I am finally in my last week I Ghana, time seems to have flown by now that I am days away from going home.
My time on the children’s ward was a good experience, I managed to see a lot and learn how nursing care is carried out.
We are able to do spoke placements while we are here, and one that is popular with other students is the mother and baby HIV clinic which is on a Wednesday, I have been to this clinic twice now and plan to go back tomorrow as I have really enjoyed my experience there. All patients attending the clinic has to have their height and weight checked and also blood pressure, as soon as I arrived there on my first day they put me in a room and I was to do the blood pressures, this is always done manually and I can only describe it as a conveyor belt of patients coming to have their blood pressure checked and written down on a scrap peice of cardboard. This has helped me a great deal with my manual blood pressure skills and I feel a lot more confident now. The mother’s and babies sit in the waiting area and a nurse speaks to them about HIV and the medication required, nutrition and family planning. They were very kind and spoke in English so I could understand, the relationship between the nurse and the mother’s was incredible, they had a bond and it was kept quite light hearted even though it is a serious subject. They then go to collect their medication and some babies have the blood spot test done to see if they have HIV from their mothers. They also carry out counselling sessions to all patients who come to the clinic, they are very empowering nurses which was a joy to see and experience. I am looking forward to going back this week and learning more.

I did get the opportunity to visit the mourge at the hospital, I have not been to visit one before so I had not idea what to expect, four of us went after our shift and we all took face masks, the staff at the mourge were very accommodating, it is as if they enjoy showing people around their place of work. I won’t go into too much detail as I am aware it isn’t a nice subject but nothing could have prepared me for what I saw, the smell was indescribable and there were bodies piled up everywhere, the staff were injecting the bodies to preserve them and Vaseline is put on the faces. We looked into the cold room which had a couple of hundred bodies in all piled 4 or 5 high, I did take some photos which I still can’t look at now and that night I had to sleep with the light on, it is something that will always stick in my mind. One of the girls was unable to come with us but wanted to visit, even though I wasn’t dealing with what I had seen too well i did not want her to go on her own, So I offered to go back the next week. The staff thought I was crazy for coming back, but we’re happy for us to look around. This time the mourge was a lot more organised, earlier in the week there had been a peer review at the hospital which meant that inspectors came round and the hospital was graded, the staff described this to me as a competition between hospitals, I saw it more like when a hospital has a visit from CQC. This time in the mourge I felt much more in control of my feelings and when invited to go all the way inside the cold room I did, stood there with hundreds of bodies around me was an experience I will never have again but it did help me a great deal, I feel that revisiting it has made me at peace with what I saw and I can now talk about it and I am proud of myself for going back to help a fellow student nurse.

Onto happier things, I started my 2 weeks in NICU (Neonatal intensive care unit) last week, as soon as I stepped onto the unit and saw the babies I knew I had made the right choice to spend some time there, I have a great sense of ease and confidence around babies and this was reconfirmed to myself while working with the midwives, nurses and doctors. I really enjoyed my Neonatal placement at the start of my 2nd year at home and knew that at the back of my mind it is an area I would love to work in once I am a qualified nurse. Working in NICU here in Ghana this has made me realise it is where my heart lies, to help a baby to have the best possible start in life when they might have had such a tough beginning coming into the world is something I want to achieve and succeed in with my nursing career. The unit is run my midwives and doctors, there are sometimes nurses around too, the house officer and PA’s do the ward round in the morning then the Doctor comes onto the ward and they present each baby to her, this was quite an infuriating part of what I saw on the unit, the lack of confidence from the staff presenting each babies case to the Doctor was quite sad to see, she would ask questions about why the baby is cold and why is the baby not under the phototherepy lights, they would never have an answer, I would never judge how they work but it is a part that I struggled with because as a 3rd year student nurse these are things I picked up on and knew the answers to but it was never my place to speak up. The doctor teaches well and I have learnt a lot from her, any questions asked I would answer and if I wanted to know anything she would be happy to take the time to explain things to me. This is something that you don’t get with the midwives and nurses, as mentioned before they don’t teach but they will answer questions if you ask, I have found that it is about how you phrase the question for them to feel comfortable about answering it, this was to make sure they did not think I was questioning why there where doing things as if it was incorrect, I only asked questions to understand why and how they did procedures, I didn’t ever want them to think I was trying to change how they do things. It is important to remember that I am a guest in their country and place of work, I have always stayed true to who I am and what I have been trained and believe in, but I would never want them to think I was better than them. An example of this was when I was asked to feed a baby, he was abandoned by his mother at birth and the unit are looking after him until social welfare care find him a home, he is formula fed and this is done with a cup and spoon, I spoke to a midwife about why they do this and not bottle feed as the baby is old enough to feed from a bottle, she explained to me that if they were to bottle feed babies they would get the teat confused with the mother’s nipple when breastfeeding, we had a conversation about how at home we feed babies and she was interested to hear about it. In Ghana breast feeding exclusively is a must for the first 6 months of the babies life, there would have to be a very good reason for a mother to not breast feed and they would be looked down on in the local community by friends and family. It is also to do with the cost of buying formula due to many families not having the money to buy it.

