Well it is 10:30 I I just got back to the hotel...so it was a 15 1/2 hour day & a really good day for so many reasons :)
I an SO GLAD I opted to stay in last night - I got a decent amount of rest & when I got up at 5:45 am I knew it was GO TIME!!! I had some breakfast at 6:15 & then the team mtg at 6:30 & we left for the hospital by 6:50 & got there shortly after 7. Pretty much all areas were finalizing their set up & we did our "mock code" emergency plan - I am the Code Med girl as in Morocco the nurses don't dilute or draw up meds etc. So I started that role already this morning diluting & drawing up all of our Nubain (pain medicine) & saline flushes while the others got the bedsides set up & prepped IV supplies etc. We also took a PACU team photo by the OSI Morocco sign & I offered the bandage scissors that I bought on Amazon to all the local Moroccan nurses in the OR & PACU & in 5 min all 24 pair were gone - they were ok scissors not fabulous but for them to even have their own scissors or stethoscope is unheard of here.
By 0730 or so the first 8 patients (one for every surgical table) were in the child life area waiting to be taken back to surgery one table at a time. They were a cute group of little ones needing lip repairs & I was able to get some pictures & talk to the moms with a translator. It is nice having Child Life so close so I can see some of the kids before they go into surgery & introduce myself to the moms. The current plan is that we will not bring the moms back into recovery room which is a bummer on 2 levels - personally I love to see the parents when they first see their child with the cleft repaired & it is so touching & 2nd it is just better for the fussy ones to have their mom present to comfort them. The local coordinator said that Moroccan moms cry a lot so it is difficult to bring them back. I guess we will see how that goes. The Child Life folks show them photos so they understand what happens in the OR & PACU & how their child will look after surgery. They all look on very intently - for many this is their first time ever in a hospital & everything is completely foreign to them.
It is ABSOLUTELY freezing in the hospital they do not have any type of heating - which makes no sense to me but I guess that is common here? Anyway the night shift is really going to be COLD!!!
I ended up keeping my long sleeve shirt on under my scrubs & wearing my jacket. BRRR...one local surgeon brought a space heater for his OR...which then sparked an idea Nour the in country Program Coordinator who asked me if perhaps I would want to use some of the monies I had from friends & family to buy space heaters. I LOVED that idea & Nour asked Madam Mahmoudi the woman who really keep OSI Morocco going & she loved it too so they sent someone off to buy space heaters & were able to get a "good deal" from someone somewhere who is fond of Op Smile & about an hour later we had 10 space heaters for the 3 other OR's, the PACU, & 6 for the Pre/Post area :) When friends entrust me with money & tell me to just "do something good with it" I really feel a tremendous weight of responsibility & last night & this morning I was really praying that I would be led to a need or needs & then this happened...tender mercies & prayers answered not to mentions - patients, parents & the team will all be be warmer. Plus then after this mission OSI Morocco will keep them & use them on other "winter missions" so this is a sustainable gift that will keep on giving long after this mission :) It was PERFECT & I was so excited. When they brought them back they stacked them outside the OR & we took a photo of them all stacked up. SO right now between the blankets for the shelter & the heaters for the hospital what I think we needed to bring to the people of Morocco was WARMTH....and that came thru the generosity & love of others who aren't even here & don't have the privledge of seeing these sweet people we are helping. Plus the thermometers I bought on Amazon before I left & brought were also going to be a great help as we start today.
The morning lull did not last too long & there were patients on all 8 tables by 8:30 & we started getting patients in the PACU by 10 am & by noon the first round of 8 were all done. Some were calm & quiet & some were pretty miserable :(
Somewhere in the mix they asked me to bring a baby back to be screened - he was SO CUTE & I took a photo with him. He is a primary lip & they were going to add him on to the schedule today but I think they are adding him another day - yippee another new SMILE!!! We had lots of babies today & by the early afternoon some of them hadn't eaten for several hours so the Physician Team leaders wanted them to have some glucose (sugar) IV fluid...the problem was we didn't have any. In our crash box we had 50% dextrose but he wanted 10% dextrose so I got to be a pharmacy technician & make up with my mad math skills 10% Dextrose in Normal Saline IV fluid...
Also in the mix we were running a little clinic for the team in the PACU. The PACU physician is also the "team doctor" if anyone feels ill. The first to fall was cute Abigail one of the students who is 17 & a senior in high school...she had some vomiting Saturday night & blamed it on her tuna pizza (which made sense to me) but then she has felt nauseous since then & started having diarrhea today so we brought her in & gave her some anti nausea medicine, some electrolyte oral hydration fluids & told her to rest - we have all had a busy few days & jet lag - I gave her a "mom hug" & tucked her in & she slept there for 3 hours then got up & felt better & came back an hour later feeling worse so then we let her rest more until she vomited again & then I told her she had just earned herself an IV & IV fluids & IV anti nausea medicine - she had never had blood taken or an IV before but the other student Caroline came to hold her hand & video the event LOL & Ranina got an IV in super easy & fast. We gave her a liter of fluid in & started her on Cipro antibiotics & sent her back to the hotel at 7. I spent a lot of time with her being both "mom & nurse". when I just got back to the hotel I checked on her & she is doing a little better but we kept the IV in locked off over night & brought IV fluids to the hotel just in case. 2 other team members came in with random symptoms but they were in & out with Tylenol or immodium. It's only day #1 I am hoping other people done get sick sometimes it starts 7 a different person drops each day!
