I’m sure most of us were riveted to our TV’s, radios, and computers on April 19th when the citizens of Boston and surrounding areas were advised to stay home and lock their doors. Mass transit and normally busy intersections were empty. Schools were not in session. Businesses were closed.
Working with hospice and needing to send out nurses on a regular basis to help patients who are dying at home, I naturally wondered how Boston area hospices coped with having to stay away from their patients.
Our hospice patients call us for many different reasons; even if they don’t call us, some require daily visits. Some need to have pump cassettes changed, dressings changed, or symptoms re-assessed and managed every day. I’m sure Boston has had its fair share of weather-related issues, but those typically come with at least a day or so warning and arrangements can be made. The shutdown that happened in April came with no warning whatsoever.
I was able to track down only a couple of Boston hospice nurses to chat with – they both said that their patients fortunately did not to require anything emergent that day. I know that almost every time I work, I take calls from people who need a visit from a nurse to help manage symptoms that have suddenly gotten out of control (shortness of breath, pain) or who have died and need to be pronounced. Catheters become dislodged, oxygen concentrators malfunction. I guess under the circumstances, non-urgent concerns were put off until the lockdown was over.
I know I was very surprised when I started working in hospice to learn that things that are an inconvenience to us (the President visiting the area or major protests, both of which can shut down major roads and highways for a period of time) can be a huge deal to patients who are at home. Hospice nurses have to figure out alternate routes (which can take much longer) or simply not visit at all in these cases. And it doesn’t only apply to hospice – home health patients can also require daily dressing changes, IV medications, and have equipment malfunction (wound vacs, anyone??).
I will leave you with a story that one of the nurses related to me. She was off from work that day, but wanted to share what her day was like. If there are any hospice or home care nurses that want to share stories of trying to help patients during natural disasters (or not-so-natural disasters), please email me at codeblogrn at gmail. Or use the “submit your story” link at the top.
Sarah Creed, RN writes:
I think that the day was so quiet because we were all glued to our televisions. I can’t recall another time where I have been more paralyzed by fear than last Friday. I live 2.5 miles from the house in Watertown where suspect #2 was found. Here is the story of my day:
I woke up to a text message from my boyfriend (who lives 2 miles from the “boat” and 1 mile from where the news was reporting from) asking if I was okay. After the rest of the week, I wasn’t sure what he was talking about, so I texted back saying yes, and of course went immediately to check CNN. I read that there had been a shoot-out in Cambridge and Watertown and that the suspect was on the loose. I called the DON of my hospice, as I am the nursing manager, and though I was supposed to be off, I wanted to help her call nurses. But at 7:30 in the morning she had already done that, and all was well. So I sat and watched. I was supposed to be packing, as my boyfriend and I are moving on Saturday. But I could not move. I sat and watched as the SWAT team entered homes so close to where I live. And then, the most terrifying thing happened – they stopped showing live news feed of the SWAT team entering homes.
We couldn’t drive anywhere, and even more than that we couldn’t walk anywhere, so my boyfriend and I were stuck apart. All I could hear was the wailing sirens of emergency vehicles. And then the whirl of a helicopter. Lots of helicopters. I looked out my window, and there were black hawk helicopters all around my building. And they were no longer showing live news feed, so I had no idea where they thought the suspect was. I was so afraid, because what if he was on my block? I know my building is safe. There are 2 locked doors to get into the lobby, and a lock and a deadbolt on my door. But still, it seemed these men were capable of just about anything. The day just continued like that.
We finally got the go ahead for people who had gotten out to work to come back home, so my boyfriend’s roommate picked me up on his way home, so that we could all be together. We just sat and watched the TV, waiting, with a very high sense of anxiety. The place was like a ghost town. My mom, who lives an hour north of the city said that no one was out by her either. I think that people just couldn’t walk away from the television. We wanted answers. One of my friends was friends with the MIT officer who was shot by the terrorists. Another one of my friends is friends with Jeff Bauman, who is now infamous as the man in the wheelchair being pushed by the man with the cowboy hat. He lost both of his legs. These are people that my people know and love. We wanted answers.
