It was really sad saying goodbye to our cute kids today 😦 I don’t think most of them understood that we were leaving and going home since we wave at them all the time unless someone translated for us. Then we got lots of thank you’s and handshakes from the parents and hugs from the kiddos. It feels like these two weeks have gone by so fast but yet when I think about my first day here it feels like ages ago. I’ve seen some pretty amazing things here that some of it is still hard to believe (I may actually not believe it later if I didn’t have pictures). I did a casual talk this morning with the nurses using our APHON book and slides. There’s still quite a language barrier that makes it hard to know if they understand me sometimes but I think they started understanding me more by today because they asked some really good questions. I’m pretty sure I wormed my way in to the heart of the head charge nurse which I was worried I wouldn’t. The nurses here really do work insanely hard and I feel could definitely continue to use some encouragement about how important their role is.
Ok I’m starting to get a brain fart…need food…
The last few days have been so full of new things I don’t even know where to start because even yesterday seems like so long ago! Thursday at the hospital I gave the nurses a quick overview of ALL treatment. Their protocols or “schema’s” are not very clear to them so they have a hard time answering parents when they ask what is going to happen yet. I realized fairly quickly when talking about this that they really weren’t sure what made up an FBC (full blood picture instead of CBC), why we worry so much about neutropenia, what the number values of hgb or plts mean to us, the timing of when blood counts are low. So my plan for the next day was to review all that. I also did spend some time discussing why their role is so important because I really don’t feel like they feel validated. We talked about how they are the people that are with the patient’s and the parents the most throughout the day and know them best and also that they are the one’s that carry out all the doctor’s orders and wouldn’t get done without them. I think this made them feel good but I’m not sure (I sometimes am not sure how much they understand me)- even one of the night nurses stayed to listen which I thought was awesome. I spent the morning with the nurse that rounded, a different one though. She was very interested in learning how to do more assessments so after the doc’s examined a patient that had a significant finding we would examine him/her after. Me and Shelton had agreed the night before that after rounds we would briefly talk about the sickest kiddos and me and her would go back and check on them later which I could tell she really enjoyed. We caught a few PRBC mistakes which I think made her feel a bit more confident that I just went and talked to Sue and the other doc’s because it seems like they don’t always feel comfortable confronting doc’s. It was a good and productive day and me and my “raffiki”(friend- I love that that’s right out of the Lion King) Henry played with his paper airplanes and threw them up into the fan a lot which he loved but we’ll have to make new ones soon.
Thursday afternoon I played futbol with the boys. Dick picked me to be on his team against Shelton and two other boys (they also played the other day with him). I told Dick I wasn’t very good so he might want to make it 3 on our team but he kept saying “no no, you and me.” And I for sure was not very good but I did manage to make one goal on Shelton 🙂 There was an older, taller player that eventually joined me and Dick that was really good. The two of them were nice enough to keep including and passing to me and we actually did win!!
On Friday I spent some time in the chemo room with the chemo nurse…it’s a bit surreal in there..and very hot. For the kids in maintenance they bring in a water bottle (like a regular 16 oz one) and they get their 5 days of IV dex mixed in there that they then take by mouth. Their BSA is calculated purely based on their weight and a chart. I was told that the doses are rarely double checked by the nurse but they are supposed to so we went through them all at least while I was there. I played planes with Henry and he brought some of his friends Baraka and Ida…so cute!!! That night we went out for dinner with Dee and one of her friends and I had literally the BEST calamari ever!!
