they're at an age when it can be tempting to see what the world has to offer.
We sang at a tiny little tin-roof church on the top of a mountain yesterday evening. So beautiful, but hot until sunset. I ended up in front of the microphone again, but instead of making me move Roseandy and Tammi pulled me in closer. I did fine. I made one noticable word mistake, but got right back on track. It's so wonderful the experiences I have. I wish I could share the experiences I have better in words and pictures, but I can't. Some of the best experiences have no pictures attached. I'm not a very good writer, but I try to share the best I can.
I'm going to cook with Beatrice's mom today. She's so generous. She wanted me to know more fruits, so she bought me a couple fruits.
I started to get frustrated a little this week over little things. We have 2 IV pumps for the entire hospital. We used the one for the heparin drip, but realized it wasn't calibrated so it wasn't giving the dose put in the machine. So we had to figure out the difference based on what it gave and what it should have gave, and then titer the dosage to that. And then without Brittany here, the labs needed every 6 hours wouldn't have happened or they would have been wrong (because the first time they did it, it was very wrong). Overnight, even though it's a 24/7 hospital, the hospital really doesn't function. Most of the workers sleep. There are so many items, skills, and people not readily available working as a nurse here (and it's not as bad here as most of the hospitals in Haiti), that you really do have to be flexible. But there are lawyers here, so it's hard too because you do what you can for what you have here, but at times you know it's not all can compared to the states.
But there are many pluses as a nurse in terms of rewarding work. Connecting better to patients. Most patients are nicer, more grateful, and patient. Learning to communicate in another language. Interacting and working alongside the Haitians. Learning very random skills. Put in position where you are the one of the nurses with the most experience to take care of critical patients, but yet I've never had ICU or ER experience. I'm very thankful for Marc and ZJ to help me learn. ETC!
Well, I think that's all for now. Time for laundry. We made pizza last night, which is just a wonderful change from rice and beans. The hospital food has the same flavor, dry. I hate to admit it, but I probably would have been one of the people complaining about having to eat the manna for 40 years. I like variety in food, but I guess it really is a luxury and comfort.
24th May 2011 (0720)
I have been feeling joyful, content in the Lord, no matter the circumstances recently. And for God never allowing me to get pushed past what I can handle. I'm thankful for the people placed in my life, family in Christ to study The Word, and for keeping me even though I don't get enough sleep. I've been trying to quiet myself to hear God speaking to me. I noticied a couple times this week, that in a frustrating situation or when I'm busy, a bible verse came to mind and helped me handle the situation better than I was about to handle it on my own.
31st May 2011 (0410)
Any time of the morning before starting on our day is a good morning. The nurse woke me up to ask what pain medications she could give, so I showed her morphine was on the chart and showed her the vial (even explained how to give it). I decided to check down 30 minutes later, and it turned out she never gave the patient the medicine but went to sleep. The child was screaming. So I gave the medication and stayed up to monitor them. So I'd thought I'd take the quiet time for bible study. Everyone's sleeping, including the workers! The roosters and mosquitoes are up!
The group of 18 people arrived that we were prepping for. But, we all met together with them on Sunday and got most things set straight. Terry actually brought up most issues. I think he is handling issues better and being more understanding. Makes my job much easier and not so stressful. Especially last night when Medishare sent a young male pelvis fracture that they said was hemodynmically stable. He arrived in the E.R., so we put him in a bed. The nurse checked his vital signs, and came to get me because his SBP was 60. Needless to say he was not hemodynimically stable, he was in shock. I got Terry and the anesthesiologist and we got him out of shock but something was terribly wrong. By the grace of God, there happened to be a general surgeon on call who doesn't normally works here. He suspected abd internal bleeding (because the guy was struck in the abd by a car). His abd was getting bigger and harder and his blood count was dropping. He took xrays and discovered it was that, but the pelvis fracture was stable. After much reluctance from the American run hospital who sent him unstable, we took him back because they have a general surgeon and ICU. He didn't have much more time before he would internally bleed to death (probably 3 hours). It was 2 am in the morning. I don't think the patient realized how serious he was. Even his family didn't want to come search for blood. I had to break it down to them that he doesn't have until the morning. We got to bed at 3:30 am, and had to get up Monday morning to start a full day's work. And of course, I'm woken up again in the middle of the night. It's going to be a long, tiring week. Ugh, this is why I have to get away on my days off.
