Leaving Acute Care

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Today we had Koew Min Gai for breakfast. I skyped the granddaughters this morning and showed them my breakfast. Angel wanted to know why I was eating that food for breakfast. I explained that in Thailand they do not have pancakes, waffles, cereal and toast for breakfast. She said she likes England better but what is funny is she was too little to even remember England. I guess she just likes her American breakfast food. The girls also had difficulty understanding how it was morning for me when they were getting ready to eat dinner. Oh, how I miss them.

This morning was cold. It was drizzling and slightly windy. The hospital is open space and there is no heat. I had wished that I had brought a sweater or something because it was chilly. As soon as we arrived at the hospital 6 of the students went to the OR for the morning. They had a great time. Several of the students observed a brain surgery and per surgeon request, scrubbed in and assisted him as he instructed. I spent the morning in trauma this morning. We had a good day. The student was able to insert an NGT, redressed 2 wounds “Thai” style, drew blood for lab work, observed burn dressings with debridement, observed 1 bottle chest tube with water seal and a foley catheter insertion “Thai” style. While on the unit we were asked to work with a new transfer patient from ICU. He was American and was in a motor vehicle accident. He had multiple rib fractures, lung contusions, collapsed lungs, open fracture of the patella and multiple lacerations. He has no family in Thailand so they are concerned about his discharge as someone will need to care for him. I obtained a medical history, explained his injuries, his surgery, the procedures, pulmonary exercises, leg exercises and obtained informed consent.

Around noon we all went to the walking street market that is set up outside the hospital every Friday. Students found some good deals. Many of the students bought food and ate as they shopped. I found a good deal on elephant pants. Put in your "color" order.

The afternoon was spent in post-conference. I was so proud of the students. The students on each of the units presented a 2-patient case study by PowerPoint. Each student presented their patient, what they learned from this case and compared/contrasted to the USA. We found out that the reason nurses do not liberally administer pain medications is because they do not want the medicine to interfere with their assessment findings. Following their presentation, a formal evaluation session was held. Students were culturally sensitive and very positive. Students addressed the sense of community, the willingness of the staff to teach and nurture each student and the resourcefulness that was evident in the doctors and nurses. Once again, the students did an excellent job.

For dinner the students ate rice, salad rolls, and sweet and sour chicken. The faculty had steamed crabs from the south and my favorite Vietnamese. The students did not have much turn around before they had to leave with their Thai buddy for the Night Safari. Everyone was looking forward to tonight. It is cold, damp and raining so I hope no one ends up getting sick because of the weather changes. Greg and I stayed behind so that we could get ourselves ready for tomorrow. Tomorrow we leave for Nan province for a Sunday wedding. Nan is about 4-5 hours from Chiang Mai so we will have to stay overnight because the wedding begins Sunday at 7 am. So, good night everyone.

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