Hospital Divina Providencia, Monday and Tuesday

It's hard to know where to begin trying to describe all we've seen, heard, and experienced in our first two days!    Monday, our day began with a tour of the hospice led by Estefan, a male nurse who has worked at the Hospital for 8 years.   We met Sister Julia (Hoo-lia) for a tour of the grounds, and then we sat and had our lunch in the shade outside the hospital.   The hospital provides food for all the patients, but not for any family members, so there is a food-for-purchase area outside the hospital.    Patients are expected to have at least one family member with them at ALL times.   After our lunch, Sister Julia took us on a tour of the church, where Monsignor Oscar Romero was assasinated in 1980.  He is revered as a saint for the Salvadorian people.   We stood on the spot in the church where he was killed;  he was taken down by a hail of bullets during the Consecration of the Eucharist during Mass.   It was sobering to be on such hallowed ground.   Following this, we went on a tour of his little home, which has been preserved exactly as he left  it when he went to church that day.   There are large cases of photographs of him as a young boy and priest, and all the memorabilia of his assasination, including his blood-stained shirts, vestments, and cincture (the rope worn about the waist).    His Toyota Corolla still sits in the driveway.   There is a banner that hangs in the church that reads (paraphrased):  "I will not abandon my people.  I will accept the consequence my ministry chooses for me."    At the altar, it reads, "On this altar, Monsignor Oscar Romero offered up his life for his people".    It was hard to catch our breath with all the emotions of the day, but Sister Julia pressed on and we gathered upstairs in the hospital with Estefan, Dr. Reyes, Sister Julia, and the 6 hockey bags FULL of donated supplies.   It was like Christmas morning for them as they began to unpack the bags and look at everything they were being given!   Dr. Reyes was hilarious as he pulled out mesh panties from one bag and a comb from another.  He wanted to model the panties and demonstrate the comb, but he's almost bald!!!    They were overwhelmed with the generosity and the contents of the bags.   Tuesday morning we would find that all bags had been unpacked, sorted, and put away under lock and key by Sister Julia!   She guards ALL donations carefully, so they're not squandered or wasted!!   As we were leaving, we met Dr. Colorado and 3 young volunteers, who spend part of every Monday afternoon dressed as clowns visiting and entertaining patients.   They find that their "Patch Adams" work does wonders for the patients.    Shortly after their visit with the patients began, Dr. Colorado was asked to attend the bedside of a young 20 year old patient who had just died.   We met her just this morning and we were shocked that she died.   Dr. Colorado was asked to speak to her Dad, but he was reluctant to do so because he was dressed as a clown, and felt it would be disrespectful, but he took his clown hat off (makeup still on) and attended to the family.    Our hearts were broken as we left for the day.    There was no blog written on Monday night as we struggled to digest and discern our day.    Tuesday morning we awoke with new excitement.    As we arrived at the Hospital, Sister Julia greeted us like we were already old friends.   Estefan was waiting for us, as were Drs. Reyes and Romero.    We did rounds with the physicians for the entire morning, meeting each patient and hearing their story.    We met their family members, gave gifts to the younger patients, gave lots of hugs and smiles, and marveled at how well this hospital operates with what little they have.    Their linens are a mish-mash of sheets, pillows, and such.   On two beds, it looked like the patients were covered with old sacks instead of blankets--they still had the printing on them!    Almost no one uses pillows--Sister Julia says they're not comfortable using them.    Every patient who was alert enough smiled at us, welcomed us and were delighted to have their pictures taken with us!    Aside from one woman undergoing very painful dressing changes, we saw little physical suffering.    No terminal delirium, no congested respirations, no one crying out.....absolutely NO odor whatsoever, and a peace that was unmistakeable.   Dr. Reyes greets every single patient with a kiss and hug, as well as his staff.    Sister Julia told us that in his younger years, Dr. Reyes would actually lie with patients as they were dying or right after they died.   She finally convinced him that he had to let go a little bit or suffer burnout.    He is loved and adored by all---it is clearly evident.   He welcomed us with open arms and asked us to teach him and his staff.    Tomorrow, Rose will take the dressing cart on rounds with the nurses and show them better ways to use the dressings they have.    They have the 0-10 pain scale in every patient's cubicle and they use it well.   Sometimes, if patients cannot understand the 0-10 scale with numbers, they compare the numbers to sizes of fruit!!!   10 is a watermelon!!   For women, they compare the scale to labor pains.    Genius!!    Another thing we found out is that although patients are required to have a family member with them at all times, there is nothing for the family to sit on except a resin patio chair, and there is NO bed for the family member--they must make up their own bed on the floor.   The shower chair is a resin patio chair bolted to a wheelchair frame.  Never again will we complain about anything we have at our workplace!!   Rose helped with a very painful dressing change and we all laughed when she showed the nurses that Mefix can be torn at the perforations instead of cut with scissors!!    They were in awe!!!   After patient rounds, which consumed our morning, we had our lunch in the shade of the tree with Estefan and Dr. Reyes (we shared our food with them), and Dr. Reyes asked Kelley and Rose to please teach him what nurses in Canada are taught about Hospice Palliative Care.   Such humility and grace.....wow!     We decided to leave at 1:00, which was early, but we have a full day tomorrow with a trip to the orphange  and to visit the Sister responsible for starting Hospital Divina Providencia around 40 years ago.    Our day ended with a visit to the market to buy souvenirs and dinner at Pollo Campero, the Salvadorian version of KFC, but much better!!