Then we hear that they didn’t find him, and that we can go outside. So we go and sit on the porch. And suddenly there are so many sirens, more than I had heard all day. My boyfriend tried to re-assure me that there had been a lot of sirens all day long, but I insisted that there were more. And then it came across my phone that there were shots being fired in Watertown. We were back to being glued to the TV. We found a link to the police scanner so we were able to hear what was actually happening. And then he was captured.
After awhile, we mustered up the courage to go outside and to the bar across the way. And the coolest thing, there were people cheering on the law enforcement personnel that were coming back to the station. Everyone at the bar was in a celebratory mood, and playing “American” songs on the jukebox. We survived. But, I have to tell you, it is still pretty traumatizing. One of my coworkers is having a pretty tough time – she was visited by the SWAT team that day and heard the shots. Forum, on Boylston St, where the second bomb went off, is one of our favorite restaurants. We are looking forward to going back there when it re-opens, but of course the innocence is gone. We had just been out on Boylston street on Saturday night before the bombing. We had been shopping in Watertown on Sunday. We feel violated. This is too close to our homes. But, we are strong, and we will move on and get through this. I can’t believe that the Boston One Fund has already raised over $28 million. We are so proud of that.
I know this is long – but this my story. It doesn’t pertain to hospice care. But this is how I know my hospice patients spent the day – glued in front of the TV, and very afraid.
I’ve encountered some interesting beliefs in my time as a hospice nurse. Before making visits or calls, we are expected to at least glance at a ‘basic information’ screen about the patient. I’ve always been intrigued when I come across an entry that says some variation of, “Do not mention the word hospice in front of patient (and/or) family.”
I can respect this. I’m more of a “let’s keep it real, yo” kind of person, but I know not everyone is. So I do my best not to mention the word ‘hospice’ while providing care for these patients, and it’s never been a problem.
But there are some patients that are SO opposed to the entire concept (although they still come on service) that they also refuse any kind of equipment that we offer them to make their lives easier while they are being taken care of at home.
Hospitals have it all, right there – over bed tables (which are nice because they have wheels and can be a tall, easy moveable surface for anything from meals to setting up supplies for a dressing change), bedside commodes (gotta pee, can’t walk, oh! there’s something we can put next to the bed! Genius!), and hospital beds. In fact, the fancy pants hospital beds we had at my job in CCU could translate phrases into like 15 different languages. We’d just pick one from a list (“are you in pain,” “please hold still,” etc.), choose the language, and the bed would speak the phrase you wanted. Needed to tell someone “I am your nurse” or ask them to wiggle their toes in Mandarin? The bed would do that. It would have been a really helpful feature, but patients often could not hear what the bed was saying.
Anyway, hospital beds, even those that can’t speak 15 languages, are pretty nice things to have when you’re sick. So part of me was always dismayed when I’d go to a house to see a patient in distress only to find that they were still on the couch or in a regular bed. Look, I get it. Having a hospital bed in your house takes up a lot of room. It basically screams, “Hi! I’m sick and/or dying!” So for someone who can’t even tolerate hearing the word “hospice,” having such a huge reminder in the room can be distressing.
But when the chips are down and you can’t breathe and you don’t have the strength to sit up? That bed can be a godsend. The head can be raised or lowered, the bed itself can be raised so that your loved ones (and visiting nurse! ahem) don’t break their backs bending over to provide care (turning, cleaning, boosting). The ability to raise the bed is actually pretty important for laypeople who aren’t used to using proper body mechanics when moving patients. The bed rails can be really useful to use to help get yourself out of bed.
