I started this post before the Covidsanity began - with the intention of making an announcement.
Fearless TL Brittany with Babacar - one of our favourite patients from this year!
My amazing supervisor, who has been expertly leading the general ward nurse team for the last 3 years now, is taking a break from her service here. A gap opened up, and, somehow - after a lot of prayer & a fair bit of uncertainty - I got poked/prodded/coaxed into applying for it. Coaxing & prodding seemed to be coming from a few sources, but there were a number of coincidences (which I really don't think were coincidences) that gave me such a strong sense of direction in this matter - I couldn't ignore them.
As a result, I can finally announce that I'm going to be returning to work with Mercy Ships for their next field service as the Ward Nurse General Surgery Team Leader! Although she is (slightly) shorter than me, Brittany leaves VERY big shoes to fill, and I'm exited yet nervous yet eagerly anticipating joining the phenomenal ladies that make the hospital wards run.
Now, you probably have questions: Q: Whaddaya mean 'returning'...aren't you already there?
A: Yes, yes I am. On the ship, that is. In Spain. Docked at a jetty. That I can only set foot on to throw out my trash. As our field service ended early, I'm working on plans to return home sometime around the end of May or beginning of June. I was supposed to be heading to Texas for some training before returning to the ship in August. Thanks to the current state of the world, exact time frames are a bit...vague...at the moment but as soon as it's possible to start serving the people of Africa again, that's where I'll be. In the interim, I'll be looking for temporary work in Canada.
Q: Returning...where?
A: Our hope is to return to Senegal to complete our planned surgeries. We left on very good terms and have a strong relationship with both the Ministry of Health and the president, and will do everything we can to fulfill our commitment to them, once it is safe to do so. After that, the next field service is planned for Liberia - a country I'm really looking forward to serving and learning more about. Bonus: English is their official language!
Q: What exactly will your role be?
A: Each surgical specialty we do on board has an OR Nurse Team Lead, and a Ward Nurse Team Lead. They work together to coordinate patient care on both sides of surgery. Most of our surgeons, nurses, and anesthesiologists come and go throughout the year, staying only for a couple months or even weeks. Team leads help maintain consistency through all that changeover, supporting the nurses & surgeons as they jump in for their time on board. They act as a line of communication between the ward nurses, OR nurses, surgeons, anesthesiologists, chaplaincy, and the hospital leadership. They also can see more of the big picture of each patient's journey, anticipating their needs and planning accordingly. It also means I get
Q: 'General' Team Leader - does this mean you outrank the Captain?
A: The Master (Captain) of a ship always outranks everyone. ;) The General Surgery* ward, though, has been my home for this past 8 months, and is a good place to get a little bit of everything. General Surgery (in this context) = hernias, lipomas (soft tissue tumors), thyroids/goiters, and the occasional mastectomy. As most of those are quick turnovers, we also get overflow from nearly every other specialty. Oh yeah...and we get those adorable pediatric cataract patients, too.
*One of my old roommates got me into the habit of saluting whenever a military rank casually drops into conversation, just 'cause. Like if you found a popcorn kernel. Or had a private conversation. Or you were having major difficulties with keeping your blog post on topic. This is a trend I fully intend to indoctrinate all my nurses into - whenever General Surgery is mentioned. I hope they don't all hate me. Q: How long?
A: This is a very hard question to answer in the midst of these uncertain times, but I plan for another year at the least, two if possible. It's hard to know what will come that far down the pipeline, and somewhere in that time frame there's going to be a changeover to a new ship which might shorten or extend my plans. For now I'm just going to trust that at the right time the right path will be made clear.
Clear as mud? That's about how I'm feeling too. Probably how the whole world is feeling right now.
I'm so grateful for all of you who take the time to read this and check in with me, and keep running alongside with me as I make rather unconventional life choices. Y'all (oh dear, the American crew are rubbing off on me) have got my back, and I can feel you there, propping me up when I falter, on a daily basis.
Thanks for being there. Thanks for reading this. Stay safe out there.
I started my day charging (manning the desk, essentially), in A Ward. Half of the ward is filled with plastic surgery patients, all splinted and bandaged up, waiting for their skin grafts to take root and mobility to improve. The other half of the ward is max-fax (facial surgeries) with a lot of drool and swelling and feeding tubes.
4 of our patients are well enough to be discharged from the hospital.
One problem.
PANDEMIC!
