The week in review

Isn't this the title of a section of the sunday newspaper in some city I've lived in? Anyways...

Monday: First day at the hospital, I can't remember anything specific about the day...oh, right, the doctor who did rounds was this guy with a really dry, dead-pan sense of humor that took me a little while to adjust to, not really something I've come across much in Ugandans. At one point he's writing in a patient's chart and says to me "what is 'ah-cahn-swah'?" I said, "sorry?" he repeated it again, and I still had no idea what he was asking me...I wasn't sure if he was quizzing me on some medical term or medicine or Lugandan term or something...I finally repeated what I heard said and replied, "I don't know what that is." He started to write the word on a piece of paper..."Ooooohhhhh, Arkansas! That's a state south of Missouri, where I am from." And he went on with whatever he was doing...so random...Oh, and then there's the volume challenge...Ugandans speak very quietly when they're trying to be polite, so quietly I can't hear them, and it just makes their accents that much harder to understand for me...So I don't get half of what's said on rounds even if it is in English because people are talking so quietly...If it seems important that I do hear what they're saying I just have to say, "I'm sorry, I can't hear what you're saying..." but there's only so many times you can say that in one conversation, you know?

Tuesday: Sister Claris hits the scene. Sister Claris is a little Indian nun who is a nurse and is doing the same thing I am at Rubaga but is one week ahead of me. For whatever reason, she wasn't around on monday but returned to the floor tuesday and we quickly hit it off. She's got a great sense of humor and is probably old enough to be my mother, and is really curious and hard working and just generally fun to be around. We became partners in crime of sorts and have taken on a few "tidying" projects on the floor. She gives me a hard time about my "American speed", saying that I do everything quickly and what hurry am I in, we have all day :) I give her a hard time about how fastidious she is about things. It's a little challenging to balance her Indian accent with the Ugandan accent, and try to take on enough of whichever one is appropriate in order to be understood...sometimes it's pretty funny...

Wednesday: Oh, yes, this was the run-in-with-the-Doctor-day. A different doctor came to do rounds and she didn't seem to like me very much. Let me just say that rounds are completely disorganized...well, I mean it seems that way to me, and I'm one of the most disorganized nurses I know. The Ugandan nurses seem to think it's organized so maybe it's just organized chaos, but
because there aren't computers, everything gets written down in a book, and not just one book but like 5 books, and they change hands constantly and people are doing different things and I just can't keep track of what's going on, so I often just stand there waiting for someone to tell me what to do. At one bedside a nurse physically pulls me over to the bed and hands me the glucometer and asks me to do a blood sugar on a patient. I reach for the gloves and needles and such and the doctor says to me "Gloves? You don't need gloves!" I looked her in the eye and told her, "I prefer to use them, thank you." She replied, "You're not going to be touching the blood, you don't need to use gloves to do that. Here in Uganda we don't have enough gloves." My thoughts were as follows: "How about you stick to doctoring, and I'll stick to nursing?!" I'd seen Uganda nurses use gloves for blood sugars and even less risky procedures, so I knew I wasn't doing anything any differently than anyone else was, she was just mad I was there...mad I was white, mad I was in Uganda, and so she was trying to make me feel bad for consuming precious medical resources...bah humbug. After confirming with all the other nurses, I learned that I was not in the wrong, that she was just being mean. It's true, there's not always gloves when and where people need them, but that's not because there aren't enough gloves in Uganda, and especially not at a private hospital where everyone pays out of pocket for each service they receive. Anyways, I could go on and on. But yesterday she softened up and this doctor and I had a good exchange involving smiles on both of our parts.

Thursday: Assembly in the morning, a short meeting of hospital leadership and staff and so forth, Sister Claris and I had to introduce ourselves...everyone chuckled when I said I was working in Bundibugyo...not exactly sure why, whether it's that looked down upon or what...There was scripture read (it's a Catholic hospital) about laying our burdens at Christ's feet, and we sang a song too to that effect ("Lay your cares upon Jesus..." or something like that) and went on our way.

Friday: I knew it was coming; Sister Prossy, a Ugandan nun/nurse confirmed that I was not only not married, but not dating anyone either, and then proceeded to try to convince me to join the sisterhood like her. She did it with a smile on her face, but seriously. "You just call your mother and tell her 'bye-bye' and then you come and live with us!" Oh geez. 5pm couldn't come quickly enough. I also took on the role of answering the phone since when it rings no one appears to move or do anything about it. Not that I know what to say to anyone on the other end, but at least it stops ringing! I spent almost all day going from the ward to the lab and back and then to the pharmacy and taking patients to ECG and ultrasound. The xray machine wasn't working for most of the week, so that cut out a lot of trips I would have had to make...

Noteable patients of the week:

"Hah-baht" (ie. Herbert but sounds as such when pronounced by a Ugandan) - HIV + and has TB and has been a bit confused and beligerent all week - solution? Give him a few sedatives.

Annet - 14 years old, 02 = 59% when they sent me in with the pulse ox...did anyone jump? Nope. What is there to do? There's no ICU, there's no dialysis to treat the renal failure she's suffering from...so there she sits, heaving with every breath and an oxygen tube down her nose (yep, down her nose, they don't have nasal cannulas, so they use 10 fr. suction catheters and stick them in until resistance is met and tape them in place and connect them to the concentrator they use to administer 02). Thankfully 3L brought her up to about 90%...but then her nose starts to bleed...

I won't even start to tell you the cheese saga from the week, we'll just say that 8-500g balls of cheese were successfully delivered to the team in Bundi on Thursday. Praise God.

Well, my time is almost out. So I'll sign off. If you've written me an email, I'm going to try to respond this week, but phone might be a better bet.