With my foot healed, and around a week left in the ETU, I was put on night shifts.
Nights are a completely different beast than days at the ETU. While Days consist of frequent frantic admissions, blood draws, lab runs, and guests from dignitaries. Nights tend to be longer periods of slow time, with short bursts of activity.
The shift starts off with report, and medication preparation before you head in, which is no different than a day shift. The difference starts with the complete lack of people. There’s seemingly half the number that are on days, and those that are there are quickly sleeping or lazily watching movies on their laptops.
Normally on nights you would go in around 9pm, stay for an hour or two, then go for a quick walk through at 5am to see if anyone had died.
Our situation was different. We had a 3 month old baby in the confirmed ward, and she required fluid every four hours. Normally a baby this young wouldn’t stand a chance against Ebola.
Bong has had one under five survivor -she was three years old, not three months.
This child had one thing going for her, the fact that her mother was an Ebola Survivor. The hope was that her breast milk would contain enough anti bodies to keep the child alive.
A normal gravity IV would give fluid to fast, so IMC “Acquired” tubing normally used for blood transfusions. This allowed us to measure down to the ML of much we were giving.
We’d suit up, head into the hot zone, draw up the fluid into a syringe, and place it into the chamber. (60 of Ringers, 50 of D5, 10 of D50).
And we’d wait.
Forever will I change “watching paint dry” to “watching fluid drop”. The IV itself was small a 23G (In IV’s the larger the number, the smaller the needle, 23g is quite small), and it was positional, so every time the baby moved, the fluid would stop. We’d have to go over there, try to hold her arm so the fluid could continue.
We were in there once for two and a half hours, waiting for 120mls of fluid to go. To put that in perspective for my fellow freedom loving ‘Muricans, a can of coke is 355 mls.
I remembered an old game we use to play in the Army. As we often enjoyed(endured) the Army’s hurry up and wait policy, and without cell phones we had to actually look and talk to each other like a bunch of barbarians.
The Name Game
To start, you say the name of someone famous say, ” Jake Gyllenhaal”
The next person has to come up with a name that starts with the first letter of that persons last name -fictional or real.
So a proper response would be,
A reply would be
And so on, and so on until you finish what you’re doing. The heat, and PPE made it quite the challenge. Normally you can spit out names without a problem for the first five or ten minutes, this time we were struggling. After awhile you get stuck on letters, and god help you if you land on X or Z.
Sometimes during this time the mother would breastfeed. We had to explain to her that her “Titty Water” (Their name for breast milk) would help keep the baby alive. Each day we would encourage her, and each day the baby would latch a little better. Her temperature maintained relatively stable, and she seemed to have more fight.
One night the IV wouldn’t push, and putting in an IV to a 3 month old dehydrated baby wasn’t any of our specialties, so it had to wait till morning. Each time they stuck the kid during the day, it would work for a few hours then give out. She was on her last scalp vein she spiked a fever of 40.9C (105.6) one day. Luckily the fever came down, and the baby was stable the last I heard.
After dealing with the fluids, we would doff, change into a new pair of scrubs and try to lay down for awhile.
Normally until around 1am, the staff would play a movie for the patients in confirmed. It really depended on who was more in confirmed, if it was kids, they’d try to play Disney films (The Lion King was a hit), adults preferred Nigerian films.
The projector cast the film on a sheet hanged between laundry and the doffing station, it being a sheet, meant that any wind would distort and contort the film. Combine the fact that the speakers were blown, and you have a near IMAX experience.
Another part of night shift, that day shifters don’t have to worry about are the bugs. With sun down, and the lights on inside, everything with more than four legs decides to hang out. Now these aren’t your normal moths and mosquitoes of the United states.
These are African moths the size of your hand, wasps an inch long, and whatever this thing is-
(Highlighter for scale)
While the light is on, they dominate the place, they outnumber us 100-1, if they wanted to revolt and take over the ETU, they would have the numbers to do so. So as soon as were done going in the first time, and have finished any work we need to in the office, we turn the light off.
The office area had a cot inside, and we would clear off one of the tables against the wall to lay on, which often left the third person faced with a choice- Try to sleep sitting up, stay up, or lay across plastic tables. I would say that medical professionals are above childish games such as rock paper scissors to determine who would get the cot, but I will say that-
Always put your money on Rock if you want a good nights sleep.
I think that laying on that Army cot, with my eyes closed and listening to the African rain patter the tin roof- hearing the occasional rumble of thunder above will always hold a place with me.
(Rains looking outside our office)
You’d drift off to sleep, just to be awoken by the doc or other nurse telling you it’s time to go back in for the walk through or to give fluid.
During this time, the sprayers would start what I like to call,
“The Ritual Bathing of the Rocks.”
Every morning, they would fill up buckets with 0.5% chlorine and throw them over the whole compound. Every square inch would be covered. If you have to kill every living cell around? except no substitution. Chlorine is the way to go.
Here’s a sprayer making sure every filthy rock got what what was coming to it.
It also had the added effect of recreating a World War One battlefield. The air became incredibly hard to breath, it burned your throat, and there was no where to escape to to make it get better. They sprayed the inside of buildings, they sprayed the latrines, they sprayed the walls, they sprayed the sprayers and then did it all over again.
You don’t have really any choice but to accept the punishment, and hope that one day a lawyer will run an add on TV promising you part of a class action law suit if you were apart of “Ebola aid” and suffered from injuries related to chlorine inhalation (1-800-coughalot)
Day shift would soon come, you’d change into your civilian clothes, let them know if anyone died, who did well, who took a naked a walk down the ward and had to be corralled back under promise of FuFu in the morning. Then hopefully, you’d make it home by 8:30, be asleep by 9, to wake up and do it all over again.