Differences

Working as a nurse on board the Africa Mercy has its own set of challenges and triumphs. After 12 weeks, many things have come to feel normal that are much different than working in a hospital back home. Here are some of the differences that are part of a "normal" work day:

Small spaces. The "nurses' station" consists of a desk with a computer for the charge nurse, and one counter beneath the medication cupboard. The nurses are always running into each other as we attempt to get our meds together, sign off charts, or just walk from one side of the ward to the other.

IV bags swaying as the ship rocks back and forth.

Praying with patients before surgery, praise and worship time every day, ward services on Sundays.

Lack of privacy. Men, women, children, and babies all together in the wards. All the patients and their family members in each other's business, listening to each other's conversations, helping take care of each other's babies. It really shows the cultural differences. Back home, my patients get grumpy if they have to be in a semi-private room, shared by two patients. Here, the few patients that get their own rooms for isolation precautions, don't like it at all. They usually prefer to be out in the ward with everybody else.

Language barriers. We have translators, but sometimes we need more than one. The other day I had to hunt down someone who spoke Mende, and it turned out to be another patient's family member. As I was doing some teaching with my patient, I spoke in English to the day volunteer, who spoke in Krio to the other patient's caregiver, who spoke in Mende to my patient. I'm never quite sure how much gets lost in translation.

Patients' family members sleeping on pallets underneath the patients' beds.

Creativity and flexibility. For example, making peanut butter and milk concoctions for NG feedings when we run out of ensure.

Living, eating, worshiping, and hanging out with my coworkers every single day, not just during our shifts.

Living in a cabin just a few steps down the hall from the ward where I work.

Getting a lunch break EVERY day....and coffee/tea breaks on slow days. :-)

Mixing up my own IV meds, instead of a pharmacist doing it.

Hanging curtains from magnetic hooks that stick to the ceiling.

Calculating drip rates, and constantly fiddling with IV drips that are running by gravity instead of through a pump.

Chatting with my patients and their family members until the wee hours of the morning when they don't feel like going to sleep.

Taking care of pediatric patients. This is a BIG difference for me, since I haven't done that since nursing school!

Always finding different brands and types of supplies for IV's, meds, dressings, etc. One week we had the IV catheters with retractable safety needles - that was exciting. Another time our betadine ointment was from Norway or someplace and I couldn't read the label - I had to open it and look at the medicine to be sure what it was.

Different terminology: calling tylenol "paracetamol" and the OR the "operating theatre"

Dancing around the ward with the kids singing "I like to move it, move it" or "Shake your body for Jesus, clap your hands for Jesus..."

Blowing bubbles and playing with balloons to keep the kids entertained

Making sure our patients understand how to use the toilet...some of them have never experienced indoor plumbing. One bathroom shared between 15 patients and their family members. Also, the plumbing runs on a vacuum system, which doesn't ALWAYS work...

Going on treasure hunts in the pharmacy late at night when we run out of meds and don't want to wake the pharmacist up.

Wearing many different "hats," not just that of a nurse, and especially on night shift. In one day I might be the nurse, nurse's assistant, respiratory therapist, lactation consultant, speech therapist, baby sitter...