August 19th: Vellore: CMC Hospital Tour

Rachael, Andrea, Sarah and Alison in front of the College of Nursing.

College Of Nursing, building was consecrated last August

Today was our first work day. We caught the bus running to Christian Medical College Hospital where we were supposed to catch another bus to the College of Nursing. We arrived at the hospital, which is rather large, and could not figure out where the bus picks us up to go to the College of Nursing. After asking multiple people, we finally found our way to a shuttle that took us to where we needed to go. After arriving we met with Dean Rosaline Jayakaran. Dean Rosaline explained the origins of the CMC, starting in 1900 when Ida Scudder opened a one bed hospital in her father's home. Thereafter, the hospital moved into a hut with more beds and gradually expanded into the 2,000+ bed hospital that it is today. The CMC Nursing School diploma program began in 1932 and the bachelor's program, the first in the nation, was added in 1946. The College of Nursing became WHO certified in 1997. Great strides have been made by this institution in the field of nursing.

Rachael's CMC ID

After meeting with the Dean, we walked to the hospital and met with the Deputys of Nursing. A Deputy, Jasmin, was very gracious and answered the plethora of questions we had about nursing practice, policy, common health issues, ethical dilemmas, multidisciplinary care, and the commonalities of nursing practice between India and the US. We were particularly interested in the research they were conducting within the hospital. We were able to share information with them about practices in the US regarding shift schedules and computerized documentation. There seemed to be an emphasis on research and many of the faculty that work at CMC Hospital as well as the Deputies and Charge Nurses all participate in conducting research on their respective units. One of the Deputies, Amala, gave a synopsis of the research she is working on in the MICU. She is comparing two types of tube feeding: the standard formula and a formula with probiotics added.

View of CMC hospital campus

Sarah walking in the busy hospital corridor

                                 

Deputy Jasmin, Alison, Marjorie, Andrea, Rachael, Sarah, and Deputy Amala

Nurses in the Coronary Care Unit

We then took a tour of the hospital. We were able to see a broad spectrum of wards, from labor and delivery to the Cardiac Intensive Care Unit. Some of us have worked in hospitals and were able to see the equivalent of the units where we have experience. For example, one of us has worked on a Cardiac Intermediate Care Step-Down Unit and was able to see the Cardiac Step-Down unit and compare. There are a lot of similarities with the monitoring of patients and the types of heart surgery conducted, but the acuity and accommodations were very different. Some of the procedures and medication infusions that qualify the patient to be in the Intensive Care Unit are used in the Cardiac Step-Down unit at Hospital of the University of Pennsylvania. There were no private or semi-private rooms, just one room with curtains separating the beds. There are less disposable materials used than in US hospitals. The only air conditioned wards are the ICUs.

One of the pediatric beds with detailed metalwork
to make the stay more welcoming 

Another interesting point is that patients can pay to receive hospital meals, but, most family members bring food from home. The families that travel from further away to receive CMC's care are able to use a kitchen (located on each ward) to boil water for rice or to make other simple meals. Also, when entering the ICU, street sandals are stored on a shoe rack, and hospital issued sandals are worn. The pediatric units are especially interesting- there are playrooms on each floor as well as a treatment room (just like at Children's Hospital of Philadelphia) and the cribs are decorated with metal designs to make the hospital more inviting and less of a "scary" place. The labor and delivery unit was also very intriguing because they only offered one private room, so the rest of the women were placed in an open room with 21 beds. Unless the women were lucky and wealthy enough to have the private room, the husbands were not aloud in the delivery room with their wives. The men waited outside in a crowded and hot waiting area, while the mothers/mother-in-laws helped the women in labor. When we asked about epidurals or pain medications and the how often women use them at CMC, our guide seemed confused. She said they only offer gas (anesthesia) for pain relief when absolutely necessary, which seemed rare. There was a lot to see throughout the hospital and the tour lasted almost four hours.

RNs, in their white saris, gathering in the nurses' station

 Our tour guide was a wonderful faculty member from the CMC College of Nursing. She was very knowledgeable about both the hospital and College of Nursing. The professors and teachers that work at the CMC College of Nursing are required to also work at the Hospital. The faculty in the different wards also teach the nursing students in clinical. Both faculty and students participate in monthly ethical committees and discuss pertinent topics. We thoroughly enjoyed our tour and are looking forward to next week when we are able to see the CMC's approach to conducting Community and Psychiatric Health.

Andrea and Rachael walking in the open-air hallways of the hospital