Today we went to Hospital Escuintla approximately 45 minutes
from Antigua. We were greeted with open arms by an amazing array of staff
including a beyond gracious, dedicated physician, Dr. Willy Melendez. We then received
a thorough presentation about the hospital, followed by an extensive tour. I knew
it would reinforce how extremely fortunate and spoiled I am in all aspects of
life, particularly work, but didn’t realize the life-changing magnitude until
this visit. Started in the ED, the first place on our tour. Escuintla’s pediatric
ED is approximately the size of the two stabilization rooms of the 33 bed ED I
currently work in. Census of five patients while we were there with only two
beds. Multiple patients share beds and/or make shift beds are created with
whatever is available. This includes everything from a two-tiered service cart
to a parent’s lap. Furthermore, there was only one code cart with outdated monitor/defibrillator
including paddles and sparse medication supply. The ED I work in has a 3:4
patient ratio in most areas. At Hospital Escuintla days and evenings have 1:2 RNs for the entire department. Overnight (my shift)
consists of one RN with no ceiling on patient volume. Essentially however many
patients can be crammed into the ED at any given time.
Regarding the remainder of the hospital, inspired by
virtually everything else on the tour today. Highlights included immense overwhelming
gratitude of staff, patients and families despite having so little. In
addition, the dedication to patient care and drive for positive change was
great to see. It was incredible to witness improvements made including a new
NICU and PICU. The old vs new per previous trip participants, hospital staff and
the tour was night and day. Furthermore, we saw nurse patient ratios of 1:2 on
all shifts, in both departments. In addition, hand hygiene initiative including
two sinks with soap in the PICU. Also, the first Purell hand sanitizer dispenser
was recently installed.
Despite the inspiration, there are still multiple hurdles to
overcome including overall hospital sanitation. A stairwell that was supposed
to be yellow was brown from the dirt present. Birds with their feather remnants
inside on the same floor many patients and families sit on waiting to receive
various services. Also, there were bats on the walls, open large food
containers on cart that roams the hospital to deliver meals, open specimen cup
containing urine on sink at handwashing station, and large trash containers in
the hallways of the units. Enclosed some pictures. Forgive my poor photography
skills. Remember I’m an ED RN, not a photographer. Motivation, gratitude and
love at an all-time high. Looking forward to returning home with plan in place of
directing personal efforts to improve health care and overall quality of life in
Guatemala.
- Mel Flynn
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