Back in ICU

I’ve moved back to ICU for my last two weeks here in Freetown. ICU has moved since I was there before. It is in a new, smaller ward with only ten beds. It is a completely different atmosphere from the old ICU. The children are still extremely sick but we are trying to keep to a maximum of ten children (i.e. one to a bed), meaning that with fewer children to concentrate on they can get far more attention that previously. The nurses are now allocated patients, which almost works as it would at home. There are some continuous saturations monitors (meaning improved monitoring, although Cat and I are still the only staff who switch off the alarms). The children are getting observations done. They are getting their medications. They are getting fed. (All the above at least most of the time). On the ward rounds I almost feel like I’m in a normal ward in the UK.

When I remember back to the old ICU I often walked in with a terribly sense of dread thinking “which child has died in my absence?” or “which child will deteriorate and die in front of my eyes today?” Of course that possibility is still there but somehow everything seems so much more controlled. I’m very pleased to say that a lot of the children who were extremely sick at the beginning of the week were well and being discharged home by the end. The nurses clearly enjoy working there and they seem to know the children so much better than previously. Maybe it also feels more controlled because I am calmer too, more used to dealing with exceptionally sick children, I know what is and what isn’t possible to achieve here, and maybe because I know that I’m only here for a limited time now, so in a week I will not have to worry every day about how many children have died or are dying. For the nurses and doctors (and parents and patients) here, that burden will continue. They will continue to be in my thoughts and prayers.

On a happier note, Friday is Africana Day in Sierra Leone, when everyone wears more traditional clothes, so I wore my outfit to work again yesterday which got me lots of nice comments of “I like your style”. It was a good photo opportunity, so here’s one (hopefully) of me with one of the ICU nurses and a student nurse.