27 February 2010

What a day! I felt thrown into the deep end without knowing how to swim. So lost, so inadequate. I felt like I was totally wrong in thinking that I could function in a role like this. How do I survive? How can I make it? The “hospital” is a series of tents – thick canvas tents with doors and you are lucky if you have window flaps. The tents are so close together and one door looks straight into another tent. And the heat! I was prepared for hot, but the sweat was literally dripping off of me. Five minutes in the tent and I was drenched. Thank God for bandannas and water!

IMC has 3 ER tents. I spent the majority of my time today in #2. Triage is right outside tent 1. Tent 2 is directly behind tent 1. And tent 3 is off to the side of tent 2. Tents 1 and 2 are mostly adult and ER type injuries. Tent 3 is orthopedic and some pediatrics. There are so many many aid workers from so many different countries. So many languages heard from every direction. Two docs were in tent 2 and Corey and I both ended up as the RNs. It was hard because we were both new and didn’t know where anything was. It was especially hectic when we got there.

A 6 year old boy came in in respiratory distress. I won’t forget the limp body in the arms of a Haitian man (his father, perhaps?). He was layed on a cot and a crowd of docs gathered around yelling out orders. They put in an intraosseous IV (into the marrow in his shin bone) because they couldn’t get a regular IV in. He was eventually intubated and transferred to the Miami Hospital, which was located at the main airport. Later we found out that he was placed on a ventilator and died shortly thereafter. Initially they thought that he was having a blood transfusion reaction, but eventually decided that it was CHF (Chronic Heart Failure) exacerbated by the transfusion and the fluid overload. …

A lot of patients came through our tent. There was a psychotic patient waiting for a psych consult who was just hanging out in a chair. IMC has at least one psychiatrist who we can contact when there are people that need their services. A woman who was postpartum x 1month was waiting for an inpatient bed – she was breathing at 30 respirations/minute due to a cardio-myopathy. There was a man with a left tib-fib fracture – the worst xray I’ve ever seen. When he was transferred to surgery, he left a huge pool of blood and pus on the cot where it had leaked through his dressing. There were a lot of dehydrated patients. There was a boy (maybe 17) who jumped off a transport bus and had a nasty wound behind his knee. You could see muscle. One of the MDs sewed it closed – it was probably 4 inches wide. Gruesome.

I missed all the IV starts I tried today. I felt useless, but I learned so much today. Supplies are crazy missing. It’s very hard to find anything. There are medications that I’ve never heard of and I’m required to reconstitute IVs… Do I hang it in a bag or push it? Through all of it I feel inadequate, but I have to remind myself that something is better than nothing and is more than these people would have otherwise. It’s really great being around the docs because I get to hear some of the diagnostic stuff which helps me understand more of what I should be doing. I think the first couple of days are just going to be frustrating, but perhaps the whole time will be.

The pharmacy/central supply center is organized chaos. It took me about an hour to pick up supplies that we had ordered to be ready an hour before hand. On the way to the pharmacy, we passed the nursing school. I was walking with Niall (he’s an ER nurse from Australia and has been here for a week already) and he flatly stated that there were still 120 nursing students buried under the wreckage. Bodies that had yet to be recovered. It’s unbelievable. Astounding. The building was pancaked. I am still feeling numb to it all and I’m waiting for the wave to hit and be awakened to these atrocities. I don’t know when that day will come…

Jesus, be my shepherd – guide me through this time. Help me to gain confidence in what I know, yet remain humble in your presence. Help me to regard these human lives as priceless and help me to attach names to faces. Be a part of my time here. Thank you for continued protection and support from home. Thank you for loving me even though I am lost and inadequate. Thank you for your promise. Help me to show love to these people even if it just through a hand squeeze or a smile. Be with me. Amen.

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