As I come to the end of my time in Ghana I am feeling a little bit anxious about coming home, this has been my home for the past month and I have fitted quite well into the laid back and slow paced life here, I have missed so many people while I have been away but it has been worth the experience. It has been a pleasure to write my blogs, I am sure once I am at home I will write at least one more in reflection of my time here. I have more than exceeded my expectations of what I had expected from this elective placement and I would recommend it to anyone who was thinking about it, it certainly changes the way you think about not just nursing but also about life and how we take many things at home for granted, we are very lucky, but the great thing to see is that the people in Ghana are very humble and make the most of what they have got. They are a very laid back and a happy country who make people feel welcome and part of their community.

I would like to thank Work The World for making this placement possible, to my friends and family for their support, to everyone who helped me raise money and donated and last but not least the staff at Staffordshire University for their continuing support and feedback while I have been away.

I am writing this on the long journey back from Accra. I am already half way through my 4 week elective placement in Ghana, time is going by very quickly.
For my blog today I was wanting to focus more on life in Ghana and how I have felt while calling it my home.
The house that the students live in is amazing, very clean and has everything you need. I have a room to myself as there are so few of us in the house at the moment, I am in a bunk bed with a mosquito net over and I have my own bathroom with plenty of wardrobe space and a lockable box. There is no air conditioning in the house, I have a ceiling fan in my room which is sufficient, the nights can get warm when you’re trying to sleep but with placement I seem to sleep fine. There is no hot water but I actually appreciate a cold shower with it being so hot. We have to hand wash our clothes outside, but there is a lady that lives next door who will hand wash our clothes costing approx 20p an item, which I have taken full advantage of as I’m pretty sure I would do a terrible job myself.
We have 2 cooks who prepare our breakfast and evening meals from Monday to Friday, We normally have leftovers for our lunch or use some of the food in our kitchen to make our own meals, they are also very good at keeping the snacks cupboard filled well. Every Thursday there is a BBQ at the house, everyone sits together outside with the music on with the house staff and even the lady who washes our clothes has us up dancing to many well known European songs such as the Macarena and Saturday night. The house does have Wi-Fi, which, as we are all very reliant on is good to have, it can be very temperamental but we all appreciate having it. The hospital is about 10 minutes away from the house and we share a taxi each day which works out about £2 each way, most of the drivers know where we live and work so it is very easy to get about. The taxis aren’t as we know them back home, these are mainly very old cars and because the roads have many large speed bumps and pot holes the cars are damaged quite badly.
We are very lucky and have a seamstress who comes to the house once a week, she comes each Tuesday evening after dinner and we buy the fabric we want and she takes measurements and makes whatever you require, fabric shopping was so much fun, there are so many amazing patterns and styles of fabric, I could have bought them all, but I didn’t, I have an order for a summer dress and trousers for myself and also a few bags and purses as presents for when I am home. Within a week she has all of your items done and the price is reasonable and the quality of her work is brilliant. We also learn the local language once a week, I am terrible at this but I try my best as it is very much appreciated by the people of Ghana if you can speak some ‘Fante’, this week we even learnt a song.
The first weekend I was in Ghana, myself and 3 of the girls from the house went to a Lake, We booked a lodge and made the epic 6 hour journey there, the lodge was basic but we were all very excited about there being prawn curry on the menu, as we do eat a lot of chicken and goat at the house so the prawns were a nice change. The next morning we set off on a bit of a hike to a horse ranch by the lake, plenty of stunning views as we walked, but typically I had only brought flip flops to wear so I was filthy by the end of the day. We reached the ranch and were met by a French lady who owns and run the ranch which is also a lodge. They have 9 horses and you can ride for as short or long as you want. We chose to ride for 1 hour, I was a bit, actually very apprehensive about getting on a horse as it has been well over 10 years since I’d been horse riding, my horse Eclipse didn’t seem to like me much but once we set off I started to feel more comfortable, the views around the lake were stunning and I felt like Eclipse was starting to warm to, right up until the end when he got spooked and tried to buck me off, but I am here to tell the tale and now it’s in the past I really enjoyed it.

