Where I Was

So where were you eight years ago on this day when the 9/11 attacks happened?

That time, I was working as an emergency room nurse in a small Eastern Saudi province called Ras Tanura. It was in the wee hours  of the morning when it happened. There were no patients that time, and the tv was on at the waiting area. Flash news started appearing on all channels.

I was working with some Muslim colleagues that shift, and I will never forget their comments about what’s happening in the United States. They said it’s good for the Americans. And that they deserved it. I wondered what they were thinking why they hated the U.S.  so much. Thousands of people were dying, and they could say something like that.

Two weeks after the incident in the U.S., I had to fly home to the Philippines passing at FIVE airports. I experienced long queues at airports because they had to be strict with all passengers, especially those coming from Saudi. Luggages had to be opened and hand carried bags could contain only limited stuff.

I took a shuttle bus from Dhahran Airport to Bahrain Airport. From there I took a plane with connecting flights in Dubai and Hongkong. I stayed in Hongkong for two days before I reached Ninoy Aquino International Airport in Manila.

And that’s my story. Wala lang, nakuwento ko lang! Hehe!

(photo credits: z.about.com, zdnet.com)

The High as a Nurse

My night shift started very busy. The call bells kept on buzzing. Patients kept on calling. I was assigned to hold the controlled drugs cabinet key, and I noticed that there has been lots of pain medications given to the patients in the unit. Well, that’s the reality of being on a surgical floor. Post op patients require lots of analgesia to control pain.

But what if the pain would just not let go – because the pain was not only physical – but also emotional? This is the case for most of my terminally-ill patients. I admit, the pain that comes from knowing that your time is almost over is the most difficult pain to deal with.

Early this morning, I woke up John (not his real name) so I could start giving him a wash. It was a big day for him today. He’s taking a 9-hour flight today to come back to his home country. He’s a colon cancer patient and the doctors had given up on him. He’s had quite a number of surgeries and blood transfusions, and the doctors have decided that it would be better if he comes home to his country and be with his loved ones, while he is stronger.

I did a complete overhaul on him. I changed the NGT tape. I did a quick aseptic dressing of his abdominal wound and packed it with lots of gauze to prevent it from leaking during the flight. I washed his hair, and gave his body a quick scrub. I attached two new empty drainage bags for his jejunostomy and nasogastric tubes so people wont start avoiding him in the airport when they see him with drain-filled bags. I removed the hospital gown and made him wear a long-sleeved shirt and black pants. I wanted him to look like just one of the normal passengers in the airport.

As I was doing all of these, I kept on conversing with him. He was genuinely happy when I told him that the old dressing I removed in his abdomen was quite dry. It was a good news for him because that abdominal wound kept on oozing with yellowish fluid for weeks now. “Haay thanks, Lord” was his touching reply. I knew he was still clinging to his last hope. That miracles still do come true.

I told him that I wanted to go with him so I could see my family too, that I would hide inside one of his luggages. He just laughed, and his sincere smile was enduring. I felt his happiness knowing that he’ll be with his family very soon. But I also realized that coming home this way – to see his loved ones for the last days of his life – was never a good reason to fly home. I could also feel the pain he was hiding.

Finally, I gave him enough pain medications-  a shot of morphine and  a fentanyl patch on the chest – to keep him comfortable during the trip. That may not be enough to relieve emotional pain, but I knew it’s going to help a lot.

He left the hospital with his wife and son, even before my shift ended at 7am. The wife texted me on their way to the airport to extend her thanks. She apologized for not being able to help me prepare her husband for the trip, but I told him it was just fine since I understood that she was also busy packing things up.

I was already having breakfast at home when I got the phone call from the wife that they have boarded the plane. She sincerely thanked me for taking care of his husband for the last weeks. She invited me to visit them in their place, when I go for vacation next time. Nurses really do get a high, when they get appreciation and acknowledgment from their patients and their families. And I am not an exception.

Today, I celebrate my first year working in this oil-rich country. One year ago on this exact day, I came here seeking for better financial opportunities. A year after, I am here reaping, not only the monetary value of my work, but moreso, the opportunity to be of help to those who really need it. Because of my work, I have a deeper appreciation of life, and that gives me all the more, the strength and wisdom to continue struggling against the sometimes harsh realities of life.

Thanks, John, for giving me a great way to cap the year.

 

(picture credits: procorbis.com, helpinghands-seniorservices.com, oldtibet.com)

Homesick :(

I woke up this morning feeling so bad about the world. I think I’m homesick.

I just arrived yesterday morning after a 9-hour flight from Manila to Abu Dhabi, and a one-and-a-half hour road trip to Al Ain. After the long travel, it just felt good reaching home at last. Mark, a neighbor invited me for breakfast so we could catch up on things and after that I crashed on the bed and woke up in the afternoon feeling hungry again. I cooked dinner and invited my buddies Miller and Remyr to eat with me. We had a long chat, and they left before midnight.

I started doing the chores around the house – laundry, dusting, vacuum. I unpacked my luggage and started arranging my cabinets. I checked my emails quickly and a few minutes later, I was found dozing again.

