Sunday, 23 October 2011
18/10/11 - 19/10/11- 20/10/11 and 21/10/11
After the excitement of Monday the next few days were relatively quite. I did some more sutures with one of the doctors who was trained as a surgeon and inserted more catheters and IVs. Luckily there were no major emergencies so all in all it was a relatively quiet few days.
17/10/11 - Truck man
On Monday I inserted my first IV into someone just before a man was carried into the Emergency Room on a stretcher. Apparently he had fallen from the cab of his lorry whilst going around the corner at full speed. Unfortunately no one knew about any other conditions he might have had before he fell, however he presented with high blood pressure and when the doctors roused him he confirmed that he had 'pressure' so he was give two sprays of nitrates under his tongue. Moments later he had crashed and the doctors started CPR immediately taking turns. He was intubated so that his trachea remained open and one of the doctors controlled his breathing; he was given a total of three shots of adrenaline and his heart had stopped beating for nineteen minutes before it finally started again. Throughout the CPR his oxygen saturation had been fine (98% or above) but as different specialists from other areas came down to ER his saturation levels started to drop. I was put in charge of controlling his air bag and ensuring that he continued to receive as much oxygen as possible. His stats continued to drop over the next hour and the surgeon announced that he thought the man had a haemopneumothorax which is where blood starts to collapse the lung. He inserted a chest tube which should help to release the pressure on the lung and re-inflate it. Although the man still wasn't stabilized he was sent to ICU where he was then sent to surgery. A few days later we found out that he had survived.
Later that day I performed my first sutures including one over the eye and a very wide cut on a young boys leg.
Later that day I performed my first sutures including one over the eye and a very wide cut on a young boys leg.
13/10/11 and 14/10/11
On Thursday I joined the UWI interns for a suturing lesson and learnt about continuous and discontinuous stitching as well as the different types of thread used. Hopefully I will be able to do some sutures of my own soon!
On Friday I spent the morning with the nurses in triage which is where the patients are first assessed; the nurses take blood pressure, glucose and urine tests as well as a brief history of the complaint. Depending on the seriousness of their stats and complaint depends on whether they are seen by the triage doctor, sent straight to the ER or sent home. I tested the blood sugar of several of the patients until a call from ER came through recalling all doctors and nurses back to ER as there had been a bus crash and all the injured persons were coming to the hospital. Back in the ER I was given a pen and paper and followed one of the nurses around as she gave some of the wounded a painkiller and I took down their names for the records later. As it turned out most of the injured where walking wounded - only one, a pregnant woman, was hurt badly enough to be admitted.
On Friday I spent the morning with the nurses in triage which is where the patients are first assessed; the nurses take blood pressure, glucose and urine tests as well as a brief history of the complaint. Depending on the seriousness of their stats and complaint depends on whether they are seen by the triage doctor, sent straight to the ER or sent home. I tested the blood sugar of several of the patients until a call from ER came through recalling all doctors and nurses back to ER as there had been a bus crash and all the injured persons were coming to the hospital. Back in the ER I was given a pen and paper and followed one of the nurses around as she gave some of the wounded a painkiller and I took down their names for the records later. As it turned out most of the injured where walking wounded - only one, a pregnant woman, was hurt badly enough to be admitted.
11/10/11 and 12/10/11
On Tuesday I was shown how to insert a urethral catheter into a man's penis then was allowed to perform the same procedure myself! That is my very first patient! Apparently the hospital have many men come in with enlarge prostates who have catheters which get blocked; as their bladders get distended this is considered an emergency so they get seen quickly in ER.
On the Wednesday there was a young boy who came in as a transfer from the University of the West Indies Hospital (UWIH). The boy had been knocked of his bike at midnight the day before but because he didn't have health insurance he had to be transferred to KPH. When he arrived the boy was in a bad state; unconscious but still able to breathe on his own, he had a compressed cranial fracture and there was blood putting pressure on his brain. The consultants or senior residents from general surgery and neurology came down to see the boy and his injuries, however while they were down there the boy went into cardiac failure. CPR was started and an air bag was put over the boys mouth so that his breathing could be controlled by one of the doctors or nurses. After two shots of adrenaline and seven minutes of CPR the boy's heart started to beat again and he began to breathe. The boy was later taken to the surgery ward so that the pressure could be relieved from his brain and his broken leg set.
