Foundation Totai - Nursing

Hi... it's Amanda again.

This blog entry is going to be all about what I am doing in the hospital. If you want any specific questions answered about my work in the hospital that I don't cover, please e-mail me at cramandaham@gmail.com.

For the people who do not know, before I left Scotland, I received my certification as a Health Care Support Worker/Health Care Assistant. I was receiving training from the Practice Nurses at my place of work in blood pressure, urinalysis, heights, weights, new patient medicals, minor dressings and stitch and staple removal. I have also been able to take blood samples for the last year. It was my hope to be able to take these new skills to Bolivia with me.

Since I am currently spending a lot of time learning Spanish, I work (well... learn really) at the Foundation generally half of every day.

You may have already read about my first shift in which I got sick, but I returned on Wednesday afternoon of last week for my first full shift. That afternoon I worked with a nurse called Odalys (I think), but everyone calls her Choca (because she has the lightest skin colour, apparently...). Oh... please also remember that I have very little Spanish and the nurses have no English... through gesturing, watching and some rapid Spanish learning I am figuring out what they want me to do.

Essentially, all appointments are walk-in/on-demand. They tried to have pre-bookable appointments, but most of the patients never turn up. Every patient that comes to see either the General Physician or the Paediatrician sees the nurse for "triage" first. The nurse takes their temperature, blood pressure, pulse, height, weight and records their age and then passes the file onto the doctor. I very quickly was able to do this, while the nurse who was in with me did the actual talking to the patient. Choca kept going "Bueno, bueno Amanda", so it was a bit of an affirmation to know that I wasn't going to be completely useless to them.

The nurses also see their own patients. There was a boy who came in for a wound check and returned later in the week to get his stitches out. This I found frustrating, because I would loved to ask questions about the procedure here and such, since I am familiar with these things, but I can't get past the Spanish.

The nurses give injections frequently as well. For example, we saw a patient for triage that Wednesday afternoon who was then sent back to us after seeing the GP for an injection. Since I can't read Spanish very well (and all GPs in all countries have ridiculous writing) I wasn't able to figure out what she was diagnosed with, but the doctor had prescribed Penicillin -- intramuscular. Choca, the nurse, mixes up the injection and then gets the girl to lie down ON HER BACK. I was expecting a gluteal injection and was confused as to why she was on her back. The nurse then drops two drops of the mixture into the girl's EYE!

I am so confused by this point... I then figure out through some rapidly-learnt Spanish that they drop it in the patient's eye to make sure that they are not allergic to it. Yes... apparently if the eye changes colour they are allergic to the Penicillin and they won't give the injection. Thankfully, this patient was not allergic and the nurse got her to turn over and give her the injection in behind as I initially suspected. I still don't know where the infection was.

As all people in health care know... there is also a lot of paperwork that is involved. There are no computers in the consulting rooms... everything is still recorded on paper (which isn't a big deal, as I believe Canada only just stopped using paper notes, is that right?). But, on top of the patient's file there are two or three different books in which you have to record general admin about the patient's visit (ie. name, date of birth, new or return patient, tariff category, etc -- there is just so much). When the nurses have time they are required to input all this data into an Excel file which will organise it all for the Foundation's biannual report.

I am going to leave it at this for the moment. The nurses also do some screening work in the local Paediatric Hospital and a local school... but I will wait to have had more exposure to those before I enlighten you all. Thanks for reading.