Clinical Experience Gabz 2/2

          On the second day of clinics, I was observing in the injection and dressing ward. The day was quite frustrating because I first-time witnessed a shortage of workforce in the clinic. Actually, there were enough nurses but I was with local nursing interns from a local college, who were assigned to the same ward. However, non of them had had any clue on how to get started. The patient line started to build up. I had to get the manager and let the head nurse aware of the situation, but help didn’t come until 9:00am. As for the student nurses, they didn't seem much to care other than use their phone constantly all the time. The clinic opened at 7:30am and patients were waiting since then. To meet the demands of the many patients, since we took our first an hour and a half later, we took two patients at a time. Privacy, you may ask? the clinic observes no privacy rule other than the caravan where HIV testing takes place. People were coming in to change their bandages for surgery cuts, bruises, burns and infections. The nurses would also clean their wounds with hydrogen peroxide.  They were also patients who came in to do blood tests. The nurses would take their blood in two tubes.  The patients would have to come in later to view their results. For a little while, I moved to the dispensary to see how drugs were distributed to patients when the injecting and dressing room was stagnant. Basically, the patients would come in with prescriptions and some were asked to show IDs for identification purposes. The clinic lacked an actual pharmacist. There was a nurse I shadowed who knew everything about the drugs and the ways to prepare them as some drugs required dilutions. Condoms were supplied for free. A HIV positive man came in to get condoms and he was given about 20 of them without any charge. This is in stark contrast to how drugs are distributed in the U.S. The country does have a private insurance system but for public healthcare they don't require it unless they wanted to be treated by private health-care providers
I managed to get more hands-on interaction with patients in the screening room the third day. I had the opportunity of recording their blood pressure, measuring their pulse, taking their temperature and administering drugs to them on site. The patients that mostly came in had fever or cold. For infants, only the temperature was taken. If their temperature was 38 C and above, two paracetamol drops were given to them. The same applied to adults. This is what I did for most of the day. The manager for the clinic briefly called me to help her in the HIV caravan outside the clinic. The caravan was where people where tested for HIV. I believe it was separate from the clinic building to preserve the privacy of patients. After I got to the caravan, I was asked to hold the baby while the nurse was taking blood samples from the heel of the baby born to an HIV positive mother. For infants, a normal HIV test, like the Elisa antibody test done for adults, cannot apply to infants because babies born to HIV positive mothers have IgG antibodies that are passed on from the mother to the fetus during pregnancy. This doesn’t necessarily mean the baby has the virus, but will give a false positive if an Elisa test is taken. So, blood samples were taken to be sent to the Harvard Research lab at the Princess Marina Hospital for PCR. Through PCR, the HIV status of babies can be determined born to HIV positive mothers. The mother was asked to come in after three weeks to check up on the results. I then walked over to the adult HIV testing/counseling room. They were doing Elisa antibody test on a local man. The man came in to do a HIV test because his partner was found to be positive. This was a notable experience because I really got to see the interaction between the health educator and the patient. He explained for a good 5 minutes how he’s going to conduct the test. There were two plastic apparatus to check if the patient was HIV positive or no. Blood drops were taken from his index finger and put in the apparatus to check for the number of lines. Two lines meant he was positive and one line meant he was negative. His result came out to be two lines on both apparatus.