Only when I woke up this morning that I realized – hey, I’m alone again! I was not awakened by my baby crying for milk, or by my wife getting ready to leave for work. Nobody asked me if I want to eat breakfast now. I did not hear any kitchen noise. The TV was not on yet. The sweet dream is over. I guess, I am back to reality. I am home alone again.

The worst part is that I’ll start working again tomorrow:(  

I think I need to go to a mall to divert my attention 🙂

An Ambulance Trip

0300pm. I was sleeping when I was informed by phone that I need to come to work early. I needed to accompany a patient that was going to be transferred to another hospital in Ras Al Khaimah, which is about 3-4 hours away from Al Ain. I came from a night shift that is why I was still sleeping, was supposed to come to work for a second night shift at 7pm only.

0415pm. Got up and got ready to come to work. Ate heavy dinner.

0520pm. Arrived in the hospital. Received endorsement from the nurse-in-charge of the patient – an ESRD patient complicated by a fractured humerus and femur post fall. The thing with this, I get a few seconds of endorsement, but then I am expected to know everything when asked in the other hospital.

Reading the file, I found out the patient was not Hep B positive as written on the medical report! He’s Hep C positive! Good I found that out, otherwise, I’ll be giving wrong information to the other hospital!

0600pm. Wheeled the patient to ER where the ambulance was waiting. To my surprise, I  will be alone with the transfer (I thought I’ll be with the EMS). I will just be with the driver. I had to figure out quickly how this techie stretcher works. We have a different one in our unit! Ambulance left our hospital.

Another surprise came to me when I reviewed the patient’s xray films. Written on the report that I will be submitting to the other hospital was that the patient was having a fractured LEFT humerus. Looking at the xrays, the fracture is on the RIGHT humerus! The xray report accompanying the films also says RIGHT humerus! Gosh, I will look so dumb when I reach the hospital there. Thanks to the people who prepared this medical report! I just made the corrections myself…

Inside the ambulance, the patient was stable. But then I had to figure out by myself how the equipments inside work. Although I have worked as an ambulance nurse before, I still felt that I need some kind of orientation about the stuffs found in this ambulance particularly. It was my first time to ride on this hospital’s ambulance, and this one’s kinda high-tech. Lots of machines, and buttons around me. 

Since I have accepted this job of accompanying a patient on a long trip, I was expected to know everything inside the vehicle and that was even without anybody teaching me. Haay… and I was supposed to save a life when an emergency inside the ambulance occurs! I just love this kind of job!

0900pm. After breezing through the traffic and a heavy rain, we were able to reach the hospital in Ras Al Khaimah safely, with the patient remaining stable. Thank God! I was received by some ER personnel who were mostly Malaysians and Filipinos.

0930pm. After the patient was endorsed to the nurse who’s going to look after the patient, the driver and I left the hospital and made our way back to Al Ain.

1230am. The ambulance brought me home directly to my flat. After staying inside the ambulance for almost six hours, I am just so thankful to be home and be back to a very comfortable and familiar place!

In Case of Emergency: ICE

I worked as an ER nurse for two years and part of my job was to take shifts in riding the ambulance whenever necessary. When attending to an accident scene, we usually needed to check the victim’s belongings to check for his identity. This is important especially if the victim is unable to think due to confusion, or is unconscious to be able to speak or dictate phone numbers of relatives who need to be contacted.

 

During my time, we usually search the victim’s wallet for identification and telephone numbers. But that was many years ago when the use of cell phones is not as much as it is nowadays.

 

I came across a personal safety campaign related to this from Aidisan recently and it is called the ICE (In Case of Emergency) Campaign. The idea is to enter in your cell phone’s address book the name and phone number of the person you want to be contacted “In Case of Emergency.” As hundreds of names could be listed in your Contacts List, the names of contact persons should be entered under the name ICE, so that the emergency services will be able to locate easily who your next of kin are and be able to contact them quickly.

 

In case of more than one contact person, the other names should be listed under ICE1, ICE2, ICE3 and so on.

 

Locating a relative during an emergency is important not only to be able to relay what happened to you, but also to find out from your nearest kin if there are other things that need to be considered in your case, such as if you have any preexisting medical conditions such as diabetes, hypertension, or cardiac problems. The relative might also be able to provide vital information such as the name of medications you are currently taking, if you have some food or drug allergies, or if you are wearing implants such as pacemakers or AV fistulas.

 

Nowadays, paramedics usually turn to a victim’s cell phone to find clues for that person’s identity. So to make it easier for the responders to get the information they need, people are encouraged to adopt this ICE idea.

 

It would only take a few moment to do this on your cell phones. You never know, by so doing, this could save your life or could put a loved one’s mind at rest. Please help spread  this campaign.

 

 

Picture from citynews.ca

Patience.

If you choose to become a nurse, I think you should have a lot of this: P-A-T-I-E-N-C-E. Last night shift was another test of how long my patience could be stretched.

 

I had another difficult patient last night. Not that his case was complicated. He was just a 16-year-old chap with fractured pelvis and femur post vehicular accident. He has external fixators on his pelvis making him unable to move a lot on the bed. These did not sound so complicated for me, but the patient’s behavior made me classify him as a “difficult” patient.

