3rd Time, New Country: Eid Mobarak 2009

As far as mentoring goes, it has been an easy week since I last posted to this blog. Ramadan ended on Sunday, with three days of Eid that started on Sunday. I have included some pictures from the Eid celebration at NMH on Sunday. My team of mentors met up with leadership of NMH, MPRI mentors, and a select few of the ANA leadership. After meeting up at NMH and congratulating everyone (Eid Mobarak is Dari for “congratulations on Eid”), we formed up to see the ANA Chief of Staff review the honor guard, before meeting and shaking hands with all present. He then visited the wounded ANA soldiers and police throughout the hospital. We went to the top of the hospital to the flower room for chai and cookies.

Monday and Tuesday was the continuation of Eid, so we didn’t go to NMH to mentor. It was only a duty crew and our interpreters also had the time off. On Tuesday, our nurse mentors met with Rick the senior nurse for MPRI and discussed the current state of nursing at NMH. The nurses are understaffed and underpaid, but that is like all other nurses throughout the world including the US. We are trying to help NMH restaff some of their wards to help with the nursing shortage. We are also offering suggestions on how to staff some wards with shift nursing, but that is a hard sell. Some hospitals here in Kabul do shifts, but not at NMH yet.

Wednesday was back to NMH for mentoring, but it was similar to Eid. Most of the staff came into the hospital, but left early. I am working with the OT director on how to schedule cases for each day. We are trying to incorporate a new scheduling tool, which is an excel spreadsheet to better manage the individual rooms. It hasn’t taken effect yet, but he and I continue to work on it. We are going to ask the surgeons to start booking their cases 2 days in advance so we can put out a schedule 1 day prior to surgery. This way we will have better time management in the OT and can block out time inbetween each case to give the staff time to turnover the room and properly clean it. Hopefully, we can implement this schedule starting on Saturday. We will brief the surgeons during morning report.

Thursday was another short day of mentoring. Our 3 nurse mentors went to a meeting with the Senior Nurse from NMH and the OTSG (Office of the Surgeon General) so we could discuss the current nursing shortage at NMH. NMH is a 400 bed hospital, but we only have 86 nurses. Try staffing that big of a hospital with 86 nurses. We calculate that NMH needs a little over 250 nurses to provide safe and effective nursing care to the patients. We discussed ways to increase staffing, but it will take time to increase their manning document (Tashkiel). In the meantime, we hope to hire some contract nurses locally here in Kabul to help bridge the nursing shortage.

Today, jumma, (Friday) is the regular day off. I use the day to get caught up on admin and to update the blog. Tomorrow, it is back to full work days at NMH. Here are the pictures from Eid: