Critical Thinking 101

Year after year in nursing school we are told to use our critical thinking skills. Ya ya we can all say we know how to critical think, well at least I thought I did….until I worked as a nurse in a clinic in Haiti.

Then my opinion changed.

Critical thinking is not having the right drugs/dosages and having to make do with what you have.

Critical thinking is not having a sharps container to put your old needles in and having to make your own “sharps container.”

Critical thinking is not having the best wound care supplies and using whatever you have.

Critical thinking is not having the right needle sizes.

Critical thinking is telling that mother whose breast milk has dried up that until she starts Medika Mamba (Haitian malnutrition program) she should add any type of oil to her mixture that she makes for the baby to add fat to the babies diet. (We had 2 babies come in super malnourished one that was 8 months weighing roughly 6 pounds)

Critical thinking is not speaking the same language and knowing that ¾ of your patients can’t read or write and explaining how to take 5 different medications without writing it down.

Critical thinking is explaining how to take a medication when almost no one carries  a watch around and most people don’t have 3 meals day, so instead using when you get up and before you go to bed even though that might not be the best way to take the pills.

Things that we would never think of doing in the hospital are done each day in third world countries because it is all they have and resources can be scarce. An example of what would make most health care professionals cringe at home; reusing gloves and medication cups because there is not enough to switch between each patient.

I was able to see things that in Canada I would probably never see, example scabies and tinea capitus which is very common in children in Haiti.

It scared me to think that when these patients were handed their drugs they may not remember how to take them when they get home.

Food for thought…Having 30 sick children and their parents waiting in this small, hot room and having 2 tiny rooms that include a triage area, two examining areas for the doctors and an area to administer medications. The one room is fully open and everyone can hear what you are saying…all privacy is out the window.

Close your eyes for a minute and imagine this. You are in labour and you arrive to the clinic fully dilated either by motorbike or walking...you have your baby in this tiny, tiny hot room with lot’s of people…about an hour later you deliver your baby with no pain medication…and then about 2 hours later you hop off the bed, put your clothes on, pick up your baby and ride off on a motorcycle.  This is a true story that we encountered on our trip and I tell you this woman is an inspiration. I honestly don’t know how many of us would say we could do that…

As a nursing student from a first world country I would have to say I am pretty darn lucky to have all the supplies and resources I need to give the best care possible to my patient’s. For all those nurses in third world countries…thank you! You are an inspiration to all of us nurses back home and you truly know the meaning of critical thinking and making do with what you have!

Again I am moved by the Haitian people and their resilience and inspired to make a difference!