Today was incredibly busy in Recovery Room. I came in at 10 am and it was already busy. Wendy and I had 4 patients already in and out before our boss Maria came in at 12.
Christian a young boy who we were told is deaf and blind (later we were told that he had cataract surgery last year and now he can see, but it sure didn't seem like it) came in after a nasal oral fistula repair (a hole between is mouth and his nose). When he woke up from anaesthesia he was flailing all over the place. We got his mom to come in and what followed was priceless. She grabbed his hands and put them on her face and put his face up to her neck. She said that the only way he can tell that it is actually her is by her smell and touch. I felt like I was watching the most amazing connection between a mother and son. She is so loving and patient with him as he is inconsolable except by her. Once Christian woke up and was slightly calmed down he went back to the ward.
Later we received Anthony who had surgery on his jaw. At first Anthony was bleeding just a little from his mouth. Then it was more and more. Then we were constantly suctioning. We went into the OR and told Dr. Gary and he came out, took a look, gave us some tips on how to stop the bleeding and went back into the OR and started another surgery. I went to a staff meeting and came back and Wendy was still suctioning poor Anthony. He was awake the whole time and very cooperative. I took over the suction duty again and tried to stop the bleeding with no success.
I went back into the OR and interrupted Dr. Gary during surgery to tell him I was concerned. God bless that wonderful man. He quickly came to Anthony's bedside and looked inside his mouth and saw a sub-lingual hematoma (a collection of blood underneath the tongue a that pushes the tongue back that closes off the airway... bad). He said "Girls, good catch. If we would have waited another 30 minutes his airway could have closed off." I don't think he could have said anything nicer to us. We adore him. For him to give us a verbal pat on the back made it worth it today.
While all of this was going on we had another guy that came back from the OR with a blood pressure of 55/21. His normal is 120/70. Needless to say we were quite busy.
Sanka Sauce (West African Foods)
A continuation of past posts: Red Palm Oil, Banku & Kenkey, Sea Monkey & FuFu
This one will be a little hard to explain, well ok, not really. Its just it may be a little hard for you to replicate if you are the kind of person who needs a recipe of exact measurements.
Elements of this sauce are mostly the basics of a lot of stews, palava sauce (althought it can be argued like most everything food can be nowadays as to origin or authenticity), meat sauces, and other soups & sauces of the West African people.
First I will explain that you can't really google (search) for this recipe the name is unique and created by a few West Africans and a North American white boy from southern part of the United States, Alabama & Georgia. Why? Because they didn't know what to call it besides red sauce, which means many different things to many different cultures. And because it was finally nice to make it difinitive in our minds.
First the basics then the story:
Start with oil (red palm oil if you got it) don't be shy, throw in chopped onions, diced/chopped/pressed garlic, saute till translucent. Add chopped bell/sweet pepper (green, red, etc...), fresh ginger, saute about 3-5 minutes longer (med high heat). Add in cayenne or local equivalent hot pepper ( use for amount of heat YOU can stand) tomato paste and some fresh chopped tomatoes. Tomato paste should be a good wooden spoon size dollop to start, more as necessary...fresh tomatoes should be about 5 or 6 roma tomatoes worth (so we are going for a medium size HOME pot worth of sauce). Let simmer, if sauce gets too thick water it down some more and let simmer. They usually let this sauce cook for at least a half hour and up to a full hour or more (depending what meats, fish, chicken feet, egg or other things they may cook in there with it.
And by the way, Chicken feet put out good taste for soups and sauces and if your not shy you can suck off whatever substance (meat & sauce) is left on them when your done cooking, its tasty.
The consistency has been between soup and a sauce most times when I have had it. Spinach and a few other ingredients can been added to make a palava sauce, goat meat for certain stews...it becomes endless the possibilities.
Check your seasonings, salt & pepper as needed, more cayenne or hot pepper? Need more sauce? Add more paste, tomatoes, and/or water (sauce should not take on a sweet taste from the paste, that would be entirely too much).
We (Reuben, Alex, Alex, Joe, Charles, Kafue, Frank...countries represented: Ghana, Togo, Sierra Leonne, etc..), loved the movie Cool Runnings and since it was one of the favorites on our small ship (Caribbean Mercy, now retired) we watched it over and over again when we got bored on a sail. In the story of the jamaican bobsled team that went to the Olympics was a team member name Sanka, and Sanka had a lucky egg. See where I am going with this yet?
Reuben made this sauce most of the time and everyone else stood around telling him how they thought he should be making it. But I think it was safe to say Reuben made it the best and he usually ALWAYS added egg in the sauce, like you would an egg drop soup. Mix egg or at least crack yolk. Drop egg into Sanka Sauce while it was simmering and then just stir around once or twice, then let it cook.
