"Nahse!"

So, let’s just review a bit…I am a nurse, not a doctor, not a nurse practitioner, not a physicians assistant, not a nursing assistant, but a nurse (hear “nahse”)…I have this mug at home that my mom gave me that has all of these ways to define a nurse. “Shot giving, uniform wearing, Dr’s order following, shift working, vital sign taking…” etc etc…Now, almost every one of the things on that list of descriptors was applicable to me and defined my work life for 7 years…I had learned the routine (as much of a routine as there can be when every patient is unique and has their own specific problems, situations, personalities, family members, and those patients change almost daily)…For the most part I knew how to get what I needed, what to ask who for, what was legitimate/reasonable to expect from myself and others, what general treatment and procedural protocols were, how the flow of each shift goes, which meds required which pre-meds, which meds required which drug levels and when, which phone number for the pharmacy/lab gets you to the person you actually want to speak to…now, my coworkers will tell you that I wasn’t always the best at, for instance, organizing my time (I was always staying late to do charting that I hadn’t managed to get done during the 12.5 hours of my regularly scheduled shift), or knowing when best to or how best to deviate from hospital protocol or rules of the trade, but I managed pretty well for the most part.

Well, all that routine that I had learned over 7 years’ time…that all flew out the window as I flew over the atlantic ocean just over a year ago. Nursing looks totally different here, and I’ve been reminded of this again as of late…for instance (now I know this won’t make all that much sense unless you’re a nurse, but bear with me), when you hang a blood transfusion on a kid, the kid doesn’t get the whole unit of blood but the lab marks on the bag with a pen where the tansfusion should end and you just tell the parents to let you know when the blood level of the bag reaches that mark and then you stop it. And the blood, like every other infusion here, runs to gravity, so when I asked another nurse for the first time how slow the blood should run the answer was, in fact, “very slow.” Oh, okay, of course. All those years of protocol…out the window…all those years of it being primarily MY responsibility to monitor patients and the progress of treatment from hour to hour…out the window…all those years of building up history in a system…out the window…the fact that everything else is totally different I guess helps in a sense (ie. language, cultural norms, etc) but sometimes those are just more variables to learn to adjust to everyday. Admitting, discharging, deciding on medications and courses of treatment and what labs need to be done…I do these on a daily basis…this is a person who before one year ago didn’t so much as give Tylenol without a doctor’s order…what am I again? Right, a NURSE.

My brother asked me if I enjoy being the “go-to” person for medical stuff while the docs are away…I told him that while there is confidence building for me in it, and satisfaction in seeing the fruit of decisions well made, there is a reason that I became and nurse and not a doctor…Sarah and Nathan and I were talked about the things we wanted to be when we grew up….astronaut was on Sarah’s list, medical researcher finding a cure for cancer was on Nathan’s list…I realized in thinking about the three I could remember, that they all have something in common…working for NASA but in the control base, not as an astronaut….working for the FBI but in the forensic lab, not as a field agent….and finally working in medicine but as a nurse, never once considering becoming a doctor…You notice a trend? All careers of support, positions that make the big shots able to do their stuff with all of the information that they need to make the big decisions, positions which involve getting stuff done – carrying out the details of the big decisions made by the big shots…that’s where I thrive, that’s what I enjoy…it’s a good thing to know about ones’ self, and it’s a good thing that we’re all not gifted in the same ways, enjoying the same things…diversity is what makes the world go ‘round…But it doesn’t mean that there won’t come times that we are needed to fill different roles, that we need to learn new skills in order to better perform in our preferred role, that we need to be stretched and challenged in ways that don’t always feel good but grow us. Children have died in my care in the last couple of weeks, that’s doesn’t feel good, that’s not easy (it’s nauseating and exhausting in fact) but God has grown me through it.

randomness-

- I just realized yesterday was Cinco de Mayo…good thing we had tacos/burritos for dinner…
- Patient name of the week: Acrobat
- Please pray for a 4 ½ year old named Thomas, a Kwashiorkor patient who weighs just under 9kg as of this morning, who has been on the ward for a week and a half now (he came to the ward while we were unloading the UNICEF milk from the deliver truck) and has been walking the tightrope between life and death, currently gaining weight (by God’s mercy), but whose skin is sloughing and peeling and cracking and bleeding in the process of losing weight from swelling, making him extremely vulnerable to infection. There is hope…
- It was 93 degrees F in the shade yesterday
- I love it when kids smile back when I smile at them.
- I love it when the moon is so bright that you can see the fluffy white clouds even when it’s dark outside.
- I love the satisfaction of using a new Lubwisi word like “kasekuskeu” or something like, that which means “hiccup” and the little chuckle that I get from the Babwisi when I use it ☺