Thursday, February 28, 2008

ICU, baby

Tonight I am finally off. Six consecutive shifts is a bit much for an American 12 hour shift girl who works three days a week and regularly uses her vacation days. Today I decided I might want to work on a part time basis when I get home.

I have spent the past two nights in the ICU caring for a four year old with advanced Burkitt's lymphoma. Burkitt's lymphoma is a form of cancer in children that is predominantly found in Africa. it should not be deadly. When found and treated in an efficient manner it is usually curable.

Sadie is four. Six weeks ago he was running around playing with his friends. Six weeks ago he was eating rice with his father. Six weeks ago he was playing soccer. Six weeks ago he was wearing the small, pink "slipper" (flip flops) that are now lying empty at the foot of his bed.

Now he's sick. Very sick. A true ICU patient.

About four weeks ago a tumor stared growing in Sadie's face. It was growing very quickly but his father had no place to take Sadie for treatment. When he arrived on the ship on Tuesday it had overtaken his entire jaw. His baby teeth were all swimming loosely by the obtrusive tumor and small beads of awkward flesh were oozing from his mouth.

My heart breaks for little Sadie. Last night he was terribly uncomfortable for the first five hours of my shift. We were able to perform several pharmaceutical interventions that made him comfortable, but getting there was awful. I really hate seeing kids in pain; I think it might be the thing I hate the most.

Last night there were four patients in the ICU and two of them were true, unstable ICU patients. I only worked in the ICU once since June so I was a bit apprehensive about being placed there. But as I think about returning to American nursing, I found it comforting to find that being a nurse is in many ways like riding a bike and your unused critical thinking skills can actually experience a rather fast revival.

However, caring for an Pediatric ICU patient on a hospital ship in West Africa is a bit unnerving.At home, I work in the world's oldest and largest PICU at the #1 pediatric hospital in America. The resources are endless. There are nurses and doctors in abundance. There are supplies and computerized charts. There are 24 hour lab and diagnostic technicians.

Last night there was Stephanie and I (and Rachel and Alli next door). There was an assortment of donated mis-matched supplies that must be used carefully because we do not have unlimited resources. There was a paper with orders. There were doctors on call that you felt terrible waking up because you knew how long and hard they had worked all day. And how long and hard they would work the next day.

I told Stephanie it was like working in the ICU minus the ICU. It was a bit nerve wrecking; a bit stressful; a bit scary.

Please keep Sadie in your prayers. Please keep our nurses in your prayers. Please keep our doctors in your prayers. Please keeps Sadie's dad in your prayers.

As I cared for little Sadie I felt sad for him. His face is so cute. It's easy to imagine him running around in his little slippers. We are doing all we can for him, but the truth is, if he was in a western country, this would of never happened. His tumor would have been dealt with before he ever got to this point. Rather simple interventions would have stopped the cascade of degradation if they were accessible.

It's sad that where you live still determines whether you live or die.

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