But, the group has been good to work with in terms of rules, working with the Haitian staff, and flexibility so I can't complain. There are a couple Haitian Americans with the group, and they'll speak some Kreyol with me. A lot of them think I'm learning Kreyol fast, but I don't think I'm learning that fast. One of my favorite parts of the day is visiting Beatrice and her mom. We laugh, talk and they love teaching me new words. I hope to visit them in July. Maxi is leaving tomorrow morning and Divegline left already. As well as another good part of my week, is speaking with Gospel Kreyol. Sometimes it's hard in the large group to understand because it's fast and lots of people are speaking loudly at once. So I tend to be quieter, but I enjoy listening. I do better with one one one conversations. I'm running into this problem, that there are too many people who speak English or want to learn English with me. Number one, I don't have time to teach English. Number 2, if I spoke English with everyone who wanted to speak English, I wouldn't advance as fast in Kreyol. I'm torn what is the right thing to do. If someone came to the U.S., I'd have no problem speaking English with them. But since I'm here, I want to speak the native language and advance. It's hard because I don't think they realize I speak too much English already because I'm around lots of Americans.
6th of June 2011 (0715)
Last week was so busy and long days, so I am really glad to get a slower week. Jeff and Francel are 2 calm and nice pediatric specialty orthopedic doctors to work alongside. We got 2 calls from Medishare for a pelvis and hip fracture, as well as Louison (previous spinal cord injury surgery we did) who fell and it loosened the previous plates & screws we put in. But they will all have to wait until Terry returns.
We actually only ended up with 3 inpatient and 2 outpatient by the end of this week, which isn't bad considering they did about 28 surgeries this week. It was a self-sufficient, cooperative, and pleasant group. They pre-oped all the patients (everyone got a H&P), handled the scheduling, and had nurses to work the recovery room. They set up the PACU nicely and brought lots of useful items. We had a dinner at the oberge. The main doctor, Dr. Jon Hezenberg is Jewish, so no arguments about no surgeries on Saturday. Plus the group wanted to get out. Dr. John was really nice and taught me a fair amount about TSF's on Saturday.
Sunday was a catch-up on sleep (well afternoon nap), laundry, and that was about it. We went to the delimart. On our way out, we tried to ask the guard a question but he told us to hurry up and get out. When we returned to enter the hospital gates, we found out why. Police showed up as we did. Apparently a visitor punched the chief security guard when he told them visiting hours were over. The guy called these police who arrived at the gates, but Francois (the security guard) left to get trusted police. So he told the guys at the gates not to let any police in. And the police did not appreciate being told they could not come in. Then people starting jumping through the hole in the fence. Of course, they couldn't let us in because then everyone would want to come in. So we found a back way through forests and a hole through the barbed wire fence. We made it back in safely, but dirty. It finally resolved, and they arrested the troublemaker. Nathan say it really only escalated to that point because security wasn't doing their job well. He said first thing today, that will change.
10th June 2011 (0648)
How grateful I am for a sunny day and life. We had lots of rain the last week, and a dozen or two people died in mudslides. This week has been wonderful working with Dr. Jeff Young and Dr. Francel Alexis. They're both calm, nice, and flexible. But, yesterday, we had someone go bad coming out of surgery. They're not sure what happened (clot, stroke, abd bleed, aspiration, etc) but he was fine throughout the surgery. Completely cleared for surgery, blood sugar & HTN controlled. He had a spinal, but started losing conscience when they when closing him up. We checked his blood sugar which was fine, but his blood pressure & sats started dropping. He ended up going into cardiac arrest. We tried to revive him for 1.5 hours but he didn't make it. It's hard to say why he died, but he was 5 days post a hip fracture, and was not on any DVT prophylaxis before coming to us. And unfortunately the Haitian anesthesiologist was not the best. She wasn't able to intubate him and didn't help with the code. But, we had enough qualified other medical staff to run the code.
I'm learning codes. I never had anyone code in the states here, but this is the 6th I've seen. And I don't even help with the NICU baby codes. It's just crazy, and I need to sit in some practice codes to get more efficient.
12th June 2011 (1252)
What a wonderful opportunity to get away from the hospital. It's just a needed day away for all of us long term volunteers to enjoy nature and relax. Haiti is actually beautiful once you get outside of PaP. We had to get up early, but it was worth it. My stomach was been upset the last 2 days, but I think it's mostly stress. I just worry about our patients sometimes. After having 2 unstable people in 2 weeks, I constantly feel uneasy about some patient going bad. So Nathan, the head boss, decided we all needed to get away because we have no group here this week.
I realized my ministery is children between the ages of 12-15. Sondy and Beatrice and both staying in the long term house. It's a joy to me to have both of them there at the same time. I went last night to talk, read the bible, pray, and sing. I want to do that every night this week because this opportunity won't come that often. Time just goes so fast! I never get to do all that I want to do. I haven't even seen Elisabeth and baby Donna in like 6 weeks.
