Day Two: Hitting the Ground Running

Actually we hit the ground last evening, and have been running since.

Right now, to paint a picture, I'm on a porch. It's pouring but the computers are sheltered by a roof. The rest of the volunteers are milling about drinking beer and relaxing, or sleeping beneath mosquito nets behind the thin wall to my left. I'm in my scrubs and interrupting my own writing to chat with two 4th year med students who are sitting with me. They are discussing creating an art therapy group for the children, who are all having nightmares. These are my new friends, comrades. I'm so proud.

I'm not sure how I want to frame all of the information I have for you. A narrative would be overwhelming at this point, and we're only two days in. So much has happened, I feel as though I've been here for a week already, and yet I'm sure as the actual week goes on I will start to think  I only got here.

I have fallen in love with Haiti and with the people here. It's a beautiful country and the people have a spirit which is incredible. It blows me away and puts any faith or hope I may have to shame.
I want to talk more in depth about it. Because sometimes it's easy to take for granted. In fact - I have to. If we spent all our time marveling at everyone nothing would get done. But once in a while a look from a patient, or seeing an exchange between two people will hit me- HARD. And it makes me stop everything.

BHCHP can be proud of us so far. Although last night we worked together we got split up today and we're each handling a tent of 36 patients. The teamwork here is amazing. Sometimes there aren't enough people to go around and that's hard, but everyone is here to help. There were two other RNs with me for the first part of the day. One had been in charge of our tent all week and she left this afternoon; she gave me a quick orientation last night. The other RN, April is an ER nurse from Oklahoma and and she's awesome. We gave out all the meds, did vitals, flagged patients for surgical wound rounds and once that was done ,  set to work immediately rewriting every chart (which are in complete disarray), creating our own plan for medication distribution, and updating the care plan papers that hang taped above the beds because they were mostly outdated.

I want to go be social, and I still need to wash the DEET off my skin. But first, another picture:

Today in my tent I was creating a system for how to communicate with our MD, who was in and out because he was also rounding with ortho across the road in the OR.  To paint the picture for you even more, the tents are hot, hot hot. It's hot outside, but worse in the tents. It's over 100 degrees easily, and muggy. Inside there are a lot of flies looking for wounds we forgot to cover. It smells like people in the tent. There are not only 36 patients, there are family members sleeping on the ground, or sharing cots.

  I had done all my patient care and was trying to sort out all the orders I needed clarified. (There were a lot of them). Then twenty men in suits walked into our cramped, thick aired tent. They were smiling and shaking hands. I ignored them after a minute because they didn't seem harmful, and there are people in and out the tents all day volunteering to help their neighbors and family.

Just then one of the patient's family members sidled up to me and said "you know, I'm not his family."
He pointed at the patient, "he lost everyone in the earthquake. But I stay here. I wash him, I bring him food. I take care of him. I met him here. I also have no family.

"I do it because the Lord loves me, so I love him."

The men in suits lined up in the center of the tent, and began singing. They were an acapella Gospel group. And they were amazing. They sang for a long, long time. My patient's "family member," translated for me:

"If you have problems... don't worry. For the Lord is with you.
"Don't cry... don't cry. He understands you."

All around us patients smiled, bowed their heads or sang along. They have so much faith. They have no doubt. They adopt one another. They live for each other because that's how to stay alive.

I have literally never seen anything like it. I'm floored.

Nurses Gone Wild: Ft. Lauderdale

 Day One (actually).

I should have called the previous entry "Day Zero," since today will be my first day in Haiti.
This will likely be my last blog update, although they said there are computers on the compound.

Had a lovely day yesterday, mostly all to myself, in Ft. Lauderdale since Colleen and Yolanda were delayed at Logan. I even got a slight tan sitting by the pool! (I know:  it's unhealthy. I'm over it.)

After dinner we embarked on a mission to Target because another co worker, Ashley, called to tell us that the hospital ( Hopital Sacre Coeur) needs staplers badly - all the patient charts are falling apart and documents are being lost. Funny how we don't think of it, but office supplies are all part of keeping patient care flowing smoothly.

Our cab driver for the evening, a Jamaican man named Seymour, quickly became our new favorite person as he explained his retirement plan. Then we had a sing-a-long with him.

When Stacey arrived I was already asleep, but it wasn't very late. My anti malaria pill knocked me out. Thank goodness that little monster is just once a week.

