I like the smell of hospitals. I know it's more than a little odd, but, I always have. Maybe it's subconsciously one of the things that caused me to become a nurse. I smell the ammonia and something feels right about it, it puts me in the zone. The zone where I feel I am fighting the good fight for health, for knowledge, for happiness, for those rare moments when I get to be the one that offers the right word at the right time in the face of pain and death. The scrubs, the light green walls, the matching hallways with little cubbies filled with COWS, and vital sign machines, the nursing station sitting in the center of all of it like the command station with the charge nurse sitting there looking grumping as all get it, because let's face it when do charge nurses not look like that? Grumpy charge and all, it feels like coming home and I love it.
Today was my first day and it was supposed to be mostly familiar plus a few new scary butterflies because maybe the walls were a little more blue than green and maybe the charting was different than I was used to and maybe I had more patients than I thought I could handle. But that wasn't the problem. There were no green or blue walls, there was no charge nurse, no beeps of Iv's needing to be changed, no, there wasn't even a hospital.
Instead, there was me, and a school, and red mud, lots of red mud. It was on my shoes and smeared on the light blue uniforms of the school kids lined up neatly in the lunch line. We filed passed the kids and into our makeshift office, me and my Kenyan colleagues. Steven my fellow nursing colleague, the pharmacist Brenda, and I, and no happy butterflies. I took stock, one table, one chair inside a 12-foot by 12-foot cement building with no roof, dirt floor, no running water. We pulled out our nursing kits slathered on the hand sanitizer and put on brave faces. We worked for an NGO that provided health assessments for kids and dispensed (though the pharmacist) a limited number of drugs and provided referrals to the hospital for cases beyond our limited makeshift clinic. Our task today was to assess thirty-five of these school kids between the ages of four and eight in the next three hours. As the two nurses, my colleague Kevin and I set up the best assembly line system we could come up with including the pharmacist in any tasks she could perform to save us time like weights and heights.
The next several hours were a blur of vital signs, and "please step on the scale", "please step off", "open your mouth", "stick out your tongue", "How old are you"? Some kids hid behind each other and wouldn't respond me until my Kenyan colleague told them it was ok, I realized about five kids in that they were a bit shy because I was white. I tried extra hard to smile and not make any sudden scary movement and to not seemed rushed though we were fighting the clock all day.
We had about ten kids to when Steven said "it's going to rain." I gave him a funny look and took the HR for the next kid. Steven hadn't spoken a word in hours not related to our task and I didn't have the mental energy for small talk about the weather. Three minutes later. "It's going to rain." This time I said "Oh?" Using exactly the .05 percent of my brain that wasn't engrossed in the task at hand. "Yes, it's going to rain, we need to go." Surprised I said "we can't, we still have several kids left." Steven patiently pointed to the line that used to have several children in it and said no they won't be here either, their parents are coming to take them home. I was startled enough to stop my mad multitasking and saw several parents appear and whisk their children out of line and outside in a matter of seconds and our last two patients be grabbed by teachers and taken outside. I still didn't get it but it packed up my supply bag as I was told, in two minutes we were running the mile back to the gas station where we would catch a ride. We worked in a slum, no cars could get back to where we were. Then the rains hit and I got it - you don't mess with rainy session in Kenya out in the slums there is no place for the rain to go, so you find higher ground. Now.
We waited at that gas station three hours before our driver could make it the two miles to get us in rain like that and it took another three hours to get the five miles back to my house that night. But in-between arriving at the school that morning and my house late that evening I found it somewhere -that this is why I do this coming home feeling. When I arrived at the school to assess the children I didn't get that feeling, just the feeling that there was a pile of work to be done and no one but us to do it. But somewhere between arriving at that school that morning and leaving in the panic of the rains I found something I had been missing. Because, somewhere between the mud, and the cement building with no sink and the line of children I realized it was never the smell, the walls, the nursing station, the familiar organization and equipment that I fell in love with when I started nursing. It was the patients. And the black smiley faces and flashes of toothy grins I received when a child realized we were there to help maybe that was when I realized that first dasy are first days and maybe they aren't so different no matter where you are. There are patients, you are nurse and you are there to help however you can with whatever you have. No ammonia, no problem. I can do first days anywhere as long as there are patients.