So when I come visit because the patient is having a hard time breathing, and I walk in to see them laying flat on a regular bed, I’m sad that their denial has progressed to causing them actual discomfort. There’s nothing more I’d love to do than push a button and raise the head of the bed so they can breathe more easily. There are wedges you can use on regular bed mattresses, and of course there are pillows you can jam behind the patient’s back, but those aren’t always very comfortable and it’s hard to get them in the right position. Not to mention having to try to get them all back in position every time the patient needs to change position or get out of bed.
So if you find yourself or a loved one needing to be taken care of at home, and your nurse brings up maybe getting a hospital bed, don’t dismiss it immediately. It can be a real asset for a sick person’s comfort and that of those taking care of them.
I’ve been doing hospice now for over 6 months. As I did in CCU, I only work weekends and some holidays, so 6 months for someone like me doesn’t really equal 6 months for someone who does this full time. I still struggle with remembering everything I need to remember, but I’m getting better. There is more to remember than you’d think!
I’m realizing how much I depended on constantly being around other nurses to learn. My hospice orientation included some different scenarios where I was able to watch my preceptor deal with what was happening, and I learned from that. But it was still only the tip of the iceberg compared to what can really happen.
In the hospital, you’re usually surrounded by other nurses. You’re at the desk with them talking about patient care, you’re at the bedside helping with patient care, you have several around at any given time to bounce problems off of and get advice. I learned how to teach patients by watching other nurses teach patients. I learned how best to say things (and how not to say things!) by watching other nurses talk to patients. I learned how to titrate medications by watching other nurses. You get the point. Throughout my entire career, I was constantly watching other nurses so that I could be a better nurse.
Now I’m on my own. If I’m really in a pickle I can call another nurse who’s on for advice, and I have done that once or twice with a good result. But when you just can’t get that foley in, there is no one else to ask to try. You just have to leave it out and hope someone on days can come do it, which can be 16 hours later.
I went to a house late one night to help symptom manage a patient that was having pain. When I arrived, the patient was asleep but had to be woken up for some medications. Despite having severe pain all day, apparently the pain was gone when she awoke. But the patient was delusional. Although she had no dementia, she didn’t recognize her husband of almost 20 years. She kept asking about a cat that she needed to take care of, but the couple had no pets. She was very very concerned about this cat. Although she was not belligerent (as some confused people can be) and didn’t seem overly agitated about not recognizing anyone in the house with her, she was very insistent that we find this cat and make sure it was okay.
The husband and I did the best we could to reorient her, and she would look at us thoughtfully and then you could just see her mind reject what we were saying outright. But again, there was no agitation, no real distress involved. It was as if one part of her mind had no idea what was going on, but somewhere in there she knew she was safe regardless. The husband kept asking me what we should do about this, but I had no real ideas. We were already reorienting her, she wasn’t distressed, everyone was calm. I asked him a few more questions (has she done this before, has she recently started any new medications, etc.) and could determine no cause for her behavior. So I just said, “We’re already doing what we should be doing.” I just wanted to give her a little more time after waking up to clear her head.
She asked her husband for some ID, he produced his license, and she questioned him further. Finally it was decided that we would call her sister and talk to her about the cat and what was going on. The husband dialed the number and brought the sister up to speed on what was happening, and I heard him say, “I think she’s having a psychotic break and the hospice nurse doesn’t know what to do about it!”
I wasn’t too offended by that statement and decided that from his point of view, I really hadn’t provided much in the way of advice. To me, she was a patient who was disoriented and having delusions, and I’ve seen hundreds of patients in that state. What did I do in those cases? I medicated them. Because usually they were agitated, pulling at things, obviously distressed. This patient was not. I just didn’t feel the need to call the MD right at that moment. Even if the MD would have ordered something (Haldol I assume), it’s not like I could go to a med station and get it. We’d have to figure out where the nearest 24 hour pharmacy was and have someone pick it up. And if the patient had been even the tiniest bit distressed, I would have been all for that plan.
