Diving In

4/15/09

I had my first day at Red Cross Children’s Hospital yesterday. The 5 of us (Myself, Jamie, Caroline, Cara and Taylor) met in the lobby for 7:40 am to be at work for 8. Taylor rented a car during her stay here and is kind enough to drive us to and from work. The morning, for me, was more of an orientation from Caroline. She was the first to arrive here in February and has done an absolutely outstanding job at initiating our program. Not only do the staff adore her, but they are incredibly receptive to child life interventions. Because of her initial, positive influence, the implementation of a child life program is off to a fluid start.

South Africa's 1st child life team

The burn unit is divided into 6 “bays”. Each bay contains up to 6 cribs (yes, even the school aged kids are in cribs). Some of their “High Care” bays have fewer. The children are divided up into bays according to their wounds and infections. There are nurses and physicians who follow up with the children, but the “Sisters” do the bulk of patient care. I’m not sure what the qualifications are to become a sister, but had I not known, I would assume they were nurses. From what I gather, they are not assigned to any patients. They cater to all of them together. We change into the unit scrubs and divide up the bays accordingly. We then provide for the children in our assigned bays…whether it be procedural support and preparation, therapeutic medical play, or various play activities. I spent my first day mainly playing with the children in Bay 2. By the time I had arrived to the floor, many of the procedures and dressing changes for the day had been completed. I did go with one or two children to the treatment room. I am still orienting myself to where the sanitary aprons, gloves and masks are, the sinks, what soaps to use and so on. The day FLEW by. We ended it with taking pictures of various “comfort holds” (non-threatening ways to hold children during procedures..on laps and hugging the child instead of laying the child flat on a table). The goal is to make posters to hang up in the treatment rooms to encourage this intervention. I got back home just after 3 and almost immediately fell asleep.

C2

My second day at work was MUCH more eventful. Wednesdays are the big “outpatient” days. With the holiday weekend, there was an overload of outpatients to see. We start work an hour early (7am) on Wednesdays to be there for the early dressing changes and “Ward Rounds”. A team actually rotates from bed to bed discussing each patient and their plan of care.

We quickly suited up, divided the bays and almost immediately began following children to the treatment room for dressing changes. The children are taken into the treatment room one by one to have their dressings changed. The staff have responded immediately to the Comfort Holds. They are already handing the child over at the start of the procedure, inviting us to hold them in the most comforting and non-threatening way. My experience has been that the staff welcomes us into the treatment room and cooperates extensively with our suggestions and interventions. The morning quickly became very fluid. We had seen over 20 patient’s before 11:00 am Tea time. (Yes, they have “Tea Time” every day.) Our day ended around 1:30 and we concluded that we had seen about 70 interventions that day. Child life was there for EVERY one. About 25 of them were mine. That is most definitely, hands down, the most procedures I’ve ever done in day…a week even.

The children have captured my heart immediately. The majority of them are young toddlers (about a year-give or take a few months). These babies are just so captivating. What they can say with their eyes is more than any other child has ever spoken to me. Beauty is in every corner of this culture and I am honored to be invited and immersed into it.

LESSON #12: THE TABLE CLOTH...The other night we were in Caroline’s room, and I was admiring her (gorgeous) panoramic view of Table Mountain. Being dark out, I could barely make out her outline, but I COULD see what appeared to be snow caps on her top. I asked the others about this (knowing it was impossible), and they casually replied, “Oh it’s the clouds.” I considered this, then decided it def wasn’t clouds. This was something that was clearly sitting on TOP of Table Mountain. Considering this, Caroline told me, “It’s probably the Table Cloth”. The what?! The Table Cloth…when the clouds pour over the front of Table Mountain draping it, like….well….a table cloth. With this new knowledge I looked back out at the mountain. WHAT a sight. Just when you thought that mountain could not get any more beautiful; any more amazing. Since this happens mostly at night, I’m afraid I may never get a decent picture of it. You will have to come down and see it for yourself. It’s def something to add to your travel must-see list. New Table Cloth pic...side view is not as dramatic as straight on.

British:
Gym Kit = Gym or workout clothes
Kettle = an electrical tea kettle. It boils water at lightening speed. I actually got made fun of by my brit roommate for boiling water on the stove for pasta. Apparently we are way behind the times in US with out stove top kettles…

LESSON #13: MAKE THE BEST WITH WHAT YOU HAVE...the staff at RCCH certainly don't have a lot of resources. I give the staff so much credit and applaud the work that they do. They are a pleasure to work with and learn from.