Chaos

Well this has been a very hectic last few days! I'm just getting used to being in the neuro section which is great! and these people are awesome.

On Wednesday after our clinical, Emily and I went with our friend Niki to help at a mobile soup kitchen which drove through the street and stopped at the three spots it always stops at every Wednesday on the side of streets or near abandoned buildings. We would then pass out cups, water, pour soup, or hand out slices of bread. Once done handing out we would talk to everyone and get to know them. It was very interesting. A very good experience!

Thursday at work I had a patient faint on me. Let me first just tell you that 70% of hospital beds here are stomach height crib-looking beds (bars on all sides that go up and down). The beds do not raise and lower and the head/feet do not raise and lower. So after doing a 2 Max transfer of a patient (SCI quad) from this tall bed to a chair after a few minutes of being fine he passed out. Oh and also there's no continuous monitor on this patient to know any vitals. So dead lift back up the huge incline to the bed where he was breathing on his own and still had a fair pulse,  they decided to intubate him. Anyway after about 2 minutes of being intubated he was trying to spit out the incubation tube. Anyway after that craziness I got to practice some chest PT and use a vibrator pad to break loose some mucous plugs (apparently gentler than chest PT on patients with 2 broken ribs and broken clavicle) which really can help get some frustrations out! Later in the day, one of the physios told me she wished we would stay and work there and another patient of mine said "oh thank you my child" after treatment! So all in all crazy day, but I wouldn't change it. I think that is what I love about neuro! Every patient is so different presenting and just about anything can happen, crash or make major gains in independence. It keeps every day interesting.

So then today (Friday), I thought my head might explode. I asked for 4 patients to be transported to the gym for treatment today and none of them ended up getting there correctly. Then for icing (of sorts) on the cake, I went to treat a patient in the ward and there was literally crap everywhere in his bed. I was going with the benefit of the doubt and thinking the nurses (sisters) hadn't seen/smelled it which was pretty hard in the open rooms with 20-30 beds, you can pretty much see everything. So I notified them and was told that there were no more linens and nothing could be done. After a few minutes of asking questions like: 'when will more get here' 'are there no more you can borrow from other wards?' 'and there are no gowns we can clean him and redress him in?' and 'could we just clean him and let him lay on the something on the mattress?' and not getting much of anywhere with the nurse seeming completely ok with leaving the dependent patient in his soiled bed for hours, I turned and walked out doing some very deep breathing and walking very quickly for a very long time. I don't care what your policies or lack of resources are my conscience can't handle that and if you can there is something wrong.

After saying all that about the state of the hospital and lack of nursing/support staff, I will say that the reported condition of the hospitals in Bangladesh, as told by a young physio who had recently traveled there, is patients lying on the floor (not on mats, literally on the floor) because there are too many patients for the hospital to handle and IV poles and curtains that wrap around each bed in the large room of about 30 are non-existent. Bara is fancy compared to that. So I guess it could always be worse. I guess I should be grateful that the sick have some place to go for some treatment whether or not they can pay. Next week I suppose I will try to be more optimistic and look for the good.