On the AFM, there are medical staff from all over the world. While the ship operates in English, one of the fun parts of being in the hospital is working out all the regional terms and abbreviations staff use in their charting! It's an extra little puzzle- in addition to trying to decipher the hand writing, you get to solve for the term/abbreviation! One nurse from London commented that she likes working with American nurses because we all speak just like the shows on TV, using phrases that she's heard on shows like ER and Grey's Anatomy. I guess other countries don't say STAT, that's an American thing to do, they will write it in orders, but don't say it aloud. For all my medical friends, here's a list of some of the terms I've seen, see if you can guess them!

NBM .................... Nothing by mouth (our version of NPO)

Group and Hold ....................  Type and Cross

Cannula .................... V ("I placed a cannula")

Observations .................... Vital signs (a US nurse had paged a doc about a patient who was having some problems, he asked her for the observations and she started describing what she was observing on the patient, he kept asking for the observations- it took a moment to realize he meant vital signs!)

Theater .................... Operating Room 

BNO/BWO .................... Bowels Not Open/Bowels Well Open (they have or have not pooped)

BM .................... Blood monitoring, which is what the British call a glucose check, but for us means a bowel movement!

Black Wednesday .................... The day the new residents start in England, the first Wednesday in August, our equivalent is July 1st. Turns out not wanting to go to the hospital the day the new docs start is universal!

Paracetamol daily 2/52 .................... Take Acetaminophen daily for 2 weeks, they will also say 3/7 (3 days) or 1/12 (one month)

 Hello all! I just finished my first stretch of night shifts (I'll have another one before I go) and the hospital is definitely busier! We have two ORs running and enough patients to fill two wards. I'm assigned to the ward that mostly takes of the patients after their reconstructive plastic surgery. Most of them are children who had some sort of burn which did not heal properly, so their scarred skin makes it difficult or impossible to move the affected joint. Reading their charts, it hurts my heart how long they have been living with this condition (years and years). Most of these patients were screened back in December, so they have been anticipating this for months! Their surgeries usually require skin grafts and take weeks to heal, which means they will be on the ship for awhile. It will be fun to get to know them, especially now that I'll be back on day shift and not waking them up all night!

Here is a picture of the ward after we finished cleaning it last week! Each ward can hold 12 patients. Note that the beds are on little risers- that's so the care giver can sleep on a mattress under the bed. If you need a parent during the night, you have to duck down under the bed to wake them up! A couple times I've been looking for my patient and realized they were asleep on the floor next to their care giver (I'm guessing that's probably closer to their sleeping situation at home). Our plastics patients are higher risk for infection and will need to stay in the bed, so that won't be happening as much now!

 It's been another slow week on the ward, we still only had one OR running, but I'm told it's gonna get busier starting this week! A plastic surgeon arrived on ship today, so I will start taking care of kids who require skin grafts due to burns or other issues. I'm excited to see a new type of patient and be a little busier!

The highlight of the weekend was I got a full tour of the ship. One of the deck crew took me around. We walked the whole ship- bow to stern on each deck (note my nautical language!). It took about 25 minutes! The tour ended in the engine room and the engineer on duty proceeded to give me a tour of all the inner workings of the ship! It was a spur of the moment tour, but they were very welcoming- a common theme I've found in Africa. Even if it's an imposition, they will go out of their way to welcome you/help you with what you need.

they had me pretend to do work!

more pretending

It was very hot and noisy down in the engine room!

me and the engineer on duty

  Let's see, here are some other random things from the week...

I sat one evening watching these guys pull in fish with this huge net

it was neat because you could hear them singing the whole time to keep them working in sync

The ship got some pet birds! I guess vendors cram lots of birds into a small cage and sell the birds for people to make a wish on. They often break their wings so they get eaten by cats when they are released. This didn't sit well with the crew so they bought 29 of them and built a cage for them on the ship

the mean dock cats 😂 they are everywhere!

