Women's health be damned!

I have discovered urgent care. Unlike most of women’s health, which requires building a patient relationship and then hounding the patient relentlessly about healthy habits, urgent care is a gritty, short-term relationship with immediate gratification at the end. No hounding involved. Granted, some of the skills I have acquired would not be a nurse’s responsibility in the states, but I can still boast about each of my new skills like a Girl Scout with new merit badges.

Two weeks ago it was EKGs (electrocardiogram – but ‘cardio’ begins with a ‘k’ in German). The French radiologist gave me a 10-minute refresher lesson and then I was the go-to girl for EKGs for a week while the usual nurse was out. This included my doing an EKG on a dead woman because the family was skeptical that she was actually dead. Though I’m only marginally passable at actually interpreting the test result, the machine does some of that, so it’s possible to have a ballpark idea of the seriousness of the person’s problem before she even has her clothes back on.

Last week it was lung puncture (bottom of the fifth intercostal space, otherwise you’ll knick the nerve!). In this case, it was to confirm the diagnosis of pulmonary tuberculosis (PTB). The doctors got a kick out of handing the reins over to me, and have initiated me into medical school culture by insisting that I buy them a snack after the procedure, kinda like throwing my own ‘congratulations’ party. Again, very immediately satisfying; hay-colored fluid is enough to confirm PTB; then we send the patient off to discuss TB treatment with the direct observational therapy (DOTS) nurse.

This week, my badge is in assisting with minor surgical procedures. One was a sebaceous cystectomy on the patient’s right pinky finger. The doctor was in charge of cutting and I was the blood mopper. The doc cut the cyst open, gave it a squeeze, and the gunk oozed out – it was gross and fascinating at the same time. It took about 30 minutes of mopping and squeezing, but we got the cyst drained and then sewn back up again.

Probably the most common minor surgical procedure in the clinic is draining abscesses. This usually involves my helping to hold the patient down because he’s writhing in pain, but I aspire to be the one to cause the writhing and subsequent draining of said abscess. These are a bit less quick to resolve, as it can take days to weeks for the infection to respond to antibiotics and then for the body to drain the abscess. However, abscesses have a really good ‘gross’ factor, so that compensates for the delay in gratification.

Future badges include suturing, wound dressing, and venipuncture. And I thought I had come to Nepal to teach!