Thursday, January 8, 2015

LBJ Tropical Medical Center - American Samoa

Here are some various photos taken around the ground of LBJ Tropical Medical Center:

This first photo is the main sign at the entrance to the main parking lot.  The hospital's main bus stop is situated behind.

The hospital is laid out in wings, with two main hallways joined by cross hallways.  The US and American Samoan flag fly out front.  It is not uncommon to see dogs sleeping on the sign (see my previous post).

One of the several open air pavilions at the hospital that acts as a waiting area.  Due to the heat, much of the hospital is open-air. 

Another view of the open-air courtyard. There is a picnic area in the middle, to the immediate left of the camera is the women's axillary snack shop, where you can buy egg sandwiches, tuna sandwiches, and various drinks.  Tuna is a staple here due to the starkist factory in Pago Pago.

There are almost as many chickens running around as there are people.

Here is the drive-up to the Emergency department.  There are usually 4 physicians or NP/PAs working in the ED per shift.  Two trauma bays, around 10 separate bays with curtains.  They do not have any advanced imaging - no MRI, CT, or even ultrasound.  They have XR and use the PACS system that we use at HCMC to view films - though the monitors are standard definition. The ambulance parking is on the right side of the building in the photo (not pictured), and patients are loaded through a side door that is guarded.  Most pediatric procedures are performed by the Peds on call - LP, catheterizations, lines, etc.  The staff in the ER are a friendly bunch, and do a great job with the resources they have available.

(I think this would be an awesome place for HCMC's EM program to rotate - they could really help out with their ultrasound and trauma skills, and the hospital could really use their help)

One of the main hallways of the hospital.  The pipes above are exposed, which adds a neat dynamic to the building. In general, the hospital is very clean and well-maintained. 

There is a very affordable cafeteria here with good portion sizes.  You can usually get a good meal for around $4-$5.

 As you can see, the placement of the wards and departments are fairly random. I got lost for the first two days any time I needed to go somewhere.  I especially like the fact that the "spare parts" are located next to the morgue. Hmmm....

The doorway to the ICU.  I did not take a photo inside for patient privacy reasons.  It is basically two rows of beds facing each other and separated by curtains.  There is one isolation room in the back.  The ICU has a reputation on the island as the place nobody leaves alive.  (I had to admit a kid for DKA to the ICU and had to talk mom out of hysteria because she thought her kid was going to die simply because she was in the ICU)... again, this reputation is a testament to the struggle that the amazing doctors here face on a daily basis.

The wards were recently renovated (I think using stimulus money). Here is the pediatric ward.  Very bright and colorful - well, apart from the seasick pooh bear on the wall.  The nurses here are very nice.   

In the corner of the outside courtyard (across from the ER) lies the Pediatric Clinic, the place where I spend most of my time when I am not on call or in the Nursery/NICU.  There are two benches outside and generally it is packed with people waiting to be seen.

The waiting area of the clinic.  This photo was taken at the end of the day. Usually this place is completely packed with patients waiting to be seen.

At the back of the clinic is where bicillin shots, albuterol nebs, and other medications are administered.  The nursing staff in the clinic are super friendly.

Here is one of the patient rooms.  It is equipped with pretty much everything you need.  The one downside is that there is not enough ear pieces to go around - so we save them for cleaning and reuse at the end of the day.  We use CPRS for our Electronic health record (same system as the VA), which is adequate to get the job done, but not as complete or easy to use as the EPIC system we use at Hennepin.  There is also a very large written component to the documentation (a fact that I kept forgetting the first few days).

For the animal lovers out there, here is my furry companion.  She sleeps right outside my door at night and is always there to greet me in the morning.  The hospital has "adopted" her, and she is the only dog I have seen around that actually wears a collar. All the other locums and families throw her scraps of meat, so she is fat and happy.


  1. I am a middle aged guy who passed the NCLEX here in the states and was thinking about moving to AS to work as an RN. Can you tell me what it's like living there? I hear the food is very expensive with no fresh anything, electric is very expensive, no hot water, no AC and lots of bugs. What is the pay scale for a new RN in AS? My email is Thanks

  2. Corn2 am a native AS who use to work at LBJ as LPN & RN last year 2016. Last I heard starting rate for an experienced RN was $31k/yr.For a new RN no experience I think it was $27-28k annually.But from what I understand because we get a lot of contract workers and many RNs from the Phillipines in addition to the salary contract workers(doctors & nurses)get monthly allowances for rent. We had a sweet southern gal who up n moved down for a year n was given monthly allowance foe housing/rent. Plus some of the new filipino nurses w b o started with me told me they get annual trips back home to their native countries paid for by lbj but of course that was bck in 2015.
    Although the pay is lower-it is based I believe on the minimum wage, if u are looking for experience LBJ I would say is a great place to get experience aa a starting nurse and I think if u can survive LBJ u can work anywhere. As doc above described dats pretty much what we got in Samoa as far as resources foe treatment. Ues there are alot of mosquitoes,and its hot n humid like any tropical island. Butif u like hiking,swimming,paddling,& an easy laid back go with the flow outdoorsy type, then Tutuila is gnna be a great adventure for you. The people are generally friendly and everyone is pretty laid bck. As far as freshness if ur referring to produce on island there are vegetable stalls throughout the island mainly on the west side of the island anywhere frm cucumbers,zucchini,tomatoes,lettuce,Corn,chinese cabbage etc. Dont get started on the fish because it caught daily n sols in stores/restaurants or fish markets otherwise u can go fishing for it urself a la boat or jst a fishing rod. Cost u Less (similar to Costco) gets abt a weekly shipment of goods from mainland US for beef n everything else under the sun otherwise there's a large communty of Asians n asian markets/stores like KS Mart. Yea the prices of goods are more expensive than the US but thats becuase like Hawaii we get everything shipped in but like a loaf of bread iS <$2

    1. Srry for spelling errors-darn thumbs lol but I think lbj has given alot of past new nurses great training. We had someone else female nurse who graduated frm a Tx nsg school also come dwn n when her contract was up she went back. So did the southern gal who came dwn last yr shes now a travelling nurse now stationed out in Alaska.Tje nurse to patient ratio tho can be pretty steep at times frm 1 nurse to at least 8 patients bit thats because we were always short staffed bit frm what I hear right now the wards are pretty well staffed now.Hope this answers ur questions.Our summers are usually the winter months so like maybe Nov-Feb is usually more hotter than usual even though it is hot yr round.