Bold Voices - December 2017 - 13

NURSE VOICES

There are countless stories like this. Patients
come to the ship, scarves covering their
deformities, downcast eyes and then leave
the ship having not only received muchneeded medical care but also emotional
healing and a renewed sense of hope.

advice on wound care. There
was no possible way that this
child was going to let anyone
touch her, and without IV
pain and sedative medications
that would be torture anyway.
Her only option was surgical
debridement under general
anesthesia. The other option
may likely have been slow
death from sepsis. Fitia was
already malnourished and
weak. So I paused.

"Her only option was
surgical debridement
under general
anesthesia. The other
option may likely have
been slow death from
sepsis. Fitia was already
malnourished and
weak. So I paused."

Can you share a particularly impactful case?
Two years ago our small team traveled to a city in the northwest of Madagascar called Mahajanga for a screening event.
On our final day screening there, one of the last patients to
present to us was Fitia, a two-and-a-half year-old who was
burned from an accidental scalding in the kitchen. I was the
one prescreening patients as they were trickling in late that
afternoon. I remember a mother holding a shirtless, frail and
scared Fitia in her arms. She stood in front of me just holding
her and not speaking. It was that all-too-familiar scene I have
witnessed so many times as a nurse working in the developing world - a loving parent thrusting their sick child in
my direction with desperation in their eyes.
I had worked in a burn ICU for five years, so I knew what
I was looking at, yet at the same time I had never seen
anything quite like it. The burn happened five months prior
and was massively infected. Fitia was clearly suffering. It's
typically not within our scope of practice to accept patients
with non-healed burns, let alone ones with large infections.
We have been very strict with this policy over the years
because of cross-contamination of infections in the ward and
limited space and resources to isolate patients.
But that day in Mahajanga I found myself pausing before
telling the mother that unfortunately there would be nothing
we were able to do to help her daughter. I paused for a long
time. I sighed. I held back tears. This burn was beyond giving

What happened?
Eventually my colleague and I decided to
call back to the ship to ask about Fitia's case
and see if an exception could be made.
The answer was yes. We accepted the
patient, and she and her mom flew with us
in our 10-seater charter plane back to the
ship the next day. Two days later she had
her first surgical debridement. The wound
began looking so good that she was skin
grafted not long after that. Just a few weeks
later she was discharged from the ward,
once again a healthy, plump child.

A year later, I was fortunate enough to visit Mahajanga again
for a screening. To my surprise, I saw Fitia bouncing down the
hospital corridor holding her mom's hand. They came to say
hello and thank us. They then invited us over to their modest
home, and we celebrated Fitia's full recovery over delicious
local dishes and orange soda. It was a truly unforgettable
experience.
What specific goals do you have for your nursing career?
I'm currently pursuing a Master of Science in Global Health in
order to increase my understanding of the health challenges
we are facing around the world. I've also had the privilege to
be a part of some research studies related to the work we do
with Mercy Ships, and I plan to continue with these and hopefully do more in the future.
It's important to have a healthy work environment and a
healthy life outside of work. Is it easy to balance the two?
I wouldn't say it is an easy balance. It's something I am
constantly aware of. On the ship we live and work in the
same place, so it's fairly easy for work to spill over beyond
the "normal" work hours. However, living and working on
a hospital ship in Africa is also quite adventurous. We are
coastal, of course, so there are usually beaches to visit and
other excursions to go on. Our crew comes from over 35
nations around the world, so there are always new and interesting people to meet as well.
Interview by Paul Taylor, paul.taylor@aacn.org

13
AACN BOLD VOICES DECEMBER 2017

What specifically about
this opportunity and the
program appeals to you?
One of the things I like most
about our work is getting to
see fairly quick results from
the work we put in. I think
we are fortunate in this regard
compared to other development work that is equally
important but not as immediately gratifying. It's not that all
patients have this immediate
transformation once they roll
out of the operating room, but many times it
truly is a radical change and the difference
that it makes to a patient is monumental.
Not only are the physical ailments relieved
when, for example, a large facial tumor is
removed, but the healing process from the
shame and stigma that the patient had experienced for years also begins.



Table of Contents for the Digital Edition of Bold Voices - December 2017

Another Angle
Pres Note Front Teaser
Masthead
AACN Updates Scope and Standards for Acute Care Nurse Practitioners
NTI 2018: Make Your Case for Attending and Register by December
Certification Holiday Reflections
Certified Nurses Day 2018
The Spirit of Giving: One Certified Nurse’s Contributions
Improving Joy in Work
Invest in Yourself With an AACN Scholarship
Disinfectant Use Associated With COPD in Nurses
The Joint Commission Revises NPSG 7 Requirements
Guidelines: Noninvasive Ventilation for Acute Respiratory Failure
High-Risk Vascular Surgeries and Postoperative Myocardial Infarction
FDA Clears MRI System for Premature Babies
New Assay Can Distinguish Bacterial From Viral Infections
Missions of Mercy
How Hospitals Can Save Without Sacrificing Care
DNA Cancer Screening Shows Potential
Smartphone App May Help Screen for Pancreatic Cancer
Cardiologist-Intensivist Model Improves Outcomes
Social Media: Legal and Ethical Issues
Unused Opioids May Pose Health Hazard
AACN’s Facebook Community Weighs In
Conscientious ‘Nudges’ Can Help Patients and Families
Helping ICU Patients With Spiritual Needs
In Our Journals
Transitions
President’s Note
Bold Voices - December 2017 - Cover1
Bold Voices - December 2017 - Cover2
Bold Voices - December 2017 - Pres Note Front Teaser
Bold Voices - December 2017 - Masthead
Bold Voices - December 2017 - NTI 2018: Make Your Case for Attending and Register by December
Bold Voices - December 2017 - Certified Nurses Day 2018
Bold Voices - December 2017 - The Spirit of Giving: One Certified Nurse’s Contributions
Bold Voices - December 2017 - Invest in Yourself With an AACN Scholarship
Bold Voices - December 2017 - The Joint Commission Revises NPSG 7 Requirements
Bold Voices - December 2017 - High-Risk Vascular Surgeries and Postoperative Myocardial Infarction
Bold Voices - December 2017 - New Assay Can Distinguish Bacterial From Viral Infections
Bold Voices - December 2017 - 12
Bold Voices - December 2017 - 13
Bold Voices - December 2017 - How Hospitals Can Save Without Sacrificing Care
Bold Voices - December 2017 - Smartphone App May Help Screen for Pancreatic Cancer
Bold Voices - December 2017 - Social Media: Legal and Ethical Issues
Bold Voices - December 2017 - Unused Opioids May Pose Health Hazard
Bold Voices - December 2017 - 18
Bold Voices - December 2017 - 19
Bold Voices - December 2017 - Transitions
Bold Voices - December 2017 - 21
Bold Voices - December 2017 - President’s Note
Bold Voices - December 2017 - Cover3
Bold Voices - December 2017 - Cover4
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