On the Wednesday there was a young boy who came in as a transfer from the University of the West Indies Hospital (UWIH). The boy had been knocked of his bike at midnight the day before but because he didn't have health insurance he had to be transferred to KPH. When he arrived the boy was in a bad state; unconscious but still able to breathe on his own, he had a compressed cranial fracture and there was blood putting pressure on his brain. The consultants or senior residents from general surgery and neurology came down to see the boy and his injuries, however while they were down there the boy went into cardiac failure. CPR was started and an air bag was put over the boys mouth so that his breathing could be controlled by one of the doctors or nurses. After two shots of adrenaline and seven minutes of CPR the boy's heart started to beat again and he began to breathe. The boy was later taken to the surgery ward so that the pressure could be relieved from his brain and his broken leg set.
10/10/11 - Second day in the ER
The start of my first proper day in ER was very exciting with an elderly woman coming in from a car crash and needed both her lower legs amputated! After that things slowed down a bit as I was given a more extensive tour of the ER. I watched the Drs perform several procedures before I was shown around the complicated filing system! There is no computer based system in Jamaica instead each patient is given an ID number according to when they first turned up at the hospital then each individual file is stored in one of two rooms. That sounds easy enough but the problem is that many of the files are missing or incomplete. Some even have the wrong name!
Sunday, 9 October 2011
07/10/11 - ER
In the morning I met up with Nicki and went to wait for the SMO only to find out that both he and his secretary were on holiday. We were ready to go home very disappointed when Dr Wong told us to come and see him in ER. Feeling sure he would tell me it was impossible for me to work in the ER we went to see him and after a very short conversation he said, 'sure you can start now.' We stood staring at each other for a moment then Dr Wong introduced me to a young lady named Dr Reid who would look after me then he disappeared and a very happy Nicki went back home.
Dr Reid looked a little at a loss for what to do with me but at that moment a young man came in who had been stabbed in the hand and back. Dr Reid told me to come and watch while they ultrasounded his heart to see if the knife had punctured it. Luckily it hadn't but the man was making so much noise you would have thought he was dying, however once he was told he was fine and would be going to have an x-ray he stopped screaming and started playing on his phone! Later on an 18year old girl came in with a stab wound in her side, she was 5 months pregnant with her second baby and she was very scared. The doctor and the nurses spent most of the time dealing with her minor wounds singing and dancing around her. The Doctors and nurses were all really nice and didn't seem to mind me being there at all. I left about 2 o'clock and couldn't wait to go back Monday.
It was my housemate's birthday today so we went with her to one of hr workmates houses and had an amazing jamaican dinner and a wonderful chocolate mousse cake. Yummy!
Dr Reid looked a little at a loss for what to do with me but at that moment a young man came in who had been stabbed in the hand and back. Dr Reid told me to come and watch while they ultrasounded his heart to see if the knife had punctured it. Luckily it hadn't but the man was making so much noise you would have thought he was dying, however once he was told he was fine and would be going to have an x-ray he stopped screaming and started playing on his phone! Later on an 18year old girl came in with a stab wound in her side, she was 5 months pregnant with her second baby and she was very scared. The doctor and the nurses spent most of the time dealing with her minor wounds singing and dancing around her. The Doctors and nurses were all really nice and didn't seem to mind me being there at all. I left about 2 o'clock and couldn't wait to go back Monday.
It was my housemate's birthday today so we went with her to one of hr workmates houses and had an amazing jamaican dinner and a wonderful chocolate mousse cake. Yummy!
