Heya Peeps!
As a new nurse a few years ago, I wrote some blog posts about a night in the life and a day in the life of my job. I'd go find them for you, but I got up at 5:30 to run a Turkey Trot this morning and already used up all of my overachieving energy for the day.
However, working as a nurse in Togo is maybe just sliiiightly different, so I thought I'd try to give you a taste/glimpse/whiff/feel/drift of what a day looks like for me here at the Hospital of Hope.
6:00am: Alarm goes off. Get dressed, eat breakfast, take my malaria prophylaxis, head out the door.
6:30ish: Drive my moto just over a mile to the hospital while braving the sand dunes that are forming on the road and the 'traffic' consisting of turkeys, mules, goats, school children, and many other motos. Cars are rare and don't cause traffic here.
6:36: Park at the guesthouse and drink a cup of coffee before the day begins.
6:56: Walk over to the hospital, greet everyone, look up which wards I am assigned (could be 1-13 patients), get my med sheets, get report (mostly in Frenglish), start to assess my patients.
That's where the schedule ends and the madness begins. I think at this point it's easier to make some lists to help catalog the day.
Types of patients I could work with on any given day
-Adults
-Adults intensive care
-Pediatrics
-Pediatric intensive care
-Overflow maternity patients
-Neonates
-Post surgical patients
-Patients in REA which is the ER area
-Outpatient injections and infusions
Things I do nearly everyday
-Give meds. This includes mixing most medications and doing all of the dosing calculations myself
-Calculate drip rates
-Measure feeds for some of the babies
-Crush one of a thousand bugs that made its way into the hospital
-Assessments
-Paper charting. I chart 1 main assessment, an update assessment, and anything notable that happens This takes maybe 20 minutes if I have a bunch of patients
-Respond to emergency patients in REA
-Put in my own IVs, give my own neb treatments, respond to codes, restock medications and supplies, clean, do EKGs, or any number of other things that I might have delegated back in the States
-Take a real 2 hour long break to eat lunch and rest and have energy to finish the day without having to carry a phone on me or eat on the unit
-Make a fool of myself mispronouncing French words and trying to act out various bodily functions or procedures
-Wash med cups so that we can reuse them
-Search around for equipment I need that is currently working
-Sweat
-Learn or experience something new
Notable things I DON'T do every day
-Tons of charting
-Take people to the bathroom. Families do this 95% of the time.
-Fetch water/coffee/snacks. Families are responsible for this.
-Answer half a million phone calls
-Ask dozens of questions to admit someone. A lot of patients don't even know their birthday, so most of the admission questions I'd ask would be kinda pointless.
-Do a lot of discharge teaching. I'm bummed by this cause I love teaching patients, and I am very limited by language and health literacy.
-Have everything double checked by a computer and scan everything to double/triple check the identity of a patient
-Answer call lights. I do however answer to family members who come and get my attention.
Common illnesses/issues
-Malaria. Often accompanied by seizures, severe anemia, and/or hypoglycemia
-Snakebites
-Fractures and injuries from accidents
-Meningitis
-Typhoid fever
-Respiratory distress from pneumonia or tuberculosis
-Premature infants
-Hernia repairs
-Cancers
Things that make my day
-All the siblings/children who hang out in the wards and stare at me but then smile when they learn how to fist bump. I also love the moms and grandmas who are so amused by the interaction.
-The way family members care for their loved one but will also step in to help someone else in the ward. They'll empty the bedpan or share food or help translate for someone they've never met.
-Getting an IV on a baby. Actually just getting IVs in general.
-Saying something in French and having the person actually understand it.
-Listening to the doctors or chaplains pray with patients.
-Seeing a child turn the corner, wake up, and start to eat and interact with you.
7-7:30pm: Give report. Say a prayer of thankfulness for getting through the day. Head home. Raid the fridge.
That's about all I got for now. Thanks for reading!
Prayer Requests:
1. Pray for the students I get to work with in clinicals.
2. Pray for the many wonderful ministries going on here. It's exciting.
3. Pray for my relationships with my Togolese neighbors.
Praises:
1-10,000. Where to start? Let's just say everything.
Peace out,
-C-
Saturday, November 24, 2018
Sunday, November 4, 2018
Every Tongue
Before I came to Togo, I tried to learn a little bit of French. I diligently spent 10 minutes a day on Duolingo and spent some time reading Harry Potter in French on my Kindle. But it turns out that 10 minutes a day doesn't make you fluent or teach great pronunciation, and knowing the French word for magic wand or cauldron doesn't do you a lot of good in Togo.... It would have been so helpful to go to a language school and take some intensive courses, but it cost a lot, and the timing didn't really work out with my time table.
Since I've been here, I've picked up more and more, but still can only track 30-60% of a conversation and can speak much less. Turns out, there are many people who come through the hospital who don't speak French at all. They come from remote villages or even other countries in order to get better care. Even if I were a fluent French speaker, I wouldn't be able to communicate with them. You have to find a hospital employee who speaks that language (or in some cases, two people to do a four way translation), and hope that at least a portion of your message gets across.
