Blog #2 -
First week at the University Clinic
I have
been working in Macedonia for the past two weeks as so far things are
incredible!! The program I am working on is called the Strategic Medical
Resupply Program. The goal of this program is to provide medications, equipment
and training to hospitals in Skopje. Currently, the hospital that we are
working with now is the University Pediatric Clinic (their word for hospital is
clinic) in Skopje. This Pediatric Clinic is in the public sector of the health
care system here in Macedonia. It is the most advanced Pediatric Clinic in
Macedonia so they receive many cases from all over the country. For the past
week, I have teamed up with another volunteer, Janet Kinney, and we have been
visiting each department in the Clinic to talk to the Chief of each department
to learn about what they do, and what they need for equipment and education.
We have
learned that there are 18 departments in the Clinic. Each department consists
of about 5 or 6 Physicians and a few nurses. One of the busiest departments is
the Clinic is the Intensive Care Unit as they receive about one child a day.
For education, physicians go through 4 years of general medical school and then
they have another 5 years of specialized training to become a Pediatric Doctor.
After that, the doctors have some continuing education to keep their license.
For nurses, however, they go through nursing school in high school and then
they have 3 years of training in college (which technically is optional). After
that, there is no continuing education. Due to this, most of the nurses have
not had any training in a very long time. This is where we have identified the
best way to help. After meeting with each department, Janet (who is a retired
Neonatologist, has had training in Infection Control, has worked for the CDC,
and who is currently a General Pediatrician) and I have come up with three
different ideas to help the nurses improve their education.
The first
idea is to have a Nurse Mentoring Program. This program would involve bringing
in general or specialized nurses that would work the day or night shift and
would mentor and teach and learn from the nurses at the Clinic. The idea would
be to make this a long term program where different nurses are coming in and working
with each department in the Clinic. By bringing in a nurse that would work the
shift with the other nurses we would be providing a resource for the other
nurses to gain knowledge and expertise.
Since
there is a large need for education, another idea is to design our own course
that is based off of the Pediatric Advanced Life Support (PALS) curriculum.
This course is required by everyone in the States who works at a Pediatric
Hospital. It teaches resuscitation, drug administration, identification of
respiratory distress/arrest, identification and treatment of shock,
identification and treatment for cardiac arrest, and more. Our goal is to
create a course that would be required by everyone to take before being hired
as a standard hospital training. This would then unify the nurses abilities and
make a stronger nursing staff. In order to keep this sustainable, we would like
to make the course a "Train the Trainers" program. This means that we
would teach the course to a few nurses who would then teach it to other nurses
who would then make another nurse the point person so that the education
continues over the years.
One of
the meetings we had was with the Chief Nurse. She is also the only person in
Macedonia who has had training in Infection Control. She is an incredible
person and has been working really hard to bring in protocols and knowledge to
the Clinic in order to reduce the spread of Infection. Unfortunately, since she
is a nurse and not a doctor, most people do not believe her or take her seriously.
Due to this, one of my goals for the 3 months that I am here is to help her
establish a database where we can record what infections occur, where they come
from, how serious they are, etc. Hopefully, this will then allow her to create
proof that the infection control is very poor in the hospital and that many
deaths and suffering can be prevented by simple protocols (and a lot of money
for the hospital can be saved). I am very passionate about helping her with
setting this up and with getting protocols that the nurses and doctors will
live by.
For
providing equipment to the hospital, most of the equipment they need is very
standard - bedside monitors, portable suctions, nebulizers, medical pumps, and
ultrasound transducers are some of the most common. It really is amazing at how
the staff is able to operate and save so many lives when they lack so much
basic equipment.
As for
everything else here, I am really loving it! Last weekend I went to a small
town called Ohrid. It is absolutely beautiful. It is a little quaint town on a
lake and is AWESOME! There are 356 small churches in the town and visited a
few. One was from the 13th century and the art work inside it was original and
really cool! Other than that everything is amazing. The people are really fun
and I love the city!