06/10/11 - Meeting Dr Wong
In the morning I received a phone call saying that my contact at KPH (Kingston Public Hospital) was going into ER later that day to find out when I could start and would I like to join her so we arranged to meet at 5. We decided to take the dog to the vets during the day so that he could have his heartworm injection, so while a housemate of mine was at the chiropractors I decided to take the dog for a walk at Hope Gardens in Kingston but as we drove through the gate I was stopped and told that I wasn't allowed to walk my dog in the park! So I decided to try Mona Reservoir which is by the University but I was told you could only walk there with a permit that you brought from the university and only very early in the morning or very late at night. So I ended up driving around Kingston with the dog in the backseat enjoying the air-conditioning until my housemate was finished that the chiropractor's! We then went to the vet and discovered that Arran is 4 years and 3 months old! He was very good as he was being given his injection and the vet was very happy with him :-)
We went back home quickly to drop the dog off and have a quick shower before I got ready to meet Nicki at KPH where we went to see Dr Wong in ER. I was quite disappointed by our first meeting, he was very negative about my chances of getting to work in the ER and was coming up with many trivial problems. He told us to go and see the Senior Medical Officer, Dr Boorasingh in the morning, so Nicki and I decided to meet up at 9 the following morning and hopefully get something sorted!
We went back home quickly to drop the dog off and have a quick shower before I got ready to meet Nicki at KPH where we went to see Dr Wong in ER. I was quite disappointed by our first meeting, he was very negative about my chances of getting to work in the ER and was coming up with many trivial problems. He told us to go and see the Senior Medical Officer, Dr Boorasingh in the morning, so Nicki and I decided to meet up at 9 the following morning and hopefully get something sorted!
05/10/11 - Spanish Day
Today I was ill again but I recovered so that I could go to the Spanish Day party in the Evening at the University of the West Indies. It was amazing; all the major Spanish Hotels across the island had produced food - from paella to sushi. They had flamenco dancers too and it was a really nice evening! I'm glad I could make it.
04/10/11 - Ill
Today I didn't feel very well so I couldn't go to Open Arms today. Hopefully I can go tomorrow!
03/10/11 - Tax and Unity
Today we had to go and get the car tax renewed there was a very long queue with only three cashiers when there could have been ten and in the middle of the busiest period one of the cashiers packed up and went away! Afterwards we went to PICA to get my stay in Jamaica extended, on the way we decided to buy a tennis racket so that we could throw the ball further for the dog but I discovered a shoe shop and brought a very nice pair of black stilettos and some trainers - but no tennis racket!
Then we walked over the road to PICA, we finally found the relevant department and waited. Eventually we were seen and the official asked 'you really want to extend your stay?' whilst looking at me incredulously. She then asked how old I was and when she discovered that I was over eighteen (which could have been determined by just looking at my passport) she told me it was impossible for me to extend my stay without having a letter signed by my employee; even though I'm not technically employed! So we went home.
We took the dog for a quick walk then got ready to go to the German Unity day party at the Pegasus hotel which was to celebrate the reunification of East and West Germany. The venue was right at the top of the Pegasus and the view across Kingston was amazing! Unfortunately the microphone wasn't working for the speeches or because the room was open the acoustics were awful but you had to be right at the front to here anything. Apart from that it was good fun!
Then we walked over the road to PICA, we finally found the relevant department and waited. Eventually we were seen and the official asked 'you really want to extend your stay?' whilst looking at me incredulously. She then asked how old I was and when she discovered that I was over eighteen (which could have been determined by just looking at my passport) she told me it was impossible for me to extend my stay without having a letter signed by my employee; even though I'm not technically employed! So we went home.
We took the dog for a quick walk then got ready to go to the German Unity day party at the Pegasus hotel which was to celebrate the reunification of East and West Germany. The venue was right at the top of the Pegasus and the view across Kingston was amazing! Unfortunately the microphone wasn't working for the speeches or because the room was open the acoustics were awful but you had to be right at the front to here anything. Apart from that it was good fun!
02/10/11 - Golf and Fish
Played golf today and took the dog around for the last nine but he kept barking every time a ball was hit and he wasn't allowed to chase after it! Never mind - it just put Karen off her game a bit! Afterwards we rushed off to Rodney's to have dinner with Armandine and Raphael; two people from the French Embassy. Armandine is the director of Alliance Francaise - the French lessons we go to, and she has been here about as long as I have but Raphael is leaving next Monday. Dinner was very nice as usual!
Sunday, 2 October 2011
01/10/11 - More revision
The last few days haven't been very exciting! I've just been practicing for an exam I have to take tomorrow. Hopefully it will all go well!
