Wednesday, May 25, 2011

Dressing Changes for the Burn Ward Rounds

         This morning we went into the hospital early to help with dressing changes for the burn patients. This procedure can be very painful because the sisters have to take off old gauze, clean the wound, and sometimes cut off loose skin. On Wednesdays the doctors have to do their ward rounds so this means all of the patients (both inpatient and outpatient) have to get their dressings unwrapped then rewrapped in clear plastic (that looks like serran-wrap) before 8:30/9:00 am when the doctors come around.
Even though I have helped with dressing changes once or twice before this morning was quite a shock. The sisters were moving soooo fast and at times there were up to 3 patients in the same treatment room.
            Right now the burn ward is in a temporary space in the hospital while the permanent ward is having some construction. This means the newly regular treatment room (that was recently painted to look more child-friendly) is not in use. Instead they are using what looks like a big storage closet with a sink and some counters. It was great to be able to be there and help the kids cope, but it also really opened my eyes to how under resourced the hospital is. The treatment tub looks old and dirty, and in between each patient they pour a bottle of sanitizer on it and place a large napkin over the spot where the child sits. They use the same scissors and tools for each patient, and these tools sit in a tub full of soap when not in use.
            However, as awful as my description of the room sounds, the sisters all seem to make it work and are good at what they do. They are super speedy; in fact they must have done 20 dressing changes in an hour and a half this morning. I was however caught a little off guard when they asked me to help with the dressing changes. I had to help rewrap the wounds and everything, maybe I should have gone for my nursing degree before coming here.
            I hope they move back into the actual burn ward before I leave, I’d love to see how everything works in their typical space.  

Tuesday, May 24, 2011

2 Weeks Down

            Sorry it’s been a while since my last blog, I've been super busy! I am finally starting to feel settled in South Africa, I’ve made some new friends, I’m feeling comfortable at the hospital, and I’m starting to get a hang of living in Cape Town.
            I have a new roommate named Francesca who is from Scotland and is doing an internship in a school, and I’ve met some other Connect people as well! So far everyone seems really great! We've done lots of fun things together. On Wednesday we went on a 2-3 hour hike up Lion’s Head Mountain and had a picnic at the top. The weather was perfect and the view was breathtaking. On Friday night we had a braai, which is what they call a cookout or BBQ here, and then the next day we hiked up Table Mountain, which was a slightly more intense hike; 5 hours of hiking to be exact (four of which were completely uphill).  At the top there was a cute little cafĂ©, and we had some lunch and coffee, then we took the cable car down because the wind was super intense and it was starting to get dark. On Sunday, we went to Stellenbosch and Franschhoek for some wine, cheese, and chocolate tastings!
            As far as the hospital goes, things are going very well! A few of my original patients have been discharged or transferred, but I still have most of the same patients from my first day, and we’ve decided to add a couple cuties (who may not actually need child life services) to our list. I’ve seen a lot of great progress from most of my patients and I’ve also had the chance to work closely with the palliative care and pain management team in planning their care. It's been pretty cool to be able to really be a part of the team and see how it all works! 
            More updates to come. As of now, this weekend we are planning to go to Robben Island, High Tea, and this meat market where you apparently choose your fresh meat, they cook it in front of you, then you go sit on the grass and eat it with sides that you bring from home…we’ll see how that goes! 

Saturday, May 14, 2011

Day One at the RCCH

On Friday I had my first day at the Red Cross War Memorial Children’s Hospital. Thankfully, Amanda, another Connect volunteer who has been working in the Child Life department for the past week, was there to guide me. We left our apartments at 7am and got on a bus and got onto a bus a ten-minute walk from us. As we drove through the city to get to the other side of the mountain I noticed the bus barely stopped to let its passengers off-and I thought riding the T was bad!

When it comes to actually describing the hospital and my role there it’s hard to know where to begin. I guess I’ll start off by telling you that it is very, very, very different from hospitals in the states. The beds are in wards, so there are always at least 4 children in a room together. There is nothing but a chair for parents and visitors, and Purell dispensers are nowhere to be seen! There are hand wash stations on each ward, but it seems that nurses (who are called “sisters”) and the doctors (or “profs” if they are the head of department) use these hand wash stations at their own discretion. Because of the ward set-up privacy guidelines like HIPPA are far more relaxed than in the US, the sisters talk about patients out in the open, mostly because there are few private areas.  And as far as my role goes, I’m pretty much considered a full on child life specialist. It’s pretty interesting, since everything is still pretty separated from Apartheid, most of the sisters are black or colored, and most of the doctors and profs are white. So it’s pretty interesting because most of the sisters seem to assume that because I’m white I have some sort of authority, even on my first day when I knew pretty much nothing about the hospital! As an intern, I will be working with the pain management team who will refer high priority patients to the child life team, which consists of Amanda, myself, and Kate who is an occupational therapist that is acting as coordinator of the child life program through Connect, so I believe she spends a few hours in the morning at the hospital and the rest of her day in the Connect office.  

