In the Médecins Sans Frontières/Doctors Without Borders (MSF) hospital paediatric intensive care unit (ICU), Noami and the multi-disciplinary team treat young children with life-threatening conditions such as severe pneumonia, meningitis, septic and hypovolemic shock, while also involving their families in their child’s care.
“The best thing about being a nurse is connecting with patients, with their family and helping them in their bad times when they need us the most,” says Noami.
“We involve them in everything from the beginning. With patient feeding, we involve the mother all the time because they need to know how to feed the baby. We explain to the patient, mother and family - fathers also.
“Last year there was a patient with meningitis. She was admitted into our hospital and she was dying. And we were [initially] going to give her palliative discharge. But we tried [to treat her]. Her father was there. We involved him in our treatment. He was constantly sitting with us, helping with the baby’s positioning and everything.
“And after 23 days, she healed and she went home. It’s a very successful story for me.”
When parents and patients might be struggling psychologically, Noami draws on the support of the mental health team, who can help them manage their tension, worry or grief.
Everyone in the ICU can be deeply affected. “The hardest thing being a nurse is when you are seeing people dying,” says Noami. “This is really painful for us.”
Skilling up to provide critical care
“In ICU there are so many critical patients. We have ten beds and two isolation beds, and we are almost full every time. We are giving cardiopulmonary resuscitation (CPR), Ambu ventilation [manual ventilation using a bag-valve-mask]. So this is different to the normal ward.”
With only basic nursing training behind them, Noami and her colleagues have welcomed training in paediatric emergency care and in the use of CPAP (continuous positive airway pressure), which is especially useful to treat respiratory distress.
“Before [having the] CPAP machine it was really difficult to continue with treatment,” explains Noami. “But after CPAP, patients are now getting better in two or three days.”