DKA

This week has past in a blur of chaos. The first year nursing students arrived on the wards on Tuesday. Although this is there second hospital placement, they are still only allowed to do day rotations on Men's and Women's ward, instead of spreading throughout the wards including Peds, Outpatients and Maternity. Although this makes sense, considering they have not covered the speciality areas in theory, it causes quite the congestion on the wards. We have 30-35 patients, 3 staff + 2 missionary RNs and 6 students. This ratio may not be strange in the hospitals back home, but considering the size of the nursing office and the limited resources, we're having trouble not tripping over ourselves.
Amid the staff chaos, we have had to deal with some difficult medical conditions. On Wednesday, the transfer vehicle from the outpost clinic dropped off a lady. She was unresponsive on the trolley as they ran past my office to Women's ward. I chased them into the room and grabbed the transfer letter. The words "diabetic with no insulin" jump off the page. The patient is a young mother, whose previous admissions have been complicated by seriously unstable diabetes. I tell the staff member in the office to get the doctor and the RN who are in the ward...the patient had died prior to arriving at the hospital. Our blood sugar machine was "HI", which means a recording higher than 33!
The news was given to the young husband and the patient's mother. The reaction was not what I expected. The mother started to wail and scream. She began to flail and colapsed to the ground. Thankfully, I was able to grab the 3 month old baby off her back just before she landed on him.
I stood in the middle of the large crowd that gathered, holding a baby whose mother just died, whose father was running away screaming and whose grandmother was sprawled out on the ground screaming.
In utter shock, I realized that we'd have a baby to take care off again. So for the next 48h baby Stanley was shuffled around the maternity unit until I took pity on the only nurse there and took him home for the afternoon.
Its hard to wrap your head around a death of this nature. At home, her high blood sugar levels would have been better controled through accurate monitoring with home glucoscans and sliding scales of insulin. But here, in resource poor Africa, the clinics don't even have glucoscans let alone the individual patient as the sticks required for blood sampling are so expensive. There is also a shortage of insulin and no one has fridges in the village to store it, anyway. The only reason Kalene Hospital has supplies is that the people from the home countries of the missionaries donate it.
It was a rough one to absorb, but thankfully, baby Stanley is doing okay, aside from having a slight cold which he's now passed on to me!
 The week was not all bad, however. There are quite a few Brits here at the moment and we were able to organize a "Tea and Scones" party (complete with clotted cream). Gathered around the only satelite TV in the area, we watched the Royal Wedding!
Only 15 days until Amy and Julianne arrive...I'm looking forward to a short time away from the mission to catch up on sleep and news from home!