So last week I had my first feeling of homesickness… It was the day Nat moved out and therefore I
started living alone and I was trying to sleep because I had a nightshift that
night. It was hot and I couldn’t sleep and I had just been beginning to realise
that I live in a different country now to a lot of my friends and family. I
woke up in the middle of the day lonely overheated (the power had gone out) and
just missed home and the support network that I have there.
I went in for my night shift and realised that I had looked
at the roster on so usually I work a night shift with one of the khmer nursing
supervisors so that I can communicate as my Khmer is barely existent yet. I
called my boss and told her and asked her what she wanted me to do and she
asked me to check on a COPD patient who had been a bit sick when she left, and
then either stay or go home depending on whether I felt comfortable. So I
walked into the ICU and went to see the patient… Who I couldn’t rouse at all, I
got the nurses to tell me what his GCS had been because to me it looked like it
was a 3/15 now, I gave him a sternal rub but got no reaction, one of the nurses
managed to get a 7/15 but this was down from a 12/15 and obviously he was
pretty unwell, I listened to his lungs
which sounded super wheezy/crackly and noticed he had pitting oedema… I also
noticed an audible wheeze from his airway just sitting next to him. We have to real
option to intubate or use NIV here yet, and I wouldn’t have liked his chances
of getting off a ventilator even f I had so I called my boss to update her and
she and then her husband (the head medical Dr) came in and had a look. We had
started the guy on new antibiotics and Dr wanted to keep him in to see if the
second dose would improve anything, but the family wanted to take him home if
he was going to die. As this was happening the Dr was called to see another
patient, and it turns out this patient had angina, and ?MI so needed to be
transferred to the ICU for a nitroglyceride drip and “cardiac monitoring” Which
in this case involved me hooking up the archaic defibrillator as a monitor… We
continued to monitor him overnight, with on and off chest pain etc, but he
stabilised which was good.
About 5am I came into the ICU to find one of our severe head
trauma patients (GCS 7/15) sounding like she was breathing underwater and
looked to see her O2 mask had traces of vomit and although she had been
suctioned her airway was obviously threatened and she had aspirated on her
vomit. She had a guedels in and I suctioned her but with little effect, I could
tell she was in respiratory distress due to the fact that she had just
aspirated, and I also knew that her quality of life was not going to be great
if she did survive, I didn’t know what else we could do apart from saline nebs,
chest physio, suctioning and starting antibiotics, I suctioned her again and
managed to get her airway sounding a bit clearer, but when I left in the
morning I was still worried about her and later on I found out that she had
died during the day.
It is so frustrating in those situations, not to be able to
speak to the nurse’s doctors and family with any degree of clarity, to be
unsure if these patients are getting a high quality of nursing care, to be
unsure if the family member has been properly informed that their loved one may
die. I was feeling pretty overwhelmed and unsure of what I could do, if I could
have done anything better that night and what I could do in the future to make
sure that the standard of nursing care is high and that families are informed
of what’s going on.
I was also really tired as I hadn’t slept the day before,
and as I rode home I bumped into a car on my bike, It wasn’t very hard and I
didn’t fall or anything It was just very shocking and I couldn’t understand
what they said when they wound down the window to yell at me, but I was already
feeling a bit fragile and it just scared me.
I didn’t get to sleep for a while that day, and in my usual
stubbornness I was determined not to let anyone see that I was feeling teary,
but also just missing the ease of being able to call a friend to hang out or
cry to someone who knows me and whom I am not shy in front of. I woke up that
day and had a little cry to myself and was starting to feel really awful and so
hot so I decided to go into work to at least be cool and be around people, I
got in there and it was nice and I ended up skyping Liz for a few hours (thanks Liz :p ) and
then going to dinner with most of the Battambang CCT crew who are super lovely
for Nat’s B’day. After that I felt so much happier and appreciative and
realised that I do have support both from home and here and I don’t need to be
so stubborn.
This weekend we went to Siem Reap and had a lovely weekend J and now I am in
Battambang ready to sleep and go back to work tomorrow. I feel so glad to be
making friends here, the weekend in Siem reap was really lovely, and I really
appreciated the luxury of nice food and a foot scrub and dancing and drinking
and company of great people J
Also staying in touch with people back home, I feel so lucky to have the
support and love that I do, and I often find myself smiling or chatting away in
my head to someone from Australia, and it means the world to be thought of by
people so busy with life and so far away J
(also sorry for all
the unexplained medical stuff, I’v just written how I would talk and it’s just
in there for anyone who’s interested but if you want to know more or it’s
annoying just let me know.)
Xx
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