community

When you work as a nurse in a developed country, there are certain things you take for granted. Things like curtains between the beds if, heaven forbid, two patients have to share a room. More than one bathroom for fifteen patients. The knowledge that you can be admitted to the hospital without having your private medical condition become the latest cure for another patient's boredom. Here on the Africa Mercy? Not so much. It turns out that nursing is a spectator sport.

Early this morning, one of the translators called me over to the man in Bed 14. His arm was swollen and cool, the product of an IV gone wrong, and not something his busy nurse had time to deal with right then. I offered my services, took out the offending cannula and tied a tourniquet around his good arm, only to be faced with a bit of a challenge.

I'm not sure what it is about West Africans, but their veins are riddled with valves, little tiny doors shut tight against any attempt to force a needle past without significant pain to the poor patient. I chose the spot that looked the smoothest and was met with my first failure; a nasty valve that wouldn't budge. The patient, poor man, kept his arm still while managing to contort his legs in every possible direction, signaling his pain to me in a pretty obvious way. I didn't push my luck, pulled out the catheter and tried again in the next-best spot. I'm a little ashamed to admit it so publicly, but that was my second failure. His legs waved even more wildly, and I knew it was time to admit defeat, so I pulled out that one too.

I was about to give up, since I have a self-imposed limit of two attempts, when I saw a big juicy vein up in his bicep. Not the usual spot for an IV, I'll admit that, but I was getting desperate and this poor man needed his fluids. I asked him whether he'd let me try again, and he agreed, shooting me a look that let me know that this really was my last chance.

The patient resumed his customary pose, eyes squeezed tight shut, legs wiggling back and forth under the blanket, while I swabbed his arm and stuck in the needle. This time it was easy; I had the catheter threaded and was starting to flush through some saline when I heard the woman in the next bed over shout.

Hallelujah! Hallelujah!

I glanced her way and saw her staring at us, intently watching every move I'd made for the past fifteen minutes. Her hallelujah was soon echoed by a quieter, Amen, from the woman on the other side, and when I straightened up after taping the IV, I realized that I'd had an enthralled audience the entire time. They apparently approved of my work, because while I stepped away from the bed, I heard quiet clapping coming from either side of my patient. He finally worked up the courage to open his eyes, and nodded his thanks to the ladies for their support.


There's nothing like a little West African culture to get you through a tough IV start.