An Update on Life in the Wards

Believe it or not, I have just completed Week 3 of being in Africa! I feel like I am finally beginning to get the hang of "Life in the Wards". At the Moi Teaching and Referral Hospital (MTRH) where I work, there are several wards - Men, Women, Pediatrics, etc. For the past week, I have been rounding with the medical staff for the Women's Ward, Firm 1. This means that I round on all the patients on the left side of the Women's Ward. The number of patients can range from 21 to 42 - there are 21 beds, but when space gets tight, we often have two patients to a bed. This past week, we have had an average of 30 patients.

As this is my first clinical rotation, it has been tricky for me to figure out how to keep up with the infinite changes made during rounds. We have patient monitoring forms that we use to keep up to date on the patients' progress, but during rounds we are also resolving out-of-stock medication issues, asking nurses about missed medications, checking doses, looking up drugs that are specific to Kenya and not seen in the US, trying to answer drug info questions, the list goes on. Add to this the fact that medical rounds sometimes include 10-12 medical students and Kenyan people tend to murmur when they speak (including when they present patient cases), and you will see that it is a difficult environment for a pharmacy student to tackle! Imagine a large team of 15 people trying to huddle around a single patient's bed while nurses maneuver through, birds squawk outside, patients across the room are calling out, and a maintenance crew is using a power drill to hang new curtain railings. Quite a sight!

After medical rounds, we usually try to follow-up on medication issues, and make sure patients are getting the medicines they need. By then, it is usually lunch time, and we walk back to IU House for lunch at 1pm. The walk back is pleasant enough if it is not raining. This past week, there was not a single day when it didn't rain. When the rains really get nasty, the entrance to the hospital floods, and parts of the roads become great, muddy rivers. The mud is this red clay that looks terrible on clothes and gets all over everything. It is impossible to look professional and well put-together when you have just tromped through the mud for 15 minutes! Add to this the fact that matatu drivers make sport out of polka-dotting the muzungus (white people, aka us) by splashing us as they drive through the puddles, and you will see that the walk home is sometimes a bigger adventure than the morning rounds!

After rounds we usually have a meeting with our preceptor, where we review patients and have educational presentations on common disease states and medications. Then, we go back to the hospital to follow up on any loose ends and review charts!

I am happy that I am finally getting to know some of the staff at the hospital. We work closely with nurses, doctors, students, and pharmacy staff, and it is challenging to remember so many names, faces, and titles. My goal for next week will be to know all of my nurses - they are our right-hand people, as they are responsible for administering meds to the patients. Without them, patient care does not happen!

But, that's thinking about Monday - for now, I'm going to think about shopping and actually getting some sleep this weekend!