We marched up the three flights of stairs carrying our typical 50 pound bag of donation supplies, which we usually deposit in the middle of the office of our coordinator, Aruna, who met us with her infectious smile and open arms. I have to admit, I always feel like I'm visiting family when I return.
Aruna briefed us on the plans for the next couple of weeks- who we are planning to meet with, how we can meet our goals/objectives, and plans for travel to our off site NICUs in the interior. We have plans to meet with many different hospital and ministry officials to discuss the needs of our program as well as how to help further their efforts to decrease infant mortality in the country. Our unit based goals include putting together policy and resource binders in addition to providing hands on education for our 9 new NICU nurses. We are also going to spend at least a day at each off site NICU in Suddie, New Amsterdam, West Demerara, and Linden, to provide a Neonatal Resuscitation Program (NRP) refresher course as well as readying the units for taking on full patient assignments.
We then got to meet with our nurse educator, Cenise, and the 9 new smiling nurses in our neonatal nurse training program. We spent the morning learning about each other through introductions and having them answer the all mighty question, "If you could change 1 thing in the GPHC NICU, what would it be?" While the question may have opened a can of worms, I was delighted to hear that at least we were all concerned about the same things. Many of the nurses were concerned about lack of professionalism from both nursing and physicians, and about the lack of communication between the two groups. They commented about the need for working equipment and the lack of consumable resources (such as not having hand soap, sanitizer, or gloves). This also leads to their concern about a clean environment, as there is no dedicated personnel or supplies needed to keep the equipment and unit clean to prevent infections. All of these things we plan to address over the next couple of weeks.
The afternoon brought a refresher of neonatal resuscitation with the students doing some "mock codes" with our resuscitation doll. We also discussed ways to deal with situations such as when a colleague (ahem...medical students...) isn't bagging at a correct rate and depth, or isn't following the NRP guidelines. It all comes down to "It's all about the baby"- putting your own fears of communication and hierarchy aside to do what is best for the patient. Apparently I said that lines so much today that Kate recorded it on her "quotes" notes page she keeps during our trips. :-)
Our evening brought a trip to bourda market for fresh fruits/veggies (stocked up on cucumbers, plantains (2 varieties), cassava, pineapple, sapodilla and onions), and then a supermarket for the other staples needed for our kitchen at Project Dawn.
As a cool breeze waves over the patio, we wind down as we gear up for another great day.
Practicing bag/mask ventilation
Kate helping position the bag/mask during resuscitation
Practicing coordinating compressions and ventilation
Cenise supervising a pair of students during their mock code
A view of the Accident & Emergency entrance and street vendors
Randy demonstrating how to cut a pineapple
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