We're heading to the airport soon but our flight isn't until 10am. My phone works on the frequencies in Haiti, but it's expensive to do much besides text message. I can text  to Twitter, so that's your best bet for anything particularly interesting or important especially if you're following from BHCHP. Just keep in mind because my phone is not very fancy, I can't see any responses. If there's an emergency at home - please text straight to my phone. I'll get it, and receiving messages over there is included in my bundle.

Day One. A new world holds me to a promise, standing by, standing by...

Day One.
This morning I am flying solo to Ft. Lauderdale. About an hour after I arrive the rest of the team will get there.
We have a hotel room booked for the night, and during the day we plan to hydrate, rest and bond. (I also plan to get some Vitamin D!) Also, yesterday I caved and bought an ipod touch, so I will also be practicing my Creole using this Byki App all day.

Tomorrow we board the cargo plane to Haiti. When we arrive we'll be given our assignments.
I have no idea what to expect.
Sinead worked in the ER. Rachel worked in the pysch unit (she speaks fluent Creole so that makes sense). Barry, our director of nursing, worked as their director of nursing while he was there. Not knowing the language, most of his staff, or the protocols, he jumped in and helped keep the place running for his seven days.  This week our co worker, Amy M. has a facebook status that says she is working night shifts... in the ICU.

There is so much that I know ("bring flip flops for when you get to shower," "use DEET it's the only thing that works..") but the unknowns of where I'll be working and how it will be set up, and what kind of skills I'll be calling on (and learning!) are just  huge right now.

Endorsements and Plugs Before I Go

I've been promoting BHCHP a lot for all the work they have done to make this trip possible. Now I'd like to take a minute to thank Improv Asylum. As soon as I mentioned going to Haiti I was given time off to leave, and the cast has been super supportive in covering the shows I will be missing (especially Kiley and Jane who have to step up for all the female roles). So ...  thank you everybody!

Also, be sure to check the grand opening of our newly renovated theater in the beginning of March!
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Tuesday, at my favorite laundromat in the world, Don Zar donated a free load of laundry to the Haiti cause, allowing me to get all my scrubs ready for the trip. The Laundry Room Etc., located on Mass Ave near Porter Square is fabulous. It's more expensive than the laundromat near my apartment, but I haul my stuff to Porter just because Don is so great, his place is so clean, and the environment is so cozy. If you have to use a public laundry room, you should go to his. Check out my Yelp review here.
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I won't be able to do it while I'm gone, so please, please remember to vote each day for Boston Healthcare for the Homeless' Dental Clinic to win the Tom's of Maine grant money!! You can vote once a day for up to five different clinics. BHCHP plans to use the money to create a more focused preventative dental program for HIV+ and diabetic patients. Preventing health problems in these patients saves money in the long run. But more importantly, because of the severity of certain complications for diabetics and AIDS patients, it can also save lives.
This means a lot to me, so please go ahead and cast that daily vote!

The Things I'm Carrying

I am leaving Friday morning for my trip and I find myself in full speed ahead mode, which explains the lack of sitting still and blogging, I hope. Almost everything is done, leaving me with some time in the next few days to relax, dine with family and friends, and second guess everything I put in my duffel bag.

I have been busy tying up loose ends (paying bills that will be due while I'm gone, finishing the script proposal I was working on all month, etc), so that I have nothing to worry about once I'm on my way.*

I've also been involved in more direct preparations like buying supplies, and transferring money to a Caribbean plane company since they don't take credit cards.

Since BHCHP first started sending people over to help staff at Hospital Sacre Coeur enough time has passed that nurses have now returned. They pass on stories that are emotional, unbelievable, inspiring, and energizing. 

They've also been passing on really useful advice about things we'll need, and things to expect.

Packing has been a big deal. I like to travel lightly, plus one leg of the trip is in a cargo plane where weight counts! Still, I don't want to find myself unprepared for working the 16-20 hour shifts every day while staying healthy.

Here's a breakdown of what I'm bringing:

-Clothes. The hospital, like many hospitals here, supplies scrubs and there are staff who do laundry for everyone. So most people going down to this particular hospital have to only bring pajamas, underwear and socks. However, because I am so small I'm concerned that they won't have scrubs to fit me. Half the nurses I asked said "it won't be a problem," and half said "you should bring your own scrubs." So to avoid any form of work-disruptive uniform failure, I unfortunately have had to take up some valuable bag space with scrub pants and tee shirts.