I visited Roseandy's apartment on Saturday evening, for a small 1 bedroom and sharing a kitchen and bathroom, she pays 3,000 HD per year ($375 USD per year)...which isn't a lot compared to what we pay. But, imagine lots of Haitians only make 125 USD or less a month. It was a study house overlooking a corn field. It was back from the main road, so a little more peaceful. There is a mountain across the street and she said it's cheaper to rent there (about 1,000 HD per year...125 USD per year), but everything is crammed together and you have to trek up the mountain. But she said those living on the mountains, did not feel the earthquake on January 12th. Although mudslides are probably a danger.
I'm excited for this week to be calmer because we only have Dr. Francel (the Haitian orthopedist who will be doing 6 months of fellowship here). I can get more Kreyol practice, especially in rounds because we don't have to translate to any American doctors. He tends to revert to English with me because he worked with mostly Americans in the Dominican, so he's used to speaking English to his co-workers. But lunch on Wednesday, I ate Mac and him so that was good Kreyol practice.
We took off the cast on Beatrice foot because she said it smelt bad and hurt. It ended up having a infection, so today we had to clean it out in the O.R. I feel like a clutz in the O.R. I need to spend a couple days so I can help with Jeannie is not there.
I really enjoy just having choir practice on Saturdays instead of a program sometimes because we do devotionals and then just sing. Then we end the Sabbath together.
21st June 2011 (0717)
I feel like a lot of Haitians go to bed early and rise early, so I need to adopt that practice. I guess if I had no electricity or internet that would help. I just have been feeling exhausted all the time. I was going to be done at a normal time yesterday, but then I had to write a medical report on a 19-year old male patient who has a bone tumor growing on his shoulder and down to his bones. They started arranging care with another hospital, which was fine with me. Apparently this place might be able to get him to the states, which would be better. Apparently it's a massive surgery they have to do to remove his arm, part of his shoulder, etc. There are lots of big vessels there and nerves. They have everything easily accessible in the states (including an ICU), so I'd prefer them to do it their if they can.
So, I try to fit everything in. Talking to Wilshaw, exercise, and Kreyol practice. Excited it's less than 4 weeks until Wilshaw comes down. Robenson bailed on us because he's not setting up the ride, but it might actually be nicer that way. I'm still going to try to find my way to the orphanage without him
Terry's back, and we have 2 doctors, as well as 1 resident & medical student staying for 5 weeks. And we have an anesthesiologist, praise the Lord! We got 1 of 4 of the hip surgeries done. There was a MSF hospital shutting down that sent us 4 hip fracture ladies between the ages of 66 and 87.
26th June 2011 (0900)
I always love mornings to wake up slowly and not have to rush into anything. I'm thankful for the opportunity to visit other church homes as a choir to worship God with them. I'm thankful for the group to laugh with, even though I'm always squished in the car and can't understand all of it. I somehow ended up sitting in between the 2 joksters of the group, so they would go back and forth standing up & sitting down telling jokes. I am slowly starting to get more of the jokes. Haitians love jokes, story telling, and singing. Glad I can join that part of the culture. Then, I spent about 2 hours with Beatrice and Chademere last night. It's time well spent. Chadmere is a 14 year old girl with bad rickets, they placed a device on her leg to make it straight. She's staying longer term for therapy. There's many people I want to spent time with, so sometimes I need God's guidance on how to spend my time the best.
This week was pretty busy- they did surgery all 5 days, but a lot of them went home. I worked in the recovery room. I'm learning because I have not had formal Pediatrics or recovery room training or experience. They have a thing called an oral airway, just to keep the tongue down so it doesn't obstruct the throat. Well, the guy starting gagging on it, so I thought it was time to take it out. Then his sats dropped to the 80's. I ran and got the anesthesiologist who put oxygen on him and taught me a technique to keep the airway open. He did fine, and we got him up and coughing. But it sure did give me a fright. I"m not used to taking care of patients with things in their mouths yet. I'm learning, and thankfully there are people to teach me- Marc, Summer, and Tim.
Other than that, slowly trying to get better at Kreyol everyday. I'm trying to make my night devotions reading the bible in Kreyol. That is really helping my Kreyol. I wish I could learn faster, but I'm getting there little by little. Mostly for work, I don't use a translator. I actually translate now for the doctors. I praise God we successfully performed all 4 of the hip surgeries. They're all doing well. 2 left, and 2 more will leave tomorrow. I still pray for them because the mortality rate is 50% a year after surgery. Mostly, for their souls to know You.
I feel so joyful in my soul. I am thankful for God to give me this joy and peace. I'm thankful for God refining my character (and I guess the trials & tribulations to do that). Even though it can be hard on the sleep habitat, I'm thankful for this opportunity to live with a body of believers to help me learn what it means to live as God calls us to live.