And then early yesterday morning me and Shelton left for safari!!! I feel like words can’t really describe it but I’m going to try my best. It was literally the most AMAZING thing I’ve done in my life so far! It was about a 5 hour drive out there which I thought was going to take forever but we had an awesome guide, Sanjay who told us so much about the park we were going to and Tanzania itself. He was so much fun! We stopped at a place to get coffee which was also….AMAZING coffee. About 30 minutes out from the park I saw a burst of steam coming from the hood. I couldn’t tell if Sanjay looked nervous or not when he got out and looked under the hood. I know it wasn’t a situation to be laughing at but I couldn’t help it…who does that happen to? I don’t think Shelton was worried either that I could tell. A truck with two guys stopped when Sanjay flagged- some seem to think it was just because they saw me but I don’t believe that though they did ask for pictures with me afterwards. Shelton tried to get in one of them and the guy just smiled this big grin and waved him to the side. I actually forget exactly what the problem was, the radiator overheated maybe?? Either way, it got fixed and we were back on the road within 30 minutes or so. Even before we entered the park I saw a “deer looking thing” that I learned was an impala (really working on my animals here), tons of baboons, and some elephants!! When we got to the park it was going to be time for lunch. There were tons of monkey’s just walking around; a blue monkey jumped into our jeep and stole the pear we had bought on the way out! We had chicken and beef curry for lunch which again was AMAZING! And something about having a beer while watching monkeys and very large elephant coming your way also makes that AMAZING! So yes this elephant just kept coming closer to us right up to the restaurant until it seemed like the staff was getting alarmed. It wasn’t hard to wave him off but how COOL is that?? We started the drive and saw so many elephants (several baby elephants that were adorable!- literally they look just like Dumbo and trip over their ears when they walk) and impalas right away. We saw a lot of giraffe which I have decided have become my new favorite. They would crack me up every time because they stand so tall and still as statues and just stare at you with this inquisitive facial expression; like seriously wondering what we are doing there. It’s just hilarious (at least to me) but I can’t explain it. The zebras are so pretty and have their quirks about them too; they typically stand facing in opposite directions with their butts next to each other. Sanjay said the idea is that they are both guarding a different side for predators but it looks like they are in an argument and just don’t want to look at each other. We did actually get to see one young male lion!!! I got a pretty good video that I’ll try to post another day but I was so excited to get to see one up close! He had absolutely no interest in us; he just looked up from his nap, looked at us, and went right back to sleep. The hippo pool was awesome too. I had never known how shy they were and they just poke their heads in and out of the water. I got some great pictures of Shelton’s reaction to them as apparently those are his favorite. We got a lesson on elephant poop from Sanjay- they only digest 60% of their food and poop out several pounds 8 times a day! EEEK! According to him if you are stuck out in a safari and there is no water you should eat elephant poop because it’s full of water and undigested grass : / It was such an AMAZING experience though and we got to do it all again this morning though it was different because it had rained a LOT last night and…I finally got my thunderstorm last night which was also AMAZING! It went from clear sky to heat lightning which I hadn’t seen since Texas, then to full on downpour and thunder. So happy 🙂
This morning we were hoping to see two female lions with two cubs but no luck, it was overall though such an awesome experience. Definitely something I would love to do again. We will post pictures another day but they don’t even do it justice; neither do words. I should say though, Melinda, we are no competition to your photography skills. I accidentally put Sue’s camera on video at one point and didn’t notice for quite a while : / I haven’t looked through them yet but I’m pretty sure there are a lot of videos that don’t make sense.
Well it’s back to work tomorrow with the watoto’s so I’m off to bed. Good night!
So my first full day with the nurses here was definitely interesting. I have to say though I’m impressed that because there is no pharmacy to calculate concentrations of anything and they draw up all the antibiotics, chemo, pretty much anything that is given IV. They calculate drips too which I’m going to get a crash course in tomorrow because I can’t say that I’ve done that since nursing school! It’s very different in that each nurse doesn’t have their own patients, they have different roles for all the patients. So the first nurse I spent part of the morning with had the role of being the rounding nurse. He went around with a rounding book that he took notes in about the plan for the patient. He unfortunately though kept getting called away to do other things so it made following along with rounds hard. I can remember now why we have reverted to a computer system! All the papers on different patients that didn’t seem to have an order that I at least understood yet were giving me a little anxiety. The next nurse I spent time with was the medication nurse, mostly antibiotics. She would draw up all the antibiotics and start going around to rooms, sometimes the patients weren’t in there and were out roaming around so we went on missions to find them. Around 3 pm her shift ended and another came on who was the afternoon rounding nurse who’s role was similar to the AM nurse but a lot less papers! It was mostly for her to know any new orders to get done, things that were maybe missed from the morning, and if there were new patients. She took me down to the basement where all the chemo is stored (I also found the cockroach graveyard) and we even took the elevator which is something Sue has suggested against doing as they get stuck a lot : /
We had some down time in the early afternoon that we chatted about some things they would be interested in learning more about- there was a lot of questions about ALL protocols and chemotherapy safety/side effects so those were things I was definitely going work on teaching. At least one also seemed interested in learning how to better do a physical assessment so that would be good too. I didn’t get to spend time with the cannulation nurse (places all the IV’s) or the chemo nurse at least today and there’s also a vitals nurse but I’m not sure exactly what that entails yet since the momma’s take the temperatures on the kids but I’ll probably find out more tomorrow. It was nice to still be able to spend some time with Shelton and Sue during rounds too!
