The numbers

There are a lot of numbers in the ICU. Actually, it brings another meaning to "safety in numbers." Numbers don't lie, though they can certainly distract from the primary problem. Patients are much more than numbers, of course, but we spend a lot of time recording, evaluating, and predicting them. And it's not that we don't care, but we often refer to patients by bed number when we're outside the room. After all, if you're not taking care of that person, how can you be expected to know the name of each patient tucked away in their private rooms? Numbers are a fact of life in a big way.

I vividly remember my stomach lurching at the sight of fifteen patients without monitors here in Africa. My heart was pounding, and I had visions of people crumping left and right. I knew it was overreacting on my part, but it was evident from the start how much comfort I get from the familiar blips, whirs, sighs, and alarms of a hospital room. Instead we are surrounded by laughter, foreign banter, five person translations, tv, falling Jenga towers, prayers, and singing. I'd be lying if I said it wasn't a bit disconcerting.

The lack of numbers also gave me some anxiety- where are my q15 complete vitals? Where are my hourly I's and O's? Where are my ventilator settings? Where are my CRRT numbers? Where are my individualized code sheets? Where is my H&P? It's not that we don't have numbers out here- we do (though less of them). We follow the values and trends because they're no less important. Sometimes we still refer to patients as bed numbers, though it happens less often since we're all in one big room and get group report in the mornings. I think the difference is that more time is spent interacting with patients (they're largely "walkie talkies" here) and establishing a different kind of relationship than I'm used to. Yes, we're nurses ("toto" in Fon), but nursing here is different. It's more comprehensive.

Sometimes I really miss my numbers. I'm a geek at heart and enjoy their company. And for the introverts and socially awkward among us, interaction isn't usually easy. But I don't think any of us came out here for easy. We're being stretched and tried in our individual ways. God knows what we need to grow. For me, I think part of that process is setting those numbers aside, looking the patients, staff, and translators in the eye, taking a deep breath, and interacting.

I'll be honest, it scares me a bit every time.