I am back on the medical unit. Set B has completed their 3 months of
introductory classes and begin their exams tomorrow (4 days of written
exams and one day of practical exams). Also Set Z is taking their end
of block exam on Mon., Tues. and Wed. The next week Set A does their
exams Mon. - Wed. and the following week Set Y will resit their final
hospital exam Mon. - Thurs. I can't tell you how busy all the tutors
have been writing exams and soon grading them!
Along with teaching this past week I have been doing assessments on
Set A students. The Kenya Council of Nursing (KCN) requires our
students to pass 5 practical assessments. The first assessment is the
Nursing Care of a Group of Patients, the one I am assessing now. I
will assess 25 students over the next 4 rotas (a rota is 4 weeks).
The other assessments are Normal Delivery, Baby at Risk, Ward
Management and Rural Health Center Management. All these assessments
are done by a tutor and a registered nurse from the clinical area (of
which we have 4). I will be the tutor that does the majority of these
assessments.
The assessment begins at 8:30am when the student gives the assessors a
brief, concise and accurate report on his/her patients (usually they
have 3 - 6 patients). After their report, the assessors review the
patient charts to make certain the information was accurate and to get
a feel for the patients, see the care plans the student has written,
and review the charting done by the student. We then watch the
student do at least two nursing procedures. The students choose what
they want to do, hopefully according to the needs of the patient.
This week I have seen bed baths, drug rounds, vital signs taken, and
assisting doctor's rounds. After the assessors are satisfied with
the procedures they send the student for tea break. When the student
returns the assessors as her/him questions about the patient's
disease, medications, the procedures done or anything related to the
care of the patients. After that the assessors score the student
individually without any discussion and then add their scores and
comments together. Finally, the student is told if they passed or
not. Two of the three students passed this week.
The pass mark has been raised by the KCN to 70% from 50%, which is
quite a high score. I find assessing the students very challenging.
I can still remember the fear and panic I felt when being watched by
my instructors during training so I try to lower the students anxiety
by meeting with them in my office a few weeks before the assessment to
review the process, assure them I am on their side, (a friend, not an
enemy), and to help them in any way possible. I also visit the units
daily for the week before the assessment to talk to the students and
have them talk to me about their patients, care, etc. However, I
still see their hands shake, their eyes glaze, they are unable to talk
to the patients except when absolutely necessary and they do the most
incredible things. Sitting here at the computer I can laugh about
some of them, but during the assessment my pulse and blood pressure
rise, my head aches, and on occasion my heart drops into my small toe.
Obviously, the students and Sr. Jerri need your prayers.
While doing an assessment, I reviewed the care and progress of a 14
year old girl that was admitted on 30 March 1999 with Pulmonary TB.
About 2 weeks after her admission she began complaining of severe hip
and leg pain. When the family was able to raise the funds, an x-ray
was taken and an additional diagnosis of TB of the pelvis was made. I
had seen her for about a week after that diagnosis as one of my senior
students was writing a case study on this patient. She was given the
most powerful TB medications. I had not seen her for about 3 weeks.
I found myself shocked at her present condition. She has lost much
weight and her limbs are so stiff that it is difficult for her to move
in bed much less walk. She has developed bed sores, her right leg is
severely swollen and she generally refuses to eat. As I watched her
being bathed, the pain and difficulty she experienced in being moved,
her tiny, emaciated body and her eyes that seemed filled with misery,
I felt as though my heart might break. Please join me in praying for
this young girl, Pena.
With the exception of Pena and a few patients with gastritis and
typhoid, the medical unit is filled with men and women with malaria.
Due to our wonderful rainy season, there is standing water everywhere
you look in Maua town and more mosquitoes than we have ever seen. The
"Maua Lake", a low area in town that fills with water during the rainy
season, is full to the brim. Maua town does not have a sewer system
nor a drainage system. As I work on the medical unit, I am constantly
reminded of what it means to have few, very few resources. The toll
in human life and health is enormous.
Thank you for your prayers for our concerns and for Bill and me. It
is a tremendous comfort to know you are praying for us. Please keep
your emails coming. We always love to hear how you are and what is
happening back home.
God's grace is sufficient,
Jerri and Bill
You can answer this letter at
savuto@MAF.org
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