In the local language 'hospital' literally translated is ‘sick
house.’ I (Erin) have now spent 8 mornings at a local Hospital observing nurses
and doctors. The best way I can describe
it is to imagine a hospital during the 1950s.
Now I know I wasn't even alive in the 1950's, but when I went through nursing school half of the practical
learning was about how to use machines.
Machines that took measurements, machines that administered intravenous
medications, and even machines that assisted in lifting or moving patients. While I worked as a nurse my hospital
transitioned to the use of computers for all patient information and charting. Another big push during that time was
infection control. Patients were in
single rooms, hand washing was monitored, and almost everything was
disposable. Now after hours at a local
hospital I feel a need to go through nursing school all over again, in
this country.
I’ve spent mornings on a general floor, mornings in
the emergency room, and this morning on the children’s floor. Everything seems so different. The hospital itself it more like an open air hotel
with covered walkways. It is even common to see street cats wandering about. There are different sections for patients.
A large room with at least 10 beds for
self paying or governmental assistance patients. Shared rooms with two beds for those with insurance,
and private rooms for VIP or financially able patients. All charting and patient information is done
on paper. Books like the picture below hold patient census information, medication records, and just about everything else except the actual patient chart. 
Most things are done manually,
from blood pressure to making balls from strips of cotton to soak with alcohol
for alcohol wipes. Intravenous medications
are not run on pumps; the last time I had to figure out how many drips per
minutes to set an IV bag was back in nursing school.
Even the procedures within a nurse’s scope of practice are
different. My first day in the emergency
room I watched a nurse stitch a cut on a patient’s head. My second day in the ER, I watched a nurse perform
multiple circumcisions. (Side note: upon turning 12, boys here are circumcised;
apparently you just walk into your local emergency room and ask for it.) Neither procedure was covered by my schooling
nor my license. In both cases the needles and extra string was saved to be
sanitized and used for future stitching. It has been a very valuable time for language and culture learning as well. Most patient care is done by family members. It is common for every patient to have at least two family members with them at all times. Family members assist with bathing and toileting, bringing or preparing meals, and giving all pills. They even retrieve all medications, IV bags and needles from the pharmacy and bring them to the nurses' station.
I have spent many days observing yet I feel I have only just began learning about the medical realm here. The biggest struggle for me in any future role I may play will be balancing what I learned in the states with what is actually practiced here.
