Since it is always empty in the PACU for the 1st two hours or so until patients finish surgery; Chris & I again went up to pre-post to check on the kids who had surgery yesterday. Some of the cute 10-year-olds we took selfies with at screening had surgery yesterday so they were excited to see us this morning, since they have had their surgeries & will be going home – more photo ops of course and some sweet hugs – they are all so precious!
Chris &
I got matching Egypt scrub hats & wore them today to be “ALL IN” for this
Cairo Egypt mission. Little did I know that maybe we bothered the ancient
Egyptians because today was “THAT DAY” for this mission; teaching me that even
on smaller, complex missions you can have CRAZY & CHAOTIC days & this
was ours from start until our 9 pm time back at the hotel – yep, you’d not
expect a late night with only 17 cases but we had it! I feel like I was also “the
med nurse” today because I am sure I gave over 20 meds on my patients &
others. Also, several of my patients must have signed up for the “extended stay
package because they were not progressing & stayed way too long!
The first patients
again came back starting at 10 am & it was steady all day. My first patient
was a very unhappy 2-year-old palate who even with meds was crying. The mom was
also distraught & bless Morag she took the baby & rocked & sang to
him & after about 20 min of that he fell asleep. But during that 20 min. the
mom of Chris’ patient came in & was overwhelmed by the PCU & her baby
& decided to go back out w/o telling anyone & fainted on her way out
but fortunately was caught by one of the students by the exit door. We elevated
her legs & got her juice & settled amid all the crazy.
My 2nd
patient was worse than my 1st…cute Abdul. Anesthesia said he had a
bronchospasm at the end of the case & was having some difficulty breathing
so they put a nasal airway in – wonderful makes sense. BUT…he then pulled the
nasal airway after he gave me report & the patient immediately crashed as
he walked out f the room dropped his oxygen level to 70%, working heard to
breath, heart rate up. We found a nasal airway & inserted it, put him on
oxygen, gave him a breathing treatment – pretty much all simultaneously & I
was just about to assist his breathing when he started to improve. It was a CRAZY
1st hour with him trying to figure out what was going on keeping him
sitting up. Every time I tried to wean the oxygen, he dropped his O2 level – I gave
a boatload of meds for pain, plus a diuretic cause his lings sounded a wet
& some steroid & FINALLY he turned the corner after some “intensive
care” for 2 hours & I was able to wean the oxygen & watch him another
hour; Yes he had the 3 hour PACU extended care package. He was REALLY cute
though & when he did finally wake up had the cutest smile. I took a pic w/
him & his mom as I took them to post op. By now it was 3:30 as my 2 patients
had stayed a total of 5 hours???
As I walked
back into the PACU the same anesthesiologist was bringing back another patient this
one w/ an oral airway & special needs who was really kicking & having a
hard time coming out of Anesthesia – seemed a little bit like ground hog day
& fortunately Saben took one for the team & cared for that patient. The
post op floor was bringing down a patient who was having some bleeding, so I
took that patient & we were able to get his bleeding stopped with a lot of
pressure on his palate for about 30 min & thought we were good but watched
him another 30 min & he started to bleed again so I added a tea bag on a tongue
depressor to my pressure regimen &that seemed to work – Hooray! When I took
him back upstairs the post op ward was “drowning” a few kids weren’t doing well
plus they were getting all the kids from us & they legit said “we need help”.
So, I said I would send people up & when I went back to PACU there was only
one pt left to come in so we sent 2 nurses & our doctor up there &
Saben & I stayed in PACU. Our last patient clearly knew the theme of the
day – “create chaos” & had a rough surgery so the anesthesia team gave him
plenty of sedation & he came out sleeping for about 10 min til he woke up
& was also bleeding. Thank goodness Morag was with us because he too had
special needs & it took all 3 of us to keep him in bed. Secure his IV so we
could give meds, and try to stop the bleeding. We sent SOS texts on our team WhatsApp
to now ask for help from us after we sent all the help upstairs. I know it
sounds comical, but it wasn’t feeling that way in the moment. A surgeon came
back & our PACU doc & they did some work in his mouth in the PACU &
got the bleeding stopped so he didn’t need to go back to the OR which by now
were all being cleaned…when we took that LAST patient up the post op ward was
still very busy but they had some help, so I think they at least felt better
& supported. BY now it was 8 pm & we needed to wait to fill the bus w/
everyone still at the hospital so that took awhile & then the drive home had
lots of traffic on a Fri night that was also Islamic New Year…maybe that is what
made this day CRAZY!?
So yes even
missions with less patients can have days like this 😊 The PACU mantra is we are typically pretty chill with intermittent chaos
& today was A LOT of chaos & intermittent chill. I can’t believe
tomorrow is our last day of surgeries & then I head home WAY TO EARLY on
Sunday. My flight is at 4:15 am (I really thought it was 5:15) so I am thinking
there will be NO SLEEP & we will have to go to the airport by 1 am or so –
we will see. Still, I would sign up for it all over again even with a day like
today. Shower, Blog & Bed were all that was on my agenda for the night so
off to sleep I go!
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