Emotional Backlash
So today it finally hit me. At breakfast I was told the little baby that we tried to save so hard yesterday had survived the night but not doing well. Lower heart rate, increased work of breathing and low oxygen saturations. And for some reason I could not really deal with it very well. And for the people that don’t know me, I can cry really well. Once I start, it’s like the floodgates open.
Every morning there is sala. It is the church service everybody attends before work. Also, new people are introduced and people that leave get to say goodbye. General information is given, like meetings or in-services. I walked in and sat next to some of the people I have been hanging out with, mostly Dutch. And the floodgates opened. Somehow when people are nice to you when you are emotional, it makes it worse. And then being able to speak your native tongue somehow makes it worse too….So the only thing I can do right now is cry. About the little baby that we saved but for whom? Ourselves, the mother or the baby? Because it is suffering, since we had to stick it a lot of times for a second IV after the first IV came out. And you don’t have the opportunity to just drop an umbilical line in. He has been struggling to breathe for almost 24 hours now. So I know he is in pain. And how about the mom? She already lost one of the babies she was carrying. Now she will lose the second baby. Not only this loss, but now she can not go home for a year beacuse she is considered ‘unclean’. So she has to deal with this all by herself.
Now I am doubting if this is for me. I can’t save the world, I know. But as a nurse it is hard to not being able to help when you know 8 hours away this would have been so very different. And I know now that you cannot really explain how it is here. You have to see it for yourself. Words are unable to express what you see. Walking through the hospital and seeing a bunch of goats in the courtyard. Cockroaches walking around little babies to go for their spit-up. Flies on preemie faces.
I was told yesterday to focus on what you are able to do instead of what you are not able to do. So that is what I have to start working on. Maybe I will do better to go to the outreach clinic since this is basic prevention and you feel that you really do something useful. Because the other thing I was told yesterday that I also have to do stuff for myself. Since I came here and have felt I should give all I have. And you can’t really do that.
So now I am being taken care of. On of the Dutch docs followed me to my room and we talked. Another visitor from Norway just knocked on my door and in a little bit I am going with her to the orphanage to hold some healthy happy kids. She has lived in Tanzania for a long, long time and told me that I am perfectly normal to be crying and it would be worse if it would not affect me at all. And it just says I have a big heart. And I’ll just listen to her, she seems she has figured things out.
To be continued….
Yesterday I started in the NICU, the nurse that is normally there is on vacation and I was asked to look after the place until she comes back. Now NICU brings views to mind of babies surrounded by ventilators, IV pumps etc. while laying safely in an isolette, snuggled up between wires, maybe a toy and blankets to snuggle. Well, not so here. The ICU holds babies that are born premature or sick, just like in Europe or the US. However, no isolette. Or a ventilator. Or surfactant. So what happens when you are born very prematurely here? Today I took care of a baby, born at 29 or 30 weeks by emergency C-section because the sibling had a prolapsed cord and unfortunately was stillborn. The surviving twin was rushed to the NICU, looking very poor. Pale, no respiratory effort, heart rate less than 40. So here I am, with the MD and another nurse (mama Kudoku) and what great team work we had. The baby recovered fairly quickly but needed more. Now if this little boy had been born back home, we probably would have intubated him and given him surfactant and he would have been fine. Here not so. Dr. Kent, a visiting family medicine MD from Colorado had brought some anesthesia bags (for you non medical readers… a breathing bag that you can use to give positive airway pressure to open up the lungs) So for the first time in a couple of years I started an IV on a preemie (on the first stick…) and then I ended up being the ventilator for about 4 hours. Now imagine sitting in a moist environment, about 33 degrees Celsius or 91 degrees Fahrenheit for about 4 hours, holding a mask on an infant that weighs about 1 kilogram or 2.2 lbs. Luckily Dr. Kent ended up getting me lunch and a Sprite. Gulping down the drink I wondered for about 2 seconds how many calories a regular Sprite has, but it tasted so very good that this thought kind of disappeared very very quickly!
