Special Delivery    From Dr. Mark and Allison Karnes

5/7/03

14/3/11

Here’s the latest news:

Well believe it or not there were no major catastrophes this week.  The maternity ward has been pretty slow and the surgical cases have all gone well.  We are praising God for this.  This has given us more time to do other things like meeting with the hospital administrator and nursing director to talk about how we can make improvements regarding patient care at the hospital.  We also have been working on various protocols for our patient care.

One problem here is the need to have ‘focused nursing care.’  That means one nurse is responsible for a particular number of patients.  This is a foreign concept.  Here, all of the patients on the wards are cared for by all of the nurses, i.e., one nurse may take vital signs while another nurse checks to see if the patient has taken their medications.  No nurse has his/her own patients.  Here, when we write orders for our patients to receive medications the patient’s family heads to the pharmacy to buy the medicine and brings it back to the room where it is kept by the bedside. This includes IV bags and tubing, injectables,etc. The family is responsible for giving the patient the drugs.  Crazy isn’t it?  So when an IV dose of medication is needed sometimes the nurses will ask the family if they have the meds and then she will administer it.

When I come into the ward and ask who is responsible for my patient I’m often met with a blank stare because all of the patients are generally taken care of by all the nurses.  This is how many times big things are missed like vital signs, meds, etc. because no one individual is responsible for a particular patient.  Patients have been admitted on the pediatric ward and the nurses did not even realize they were there.

Sadly this happened yesterday.  There are several orphanages here in Soddo and Stephanie Bowers manages one for babies and small children who are adoptable.  A ‘caretaker’ dropped off a severely malnourished little girl at her orphanage to be cared for.  This child had obviously been neglected and was near death suffering from kwashiorkor.  Her body was markedly swollen from the lack of protein and she was in kidney failure.  Her story goes something like this: her father had died and her mother had left her behind with friends and family to go looking for work in a town three hours away.  Those ‘caring’ for her essentially did nothing for her.  In the U.S. these people would have been arrested for child abuse and neglect.  They had dropped her off at the orphanage so that they would not be accused of murdering her when she died at their home.  After being dropped off Stephanie brought the girl to the hospital on Friday.  The outpatient Dr. wrote orders for her and she was admitted to the pediatric ward.  Her ‘caretaker’ came along with her to care for her but soon left the child alone.  None of the Drs. orders had been carried out by the nurses and the child expired Sunday morning.  She had not been fed, no IV’s had been started. No one bothered to notify Stephanie that the ‘caretaker’ had left so consequently Stephanie did not know to call another worker to come to the hospital.  This little 4 1/2 year old girl died alone not being fed or held.  No one was taking responsibility for her care.  This is a significant problem and makes one wonder if it is cultural. Did they think that the child was going to die so why bother?

Saying all of this, we do have caring nurses here who want to give good care.  It is just a matter of mentoring them and teaching them how to be more responsible and showing them how they can be more efficient in giving good care and taking ownership of  their patients.

Our responsibility here is more than just patient care.  We have to educate and love, educate and direct, educate and serve, and educate and mentor our physicians in training as well as our nurses.

Good News!!!  Today we have heard the first positive news about Stephanie’s license.  We have heard from the Ministry of Health that they will be granting her license next month!  This has given us tremendous joy. God DOES answer prayers.   Thank you so much for your continued prayers regarding this matter.  Stephanie is not celebrating until she gets the license in her hands but we  are thrilled.   Thanks also for your words of encouragement.  We look forward to your short notes of encouragement that help sustain us.

Allison’s blog follows.

Love, Mark

One Response to “Missing My Nurses, Part II”

  1. Florentino says:

    Great contribution, neat site style, keep up the good work

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