Its about 12:30 am here and I am having a hard time winding down. Gurpreet, Becky, Shaun and I just returned from playing "santa" to the kids in the hospital. We created little goodie bags with coloring books, crayons, pixie sticks and toys and then placed them by each sleeping child so that they could have a suprise when they woke up!

This morning we woke up early to do rounds with the orthopedic surgeon. Afterwards we had planned to begin doing wound care on the patients but the triage tent was so busy that Gupreet and I were asked to help down there. Dr. Turner and Emily had a long line of people waiting to be seen. I was told to take vitals and triage but after an hour and a half I was drenched in sweat and began to feel overwhelmed as I realized there was no end in sight. Not to mention I still had a lot of dressings to change! I decided to ditch the triage tent and do wound care with Brad. Wound care has been taking a lot less time because we did a mini "LEAN" project on our supplies bin. There are still a few complicated wounds, one patient takes an an hour + no matter how much we prepare for it, but for the most part we have a good workflow. I am even proficient enough in my creole that I find I dont need my translator to be with me during the dressing changes!
After lunch the wound care team was helping the ED. There was plenty for everyone to do - lab draws, giving meds, starting IVs in dehydrated people, and if nothing else there is always someone who cant find a supply they need and needs a "gofor" There is a definite lack of organization here with the supplies. It is immensly frusterating. Gurpreet was involved with some complex cases today as well as being stuck with entertaining 4 nursing students and teaching the lab about the necessity for correct lab supplies in the ED. I had tried earlier with an interpreter but gave up because not even my interpreter understood me. Becky is just doing great things in the ED and is the go-to girl in that department.
We also went out to eat tonight at a local restaurant. We had a few beers and shared our "war" stories of the day as we munched on fried plantains and piccoleas (sp?). It was nice to get away after a long crazy day. We had this young 24 year old mother with the skull fracture was a very sad case. She was assualted by a baseball bat last night and sustained severe head injuries. She has no family or relatives that we know of and the only one who came with her is her employer. She was transferred from Doctors without Borders, and after more than 6 hours spent trying to save this girl which included measures such as cooling her core body temp, inserting our only central line in the hospital in her, intubating her, giving her IV meds and IV fluid and more it was decided that there was no hope for her after a consult call was made to a neuro surgeon and the MD director advised letting her go. The whole situation is just extremely unfortunate and sad. But even in the best hospital we couldnt of saved her.

OK well I have to get at least a few hours of shut eye before tomorrow.

I will try and post pictures later. It might take some time because my laptop is the only thing with a built in cardreader and its dead. (i didnt bring the charger)

good night :)