Day 4

Hola!

Day 4. Wow. Already day 4? This trip has to slow down !! I got up at 5:45 this morning and took a shower. We had to be ready for breakfast by 6:30 (we had hotdogs and eggs, and as always the best fruit I have ever had in my life). The bus left about 7:10 to go to La Hospital de Ninos! For those of you who are not sure what that is..... its THE CHILDREN'S HOSPITAL!!! Dr. Peterson- try not to be too jealous! :) This hospital is very historic and it treats kids all the way up to 13 to 15 years old. If the child was born at the hospital - they get treatment at this hospital until they are age 15. If they were not born at that hospital- they get treatment until they are about 13 years old. The hospital consists of a burn unit, cancer unit, HIV and AIDS treatments, transplant units (kidney, heart, liver, bone marrow...etc). We were told that Social work MUST BE DONE before a treatment to assess the candidates for transplant, and just like in the United States, the transplant list is very long for these little guys. Each social worker -in all (not just transplant cases) has about 15 cases, and the incidence rate for social work cases is about 455 new cases since February. In the Estados Unidos (United States) many social workers can have up to even 100 cases to handle!
The children's hospital is public and it is the ONLY HOSPITAL FOR CHILDREN IN THIS COUNTRY! They get children from all over, and coverage is equal to each and every child no matter what they pay. The idea to have this hospital just for children was started by Dr. Carlos Saenzherra in 1971. This hospital is also a research hospital and a teaching hospital for students in the country. In the future, they are hoping that they can expand the hospital to especially cover critical services and allow helicopters to land in the area. Sometimes if a child needs continued care, they may be moved to the adult hospital which is called the "program of transition". This is so that they can make room at the hospital for other children if needed. DR. PETERSON: The nurses here use the nursing process too!! They made a point to tell us- oh! and some of the nurses wear all white, old fashioned uniforms with their hats, skirts and collared top! They look amazing! Makes me want to dress like that with a hat and all. Here in Costa Rica, they also offer "room in" too! "Room in" is a term that is used to say that parents can stay with their child the while they are hospitalized.
Another point the nurses made today was that they have an evacuation plan that they follow in case of a hospital emergency.
What I got to see in the hospital was:
1. ICU
2. OR
3. Recovery Room
4. Palliative Care Office
    We talked about many things here, and discussed how the children have an interesting way at looking at death. We talked about some of this in Peds. The nurse talking to us about Palliative Care said that children under 2 do not understand that they are dying so it really is not discussed with them. From age 3-6 they understand that they are going to DIE but they don't UNDERSTAND the word. From about 7-10 years old they have a magical thinking and each have a different way of looking at death ( I can't wait to see my dead dog, or I can not wait to see my grandparents ...etc) Above 10 yeras old- they really start to understand that they are going to die.
 5. Heart Unit

After the tour we all took the bus back to school. In school today we did 3 activities. We read a small script about a sick man named Carlos and then read symptoms that are associated with a heart attack, appendicitis, and diabetes (of course everything was in Spanish). The second activity was that we interviewed eachother to see if we had any health problems, age, allergies and other health facts (we got to make them up), and of course again this was all in Spanish. The third thing that we did was an activity packet with pictures in them and we all discussed the pictures in Spanish.
Then we headed home for ham, rice, beans and slaw and potatoes for dinner ... so gooooood!

All in all it was a very good day, but I am sorry that I have no pictures because again I was at the hospital. No pics allowed.

Love,
Kara