It almost seems silly to compare and contrast the nursing I've known with the nursing I see here. There are over thirty nationalities serving on the ship, and that includes the medical staff. There isn't uniformity with what nurses have been doing prior to coming here (for a small example, some European nurses don't use stethoscopes for their assessments- that's for the doctor). Our patients are not as medically complex as what I'm used to, and consequently assessment and treatment are very different. There's no need for continuous cardiopulmonary monitoring (ack! ACK!), I&O's, labs, and even blood pressures with routine assessments- much of what I've considered routine is only done if it's immediately relevant to the patient's wellbeing. I'll be honest- the simplicity of it scares me because I'm used to a lot more numbers and monitoring (helloooooo ICU). I'm realizing the extent of comfort those numbers provided- and I'm not entirely sure it's good. My concept of what medical care is needed versus nice (or even helpful) to know is being tested.
I should point out that our pediatric census and acuity is notably low, so I'm aware that we do usually have more complex patients, but even at that we don't have the capability to monitor every patient in the way that I'm used to- and many still won't need it. That's not what we're here for. Our patients should be relatively straightforward medically, if not surgically. The types of patients we see are dependent upon the types of doctors aboard. Orthopedic surgeon for a few weeks? Club feet and mal-union repairs. Maxillofacial surgeon? Cleft palates, facial reconstructions, and tumor removals. General surgeon? Hernias, hemangiomas, and thyroidectomies. The list goes on.
One of the things that really struck me today is the language barrier. Okay, so I get the interpreter thing- my previous jobs have had interpreter phones, staff, and online resources. But imagine translating through multiple languages and therefore interpreters- English to French and then/or to Fon and sometimes again to a regional dialect (though it appears here that "dialect" actually means a completely different language). Actions speak decibels louder than words. And that's just talking about language, let alone cultural communication. I haven't the faintest understanding of our differences yet- I've only just scratched the surface today. I do know that put in most of these situations, I would be doing and saying whatever I thought would make Mercy Shippers happy- whatever it took to get life changing and/or saving treatment they might offer. Through Ali, here were my patients today.
Working with these patients is going to be an eye opener to what we can do to help people- and what we can't do. And, perhaps most importantly, what we shouldn't presume to be able to fix. The thing is, we all know it- we all know and acknowledge who is really in control. I don't even understand why, but I'm finding this liberating and relieving. I'll tell you what, though. Watching a patient wake up from a transformative surgery in the swirl of colors and noises of the ward is pretty exciting. I've only had eight hours of orientation (with only eight more tomorrow), but I'm strangely ok with that. Oh, I'll be struggling and feeling stupid and lost and even make some mistakes to be sure, but I'm ready to help out. I'm on a floating ship off the coast of West Africa with a community of Christians here for the purpose of helping reconstruct the bodies and spirits of the forgotten poor. I suspect there will be a fair bit of reconstruction done on all of us as well.
How cool is this?
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