One Month Later ...

So, I thought that it might be about time to let everyone know exactly what it is I am doing down here ... I imagine that some of you have painted some colorful pictures of what you THINK I am doing and I would love to enlighten you on the subject.

First let me describe it according to our North American idea of healthcare ... So, I am currently the charge nurse/nurse manager of a 30+ inpatient ward of a rural hospital. Our focus tends to be a combination of ortho/plastics/pediatrics. Most of our patients have come from major trauma centres or surgical hospitals and they are recovering with us. Disharge planning is a challenge as most have no home to return to and there are no longterm care or rehab facilities.

Currently, we are also seeing an influx of medical patients suffering from various illness and infection.

Our staff includes eight nurses, two physicians, a physiotherapist, an ortho PA, a pharmacist, two midwives and a paramedic/EMT team. We also have tonnes of support staff.

We do have a small ER/Outpatient Clinic which specializes in all sorts of acute and chronic complex wound care. One of my other roles includes triaging the flood of patients we get coming to clinic each day. The minor cases get seen my our in-house doctors and PA, but the major cases get shipped to the surgical or trauma centres once stabilized. Just recently we have had some gun shot wounds, motorcycle accidents and edical emergencies.

We have one ambulance that works in the communities of lower economic status, doing dressing changes in the field and bringing the acute or trauma cases into the clinic.

Now, do you want the Haitian twist on the reality you know and recognize?

The hospital is housed in what used to be an old boys home. None of the patients will sleep inside due to fear of more earthquakes. So, we have 32 patients housed in the courtyard under tarps. The two critical patients are in the front foyer of the building, closest to the nurses station. If it rains, half the patients come indoors.

As a nurse here, various tasks have included IV push antibiotics, gravity nitro drip infusion with no monitor, patient transfers and/or transport, preparing baby formula, various wound care with and without ketamine sedation, and pain management.

Our nurses station is a table covered in papers. We don' have enough pens, paper or charts do work successfully. We are recycling med cups because we ran out. Our narcotic cupboard has a lock but no key. Our med fridge contains medications, baby formula, soda, beer and trail mix.

The "ambulance" is actually a large truck with a cage on the back for safety. It seats at least twenty people. But, there are no flashing lights or emergent paraphenalia. And, no one gets out of the way when we have an emergency.

Our wound care/examination tables are old picnic tables propped on saw horses. They are using honey with the skin grafts for its antimicrobial properties.

We have two blood pressure cuffs, one oxymeter, 30 glucoscan strips left ... We have very creative, but limited ways to stabilize any patient that presents with problems related to these investigations.

We have no crash cart, but have a few crash cart meds in a box on the top shelf.

Our power is supplied by generator and invertor, so we go without if either source fails.

There are church services on the ward every morning and night, sometimes lasting five hours.

Each and every day, it is my pleasure, joy and honor to come and aid these patients in the healing process. Their smiles and joy is inspiring. Hearing the patients greet me when I walk through the gate is wonderful. The way they say my name is special, pronouncing every letter. Laughing and playing with the kids is wonderful, seeming less like work and more like play.

Most days this doesn't seem like work to me, but a gift from God. How amazing that He gives us the desires of our heart and that as we pursue them, He fills our days with joy. What a great God is He.


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Unbelievably, a month has already passed me by as I work here in Haiti ... And as the need for nurses remains great, I have commited to staying for another month. Then, I will be helping out with another mission in Port au Prince for a few weeks before going to the northern part of the country to work with the surgical team. That would put me to return home towards the end of April or beginning of May.