The Nurse On-Call

Preparing our patient for transport to Australia

I was jarred awake by the jingling of the on-call radio. I fumbled for the light with one hand and the radio with the other. Blearily I looked at my watch; 2:30 A.M.. I pressed the button to talk on the radio, “This is the nurse on call.” I waited for the crackly response over the radio. A response came through and I asked where I could call them and ended the radio call. Throwing back the blankets I hauled myself up and stumbled to the phone to find out what was going on. I called the number I was given and heard the brief story from the patient’s father. At the clinic we’d been monitoring his daughter over the last few days for suspected pneumonia. Over the course of the night she’d begun to decline and now was struggling to breathe with decreasing oxygen saturation. Now, he wanted to know what he should do. I ended the call with a promise to call back in a few minutes and I called the doctor on-call with me over the weekend. He was already up and had been mulling over the case for hours. He decided we needed to bring the little girl to the clinic and determine if she would need to be evacuated to Australia for further medical care. The next few minutes found me calling the patient’s Dad and asking him to bring his daughter to the clinic, calling the “ambulance” driver to pick me up and take me to the clinic and pulling on clothes and trying to gather my wits coming out of a dead sleep.

As the ambulance driver and I pulled up to the clinic the flurry of activity began. The on-call doctor had arrived, followed closely by our pediatrician who had brought the patient and her father. Then our lab specialist arrived and we began assessing the patient, taking vital signs, running tests, getting blood samples and x-rays and generally working hard to determine what the root of this little girl’s problem was and if we’d be able to treat her. Within an hour we’d exhausted the limits of our diagnostic resources and determined that her condition was deteriorating enough that she would need to be medevaced to Australia. I began preparing everything needed for the medevac as calls were made to various departments and to Australia to get the medevac approved and rolling. I would not be going since I’d been on the last medevac and because the other two doctors and I had been up most of the night with the patient. So, I prepared, waited, gave report to the nurse who was going to be accompanying the patient and handed everything off.

Me and my on-call radio ready for action

Just as the soft pink of dawn was tinting the deep purple of the twilight of early morning I slid the key of my apartment into the lock and stepped back into my home. What a night. I fell exhausted into my bed and prayed for our patient as I waited for the sound of the airplane that would carry her to Australia. Before I came to Papua New Guinea (PNG) I had worked on-call when I was a home health case manager. However, when you add the dynamics of living in a country like PNG, on-call is a whole new ball game. You can have everything from kids with fevers, to translators working in villages with potential injuries that you are trying to screen over the phone and determine with the doctor what should and can be done. Now, don’t misunderstand. Sometimes when I am on call the radio is as silent as a church mouse. Other times I get calls in the middle of the night and end up going to the clinic for the rest of the night like the one I’d just returned from. It’s a game of chance. It’s also just part of being a nurse here in PNG in a missions context.  It’s stretching, exciting, frustrating, exhausting and exhilarating. As one of the doctors here says, a typical day can either be sheer terror or utter boredom, and it’s true. However, I’m so grateful that God has placed me here and allows me to be a part of the care of those He’s sent to serve here in PNG. So, here’s signing off, from the nurse on-call.