18/1/12 - Challenges: bring them on!

The new year has started good, nothing unusual, just working as normal, if you can say that its normal for a general nurse to be in charge of the main operating theatre in a maternity wing...

Midwife: no. Theatre nurse: no. In-charge experience: no.

As I have said before, the challenges don’t come to rare...

I have finally started getting used to bossing around, both with nurses, maids and doctors. Routines are in place, and I’m getting used to the different surgeries. All though there is a lot of things I don’t know yet, I don’t feel so completely lost as I did in the beginning.

Some other challenges we meet every day at work, is the problem of getting the things we need. I can say I’m so “lucky” not to work in the other wards, where the biggest problem is to get the medications that saves peoples lives, we don’t have many medications in theatre, only the anesthetist use them, but every day the order box comes back from the stores with only a small amount of the things I have ordered. For example, surgical sterile gloves, we only get in size 7, which is perfect for me, but for most other people, especially the male doctors, it is a big problem. Last week one of the surgeons got cramps in his hands because of poor blood flow since the gloves are too small!

And urine bags for catheter use we don’t get anymore, so we have to run around borrowing from other wards, but they don’t get it either of course, so I wonder what we will do when there is none... Imagination should come to a rescue I guess.

And every week I see disturbing and terrible cases and destinies. Yesterday we had two (!) cases of , Google it if you wonder what it is and want to know more about it, but it is a cyst that grows on the ovaries (don’t know if they can appear other places), its called a teratoma, and the cyst doesn’t consist of fluid only, no, it was actually filled with hair, and there was also a tooth in there. OMG! I felt sick when I saw it! And I was the nurse scrubbing in for the surgery, so I had to look, had to touch. It is not a very common thing here, so we were very surprised when the next case was the exact same thing! I wasn’t even over the first case, and there comes another one making me sick again!

And another thing we see here a lot, is patients that comes in, maybe a week or so after a cesarean section, laparatomy or other big surgeries, they had the surgery at a district hospital, and they have terrible complications. Peritonitis, necrotic uterus, wound infections, perforated bowels and bladder, you name it, they have it. And they come in to be fixed up, and it is not a pretty sight! The sight, the smell, everything... And we do our best to fix them, but if they make it through at the end, I don’t know. That is a thing I miss from working back home, the possibility to follow the patients and see results and outcome. I don’t know if I ever will specialize in this area, we'll see!

Dinner at Cool Runnings

The weekend after new years weekend, Tone, Frida and I went to Senga Bay and Cool Runnings to get some beach and sun. We left the Friday afternoon, came there around seven, it was raining (…) but we enjoyed the perfect Chambo (fish from Lake Malawi) dinner, the only thing I eat for dinner there. They prepare it so nicely! That night it never stopped raining, lightening, thundering, and it continued till next morning. We were not too happy about that, but around noon, the sun came out and we could enjoy some hours on the beach, get some sun. it was amazing! Bathing, reading, sleeping, and no sunburn!

In the evening the rains started again, but the next morning it didn’t, so we had some hours to enjoy again, but the sun didn’t come out completely, but it was actually nice, it wasn’t too hot. At lunch hours we headed back home. It was a nice and relaxing weekend with good company! And it was nice to see Samantha, Felix, Tiger, Isaac and the others again, people that work there. They know me by now, I have been there so many times! Its one of my favorite places by the lake!

Last week and this week we have had a “visitor” in theatre. She is Nicole, a German theatre nurse, has worked in Norway, Haukeland University Hospital, in many years, and is now in her third year of working in KCH theatre. She is very good, and very experienced, so she came to us in EMMW theatre to see what things we need to improve, find good solutions, and just help us out where we need it. It has been very good, she is a nice girl, I enjoy her company.

Update on Malawians in Finse:

Tuta is going home on Friday... Things are not good at home when he is not there, his grandma is sick, too many unsolved problems before he left, bad planning I call it. Call me cynical.

Mike will stay, it is not too nice for him I guess, but he is determined to stay and work, and I support him 100% on that. It would be a waste of money and effort to go home now, he hasn’t even made enough money to cover for the plain ticket. But we will see if he stays there as long as planned, now that he will be alone. For my self I hope he doesn’t...