It's the rainy season in Senegal, which so far hasn't been too crazy- just some occasional rain. I did get caught in a pretty impressive thunderstorm on the way back to ship yesterday! It started with a quick wind storm then the skies opened up!

these guys were washing their goats, most likely getting them ready to be sold at the market

the wind storm- the streets emptied very quickly!

thankfully the rain didn't last too long!

 Hi all! I'm settling in to life on the ship! I had two training shifts this past week, then my first two shifts this weekend. Because we only have one surgeon on board, the hospital is still pretty calm. It's been a nice way to ease into working on the ship! 

This week we mostly took care of patients who needed thyroid surgery. Due to malnutrition, especially a lack of iodine, goiters (or an enlargement of your thyroid) are more common here. Most of the patients have had part or all of their thyroid removed and stay in the hospital for a day or two after to make sure everything looks ok. Some of the patients I took care of had been living with a large lump in their neck for over 10 years. I commented to one patient that I was impressed with his ability to sleep in the noisy wards (there aren't any private rooms- 6+ people are sleeping in the same room). He said that he was able to sleep so much better without the lump on his throat that the noise didn't matter!

I got to be a pediatric nurse this weekend as I was assigned a 2 month old baby! She has a cleft lip and is hoping to have surgery, but is only 2.5kg (5.5lbs). On ship, all the patients have to be at least 3kg to receive surgery, in order to decrease the chance of complications. So this little baby came in to get help with feeds to fatten her up! For the first time I was glad that I had been floated down to work in the NICU at Children's (something I always hated!) so this wasn't the first time taking care of a kiddo that small. I think all the adult nurses on our shift were also glad!

Other than work, I've been getting off the ship and exploring Dakar a little bit. Tonight I'm starting Wolof classes- that's most common language spoken here. We'll see how that goes! 

PS -if you want a postcard- send me your address!

One of the common areas on the ship- there's a Starbucks!

I'm a big fan of these prices 😃

exploring off the ship

a view of Dakar for our dinner spot

a view of the city from our pier

post shift ice cream for dinner- i'm really roughing it over here 😃

Hi All!

I decided to commandeer our (Rachel, Stephanie and I) old blog from our days in Tanzania and use it to share about life aboard the Africa Mercy (AFM). I arrived to Senegal on Saturday without any issues and after quarantining 24 hours, made it on board the ship! So far it has been mostly orientation, learning about living on a ship and how the hospital functions. 

Right now I'm working on adjusting to life onboard! I'm in a cabin with four other women. They have been very welcoming and helpful- especially the tutorial on how to take a quick shower without flooding the bathroom! My roommates are from literally from all over the globe- South Africa, Australia and Germany and all work in different capacities on the ship- in the lab, physical therapy, outpatient nursing and anesthesiology. As the newest person, I get the honor of sleeping on the top bunk. The beds are small but comfy and I've only hit my head on the ceiling once 😊 My favorite thing about being on the AFM so far is meeting people from ALL over! There are about 30 different countries represented on board.

The ship is docked in a pretty large port, so it's been interesting watching these huge container ships come and go. Our neighboring ships are importing rice and corn. While the views of the port are more industrial than spectacular, it is nice being by the water. The Mercy Ships rent out dock space, so we are able to go off the ship and walk around the dock to stretch our legs/get outside.

Tomorrow I start my orientation in the hospital. I have two training shifts, then will start working. I guess right now things are a little slower in the hospital because they only have one OR in use (so I'm only having to work 4 days a week!). We are currently providing surgeries for people with thyroid problems so I think I will start off by taking care of adult patients. We'll see!

my cabin doesn't have a porthole, so I think I'll be spending more time in common area 

the neighboring ship unloading rice, the area inside the yellow containers belongs to Mercy Ships, and the upper level of the parking lot (our outdoor track!)

Mercy Ships dock area

my scenic view

My home, The Africa Mercy (AFM)

my cabin