Day 2 of clinical sites and Monastery visit

Today is Tuesday, April 13th...what a fabulous day! Much better than yesterday! I think it just took me the whole first day to feel somewhat oriented to the hospital to know where we were going, what our role is, and how we are going to go about it. We had a great time with our patients. We started out in the ICU. I helped one of my students first with a 6 year old girl who had basically a traumatic brain injury. She just started opening her eyes and attending to stimuli, but only localized. Then we saw another girl who was 6 years old and in for ketoacidosis/dehydration with blood sugar =351. We decided it would be good to get her out of bed and walk her around the ICU since she was fairly mobile, and the nurses seemed somewhat confused by this. I don't think that the kids in the ICU there ever get out of bed. We had to wait awhile though because they wanted her to eat first because I guess they were concerned about her diabetes even though her last blood sugar taken was fine. And they were saying that she had an IV, which we said (of course!) we would take that with her! Mobility is just not something they really do there, so it was neat to be able to talk with the staff and for them to see that walking a patient in the ICU not only is OK, but that it is really good for her and can be done!

We spent some time in the neurological unit (which of course I love). The highlight patients we saw included a teenage boy who according to the staff, has a brain tumor (but we aren't sure?) He did awesome today! He is starting to get some return strength in his weak leg and we did a lot of cool facilitating movement. He works with us really well and the family is actually very receptive. The struggle for me is that I wish I had the resources/equipment here that we have in the US. I guess I am learning to be more creative, but a set of parallel bars sure would be nice! The other highlight patient was one of the cutest 4 year old boys ever. I noticed he had a subdural drain in, and thought he would be a good patient to check out. As we presented out plan his aunt who was there, she kept saying, "no puede, no puede....(he can't, he can't)" because of the drain. We spent some time talking with her, telling her that it was ok, and why helping him with mobility right now was important. We walked in the hallway with him and played with bubbles which he loved.

There are a lot of challenges where we are working since PT is almost nonexistent there and we have to work through some barriers with the language and culture. We are trying to help some patients and also educate family/staff about mobility, but we also don't want them to think that we are the Americanos trying to change their place and stepping on their toes. We try to be very respectful while pushing forward at the same time, and so far it's going great!