Fieldset
Nursing in Pakistan: We got that ECG done!

Annke is a nurse from South Africa. She's recently joined the team in Pakistan, where she's finding that sometimes words are not needed...

The Emergency Room is a large, busy place. It’s like a well-oiled machine that huffs and puffs with patients, attendants and staff flowing in and out of rooms and through gates in a rhythm that tells the story of twenty thousand patients being given care in a month.

When I arrived I was given a short introduction to all the different rooms in the ER. We started with the Triage Room, where all the patients start their journey, and went all the way to the exit gate where the friendly watchman opens the gate to let you out, back onto the main road.                             

I also got to meet the team of nurses. It was a sea of unfamiliar names and new faces! To put names to faces is not easy for me. My pocket-sized orange notebook quickly filled with names and shifts and recognisable traits to help me remember the names of the staff, all 64 of them!

Annke and the ER team

Annke with some of the ER staff at the ER entrance.

This ER uses the South African Triage Score (I am proud to say as I am South African!) to score the patients that come to use the service. This system ensures that patients receive the right kind of medical help in the right way.

Patients who have a score of seven or higher are sent to the Red Room immediately. This room is equipped to treat critically ill patients and it looks like a small two-bed intensive care unit, with electronic monitors and emergency equipment.

I spent much of the first few weeks in the Red Room, because it was the most familiar to me. My clinical background is in intensive care nursing. The sheer volume of patients this ER team cared for in that first month left me a bit overwhelmed (but quietly very impressed).

An elderly lady was brought in with a chest condition. She urgently needed an ECG...

The staff here in the ER can communicate well in English, but the patients and their attendants speak mostly Pashtu. One very hot day, I was helping out in the Red Room when an elderly lady was brought in with a chest condition. She urgently needed an ECG.

The culture here dictates that a female staff member is to attend to a female patient when a nursing procedure needs to be performed that will expose the patient (like putting the ECG leads on the chest). This woman was very restless and would not keep still for long enough to get a proper tracing on the machine.

The need for care and the appreciation of receiving help does not need a word to be spoken, or a word to be understood...

After many minutes the two women who had arrived with the patient and I all had sweat running rivulets down our faces, as we tried to keep the patient still. We smiled at each other as I tried to explain with gestures how we could work together to keep the patient from moving too much.

At that moment I realised that the need for care and the appreciation of receiving help does not need a word to be spoken, or a word to be understood. We all care for our people and we want them to get help when they need it. I just smiled at the two ladies and they smiled back and we got that ECG done!