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A volunteer makes a difference in Bhutan

RN Dallis Fellows shares her story of setting up the first operating recovery ward in Thimphu, Bhutan.

Fellows, an operating theatre recovery nurse, completed a one-year stint in Bhutan in March 2014 – one of the first Australian nurses ever to work in the country.

She was tasked with teaching the team at the main referral hospital about recovery nursing – specifically documentation, streamlining flow from theatre and then workflow.

The hospital had a post-anesthesia care unit; however, observations and pain relief were left for the ward to do.

“They didn’t do recovery nursing. They would [just] send the patients up to the ward earlier than we would,” Fellows said, adding during the first few months technicians – rather than RNs– were staffing recovery.

“Some nurses straight out of college were sent through, they were great. They were like big sponges and very keen to learn a new form of nursing. Because that’s what it was; it was completely new to them.”

Fellows recalls a time when a young child who had fractured his arm came into the post-op recovery ward. At the time she noticed that the plaster was obviously on far too tight.

“His fingers were actually going black before our eyes,” she said. “I tend to think that if I hadn’t have been there the child would have been sent up [to the general ward] with that arm getting worse and I don’t know when it would have been corrected, they just didn’t know to do that sort of thing.”

Since its establishment, the recovery ward has resulted in new standards and practices, such as post-operative airway management, observations, documenting key indicators such as blood pressure and pulse, and checking surgical wounds and circulation.

Fellows confirmed the hospital staff are seeing fewer infections and better patient care outcomes. Measures such as providing adequate pain relief mean that patients are also  spending shorter times in hospital.

The Red Cross said there are new processes for post-operative care in Bhutan as a result of Fellows’ work.

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