Friday, May 24, 2013

Hospital General y una salamandra en la casa

Spotty internet - hence this post is from yesterday (Thursday):

Today we headed to Hospital General bright and early in the morning. Mary decided we needed the exercise from the 20-30 minute walk so we made the trek over from the university to the hospital by foot instead of our usual van ride. At one point we had to use a bridge to cross over the busy highway. According to everyone else, the bridge wasn't that high up. To me, on the other hand, thanks to my fear of heights, it felt like I was a mile off the ground. I gripped Hannah's hand the whole time and tried to focus on looking up instead of down. Everyone else was taking their time snapping pictures of the view and I just sped along. Luckily Hannah (who is also my motion sickness buddy) just charged ahead with me. 

The group split up in pairs among three different floors - post-op, internal medicine, and intensive care. I honestly can't remember who was where but the pairs were Heather and Sarah, Elli M. and Katie, and Hannah and Ellie B and each were subsequently paired with a nurse on the floor. Once we got the them settled, Mary, Nanci and I headed down to the Urgencias unit. Mary was especially curious to observe this area because she is an emergency nurse back home in the U.S. and has been for over 30 years. Nanci also said that she is interested in possibly pursuing a job in emergency nursing so she was eager to see this unit as well. 

When we first arrived, there were already some beds lined up against the wall since the rooms were all occupied. The heat and mixture of odors was present but not completely overpowering, though it still made me feel a little dizzy - I made sure to drink plenty of water. We met one nurse in particular, Marcos, who spoke English because he lived in Georgia for a few years. He let us follow him around for a while and we were able to visit with a patient who had suffered complications from a brain surgery that left him handicapped. It was so sad to hear the story of how the surgeon had made a mistake that resulted in brain damage and subsequent neurological problems. When I asked Nanci if legal cases were often filed in Mexico and she said that although they are, it is always a long process that takes a lot of time and effort and energy to work out. From what I have gathered, it appears that there is not the same sense of "entitlement" and frequent blaming of health care workers for deaths or medical complications like there is in the U.S. When we were in the clinics, Nanci had explained to me that Mexicans more or less accept these things as being inevitable given the situation and there wasn't anything that could be done by the health care team to prevent them from happening. When we later returned after taking a break, the floor was even busier and people were seated in chairs along the wall waiting for beds with their IVs already started. I was allowed to start an IV on an elderly patient and he had such a good vein that I got flashback right away! The nurse stepped in to collect blood samples and then I helped her hook up and start the normal saline solution. After all this great practice with IV starts, I'm hoping that I will feel very confident in completing this skill on patients once I get back to the U.S. and start my Adult clinical and internship in the fall. 

We then went to check on the pairs on each floor and spent some time in patient rooms with them. At one point, we were on the intensive care unit and were able to visit with the family of a burn patient. He had suffered third degree burns after an electrical accident at work. Mary, Nanci, Elli M., and I were given disposable gowns (which we later found out we were supposed to share and use to go in the room in pairs rather than all four at once...the nurse manager was not happy with us for using them all at once...) and masks to wear. When we entered the room, I was immediately hit with the smell of burned flesh. This paired with the fact that the room was at least 10 degrees hotter than the already-warm floor hallway and the fact I was feeling funny in the emergency unit made my head spin a little. I tried my best to listen to the conversation Nanci was having with the family member but I was just trying to concentrate on not locking my knees and keeping my breathing even. Mary explained the differences between the treatments in the U.S. compared to Mexico for burn patients. For example, the patient's skin was open to air whereas in the U.S. there is a certain covering they use to put over the body. Subsequently, the open air dries the skin and they use heparinized solution (a blood thinner) to break up the dried blood for debridement and cleaning. The covering used in the U.S. contains a solution that keeps the blood from drying. Later, once we had thanked the patient's family for taking the time to talk with us, Nanci said that there was a great need for nurses to work in the burn hospitals (which is where this patient was being transferred later). Apparently there is a shortage because hardly anyone wants to work in these facilities. Nanci said that because of this need, she would be willing to work in one of these hospitals to do her part in helping these people. It was inspiring to hear about her great desire to help others, especially those who are underserved. 

After checking on all the floors, the three of us (Mary, Nanci, and I) wandered into the peritoneal dialysis area and were surprised to find a young teenage patient who appeared to belong in the intensive care unit with dozens of medications and tubes. As we were looking over the patient's chart to review the reason for hospitalization, diagnosis, and symptoms, I could hear and see a family member carefully and gently providing care. He had brushed her hair so it was shiny and laid flat on the pillow and was singing softly as he massaged her feet and calves. When we walked in to talk to him about exactly what happened, I could clearly see the pained look in his eyes while he explained how his daughter had gotten there yet also the tenderness he showed as he rubbed her feet and held her hand. I don't know what came over me but I suddenly felt tears sting my eyes and threaten to cascade down my cheeks. I excused myself from the room and let them fall down my face. I couldn't believe this young patient's grave prognosis and my heart broke for her father who so obviously adored her. I hope and pray for them and the rest of their family as they work through this difficult time, that God watches over them and brings them comfort. 

