'It's Not about Me. It's about My Patients'

An insistent beep, beep, beep filled the neonatal intensive care unit at University Hospital in Mirebalais, Haiti. It came from an alarm on a CPAP machine regulating the breathing of a premature infant in one of the ward’s incubators. A nurse approached the machine and checked the settings, but the beeping persisted.

Lauria Cadet, the hospital’s 29-year-old nurse educator for pediatrics and neonatology, appeared at the nurse’s side. She noticed that the infant’s temperature had plummeted and that the machine’s oxygen level wasn’t right, triggering the incessant alarm. In a few quick motions, she showed the nurse how to fix the situation. Soon, the tiny patient’s temperature rose, silencing the machine.

Last year, Cadet had learned how to respond to situations like this during a neonatal and pediatric intensive care training sponsored by Zanmi Lasante, as Partners In Health is known in Haiti. Over the course of 24 weeks, she was among 25 nurses who acquired the skills necessary to take care of the tiniest, most fragile infants at University Hospital.

Cadet then passed along that knowledge. From January through July, she helped mentor and teach PIH’s second class of NICU/PICU nurses recruited from hospitals across Haiti. These 26 men and women, hand-picked by the Haitian Ministry of Public Health and Population, graduated in late July and received a government-sponsored certification in recognition of their efforts. They have since returned home to hone and share their newfound skills.

To nurse leaders like Cadet, the training is invaluable: “It will benefit not only the patient, but also the nurse and institution.

Watching her work with patients and staff, it’s hard to imagine Cadet as anything but a nurse. Yet the profession was not her first choice. A lover of math, physics, and chemistry, the Cayes native dreamed of becoming a civil engineer in her community along the southern coast. Her mother had other ideas. Tuition for nursing was much more affordable, so she pushed her daughter to pursue the career against her wishes.

Cadet was in her second year at the National Nursing School of Cayes when her father mysteriously fell ill. He started driving four hours, one way, to Port-au-Prince to visit doctors in search of answers, and his daughter often accompanied him.

“We went to five different hospitals hoping for a diagnosis, but were never given one,” Cadet said. The young nurse thought her father might be suffering from tuberculosis or pneumonia. She talked to him about his illness, bolstered his hope, and encouraged him to keep taking his medication. Finally, at the capital’s TB sanatorium, they learned he had lung cancer.

“My dad died in May of 2010,” Cadet said. “It was too late for the doctors to do anything for him.”

I needed to continue this work, because people needed my help.

Caring for her father made Cadet appreciate the value of her new profession, and small encounters during her clinical rotations reinforced her sense of purpose. One patient from her early years of nursing school stands out in her mind. The woman was in a “horrible state,” Cadet remembered. Her catheter hadn’t been changed. She hadn’t been bathed in four days. And her hair and teeth hadn’t been brushed for likely as long. The young nurse carefully washed her, brushed her teeth and hair, and changed her clothes and bed sheets.

“It was then when I realized I needed to continue this work, because people needed my help,” Cadet said. “I learned the importance of nursing; it’s not about me, it’s about my patients.”

After graduation, Cadet worked as a mentor and teacher at her alma mater. She then moved to various hospitals across Haiti to do the same or to provide care for mothers and newborns. In March 2014, she began working at the PIH-supported University Hospital as a nurse educator and quickly became an invaluable member of the team.

Cadet changes the IV on an infant who was born the day before with hypoglycemia.

Cadet appreciates the opportunity PIH provides her to grow and excel. She picked up a number of skills through last year’s NICU/PICU training, from how to resuscitate children and work the CPAP machine to how to properly use an IV pump and care for newborn sepsis patients. She started incorporating simple tasks into her daily routine, like pressing babies’ diapers to ensure the infants were hydrated and urinating regularly. And she learned the importance of including parents in patient care. When babies are hypothermic, she encourages parents to snuggle them close and use their own bodies as a source of heat. This “kangaroo care” method helps the child’s temperature return to normal.

“We are trying to practice these new methods regularly so it is not only standard, but second nature and systematic,” said Cadet, referring to neonatal and pediatric nursing staff at University Hospital.

Cadet was among a select group of national and international staff who organized and led this year’s NICU/PICU training. She helped facilitate sessions, translated for English-speaking instructors who weren’t well-versed in Krèyol, and supervised nurses as they practiced what they had learned in University Hospital wards.

She takes pride in seeing the nurses master new techniques: “I love working with other people; I like to help them become better and more skilled in what they do.”