- Medical Equipment. I'm bringing my own scissors, tape, and stethoscope and a fanny pack for carrying patient meds in the tents, as recommended. Each team member is also helping to bring donated supplies from BHCHP** such as gauze, sanitizer, bandages and gloves by taking as much as I can fit in our checked luggage. 

- Nourishment. The food situation is apparently good. Staff gets three meals a day, but although the food was raved about by the nurses, they also said it wasn't enough (quantity wise) to sustain them for those long shifts. My eating habits are defined by "grazing," and  I'm a person who becomes disoriented, cranky and labile when I don't get to munch. So into the bag went a ton of energy bars from my local Eastern Mountain Sports.

 In the same theme, there is apparently plenty of good, clean, bottled water where I am heading. However, it's easy in temperatures that are consistently over 100 F, to overdo it on "free" water. One of the MDs there a few weeks ago actually became severely hyponatremic ( his Na+ was 113!). He had a seizure and experienced some rhabdomyolysis to boot. To prevent this, I invested in some nuun tablets.

- Physical Needs. Normal toiletries plus a super absorbent towel, a personal first aid kit, all the medications listed in my Travel Clinic post, SPF 40 sunblock, and DEET. 

-Emotional Needs. My prayer book. My journal. My ipod. And, of course, my awesome team.

On the subject of "my awesome team,"  I am so excited about the people I am traveling with. To be fair, I thought about it and realized there is no one from work who I would not be excited to go with. Still, Colleen W. is in my group and she and I are close friends besides being good at working together. 

This past week, at an old friend's birthday party I got to talk briefly with an acquaintance who spends a majority of his time in Haiti. In fact, he was already there serving as a member of the medical community with Partners In Health when the earthquake hit. I told him that I felt like what I'm doing is small beans in comparison. 

But his response was reassuring, as he reminded me that they need nurses, and that's why we're going.

Our work is only a small part of a much larger picture. But I am grateful for a chance to work on something so big. 

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* Go ahead, you can say it. I'm the model of functionality. I know. 

** The fact that a non profit is donating medical supplies to this cause takes my breath away

Playing the Game

Overheard between nurses...

#1:  I haven't talked to him in two weeks. When we talked I was like "I'm going to Haiti," so I don't know.

#2 : Yeah, girl. That's good. Only, don't tell him why you're going. Leave him guessing. You know, let him get jealous.

#1:  Isn't it kind of obvious why I'd be going?

#2:  Well yeah to us, but let him wonder if you're just going down there to meet up, have a rendezvous...

#1: In Haiti? Now?

#2:  Those Doctors without Borders are nice guys!

Lenten Dread

The true focus of Lent is on a renewal of Baptismal promises. A turn away from sin and a return to true Life offered in the Gospel. However, many of our Catholic Lenten rituals come to us from pre Vatican II, when the focus of Lent was more on the suffering and death of Jesus.

And that is why I have been dreading Lent.

 I find it hard to focus on that for very long. The reason used to be a childish one. It was because I felt guilty for my own shortcomings.  As a child I remember a certain elementary school teacher vividly describing the mechanisms of a crucifixion and then reminding us (as we pondered things like hypovolemic shock, mind numbing pain, and asphyxiation secondary to the body's inability to expand the thoracic cavity efficiently) that it was for our sins that this human sacrifice occurred. That stuck with me a long time.

I have since processed a lot of this guilt into a much healthier faith life, a topic for a whole other conversation.

But the reason I now find it hard to concentrate on this suffering for very long is because there is still so much suffering in the world. Jesus' death and Resurrection bought us all everlasting Life after death, but it did not wipe out the darkness and sorrow in this life. It wasn't meant to.

I find it nearly impossible to  bear witness every single day to the personal tragedies of the individuals I work with, and then meditate on even more suffering when I get home without getting deeply depressed. 

Watching The Passion of the Christ in 2004 did not inspire me, or help me feel closer to God, or turn me away from sin. It traumatized me because I can not watch senseless violence inflicted on a living creature without a great deal of mental anguish. It effected me the way Requiem for a Dream did and I have only seen each film once because of it.

Working as nurse has only augmented my aversion to thinking about suffering for the sake of just thinking about it.

What I find brings me closer to God is focusing on the promise that He will "wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore" (Rev 21:4).

I always rationalized it as "we need the forty days to really appreciate the miracle of Easter".  But I don't buy that anymore. Why does Death get 40 days and the Resurrection only get Easter Sunday?  How can anyone expect me to manufacture sadness for this long? Why isn't anyone else going crazy with this gloom? 