29/09/11 - Nails and nothing exciting
I went to have a pedicure today as I spend most of the time walking around in sandals and don't want to inflict horrible feet on everyone!
28/09/11 - Homework
Spent the day at home doing my French homework - and its been a while since I've had to do any French homework! And also practiced some maths - especially percentages! We tried to go and see the Help at the cinema - we had looked yesterday at the listings and it said that the film was on, however when we looked again today that had taken it off! So instead we went to have a curry.
27/09/11 - Open Arms
Went to Open Arms again and after sitting in on the Staff Meeting I worked on the Staff Manual. I managed to finish a large chunk today so hopefully by next week I will have finished completely!
This evening I went to French again and had Jerk afterwards
This evening I went to French again and had Jerk afterwards
26/09/11 - RISE
Today I went of to visit RISE (Reaching Individuals through Skills and Education) which is an NGO that has been running over twenty years and covers a huge scope of activities from recycling to treatment of gambling and drugs addictions. Compared to Hear the Children's Cry and Open Arms, RISE is a huge and very well established organisation. I went o look around with their financial director with an eye to work with them later on. The organisation was very, very impressive and it gives me an idea of what the others might look like in a couple of decades time.
I have also heard that an internship might be opening up in the ER of Kingston Public Hospital (KPH) which would be amazing if I could get it!
I have also heard that an internship might be opening up in the ER of Kingston Public Hospital (KPH) which would be amazing if I could get it!
23/09/11 - Human Trafficking Conference; Day 2
We attended the conference again to hear a resume of the previous day. They had many really good ideas and if everything can be implemented then Jamaica will do much to improve its current record on Human Trafficking (which with no convictions to date is pretty poor).
During the conference one of the police officers had read a newsletter from Hear the Children's Cry an attacked us because we had said that 20% of missing children might have been trafficked. He thought that we were saying that the missing children were being trafficked and that we had evidence for this that we weren't sharing with the police. Seeing as all our information came from the police in the fist place he didn't really have much of an argument!
During the conference one of the police officers had read a newsletter from Hear the Children's Cry an attacked us because we had said that 20% of missing children might have been trafficked. He thought that we were saying that the missing children were being trafficked and that we had evidence for this that we weren't sharing with the police. Seeing as all our information came from the police in the fist place he didn't really have much of an argument!
22/09/11 - Trafficking Conference
Woke up bright and early today to take Arran for a walk, we used the remnants of his broken lead around a lanyard, but unfortunately Arran seems to clever for that and he managed to escape a couple of times! Unfortunately the lead broke again and Arran was free! He galloped around the green and discovered sprinklers - he tried to chase the water as it came out of the sprinkler and and had to visit all four sprinklers before he came away! On another green Arran did exactly the same, but one of the green keepers turned it off as he was drinking it and as we walked back we were determined to buy him a decent lead and collar! But at least Arran enjoyed his walk!
I had to attend a Human Trafficking Conference at the Pegasus Hotel for Hear the Children's Cry which is a charity that helps missing children in Jamaica. We were told that the conference was from 8.30 to 10.30 but when we arrived we discovered it was actually a two day workshop! It was a very interesting workshop, involving many different organisations (both NGO and governmental) as well as many different embassies.
That evening I had my French lesson again and I had to do a presentation on life in 1905. It wasn't very long - only 100 words, but it went quite well. Later that evening I was invited into the French embassy as a friend was receiving the Medal of Honour for his work in Haiti and France. That evening we went to a bar at Devon House for something to eat!
I had to attend a Human Trafficking Conference at the Pegasus Hotel for Hear the Children's Cry which is a charity that helps missing children in Jamaica. We were told that the conference was from 8.30 to 10.30 but when we arrived we discovered it was actually a two day workshop! It was a very interesting workshop, involving many different organisations (both NGO and governmental) as well as many different embassies.
That evening I had my French lesson again and I had to do a presentation on life in 1905. It wasn't very long - only 100 words, but it went quite well. Later that evening I was invited into the French embassy as a friend was receiving the Medal of Honour for his work in Haiti and France. That evening we went to a bar at Devon House for something to eat!
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