The sister decided to come over, the patient recognized her immediately and eventually become more reoriented. She still wasn’t sure about the guy sitting at the table with us, but took her sister’s word that she did indeed know him very well. She still asked about the cat, but her sister assured her that there was no cat. I believe her behavior may have been caused by disease progression, but who knows. By the time I left, she was fairly reoriented, in no pain, in no distress.
But the “she doesn’t know what to do” comment has really stuck in my head. People always say that CCU nurses have “autonomy.” And they do. But you really don’t know what autonomy feels like until you’re the only medical person there and everyone is looking at you for answers.
This is a story submission from The Gypsy Nurse.
The following was originally written back in April 2005. I’d been traveling for about a year at this time. Working in McAllen, TX. McAllen was a mixed contract for me. I had some minor difficulties on the job with a co-worker but met some wonderful and lasting friends while there. There are so many experiences that I attribute to having worked as a Travel Nurse. Things that I don’t know if I would have ever seen or done if I had remained a staff nurse in my hometown.
The Hidden Danger of Candied Pecans
Yep…candied pecans! Made fresh on the street in a boiling pot of oil, sweet, hot and so very innocent looking. Very yummy and you know my love for sweets! I couldn’t pass them up. However….as wonderful as they are, I will never eat them again. I picked up a small bag of these delectable yet dangerous goodies in Progresso, Mexico today and saved them for an evening snack. Upon crunching on my first bite….yes, my FIRST bite…I chipped a tooth!! Guess I need to go back to Mexico and see the dentist next time. So, no more candied pecans for me! Guess I should have passed them up this time as the waistline doesn’t need them anyway! Maybe someone is trying to tell me something?
My new Travel Nurse friends; Theresa, Ed and Paul joined up with me for a day-trip to Progresso Mexico. We drove to Progresso today and had a great time. We stopped in a little cafe and had breakfast while listening to a Mariachi band, then we wandered the streets and attempted to make a few deals with the street vendors. All over town, you can hear the hawkers calling out “almost free” as they attempt to sell whatever trinket they have for sale. I picked up some sort of noise maker/toy for my daughter for “almost free!” She will love them but I’m sure that her Dad will want to kill me for sending them.
After shopping all morning we landed at a local place named Poncho’s for beer and margaritas. Live music today included some really BAD country singer!! We were more than happy when the Mariachi band wandered into the bar and gave a slight reprieve from the bad karaoke type country music! After a couple of drinks, we wandered down the street for some fresh taquitos from one of the street stands. One of my favorite things when visiting a new place is to savor the food. The street vendor didn’t disappoint. Final stop included the liquor store as everyone knows that no trip to Mexico is complete without cheap alcohol…and of course noisemakers touted ‘almost free’.
It makes me sad that the safety along the Mexico border has changed so very much since I was there in 2005. I don’t know if it’s even feasible to drive across the border anymore.
I recently spent some time in the south-central area of Mexico and felt perfectly safe there. I just don’t know if I would cross over from the US at this time. If you do happen to make it to Progresso…stop in at Poncho’s for a cheap (yet tasty) Margaretta and find your own trinket “Almost FREE!!”, but be sure to stray away from the candied pecans…they really are dangerous.
I’d love to get more stories from travel nurses! If you’re a travel nurse and have some good stories, use the “submit your story/contact” link at the top to send ‘em my way! Happy New Year everyone!
Recently, I was contacted by Dr. Jennifer Namazy who came up with a very cute way to decorate your stethoscope. Dr. Namazy started CharMED, which sells sparkly crystal cuff charms for your stethoscope. The “about” page on her site says, “From ugly scrubs to dreary white lab coats, ask any woman in the medical field and they will agree…there are few opportunities to sparkle.”
Besides jewelry (which we are normally encouraged NOT to wear), medical professionals really don’t have many ways to jazz up their wardrobe for work. Dr. Namazy graciously gave me a charm to review AND is giving one away to any codeblog reader that leaves a comment on this post stating what color charm they’d like to have. More on that later!