At an all-crew meeting yesterday (Friday the 13th, no less...), a panel of our hospital & operational leadership delivered the news that surgery was being stopped, our programs would quickly wind down, and we'd prepare the ship to sail as soon as reasonably possible. The room was dead silent. My friend Maddy, a screening nurse (I've talked about before), was sitting next to me, grabbed my hand and started squeezing. I know, in her mind, she was racing through the hundreds of patients who had been scheduled to come for surgery in the next few months. Over the next week, they would all be called and told the unfortunate news. The 60+ who had already arrived to the HOPE Center who would have to be sent home.
Heartbreak is an understatement.
It was difficult news, but I think it was the only sensible option. So many of our crew are itinerant; our programs depend on dozens of new arrivals, from around the globe, every weekend. In the current outlook, that was going to become increasingly risky - if not impossible. Not to mention how devastating it could be if such an infectious contagion got on board. This was the right choice.
But that didn't make anything about it easy.
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During my shift, the 'bing-bong' of the ship-wide PA went off heralding this announcement: "All shore leave is cancelled. All shore leave is cancelled. If you know of any crew ashore, please contact them to return immediately." We later learned that from our 250 day crew who usually help in all our departments to keep the ship running, 53 were asked (if they were willing) to stay here with us as temporary crew. They would live in a tent on the dock or in our admissions ward - on mattresses on the floor. They would stay in our quarantine 'bubble' to help with the final essential tasks (not the least of which was caring for and providing information to our patients before they left).
At the end of the day, though I probably should have been sleeping, the day's news and events kept me thinking there was things I should do. I scrounged some extra toiletries (including those of a cabin mate who was unable to return from her 2 weeks of time off), and headed back in to the hospital. All 20 steps. One of our team leads had suggested we bring some donations for the day crew who were unable to get home before hunkering down with us. They had toothbrushes, toothpaste and soap from hospital supply, but that was basically it. They worked a 12 hour shift then agreed to just stay on for the next 2 weeks without seeing their family. Or getting a change of clothes. Not a single one complained.
They are my heroes.
Walking down the hall, I passed a patient I had cared for the past couple of days on D Ward. She had been missing the whole part of the lip that sits under the nose - a rather more extreme type of cleft lip. Dr. Gary cut and stretched and built her a new one. She was still a bit swollen, but when she saw me, her face lit up. We exchanged greetings, I told her she was looking beautiful, and she gave me the most unexpected but wonderful, french-style, hug-on-this-side-then-hug-on-the-other hug I've ever had. Plus a little dance to boot.
In the midst of the days chaos; all the uncertainty and worry, that moment stood out as quite possibly the most important thing that happened in my life that day.
3 Days Later...
I'm sitting on the floor, leaning against a bag of blankets, pillows, toiletries and gowns, ready for a patient that will be transferred to a local hospital the next day. Several other nurses, and our rockstar nurse team leaders are sitting nearby, all of us spent. We've transformed the now-vacant Opthalmic Team room into our Master Control Center for the biggest exodus of patients I've ever been involved in. 53 patients were on board when the decision was made to shut things down. At least 30 of those still required complex wound care, physiotherapy, and medical follow-up. 3 of them needed another surgery before they could leave. ALL of them needed documentation, dressing supplies, medication, nutritional supplements, transportation, and thorough teaching about their self-care. One of our biggest challenges is: 'how are they going to CARRY all these cans of Pediasure!?'
The first few days were stressful beyond belief, with our team leads working 16 hour days to get things in motion. We are so grateful to have strong partnerships with a number of hospitals & clinics throughout Senegal, who were willing and able to accept our patients. Transferring one or two patients, who just need a little more time, at the end of a field service isn't unusual. Transferring this many, though, was unprecedented.
Our 'Discharge HQ' - plans for each patient plastered on the wall. The bags are for hospital transfers are under the table.
Bags upon bags of dressing supplies & nutrition supplements. Most patients took at least 2 of these bags home.
Team Leader Brittany ticking off the 'Left the Ship' box - cause for a small celebration at the end of each day.
