A day on the ward…

My room is pitch dark when i wake up a little after 6 in the morning to get ready for my day shift at work. I live in a 6 berth cabin on the third deck in the middle so there are no outside windows. I remember the first night I saw my cabin incredulously thinking, “This is ALL the personal space I have?? How am I supposed to fit all my stuff on 2 tiny shelves and half of a little closet?” Now, a month later, it doesn’t seem like an issue anymore and my stuff actually fits just fine with some expert maneuvering. 
I eat breakfast quickly with other day shift nurse friends and we walk down a couple flights of stairs back to the third deck which is also home to the operating theaters and all the wards. I work on D ward which is home to the post op maxillofacial patients. The surgeries that they have had include things like cleft lip/palate repairs, facial tumor removals, maxillectomy and mandilectomies, etc. Most of us on this ward are either pediatric or adult ICU nurses because of the higher potential for there to be complications involving the airway after these specific surgeries. 
At the beginning of each shift the oncoming and offgoing shifts (both nurses and Malagasy day workers, and sometimes some curious patients!) meet together for any updates and a brief time of prayer for the day and upcoming admissions or surgeries. Then our day starts. The ward feels so different than what I am used to at home with all the patient beds right next to each other in one room, caregivers and younger siblings sleeping on mattresses under the patient beds and generally people all over the place and lots of activity going on all the time! At first it felt kind of chaotic and stressful for me but I’m getting used to running into people and hearing constant chatter from babies playing and parents conversing with each other or with the day crew. 
Yesterday was the first day that I had a little extra time during my shift to be able to play with my patients between nursing tasks. One of my patients, a twelve year old girl who had gotten a cleft palate repair, wanted me to paint her nails. Ten nail polish colors later (each finger was a different color!) she was finally satisfied with her results. We also had a little hair washing/head massage session after taking out her NG tube since she had not had her hair washed or brushed since her surgery 5 days previously. The rest of the day she proceeded to be my new best friend and follow me around the unit with her arm around my waist and communicating through random grunts and hand gestures. (Surprisingly effective when you don’t speak each other’s languages!) 
Every afternoon between day and evening shifts we take all the patients who are able to get out of bed up to Deck 7 outside. There is lots of room for children to ride tricycles around, a basketball hoop, tables to play jenga and board games and lots of times an impromptu concert with guitars and drums. There is a beautiful view of the ocean off the deck and a salty tasting breeze and it feels refreshing to be able to focus on playing and relationships without having nursing responsibilities for that one hour every afternoon. Today one of the second officers on the ship even took a couple of the nurses and patients on a tour of the ship bridge where all the control panels are. My new little friend had quite a blast and there were lots of giggles. 
As I was leaving the ward, I told her I would stop by the next morning to say goodbye before she gets discharged to the HOPE (Hospital outpatient extension) center tomorrow. Patients get to stay there between being discharged from the hospital and follow up outpatient appointments since many of them live more than a couple days drive away. I got one more big hug and squinty eyed smile as I walked out the door. 
D ward nurses! 

Exploring a local town. 

Yes, we do have a Starbucks on the ship. Coffee and tea breaks are taken very seriously. 

Madagascar week 1

It is hard for me to condense and put into words an accurate picture of everything that has been happening and all the changes since arriving here but I will try to give a glimpse. 

It has been, and will probably continue to be an adjustment living on a ship with 400 other crew members. It’s hard for me especially to have much less personal space than I’m accustomed to at home. But at the same time it is such a unique opportunity to be able to live in community with (for the most part) like minded people. I have already been blessed several times by someone’s encouraging words or thoughtfulness. 

Another thing about living in community though is that is tends to show me exactly how much more selfish I am used to being. I’ve caught myself thinking “How can I be most comfortable in this situation?” or “How can I feel better about myself in this situation?” I hope that through the coming months I learn to think about others needs as easily and naturally as I think about my own. 

This last week has been full of orientation and cleaning and setting up the hospital wards. The whole hospital is packed up and stored during dry dock season so it is a process to get everything ready for surgeries to start again. During the week we also got to spend some time meeting and getting to know the Malagasy day crew workers. Mercy Ships hires many local people from the country they are serving in to help with many jobs on the ship as well as being our primary translators and kind of cultural bridge in the hospital. At first I thought that we (Mercy Ships) were helping these people by giving them jobs, but I quickly realized that we would be pretty ineffective without all the help and cultural knowledge and translation that these day workers provide for us. I’m looking forward to working closely with these people and getting to know them even better. 

Patients screenings for surgeries have been going on for months, we began admitting patients to the hospital yesterday, and surgeries have just begun in the last couple hours. I will be primarily working on D ward which will be both pediatric and adult Maxillofacial surgical patients. D ward is also connected to the ICU so I will take care of higher acuity patients if needed as well. 

This next week will consist of more ICU orientation, a 2 day cultural training course, and maybe whale watching this weekend! I’m looking forward to my first shift on the ward next week and using my nursing skills again too. 

A few pictures… 

Lemur. Obviously. 🙂 

International church service in Antananarivo last Sunday. 

Setting up the ICU. 

Group medical crew photo. (Photo credit: Katie Keegan)