Our voyage is 25% complete. The last few days on this side of the international date line have been intense! I was pulled from orientation to work as charge nurse this week and interesting cultural issues abound. The patients are educated to remove clothing before showering (not after) and to sit on the toilet (as opposed to squatting next to it). Last night a patient looked askance when I used a water fountain and was so pleased when I pantomimed an invitation to him to drink (he did -with a big grin). When I presented a gift of markers to a young woman she asked (through the interpreter) if she may eat them.
Our patients are very poor and very appreciative. Last night I had on my ward a young woman around my daughter's age who weighed 65 pounds (you read that correctly). We gave her food and she seemed so shy and so grateful. She is only 35-years old but has a 20-year old daughter herself. She is very ill and I tried to comfort her. Another patient on the ward suffered from terrible burns, another chest pains, some will see dentists for the first time, and others are there as "escorts" because each patient may bring one person with them. Frequently our escorts turn into patients themselves and who can blame them for desiring food and care?
The wards are built with efficiency in mind. The beds drop down from poles like petals on a flower. There is no privacy; patients sleep in what looks like a dorm room with each escort nearby. Every patient is offered pajamas and a robe (many refuse, opting to sleep in their clothing) and given a towel, a pillow, and a blanket. Restrooms, which include showers and stocked with soap, are segregated (of course) by sex. Overhead lights are extinguished at 10 p.m. The nurses' station is a desk with several computers (that I am unable to access) and the (locked) medicine cabinet located to its side, alongside a sink. Basic supplies are unlocked and lined up neatly with a more adequately stocked supply room located unobtrusively to the side. All garbage (everywhere on the ship - personal berthing, the dining hall, the hospital wards) is separated into paper, plastic, metal, vegetable/hazmat(biological waste).
The work is rewarding - and endless. New shifts start every few hours (remember, this ship is a city and military personnel may include barbers, plumbers, secretaries, and cooks, in addition to medical personnel and volunteers). Also, this is a humanitarian mission so people come and go from the ship constantly to build clinics, provide healthcare, and even to ensure our safety in the water and on land.
Initial screening, including TB and lice, is done onshore for those boarding the ship for in-patient care (although late last night radiology identified a potentially active TB patient in my ward and I spent several hours before I could transfer him to an isolation unit). Patients and their escorts with lice are treated, given new clothing, and show up on the ward wearing hospital gowns, robes, and slippers.
Our shifts are longer than civilian shifts (both regarding the amount of hours per shift and the amount of shifts per week) and, in accordance with the ever-present efficiency credo, time is not wasted. For example, friends waiting for a jitney during shore liberty were asked to count pills while waiting. Tomorrow, my day of liberty, I will be ashore helping set up a medical post during the morning, return to the ship to sleep in the afternoon, and report for night shift hospital work after dinner.
At midnight I receive "mid-rats," short for "midnight rations," consisting of dinner leftovers. Each of us rotates up to the mess deck to eat. Once daily everyone on board "musters" (gathers) in their functional unit (the volunteers, like active duty personnel, work in a variety of departments) to ensure safety. Attendance is taken and announcements are made. A "man overboard" drill means mustering in the unit and an "abandon ship" drill means mustering next to our assigned life boat (there are 10).
Every room has its own address, like a house, that looks like a social security number. The first number is the deck, which corellates to the story of a building. The second number is the location as it relates to the front or back of the ship. For example, "0" is in the front ("bow") and "150" is in the back ("stern") so front/back location is ascertainable via the middle number. The third number acts the same way a street address' last digit identifies which side of the street to find a house. An even address may be found on the port side, odd on starboard. ("Port" is to the left when facing the bow.) So if I am told I may do laundry at 3-100-5, I find the third deck, walk toward the end of the ship, and look on the right side of the hallway.
This week I presented a short talk, through an interpreter, to a group of Vietnamese generals. I explained how standardization of nursing in the USA is accomplished through texts and tests. Their cordial but probing questions revealed that Vietnam is working on implementing licensure standards. There had been other nurse presentations prior to mine which, unfortunately, I missed related to work hours. The generals (5-star, 4-star, and 3-star) had clearly been researching which system to implement as they compared and contrasted ours to those of other countries. They shared some of their opinions about nurses that reflected the unfortunate universal bias against predominantly female vocations and, to my surprise, they asked why Vietnamese students in the USA opted to be nurses instead of doctors or lawyers.
This evening a group of us were transferred into officers' quarters. The new berthing differs from enlisted quarters in that there are only 6-8 people in each room, with 2 sinks, and a small table with 2 chairs. The beds seem slightly larger (but I may be in error) and instead of 2 lockers, each of us received a set of lockers that resemble a small armoire replete with pull-out drawers. In lieu of floor-to-ceiling bunks ("racks"), the racks are limited to 2 tiers, akin to traditional bunkbeds with small ladders.
So that was our first week and 25% of the mission. A lot of work and very rewarding but it is now past midnight Sunday morning and in 4 hours I need to rise to catch the boat to shore and help set-up the medical post. I'm going to grab some mid-rats, take a shower, and take a nap (I'm trying to stay up most of the night to prevent falling asleep on the job when I return to night shift tomorrow).
Thanks for keeping our mission in your prayers.
