On Monday, I headed to the pharmacy for my pharmacy orientation. Joe took us for a little tour of the ship and then walked us through the process that a patient would go through when they came aboard the ship.
The only patients on board are the patients who need surgery. They are screened at the clinic sites and then the patient with their escort will be transported to the ship either by helicopter or hospitality ship. A patient once aboard the ship will be take to CASRAC to fill out the necessary paperwork to be admitted to a hospital.
Once they have been admitted, they will spend the night in the “Comfort Inn.” The Comfort Inn is a ward where patients can sleep well the night before the surgery. There are 80 beds in this ward but generally only 40 are used. Most of the escorts will sleep on mattresses on the floor or cots that can be placed near their loved one.
The next morning patients will begin being prepped for surgery in the staging area of the OR. When the surgeons are ready the patient will be taken back to the OR. They then head to PACU where the patient will stay 30 minutes to 3 hours depending on their pain management and their recovery progress. After the PACU the patients will head to one of two wards: the ICU or the AFT 2 (the outpatient ward).
Most patients are only on board for a total of 3 days. Patients are usually discharged the day after their surgery with Percocet for pain and some type of oral antibiotic. There are a few exceptions to this length of stay. The longest a person has stayed on board is 8 days and some of that time the patient was in the ICU.
The pharmacy has a very important role to fulfill. It has been very slow for the past few days since we really don’t start seeing patients until the 3rd day in port. Most of our drugs were prepacked for this country en route, so there hasn’t been much for us to do. (There are 4 other pharmacy students from UCSD on board. I don’t think that the Lt. knew that they were coming).
The first order of business for the day was to get two sets of “uniforms” prepared for us to head ashore. When we first got on the boat, we were given two cans of permethrin spray. In order for us to go on land, we have to spray a pretty heavy layer of permethrin on our clothes (one can for each uniform). This treatment will help to repel bugs as well as protect us from contracting certain insect related diseases. So the lot of us headed down to the aft armed with gloves, goggles, and hangers. Once sprayed the clothes are hung on the line near the aft and let them dry for about an hour. Then head down to mission laundry to get our clothes washed before the next day. This coating on our clothes is good for 6 washings. The military uniforms are sprayed so well that they can wait a year before getting their uniforms treated again.
One of our other projects over the last few days has been to prepack meds that will be sent as replenishment stock to each of the sites. We started out with children’s chewable vitamins. We dump all of the vitamins into a large bin and then take vials that are marked with a line around the middle that shows you what approximately 30 vitamins looks like. Then we bag them and label them. We also had to bag albendazole. We spent most of the day today cutting the tablets in two with box cutters and there was powder everywhere. The pills are shaped funny so a regular pill splitter wouldn’t work. At least the chief had a good sense of humor about it and made everyone stickers that said, "I got De-Wormed today." We also have one pill counting machine which helped a great deal when counting the 10,000 Motrin that arrived today.
Soon I will head out to Loma Largos for three days for an overnight trip. I will be staying ironically in the Comfort Inn located near our site because we are so far away from the ship to return each day.
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