Ambulatory Trauma

After my last post, I was chastised by someone with an intense fear of needles for not including a warning that I was telling stories involving needles. So let me state that right off the bat: this post involves needles.
I also need to preface this by saying that Yvena, the only English-speaking nurse, had today off. Another nurse, Hermicia, was helping out and she is in the "first grade of English." Other than that, this was a fairly normal day at the clinic (maybe "typical" would be a better word). Around noon, a woman was carried in. She had a thermos with her which was holding vials of insulin. I took her blood pressure and temperature and then we kind of moved her off to the side (she'd had a leg amputated so we didn't make her move around a lot). She sat in the corner for close to an hour. Then things like a liter of saline and a liter of 5% dextrose started appearing on the table. I was pretty confused as to why we were going to pump her full of dextrose if we were also giving her insulin, but then after some rapid Creole, the dextrose was replaced with a liter of saline with potassium. Mind you, it is after 1pm at this point, and the clinic closes at 3. And if people have IVs running and its getting close to 3, the nurses speed them up so we can get out on time. Then a random assortment of needles is thrown onto the table. I see 18gauge first. That is a fairly big needle, considering the size of this woman. The other ones were 22g, my nemesis needle. The needle I used when I missed my first IV. The needle that doesn't show a flash of blood until its just about too late. I feel validated in this because my mom also said they can be tricky (maybe she was trying to make me feel better, but we'll go with it).
"Sarah!" The woman's veins were officially mine now. I put the tourniquet on. I can sort of see some really tiny squiggly veins in her hand, but nothing I liked, so I moved it up above her elbow. When no veins popped up at all, I broke out in a sweat. I think it was at this point that the woman started removing her clothes with the tourniquet still on her arm. I tried telling her that wasn't necessary, but to no avail. Eventually I got my tourniquet back and put it on the other arm. Nothing. Moved it again. Something that I thought might be a vein showed up on her arm, so I went for it. Me and the 18g needle. It was a miss. So I went hunting for veins again. There was a tiny one in her hand that looked like the best option. I was handed the 22g, and by this time, a crowd of nurses is gathering. So I stuck this poor woman again, and just when I was about to take it out because I just wasn't getting it, I got a flash of blood. Then starts the chaos. Another nurse takes the needle, I'm still holding the catheter in place with my hand, and yet another nurse is trying to hook up the saline with potassium (nevermind that I can practically hear instructors yelling at me for even opening the packaging without knowing the woman's labs). Then the patient starts pumping her hand like I had her do when I was looking for veins. So I'm trying to tell her to stop, hold the catheter, and get someone to give me tape. All the while, the roosters are going crazy outside. Hermicia started speaking to me in rapid Creole at this point until I ended up nearly yelling, "Hermicia! TAPE!" By that time it was too late. The catheter was bent and partially out of her hand, and no amount of adjusting could get it back in.
For some reason, they handed me another needle. This was when the head nurse showed up. Sweet woman, but just the title makes her intimidating to me. So I went back to the other arm. Found another vein and stuck her for third time, officially making her a pincushion. I missed. The head nurse tried moving it around, but we ended up taking it out. I threw in my gloves at this point, and the head nurse took over. I felt a little better about myself when she looked at the patient's arms for awhile and all she could say was, "Oh, piti! [small]". She stuck this woman twice. And yet a third nurse went to work on this woman. She stuck her three or four times before she finally got the line in. Overall, it was a mildly traumatic afternoon for me, and I wasn't even the one being repeatedly stuck. But that lady was quite the trooper.
I got home and stopped in the kitchen on my way up. Leah and I sat down at the table while I was eating my snack, and then she got a phone call. I was pretty intent on my banana and trying to fix the damage she'd done to the peanut butter by just digging into the middle of the jar and didn't really notice what she was saying. She hung up and said, "You're going to go clean wounds on a man with spinal cord injuries." Shortly after, we were picked up by Audrey (YWAM staff who was previously involved with the clinic) and taken to this man's house. Here, it was the same man who came to the clinic last week with lots of random cuts and stitches on his head and ear. It was there that I went from RN to MD. This man has intense pain in his neck and back, radiating down into his arms, and can hardly walk. I cleaned his wounds and then his wife handed me his xrays. I have no idea how to read an xray. But I didn't see anything sticking out of somewhere it shouldn't be or anything like that. I asked Leah about MRIs, but she said it's not an option in this country. So I asked what he was given at the clinic. He was a recipient of the basic package: ibuprofen, tylenol, amoxicillin, and vitamin c. So I'm prescribing him some muscle relaxants for now, which he'll get tomorrow when I go back to take his stitches out. Praise the Lord, all his lacerations are clean and nicely healed.
What I truly intended for this post to be was an update on my transportation situation, since that was the only specific prayer request I had before leaving. This morning on my way to the clinic I was trying to think of what to post about since certain members of my family get a little excited if I wait too long. And I decided transportation was the topic since nothing too exciting has happened in the last few days. (And by that I mean I've gotten used to the fact that every day is some sort of adventure). So that's the last time I'll think that I've gotten used to life here. Anyways, I pretty much have stable transportation to the clinic each day. Leah and I found these two moto drivers who are pretty reliable, fair, and safe. So one of them has been outside our house each morning to take me. This morning neither could take me, but the one was still outside to say he had someone else he knew who would. The afternoons have definitely been a lot more of an adventure. I'll spare the details for my mother's sake, but I have made it home safely (eventually) each day. It's almost more fun this way, just because God has provided something different every day, but there's always something. However, something stable would be appreciated as well. In the meantime, the nurses have taken to staying until they make sure I'm on a moto and the driver knows where my house is. I believe I've now perfected how to hold on with one hand and hold my skirt down with the other. And I think I've discovered the pecking order for street use around here. Pedestrians are at the bottom, trumped by pedestrians with wheelbarrows. Above them is bicyclists, then motos. Motos are trumped by cars, cars by trucks, and trucks by busses. The coke truck trumps all, unless there is a goat involved. Or if a fight breaks out in the street. But that's a story for when I'm on US soil again.