Nursing Prac begins for UQ students in Cambodia

Day 6 – Tuesday

Today was our second day out on prac and after a not so confident day on Monday we were feeling more self- assured and ready to take on the challenges of the day ahead. After another delicious breakfast the groups dispersed to the different clinics once more. Upon arriving at the clinic we completed a quick run- through of the new medical assessment forms that we were to be using to assess the patients as they arrived at the clinic.

These forms were to be used to assist the doctor and nurses in the clinic by reducing the amount of time taken for each patient consultation as the initial patient assessment and patient observations would already be completed by the time they reached the consultation stage. As a patient arrived at the clinic we would use a translator to ask the patients questions about why they were there, how long they had been experiencing their problem for, whether they had been treated for the same problem in the past and we would do a basic assessment such as blood pressure, temperature, pulse rate and respiratory assessment.

All of this information would then be recorded on the medical assessment form and the patient would give it to the nurse or doctor when it was their turn for a consultation. Using this system made it easier for us to assess each patient as we were able to have direction not only with what we needed to do overall but also with the individual questions that we needed to ask each person based on the problem they were having. It also gave us the opportunity to have an attempt at possibly diagnosing the problem and then checking our thoughts against the doctor’s thoughts. At 10.30, Amy, Jane and Abi headed off to do education with the staff of the SHCC School.

Today they were teaching sanitation and a bit of basic first aid. Maddie C and I stayed at the clinic and split between doing triage and sitting in with the doctor for consultations. That afternoon after lunch Maddie and I continued health assessments in the clinic whilst Abi, Amy and Jane taught some of the children from SHCC some basic hand washing techniques and also basic wound cleaning.

The children often become distracted easily so the girls also played games with them throughout the lesson to keep them enthusiastic and willing to learn. Overall it was a better day then Monday and on our way home we passed a official wedding tent being set up for a wedding which was to take place the next day, we got very excited about that because we had never seen an official Khmer wedding before. That night we all went and had Indian at Curry Walla…. delicious!!! Day 7 – Wednesday

Third day on prac. On our way to the clinic today we noticed that the festivities for the weeding had already started and people were cooking and preparing the tent for the many people who were to arrive. Today was an extremely busy day as there seemed to be a large amount of people at the clinic all day which was great because it ment more people that we could possibly help. As it is the Cambodian winter (even though it still reaches 30°C) a lot of the people coming in for themselves or their children tend to have colds or chest infections just like we would get during winter in Australia.

The majority of people do not have the proper clothing or blankets to keep them sufficiently warm at night time and often get sick quite easily. One of the things that I also notice at the clinic is that the large majority of people do not come in straight away when they have a problem and tend to put off coming to the clinic for up to a month, which is sometimes the case in Australia, however personally when I know that I’m getting sick I try and get on top of it straight away.

Today it was Maddie and my turn to deliver the education session for the SHCC staff. Today’s topic was Lifting and Moving as well as the stretches to complete before and after lifting or moving heavy objects. We made the class interactive and showed them how to first complete a full body stretch. We then asked them to show us how they lift a variety of objects and got them to discuss if they thought anything could be changed. After they gave us their example of lifting the objects we then discussed with them the proper technique of not only lifting heavy objects but also lifting light objects as proper technique is required for both to reduce incidence of injury.

We then asked them to lift a variety of objects using their newly learnt technique and quizzed them on the reasons why it was important to lift and move things correctly. It was extremely satisfying to hear them getting the answers to our questions right as it ment that they were actually absorbing the knowledge. At 11.30, Abi, Jane and Amy arrived at the Khmer house where we have lunch and we all helped to prepare the meals, it is really interesting to see the difference between the Australian cooking set up compared to the Cambodian cooking area.

For starters the Cambodian cooking area at most houses is outside which is really crazy considering how much food actually gets prepared in this area. After lunch we headed back to the clinic and Maddie and I taught a new group of kids from SHCC basic hand washing and wound cleaning whilst Abi, Amy and Jane worked in the clinic. The children left rather early today however during the class to the children we gained a group of women who were eager to learn from us. Maddie and I, with the help of a translator, gave the women a quick run down on the lifting and moving class that we had taught previously that morning and Abi gave them a class on rubbish collection and composting which was the personal topic of her own that she had prepared before leaving Australia (each one of us had to prepare one topic to present during the lunch breaks throughout our prac).

The women seemed to really enjoy these lessons and listened intently throughout the whole session. That afternoon on our way home we were getting all excited to see the wedding when we discovered that it had already finished…. Hopefully we will have a chance to see another one. Day 8 – Thursday Today was our final day on our first rotation for our placement. By this point we had grown so attached to the Krabei Riel Clinic that we did not want to leave, it’s such a great atmosphere at the clinic and so welcoming it was such a pleasure working there. Today’s day had the same structure as the previous days however today Abi, Jane and Amy were completing the education session. Today’s session was on Diabetes, which happens to be a prevalent disease in this country however there is also a lack of basic knowledge on this topic that prevents the detection and treatment of the disease leaving many people untreated and open to the wide variety of complications that it can cause.

While the girls were out doing the education session, Maddie and I got to complete our first intramuscular injections of the placement (which was really exciting!!!!). They were both tetanus vaccinations for adults and Maddie and I were both quite nervous as it was Maddie’s first IM injection and I had not completed one for quite a long time. One thing we realized quickly when giving the injection was that a Cambodian person’s skin is noticeably thicker then our own making it harder to get the needle in initially.

Peta told us that this was because of their constant exposure to the sun, which made a lot of sense and gave us something to work on for the next time that we had the opportunity to give a needle. Just after I gave the needle to my patient I learnt that she was pregnant with TWINS! Which was something I had not come across yet during our week in the clinic. She was 4 months along and this would be here third and fourth babies. I had been hoping to practice my skills with using a pinnard ( non- electrical tool used to listen to babies heart beats within the uterus) and after asking permission from the patient the next thing I knew I was trying to find the twins heartbeats, I was so excited but also unsure of the proper technique as I had only used an electric doppler in Australia.

Unfortunately the twins were moving around too much for me to find hear the heartbeat clearly however I was glad I got the opportunity to try and hopefully I’ll get to practice again before the end of the placement. Our last afternoon in the clinic was extremely busy and hectic and after saying our good byes to the SHCC and clinic staff that we could now call friends we headed back to Jasmine Lodge for a much needed rest. That night Amy, Leselle, Maddie D, Jane, Jess and I all headed to A Viva for an amazing Mexican Dinner followed by a shopping session at Centre Market where we met up with Anna and Katie. That night I went to sleep reflecting on the week that had been and looking forward to out trip to Phnom Penh that was to occur the next day…