Each week I get to work one day at the hospital while Matthew is home with the kids. I feel like I am taking a crash course in nursing all over again, this time in a low resource setting where the language, culture, and names of medicines are different– and the acuity tends to be much higher. When we first got here it had been ten months since my last shift, as I stopped working before Leo was born. I’m slowly figuring out how things work (no weeklong orientation or orientation protocols here, though the preceptors are pretty great), and how I can be helpful. Every day can look different, depending on who walks into the hospital. One of my first mornings I worked, I shadowed Kitty, a fellow missionary nurse. In between keeping meds stocked, making sure staff has shown up and clinic gets started, dressings for major wounds get changed, the morning looked like this:

• Starting with prayers with fellow missionary nurses
• Joining in with staff devotions
• Listen in on the first half of staff education hour, glad for the opportunity to refresh on the pathophysiology of pre-eclampsia
• Begin CPAP for a 29 week baby just born (footling breech) who is retracting deeply. CPAP is set up using neonatal oxygen tubing that’s split– one end gets tied off and the other goes 6 cm into water to provide adequate pressure for respiratory support
• Greet a guard whose baby was born on Christmas and ask how baby Immanuel and his mom are doing in Arabic. (I realized after I walked away that I asked how MY baby was doing, not HIS… grateful he understood what I meant!)
• Assist with setting up a c-section, helping the doctor start a spinal, getting set up for anesthesia using ketamine when the spinal didn’t take, setting up to receive the baby, running anesthesia for said c-section (went well, phew!). Get patient cleaned up, transferred to the antepartum unit (which doubles as postpartum).
• Head to the office to catch up with Kitty, getting intercepted by the x-ray tech, Morris, who is drying an abdominal xray for said 29-weeker to check the UVC (an IV that goes into the umbilical cord) placement. Get asked opinion on whether or not it was advanced too far, into the heart. Observe that wow, it does look like the line goes up into the chest and then curves, then
• Snap back to my senses and remind myself that though I just played the part of a nurse anesthetist, I am DEFINITELY not a radiologist, and say, “Hmm, what did Dr. Perry think?”
• Go to lunch. That was only the first half of the day!