As I mentioned I am currently travelling back to the Work the World house from Accra, we left the house on Friday and made the 5 hour journey to Accra, this time just 3 of us, one of the girls was flying home on the Saturday night and we didn’t want her to travel on her own so we went with her to Accra with her and stayed over for 2 nights. The hotel was nice and I managed to have my 1st hot shower in 2 weeks, we had Wi-Fi and air conditioning in our rooms and even filter coffee with our breakfast, which made us all very happy. Yesterday the 3 of us ventured to James Town in Accra, we had a tour guide who took us to meet some of the children at the local school, the children are very friendly and want to hug you and hold your hand, they always want to have photos with you too. We spoke to some of the children that were having lessons there then we moved to the fishing village, this is the poorest part of Accra and I don’t think anything could have prepared me for the level of hard work and poverty that I saw, also a lot of fish. We all felt very privileged to go and see this community of fishermen, their wives and families, it really did leave a lasting impression on me. We then heading to the mall in Accra and the contrast of the way people live was shocking, from extreme poverty to how the rich live and shop. That night we said our goodbyes to one of the girls who flew home, even though I’ve only known her for 2 weeks, I am going to miss her. So as I write this travelling back there are 2 of us, with 2 other girls travelling somewhere else this weekend. I am now the only student nurse as all the other girls all training to be doctors, but it is nice to exchange views, skills and experiences between each other.
My next blog I will talk more about my experiences at the hospital as I did manage to visit the morgue, twice, and also be part of the mother and baby HIV clinic. Tomorrow I start my 2 weeks in NICU which I am looking forward too as I thoroughly enjoyed my Neonate placement in my 2nd year and it is an area I may pursue once I am qualified. Until next time I’ll say bye, once again thank you for reading my blog and I hope you are enjoying it. If you are on Twitter you can follow university account for my more regular updates with photos @A011340fKatie

Hello from Ghana. I have now been in Takoradi, Ghana for 10 days and I can’t quite believe how fast the time has gone and how much I have seen and experienced.
I arrived in Accra late Saturday night and was met by a Work the World representative Alhaassan, we took a short taxi ride to a local hotel to stay in before our long journey to the house in Takoradi the next day. The hotel was basic and adequate, I was exhausted from the travelling and managed to get a good night’s sleep even though everything was so unfamiliar to me.

The next morning myself Alhaassan set off to Takoradi, being in and amongst the local people while getting on the bus made me feel like this was going to defiantly be an adventure. After 5 hours on the bus I arrived at the Work the World house, the house can sleep up to 32 students so as you can imagine is a huge house. I initially met two of the girls who are from the Netherlands, with my tour of the house complete I was ready to relax. My room sleeps 4 people in 2 sets of bunk beds with an ensuite bathroom, I have this room to myself for the 4 weeks as there are so few of us here. All the beds have mosquito nets over them and a ceiling fan. The other three girls returned from their weekend away at the beach and I soon got to know them. Two British girls and a girl from Canada. It is just myself and one other who are student nurses, the others are student doctors.

