REPUBLIC OF CAMEROON REPUBLIQUE DU CAMEROUN

PEACE – WORK – FATHERLAND PAIX – TRAVAIL – PATRIE

MINISTRY OF HIGHER EDUCATION MINISTERE DE L’ENSEIGNEMENT

SUPERIEUR

ST LOUIS HIGHER INSTITUTE OF

MEDICAL STUDIES, DOUALA

DEPARTMENT OF NURSING
BLOCK POSTING CARRIED OUT IN SCHOOL AND AT THE
BONASSAMA DISTRICT HOSPITAL
DOUALA/BONABERI
FROM THE 28TH OF MARCH TO THE 1ST OF APRIL 2022

PRESENTED BY:
NGONG GIDDY BRANDON NSOM MAT:NSG /21/0202

GENERAL SUPERVISOR : Mr. NGOUOPAYOU DALHAD

VIENNY

2021/2022 ACADEMIC YEAR

TABLE OF CONTENT
1.ACKNOWLEDGMENT

2.CHAPTER ONE

3.CHAPTER TWO

4.CHAPTER THREE

ACKNOWLEDGEMENTS
I acknowledge my teachers in school for giving me the opportunity to carry out
this block posting.

The health personnel of BDH for directing, teaching, correcting and supervising
all the activities carried out in every unit

I equally acknowledge my family for their constant support.

And lastly I acknowledge God almighty for seeing me throughout the study
period.
CHAPTER ONE

Introduction:
The administrative organization of hospitals running in Cameroun is from
top to bottom level and it describes how powerful it is from one level to the
other that is;
1. Directors: The director is been appointed by the minister of public
health and the director is in charge of everything in the hospital .Below the
director they are two people.
1 in charge of medical and the other in charge of para medicals

*paramedicals(non health specialist)

*Every unit has the in charge e.g the nursing unit it is the nurse in charge
*Team leaders and every other workers
*Medicals
.Medical adviser’s
.Chief of service in each unit

The health care system in Cameroon involves three sub-sectors:

• A sub-public sector constitutes of; a public hospitals and the health
structures under guardianship of other department members (Departments
of Defense, Department of Employment, Labor and Social Welfare, Ministry
of National Education).
• A sub-private non-profit sector (religious denominations, associations and
various non-governmental organizations) and those for-profit.
• A sub-sector of the traditional medicine which is an important component
to the system and that cannot be ignored.
This system is also structured in three levels of health which each has an
administrative structures, sanitary formations and structures for dialogues:
I- Central level
* Central Services of the Ministry of Public Health: These services
coordinate, regulate, and develop concepts, strategies and policies in the
field of health.
* Structures of care: These structures are represented by: the general
hospitals in reference, the Centers Hospital-Universities, the central
hospitals and agencies under guardianship.
* Structures of SYNAME: These structures are represented by the CENAME
(National Center to supply essential drugs), wholesalers private, the central
purchasing of the private non-profit sector.
* Structures of this dialogue
There are the boards of directors or management committees.
II- Intermediate level
* Administrative Structures: These structures correspond to the different
provincial delegations. They provide technical support to the health
districts.
* Structures of care: These structures are represented by the provincial
hospitals and assimilated.
* Structures of CENAME: These structures are represented by the CAPP
(Center Pharmaceutical Supply provincial) and the pharmacies in general
hospitals and central.
* Structures for dialogue: What are the management committees (COGE)
III- Peripheral level
* Administrative Structures: represented by the district health services,
they implement the national programs.
 * Structures of care: These structures are represented by: the district
hospitals, medical centers and district health centers.
* Structures of SYNAME: These structures are represented by the
pharmacies for health training courses of the previous levels, as well as
private pharmacies.
*Structures for dialogue: These are the COSADI, COGEDI, COSA, and COGE.
Source: conceptual framework of the D/S viable revised (MSP)
For more information, see the website of the Ministry of Public Health

The main aim of this block posting was to have the opportunity to put into
practice the knowledge and skills acquired in class under supervision in order to
reach the competence level required at the end of my studies in St Louis.