I recently received my iridescent charm in the mail and immediately went to put it on my stethoscope. It fits well and looks great. It does slide up and down the tubing, but it came with a foam insert that you can also use to help it stay put. It’s very sparkly and quite pretty.
I asked Dr. Namazy a few questions about her charms. She says that she and the other medical professionals she works with felt limited in terms of being able to show some style and bling in the workplace. Knowing how popular charm bracelets are with the staff (giving them the opportunity to show off their favorite colors, initials, etc) she thought it would be cool to have charms for stethoscopes!
The charms needed to be seamless, preferably without clasps that could loosen or come open. She designed the shape of the charm herself so that it would fit snugly on the stethoscope’s pliable tubing.
Of course there is always concern about germs, especially in hospitals. To head off any problems there, Dr. Namazy chose a metal that is naturally antibacterial for the base of the charm. It can be easily cleaned with an alcohol pad and doing so will not damage the crystals that adorn it!
The charms have been available for about 5 months and are already popping up in hospital gift shops around San Diego. She has plans to expand nationally soon, but the charms are available now in her online store at get-charmed.com. You can also find her on Facebook and Twitter.
And as I mentioned before, there’s a giveaway for codeblog’s readers. Just leave a comment stating which color you like best, and one commenter will be randomly chosen to receive that charm. Good luck! The contest ends on Wednesday, December 12th. (12/12/12!)
(Update: Contest CLOSED! The winner is Megan, who left the 7th comment. Thanks everyone!)
Submitted by Margaret Gambino RN BSN
As a teacher in a small community you are bound to run into your students while out to dinner, at Wal-mart, or at church from time to time. This is the joy of teaching, to see a student you taught many years ago who is now a successful working professional. To know that you as a teacher played a small role in that person’s life and helped to propel them into the field of nursing is rewarding. I have worked with former students side by side, who are leaders in the profession, while training new students who are just starting out. To walk on a unit and see a former student working as a charge nurse is teacher bliss!
However, as a Health Occupations Teacher who, from time to time, needs medical care in a small community you are bound to run into a former student. Yes, we teach patient confidentiality and HIPPA but we never expect or let’s say “hope” to be the patient of our former students. I began to stress about an upcoming medical appointment where I knew two former students worked. They worked at the facility because I placed them there during their internship for school. The physicians liked them so much they were hired. That was several years ago and they are still employed at the medical office while working towards their BSN at our local university.
I was very stressed about having to be weighed, measured and pricked by a student for whom I taught these skills. The skills are simple enough, but this was not the issue. The issue was the students had always regarded me as their teacher. How would they feel when the roles changed? Would they always view me as their teacher or would they see me as their patient?
The day of the appointment I went to the office and there to greet me was a former student. We were both apprehensive at first about our new role as nurse and patient instead of teacher vs. student. However, the student treated me professionally and with utmost respect. Wow! It was great to be taken care of by a health care worker that I personally trained! The field of nursing is so rewarding and to be privileged to teach it as well is the icing on the cake! I hope to continue in this role as RN/Health Occupations Teacher for many years to come. I am proud to be a nurse, it was simply one of the best decisions I ever made, but combined with education is it also gratifying and humbling.
I’ve written about my son’s peanut allergy several times before. It’s obviously a cause near and dear to my heart. When a friend asked if I wanted to do a 5k sponsored by FAAN (Food Allergy & Anaphylaxis Network), I thought it was a great idea. FAAN’s mission is to raise public awareness, provide advocacy and education, and to advance research on behalf of all those affected by food allergies and anaphylaxis.
So I signed up, and I have a donation page if anyone would be interested in helping me reach my goal (I’m almost halfway there!) The 5k is this Saturday and I’m looking forward to participating in my first one :)
My new hospice job is going pretty well. I really like it. It’s been an adjustment, but worth the stress of change.
Overall, I’ve been pretty surprised at how little I know/knew about how people die naturally.
