New Intensive Care Unit

 

Holy Spirit Hospital has just opened a brand-new Intensive Care Unit (ICU). Sister Julianna had been trying to open one for so long and right when she leaves, it becomes ready to use! It’s not like our ICUs in the States. It’s closer to what we have in general admission wards. They have monitors and IV pumps and oxygen that can be plugged into the wall where it is attached to oxygen tanks in a separate building. Usually, patients don’t have monitors or IV pumps to deliver medication and if they need oxygen, it comes from a machine that relies on electricity. Many of the nurses here have never worked with machines like that and don’t have the proper training. So, I have been spending a lot of time on the new ICU helping set up monitors. I really need to teach more people about how the settings on a monitor for a child are very different than the settings for an adult. I also need to reinforce the need to not allow bubbles in the IV line. Even one tiny bubble can set off the IV machine. They also have a baby incubator in the ICU. They have no plans at the hospital to use it any time soon, but I want to ask if I can check it out to see if it works like the ones we have in the States and teach some nurses how to use it in case the need ever comes up. I can see myself spending most of my time in the ICU, but I am primarily a pediatric nurse and while I don’t just work with children while I’m in Sierra Leone, I feel I should spend some time on the general pediatric ward as well as the ICU.

 

The other day I had a chance to use my knowledge of medical machines and pediatric nursing care. In the morning while doing rounds, I saw a child with increased respirations and labored breathing. I knew the signs that the baby would soon exhaust itself and wouldn’t be able to keep up breathing like that. I began doing what we do in the States and had the baby sit up and I made what we call a nest so she could sleep while sitting up. I also placed a shoulder roll under her shoulders to help open her airway. Dr. Turay saw what I was doing and examined her for himself. He recommended the child be sent to ICU. Now I should explain, ICU is much more expensive than the general ward and the family has to be consulted first, so they are aware of the cost and to be sure if they have the money available. It took a while to figure that out, but eventually we moved her to the ICU. I taught the younger nurses who were there about the difference between pediatric and adult monitor settings, but I don’t think the understood my broken Krio. I also taught them about positioning that helps with the baby’s breathing. Besides teaching, I was also trying to advocate for the baby to get the proper medications to help open her airway. What she really needed was a dose of albuterol from a nebulizer. But it took so long to find all the parts for a nebulizer and then when I finally assembled one, it turns out the hospital didn’t even carry albuterol, so we had to wait until we could send someone to buy some at another pharmacy.

 

If there are two things the hospital here truly needs, it’s more resources and better communication. Maybe one day when I’m back home I’ll set up a fundraiser to help with acquiring more resources for Holy Spirit Hospital. And maybe one day I’ll figure out some kind of class where I can teach methods of communication. Until then, I’ll just keep doing my best helping where I can and teaching where I can.