Then, at the 8pm Mass at St. Clement's on 2/21 something amazing happened. Father Peter gave a sermon that made me think of Lent in a refreshing new way.

"In forty days," he said, "you'll be watching the Red Sox play baseball. Think about that." We thought about it.

"In forty days," he continued, "you'll hear birds outside your window. In forty days the bulbs I planted will be growing and in forty days that tree outside will have buds."

I have been taught about mentanoia, and the deep change we are supposed to go through during Lent, but my own experiences with Lent have been too wrapped up in a focus on the darkness to really feel a change within me. 

But Father Peter put it this way. He told us he's been cranky recently. Irritable. It's hard to do service to others when you're irritable all the time. So he gave up answering email at night and started reading books.

Sounds selfish, right?  Sounds less like a sacrifice and more like a leisure. Not very "Lenten" at all. 

But it made him stop being cranky. It made him less likely to be short with his loved ones. It made him happy to get up and go to work in the morning. It made him better at helping people.

He asked us to replace one undesirable behavior or habit with a good one some how.

"In forty days," he asked us all, "everything will look different. What will you look like?"

I like his take on Lent because it matches the beliefs I am newly forming. Which is to say:

I believe that Lent doesn't have to be about gloom and doom and pain and hurting. 

It's about finding new ways to combat the gloom, doom, pain and hurting we see every day.

Lent is a training season for putting our own needs second, and the needs of others first. 

It's a challenge for us to seek out the suffering of others and to find ways to relieve it.

Because then and only then do we imitate Jesus' victory over evil and death.

So as Lent marches on I find myself still having some problems with the ways the Church goes about observing the season. Many people have to go into the Dark place to find the Light. The long Latin prayers, and the stripping the church of decorations, and the songs about bleeding and dying bring them there. 

 But  I am beginning to  understand that I personally do not have to go into that dark place if it will actually be more harmful than useful. There are other ways to glorify God, and those are the actions I must identify and engage in. For that will bring my personal mentanoia. 

The Best Valentine's Day

It took me a long time to decide whether or not to post this entry. I wrote it in 2009 on Valentine's Day in response to a friend's livejournal request for a "nice" Valentine's day story. I never posted it because it felt too personal.


Although it may seem like it in the beginning, this is not a sad story.  As requested, it is a nice one. 

February 12, 2003 my mother called me at school.
"Your uncle is going to come get you, you shouldn't drive. It's dangerous to drive when you're upset."
 It didn't make any sense. I wasn't upset. I was hanging out with my roommates. Slowly I got a story out of her, my father who had been ill recently, was in a coma. I still had no idea what was going on. Blame it all on the Irish in my family, I had been told Dad was sick but "getting better." I was under the impression that it was a touch of pneumonia. I had no idea how sick sick was until now. I tried to remember how Dad had sounded last time I talked to him on the phone.

In the ICU,  Dad was in rough shape. Family had gathered. My brother was there but soon another family member took him home. Then the doctor spoke to my mother in whispered tones about "a 24 hour plan." I knew what it meant, but didn't at the same time. Things became very clear when we were led into a "family conference room", and the doctor told me and my mother that he didn't expect my father to last the night.

 Looking back, I recognize that this was the moment I became an adult in my family. They may have taken my brother away from the scene, but I was going to be burdened with both knowledge and choices. There was no ceremony for this rite of passage,  no cards with money, or a cake - I was just a grown up now and needed to act like one.

Because he wasn't involved, it felt like we were conspiring against my father, and I remember hating the doctor. It was the worst hate I've ever felt, and certainly the worst I've admitted to. I couldn't speak.  I let my mother do the talking, feeling like a snake for leaving her to the work. I had been an adult for two minutes  and was failing miserably.  I sat and began to count the brochures that lined the walls "How to Care for YOUR diabetes" and "Living with a Pacemaker." If I could have torn up every single copy of "When a Loved One Dies," I would have. We went home and awaited a phone call.

On Valentine's Day in the morning we stopped at CVS where discreetly I picked up a card for my father.  Mom caught me and in a terrifying voice that was unspeakably wise and weary at the same time said, "He's not going to see the card."  Each word individually held the weight of the entire situation, and made a sound like stone hitting stone.  I shrugged, embarrassed and feeling stupid but stubborn. "So?" I said, and that was all.

