Every wonder what it’s like to work on the Maritime Vessel
Africa Mercy (AFM)? The following is a description of the typical working day
for a ward nurse here. No two days are the same, but this is fairly close to a normal one.
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| Our tiny sitting area in the back of our cabin |
0620 – I awake to the
piercing sound of my alarm. Turning it off quickly, I slip out of the bunk
space and into the back of our cabin where I have laid out my scrubs and can
turn on a light without waking my three sleeping roommates. Then it’s off to
breakfast, a long walk to the opposite side of the ship. Ok, ok its probably a
60 to 90 second walk, but the dining room is at the bow (front) and my room is
nearly all the way aft (back). I get to the dining room just after the
breakfast line opens at 0630 and take my food to one of the back windows. While
I love living in a community, I don’t love the happy group of morning people at
the front of the dining room this early. I need my coffee before I can even
think about extroverting. I eat as I catch up on Facebook. My family and
friends back home on the other side of the world have only just gone to bed a
couple hours before.
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| The Ward on the day it opened. Mikwabo means Welcome all in Fon |
0655 – I stop by my room to grab my stethoscope and head
down one flight of stairs to A-ward. As I enter I am usually greeted first by
our day crew. The day crew on the AFM consist of local people who do not live
on the ship, but are hired by Mercy Ships to help in a variety of roles. We
could not function without them, they work so hard and with excellence. Many of
the work areas in the ship utilize day crew; in the hospital we have two
different day crew positions, hospital chaplaincy and ward day crew. The most
simple job description I could give for the ward day crew is that they are part
translators and part nursing assistants, but that underestimates what they do.
I could not do my job without the ward day crew. They are phenomenal! They help
us understand our patients, not just by breaking down the language barrier.
They are also great resources as cultural translators. We have learned so much
from each other. They help with ward tasks ranging from cleaning, meal
distribution, patient/visitor escorts, and so on. They keep clean supplies
stocked on the ward. To be good stewards, we reuse anything that is washable.
We even reuse the little disposable plastic medicine cups. One of the day crew
responsibilities is to run the sterilizer to replace all the equipment we go
through.
0700 – Night shift and day shift meet for huddle. Night shift
briefly discusses any problems the team as a whole needs to know and then we
pray for the day. Prayer time on the AFM is unlike any other. With so many
people from all over the world we offer up our prayers in whatever language we
are most comfortable with (English, Dutch, German, French, Fon, etc.). It’s a
powerful testament of the body of Christ. We may be different, but we are one
and share the same purpose.
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| Double checking pediatric doses for meds |
Once we finish I get
report form the night nurses on my patients. I have five patients today. The
first are two women with goiters caused by an over active thyroid. The first is
on her first day post op, having had her goiter and most of her thyroid removed
the day before. The second is waiting for her surgery today. She is a mixture
of excitement and nerves, but she is in good company, surrounded by woman who
share a similar story. I also have two plastics patients: Baki, a 14 year old
boy who injured three of his extremities due to an electrical burn several
years ago. He walks with a limp and is missing his left arm, but Mercy Ships
was able to release the burn contracture to his other hand. Jeanne is my other
plastics patient. She is only slightly younger than myself, but has been living
with a burn injury to her hand since she was five years old. My fifth patient
is a little out of the ordinary. He’s one of the day crew who has been sick and
needed IV antibiotics.
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| Administering meds through a feeding tube for a patient |
0730 – I see each of my patients. “Bonjour! Ca va?” Or “Me fon gon gia” I say, depending on what language
they speak. I check vital signs, have them rate their pain on a picture scale
and start passing morning medications, mostly consisting of vitamins, while the
day crew hands everyone hand sanitizer and begins passing out breakfast. Last
week A-ward had a much larger pediatric population so I spent half of my time
kneeling on the floor trying to reach my little patients who preferred to sleep
under the beds on the mattress for their parents then they did in their
hospital beds.
0800 – One of the hospital physicians comes in to check on
my day crew patient. He has been fever free since last night and can get
discharged!
0820 – I get my patient’s discharge paperwork completed as
general surgery rounding begins which consist of the current surgeon, his
resident helper, the A-ward nursing team leader and day crew to translate. They
visit each patient at the bedside, evaluate their progress and discuss the plan
of care. As they finish the first patient heads off to the OR, a women with
probably the largest goiter I have personally seen preoperative.
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| Doctor Parker (far left) during D-ward daily rounds |
0830 – Next is plastics rounding which is much more crowded.
So many people are involved in these patients' care. Into the ward we crowd 2
surgeons, 3 physical therapist, the dressing’s team leader, the ward nurse team
leader, a hospitalist and of course a day crew to translate.
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| Patient getting a dressing change in the in-patient treatment room. |
0900 – One of the dressings nurses comes to take Baki and
another patient back to the inpatient treatment room for their dressing
changes. They also need one of the day crew to help translate, but this is
easier said than done. Both patients speak Bariba, a northern dialect very few of
our day crew understand. We do a little rearranging and soon Samuel is off to
help translate as I sit down to do discharge teaching. Discharges normally take
a long time because every word needs to be translated, but this time my patient
spoke English and after ten minutes he was on his way out the door, antibiotics
in hand.
