Already 2 weeks of living in the Philippines and time is flying by! Elia and I have been keeping busy with work and exploring the surrounding areas in our free time. This blog post will be dedicated to describing what my internship is like at St. Frances Cabrini Medical Center. Cabrini is a private hospital located in Santo Tomas, Batangas. It is a smaller hospital so most of the time it is at full capacity. In general, the Philippines is facing a nursing shortage (even worse than in the USA) so it is extremely difficult to staff units. At Cabrini, some units are closed, such as the pediatrics unit and the NICU, simply because there is not enough nurses to fill those positions. Reasons for the nursing shortage include: poor compensation and many nurses immigrating to other areas in North America, the Middle East, and Australia. There were many patients who came into the ED that simply could not be admitted due to lack of space. I also found it interesting that there are different units based on how you are able to afford healthcare. The wealthier and better insured patients are sent to unit 3 where they are treated to their own private room, plus an extra bed/couch for family members. VIP patients are treated exceptionally well and provided with the best and fastest of treatment. The uninsured patients are sent to unit 1 where sometimes they'd be placed in rooms with 6 other patients with no dividing curtain! It's amazing what wealth and status will get you.
I was fortunate enough to be placed in the emergency department for the last few weeks which was a real treat. As someone who is interested in working in the ED in the future, it was a great preview of what I will be experiencing. The most common causes of ED visits at Cabrini are industrial and vehicular accidents. I've seen many smashed and severed fingers and other broken body parts. I also was able to witness a code and help provide post-mortem care. I assisted in transporting a body to the morgue which is a stark difference to the morgues I've seen back in the Unite States. At Carbini, the morgue consists of an open room with AC to keep the body cool until transport. Other things I've observed include: a foley catheter insertion, plenty of IV insertions, blood draws, suturing, dressing changes, ultrasounds, ECGs, and patient hand-off report. I've been able to assist the nurses in preparing medications, doing vital signs, putting charts together, and priming IV tubing. They do not have any electronic charting as everything is done by hand. It is a really humbling experience learning how to paper chart, and I'm thankful that the nurses are helping me learn since there isn't a lot of opportunities for me to paper chart in the United States. They also do not have a Pyxis to automatically dispense medications so the nurses really have to be on-top of their game to prevent medication errors. It's been great being able to witness how efficient these nurses can be despite not having automated systems such as an electronic medical record or a Pyxis (if you couldn't tell already, I'm definitely part of the millennial generation).
Overall, I am thankful to have worked in the ED and will miss the experiences. The staff was exceptionally nice and answered all of my questions. I will miss our endless conversations and laughs. They fed me constantly and made sure I tried traditional Filipino food such as buko, lomi, and pancit. Can't wait to explore a new unit at Cabrini! Stay tuned :)
