Child Life

What is child life? 

Well, according to the Child Life Council, specialists who work in this field are "trained professionals with expertise in helping children and their families overcome life’s most challenging events."

At Duke we have an entire department of people who are dedicated to helping children and their families cope with their hospitalizations and/or with difficult outpatient procedures. The people I've met who work in this area are incredibly talented individuals who somehow manage to make things less scary, less painful, and less confusing for our patients. Their work includes distracting patients who are undergoing procedures to providing companionship or a playmate for a patient whose family cannot be with them at all times. 

The children on our wards here in Nicaragua have no such thing. Not only do they share a room with up to nine other patients, but they also have to endure painful procedures without anesthesia and having to watch other children undergo similarly terrible procedures. We have one television for them to share but for the most part they are BORED. 

 

With only three patients on service today I was bored too. Enter flag making!!! We made flags out of prescription pads, tape and pens and had a great time decorating them and parading around the room. I'm bringing some crayons tomorrow so they should get a bit prettier :)

Medical records

Our attending asked us to pull some charts today. We were pointed toward a stack, told "there are the charts from July 22nd," and then ignored. We proceeded to sift through hundreds of pages of poorly bound charts. Good times.


In other news, here's an updated pic of my malnourished patient who is now standing on his own (sort of) and is on his way home!!!

Discharge talk

This is a poster in the emergency department in the hospital that outlines warning signs for new parents to look for after bringing their baby home. Great visual example and helpful knowledge for new parents. This has been updated with translations :)

1) If he is irritable and cries a lot

2) If he is difficult to arouse

3) If she will not breastfeed or vomits after every feed

4) If he is breathing heavily and you can see skin pulling in between his ribs

5) If there is redness around the umbilical cord stump

Working from home

Kitten pictures will follow in abundance. Here's your daily cathedral shot.

There's no such thing as a free lunch

But there are plenty of free medicines from drug representatives!!!

Today after morning report (which is mostly just a list of the patients who are admitted with case presentations on Tuesday and Thursday) we had breakfast brought to us by representatives from Unipharm. In addition to empanadas and orange juice, we also got massive quantities of free prescription medications. 

Drug representatives have been banned from most academic medical centers so my experience at Duke has been completely devoid of interactions with them. From working/shadowing in some private clinics, I was able to meet some drug reps in the past. Generally, they had good relationships with the physicians they were working with. They would bring lunch and then talk for a few minutes about whichever drug they were bringing that day - the talk included recent studies that showed why this drug was awesome and that was that. The doctor was then free to give these samples to patients.

Today's visit was different. There was no technical discussion of any of the medicines being handed out. Also, we got literally bags full of different medications from antibiotics to iron supplements. Finally... these drugs aren't for patients. They are for us. To keep. When I asked what I was supposed to do with all the medicines I was told "Take them home for when you're sick." Can I give them to patients? "No."

I'm still trying to work this one out...

Good morning

The light in this house is amazing in the morning.

SIDA

More later for this post but we're about to head out for a drink to send off one of the housemates who is going on holiday for a couple of weeks.

Part of my rotation on the infectious disease service is going to the outpatient clinic with my attending. Tuesday is HIV/AIDS clinic. Below are two patients who acquired this infection while their mothers were pregnant with them. Thankfully, they are both doing very, very well.

Again... more later.