Juanga Nurses

With about a week left in my stay, the following is brief update of some of what I can do/have done here, with the help of a splendid and very accepting nursing staff, as well as some keen advice/observations from a Spanish doctor named Marta Miquel who lived here the past six months and recently.

Photo one: Perhaps the most exciting of developments, I got a shelf to store our urinals and bedpans. Before that point, it was unclear when a patient was discharged whether or not the devices had been cleaned before they went on to be used by the next patient. This shelf cost 100INR ($2.00 or so) and now there's a system in place.

Photo two: Our weekly nurse meeting where we sit together and discus how they want to improve patient care and the systems in place for them to do their job. Some requests are large: finish the work to get the new transformer so no more nights/days/weeks (as we've had the last two) without electricity. Others are small: is it possible to get a chair to go with each patient bed for their family/attendant to sit? It often ends with them quizzing me all about my work in the US, and what an ICU is like.

Photo three: Pratima, our head nurse, on the phone with a doctor at the new and evolving nurse's station. We've created an ER for abdominal pain, fever, and diarrhea patients, and within it created a nurse's station for them to organize their work. Previously all patient medication were kept with the patient. Thanks to a shipment from Spain that included some organizing boxes and the crafting of a new wood cabinet with a lock, the meds will now be kept by the nurses. We also purchased 17 clipboards (we are a 17-bed hospital) and now each patient has it's own clipboard/chart system. The paperwork was always done, but now it's in one place for each patient. Each nurse individually has expressed her gratitude that they now have a home-base from which to start and end their work. Future goals are to establish an actual nurse's room...

Photo four: A pending OR patient having just received her 2nd blood transfusion (almost all the women we operate on have low hemoglobin and need at least one transfusion pre-operatively), on a new patient bed (thanks to the Spanish doctor) with the new patient organization system in place - each bed now has a number that corresponds to the patient, his/her chart, and the place where his/her meds are kept. You can also see some of the HIV/AIDS posters from the Orissa government procured by an American medical student who was here for a month.