 The first patient I met is named Cassidy. She is just a year and a half old and pretty much the most adorable, little girl you could imagine. She was on the burn ward and had burns covering her left arm and leg. She also has major separation anxiety. According to the sisters, her mother has schizophrenia and her father’s mental state does not appear completely stable. Cassidy pretty much just wants to be held and snuggled! Amanda had been working with her all week trying to get her engaged in some play and utilizing her arm, but told me that progress had been slow. We sat on the floor, with Cassidy in Amanda’s lap, and played with a couple of toys and read an interactive peek-a-boo book, and after a while we got her to use her hand to push the sliding parts of the book in and out! This was very exciting; she even gave us a little smile! Although it was sad when we had to leave her to see other patients because she just cried and cried, we were lucky enough to have a “friend” (or a volunteer) take over. The sister (who I believe is a medical student) suggested that next week we bring in some bubbles for her to try and pop to get her arm stretching.

One patient that I saw had been in a car accident and serious injuries to her hips and legs, another had rare disease that causes temporary paralysis called Gullien’s Disease, another had a failing kidney. She experienced 3 surgeries in the past week including a kidney transplant from her father, that unfortunately was rejected by her body. I also saw a patient in the PICU who had a serious lung infection. The PICU was the only place in the whole hospital that smelled like a hospital from home. Each bed space had almost as much equipment that might be seen in a regular hospital room in the States, but no where near the amount that is seen in our ICU’s.

I’m really excited to actually get started on Monday. We have a meeting with the pain management team and I will be given some of my very own patients! I’m a little nervous about understanding the medical side of some diagnoses, as I’m not sure that I have internet acess at the hospital, but I guess I’ll just have to wing it on the first day of meeting patients, and then do research on their particular diagnoses when I get back to my apartment. I’m also a little concerned because I will be expected to write chart notes, which I’ve never actually done, and there will be no one there to tell me if I am doing them correctly or not. Hopefully I’ll get the hang of it though, the other notes from the doctors and sisters seem pretty casual.

Ok, I think that’s it for now! Oh and tomorrow I’m going to hike Table Mountain! That should be amazing!!!!

See you all in 3 months,
<3 Cammy

Friday, May 13, 2011

My New Home

Hi everyone—so yesterday I didn’t do much at all. I met with the Connect staff and got oriented to Cape Town and my new apartment and what not. The most exciting thing I did was venture to the grocery store, about a  15 minute walk from where I live. Within about 20 seconds on the street I was already asked for money by a woman who was pregnant and I felt terrible saying no. But I was advised to not give money this way because it encourages the begging, and additionally, there are much safer ways to give or help. The beggars seem to be much more assertive here than in Boston. Anyway, I got to the store and walked around aimlessly just trying to find some basic groceries to get me through the week, someone could have just as well stamped “foreigner” on my forehead and it wouldn’t have been anymore obvious!
After grocery shopping, I went home and explored my new apartment building! It’s amazing! My living room windows overlook Table Mountain (the landmark of Cape Town). Every time I walk past my living room, I have to just go stand by the window for a minute and look. I’ll try to post some pictures soon! I can’t wait to watch the sunrise and sunset from it! Also, on the roof there is a gym with glass walls, a sauna, and an outdoor pool that overlooks the city. It’s breathtaking! Soon I'll post about my first day at the hospital! 
<3 Cammy
ps- I've met a few really nice people from Connect!

Tuesday, May 10, 2011

Terminal A, Gate 14

Hello All!
Just wanted to give everyone a quick update. I am now en route to South Africa! Can you believe it?!?!? I'm waiting at the terminal in Washington DC to take my flight to Johannesburg (from there I'll fly to Cape Town). I've already met some interesting people along the way including a feisty old lady who had very interesting stories, and a pilot who informed me that the plane I'm about to board is the biggest airplane that exists! 
If all goes as planned I will be arriving in Cape Town at 9:30pm on Wednesday (2:30pm on Wednesday in the States). So far my only instructions were to "find my driver who will be holding a sign, get my room key, welcome packet, and cell phone, and then go to my apartment and try to get some sleep."  I'm not exactly sure what I will do when I wake up, but I'm sure I'll figure it out! After over 24 hours of traveling, I think I'll appreciate the time to sleep. 
Anyway, I guess that's it for now! 
Thank you to everyone who has been so supportive in getting me here and encouraging me to do this! 
Missing everyone!
<3 Cammy

Monday, May 2, 2011

One Week Until Departure

Hello All,
So I am officially leaving for Cape Town, South Africa in a week. My Visa has been approved, I have a place to live, and the Red Cross War Memorial Hospital is expecting me soon (now all I have to do is finish up a few papers for school and pack my bags)! I decided to start this blog because rumor has it that I won't have great internet connection while I'm there (which means limited facebook and email time) and thought this would be a good way to keep everyone who is interested updated on my whereabouts.
So in case you don't already know, I'll give you a general overview of my trip and what it's all about. I leave for Cape Town on May 10th. Through a study abroad program called Connect-1-2-3 and some connections from Wheelock, I will be spending my time (5 days a week) volunteering my child life skills at the Red Cross War Memorial Children's Hospital. Basically, I will be working with children and families who are experiencing the many stresses of being in the hospital. Using therapeutic play and preparation techniques, I'll work with children to help reduce stress and increase coping skills. I'll be doing this all summer and returning to the states at the end of August.
So far this is about the best detailed description I can give. Once I get there I'l be sure to give an update on the unit I'm working in and some of my experiences. But as for now, I'm just going with the flow!
I can't believe I'm actually leaving so soon! I've been planning this trip for so long, and now it's finally becoming a reality.
So, I think that's it for now. I'll be sure to add another post once I get there!
I miss everyone already!
<3 Cammy