1 Week Later...
Our last 5 patients have made it out the door. All the remaining nurses on the ward, mostly working all day to clean & pack up, paused to clap them off. We started out in a mad frenzy, but every day got a little bit easier as our planning and preparation smoothed out (almost) every wrinkle. Still, we are exhausted. Physically, emotionally, and mentally. In the midst of our focused drive to do the best by our patients, over 200 crew members left to get home while they still could. Every day, it seemed, another group of cars would head off to the airport. So many goodbyes were said not knowing when we would see each other again; sometimes knowing we'd likely never see that person again. The future beyond the next 12 hours was as unknowable a thing as the number of hairs on my head. Every time the PA 'bing-bong' went off, we all flinched, wondering what new wrench in the works it would be this time.
The biggest encouragement - the thing that kept me going through each of these non-stop days - was the patients. Every single one of them, when we'd finished cramming their heads with information about diet and mobility and wound care and preventing infection and what to do if they had problems...every single one said 'jerejef' (thank you). But not just 'jerejef' - it was a deluge of thanks and prayers and blessings. 'Jerejef. You've done such good things for us. We are so grateful for how you've looked after us. Jerejef. Jerejef. We pray for your health, for your family, for the whole crew of the ship. Don't be worried about us. Jerejef. Peace be with you. Peace only.'
- Lin Manuel-Miranda
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An article from Al Jazeera popped up on my newsfeed: "Senegal shuts borders amid WHO fears Africa is next virus hotspot." I took note to watch the video later. When I do, I'm surprised to see the Africa Mercy come on screen. "Even the United States' Mercy Ship, a floating hospital with 400 nurses and doctors on board meant to offer help, is leaving Senegal when it's needed the most."
SERIOUSLY. I can't believe my ears. So much misinformation crammed into one sentence. We're not affiliated with the US, we're an international NGO. There are probably fewer than 100 medical personnel that make up the 400+ crew. The help we offer is elective surgery to correct chronic, debilitating conditions. We are NOT equipped or qualified in any way to intervene in this situation. Not to mention that, as has become painfully evident from the cruise ship debacles, ships are NO PLACE to try to contain this virus. We are leaving with the full approval of Senegalese Minister of Health.
We hated that we had to leave. We desperately hope, as we say our goodbyes to daycrew and patients, that this is not the last time we will see them. But it's out of our control. We have to say goodbye. Staying could do more harm than good.
I send a very pointed comment to the editor. I hear nothing back.
2 Weeks Later...
We are about to sail.
We're now only 239 souls (including enough children to keep the academy running). It seems like a big number, but it feels eerily empty and quiet. Instead of a packed out dining room at lunch, there's only a smattering of people around. Nurses that didn't make it home have all been reallocated to other departments - it's very strange seeing them out of scrubs and instead in a galley or housekeeping uniform. I end up (after a couple days 'rest' where I don't know what to do with myself) transferring to reception. This is usually a very busy position overseeing arrivals and departures, but at the moment it's almost entirely answering the phone and keeping an eye on the fire safety system.
New job, who dis?
The hospital is packed and strapped in for a rocky sail - but much of the usual cleaning was cut short and will have to be completed sometime down the road. The normally restricted OR corridor is wide open, changing my usual route to the hospital offices. It's very odd walking through there in normal clothes. I do a little admin work for the hospital to fill the downtime. It's hard to not be working after such an intense period of life.
24/7 stowaway watch to ensure no uninvited passengers come aboard (standard before any sail). Good time to think.
The sail is lovely. The ship is extra empty; everyone with bad seasickness just stays in their cabin. It only takes us 4 days to get to Tenerife, where the Spanish authorities have permitted us to dock (but remain quarantined on the ship). Reception has shortened hours while sailing, so I have a lot of down time (and, fortunately, don't get seasick). Time to think. Time to sleep. Time to watch for whales breaching or dolphins skipping alongside the bow. Time to soak in the spectacular sunsets.
Today.
Life on board is getting back to the 'new normal' - new routines are starting to slowly settle into place. News still rolls in, but it does so in gentler, lapping waves instead of crashing breakers. Plans & possibilities for the future are beginning to formulate and emerge from the fog, though a great deal of mystery is still clouding the view. For the time being, I am hanging tight here on the ship in Spain, until such time as I can get a break at home, or we can return to our work for the people of Senegal.
I am incredibly grateful for the people around me, for their grace, their incredible drive, and for holding me and this ship together.
I am grateful for chaplains and friends, checking in on each other and carrying each other through the hard days. I am grateful for the planners, who are keeping us busy during our 'isolation vacation.' I am grateful for family and (albeit spotty) internet that can keep us connected across the globe.
I am grateful for the first rule of flying...and that it can be applied to a vessel of the sea as well.