Meat or additional things could be added almost anytime taking into account you simmered the sauce long enough to cook what was in it, or if it was a bean or pea of sorts then it would go in when the fresh tomatoes and paste went in.
Sanka Sauce. Nothing more than the traditional West African red sauce with an egg thrown in, or not! [now maybe after I post this you can google search for Sanka Sauce and it may start coming up. SMILE]
* I am not an authority by any means on West African food or cooking, these are my personal views and experiences as they have happened to me and many of my friends who are from these regions of the world*
This one will be a little hard to explain, well ok, not really. Its just it may be a little hard for you to replicate if you are the kind of person who needs a recipe of exact measurements.
Elements of this sauce are mostly the basics of a lot of stews, palava sauce (althought it can be argued like most everything food can be nowadays as to origin or authenticity), meat sauces, and other soups & sauces of the West African people.
First I will explain that you can't really google (search) for this recipe the name is unique and created by a few West Africans and a North American white boy from southern part of the United States, Alabama & Georgia. Why? Because they didn't know what to call it besides red sauce, which means many different things to many different cultures. And because it was finally nice to make it difinitive in our minds.
First the basics then the story:
Start with oil (red palm oil if you got it) don't be shy, throw in chopped onions, diced/chopped/pressed garlic, saute till translucent. Add chopped bell/sweet pepper (green, red, etc...), fresh ginger, saute about 3-5 minutes longer (med high heat). Add in cayenne or local equivalent hot pepper ( use for amount of heat YOU can stand) tomato paste and some fresh chopped tomatoes. Tomato paste should be a good wooden spoon size dollop to start, more as necessary...fresh tomatoes should be about 5 or 6 roma tomatoes worth (so we are going for a medium size HOME pot worth of sauce). Let simmer, if sauce gets too thick water it down some more and let simmer. They usually let this sauce cook for at least a half hour and up to a full hour or more (depending what meats, fish, chicken feet, egg or other things they may cook in there with it.
And by the way, Chicken feet put out good taste for soups and sauces and if your not shy you can suck off whatever substance (meat & sauce) is left on them when your done cooking, its tasty.
The consistency has been between soup and a sauce most times when I have had it. Spinach and a few other ingredients can been added to make a palava sauce, goat meat for certain stews...it becomes endless the possibilities.
Check your seasonings, salt & pepper as needed, more cayenne or hot pepper? Need more sauce? Add more paste, tomatoes, and/or water (sauce should not take on a sweet taste from the paste, that would be entirely too much).
We (Reuben, Alex, Alex, Joe, Charles, Kafue, Frank...countries represented: Ghana, Togo, Sierra Leonne, etc..), loved the movie Cool Runnings and since it was one of the favorites on our small ship (Caribbean Mercy, now retired) we watched it over and over again when we got bored on a sail. In the story of the jamaican bobsled team that went to the Olympics was a team member name Sanka, and Sanka had a lucky egg. See where I am going with this yet?
Reuben made this sauce most of the time and everyone else stood around telling him how they thought he should be making it. But I think it was safe to say Reuben made it the best and he usually ALWAYS added egg in the sauce, like you would an egg drop soup. Mix egg or at least crack yolk. Drop egg into Sanka Sauce while it was simmering and then just stir around once or twice, then let it cook.
Meat or additional things could be added almost anytime taking into account you simmered the sauce long enough to cook what was in it, or if it was a bean or pea of sorts then it would go in when the fresh tomatoes and paste went in.
Sanka Sauce. Nothing more than the traditional West African red sauce with an egg thrown in, or not! [now maybe after I post this you can google search for Sanka Sauce and it may start coming up. SMILE]
* I am not an authority by any means on West African food or cooking, these are my personal views and experiences as they have happened to me and many of my friends who are from these regions of the world*
Favorite Things About Living On A Hospital Ship in Africa
As I sit in the recovery room all by myself awaiting my first patient to come out of the OR I have been thinking about my time here. We have been here for 5 months now. Let's be honest. There have been a couple of days when I was looking for plane tickets to get the heck out of here. And others when all I can do is think about how the Lord has blessed me so much to be here. I guess this reflective mood stems from the decision that Tyrone and I will come home after our 1-year commitment is complete. I don't know where home is. We think we will travel a bit more, maybe take a travel nursing job here and there. We have not made any decisions but we do know that we want to enjoy our time with Mercy Ships as much as possible therefore we want to leave before we become burned out or bitter.