We had the following objectives.

 Students should be able to interpret medical diagnosis.

 Develop and refine understanding of clinical administration and
management.
 Students should practice and progressively develop professional skills.
 This block posting gave me the opportunity to put into practice the
knowledge and skills acquired in class under supervision in order to
Reach the competence level required.
2.1 Description of the health facility (history and geography)

2.1: HISTORY OF THE HOSPITAL:

The Bonassama district hospital Douala started as a dispensary and later

transform in to a health district in 1995 it has a capacity of 78 beds with a total

of 136 staffs. It is the 4 largest structures in the wouri after laquintini and
general hospital of Douala. It has about 11 specialists all together and it is made
up of ten (10) buildings

Administratively, it is being run by a medical doctor appointed by the ministry

of public health under the ministerial decree NO: 026/A/MSP/SG/DSG of 27
August 1995.

On like most hospitals, they have as objectives; to ameliorate the health

status of the population, even the most severe, dispense primary health care
units with good intelligence, encourage women to give birth in the hospital than
home and even do surgeries. They also improvise essential medications to fight
against the sales of non-confident street medications.

2.2: GEOGRAPHY OF THE HOSPITAL

Bonassama District Hospital is located around the administrative center of

Douala IV district. The BDH is situated in the littoral region in wouri division
precisely at the sub-division of Douala IV. It is bonded to the north by the
central police station, to the south by a post office then to the west by the river
Wouri Bridge and to the east by a city hall and the bonaberi court of first
instance.
Figure1: Google Maps, 2020-Bonassama District Hospital
2.2 HEALTH MAN POWER

 The General Director

 The General Supervisor
 An Economist
 A Secretariat
 A Subject
 Permanent Doctors
 Student Doctors
 Majors ( Nurse Supervisors )
 Nurses
 Security Personnel
 Cleaners
2.3 Organizational Chart

DIRECTOR

Medical counsellor

CHIEF OF SERVICE

DOCTORS

ECONOM GENERAL ACCOUNTANT Receipts manager

SUPERVISOR

NURSING COODINATOR

INCHARGE

NURSE, LABORATRY
TECHNICIANS
Functional departments of the health facility (Describe the various units and daily activities in
bonassama)

No Department Activities
1 General Management of human, material and financial resources
Administration allocated to the hospital in order to provide quality health
services in accordance with government health policy.
2 Adult Out- Patient -runs two shifts from 7:30am-5pm and from 5pm-7:30am
Consultation -Screen and orientate adult patients, give IEC.
- Paediatric Out - -Screen and orientate children from 0-15 years and also
Patient dispense ART drugs
Consultation
3 Emergency Received and managed surgical and medical emergencies,
do emergency preparations and coverage of public events,
carryout minor surgery and general consultation after
working hours. The department operated 24 hours per day

4 Medical unit Provides medical care to patients with medical conditions.

5 Obstetrics/ Received and mange patients with reproductive care

gynaecology( post-
op natal unit, ANC,
family planning)
6 Pharmacy
problems and also render care to families during
pregnancy, delivery and the immediate after period. Also
assure follow - ups in PMCT and other obstetrical and
gynaecological complications. Also provides a range of
care associated with treatment and prevention of
reproductive care cancers.
It is part of the cost recovery program whose main activity
is ordering, storing and dispensing of drugs at affordable
prices. It is mainly supplied with drugs. Sometimes we
make small orders from other authentic suppliers with the
approval of other pharmacist of the fund when there is
stock out of certain drugs at the level of the latter.

