mayhem

We pray before the start of every shift here. It's become routine for me, second nature almost, to pause before my day begins, sit shoulder to shoulder with my coworkers, and lift the day up to God. I'll miss it if I ever work in North America again.

Today I was in charge. Note that I don't say this evening. No, for the first time ever, I was a full-fledged Daytime-During-the-Week (with all the mayhem that implies) Charge Nurse. As is our custom, we started with prayer. Somewhere in the midst of it, I was struck with something that I felt I should really thank God for. So I praised Him that He is deeply concerned, not just with the grand scheme, but also with all the intimate details of our lives and work. We said amen, and the mayhem began.

Now, I'm not trying to complain or get sympathy (although a little bit doesn't sound too unwelcome right about now), but today was the worst one I've had since coming here. And I was supposed to be running the place. There's no way I can put it all in chronological order for you, since the eight hours have all run together into a sort of strange, 'did that honestly happen?' memory by now.

None of the surgeons rounded on their patients before starting surgeries. I have no idea why they decided to skip that critical portion of their mornings, and it didn't help that half of those patients are listed under surgeons who have left the ship. I picked names out of a hat as I called into all the ORs, begging doctors who were in the middle of surgeries to come and write orders for their respective people. Because we were planning on sixteen admissions, and if I didn't discharge a whole bunch, we were going to have to start installing bunk beds.

Somewhere in the midst of this, I heard screaming and ran to A Ward to find out that a patient and another patient's sister had just gotten in a fist fight. A real hair-pulling, face-slapping throw down. The etiology was unclear, but the patient was red-eyed and hysterical, screaming in her tribal language that she was going to pay her debt, while trying to push past me and clobber the sister, who was looking confused and backing away slowly. At which point the toilets stopped flushing and the lights in the hallways and the wards (even the emergency ones, which aren't supposed to ever go out) flickered and died. In a much-needed break from the tension, I then heard a small voice from behind a curtain where two friends were engaged in a complicated wound dressing. Um, can we get a torch back here?

The lights eventually came back on, but the computer system had completely failed, leaving me unable to update our charge charts or print out sheets for the oncoming nurses. We ended up writing all those by hand, and the evening charge nurse got report from me on a series of small pieces of paper, each filled with a to-do list left mostly undone.

Add this to the fact that the power outage had also stopped the ventilators and the gas supply in the OR from working, and you've got a whole bunch of harried hospital workers, to say nothing of my translator who had abdominal pain and ended up in the ICU while we ruled out appendicitis. Or the baby in A Ward whose blood oxygen levels were reading at anywhere from fifty to seventy percent, despite the fact that she was wide awake, pink and looking around at us as we fussed over her, trying to figure out what could be wrong. (Above ninety-five is normal, for those of you not medically inclined; anywhere under eighty-five and we start to get worried. Fifty would be panic mode, if the baby didn't look so paradoxically good.) We never got an answer on that one. Just a call us if she starts to look bad, otherwise we have no idea what's going on.

Really, God? I wanted to yell. Really? We commit everything in this day to You in prayer, and this is what we get in return? Are You kidding me?!

At which point the evening shift came on and we all sat down again to pray and I realized all over again that God is intimately concerned with the details. I'd been seeing nothing but the big picture, a day gone incredibly, spectacularly wrong. God, I think, saw it differently. When a fight broke out, He used it as an opportunity to have us teach forgiveness. When the electricity stopped, He protected every single patient in each of the operating rooms. Even though the baby's oxygen levels were reading low, she was fine. We had just enough patients fail to show up (not really a good thing by most accounts) that we could fit everyone in their own bed, no sharing required. And so what if the computers weren't working? Another nurse had finished her tasks in perfect time to help me write out the handover sheets.

They were just little things, these small graces scattered throughout the day. I could just as easily remember nothing but the frustration and headaches. But added up, taken as a whole, I can figure on nothing but God's perfect provision.

And I'm still so glad I'm not the one who's really in charge.