Paediatric ward in Kiwoko

Wilsons_2013 Posted by Rory Wilson on Fri, 17 Jun 2011 | 0 comments | Bookmark: digg this Post this to del.icio.us Post this to Facebook

To register in Uganda with the Nursing and Midwifery Council, you have to complete an 8 week internship at a designated hospital. After this, if you get a good report from your supervisors, the Council will then register you to begin practising. So as of the last week in May I have been working on the Paediatric ward at Kiwoko. ( I will do 4 weeks paeds experience and 4 weeks in an adult placement).

I hope that I have always tried to be empathetic to my families and children under my care in the past but definitely now as a mother, it is a little more emotional to nurse sick children or watch them die. During my time on paeds the major cause for admission has been malaria, sometimes complicated by severe anaemia and seizures, malnutrition with associated TB, HIV or neglect.

The paediatric ward here admits children to the age of 5 ½ years, unlike our paediatric wards in the UK that take children up to the age of 16 years. The cots are colour coded, red if you are seriously ill, yellow if moderately ill and white if you are near to discharge. Parents and attendants stay with their children and sleep on a mat beside their cot. During busy seasons (like now!) the parents are needed not just to comfort and care for their children but also to report any changes to the nursing staff.

Staff roles are very different here, for example nursing assistants insert cannulae, take blood and give intravenous drugs. Nurses carry out many duties that until recent years in the UK, doctors were carrying out. The staff are friendly, and enjoy their work, as with any place there are a few staff members who simply shine in their work ethic and standard of care. The first week I worked with some of the students that I have been teaching. Very interesting to see them in the practical setting, some who are quiet in class look to be excellent in the ward setting, and of course there is the odd one that needs a fire lit under them to get them going!!

One of the biggest shocks has been the attention given to sundries used – like sterile gloves, syringes, cannulae, the giving set for intravenous fluids, intravenous fluids – the list goes on. Each item is individually priced and when used on the patient must be recorded in their notes so that on discharge they can be charged appropriately. While patient fees are subsidised considerably here, it is still not easy for many of these families to pay the bill at the end of the admission. As nurses we must try and limit the sundries that we use so that we help to keep the cost down. In comparison when I think of how much is wasted in the U.K. it is crazy.

I am happy to say that my training is serving me well. In fact it is amazing how ingrained various nursing principles are. I have still a lot to learn about various tropical diseases admittedly, but still there are many conditions that are common to the U.K. and Uganda alike, for example, pneumonia or bronchiolitis, so in some ways I am very much at home.

It has been amusing to see staff and students react to my sudden appearance in a white uniform. ‘You are smart’ is the common comment. My prayer is that I am a ‘smart’ nurse in relation to my practice.

Keep praying please!

Next week I hope to go to Neonatal Intensive Care Unit – I will keep you up to date with my progress!

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