Orientation

It seems the only way I can post is to do it first thing in the am. It is 5:30 and I am awake so here we go.
Yesterday was very long and busy. The free time is officially over. We met at the hospital at 8 am, toured, talked etc. It is an amazing place and they are doing good work. It is the only non-government hospital in Cambodia and therefore can do things in a less regimented way. This has given them the freedom to be innovative and to set the standard for pediatric care in Cambodia, however the Ministry of Health still has oversight and the administrative structure comes from them. That is another story.
The director of Nursing, Manila Prak, spent a lot of time going over the hospital mission and their goals for pediatric care in Cambodia. They teach Nursing students- all 5 nursing schools send their students to Angkor on a 2 weeks rotation which is lecture as well as bedside nursing. The hospital’s Nursing staff gets ongoing education from visiting volunteers as well as the hospital’s own staff educators. The nurses are required to take English classes, provided at the hospital, and their charting (record keeping) is in English. I asked to review a chart yesterday so I could have a better idea of our focus on when we do a journal club on documentation. I was trying to understand what one note meant and the other nurses could not tell me. That is the concern when your documentation is not in your native language.
After lunch, I spent a couple of hours on the surgical unit whose primary diagnosis was osteomyelitis. This is an infection in the bone. The children stay in the hospital for 2 weeks of IV antibiotic therapy and then 4 weeks of oral antibiotics at home. I observed a physical therapist working with a child on weight bearing on the injured leg. He was most unhappy but she was very good and persistent and turned it into a game with the other children. I was included in the games which was fun for me. The ward is open, there are no sheets on the beds and no privacy curtains. Parents and siblings are there in the ward, and one parent sleeps in the bed with the child. The parent does the toileting, bathing and feeding of their child and uses the family kitchen which is supplied with nutritious ingredients. They do have play therapy, 2 of them, which is unique in Cambodia.
The last thing we did at the hospital was to review my talk on critical thinking which is to be given Thursday. They wanted many changes, mostly to align the language with what is in their education packets, and we worked on that for a long time last night to incorporate their suggestions. They do not want to offend and we want our teaching to meet their needs so this is how we will approach all of our talks. By the time we finished, we were exhausted but at least we could do this at the hotel. The only working plug in our room is in the bathroom so the set up that works is I am in a chair just outside the bathroom with the computer on my lap, and Barb is on the bed by the only light so we can review the talk together. Not ideal but it works.
I will attempt to send pictures from the hospital wireless connection later this am.