A different normal

More and more often I have moments when I forget I haven't always been here.  It's normal to tie an infant on my back if he's fussy and causing trouble - it doesn't matter that he's not mine.  I'm full of ideas of what to do when the usual procedures don't work, whether it be cutting the end off an IV cannula cap to put together oxygen tubing, or readily offering piggy back rides down the stairs when my patients get tired and the elevator is broken again. And I never, never would think to throw out a bed pan.  I'll probably be peeling the labels off of medication bottles and cutting my IV bottles in half for the rest of my nursing career.

We've run out of Ensure, the versatile canned milky supplement we usually use for NG feedings.  In it's place, our dietician Jess has cooked up a recipe involving milk and peanut butter, vitamins and fiber...and the nurses mix it up in the blender.  There are no Walmarts where we can pick up canned supplements - here we make our own.

This weekend we ran out of smooth peanut butter.  Several of us offered up our personal stash to make feeds with (mine was rejected - too chunky), and some of our nurses tried straining the mixture.  Eventually Jess melted down some chunky peanut butter and strained it, to hold us over until we could get some smooth peanut butter from town.  Even the smoothest of peanut butter has residual though, and when the NG to gravity drips ran slower and slower I fixed one with a pressure bag borrowed from the ICU.

It's creativity on a level I never really needed in the States, and the longer I'm here the more creative I've become.

Sometimes I remember that once I did things differently.  When the baby on my back gets his foot tangled in my patient's IV line and drops the pens from my back pocket all over the floor and I remember that they never told me in nursing school I might have this problem.  The moments when I look down at the working suction unit I've put together with a pair of trauma scissors, a variety of tubing types and sizes, a few odds and ends and a lot of creativity, and realize this wouldn't be considered a "normal" part of a Western nursing job.  Or when I put together pieces from two different blood pressure cuffs when the one we had on the machine didn't fit the patient in ICU.  I realized I had reached a whole new level when I heard myself suggest a partial endotracheal tube as a sterile trach cannula replacement, and realized that the idea actually had potential.

I've gained a different perspective here as well.  I've seen the joy in loving and being loved, in seeing past deformity to the person within, and joined in the worship of the broken.  I've learned pieces of languages and bartered in the market, gotten a wide variety of marriage proposals and comments on my fine African baby-tying technique...

And I've gotten peed on.  A lot.

I suppose it comes with the community aspect of ward life.  Babies are for everyone, and they get passed hand to hand and bed to bed, claimed in turn by each patient and nurse.  It happened to me again this weekend as Ibrahim's mama patiently fed him milk from a spoon and I entertained his baby brother Fala.  As breakfast finished, Fala climbed off my lap where he had been studiously chewing the plastic duck on my name badge and wandered away in his little-girl plastic sandals, leaving a few damp puddles on my scrubs.  Not even 9 am yet, and already I had gotten peed on.  Any American hospital, and this would have been an unfortunate event.  But here?

Me: I think the baby just peed on my pants.

Translator: Laura, this is very fortunate for you.

Me: I remember they said in Sierra Leone that getting peed on was good luck...something about fertility?

Translator: Yes, you will have many children.  Maybe fifteen.

I am wondering though, is that fifteen children total, or one for every time I get peed on..because I must be up to at least thirty by now.

Hear that, Mom and Dad?  Apparently you'll be having a lot of grandchildren.