By Niki Pham
For my final week and a half (June 26th – July 4th), I got to observe two new units at the Vietnam National Hospital of Pediatrics – OR and Oncology.
Operating Room
I got to observe two newborn patients undergo heart surgery to correct their congenital heart disease. Both infants were diagnosed with Transposition of the Greater Arteries (TGA) where the aorta is connected to the right ventricle and the pulmonary artery is connected to the left ventricle.
The juxtaposition of ‘modern’ and ‘developing’ that is prevalent throughout all of Vietnam is also seen in the set up of the operating room. The unit itself is located in the old hospital building and has old walls with aged paint and slight cracks. There are 3 air conditioning units placed in different corners of the room because the old infrastructure of the building didn’t include the luxury of AC back when it was built in the 1970s. However, the contents of the room nearly rival that of any developed country. There are mountains of machines with different functions (circulatory system replacement, vital monitor, etc) placed around the bed where the operation takes place.
The operating team comprises of two scrub nurses, two other assistant nurses, three surgeons (1 head surgeon, 2 assistants), and one anesthesiologist. One scrub nurse assists the doctor during the morning shift while the other is on stand-by to assist the scrub nurse if anything arises. They then switch roles for the afternoon shift. The two other assistant nurses divide their shift the same way, except they would monitor the gigantic machine that takes over the circulatory system of the patient while the heart is being operated on.
The scrub nurse I shadowed, Thu, expressed that she went to Japan for two months to train in sterile technique. She said that it is common for OR staff to go to Japan to train. While the only operations I’ve observed have been Cesarean sections, the sterile technique I witnessed before, during, and after heart surgery (drapes, opening of packages, scrubbing in protocols, preparation of sterile area, etc) are comparable to what we do in the US.
Furthermore, during my tour of the unit, the head nurse proudly presented the two machines they have to do robotic-assisted surgeries. This pleasantly surprised me and I was glad to know that the hospital has more resources available than I first expected. However, it is important to keep in mind that the hospital I interned at is the National hospital. I expect the smaller hospitals are less fortunate.
Oncology
My last two days were spent on the Oncology unit with Christina, another foreign nursing intern from Denmark. We had many great discussions comparing and contrasting our countries’ healthcare systems; I learned so much about Denmark’s take on healthcare this way. It was also nice to have someone else to speak English with (and is a nursing student!) after all these weeks.
The oncology unit is divided into several rooms where a total of 8-12 beds are crammed in depending on the size of the room. A large portion of these rooms are for families who need round-the-clock treatment. Children’s clothes, blankets, and toys littered each room in an organized chaos. Two rooms are reserved for outpatient treatment. One nurse is assigned to each room and works tirelessly in the morning to pass out morning meds.
In the afternoon, the nurses have to prepare the medications for the next morning. They do this every day except the weekends. Weekend medications are prepared in advance on Friday afternoon. Christina and I assisted with this process by going to the pharmacy to pick up bags of medicine to sort through. After a nurse explained how to read the chart containing the doctor’s orders, we got to work. The medicine is then divided into bags labeled by room number and filled accordingly.
On my last day, Christina and I got to observe one nurse collect blood for testing from almost 20 patients. She didn’t miss a vein once! Even when the kids were screaming bloody murder and attempting to wiggle out of their parents hold. After witnessing her work in awe, Christina and I made her our new “intravenous idol.”
Other noteworthy moments:
- I smelled burnt flesh for the first time when they cauterized a child’s skin before sawing past the sternum. I also saw “human ribs” for the first time and don’t think I can stomach eating animal ribs for a long time.
- The parents of the oncology patients seem to have built a great community amongst themselves and really work to support each other. For example, there is one child that is notoriously difficult to start an IV on because he screams, cries, and breaks from his mother’s hold really easily. One of the other dads would put the patient in a safety hold instead while his mom held his legs and faces him to talk him through the procedure. It struck me as very moving because the mother of the child didn’t even ask for help; the community already knew she would need it and the man stepped up. Another example is when one mother told the mother in the patient bed beside hers to go get lunch because she seemed tired. I could see the relief in the tired mother’s eyes as the other mom plucked her child from his bed and put him on hers to watch both children.
I’m still in awe that these past four weeks have flown by so quickly! I’ve gained so much valuable knowledge, practice, and experience working at the Vietnam National Hospital of Pediatrics. Lastly, I’d like to thank Mrs. Mary M. Jacobs, Ms. Jean Hackett, and the Kuhn Foundation for providing the funds for me to go on this life-changing adventure!
Hook Em Horns from Vietnam!