On a total side note, Hilda, the wonderful housekeeper definitely laughed hard this morning when I asked her when it was going to rain. She asked me if it doesn’t rain where I live very much and I told her it actually rained a lot I just wanted to hear a thunderstorm at some point 🙂 She felt pretty certain I would before we left.
Good night everyone!
I had to post these separately because my phone wouldn’t fit in the USB port with the internet dangle (dengle?) the thing we just to get on the internet 🙂
So here’s my great list of instructions on how to get us to Dee’s apartment in Tanzania without Sue (I’m laughing now at the fact that I actually made check boxes and put a check mark in them to make it look like a visa form). And one of the funnier murals at least to me since I love the Little Mermaid…Ariel’s not looking too good and there’s a pig riding on her fin….no idea where the idea to paint that came from…
Ok now for sure I’m off to nap!
I realized I’m the only person who hasn’t posted since we got here! I feel like the jet lag is finally starting to kick in though and my brain isn’t making much sense so I don’t know how great this update will be… So the long flight I was worried about (I’m really usually horrible about sitting still for so long so I was worried) was really not that bad! I should say that on the way to the airport I got a frantic call from Sue saying that there was a chance she might not make her flight due to delays and that me and Shelton might be on our own when we get into Dar. I wrote down all the instructions she gave me on the back of a receipt that I found in the car that I’ll try to attach here somehow because it really doesn’t look like we would’ve gotten very far with it. I can say this all now and didn’t share it with my mom when I talked to her at the airport (no point worrying you mom). Ultimately we would’ve been fine with the Holiday Inn back-up plan. Shelton told me he’s glad I’m the responsible one of the two of us which I don’t think many people have told me before on trips mainly because I have a horrible sense of direction. We had like 40 minutes before take off so we decided to get a beer and by the time we started towards the gate, it was totally empty and they were waiting for us! Eeeek!!! I think it worked out in our favor because we were told two seats to sit in that were closer to each other and it was definitely an upgrade because we each had our own row to ourselves! Like Shelton said, I made him play trivia for several hours, which I can’t say I’m very good at (especially ones about movies and actors). I don’t remember any of the questions right now so I obviously didn’t learn much from it either but it was fun and killed time.
Yesterday and today are both holidays here and according to Sue and Dee (our great contact person here) everything is very quiet and the streets are practically empty. I’m curious as to what it looks like tomorrow. Since it was holiday yesterday, we went out to the shops for a bit! And I’m very proud to say I didn’t buy anything…yet 🙂
Today, Dee gave us the tour of the hospital and the grounds. The murals on the walls were beautiful (some really strange and we’ll have to post some examples at some point) but overall mostly so colorfully painted with safari animals. It’s definitely warm…or hot…I’m not really sure which one. It’s really only uncomfortable during the process of starting to sweat and I found that once you’re just full-blown sweaty, you kinda just forget about it or you get cooler somehow or maybe it just doesn’t matter at that point. When we got to the ward, we slowly developed a posse (spelling?) of really adorable children following us around that continued to grow. The first one I saw gave both me and Shelton a hug and I knew for sure at that point that these kids were for sure going to steal my heart.
And now I think I might need a nap…
I’m thinking you have to be an efficient packer when you are a pilot so I’m glad I begged Nyah to help…one day I’ll be that organized (maybe)…and yes I do need all this stuff (I even eliminated several pairs of shoes). I’m pretty much packed as are lots of stuffed animals, kids clothes/shoes, books, and of course extra medical supplies…and workout DVDs (no eye rolling from any of you)!!! I swear my body in the past week has somehow known it’s going to Africa and has been intelligently storing some fat for me 🙂 Bon voyage!
I’m testing this out since I’ve never done a blog before….me, Sue, and Shelton are headed to Tanzania for to weeks to work at a children’s hospital. Suman will be taking our place for 2 additional weeks after we are gone. We are so excited…I don’t know about any of you but I haven’t even started packing! Speaking of which….