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| Taking a moment to dance to the music |
0930 – After discharging my patient, one of the fathers
challenged me to play connect four; he had already beaten me three times when
the hospital chaplaincy team filed in, saving me from a fourth loss I’m sure. When
the chaplains enter all nonessential work stops. I had a difficult time with
this the first time it interrupted discharge teaching I was completing. The
culture of my task oriented mindset wanted to finish, but I’ve since seen that
the relationship oriented culture of my patients creates an atmosphere where
pausing a task to join in on what the community is doing is not only accepted,
it’s expected. The chaplains lead a time of worship, scripture reading, prayer,
song, and dance. Everyone who can is on their feet dancing, those who can’t dance clap to the rhythm and sing along. The mamas sometimes have what I can only
describe as a dance off, taking turns praising God with their whole bodies.
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| Chaplaincy leading a time of worship through song and dance |
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| Walking the long corridor that makes up the hospital |
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| Eye patient just after surgery, before the patch is removed. |
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| Eye patient as she sees for the first time in years. |
B-ward where all the plastics
patients start off, then C-ward where our most stable longer stay patients end
up when they are getting close to discharging. Next is the eye room full of
outpatient cataracts patients who will arrive on the ship blind and leave with
their sight restored. As I pass, a day crew comes out carrying a child in her
arms. Even with his eyes covered in gauze he knows I’m there. He smiles and
reaches out his arm so I shake his little hand. I tear up a little as they continue down the hall and imaging his face when he sees for the first time and the whole world is opened up to him.
1000 – I’m back on the ward and it’s time to start passing
nutritional supplements to our plastics patients who need extra nutrition and
calories for their skin grafts to heal. I go in search of Baki who is no longer
in the ward and find him down the hall with one of his new friends from B or C
ward. Patients and parents come and go from the wards all day. Its like one big
and loud family. When I get back to the ward I sit down at a small table with a
group of boys to color and joke with each other (boys are the same everywhere
when it comes to what they find hysterical) until the OR calls that they will
soon arrive to pick up my preoperative patient for surgery.
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| Some of our goiter patients, mostly woman, but we do see a few on men also. |
1145 – I let my patient know that the OR will be here soon
and scrub her neck with an antibacterial soap. The OR nurse arrives with a
translator and we go through the check list, and she reminds the patient what
to expect and answers any questions. The OR nurse then asks the patient if she
can pray for her before she goes into surgery. The patient smiles and nods so
we lay hands on her shoulders and the OR nurse begins praying in Dutch.
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| Goiter patient at her out patients appointment |
1300 – I get vitals on my first day post op patient,
reassess her incision and empty her wound drains. She is healing very well and
will likely have the drains removed tomorrow morning and then discharge after
lunch. She will follow-up a few days later for a wound check with outpatients.
1330 – The first surgery of the day is back from PACU and wow does she look different without the large goiter hiding her neck. Except for a scar across her neck you would have never known it was there.
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| Goiter patient post surgery, day of discharge. |
She is
smiling ear to ear as we get her into bed and I check her vitals as her nurse
gets report from the PACU nurse.
1400 the evening shift arrives. Our team leader Jane leads
us in a devotion or plays a worship song before we again pray for our patients
and each other. I hand over my patients to the oncoming nurse.
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| Watching a container ship come into port on deck-7 |
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| Giving mom a break on deck-7 |
1525 – I help to lead the patients back down to the hospital, taking those on crutches down in our tiny elevator. While we were gone three new thyroid patients have arrived to be admitted before their surgeries tomorrow, and the day crew is currently orientating them to the ward. Once everyone is safely back in the ward I head up the stairs to my room. I close the door behind me, but I can still hear the faint sounds of the hospital below.
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| Deck-7 fun |
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| Playing games in the cafe' |
1535 - Since I am off before most of the ship in the
afternoon when I work days, I have a perfect opportunity for quiet time. I’m
usually alone in my cabin for the next couple hours. At five I’ll go get dinner
and then in the
evenings I do a variety of things. Sunday Evenings we have
Church and Thursday evenings we have a community meeting which ends with ice
cream. Other evenings I have off are spent playing games, watching movies in
one of my teacher friends’ classrooms, practicing with the acapella group I’m
in, going on the occasional outing for pizza, or just hanging out in my cabin
with my bunk mate, who is awesome by the way.
There you have it a typical day on the Africa Mercy. I have
good days and bad days. Some days are crazy while others can drag on, but it is
a joy to be here. I am so blessed and I wouldn't trade my new job for anything.
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| More deck-7 fun |
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| The last few plastics patients to discharge after our first stage of plastics surgery getting a ride out of the port. |
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| Deck-7 fun with Ricardo and Joseph, nicknamed the twins because they had the same surgery and were always found playing together. |
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| My awesome bunk mate, Tiffany, trying out the new backpack style vacuums to clean out our bunk space. |
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| Not all days are the same!!! on this particular day one of the patients kindly offered to cut another patients hair which turned into cutting everyone's hair. |
Author's Note: While I am currently serving with Mercy Ships the ideas and opinions expressed here are my own. Mercy Ships has not reviewed nor do they endorse the content written within this blog. A big thank you to the photographers who shared the pictures this post contains.
