Tuesday, April 15, 2008

Volunteers Continue to Bring HOPE to Patients and Staff at JFK

Project HOPE volunteer Cherri Dobson flew all the way to Liberia with a baby in her suitcase...a resuscitation baby that is. Today she, along with volunteer Dianne Bennett, used that baby to teach a class of 28 JFK nurses, respiratory therapists and midwives the basics of neonatal resuscitation.

“I have been a neonatal nurse for 25 years,” said Cherri, a first time Project HOPE volunteer. “This has been the most receptive class I have ever taught. I got the impression that they wanted to be there and they appreciated the knowledge. Here they don’t have the resources that we take for granted and they are interested in any kind of information that will help them have better outcomes for their babies."

In addition to teaching several classes this week, Cherri worked side-by-side with her counterparts in the neonatal unit last week, caring for premature babies in very simple medical settings. One of the highlights of her volunteer experience happened when she noticed her counterpart, Carrie, modeling herself after Cherri. “We had discussed anemia in infants and later when I mentioned a baby looked anemic, Carrie went right over and filled out a lab slip.”

Cherri brought several pieces of resuscitation equipment and books on neonatal care to pass out to her counterparts. “When I gave them a neonatal drug formularies book, the staff took the book and began reading it like it was fiction,” she said.

Like many volunteers, Cherri has found her teaching function has also lead to learning. At JFK, premature babies are often feed by hand with a syringe, one drop of breast milk at a time. Cherri was amazed with the preemie’s ability to swallow on his own. “This has definitely been an information exchange experience for me. I have learned different ways to feed a premature baby that are perhaps less invasive that what we do in the United States. I have seen very simple and effective treatments work that I may have considered archaic before. but have now given me the view technology doesn’t always equate to best care.”

The neonatal resuscitation classes were specifically requested by the JFK administration said Joel Trinidad, the Project HOPE volunteer Chief Nursing Officer on the mission. “They deliver a lot of babies here,” Joel said. “Now if a baby is in distress, the midwives rush the babies to the nurse anesthetist, but they want the midwives to learn to treat the babies in labor and delivery.”

Cherri and Dianne emphasized simple techniques that could save a baby’s life such as warming and drying, stimulation, insuring a clear airway and checking for breathing and circulation. “It was very important to emphasize that they could make a difference without medicines and without equipment to save a baby’s life,” Dianne said.

In addition to several health education classes, Dianne, on her second volunteer mission with Project HOPE has also been spending her time in the Pediatric ICU, the Burn unit and the Emergency Room.

A natural at nursing, patients around the hospital, especially children, respond immediately to Dianne's smile, her gentle words and lots of high fives. “Pediatric ICU is a very serious setting at JFK ,” Dianne said. “Imagine no screens for privacy, and small children seeing and observing all the dressing changes and other procedures going on right in front of them. These little eyes are seeing a lot. If I can find a way to add a little bit of laughter, a caring touch and a few smiles to their day, I think it’s healing.”

Dianne is also aware that she is being observed by her counterparts . “Any interacting I do with patients, families and other nurses is a great opportunity to do teaching and hopefully by doing the teaching the patients will get out of the hospital little bit faster.”

When choosing her career, Diane had planned on becoming a doctor. But after watching her Dad go through an illness, she deiced to change career paths. “When my dad was sick, I noticed it was the nurses coming to his bedside making him laugh. The doctors came in and out. I wanted to be a nurse so I could spend more time with the patients.”

Dianne participated in the Project HOPE US. Navy partnership Mission to Southeast Asia Oceania last year on board the USS Peleilu. In contrast, the mission to West Africa has been land based. But the outcome has remained the same. “Like the last mission I went on, this has been a rewarding and eye-opening experience that really makes me appreciate health care in the States and also reminds me how fragile life is,” Dianne said. “We’ve also formed great relationships and bonds with the JFK staff on this trip. There has been a lot of conversation and a great exchange of information. I hope we can continue what we have built on.”

In anther section of the hospital, Mary Kennedy presented her second trauma workshop, this time on burn wounds. In addition to a full schedule of education classes this week, Mary has spent much of her time working in the Emergency Room, one of the toughest departments in the hospital. “I have been a trauma coordinator in the ER for many years in city hospitals, and I have seen a lot of trauma. But this is one of the poorest places I have been so far. People only come in here with serious stuff.”

She has seen multiple serious bone fractures due to all too common car accidents in Liberia. She witnessed serious infections due to tropical illnesses like typhoid and even cared for a man who was injured with an ax.

There is no insurance program in Liberia, and payment is required of patients before they receive diagnostic treatment. “The payment method is weird here,” Mary said. “There have been patients left in the emergency room for days because they can’t pay to have an x-ray for diagnosis.”

Mary, and some of the other volunteers have had the opportunity to get to know Jimmy while working in the Emergency Room. Jimmy, a 6-year-old boy was abandoned at the hospital quite some time ago. He’s been in the emergency room ever since. He can’t walk and has some mental disabilities, but he smiles and responds happily to everyone who walks by. The nurses say he is unadoptable, and although his environment is harsh and heartbreaking to imagine, it’s better than living on the street alone.

Despite the dire circumstances, there are stories of success. Mary, who taught a class in trauma assessment yesterday lectured about the use of different types of fluids and which were appropriate for different types of trauma. Later in the afternoon, when she returned to the ER to work one- on-one with students in the class, a very proud ER nurse came up to Mary and told her that a very sick patient had been discharged from the ER because she had changed his previous IV fluid to a saline fluid. “This man was very sick, “ Mary said. “And while saline was the appropriate fluid, I don’t think that it healed him. But it’s a start,” she said.

Then there’s the story of 14-year-old Darius. Darius came into the emergency room with severe abdominal pain. “He was very very sick,” Mary said. The boy was suffering from typhoid perforation (a common aliment in Liberia) which requires surgery and a long healing period. Yet the boy remained in the ER for nearly two days. Mary, along with Project HOPE volunteers Dianne Bennett and Amy Bream personally sought out a surgeon and had him commit to the surgery that day. The next morning when the volunteers visited the boy in the ICU ward, they asked to take his photograph. “Like everyone else here, he asked to see the photograph after we took it," Mary said. “But instead of just looking at it, he pulled the camera screen to his face and kissed it and thanked us. The work here we have done has been overwhelming at times,” she added. “And while sometimes you can’t change much, you can see that change can happen with just one person.”

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