It's back to work I go!

I must say that the first few days back at work without Karen have been quite strange! We're always a great support for each other and when things get a bit frustrating or upsetting we cope with it together. So, first day back I was slightly apprehensive about what the day would hold. However, I soon found that there was nothing for me to be concerned about because when I entered the ward I was greeted by numerous staff welcoming me back and asking after Karen (or 'Lamara' her Acholi name meaning loves her work/hard worker!)

Unfortunately, on friday, I sustained a small needlestick injury after inserting an IV cannula (the needle pierced my skin after being in contact with a patient). This is never an easy experience as you go through a range of emotions and worry about what might happen. Straight after the incident I followed the protocol that we are taught back at home and then I informed the Sister-in-Charge who was very apologetic and went to ask the Consultant for advice. The patient then consented to having a HIV test and I went home to get our emergency antiretroviral pack. On my return, feeling quite shaken and worried, the nurses on the ward were extremely supportive. They said that 'God would protect me' and that I shouldn't worry. The HIV result came back negative shortly afterwards which was a huge relief. The Consultant advised me that I should continue to take the antiretroviral drugs just in case the patient was in the window period where HIV cannot be detected. The Intern Doctor relayed how he'd had two incidences where he had needed to take the antiretrovirals and that everything would be ok. The Sister at the HIV clinic was very supportive and helped me to get the full course of medication from their pharmacy.
It just goes to show that, even when you might feel a million miles away from home, there are always friendly faces to offer help and support. I was really impressed with all of the staff at Gulu Regional Referral Hospital in this situation and, without my Acholi sister Karen with me, I was glad that I was surrounded by Gulu friends!

Today I went onto the ward to find two patients who were unconscious, one who could hardly breathe and then not long into the shift another patient started having an asthma attack. Now on days like these it's difficult to know where to begin and, with only one other nurse on the ward for 45 patients, I realised that we were in for a busy day!!
I started work going to look at our unconscious patients who both appeared to be surprisingly quite stable and not requiring anything urgently. I then went to a very unwell looking lady who was gasping for breath! After recording her observations and finding them to be extremely unsatisfactory I put up the fluids that were prescribed and went off to A and E to find the Oxygen Saturations machine (to measure her oxygen levels) and a Doctor as our Medical Intern Doctor has unfortunately gone on leave this week, leaving one Intern working between A and E and the Medical Ward. I luckily found the Sats machine easily but then two barriers stood in my way - one was the A and E Sister who wasn't very keen to lend it to me at first (I promised I'd bring it straight back!) and the other was that there were no batteries in it. So, having signed to say I'd return it, I went off in search of batteries. These purchased from a local kiosk, I went back to my patient and found that her oxygen levels were very low. I trundled back to A and E and presented the case to the Doctor who said that he'd come straight away.
We decided to put the patient on oxygen so we had to borrow the oxygen concentrator from A and E - the Sister said that she'd come and arrest me if I didn't return it!!(I can understand her worries as things go missing very easily around the hospital because it's so under resourced that every piece of equipment is in great demand!I think that it worked in my favour that I had just brought back the Sats machine complete with batteries!) So the Doctor came up and reviewed the lady and decided that she probably has TB...he asked for some further investigations and we are now giving her the maximum treatment that we can from the medical ward: 2 litres of oxygen (a very small amount by UK standards), IV antibiotics and TB treatment if her sample results come back positive. I hope she pulls through...

Another patient today was very quietly lying on her bed under a sheet and when I asked her name it transpired that she was having an asthma attack! She was very wheezy and really struggling for breath. Just as I was going to find a Doctor the Intern walked onto the ward and he reviewed her immediately. I cannulated her and gave her some IV aminophylline and within 15 minutes she was sat up chatting and giggling with her son and daughter. When I went back to see her she gave me a big grin and said Apwoyo Matek! (Thank you very much!)