Each of the 8 tables has 2 lip repairs then a palate repair - which is more complex. We got our first palate back at 2:45 & it seemed like we had a lot of chaos until 6:30 or so when the last one came off. At 8:30 pm we had 4 patients still on tables so we sent half of the PACU nurses back to the hotel & 3 of us stayed. I stayed & tonight & will be one to leave earlier tomorrow although tomorrow we have 24 palates...3 on each table so that should make for an interesting day...
we started bringing moms back the last 5 patients to 'try it out" & it really worked so we are going to see what we can do tomorrow. One of the patients in that last group of 4 was #40 Salma who was 11 months old getting alip repair - her mom was one we let back & I saw on the chart it said they traveled 48 hours to get here & were staying at the shelter. I asked Samia a local nurse to translate for me & asked her where she was from 0 it is a small town across the Sahara desert. I cant do justice to the story she shared & the hardships she had but she said she heard bout this on social media & she felt that "she needed to do whatever it took" to get her daughter this help that would never come to her town because she knew a boy with a cleft who had been shunned & teased & she didn't want that for her daughter...so they trekked across the desert on buses & another type of "trailer" pulled by a burro? (some of it got lost in translation). I asked if there was anything I could do to help her & she said that if she could get a "different bus" that only leaves on Wednesdays they could get back easier so I am going to ask about that tomorrow because Samia said she did not think it was a lot of money. It again reminded me that these people all "have stories" & without eh moms there we don't hear them so I was glad I had this reminder of the sacrifices these families make to get their children the medical care they need - something most Americans don have to worry about. I am not naïve - I know there are access to care issues in the US but not at all like this - we are at a whole different level of need & access here.
So now it is midnight & I have been playing Christmas Music on my phone as I have been blogging & while I am missing some Christmas events at home that I love I am feeling the true Christmas spirit in this mission opportunity & today I definitely had the opportunity to "light & warm a little part of the world" & some peoples lives here in Morocco & that is really what this season is about...giving.
Gotta get to bed my alarm is set for 5:30 & we have a busy day on the schedule!
I an SO GLAD I opted to stay in last night - I got a decent amount of rest & when I got up at 5:45 am I knew it was GO TIME!!! I had some breakfast at 6:15 & then the team mtg at 6:30 & we left for the hospital by 6:50 & got there shortly after 7. Pretty much all areas were finalizing their set up & we did our "mock code" emergency plan - I am the Code Med girl as in Morocco the nurses don't dilute or draw up meds etc. So I started that role already this morning diluting & drawing up all of our Nubain (pain medicine) & saline flushes while the others got the bedsides set up & prepped IV supplies etc. We also took a PACU team photo by the OSI Morocco sign & I offered the bandage scissors that I bought on Amazon to all the local Moroccan nurses in the OR & PACU & in 5 min all 24 pair were gone - they were ok scissors not fabulous but for them to even have their own scissors or stethoscope is unheard of here.
By 0730 or so the first 8 patients (one for every surgical table) were in the child life area waiting to be taken back to surgery one table at a time. They were a cute group of little ones needing lip repairs & I was able to get some pictures & talk to the moms with a translator. It is nice having Child Life so close so I can see some of the kids before they go into surgery & introduce myself to the moms. The current plan is that we will not bring the moms back into recovery room which is a bummer on 2 levels - personally I love to see the parents when they first see their child with the cleft repaired & it is so touching & 2nd it is just better for the fussy ones to have their mom present to comfort them. The local coordinator said that Moroccan moms cry a lot so it is difficult to bring them back. I guess we will see how that goes. The Child Life folks show them photos so they understand what happens in the OR & PACU & how their child will look after surgery. They all look on very intently - for many this is their first time ever in a hospital & everything is completely foreign to them.
It is ABSOLUTELY freezing in the hospital they do not have any type of heating - which makes no sense to me but I guess that is common here? Anyway the night shift is really going to be COLD!!!
