Doing my night shift today. Although it will only be for about 3 or 4 hours because travelling home any later than about 11 or 12 is not recommended because of car/motorbike-jacking (wait does that even make sense?). Anyway, I start at 9PM.
My first shift was yesterday, I did the afternoon shift from 2:30PM-9PM. It’s quite crazy here. There are far too many patients for the number of beds available. The ED was set out in rows upon rows of beds with a narrow walkway between each half of the room. Any remaining space was used to shove in what beds/stretchers/trolleys that would fit. Getting to patients involved a tetris-like skill, only with one’s body and trying to fit into small gaps between the beds. Some people need to share their bed with 1-2 other people.
I’ve only ever sutured someone’s face once before. And that was following the removal of a cyst under operating conditions and with supervision. I think after my 5 weeks here in HCMC, I’m going to feel more self-sufficient because they teach medicine like the old days (the way the consultants tell it). Watch one, do one, teach one.
My supervising doctor supervised the suturing of one head laceration and then said I could do the rest on my own. Even though, I’ve sutured before, they were all sutures of surgical incisions which are neat, whereas head trauma isn’t quite so nice on the eye. I did feel a little strange at one point during the shift when I’d unravel the bandages on a lady and found a jagged laceration revealing a bit of skull. Normally, I wouldn’t have touched anything like that but watching some of the doctors here, they don’t have as much time as me. I’m a medical student so my obligations are comparably much lesser than the doctors who have hundreds of patients to see. At first, I thought the edges wouldn’t match up because it looked as though some tissue had avulsed, but luckily it did. Things fall into place when you’re patient and careful.
I met some third year medical students from Vietnam last night. They were standing around unsure of what to do because the DEM here is quite chaotic and only being in their second week of clinical rotations, I can see why they would feel a bit lost. I always try to keep in mind that medicine was (and still is) a profession that is handed down. So whenever, I have the chance it’s nice to share what knowledge I have. That was how I learned and it was also nice to have people to talk to as well (I’m so lonely lol). I’m alone for the time being, although more medical students may join the team I’m on as the weeks go on.
Resources here are also quite limited. One mask for one shift (NOT one mask for one patient, as I had originally thought after dumping my first mask). I’m not sure how sterile, picking up an ampoule after gloving up with sterile gloves is (actually that’s a lie, I know it’s not sterile practice), but you kind of have to make do. I could ask a nurse to hold the ampoule but everyone’s so busy. That and I would love one of those ampoule snapping tools. I shattered one ampoule last night but luckily I had gloves on, so it didn’t end badly. Also need to stop wearing my contacts and start wearing my glasses. Scared I’m going to cop some blood in the eye one day.