7 maternity
Provide ANC, care during child birth, post natal support
districts of the LR and it is on the units under obstetrics
and gynaecology

8 paediatric ( child Manage children 0-15 year's problem for in and outpatient
 and consultation, basis. The nursery provides high dependency and special
nursery care of new normal and preterm babies
9 Theatre Carryout major and minor surgeries
10 Dentistry Provides oral care and treatment including oral and
maxillofacial surgery, orthodontics, and restorative
dentistry.
11 Laboratory Runs two shifts from 7:30am-6pm and 6pm-7:30am.
Patients are admitted after an operation and continue
follow up is done (female and Male wards).
12 Medical ward Runs two shifts from 7:30am-6pm and 6pm-7:30am.
Admits patients with various disease conditions (male and
female wards), nursing care, and Drug administration,
informs doctor when conditions become critical requiring
referral, follow up and discharge
13 Housekeeping and Maintains a safe clean environment and carry out
maintenance preventive maintenance and repairs all machinery
14 Maintenance Looks after mechanical equipment’s.
15 oncology Looks after cancer patients
16 UPEC To care for carriers (HIV patients )
17 imaging Where scans, echography and x-rays are done
18 Vaccination units Where all vaccines are given
19 Neontology Where new ill born infants are being kept
22 Sample collection For the donation of blood, laboratory test and
lab physiotherapy
23 Cholera cleaning For patients having cholera infections
center
24 Hospital hygiene Cleaning and keeping the hospital clean
25 Endocrinology For endocrine diseases
CHAPTER TWO
ACTIVITIES OBSERVED, PERFORMED UNDER
SUPERVISION AND PERFORMED INDEPENDENTLY AT
BONASSAMA
During this block posting, I was placed in the laboratory unit.

(a)Activities observed

 I observed that the laboratory was divided into two. In which the first
laboratory was bacteriology and the second laboratory was made up of
hematology, biochemistry and serology.
 Again I observed that in the bacteriology laboratory it was mainly used
in checking infections in faece, urine, blood and the infections we
checked by the use of a microscope.
 I observed how bacteria's were been cultured.
 In the second laboratory i observed that it was made up of three
different units inside that is hematology which a machine called the
mixer use for mixing blood and hematology analyzer used for analyzing
blood .
 In the biochemistry unit the use of machine to check if the amount of
cells has increased or decreased. A colorimeter machine was used for
checking renal and heart infections and a machine called ionogram to
calculate the amount of Na+, k+ and Cl-. I also observed a polymerase
chain reaction for mother's which are HIV positive which is used to
check if their baby's were contaminated when given birth. In the
serology unit it mainly made up of different test for anti- bodies and
antigene reactions and the type of test carried out there was blood
 group, CRP(c-reactive proteins) test which is an inflammatory infection
and ASLO(anti-streptolysin O) .

ACTIVITIES OBSERVED, PERFORMED UNDER SUPERVISION IN THE VARIOUS

LABORATORIES IN SCHOOL

1-DENTAL LAB

OBJECTIVES

 How to brush the teeth

 The causes of tooth decay
 The formula to calculate teeth
 How to care for the teeth
Functions of the dental lab
 To prevent infection
 To treat patients from tooth problems
 How to prepare disinfectants
Chemicals for disinfection and equipment
 Alcohol(70) swiping the hands after working on the patient
 Hypochlorite solution (corrosive) not very favorable dental varieties
 C4 sonic cleaner to wash, dry, disinfect
 Portable, distilled water, water system
 Armamentarium is where instruments are stored
 Germicide lamp to keep and kill germs if present
 Denture trimar, vibrator, denture pressure, air compressor, impression and
cass , dental radiographic machine, mobile dental unit


 2-PHARMACY LAB

OBJECTIVES

-How drugs are arrange in the pharmacy

-the nomenclature of drugs.