My 1st day was an orientation of the hospital in the morning to meet the staff I would be working with while I am in Ghana. The hospital is much bigger than I had expected and I was introduced to many members the nursing team  on various wards including the children’s ward and Neonatal intensive care unit, My first impression was that everyone was very friendly towards me. I had a briefing and a tour of the local area later that day, there are some beautiful spots in Takoradi and also some extreme poverty. In my briefing I was told about the local culture and how to great people, this is something I have found very important, ensuring that you great everyone you meet with a good morning. I was also told to keep an open mind about that I will see on the wards and that the ‘caring’ side of nursing is very different to the culture of home. You should never wave with your left hand as it is considered as a person’s dirty hand.

My 1st day on the children’s ward was quite daunting, as with any 1st day on a new placement there is the anxiety of being new and not knowing anyone, this was on another level. The nursing staff don’t teach in Ghana, it will be the doctors that I will learn from, but I also feel that by observing and asking questions the nurses have grown to like me and see me as a part of their team. Out of respect I am to address the female staff as Aunty or Sister and they call foreign people ‘Oburoni’, this isn’t meant as an insult and I have quickly learnt to respond to this when they call me to assist. The ward had capacity for approximately 40 children with two isolation rooms, there are normally two sister’s and two nurses on shift at one time, I did speak to a nurse who told that that when you are newly qualified you can be responsible for up to 30 patients. The nursing staff do not have patients assigned to them, I’m still trying to understand who takes responsibly for what, as there doesn’t seem to be much structure or delegation. I will say that team work is very strong and they do work together well. Many of the cases I have seen have been malaria, with a few cases of sickle cell and meningitis. The healthcare system is very different and the lack of money is very obvious by the lack of equipment in the hospital. When I child is admitted onto the ward they are then prescided the medication needed and the parent has to take the patient folder to the pharmacy to collect the medication to bring back to the nurses who then administer it, This can be at the nurses station, the patient bedside or just wherever the patient is.

The hardest part so far is when a child has blood taken or they are canulated, this is done by the nurses mainly and is an example of how we at home do things very differently, the needle size depends on what is available and the cuff of the gloves is used as a torneque, the parent is asked to hold the child down and squeeze the arm or leg to assist the nurse, a child can be screaming and kicking and this is deemed normal, they will have many attempts with the same needle and I have seen them try up to 15 times on one child. This is when I realised during my training at Staffordshire University and while on placement at home I have learnt best practice and distraction techniques, it makes me appreciate the resources and specialist staff we have to ensure a child is at ease as they can be, it is also something I have stayed true to. Over here I am still the person who comforts a child and wipes their tears, reassuring them and trying to care as much as I can, I believe that the 6 C’s are running through my veins are are truly a part of who I am. This does not mean how the staff her do things are bad practice, this is how in their culture they have and will continue to do things their way, all I can do is be myself and let them see how I carry myself as a student nurse and represent Staffordshire university, we recognise bad practice but who is to say that over here things are being done incorrectly?

The level of treatment and care that is given all depends on how much money a patient and their family has, for example a CT scan can cost up to £100 and in Ghana that is a lot of money, if a family cannot afford it they will not get the treatment.
All medical notes are written in English and one thing that is very similar to how we write at home is the terminology, if someone was to read the nursing or doctors notes here you could be mistaken to reading notes from home, this does make me wonder is the level of treatment and care down to lack of money and resources?

So far my experiences have made me greatly appreciate what I have learnt so far in my nurse training and it has also made me realise that I have learnt a great deal already, without thinking about it I can recognise a deteriorating child, I always have best practice in the back of my mind and I am constantly aware of what is going on around me including correct documentation.

I am enjoying this experience and I am looking forward to what comes next, with a trip to the mourge planned and time in the mother and baby HIV clinic I am sure there is a lot more to learn.

On a final note I am grateful for this opportunity and how the nurses and doctors have allowed me to interrogate into their team on the ward and answering my questions honeslty and professionally.

Until next time I thank you for taking the time to read my blog.