When we arrived at the ICU the nurses greeted us brightly. "Go on in," they chimed, yes,  practically winked. And there he was:  my hero, my father - sitting up in bed and eating an orange Popsicle of all things.
He greeted us warmly and we three swarmed him , demanding if he remembered anything from the coma (he did not), asking what he thought when he woke up (he wanted to see us), and how he felt (just fine).
The doctor came in, saying that my father had beaten the odds.
 "It's a miracle. It's God's work," I said.  The doctor told me he didn't know if he'd say that exactly, and my nineteen year old self exasperatedly told him, "well I would." I like to think my Dad laughed at that but I don't remember. I gave him his Valentine's Day card.

My father only lived one more month. However I had that whole month to spend with him and to begin to properly say goodbye. Which is what we did,  even though I had no idea that's what I was doing. Until the very end, no one did. For the rest of my life that Valentine's Day will trump every other year because my Dad, who was the first man to teach me what love really is, made it through the night.

Behold, now is a very acceptable time

Lent started on Wednesday. 
I had prepared this really great post on the history of ashes to mark the start of the Lenten season.
And an argument on whether or not the use of ashes to mark people's foreheads was contrary to the traditional Gospel reading read in Catholic churches all over the world on the first day of Lent.


The post started like this:  

Today at church we read the standard Gospel selection from Matthew 6: 1-6, 16-21 in which Jesus warns His followers to give alms secretly, and not to call attention to oneself while praying or fasting. 

It's a message that made a lot of sense to me, growing up and now. Performing good works and praising God are things that should be done for their own good. Our relationship with God is personal, private, and certainly not a show we're performing for those around us.

Yet then as a child I noticed, after this Gospel reading, we would all get to our feet and have the cross marked on our foreheads in ash. A clear sign for the rest of the day that we are fasting, and that we had gone to church. 

So isn't that exactly what Jesus warns us against? 

Today I argue, no. Not at all.


 Then I went to to explain the use of ashes by the Catholic Church throughout her history, and how that's changed. And then I explained the contextual significance of Jesus' words. And then I brought the whole thing together with what the modern Church believes the emphasis in Lent should be about.

But. Here's the thing. If you want to know those things you can certainly look them up. You found this blog. You know what "Google" is. The point here is that I have a really great sounding argument for people who say "hey aren't those ashes on your head hypocritical??" but I no longer feel the need to post the argument preemptively in my blog, as though I am approaching Lent defensively.


Because that is exactly what I was doing, you know. Approaching Lent defensively. 

So, no more of that. From here on in I will be entering Lent honestly and thoughtfully. 


I will even explore the reasons I was feeling defensive about Lent.
I am absolutely open to questions, and if I get very interesting ones I may even blog about them, but I'm not going to field imaginary attacks to justify my own growing unease with this solemn Church season. 


I promise.

Tom's of Maine Contest

The Tom's of Maine community voting project continues. You can vote for up to five clinics once a day until March 12th. Please go to the Tom's of Maine website and vote for Boston Healthcare for the Homeless.
We would like to put the $20,000 towards a new initiative to target the dental health of diabetic and HIV/AIDS patients.

Happy Valentine's Day

Mom: Did you read your card?
Brian: Yeah, I liked it.
Mom: Read it to your sister. I thought it was very appropriate.

Brian: (reading) "Your sister's a skank. I wish I never had her. She was the real mistake, not you. I was way too young. Happy Valentine's Day."    Wow. Quite a card, Hallmark really outdid itself this year.

Mom: (through hysterical fits of laughter) That's not ...what ....it said.

to resist despair in this world is what it is what it is what it is to be free

At some point this fell out of my music rotation.

 But this week I searched You Tube for some of my old favorites from high school, and then I found Energy among the CDs I keep in the car.


This brings back a lot of really amazing memories from high school years. Back yard pool parties, hanging out late in the summer time on back porches,  road trips to the Cape with my best friends, and even just hanging around Copley Square after school sharing headphones and sodas. 


 There is just something so redeeming about those upbeat tempos, passionately positive lyrics, and rapid fire playful rhymes. 


 It's not glamorous or sexy.  We can't go clubbing with it.  But somehow this music feels more honest.
It doesn't have a beautiful harmony that breaks my heart or takes my breath away. But I get out of breath dancing to it.
It doesn't mention God  once, but it brings me closer to Him because the lyrics affirm my faith in goodness.
 It's not something a grown up lady who gave away her shants and Dr. Martins a long time ago might listen to. But I do.


