Stepdown Happiness and Concerns-Part 1

1. Leslie Sabatino doing more inventory of our mountain of supplies, while waiting on rounds and procurement meetings as begin our planning for next year even as we are still working. We took a break to visit the national center for procurement, greeting a friend Juliet Mbabazi, the new CEO. Beginning to purchase in Rwanda and have delivered direct is a goal for 2012.

2. Drs. Igor Gosev and a sleepy John Connell wait for rounds with Dr. Nathan which are delayed by lab data missing. Adapting to a system which can work to provide both care in follow up and with in the system is a struggle. Many times I think that the local team just figures out a way to make it work for them and in small numbers of INR 1-2 a day, it is OK.--But after 4 years; how can we still be waiting on 8 INR's at 2 pm?

3. A happy Shabani, the patient who returned to theater for oozing is also going home today. A handsome man, he is anxious to return to work. He already looks so much better you have to caution against doing too much too early, along with the discharge teaching they are each receiving. Jean Damascene has been giving speeches of thanks to each person walking though the door. Both are anxious for the final rounds saying they can leave yet today.

4. Pat Caruso, RN, St. Vincents, a veteran cardiac surgical misson nurse from Worcester brings calmness and expertise to her group of "young men"--here with Shabani. You can just tell they all adore her as she moves competently between them, keeping it all straight and providing compassionate and tough love care.