A lot can happen in a month. Before I came and even when I
first got here, a year sounded like a long time. 13 months sounded like a long
time, but I was realizing the other day that I’ve already been in Honduras for
3 months now and each week feels like it’s flying by. The days are long but I
have felt very present and at times very exhausted (in a great way usually).
I’ll be doing a “Day in the Life” post here soon but for now I’ve been thinking
a lot about transitions.
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| They're kind of like driving along in your car then realizing that it has wings and you have to learn to fly or you're going to just crash and only know what its like to be on the ground. |
Right now I think I can safely say that my life here is
broken up into three main sections: my time in the clinic, my time in hogar,
and my time with the volunteer community. I have been in a period of transition
in all three areas and in very different ways. It’s a lot to reflect on and to
sit down and write out, hence I have been slacking on this blogging business.
I’ll start with the clinic now, my hogar later and the volunteer community will
be shared in bits and pieces.
The External Clinic:
I started out in the external clinic learning the ropes from
the other volunteer nurse Jen. I had to somewhat re-learn and practice starting
I.V.’s, learn our check in process and pre-clinic procedure, get to know what
medications we have available and their uses, etc. That part was all pretty
smooth and straight forward. I found that once again, the hardest part for me
has been language. The times when I ask the patient where they’re from and I
can’t understand in the slightest bit what they said can be a bit ridiculous.
As I’m getting familiar with names of the pueblos nearby it’s gotten easier but
mistakes are so easy to do. For example, I heard a patient was from was “Port
Venir” when in reality they live in “El Porvenir.” Super simple mistake but they
definitely don’t live in Port Venir. I don’t think it exists.
As I got more comfortable with the clinic my first 3 weeks,
I came to learn that Jen had decided to return to the U.S. and with that, I
would be the coordinator of the external clinic. The news came by surprise to
me as a new volunteer, but Jen’s decision was very thought out and overall the
best thing for her right now. I’ve since been learning more about continuous
projects I need to carry out such as Dia de Diabetes and the de-parasiting of
the kids every 6 months. I’ve also transitioned into activities that keep the
clinic running such as getting the weekly meds and monthly supplies from the
ranch resources. So far I feel as though everything has been going smoothly and
I’m at a point where if there’s something I don’t know how to do yet in regards
to running the clinic, I’m not aware that I don’t know how to do it quite yet.
I think I’m in a place though where I know who to ask when confusion arises.
There are some aspects of the clinic that are hard to adjust
to. Well, not even adjust. There are things that are hard to realize and to
understand what can be done about them, especially with limited resources. They
aren’t skills to be learned, but realities about where I’m working and the population
I’m working with. Here are a few thoughts:
- We currently are in a crisis and can’t hire another nurse to run the external. I love my job, but I don’t feel comfortable with the idea of a volunteer always running the clinic.
- Our charting system is all paper, with white pages stapled to it when more information needs to be added. If people don’t bring their carnet/other paper with their chart number on it and their name isn’t in the computer or these stacks of notecards we have then they get another new chart. We can’t afford an electronic charting system and the power isn’t always reliable, hence paper charts make sense. They make sense, but it needs some revamping about now.
- There’s a lot of poverty. Not a surprising realization, but how do you feel ok sending someone home with vitamins and their medications when they have 3 kids with them that are all different ages but practically the same weight and they said specifically that they can only afford to eat beans. We have some resources that are provided by the ranch, but it isn’t always enough to reach everyone.
- The clinic isn’t open all day so we can only see a limited number of patients. If there are more than can be seen or too many are let in with tickets for the day, it’s part of my job to tell them that they have to come back another day. When someone rode a bus for 3 hours starting at 4 or 5 in the morning to come see the doctor and you tell them that they can’t be seen, it feels awful. There are of course exceptions when it’s serious but there isn’t a system in order based on where people live. There are people with some of the first tickets because they live 30 minutes away but they can see the doctor and others might not be able to. This system seems changeable.
- The role of the nurse is different. It’s hard for me to be okay giving someone a prescription without having their chart and history to understand why they are taking each med. I can make a pretty good guess, but I need to make those connections based on something besides the typical uses of each medication. I’ve been working on this a little by sitting in with the doctor here and there but I’m still considering what can be done.
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| The charts. They're about as sleek as a computer and very weather resistant. |
What I see each day and the conversations I’ve had are
opening me up to the reality for many people in Honduras. I feel sheltered in
other aspects of my life here so I love what the external clinic has to offer.
My role there has changed, my relationships with other nurses are growing, my
Spanish is improving, and I’m continually getting a glimpse into the lives and
health of those who live around me. Transition is a good thing.
One last bit. I’ve been reading Mountains Beyond Mountains
and I’ve been trying to keep this in mind:
“You can’t sympathize with the staff too much or you risk
not sympathizing with the patients.”
Much Love,
Alissa
