Florence Nightingale's December Update

more news directly from Baghdad-

Well this has been a long overdue update. There really has not been too much going on here. I have to say that luckily it has been slow and quiet. Usually that means that American soldiers are not being injured, at least in my general area of Baghdad. We still have many Iraqi patients to care for in spite of the relative calmness.

There has been a 6 year old little boy that has been a patient in our ICU for the past few weeks. He came to us in respiratory distress and had to be intubated. Let’s just say that this little boy gave me a run for my money the night he was admitted. I was in charge and I took on this little boy as my patient. He had this terrible habit of turning blue, which is never very good for kids. So there I was with 2 doctors giving me orders and I’m trying to tread water to keep up with their multiple orders in between trying to get better IV access and resuscitate this kid back to acceptable oxygen saturation. Luckily my battle buddy, was there to lend me a hand and write out all my orders for me and help keep me on track.

It is amazing how an adult patient can roll up on the floor covered in blood and have no blood pressure to speak of, but as soon as a kid rolls up I loose all my color. I’ve decided that it has to be because there is much more of a margin for error in an adult than with a child. I have to quadruple check every medication, and calculate every safe medication range. I check and recheck the ETT, the vital signs, and countless other things.

I have calmed down over these last few weeks working with him. I haven’t gotten as nervous about having to “breath” for him as I use the ambu bag to bring his color back and bring his oxygenation back above ninety. I actually have the confidence to take care of him without being a nervous wreck. It is honestly sink or swim here sometimes. The great thing about having your patient for more than one day at a time is that you can learn from your mistakes and do it better next time. You can also learn from your patient too, in order to better prepare yourself for the incidentals that come up.

I also got to fly again this past month. This time however, I didn’t have a ride home. I had to spend the night in Balad. The Air force facility is very different from our hospital. The hospital is set up in a tent or depmeds. Depmeds are deployable medical equipment and tentage. They have the same sections as we do at Ibn Sina, but there seem to be more. I think they had 3-4 ICU’s, 4 ICW/MCW, EMT, and Pad. They also have a pharmacy, radiology, and lab sections. They have a MWR section with phones, computers, and a TV in the hospital. There is also a small dfac.

Patients sleep on cots and they have to go outside to the portable latrines when they need to use the bathroom and don’t have a catheter. Imagine you have broken bones or got blown up in an IED blast and you have to go OUTSIDE to use a bathroom! Everything is covered in a fine powdery dust like here, but it’s more of a problem in the tents.

This facility is how I thought we would be operating here in Baghdad when I was deployed. I have trained in these tents before with other CSH. I realized that I have things pretty good here being in a fixed facility with running water and latrines. We don’t have all the things that we would like to have like back in the states, but you quickly learn to adapt and overcome the challenges that being deployed raises. Our patients here at least have real electronic beds versus cots!

I was able to get a “ride” back “home” the next evening. “home” being wherever I lay my head at night and for now it is in Baghdad, Iraq in my room with my battle buddy Kim. I had the night off, so it worked out that I could get back to my room and rest. I wish I could describe how exciting and scary it is to fly in those helicopters. The countryside or Iraq can seem so peaceful and beautiful as you are flying overhead looking out at the twinkling scattering of lights and feel the cool crisp air streaming in from the window. Then you think about the potential danger you’re in by being in a combat zone. The bird lands and it’s time to snap back into reality and get back into work. I didn’t have any patients on my flight back so I could just enjoy the scenery and think. The rotors are spinning and you are greeted by soldiers awaiting the patient on board. Stooping low to avoid the rotors they pull the patient off and carry them to the Gator. Equipment in hand I walked up the small stretch of street to the hospital from the landing zone and check in with the TOC (Tactical Operating Center). It is almost like your breath is caught when you get on that helicopter and given back to you once you’re walking back on the home stretch. It is a rush.

I’m hoping that I will continue to get the opportunities to fly with our patients. Right now only the ICU trained or identified nurses are able to fly unless the Head nurse approves. Keep your fingers crossed that things will change for me. It is always a good feeling to be sending our patients on their way back home. Granted they don’t want to be going and they feel terrible about leaving their buddies, but they all have a new journey to embark on. I’m just glad that I can be a part of that sometimes.

I want to wish everyone a Merry Christmas and Happy New Year. Christmas this year was certainly different and was challenging. The dfac was highly decorated and they had a Christmas dinner. My battle buddy and I opted for pizza instead. Our unit had a small pizza party and exchanged secret Santa gifts. I got a little massager and some other cute items! Other than working that sums up my Christmas. My battle buddy and I opened presents on our day off which was the 26th. Her family sent us a real Christmas tree which we decorated and put up in our common area a few days before. It smelled wonderful. We did the best we could as for keeping spirits high. The command group along with the Chaplin and some of the other CSH (Combat Support Hospital) soldiers went around on Christmas Eve and sang carols on the units. I guess you don’t really realize just how much the holidays mean until you are away. I’m hoping that next year will be a different sort of holiday season. I hope that all soldiers are home for the holidays next year.

I am challenged everyday. I am so thankful to have all of you to lean on when I need to vent and to share my experiences with. I hope these updates help to shed some light on the things that I do here. I will be in touch and be sending out some new pictures soon. Until the next update, have a safe and happy holiday season. I think of you often and look forward to seeing everyone again soon. Keep in touch!