Where to begin?

So, my first few days her have been so full and interesting, I hardly know where to start. The hospital feels a bit like that, actually. So full and interesting.

On my first day in Saint Marc S, my boss from Boston, was visiting. We had a really productive discussion with the Haitian pediatrician with whom I work. We talked about seeing the sickest inpatients together, which has so far worked out well. We also made some moves to try to begin improving patient care, such as weighing all of the sickest babies every day and making an effort to use pulse oximetry (measuring a patient’s oxygen level) to help guide our decisions about keeping them on oxygen. Prior to that none of the patients were getting weighed, nor were oxygen levels being checked regularly. With only two nurses and one or two physicians providing care to around 40 patients, there are many aspects of patient care that have simply fallen by the wayside. My hope is that by improving how things are set up we can get things moving in the right direction. For instance, the scales for the babies were both tucked away in a side room. One needed to be calibrated, the other wasn’t working properly on an uneven surface. The scales are now calibrated and one is in a location closer to the “NICU” rooms.

I will admit I feel a bit overwhelmed by how chaotic the current system is at the hospital; there is a lot standing between my patients and good care. It is not the fault of any one person, but rather a system which has been set up for failure. I have to believe that the people I work with there are doing the best they can, given the circumstances, and as of Thursday I am doing the best I can as well. We don’t always have the medicines I want to use or the resources I wish were available, but I’m doing my best to begin sorting out which of the problems are ones I can tackle (not weighing babies, a lack of communication around plans of care, etc.) and which ones I cannot (issues with drugs not being available, not having enough nurses, etc.). My initial reaction is to want to try to fix everything at once, but I have to remind myself that Rome wasn’t built in a day. (Piti piti.) So I’m picking my battles, figuring out who my allies are, and beginning to try to make some changes.

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1 Comment

  1. Hi Sara,
    So interested in reading your reports on the goings on over there. Understand you have shortages of food and/or medicines. Might try emailing Anderson Cooper of CNN. He spent a long time in Haiti after the hurricane and seems interested in helping poor folks. We’re so proud of you Dr. Sara and happy that your living your passion of helping the children. I love you Sara!

    Uncle Dick


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