-drug prescription

Functions of pharmacy lab

-To know the right dosage of drugs

Equipment

-Gas and gas plate use as heating source

-Mixer

-Mortar and pistol use for size reduction

-Amber container use to package substances that are sensitive to light

-Electric heater

-Beaker for heating

-Water distiller

-Condenser

-Heating gauze and a tripod stand

-Electric magnetic sterile use in mixing

-Clam and stand

-Burette use in titration

-Conical flask

Drug arrangement and prescription

Drugs are arranged according to the following ways;

According to their therapeutic class

According to alphabetical order

First to expire first to be sold (FEFO)

First in first out (FIFO)

Drug prescription; an order from a licensed personal to the pharmacist for the
patient

Parts of prescription

Inscription is the information given by the doctor about the drug it includes the
following parts; Name of the drug, strength of the drug, form, time of
consumption, duration to take the drug, advice to the patients about the drug.

Subscription is the information given by the doctor about himself which

includes; his name, phone number signature stamp and qualification.

-Test tube, test tube draft and test tube holder

-Measuring cylinder

-Volumetric flask use for the preparation of standard solution

-Viscometer use to measure the viscosity of substances

-Stop watch

-Separating funnel

-Spatula use to pick up salt

-pH meter use to determine if it is an acid or base

-Stock container

-Soxhlet extractor use in the extraction of natural plant

-electric balance and triple beam balance

-Chemistry analyzer use to analyze chemical substance in human

3-MEDICAL LAB (MLS)

OBJECTIVES

-How bacterial are cultured

-How blood group is done

Equipment

-Clinical biochemistry use to measure biomolecule

-Biochemistry analyzer use in carrying out test

-Micropipette use to disperse tiny and measure micro volume

-Serology and immunology use to test for tropes

-Clinical hematology

-Centrifuge use to separate dense flood

-Autoclave use for sterilization

-Incubator use to maintain the temperature of microorganism for growth

-Microscopy use for view of organism that cannot be seen with the eyes

-Nuearer counting chamber use for differential count

-Electronic scale
4-NURSING AND MIDWIFERY LAB

Four units which are ;

1) Medical unit

2) Maternity

3) Outpatient unit

4) Emergency unit

In this unit I went through 4 units that is emergency unit, ANC, Outpatient department and

the medical unit

In the medical unit I observed how to do bed making. this procedure is carried in other to

ensure the patients safety and comfort and prevent bed sores for bed ridden patients it can be

done in other to improve the patients’ hygienic condition.

Principles of bed making include; working in pairs, limited movement, materials should not

go above bed level.

Emergency unit

At the emergency unit I got to learn how to do CPR (cardiopulmonary resuscitation)

In order to carry out CPR, you have to identify the incidence, take the patient away from

danger, call for help, measure the level of consciousness,

5-Physiotherapy Laboratory

It is a branch of medicine that diagnosis and treats various health conditions or

States by physical means.

Various equipment found in the laboratory: the standard folded walker, physio
ladder, therapeutic cage, bicycle ego-meter.

Branches of physiotherapy

Orthopedic, physiotherapy neurology, autism, mechanical therapy, massage

therapy.

Types of massage: frictional massage, petrissage massage and tapotement

massage.

6-Medical Imaging Technology (MIT) Laboratory

It is the use technology in order produce images of internal structures for

diagnosis and treatment.

Modalities

Conventional radiography; it is the use of x-rays to produce images of bones

Radiation therapy; using high energy to destroy cancerous cell

CT scan (computerized tomography scan):uses x-rays to produce images of

cross section of the skeletal system.

CHAPTER THREE

Conclusion
Limitations
  Construction of other specialties hospitals.
 Population declining due to high prices of medications.

Recommendations
 Allocate more time for clinical internship because 1month is not enough
to pass through various units to grasps practical knowledge, and skill
 I recommend that more young staff should be employed in order to
reduce the work load of the hospital and to promote efficiency.
 Also, the emergency unit should also have emergency drugs with them
and after intervention, the patient relative should settle the bills
 The nurses should be mixed with nurse aiders when organizing working
teams and the works of