Wednesday, July 29, 2009

Not everything translates as you would think...

As you can tell from these pictures, not everything translates correctly. As I walk from the main hospital building (NMH) to the OR on the 3rd floor, I pass these 2 doors. 339 is to the right and the other is on the left actually under the stairs. I would really like to see what is on the other side of the doors...

So, let me recap what has been going on since I last posted. I continue to walk up to NMH everyday except jumaa (Friday). Only a few duty personnel are at the hospital as it is their day off. I am still not used to starting my week on Saturday. I usually start my day with the Chief Nurses meeting. All the Chief Nurses from throughout the hospital have a morning meeting for report from the previous evening. Then, I will go up to the OT (Operating Theatre) or OR. I do have an interpreter (Walid) with me each day. It makes my job easier. I am learning short phrases in Dari and most of the nurses already know short phrases in English.

As far as mentoring in the OT, the nurses are skilled in scrubbing the cases. They know how to set up the room and how to assist the surgeon. One of their drawbacks is that they only have 1 nurse to circulate 7 rooms. It keeps him very busy. In the US, we have at least 1 circulator per room. In Afghanistan, the housekeepers are the ones who help with positioning of the patients and bring the patients to and from the OT. In the US, the circulator meets the patient, reviews the H&P, and explains the procedure to the patient. Maybe one day, they will have enough staff at NMH to do this.

Now that I have been here a few weeks and had observed what a normal day in the OT is like, I can now better understand what my role will be. As I have mentioned numerous times, I am a mentor. I am not in their chain of command so I cannot tell them what to do. My role will be to offer the nurses suggestions on how to make their job easier. I will continue to help them improve their sterile technique in the OT. One of my projects will be to help them learn and develop a surgical conscience. I have written out a short paper (2 paragraphs) on what surgical conscience is and I had it translated to Dari. I will go over this with all the staff members who work in the OT. For the next 6 months, I hope to empower the nurses. It is the nurses who should run the OT. They lead by example and correct those who do not follow established protocols. I can only point them on the correct path. It is up to the Afghan nurses whether or not they want to follow it.

We continue to convoy out to some of the local spots here in Kabul. We as a team had to go to Camp Eggers last week for a briefing. I was lucky enough to be the driver for the lead vehicle. The other night, we went to ISAF for a medical BBQ. This time I didn't drive, but I was the TC (Tactical Commander) for the 3rd truck. ISAF is a NATO base. We had supper with French, Italian and British medical personnel. It was a good dinner. The Italian's cooked. I am going to butcher the spelling and labels, but we had fresh bruschetta on grilled bagel-like bread, a thinly sliced ham and other meats with cheese cubes for an appetizer followed by grilled steak. It was an awesome meal. We had several different cheeses, but being the cheese connoisseur that I am, I only remember one name, Parmesean (SP). (In my usual sarcastic self, the only cheese I usually eat is the processed American slices. I can't name most of the others...)

One last note, if you want to know what the day to day tempo is like here, watch the movie "Groundhog Day" with Bill Murray. He repeats the same day over and over again. That is what most people who are on deployment call it...Groundhog day.

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