In ICU, if you are actively dying, you look terrible. In most cases, people dying in the ICU are there because we were or are trying to save their life. This requires some treatments that cause other problems. The fluids and medications we give cause pretty severe swelling. Add in mechanical ventilation and the patient may even end up with scleral edema – where the whites of the eyes fill with fluid from pressure and swell to the point of not allowing the eyelids to fully close.
Don’t Google it. It isn’t pretty.
The medications can also cause the circulation in the extremities to shut down, leaving them cool (or cold) and discolored. Really discolored… we’re talking blue. And even if the patient is on a ventilator, they can still do what we call “fish breathing” which looks exactly how it sounds. It looks like the patient is gasping for air, even if 100% oxygen is being forced into their lungs 20 times a minute.
That is what dying looked like to me for 14 years. Turns out it’s a pretty exaggerated version of how it is when people naturally die without life-saving interventions.
On my second night out sans preceptor, I was called to a house early in the evening to help with symptom management. I was told that the patient was minimally conscious and was starting to have labored breathing. The family had started giving oral morphine liquid to help with this and were panicking about the whole thing a little. I went and assessed the patient. She was mostly unconscious, her breathing a little labored. I provided a lot of education about what they could expect as the process continued and how often to give medications. I really spent a lot of time talking with them about what was happening.
The family’s greatest concern was that she was going to die that night. They just weren’t ready. They didn’t want to fall asleep only to wake up and check on her in the middle of the night to find her gone. Things that are already difficult are made all the more so for some people when they happen in the quiet loneliness of night.
They asked me if I thought it would be that night. Honestly, despite being unconscious and breathing a little differently… ok, maybe her color wasn’t great, but it wasn’t awful – her feet felt only the tiniest bit cool and weren’t discolored at all (there was no mottling, which is when the skin becomes discolored and blotchy). Compared to what I was used to seeing in patients who were dying, she didn’t look too bad.
So with my inexperienced eye and a desire to tell them what they wanted to hear, I fairly confidently said that I couldn’t say for sure, but I didn’t believe she would die that night. Their relief at hearing this was obvious. The taut faces and bodies in the room eased a little. The aura of the entire room changed. An actual hospice nurse just said that their mom would probably make it through the night.
Show of hands – how many of you reading that just slapped your foreheads in disbelief? I did as soon as I got back into my car and spent the drive home beseeching death to keep its scythe to itself until after the sun had risen again.
I was on all night. I went to bed a couple of hours later after again offering up a silent request that she make it through the next 8 hours. I didn’t mind having to go out in the middle of the night. I just didn’t want to be wrong. “Ok, I get it,” I said to the universe. “I shouldn’t have said that and I will never say anything like it ever again please just don’t let her die tonight please please please thanks.”
The chime of my phone woke me up a few hours later. It could have been for anything, for any of the patients that we have on service. “I have a time of death visit for you,” the triage nurse said. My fogginess cleared up in an instant. “…. Who?” I asked. When she spoke the familiar name, my shoulders slumped.
I felt awful. I drove to the home in the darkness, nervous about what to expect. Would they be angry with me? I would have deserved it.
I arrived at the home and when they answered the door I told the teary daughter that I was so sorry for her loss. She just nodded. I asked if I could go back to see the patient and confirm the death. She opened the door to let me through. After looking at the patient, I turned to the daughter and said I was sorry about what I’d told them earlier. She nodded again and was quiet. But then said, “You did a great job telling us what to expect, though. Her breathing changed a few hours after you left and we checked her feet – they were cold and didn’t look right. I knew it was close.” That made me feel a little better.
