Tuesday, January 5, 2010

Eu sou uma enfermeira.

I am a nurse. What a HUGE statement to make? Some days it overwhelms me, others it makes me feel accomplished, others it brings about fear and worry, others I sit at the Lord's feet in utter surrender or thanksgiving...today it brought about questioning...

I just spent some time looking up the definition for nurse:
n. a person formally trained to care for the sick or infirm
v. to tend or minister to in sickness or infirmity, to look out for carefully so to promote growth and development, foster, cherish, to keep steadily in mind or memory, to bring up, train, or nurture, to clasp or handle carefully or fondly

How many times in school did we define what/who a nurse was? I can't even count (yep that's right I did listen all those days!). Someone who cares; the number one trusted professionals in the US for so many years running. The one part of the definition I'm stuck on today is...a nurse always does good and never intentionally does harm. What does that mean when you live in a developing nation? What does that mean when you have access to some things and not others? What does that mean when you live, eat, and breath your work place and therefore your patients?

So this afternoon I was called and asked to fill a few prescriptions for a community lady (a mother of two boys here at the center) who had just given birth. She had a c-section a few days ago and has had no antibiotics or pain killers since she left the hospital yesterday. I headed over to get her prescriptions and encountered about 4 drugs I had never heard of, amoxycillin, and no pain killers (at least none I recognized).

So let me just throw some stats at you about Moz:
~Only 2% of births are done by c-section and over 50% of deliveries are done at home.
~Less than 50% of births are attended by a skilled delivery specialist.
~Infant mortality rate is 11%
~1 in 45 women will die from childbirth during their lifetime.
~Contraceptive use is 21% (much less in some populations).

Where I struggled was in the fact that a nurse who has been here much much longer than me and knows this particular lady from previous issues wanted to send her away until tomorrow when we specifically see community members and the clinic is open. So where does my responsibility as a nurse come in? What call do you make? Do you send her away and pray that she has the money/energy to come back tomorrow and that antibiotics tomorrow will be enough to fight against whatever infection she already has (I'm just assuming her incision is infected after seeing the hospital the other day)? Do you follow leadership or the gut feeling you have that this particular lady needs antibiotics (she surely didn't look great) and is not going to adequately feed her baby without some painkillers as well?

Here's what I've learned so far as a nurse. You go with your gut. The Lord has given each of us that still small voice that speaks to us and nudges us in one direction for another. When in doubt go with the safest route (the one covering all bases) and just go with your gut initial reaction. So...for those of you wondering...I packed up 7 days of amoxycillin, ibuprofen, and paracetamol (that's US tylenol) and let her know if she did want to take the other meds as well to come back tomorrow. As for those wondering...the baby was GORGEOUS! And he weighed 3.61 kg (almost 8 pounds) on delivery!!! So great; praise Jesus!

So...that was my day...I still don't have answers to my questions but I'm praying God will reveal them in His time.

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