A bit out of my league!

So this past week, I was again on a stretch of night shifts. I went into them anticipating great nights, becuase most of the B ward patients were hernia patients who wouldn't require much during the night hours. If I only knew that I would actually be on C Ward, which is our overflow unit, which is currently populated with Maxillofacial patients.

To say the least, I was out of my comfort zone. I had gotten used to and quite comfortable with all the general patients and even the plastics patients, but hadn't yet cared for a max-fac patient. The first night I was actually split between B and C ward, and I was thankful that the C ward patients I had were a few days out from their surgery dates and generally slept through the night. Three of the patients had had ICBG surgery.
That stands for ileac crest bone graft. Patients who have facial tumors removed from the lower portion of their jaws often also require mandiblectomies (or removal of the mandible or lower jaw). During that initial operation, metal plates are placed to create a new jaw and then after that initial surgery heals, the patient returns to have the bone graft. Bone is taken from the top of the hip bone and manipulated and placed onto the metal plate to provide added strength to the plate. This is necessary so that the person will be able to chew and eat as one with a normal jawbone would be able to. These patients, as can be imagined, have alot of pain and actually require bupivicaine injections into the hip for a few days post op, in addition to oral analgesia to help with the jaw pain. I also had a baby who was post op day 1 after having a cleft lip repair. This baby required scheduled pain medication during the night but otherwise slept. So all in all it was a great night.

On the third night of my stretch, I was placed solely in C ward and had 10 max-fac patients to care for myself.  What a challenge! I felt so overwhelmed when getting handover, firstly because they were all max-fac, secondly because I was by myself, and thirdly because there were many things I was going to have to do that I haven't done yet while being here on the ship.
I had 5 ICBG patients, all in different postoperative stages, one still had her bupivicaine catheter in her hip.
One patient who was post op a hemimandibulectomy (portion of mandible removed). She had a cancerous tumor which had been removed. After surgery, she had some issues with healing and developed some necrotic tissue and nerve exposure. She was experiencing alot of pain and may eventually need to go back to the OR. She had an NGT for liquid feedings.
There was another patient who had a displaced jaw and was post op (I forget the name of the procedure). During her immediate post op period, however, she was unable to swallow meds and ended up needed a nasogastric tube for medication administration.
I had a pre op cleft lip repair baby and a post op cleft lip baby, who had just had surgery that day.
My last patient was a young girl who had a supraorbital mass that was going to be removed the next day.

Sounds busy enough, right?! I asked the Lord for grace for the night and I'm so glad He was with me along the way. It was one crazy night! It was the first night where I didn't get tired or had time to sit. It was go go go all night. Pain meds here, pain meds there, feedings for this baby, oral rehydration for this patient, NGT feed for that patient, preop washes for the preop patients, starting IV fluids on this patient, more pain meds here, vital signs on all of them and those who were postop only 1 or 2 days, it was vital signs every 4 hours. I had one patient who started vomiting. Another choked on his meds. It was quite the night. I thank the Lord He helped me through.

I was able to witness and can with confidence say that He never gives us more than we can handle. Mother Theresa once said, “I know God won't give me anything I can't handle. I just wish he didn't trust me so much.” I sort of felt this way, but remembered that not only does God not give us more than we can handle but He always is there to help us through. He never leaves us to do it by ourselves. How encouraging! So to all my fellow friends and readers, trust God and know that when the task ahead seems impossible or very difficult, know that we have a God who cares and who will never leave us on our own. He is with us each step of the way. Be encouraged!



Some of our cleft lip babies from C and D ward! I took care of the one with the balloon on my first night!! Cutie :)