admissions, this rachael

Now that I've been in the OR office for several weeks, I feel like I can now give you a good idea of what actually happens there.

Surgeries are the practical backbone of what Mercy Ships does when it visits a country.  Bringing in surgeons from a variety of specialties, organizing patients in need, maintaining instruments and operating rooms...this is what the OR office does.  

It's hard to describe a typical day for me, but I'll give it a shot:

0800: White Board Meeting- The whole OR staff gets together to start the day.  When I say "OR" I technically mean "Surgical Services," which includes the OR administration, surgeons, OR nurses, anaesthetists, sterilizers, and PACU (post-anaesthesia care unit) nurses.  It's a big group, especially when we are running at full capacity, like this week.  During the meeting, we make announcements, do welcomes and goodbyes, have a verse of the day and prayer, and update the daily schedule if need be.  

0815-1030: As surgeries get underway, I get to work in the office.  Firstly, I'm always available to answer phones, field questions, and greet visitors.  Crew members have the opportunity to sign up to observe surgery once during a field service, so just about every day at 0930 and 1330, I orient a visitor to the OR guidelines and show them into one of our six operating theatres.  During this time, I also work on our supply and usage records.  In order to be more efficient in ordering supplies, we record everything that is used in the ORs.  And I mean everything.  Every 18-gauge needle, every gauze pad, every pair of size 7 sterile gloves.  This also helps us to figure out what an average surgery costs to perform.  It can be a tedious process, but I have the whole week to record the previous week's usage, so I usually spread it out.  In the mornings, I also help Missy (now the OR supervisor) and Ginger (the assistant OR supervisor) with ironing out the issues that arise with the scheduling.  We usually get a lot of calls from Rachael (Admissions team leader) in the Admissions tent.  These calls often go like this:

[ring ring]

• Seth: Admissions, this Rachael.
• Rachael: What?  Wait what?
• S: Just kidding.  What's up?
• R: Now listen here, Patient SLE15555 is here and has malaria.  I need a reschedule date.
• S: Okay.  I will call you back.

On a good morning, we get only one or two of these calls.  On a bad morning...let's just say that "malaria" can be replaced with any of a variety of surgery-postponing conditions, including but not limited to "query tuberculosis," "worms," "pregnancy," "a chesty cough," "pneumonia," "fungal infection," "open wound," "lice," "no caregiver," and "mulluscum contagiosum."  Yes, these are all real things I hear on a daily basis.  And yes, all these things lead to a lot of rescheduling, cancelling, and postponing of surgeries.  The surgery schedule could be X one minute and Z the next.  All of this leads up to...

1100: Daily bed meeting- Every morning, Rachael, Kirstie (Ward Supervisor), Dan (Patient Services Coordinator) and a few ward nurses (pick from Maaike, Laura Z., Natalie, Frances, Sharon, etc.) come to our office to discuss which patients have turned up for admission and which beds they will be assigned on the ward.  It usually lasts about 10-15 minutes, but our tiny office goes from three to at least eight bodies, so it can feel a little hectic at times.  By the time this meeting is over, it's almost lunch.

1145ish-1230ish: Lunch.

1230-1430: In the afternoon, I continue with my morning work.  Depending on the day of the week, I may have to print and distribute welcome notes, prepare orientation or evaluation paperwork, or prepare the potential admissions list for following week.  More phone calls answered, more e-mails sent, more fires put out, etc.

1500ish: If I haven't completely lost track of time (which is easy to do), around 3pm, I start working on the next day's surgery schedule.  After making sure that our handwritten schedule book agrees with the computer database, I check in with Rachael to make sure that everyone has been cleared down in Admissions.  With the green light, I assembled the Word document, allotting surgeons, anaesthetists, and patients to their appropriate ORs.  I print a draft copy and check in with each surgeon to make sure that he or she is happy with the list and the order.  Sometimes tracking down 4-5 surgeons is easier than other times.  Once I get the okay, I print out about 15 copies and distribute them to the ORs, PACU, the wards, the lab, and make a personalized copy of each surgeon's individual list.  By the time I finish this, the ORs are nearing completion for the day, so I help with the day's data entry.  

1700: Close of business day.  Evening commute.

So that is pretty much my day!  As I mentioned, we are currently running at full capacity, with two eye ORs, one for Max Fax, one for ENT (ears, nose, and throat), and two for Plastics.  Next week, one of our Plastics rooms will switch to General.  In case you are wondering, "Plastics" on the Africa Mercy is what you may think of when you think of plastic surgery.  No nose jobs or breast enhancements here.  The most common procedure is a contracture release.  This happens when a patient has suffered a burn and their body has healed in a way that has limited the range of motion of say the hand or arm.  It involves skin grafts and flaps and it a fascinating procedure to see.  Our plastic surgeons also correct syndactyly (fingers fused together) or polydactyly (extra fingers or toes).  It is so great to have the variety of specialties going on at the same time--I'm always learning or seeing something new.

On a completely different note: 6,988 pageviews.  What the what?  This is incredible and more than I could have ever imagined.  You are amazing.  Yes you.  Whether it's the first post you read, or you check the blog daily (I'm talking about you, Moma), thank you for reading.  It means so much to me to know that you are interested in what I, and the rest of the crew, are doing here on the Africa Mercy.  So, thank you for reading, tell a friend, and I'll be back with some more later in the week!