I would say that “When do you think it will be?” is by far the question I am asked the most. Interestingly, sometimes patients I think are pretty close actually hang on longer than I expect, and the opposite is true – patients who seem to be far from dying die much sooner than I would have guessed. The best example of this is a patient I went to see one night. He had been conscious that afternoon but was mostly unconscious by the evening. I was called out because he’d been having periods of apnea (not breathing). The entire time I was there his breathing was perfect. His vitals were perfect. I felt a very strong radial pulse. His extremities were warm and pink. The family asked me in about 10 different ways when it was going to happen. I just said that he had some signs of death being close, but not others and that it was hard to say.
He was dead by morning.
So I have learned that a dying person’s condition can change very rapidly. This is different from what I’m used to for sure. The ICU course follows a fairly predictable pattern most of the time. Not so predictable outside of the hospital!
I get a lot of email asking me for stuff. Ad requests, what my thoughts are on this or that, could I post this link? Would I like a guest post? Hey, we’ve linked to you, can you link back to us? And really a whole lot of “we are positive that your readers will find this link very interesting! You should post it!” Sometimes someone does actually send something interesting, and I’ll read it and think, “Oh, this sounds neat” but then I’ll get distracted and forget and then I go back to reading through all the email a week later and it’s too late. Anyway, my point is that I’m terrible at answering email, even when I find it interesting.
But today I got a different sort of email, and the sender asked me to share his personal fundraiser on my blog. “Seriously?” I thought. But something caught my interest (and both kids were napping, so that helped) and I clicked his link. It’s an interesting back story and that last perk there at the bottom just made me laugh, so I made a deal with the guy – I’d post his link if he gave me some stories to go along with it. And he did.
So the email said this: “My name is Paul Sebring and I am currently enrolled at the Ida V. Moffett School of Nursing at Samford University because after having helped in Haiti after the earthquake and leading a cleft lip/palate mission in Ecuador, I realized that becoming a nurse was the most important thing I could do in this life.”
And then he provided a link wherein he asks for money. So here are some stories he wrote about his experiences in Haiti. If you like them, throw a few bucks his way. He gave me a few choices – I found these interesting:
Burr Hole Boy: 06/11/2010
On Monday night we went to the Plaza Hotel to check emails and such when Gabe from IMC pulled me to the side and asked if there was anything we could do to help a 16 year old boy that needed a Neurosurgeon. It turns out that 3 days earlier this kid was in a motorcycle accident in Gonaive and his family finally got him to the General (state run hospital). He had a pretty bad head injury and he seemed to be somewhat stable but he still needed a Burr Hole procedure. This is a simple procedure where they drill a few holes into your head to relieve pressure on the brain. Anyway, so Gabe tells me what’s going on and what the kid needs when the attending doc at the General calls me to tell me about the kid too.
It’s apparent now that we need to get this kid to a Neuro team to save his life. Medishare hospital wasn’t an option since they were right in the middle of being moved to their new facility and Adventist hospital didn’t have a Neuro team at their facility either. I knew that the hospital in Milot (I was there a few weeks ago doing a supply run) had a Neurologist showing up soon so I called Jo and asked her if they could take the kid. She was really excited to take him since their Neuro team was showing up the next day, but when she talked to the local hospital administrator he denied our request because he felt they were not well equipped to do brain surgery. The problem is that this kid didn’t need brain surgery, just a decompression. Jo tried her hardest but knew there was no way to change this guy’s mind so Jo took it upon herself to call a hospital in the Dominican Republic and she actually got the hospital there to accept the kid, a full Neuro team to receive him, and she lined up an ambulance to pick him up from the heliport. Jo, you’re amazing.
This is where it got good.
I called up Sam from Grass Roots United because I needed his help with getting a helicopter and he had a connection. Keep in mind that Grass Roots is about as big an NGO (Non Governmental Organization) as ourselves. When he heard of what was going on he called up his contacts and got the helicopter.
Now all we have to worry about is how are we going to get this kid through customs and out of Haiti.