Hospital General was definitely busier than the other clinics and hospitals we've visited thus far. Not only were people lined up in the emergency unit, but rooms on the floors often held 2-4 patients, and all the rooms were at full capacity. It amazes me that on average, the nurses who work on the general floors have at least six patients each and those in the intensive care unit have at least three critical patients at a time. It is for this reason that often family members are very involved in patient care, providing baths, helping with feeding, assisting in the bathroom, and changing clothes. Without the assistance of unit techs, I am sure the nurses are grateful to have the help of willing family members. 

When we got back to the university in the afternoon, Mary and I headed home to eat before going downtown to run some errands. We exchanged dollars for pesos, retrieved some money from the ATM (with a bank withdrawal fee of $69.50 pesos! eek), and were sorely disappointed when we found out from the department store that they didn't carry small fans, or any fans less than $299 pesos (about $25 USD) for that matter. It's been so hot and mosquito-y in our rooms that we were really looking forward to picking up some cheap fans for the remainder of our time here. However, we left the store empty-handed and refused to take the long ride to Walmart (suggested by the Del Sol department store employee) in search of small fans. To drown our sorrows, on our walk back home, we got iced coffees from Express Arte Caffe  to go and also picked up some freshly baked cookies and cheese bread from our favorite panadería down the street from our house. Once we got back, we settled onto the patio and read while sipping our drinks and taking bites of our baked goods. 

We did this until 7:30pm rolled around, when Melisa picked us up. We went downtown to San Miguelito (the restaurant with the fabulous margaritas) and met her 31-year-old student, Juan, who meets with her twice weekly for private English classes. Melisa had decided him meeting me and Mary would make for great practice since we are native English speakers. We spent two and a half hours drinking margaritas, eating some totopos (tortilla chips) and guacamole, and having some good conversation. We found out that Juan is planning on traveling to New York City in June and will be staying there for two months to attend English language school. Although he is a lawyer who works as a public notary in Mexico, he wants to improve his English and was granted time off to go to this school. Melisa had him practice asking questions so he also was able to learn about me and Mary and the U.S. It was fun having things flipped for once here where we were the ones being asked to speak more slowly and repeat things! 

Melisa drove Mary and I home and we had our final goodbyes since we will not see her again before we leave next week. When we walked into our house, we were "greeted" with a nasty surprise - a salamander hanging out in our entryway! It was actually really gross - almost translucent with beady eyes and about six inches long including its tail. Mary screamed right away when she saw it and I ran upstairs to grab my camera! She got the broom out from the cleaning closet and attempted to get it to run towards the front door and outside. However, it kept circling around one of the pillars and out of her reach. Mary was screaming the whole time for it to just get outside and I had this mixture of laughing, snorting, and screaming coming out of my mouth at the same time. We must have been quite a sight, two American women jumping up and down and yelling at a tiny lizard, one trying to bat it away with a broom and the other just taking pictures the whole time. One of the neighbors who was walking outside with her son asked if we needed help and without hesitation we unlocked the door. Her son walked in, grabbed the broom that Mary had abandoned on the wall when the thing wouldn't move, and proceeded to shoo it away from the pillar and stomp on it when it tried to escape, all the while we are still freaking out and jumping up and down. He managed to beat it to a pulp and sweep it out to the street, but we didn't realize until after we thanked him and shut the door that THE TAIL HAD BEEN LEFT BEHIND AND WAS NOW TWITCHING ON ITS OWN (I kid you not). I went back to screaming while Mary had no idea what was going on and just followed me into the living room as I jumped up on the couch. She then went to look to find it and when she did, resumed the screaming right alongside me. Since our neighbor boy was long gone by this point, having already gotten rid of the salamander's body, it was up to us to get the (thankfully-no-longer-twitching) tail outside to join it. It took about 15 minutes of screeching and maneuvering the tail over our stony entryway before we could sweep it out. 

All in all, the whole process probably took about a half hour to 45 minutes. People were definitely outside on the street either watching us, laughing at us, or both as Mary and I couldn't help ourselves but absolutely freak out about the incident. It seems like everything is starting to creep out in this house now - the salamander, the mosquitos and we've found four cockroaches (one in the fountain in the entryway, another in one of the bedroom doorways, and the other two outside by the washing machine). If there is anything that is making me look forward to going home, it's the lack of these things in my home! Though, I can't speak too soon, since Husband sent me a picture of a huge spider in our bedroom...I'm going to try to ignore that for now, though...

Ay caray. 
Let's hope and pray and hope and pray again that we don't have to deal with THAT again. 

Hasta luego :)

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