We landed in haiti and were driven by pickup truck and car from the airport to our compound with Project Medishare. Barry (who is from SEIU 1991- we were set to travel together) and I worked as soon as we arrived at 1am as the coordinators stressed a dire need for nurses immediately. We gave our bags to people we met in the aiport for them to claim us a cot in the tent for morning and set off to work. He went to the adult tent and I was sent to ICU/OR.
Not much of an orientation, literally thrown into the unit. To my surpise we had a tarp as our OR door (which was about a foot from the ground preventing a true “seal” for sterility) and to my left was OR1 and my right was ICU.
There was a cloth separating OR1 and 0R2 across the way was OR3 and OR4. The back of the tent was shelves of medications and supplies.
The OR pictures will explain everything- The beds made out of 2x4s and a piece of plywood. They were set up as best possible.
The ICU was amazing and again the pictures will prove just that. I had about a 15 x 12 foot space to fit 3 to 5 patients on cots with air mattresses (if we could find one) along with large O2 cylinders, ventilators, monitors, defibulators, “crash carts”, a table of meds/supplies and just about anything you can imagine including space to fit nurses & doctors to provide care. I am amazed.
Of the initial 3 pt’s I cared for when I arrived, 2 had tentanus, a tracheotomy (with kerlix as a neck tie), one was intubated with a neck skin graft that didn’t take, a leg amputation (where one case of tetanus is suspected), wound vacs, external fixators and a pt with so much mucous that needed to be suctioned constantly to prevent aspiration that it was near impossible with super low suction capabilities. But we made do.
An FYI to all those who forget to get their tetanus shot- GO GET ONE! The symptoms of tetanus are horrific and ill-treatable especially with other medical conditions coexisting.
My first night went well. I worked with a VET (yes I said that correctly, not a nurse, but a vet, in an ICU) who did a great job. As an icu nurse you must lose your anal retentive ways about procedures, cleanliness and protocol and have to remember where you are and why your there- use what you can and make what you need. Improvise, open your eyes, work smart and treat the cause.
Treating my pts was a constant mission. We “charted” on notebook paper that also includes “orders” from the MD. Basically we treat what we see. If we need fentanyl we get fentanyl, propofol? Sure! We were lucky to have the most of the medical supplies we needed and if not we made something else work. Typically at night there was a float doctor we could grab but we worked as a team rather than the norm.
The VET- RN left around 630ish to head back to her camp. And around 720ish the next crew came to relieve me in the morning. I gave a “report” of what was most prevalent of each pt and what was used to help calm symptoms, etc and then I was off to find my bags so I could sleep.
Sleeping is rare as I realized that lying on a cot on top of my sleeping bag sopping wet using my fanny pack as a pillow. 2 hours of dozing in and out isn’t too horrible- just find me some water 🙂