Mama Tica went with me on the bus to the hospital in the morning for fear of me getting lost again, and I arrived right on time at 7. In the morning I went with Johnny, the purchasing/stock technician, and Dra. Méndez, the pharmacy director, to check the expiration dates of of all the "carros de paro" or our equivalent of crash carts, and to see what medications that are stocked on the floors but not being used. We went to all 5 crash carts, and all the floors to gather the unused medications. This process is repeated every 15 days. Here is a picture of one of their crash carts with the list of medications and their expiration dates on the top:
While on one of the floors, I believe it was the all-women's oncology floor, the director told me to go into one of the rooms (almost all are shared rooms with 4+ beds) to look at the view. In this particular room there was even a balcony for patients to walk out onto! Very different than our hospitals where the windows are sealed so that not a drop of fresh air can enter! Below are 2 pictures of the beautiful view from the hospital rooms.
When we finished, Johnny and I went to the pre-ante-room which down the hall from the pharmacy, to input into their computer system the extra unused medications we had collected from the floors. Below is a picture of Johnny inputing all of the quantities in to the system.
While we were inputing the data, Dra. Méndez came back to collect me to go to a video conference with her regarding the outbreak of cholera in nearby Panama. We went into a conference room on one of the floors where we were joined by nurses, doctors, and nursing students. The conference call was led by a doctor who works for La Caja, and all thirty public hospitals of La Caja were in attendance on the call. During the PowerPoint presentation, we went over what medications would be used as first, second, and third line for cholera, should any cases pop up in Costa Rica. First line treatment is doxycyclina, second line is Bactrim, and third line is clindamycina. As you can see, almost all of the generic names for medications are very similar to their English counterpart which makes my life much easier! We also went through the 3 phases of action they have laid out to try to prevent any cases of cholera in Costa Rica. Here is a photo I snuck of us in the room.
It was at this meeting that I first really noticed the huge amount of respect pharmacists have as healthcare professionals here. Aside from the fact that they are always referred to as "doctor" or "doctora", the trust other healthcare professionals have in pharmacists is palpable. For example, during the meeting, the doctor leading the call emphasized the importance of directing all questions that should arise regarding the cholera outbreak to the pharmacists at the respective hospitals. And it was Dra. Méndez whom everyone looked to at the end of the call when it was time for questions. At first I thought this might just be her reputation, or the experience she has, but after going to many other pharmacies around Costa Rica, I feel the same sense of respect in all the settings I have visited.
For lunch I went across the street to "El Solito," a small restaurant with food to go, and ordered a chicken/beef stir fry, rice, and picadillo which is a typical Costa Rican side of potatoes in a soup-like salsa. The food is delicious and I can't believe how cheap it is!
In the afternoon, I went with the IV pharmacist, Dr. Garro, to the clean room to prepare parenteral nutrition for the babies in the ICU at La Carit. It was very interesting to see how he went about doing all the calculations for all the additives and the large amount of mathematical prep work that we did before getting dressed for the clean room. At La Carit, pharmacists are the only healthcare professionals that can make the parenteral nutrition for the babies. After gathering everything we needed from the pre-ante-room, we went into the ante-room to scrub up. Dr. Garro explained that there is one cart that can go from the pre-ante-room to the ante-room, and another that can go from the ante-room to the IV room, but neither cart can go to all three rooms. We scrubbed up and entered the IV room. There were a few things we in the scrubbing up process that were different from what I've seen in hospitals in the US. The scrubs we put on were all made of cloth and reusable. They came wrapped in a towel with sterile tape holding it together, and inside were booties, pants, and a long robe to put on over our clothes. The hats and masks were disposable. There was also nothing to dry your hands with but by the time we put all of our clothing on, our hands were dry. It was very interesting watching him make the parenteral nutrition and preparing the lipids. His technique was, in my opinion, impeccable, and I could tell he had been doing this for a while. He explained that his shift was 2-10 PM each day, with the first part of his shift involving preparation of the parenterals for all of doses for the following day. I asked if they make parenteral IVs for the other patients in this room, and he explained no that they only prepare parenteral nutrition in this room, not parenteral medicines. I asked what happens if he is sick or on his days off, and he said one of the other pharmacists fills in.
I went home on the bus and on foot without any problems at all and arrived home in less than 1 hour! For dinner we had fish, rice & beans (gallopinto or pinto), platanos maduros, and salad. Another great day!
No comments:
Post a Comment