Something else I've discovered is that gestures are not universal. Not everyone rocks a baby like I do. Not everyone physically expresses pain, so acting out pain doesn't always translate. Drinking from a cup is something I take for granted, but might be a foreign concept to someone from a remote village. Even things like telling time or counting seem like simple concepts but can still cause more confusion than clarity.
To further complicate things, there may be next to nothing in terms of health literacy. I've heard doctors have to explain that if a person is not breathing, it means they have died. There's a big misconception that malaria is caused from too much sun because the person may feel hot (with fever). Teaching patients sometimes feels futile.
If you can't tell, language is a huge barrier to communication. It can be so frustrating- especially in an urgent situation where there isn't time to figure out the proper communication. If I can't even tell someone that they are going to have surgery in an hour, how can I possibly have a meaningful conversation? How can there be any sort of relationship?
Some of the best and most relational things in life transcend language.
Celebrating a good save in volleyball doesn't require words. Turns out that even trash talking can cross that barrier. Team bonding occurs even if you can't pronounce the names of your teammates.
No one gets confused if you admire their baby. Cuddling and cooing over tiny fingers and toes is something everyone understands.
Everyone laughs.
This morning, my roommate invited some of our Togolese neighbors over for a late breakfast. We sat on the floor for our meal. We drank coffee with ridiculous amounts of sugar and ate breakfast sandwiches made from bread that was baked this morning. One of them started playing music, and we got up and danced. We ate and we laughed and we communicated both our words and our actions.
So. I'm going to keep studying French. I'm going to keep attempting to communicate and educate as much as I can. I'm going to figure out alternative gestures. I'm not giving up.
But even more so, I am going to play games and cuddle babies and laugh and open my home and eat with my neighbors and sing and dance and love these people whenever I can. I have 6-7 more months here. There are so many more things connecting us than barriers separating us. My relationships are not dependent on my fluency in French.
And then, when I come home and can relax into my own culture and language, I'm not going to change a thing.
Since I've been here, I've picked up more and more, but still can only track 30-60% of a conversation and can speak much less. Turns out, there are many people who come through the hospital who don't speak French at all. They come from remote villages or even other countries in order to get better care. Even if I were a fluent French speaker, I wouldn't be able to communicate with them. You have to find a hospital employee who speaks that language (or in some cases, two people to do a four way translation), and hope that at least a portion of your message gets across.
Something else I've discovered is that gestures are not universal. Not everyone rocks a baby like I do. Not everyone physically expresses pain, so acting out pain doesn't always translate. Drinking from a cup is something I take for granted, but might be a foreign concept to someone from a remote village. Even things like telling time or counting seem like simple concepts but can still cause more confusion than clarity.
To further complicate things, there may be next to nothing in terms of health literacy. I've heard doctors have to explain that if a person is not breathing, it means they have died. There's a big misconception that malaria is caused from too much sun because the person may feel hot (with fever). Teaching patients sometimes feels futile.
If you can't tell, language is a huge barrier to communication. It can be so frustrating- especially in an urgent situation where there isn't time to figure out the proper communication. If I can't even tell someone that they are going to have surgery in an hour, how can I possibly have a meaningful conversation? How can there be any sort of relationship?
Some of the best and most relational things in life transcend language.
Celebrating a good save in volleyball doesn't require words. Turns out that even trash talking can cross that barrier. Team bonding occurs even if you can't pronounce the names of your teammates.
No one gets confused if you admire their baby. Cuddling and cooing over tiny fingers and toes is something everyone understands.
Everyone laughs.
This morning, my roommate invited some of our Togolese neighbors over for a late breakfast. We sat on the floor for our meal. We drank coffee with ridiculous amounts of sugar and ate breakfast sandwiches made from bread that was baked this morning. One of them started playing music, and we got up and danced. We ate and we laughed and we communicated both our words and our actions.
So. I'm going to keep studying French. I'm going to keep attempting to communicate and educate as much as I can. I'm going to figure out alternative gestures. I'm not giving up.
But even more so, I am going to play games and cuddle babies and laugh and open my home and eat with my neighbors and sing and dance and love these people whenever I can. I have 6-7 more months here. There are so many more things connecting us than barriers separating us. My relationships are not dependent on my fluency in French.
And then, when I come home and can relax into my own culture and language, I'm not going to change a thing.
"God exalted him to the highest place
and gave him the name that is above every name,
that at the name of Jesus every knee should bow,
in heaven and on earth and under the earth,
and every tongue acknowledge that Jesus Christ is Lord,
to the glory of God the Father."
and gave him the name that is above every name,
that at the name of Jesus every knee should bow,
in heaven and on earth and under the earth,
and every tongue acknowledge that Jesus Christ is Lord,
to the glory of God the Father."
Philippians 2: 9-11
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