VCU School of Nursing News Archive

First hospital day in South Africa –Elayne’s blog

Today was our first day visiting the local hospitals. We are going to all eventually visit 3 public hospitals and 1 private one. My experience was supposed to be at Livingstone Hospital which is the busiest of the public hospitals and whenever I mentioned that I was going there everyone said, “Oh my, it will be quite an experience.” I guess it was not supposed to happen for me. My student did not report to her rotation today so only Mica got to stay at that hospital. I heard her say they are very busy there.

I actually went to Provincial Hospital. This is where thoracic, cardiac, ENT, and eye surgeries are performed. There used to provide more services, but since the political changes there has been some relocating of services to other hospitals so that now difference services are offered at different hospitals. Becca & I were assigned to the ENT wing. There we met up with 2 NMMU nursing students that were absolutely excited to show us around the hospital, discuss our needs, etc.
We visited the theatre (OR), recovery (PACU), where they clean and sterilize the equipment (Central Sterile), intensive care, & Oncology.
The general wards hold 6-8 patients in non-electric beds. Each bed is separated by curtains. Suction & Ambu bag are present in each room, BP done with dinomapp type equipment, thermometers are glass. Even though, all the equipment is old (I guess about 25-30 years outdated by my US experience), the routine is the same. Preop check consists of reviewing VS, labs, consent, pre-op meds, etc.
The ICU was 6 beds, equipment somewhat more up to date. The ventilators were a brand I was not familiar with, but appeared to have most of the same bells and whistles. However, I did not see any in-line suction equipment. (Will have to ask more questions to the students). The thing that impressed me the most was the charting. There is a table at the end of each bed with a charting sheet THE WIDTH OF THE FOOT OF THE BED. This sheet is broken into sections just like our (I&O, IV solutions, VS, Assessment, etc). I guess they fold it up much like a road map to fit it into the chart. Each hospital has an ICU so there are no special ICUs. Neonatals are at another hospital. There is a code cart on the general floors and in ICU, but the drug supply is definitely not like ours.
Surgery packs are cleaned in one area, put together, sent across the hall and autoclaved. This hospital has received new anesthesia equipment last year and is going to receive more. We did get the see their cell savor and pump perfusion equipment. It was explained that once a year they have eye surgery clinic. All surgeons are asked to clear their schedule so that the eye doctors can remove cataracts for this particular week. About 300 cases are done. Two patients are in the OR suite so that when the surgeon is finished doing one, he can turn around, re-gown & glove and start another case while the first one is being taken out. This way they can get to 300 patients. These cases are done under local anesthesia.
All and all, while the equipment is outdated, and I feel like I am stepping back in time, the nursing care is comparable. There are “house recertifications” yearly (like our CPR recert, etc.) and competencies that must be addressed – Elayne

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