I ended up keeping my long sleeve shirt on under my scrubs & wearing my jacket. BRRR...one local surgeon brought a space heater for his OR...which then sparked an idea Nour the in country Program Coordinator who asked me if perhaps I would want to use some of the monies I had from friends & family to buy space heaters. I LOVED that idea & Nour asked Madam Mahmoudi the woman who really keep OSI Morocco going & she loved it too so they sent someone off to buy space heaters & were able to get a "good deal" from someone somewhere who is fond of Op Smile & about an hour later we had 10 space heaters for the 3 other OR's, the PACU, & 6 for the Pre/Post area :) When friends entrust me with money & tell me to just "do something good with it" I really feel a tremendous weight of responsibility & last night & this morning I was really praying that I would be led to a need or needs & then this happened...tender mercies & prayers answered not to mentions - patients, parents & the team will all be be warmer. Plus then after this mission OSI Morocco will keep them & use them on other "winter missions" so this is a sustainable gift that will keep on giving long after this mission :) It was PERFECT & I was so excited. When they brought them back they stacked them outside the OR & we took a photo of them all stacked up. SO right now between the blankets for the shelter & the heaters for the hospital what I think we needed to bring to the people of Morocco was WARMTH....and that came thru the generosity & love of others who aren't even here & don't have the privledge of seeing these sweet people we are helping. Plus the thermometers I bought on Amazon before I left & brought were also going to be a great help as we start today.
The morning lull did not last too long & there were patients on all 8 tables by 8:30 & we started getting patients in the PACU by 10 am & by noon the first round of 8 were all done. Some were calm & quiet & some were pretty miserable :(
Somewhere in the mix they asked me to bring a baby back to be screened - he was SO CUTE & I took a photo with him. He is a primary lip & they were going to add him on to the schedule today but I think they are adding him another day - yippee another new SMILE!!! We had lots of babies today & by the early afternoon some of them hadn't eaten for several hours so the Physician Team leaders wanted them to have some glucose (sugar) IV fluid...the problem was we didn't have any. In our crash box we had 50% dextrose but he wanted 10% dextrose so I got to be a pharmacy technician & make up with my mad math skills 10% Dextrose in Normal Saline IV fluid...
Also in the mix we were running a little clinic for the team in the PACU. The PACU physician is also the "team doctor" if anyone feels ill. The first to fall was cute Abigail one of the students who is 17 & a senior in high school...she had some vomiting Saturday night & blamed it on her tuna pizza (which made sense to me) but then she has felt nauseous since then & started having diarrhea today so we brought her in & gave her some anti nausea medicine, some electrolyte oral hydration fluids & told her to rest - we have all had a busy few days & jet lag - I gave her a "mom hug" & tucked her in & she slept there for 3 hours then got up & felt better & came back an hour later feeling worse so then we let her rest more until she vomited again & then I told her she had just earned herself an IV & IV fluids & IV anti nausea medicine - she had never had blood taken or an IV before but the other student Caroline came to hold her hand & video the event LOL & Ranina got an IV in super easy & fast. We gave her a liter of fluid in & started her on Cipro antibiotics & sent her back to the hotel at 7. I spent a lot of time with her being both "mom & nurse". when I just got back to the hotel I checked on her & she is doing a little better but we kept the IV in locked off over night & brought IV fluids to the hotel just in case. 2 other team members came in with random symptoms but they were in & out with Tylenol or immodium. It's only day #1 I am hoping other people done get sick sometimes it starts 7 a different person drops each day!
Each of the 8 tables has 2 lip repairs then a palate repair - which is more complex. We got our first palate back at 2:45 & it seemed like we had a lot of chaos until 6:30 or so when the last one came off. At 8:30 pm we had 4 patients still on tables so we sent half of the PACU nurses back to the hotel & 3 of us stayed. I stayed & tonight & will be one to leave earlier tomorrow although tomorrow we have 24 palates...3 on each table so that should make for an interesting day...
we started bringing moms back the last 5 patients to 'try it out" & it really worked so we are going to see what we can do tomorrow. One of the patients in that last group of 4 was #40 Salma who was 11 months old getting alip repair - her mom was one we let back & I saw on the chart it said they traveled 48 hours to get here & were staying at the shelter. I asked Samia a local nurse to translate for me & asked her where she was from 0 it is a small town across the Sahara desert. I cant do justice to the story she shared & the hardships she had but she said she heard bout this on social media & she felt that "she needed to do whatever it took" to get her daughter this help that would never come to her town because she knew a boy with a cleft who had been shunned & teased & she didn't want that for her daughter...so they trekked across the desert on buses & another type of "trailer" pulled by a burro? (some of it got lost in translation). I asked if there was anything I could do to help her & she said that if she could get a "different bus" that only leaves on Wednesdays they could get back easier so I am going to ask about that tomorrow because Samia said she did not think it was a lot of money. It again reminded me that these people all "have stories" & without eh moms there we don't hear them so I was glad I had this reminder of the sacrifices these families make to get their children the medical care they need - something most Americans don have to worry about. I am not naïve - I know there are access to care issues in the US but not at all like this - we are at a whole different level of need & access here.
So now it is midnight & I have been playing Christmas Music on my phone as I have been blogging & while I am missing some Christmas events at home that I love I am feeling the true Christmas spirit in this mission opportunity & today I definitely had the opportunity to "light & warm a little part of the world" & some peoples lives here in Morocco & that is really what this season is about...giving.
Gotta get to bed my alarm is set for 5:30 & we have a busy day on the schedule!
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