I wish someone had been there to see this

     Being a visiting nurse is what I did for a long time before I came here, so it feels familiar and comfortable.

     And I like familiar and comfortable, because so often in my life here, I'm not sure of things. I know what I would do back home, or I know what my past experience tells me makes sense, but this isn't back home and often things that make sense there don't make sense here. So even in that familiar role as a visiting nurse, there are countless challenges and moments of confusion and doubt.

     But some things are clear. When a child who has had surgery needs her bandages changed every couple of days, that's pretty straight-forward. There is room for improvisation within the general principles of what should be done, but there are those general principles, and they seem clear and obvious and without need for cultural considerations. Take off the old bandages, clean the wound, put on the new bandages. A simple, technical task.

     Back in in my VNA days, we all entertained ourselves and each other with tales of odd things that would happen in home visits. Everyone had stories of challenging situations, surreal environments, and general WTF moments. I have my share of stories. And now I can add to them. Here was my "only in Cambodia" moment of the week:

     I went with the translator to the home of one of our kids who had surgery last week. The first thing that caught my attention was his announcement that the girl would be at home waiting for us, but her parents wouldn't be there because they were out harvesting their rice crop. Which doesn't sound so odd, except when you realize that this meant she was home alone all day, unable to walk or move around. No neighbor or grandma standing by to take care of her or bring her food and drink or carry her somewhere when she had to pee.

     So we arrived that morning, and there she was, under the stilted house, lying on something that looks sort of like a very rustic dining room table, cobbled together out of random boards and bits of bamboo, with a few stray nails poking out here and there. I was relieved to see that she wasn't exactly alone: there were half a dozen other kids crowded around, admiring her new markers and coloring book from her hospital adventure. The kids all stared at me, as kids here so often do, particularly out in the countryside. A few smiled in response to my greeting, but some just stared open-mouthed.

     Our little patient was looking quite comfortable, but a bit dirtier than than when I had seen her 48 hours earlier. Both of her feet and ankles were still bandaged, but the outer layer, which was once white, was a serious shade of dirt. It was hard to imagine how it got that dirty so fast, especially since she can't move around at all, but then I saw that her legs were resting on a pillow that looked like it had never been washed in all its years of existence. But she actually had a pillow, which is a bit of a luxury item, so all was good.

     I went about setting up the supplies for the dressing change. This means pulling out all the gauze and scissors and tape and irrigating solution and gloves that I might need and laying them out on a clean surface where they were easily accessible. I had brought one of our clean bathroom towels just for this purpose, and in a couple of minutes, everything was arranged and  ready to go. I put on gloves and started to unwrap the bandages from her feet.

     At this point, a scrawny but very energetic chicken appeared from over my left shoulder, flapping and squawking and landing right in the middle of my supplies, sending a flurry of gauze and paper and gloves and saline flying in all directions.

     In my previous life, I learned to make sure that a client's dog or cat wasn't in the room when I did dressing changes. I figured out how to change a C-section dressing while a mother was nursing her newborn. I've worked where the lighting is poor or the room is cramped or a nervous parent was watching. I know how to handle a variety of situations. But nothing in my past experience had suggested I needed to chicken-proof my plan.

     Oh well. All in a day's work.

     I just wish someone who could appreciate the situation had been there to witness it - because, of course, no one who was actually there even batted an eyelash.