Je Suis une Infirmìere en Salle D’opération

Our amazing dayworkers

What is a Dayworker?  Dayworkers are: cooks, housekeepers, deckhands, dishwashers, photographers, sterilizers, dental assistants, translators, orderlies & a hundred other things.  They are local people that are hired on to help us while we are in port.  In the hospital, our dayworkers act as translators, nursing assistants & orderlies.  Most of our patients don’t speak English & for most French isn’t their first language.  Our translators speak numerous tribal languages & are able to cross that barrier to allow us to communicate with our patients.

Fatmata learns to prep the patient

Umu, Fatmata & Dereka scrub their hands

Teaching about instruments

In the OR, not only are we blessed with seven amazing translators, but 4 of them are nurses.  They gave up their jobs in the local hospitals to come work with us while we’re here in Guinea.  Officially, their roles in the OR are not those of nurses & none of them have had any OR experience prior to coming to work with us on the ship.  All seemed very eager to expand their nursing knowledge & skill base.  In Guinea, nurses can have 3 years of schooling before becoming a nurse.  With the limited resources & the education foundation available, the schools tell them what a nurse does, but not why nurses do what they do.  We figured 10 months would be enough time to help teach them at least the basics of OR nursing. 

Fatmata scrubs for a hernia surgery

Tina & I started to put materials together to come up with a plan.  We started off with simple things like what is sterile in the room & what is not, the different roles of the nurse in the OR & patient care & safety.  We practiced how to calm the patient & help with anesthesia.  During the week, each dayworker is assigned to one OR to act as the translator/orderly for that room, but also provides an opportunity for mentoring with our crew nurses. 



Umu preps an eye patient for surgery

When the surgery schedule was light, we would have a practicum in one of the ORs.  We would often focus the lesson on the type of surgeries we were doing at the time; during VVF, we practiced positioning patients for a spinal anesthesia & how to put a patient in stirrups.  We learned the importance of a proper surgical prep.  We spent time learning the names of the different instruments & what they do.  And we talked about patient safety & the care of the patient in the OR. 

In the ORs, they put their new knowledge to work.  Soon they were checking in the patients in pre-op, opening supplies & helping to set up the room, initiating the Time Out before the surgery started, counting with the scrub & running for supplies, all the while still doing their official job as a dayworker/translator.    

Gradually, we started to add another aspect to their repertoire: scrubbing.  We practiced scrubbing our hands & how to glove & gown ourselves, how to remain sterile & how to gown & glove others.  We worked on set up, how to pass instruments & handling of the sharps on the field.  They started to double scrub with other nurses to learn & watch how it is done.  Lately, they have been able to scrub for eye surgeries, hernias, lipomas & other smaller cases on their own.  It’s great to see them so involved & happy about their new roles.



Fatmata checks in her "patient" Umu

The other day, Tina & I set up a simulation to test their knowledge of what they had learned so far & to have a little fun.  The scenario was that two of them were the nurses, someone was the patient, Tina was the surgeon & I was anesthesia.  Others played the role of the patient or of PACU or even an observer! 



Fatmata brings her "patient" into the OR

They had to set up the room, check in the patient, & do all the things an OR nurse would do, we would not give them hints or tell them they missed something. 

Each had a role to play.

One would be the circulator- having to help set up the room, preop the patient, helping anesthesia, positioning the patient, doing the Time Out, counting & charting.

Fatmata charts

Someone would be the scrub nurse- opening up the supplies, scrubbing their hands, gowning & gloving themselves, setting up their back table, counting, gowning & gloving the surgeon, helping with draping, maintaining sterility, passing instruments, maintaining the surgical field & handling sharps.

We ran the simulation from start to finish, going through all the steps & everyone had the chance to perform in each role.  At the end, we would discuss what they did well & what they wanted to improve.  It was so much fun! 

Moise & Umu count the instruments

Even though it was a chance for us to assess their knowledge & give them an opportunity to run a room by themselves, they made the atmosphere light & exciting.  These nurses are amazing, they absorb everything we’ve strived to teach them & are gaining confidence in their ability as OR nurses.  Our goal is that when they leave the ship at the end of May, they could get a job in a local OR, if they so choose to, & hopefully, pass on what they had learned.

Umu & Amara talk about the Time Out

Umu passes instruments to "Dr" Tina

 

 

 

 

 

 

 

 

 

 

I’m so proud of our nurses!

Blessings