Today was our first day in the hospital. We were all anxious to see the hospital and to see what our roles would be. As the largest group Belmont has sent to Cambodia it was interesting figuring out where each person would go in the small hospital in order to balance experiences and staffing. The group began the day by touring the hospital areas including ER, OR, surgical ward, medical ward, pharmacy, outpatient clinic and chronic care facility. We met many of the staff who are familiar with the Belmont groups and they welcomed us graciously.
After we split up into groups, I took three students with me to the Emergency Room/Wound Care area. The emergency room is divided into four areas: triage, main ER, infectious disease, and wound care clinic. All patients admitted through the hospital are triaged through the ER. The day began busily with many patients waiting outside for triage through the ER and several patients already inside. One student was paired with a nurse in the infectious disease area where she was able to work with acutely ill HIV patients and patients suspected of having tuberculosis, meningitis and other tropical infections. Several severely ill patients came into this area who were admitted to the hospital. One young woman came in with a high fever, low blood pressure, tachypnea and decreased level of consciousness. After working with the patient, drawing blood, and admitting her it was later found out that she has septic pneumocystis pneumonia as a complication of late stage AIDS.
In the main ER two students and I were able to get to know four Cambodian nursing students and work with them and the veteran staff to take care of several patients with chronic medical complaints. The nursing students from Cambodia formed instant bonds with the Belmont students and shared experiences and a few laughs. Together we saw many patients with congestive heart failure, liver failure, acute diabetic complications and complications of tuberculosis. In the wound care area, one student was able to work with the wound care nurse on many diabetic foot ulcers, post-op wounds and wounds as a result of car/motorcycle accidents. The students and I learned many things from the Cambodian nurses about traditional Cambodian culture, diet and medicines. We learned that most patients are treated with traditional herbal medicine before seeking care at the hospital and unfortunately some of this medicine causes complications like liver failure on top of their medical illnesses.
We were also able to observe the role of the family member in the care of the patient. Patients are attended closely by a member of their family. These family members bathe the patients, feed the patients and assist the patient in moving. The respect for elder family members is evident in the attentiveness of the younger family members to their needs. All in all we had a wonderful day and were able to learn and grow as nurses and as visitors to a new place. For me, this is a fantastic group of students and faculty and it is exciting facing each day with such a wonderful team.