Back to Jo, she’s now working with the Dominican Republic to get his papers approved, I’m working with the General to get the kid’s papers ready and Sam is working with Haitian customs to put it all together. At 10am the next morning we had all the paperwork in order, a green light from Haitian customs, a green light from the DR customs, a helicopter, a doctor to go with the kid, a medical team to receive the kid and an ambulance to take him to the hospital. Time to put everything in to play.
Christina and Micaela go to the General and scoop up the kid and take him to the airport. When they get there, guess what, the Haitian official “claims” that she never received the email with paperwork and it would cost $100 USD to get the kid out of the country. Sam pays the $100 fee (bribe) and gets the kid on the helicopter, which just happens to be the size of a VW bug, and gets him to the DR. When they arrive in the DR it was a bit of fiasco with the Immigrations department but the receiving hospital got them to accept the kid, they loaded him into their rig and got him to their facility to do the procedure.
Now, let’s put this in perspective. What we did for this kid saved his life and it was all done by 2 small NGO’s with no funding. You all know how I feel about this topic, and I’m not going to go on another tirade about how ineffective the big NGO’s can be. All I have to say is thank you Jo and Sam for helping us get this kid to a medical team that saved his life.
All in a days work: Haiti update from 8/2/10
Let’s start off by saying that the Haiti diet is the best way to lose weight. Between the flop sweating, mass consumption of water and overall repetitive diet I have lost almost 65 pounds since my first trip here. Jenny Craig ain’t got nothin on Haiti. The bad thing is that I am still out of shape. Granted I’ve had to have people bring me new clothes because all my original pants would fall off me and the 3-4x shirts looked like tents on me. I’m now at a 40 inch waist and a 2x shirt.
Now, back to the out of shape thing.
This morning a few of us had to go to the General (state run hospital) today to transfer a pre-term momma to Adventist hospital. She is TB positive and about 30 weeks along. Contractions were 10 minutes apart so we had to get her to a place that was much more well equipped to handle the mom and baby.
LP (co-founder of MMRC) was dropping Tuwanda, Jeanne and Ellen off at a clinic near the Embassy so we had to walk to the hospital. It’s only about 1.5 miles but the fun part is that you get to dodge traffic and pedestrians while walking at a very brisk pace. I was on the phone with the TB Clinic Doc about this patient and it was apparent that we had to get her out of there and to Adventist ASAP. About 6 blocks from the hospital I told the boys we had to pick it up so we started running. Now please try and picture this: 2 marines and a fat guy running the streets of Port Au Prince. The marines look like they are in great shape. They’re running in unison, have great form and are weaving through cars. They don’t even look tired and they’re barely breathing hard.
And then there’s the fat guy…. ME
I’ve got one hand on my backpack to keep it from flailing everywhere and the other on my belt to keep my pants from falling off. I’m trying to not get hit by cars that I can’t see because the sweat is flowing so profusely down my face it is blinding me. I’m beet red and am huffing and puffing so hard that the locals can’t stop staring at me. And the best part is, you can’t stop this much momentum without a few hundred yards notice.
So after about 3 blocks I holler at Sully (one of the marines) that he can run if he wants but poppa bear is going to have to keep it at a brisk pace. We finally arrive at the General and I am sweating so bad and I’m so hot I can’t even form complete sentences. Oh ya, I almost forgot, my pants are soaking wet and my grey shirt is dripping.
After being there for about 15 minutes we get the ok to use an ambulance, we load up the patient and Michelle (RN), Sully (Marine), Riaan (Corpman) and myself head over to the Adventist hospital with her. The best part is that I still can’t stop sweating but now I have to wear gloves and a mask the whole time we are en route and try to comfort a very scared mother. Brooke (RN) was expecting us when we arrived and she made sure everything went through smoothly.
As we drove back I had a chance to look down at myself and it is apparent that I’m a hot mess. I just wish I had video of this so I could just see what the locals got to witness.
I found out 2 days later that both the mom and her new baby daughter are just fine. The family brought the mother back to the TB ward 24 hours after the delivery.
Good luck, Paul!
- I am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!