Page 11 - QARANC Vol 16 No 1 2018

nurse elective in Zambia
critically ill children showing the trust and hope they have in the nurses. We then moved to the main hospital where we saw the adult wards. We couldn’t get over the size of the hospital and overcrowding on the wards but were pleasantly surprised by the range of specialist wards available. During our placement we were to spend one week observing on an acute medical ward and one week on adult ICU.
The medical ward was certainly an eye-opener. There was no comparison to any ward we had worked on in the UK. Some shifts consisted of only two nurses to care for over forty patients, with diagnoses ranging from leukaemia, TB, anaemia, heart failure, advanced retroviral disease, sepsis and we even saw a case of leprosy. To care for this amount of patients, the nursing care was very task-driven with the nurse in charge writing a list of jobs in handover for the student nurses to complete. We were able to assist the student nurses to take the patients’ vital signs using a handheld blood pressure machine and mercury thermometer that was cleaned with methylated spirit between patients. With no escalation protocol for deteriorating patients, observations were documented and the nurses would wait for a doctor to review the patient on the next morning ward round before any nursing care could be provided. Seeing critically ill patients deteriorating with conditions that are
left to right: Maj Viveash, Pte Ball, Pte Murphy, Pte Lewis, Pte Metson, Pte Petch, NN Jenkin and Maj Carter
THE GAZETTE QARANC 9
The University Teaching Hospital, Lusaka, Zambia
Nearly all the oxygen tubing and masks are reused once it had been sterilised in cidex
easily treated in the UK was something we found challenging, although there was little that could be done with the limited resources and handful of drugs that were available.
Our experience of the ICU was much more Westernised compared to the medical ward. A 10 bedded unit with around one nurse to two patients, we found the department much better staffed. However, problems still existed as most days we observed problems with ventilators and the portable oxygen bottles malfunctioning. All oxygen tubing and masks were sterilised and reused. With limited resources such as sedative drugs available, it was common practice to see ventilated patients having their wrists tied to the sides of the bed and an occasional bolus dose of propofol given if the patient became too restless. For some
of us this was our first experience of ICU and we were able to learn so much about nursing a critically ill patient in the developing world.
Our time at UTH was an eye-opening experience and definitely tested our emotional resilience at times. As military student nurses it was a great opportunity to gain exposure to nursing in the developing world and how the nurses manage in a resource limited environment. It has made us not only appreciate our healthcare system in the UK but also how we cannot always rely on modern practices and equipment. We will never forget our time in Zambia and it has made us better prepared for our future as qualified military nurses.
Pte Murphy, Pte Ball, Pte Lewis,
Pte Metson, Pte Petch & NN Jenkin Defence School of Healthcare Studies