I'm sorry I ever lost you, Operation Ivy. But I'm glad to have you back.

The Giving Tree

I found this video and it made me really happy. Listening to the audio brought back some pieces of an early memory.  I'm in kindergarten, and sitting on the floor of a small room with big windows. I have huge beige headphones on, and I'm listening to a book on tape. The tape players are huge. I picked the book myself, and although some of the books have different narrators on tape they all have the same chime noise to tell you when to turn the page. But I know when to turn the page without the chime, because I can read. The books smell like books, and I like that smell. I don't like when reading time is over.

 I imagine the room was called the "Reading Lab" because I don't know why else that phrase would be so connected with this memory.  I don't think Shel Silverstein was the voice on the tape. I don't even remember if The Giving Tree was one of the books I listened to. The more I try to focus on the details of the memory, the more distant it is. Like looking directly at a star.  


But even more than loving the Reading Lab I loved having Mom read books to me at home. Because she would do all the voices of the characters. The narrators sounded like Mom, but everyone else got a completely different voice.  And when I started reading too, books became more like small plays, with both of us taking turns doing the voices. Even better than Reading Lab.

It's cold and snowy outside today. As this auto - posts  I'm at work, bustling up and down the hallway trying to make my eight hours count for every patient.


But somewhere deep inside me is a five year old girl, curled up on a rug near a dirty window looking out over Washington Street in West Roxbury. She's wearing huge beige headphones, beginning a life long love affair with words. 


And trees for that matter.

Preparing for Haiti: Travel Clinic

I've been waiting a couple of days to post anything about Haiti, because I wanted to tell my mother in person. A blog entry is no way to find out your daughter is going to spend a week in Haiti.  Mom knows now, so now I can write about it to my heart's content.


As you may have read in yesterday's entry I am going (in part) through work. This is great news because I know most of the people I am traveling with, and one of the nurses going is a close friend of mine.

Yesterday I went to the Boston Medical Center Travel Clinic to start my medical preparations for the trip.

I can not recommend this place enough if you are planning a trip to a country with any health warnings. The Travel Clinic was clean and pleasant. The waiting room was very spacious. And every single person I interacted with from the moment I stepped through the door was friendly and helpful.

The nurse who took my vital signs was actually from Haiti. She asked where I was traveling and she thanked me, shyly, for going. I didn't know quite how to respond to that. I (shyly) told her I was scared but looking forward to being there. Which is the truth. 

Then I met Dr. Thea. He greeted me with a smile, asked where I was going and then asked some other questions about my life. He then asked if I wanted to ask questions first, or hear his "spiel." I opted for the spiel. He was well prepared with a small lecture on the diseases to watch out for in Haiti, including symptoms, pathology and treatments. 

Basically he reassured me that there is almost nothing medically that can go wrong on my trip.*

Meeting with Dr. Thea was great. He took a lot time to explain all his recommendations to me, and let me ask as many questions as I wanted. 

Next I headed to the lab, where I met a student doing a research project, a phlebotomist, and the nurse who gave me my vaccinations. We all chatted about our connections, strangely enough to BHCHP. 

For those of you who are curious, I'm going to write a bit about the precautions I've taken, and by proxy some of the dangers. So Mom... consider this one fair warning!

Here is what the Travel Clinic helped me with:

-  Hepatitis A vaccine. 

   Got this one yesterday. Pretty sure I already got this, in order to go to nursing school. It's 90% effective with the

   first dose.  So I'm considering this one a booster.

- Typhoid Vaccine

   Started this one yesterday. It's actually a series of four pills. The capsules contain live attenuated bacteria, so I

   have to keep them in the refrigerator. I am fascinated by the little pills and the orange brochure with a smiling capsule on the front which explains how to administer the doses effectively.

- Anti Malaria Pills

 I am taking a four week course of chloroquine. I feel confident in this choice of antimalarial agent because according to my own research into the subject this is the best tested and safest of them all. And the least expensive!

- Antibiotics

  I got a prescription filled today for some antibiotics to take with me in the event of traveler's diarrhea. Dr. Thea   explained the different types of diarrhea and what I can expect to do if it's not a bacterial case.

