Thoughts One Year Later

I didn’t quite know what to expect today.  For the past year, I have been wondering how things are coming along here… and, today, I am finally starting to find out!  To start:  the radiology department now has a computer to which images are uploaded (only Xray, still no CT).  The last time I was here, there was a pile of Xrays that I would have to shuffle through.  The computer had me super psyched!  However, I have quickly come to learn that many of the patient’s names are improperly spelled in the computer.  This makes searching for images almost as challenging as it used to be.  It’s an improvement though! 

The charts that I made on the pedi ward last year are STILL IN USE!  Not gonna lie: I had my doubts that the organization would last a whole year.  But, the nurses and other staff have incorporated this new, organized charting system into daily practice.  SCORE!  My hours of hole punching and sorting through papers last year in the 100 degree heat were not for nothing!  This is making rounding much easier.  There is a section for orders, labs, xrays, nursing notes… it’s really fantastic. 

The patient census seems to have decreased.  I am not exactly sure why though.  I would like to think that we are doing a better job at preventative medicine.  An even more optimistic thought is that our Chronic Illness Clinic is keeping our “frequent flyers” out of the hospital.  But, I do wonder if children are going to the few other hospitals in Monrovia.  JFK Hospital (where we work), is the largest in the country and considered the tertiary care center.  I am really hoping to visit at least one of the other hospitals during my trip, just to see how it compares to JFK.

Sadly, there is much that has NOT changed.  Malaria is as fierce as ever.  Most of the ward is filled with children with severe malaria, including cerebral malaria.  Malnutrition is still the second most common diagnosis for kids and has a staggering mortality rate.  Children are still suffering immensely with tremendous pain from various disease-processes…. Morphine (or any other narcotic) is still very hard to obtain here.  The nurse-to-patient ratio is still about 1 nurse to 15 patients.  (Can you imagine what one of our 5East nurses would say about that?!?!) Overall, JFK remains very understaffed…. This seems to be the key problem here.  They are in need of more educated healthcare workers. 

I was happy to see many of the same nurses on the pedi wards.  (Even happier that they remember me)  I would like to pick right up where I left off last year, and a lot of that depends on gaining the trust and respect of the JFK staff.… just need to get over this jet lag/post-NF exhaustion!