Lake side Clinic

First Week

On Monday March 14, I began working at the ER at Ankaase. I worked the 8am to 2pm shift. The shift system at this location is different from what I am used to in the US. They have 8am-2pm shift, 2pm-8am shift and an 8pm -8am shift. Nurses who work the 6 hour shifts work 5 days with a day or 2 off. Those working the 12 hour shifts get 4 days off. The staff are then rotated through all the shifts.

About 2 hours into my first day, an unresponsive patient in cardiac arrest was brought in by his friends. We began chest compressions on the patient only to realize that we didn’t have any resuscitation drugs or equipment in the department. Unfortunately, this patient didn’t survive. With the help of some guys rotating through the hospital as part of their paramedic training, we discovered that the emergency drugs had been locked in a cabinet. The key was nowhere to be found.

The charge nurse found someone to break the cabinet and we discovered a bag valve mask (BVM) device used to resuscitation. Although all the components weren’t available, we were glad to have made that discovery The BVM was lacking a mask and an oxygen connector, both vital pieces in resuscitation. With the help of my paramedic friends, we rearranged the emergency cabinet and restocked it with emergency drugs (epinephrine, hydralazine, lidocaine, diazepam, atropine and hydrocortisone). These are life- saving drugs.

Throughout the week we worked with the CEO and nurse matron (nurse manager) to obtain an automated external defibrillator (AED) and a cardiac monitor for the unit. These resources were available but they didn’t have anybody who knew how to use them or teach the staff how to operate them. We even had some of the staff ask us about the purpose of the AED. We are planning a training session for the staff in the very near future. We will be teaching basic cardiac rhythms and proper usage of the AED and cardiac monitor. Please pray for strength and direction as we plan for this educational opportunity.

On Thursday March 17 I helped transport an infant in respiratory distress to a tertiary facility in Kumasi. We had to manually resuscitate this infant in the ambulance as the driver attempted to avoid pot holes as big as valleys. In addition, the siren on the ambulance was broken and the horn shut off in transit. Unfortunately, most Ghanaian drivers are not that kind to emergency personnel. Thus, they do not readily get out of the road when an ambulance approaches. Needless to say, it was a nail biting trip with multiple close encounters. We are not sure about the outcome of the infant but my last assessment prior to handover showed minimal cardiac activity with below normal vital signs.

On Friday March 18 we had a brief moment of rest at the unit and I used the opportunity to teach some of the staff about physical assessments. The nurses at this location use the stethoscopes provided by the hospital for only blood pressure checks. They were surprised when I used mine to assess patients and evaluate the efficacy of interventions. So, I showed a few of the staff about correct stethoscope placement to auscultate lung, cardiac and bowel sounds. One enrolled nurse (similar to an LPN) heard bowel sounds for the first time and was very excited. We are thankful to God for this learning opportunity. There is always hope and we are praying for positive changes at this location.

I procured a mask for the BVM this past weekend. I also obtained a BP cuff and asked around for the price of a digital/automated BP cuff. We are praying for God’s direction in obtaining funds for this equipment as it will greatly increase the level of care and change lives. This hospital hasn’t received any payment from the national insurance in 8 months. So we are praying that God will help us find a way to get a few essential things for the facility.

The new manual BP cuff...

As we (my mom and I) looked for medical items this past weekend, we stopped by a coconut seller’s stand for a quick break. He (name Hamilu) was a nice guy and provided some delicious coconuts in the 100 -degree temperature. It was very refreshing and tasty. Mr. Hamilu even posed for a picture J  It is now a cool thing in Ghana to drink coconuts with straw so I consumed my coconut milk with a straw J J

coconut with a straw

master coconut man ..Hamilu

Until the next post, I wish you all a very blessed Easter and a very good Friday. Enjoy the egg hunts and the rabbit chasing and may the peace of the Lord be ever present with us always.