In my time here I have come up with my favorite things about living on a hospital ship in Africa:
1. Short commute to work
2. Friday nights at the snack bar, with music playing and people dancing and chatting. (you'd have to here to understand the true beauty)
3. The patient's first glimpse in the mirror after life-changing surgery.
4. Friendships
5. The things that we do when we are bored: playing in the rain, playing taboo with people from all over the world, just sitting around chatting.
6. This one sounds cheesy but it is truly one of my favorite things about living on the ship. I love to walk down the halls of the ship to where ever we are going, holding Tyrone's hand and knowing that I get to experience this crazy life with my best friend.
7. I love to sit on the dock and watch the sunset and be silly with my girlfriends as we discuss the meaningful things in life like what we would be if we were a superhero.
8. Being a part of our Bible study with our girls at the orphanage, some times I think maybe they are the reason why I am here in Liberia.
9. Taking a shower after being hot and sweaty from the Liberian sun.
10. Sitting at the Starbucks cafe on a day off sipping my hazelnut double shot latte chatting with people as they pass through.
Hamburgers (BULK) The Simple Way
Do you get your ground hamburger or minced beef (Europe) in big round tubes? Packed in a cardboard box? Maybe 5 to 10-pound tubes of them frozen solid, or fresh is how they usually come.
First I want to say that YES, if you can mix spices, herbs, or your 'special seasonings/flavors' into your beef, then that is the way to go...A lot of time I do not have this option (I have the option but not the time) so I move on to the next best thing for time, flavor, and mass production at a cheap price instead of paying for pre-patties and wasting a lot of freezer space.
I won't waste a lot of time describing how to do it but rely on my pictures to tell the tale.
If you have a good slicer (commercial or restaurant-grade of course) then set it to the width of the burger you would like, take your defrosted ground burger/minced beef (leaving plastic wrap on), and start slicing your burgers.
Use large cambro's or containers of your choice to layer the hamburger in, we separate our burgers with pre-sized parchment paper that comes in large sheet tray size. For the first layer of the burger put your seasonings, flavors, etc...down in the bottom of the container. Then from there just keep applying it to the top of each layer of burgers. As the weight of the burger and the release of more blood/water happen over a course of time it pushes the flavors down over the rest of the burgers or lends more time for seasoning to dilute and spread. OH! And of course, remember to pull that plastic ring off of the patty!
We just use that wonderful Worcestershire Sauce on each layer.
Later you can move the burgers to large sheet trays and cook them in the oven OR-AND THIS IS WHAT WE DO, sear them on both sides at a high heat poking them in the center on a flat top grill or brazing pan. This releases juices fat/blood in the burger so it doesn't swell up and turn into a meatball!!! Then continue on to layering them on the large sheet pans and finishing them in the oven as slow or as fast as you want to cook them.
The process I wanted to show you here today was more about creating the burger patties quickly with no filler and without wasting money or space by buying pre-made patties.
Pictured here in this post is Ernest from Ghana, one of our Galley Cooking Team Leaders.
Recovery
At the beginning of the out reach (Early Feb.) I looked at the schedule and thought " When am I ever going to spend time with Tyrone?" As the months have gone by, sometimes my schedule is great and we get to spend alot of time together but then there are those times that I don't see him for 5 days. I knew that being on the ward was indicative of have a "flip floppy" schedule but I did not think it was going to be this bad. Kirstie our Ward Supervisor does an amazing job doing this extremely difficult schedule with nurses coming and going every week, I don't envy her job at all.
About 2 months ago I went and talked to my boss Kirstie who is incredible understanding, and told her my feelings about the schedule. I asked to be transferred to Recovery room or anything that had a more normal work hours. She responded with the obvious "We re really short ICU nurses so, no". I knew that would be the response and if I was really honest I know that I would really miss the ward. I would miss the close connections we develop with our patients and I would miss the ICU when we get ICU patients.
On Friday I got an email asking me if I could work in the Recovery Room this week. I did my first shift yesterday and I must admit, it was wonderful. I love Maria and Wendy who will both be here until the out reach is almost over. And I love that once the patient is recovered they go back to their room. It kind of reminds me of the ER.
About 2 months ago I went and talked to my boss Kirstie who is incredible understanding, and told her my feelings about the schedule. I asked to be transferred to Recovery room or anything that had a more normal work hours. She responded with the obvious "We re really short ICU nurses so, no". I knew that would be the response and if I was really honest I know that I would really miss the ward. I would miss the close connections we develop with our patients and I would miss the ICU when we get ICU patients.
On Friday I got an email asking me if I could work in the Recovery Room this week. I did my first shift yesterday and I must admit, it was wonderful. I love Maria and Wendy who will both be here until the out reach is almost over. And I love that once the patient is recovered they go back to their room. It kind of reminds me of the ER.
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