El hospital

Saturday January 5, 2019-Today we went to the Rio Grande communitaria hospital for a 5 ½ hr observation.  We are lucky to get this opportunity, thanks to Dr Enver , he works there, so got us in.  This hospital is very small, it has an ER and one ward, here were 7 patients on the medical ward, 6 adults (5 OB and one medical) and a baby with early sepsis.  It was hard for me to understand the nurse on the ward so Kylie and I read through the chart and was able to translate the spanish.  We did not understand some of the abbrevations.  Laura brought us almuerzo we went to observe in the ER. The nurses were making masks so we helped them.  We  noticed that the nurses wear masks when caring for the patients.  We were told to protect themselves especially that it is winter now.

One of the ER nurses gave us a tour of the OR, birthing room and PACU.  The equipment is not as modern as ours. 

After the tour, we got a GI bleeder in the ER with systolic pressure in the 60’s.  The ER nurse expertly placed an IV and started fluid, boy did that make a difference.  The ER doc consulted the internal medicine (IM) physician (who we know from the Corbana clinic).  The IM physician explained to the diagnosis with the patient  and I was able to follow in spanish, maybe because I am so familiar with the diagnosis.  The nurse drew the blood for analysis and gave the three tubes of blood to the patient’s brother who took these along with a form to the lab in Rio Grande, 10 minutes away as the hospital’s laboratory was closed (perhaps because of the holiday).  I noticed that the lab tubes were not labeled and they were not in a biohazard bag.  Some other differences I noticed

-The suction apparatus is much different

-There were four shared rooms and one single room.  A lady who lost a baby was sharing a room with 2 ladies who delivered babies.  I felt kinda sad for the lady who lost her baby. 

The nurses document all their notes on paper.

The doctors entered the orders in the computer and printed them.  However, when the computer was not working, the doctors typed the orders, yes using a typewriter.

The nurses rotate to both ER, OB, and the ward. They usually work 8 hours but during the holiday, they work 12 hr shifts and get 5 days off.  The nurses in the ER was super nice, and willing to show us how they do things here.  The visit was insightful just seeing how health care is delivered in rural Mexico. Having seeing what I did today in the hospital makes me very grateful for the resources that we have in the US and how fortunate we are.

We went back to Cacalotepec then back to Ernesto ‘s cafe for a mango smoothie.  After comida, we took a little siesta.  We then went to the public health department and did our diabetes teaching.  I started off the session, the group was divided in dyads and presented the AADE7 selfcare topics of healthy eating, being active, taking medication, problem solving , healthy coping, monitoring, and, risk reduction. I felt we did well and there were a lot of good audience questions. It also emphasized to me even more that the population here is low or no literacy, there are some with disabilities (such as blindness from diabetes), so one has to be very mindful of of this when providing education. I was able to conduct a short interview with the clients (with diabetes) after the education session. Evening well spent, everyone did an amazing job