Additionally, I have already completed not one but two Hep B vaccination series in my lifetime and all my routine vaccinations are up to date, including tetanus.  The only other recommendation Dr. Thea had was to purchase an insecticide treated mosquito net for my sleeping quarters. I'm agreeable to the idea, but for now  I'm waiting to hear back from the first group about where they're sleeping before I decide on which net to order online.

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* This sentence has been censored and edited to protect my mother from going crazy when she reads this entry.

BHCHP in Haiti

Boston Healthcare for the Homeless was approached recently  for help with relief efforts at Hospital Sacre Coeur in Milot, Haiti. In response, BHCHP has committed to sending four staff members every week for six weeks, for a minimum of one week of service for each group.  

The first group is already there, including two McInnis House nurses. We've been in touch with them, they are working in the Emergency Room and the Psych Unit respectively. 

 The next group leaves this Friday. 

From staff members who are unable to make the trip at this time, the response is just as overwhelming. People have been donating hours to the "vacation bank" so that those who are going don't use up vacation time, as well as donating items for the staff like hand sanitizer and insect repellent. And, at McInnis House at least, since I can't speak to other parts of the program, nurses have been stepping up to cover shifts while the others are away.

There is amazing team work happening here at home as well as in Milot. 

I am always proud of the work that we do, but seeing everyone around me jump at the chance to contribute to Haiti's relief efforts gives me yet another reason to love this program.

the role of nurses in disaster response

An interesting post, the other day, from my friend Erin about the importance of nursing in disaster response.
Erin, who is training to be a Nurse Midwife, points out

"you can have the best surgeons and trauma docs in the whole wide world performing incredible surgeries on people, but if you don't have the nursing care afterwards to change dressings, pack wounds and dole out timely antibiotics, among other things, all that surgical effort was wasted if people die from infections."

Erin's full blog entry links to two very interesting articles, one from boston.com and the other from the executive director of Partner's In Health, both of which mention the need for good nursing care in Haiti.

That's all. I wanted to share Erin's point of view and by doing so join her in advocating for the important role surgical post op and med surg nurses can play in  responding to a disaster situation.

The more I hear about the efforts in Haiti and how many different disciplines are coming together to create a holistic response to this emergency situation the more amazed I am.

Just remember, we can ALL help to provide the supplies that are needed with simple online donations.

what the patient smelled

"Are you my nurse?"
I looked up from the medication order I was faxing to the pharmacy.
"No,"  I said, "your nurse is at lunch, but she'll be with you in five minutes."
"Can you come look at something?"

I hesitated. I was also at "lunch", but had just interrupted my meal at my desk to fax this high priority order. Going to her room meant forfeiting my last five minutes of lunch. A lunch break I started twenty minutes late. Which left me with ten precious minutes of lunch.

"Is it an emergency?" I asked, "can it wait five minutes for your nurse to come back?"

"I need you to look at it. I can't tell you what it is here in the hallway."

"But is it an emergency? Five minutes. Your nurse will be right back." The woman stared at me and raised her eyebrows meaningfully.

Worried that there was a blood spill or drug paraphernalia, an illegal animal or something similar, I consented, tossing one longing look over my shoulder at the chicken fajita rapidly cooling next to my medication book.

 Entering  her room, I saw nothing out of the ordinary. She stood by the door with her arms crossed.
"Yes?" I prompted.

"Over there," she said, "stand by that mattress."

I complied. Her roommate rolled over, woken from a nap by our talking. The woman would not come any closer to where I was standing. I surveyed the room again, suddenly  remembering a lecture from the very beginning of nursing school on how a nurse is like a detective - when you enter a patient room you have to notice everything. I noticed the cell phones plugged into the wall, the dirty clothes in a plastic bag on the floor and the photos of family on the bedside table.

"I'm sorry, miss," I said, "will you tell me what I'm looking at?"

"Sniff." She ordered.

"Excuse me?"

"Smell that?"

I took a deep breath in. I smelled oranges. Every bedside table in the room had a bowl of fruit from lunch that day. I tried again.  Oranges. Oranges. I got closer to the bed. Oranges.

"I smell... oranges," I reported.

"No. No." she said impatiently, "smell again."

I did as I was told. I smelled nothing besides the oranges, and told her as much.
"Miss, will you please tell me what you are smelling, perhaps I can help you anyway." Dozens of scenarios went through my head, not excluding the possibility that she  had recently had or was about to have a seizure.

"No. Nevermind. If you can't smell that I'll just wait for my nurse." She motioned me out of the room in one quick gesture.

I still have no idea what that was all about.