 

He pressed the buzzer several times to call for a nurse and I think I made about thirty trips to his room. Initially, he was having left foot pain. I gave him some analgesia. He called again several times after I gave his pain medicine, so I had to explain several times that the drug would not effect immediately, that he needs to wait a couple of minutes. Later, I decided to page his doctor to get a telephone order for a stronger analgesia. The medicine ordered was an intramuscular injection which took me a lot of my convincing powers before I was able to give it to him.

 

He also complained several times of itchiness on his back and left leg. I had to turn him several times in order to massage his back to apply some lotion or some damp wipes. I also had to do the same for his left leg and I had to reopen and close his knee immobilizer often for that.

 

I would not mind relieving all his discomforts, for that was part of my job. But the problem was the way he talked to me. He shouted and yelled at me as if he was talking to a slave. He seemed like a spoiled brat, because the parents were there and they just tolerated it and they even add to the shouts and yells. Initially, I had to tell them that they do not need to raise their voices, but then I felt I was talking to deaf ears. That explained why this patient was being rotated to different nurses each shift. Nobody seemed to like entering his room.

 

A couple times I had to be asked why I was late coming in to his room, when he was buzzing for a long time. I had to explain myself that I was looking after five other patients who were as sick as him. I knew I should not be explaining myself because I knew that they were not really waiting that long, that they were just exaggerating.

 

I never felt that he got satisfied with everything that I did for him, and I never even heard him or his family say some words of appreciation. All I got from them were complaints, smirks, and pouty faces. Each time I had to enter his room, I needed to take a deep breath, in order to give me enough powers to smile in front of them.

 

Every time I leave his room, I just tried to understand his behavior. But to feel bad about how people treat you is but human. I have my own emotions that can be hurt and I could not be blamed for feeling that way. Nurses are not stones.

 

I know patients deserve all the care, and understanding they need, so I just shrugged everything off. I do not allow situations like these go through me, around me, and never ever allowing the emotions stay inside of me. If I do, I could not continue my job. I had other patients who need me and who knows how to appreciate other people. And it is because of them why I am coming back for my next shift 🙂

 

Nursing was never an easy job, especially if you work in a busy surgical unit like mine. You have to have a lot of patience in order to deal with the demands of the profession. Most of all, you need to have the versatile heart to feel for other people 🙂

30 Hours Awake!

 

Have you been awake for 30 hours straight? Well, I just had my longest 30 hours. Here’s a recall of the last 30 hours before I finally slept last night…

 

09 Oct 0430pm. Woke up to prepare for my night shift. Started cooking dinner. Checked emails.

 

0630pm. Left the house to come to work. I usually walk my way to the hospital.

 

0645pm. Arrived in the unit.

0700pm. Received endorsement from the outgoing shift.

0730pm. Started a gruelling 12-hour shift. I had six patients:

 

1.  A diabetic patient who just had a right knee arthroscopy who complained of pain several times. I had to check his blood sugar twice during the shift.

2.  An old man with Bilateral Hydronephrosis with left and right nephrostomy tube. He was on a lot of pain also.

3.  A post left catheter nephrostomy insertion, also in pain.

4.  A comatose man on tracheostomy. Suctioned secretions. Turned to sides. Fed per PEG. Washed on bed early in the morning.

5.  A left lung sarcoma patient with amputated left leg. He has two chest tubes attached to suction. He complained of pain although he was already on Patient-controlled Analgesia (PCA). He also complained of inability to pass urine post foley’s cath removal during the day shift. I inserted another foley’s which needed a lot of convincing before it was done. I pushed him by the bed to the xray department in the morning.

6. A patient with an external fixator whose urinal gets full whenever I checked him out. He was on some IV antibiotics.

 

I had a very heavy non-stop night shift. I planned to take a 30-minute nap during my break, but I was not able to do that. I had my dinner break at 2am.

 

10 Oct 0700am. Endorsed to the next shift.

 

0730am. Left the hospital. Went to the nearby gift shop to buy some gift wrappers, only to find out the shop was still closed. Started walking to go home, till a nice guy with a car saw me and gave me a lift.

 

0800am. Home sweet home. Prepared breakfast. Grabbed TV remote to catch the morning show. Opened my laptop to answer emails.

 

0900am. Prepared to attend a baby dedication (same like christening, but this one’s for the Baptists). Can’t wrap the gift I previously bought from a mall. Decided to just place it in a nice plastic bag. Took a bath.

 

0945am. Picked up by the couple whose son will be dedicated.

1000am. Arrived at Palm Resort. There was a program for the 4^th Anniversary of Lighthouse Baptist Mission in Al Ain and the dedication was included in the program. Was feeling so sleepy in between and my eyes was starting to give up.

 0230pm. Lunch at last. Food was nice. Met new friends.

 

0400pm. Picture taking. My contact lens were starting to dry up.

 

0500pm. Went home. Opened TV again. Checked emails again.

 

0600pm. Prepared to leave again for a scheduled 7pm dinner party. Took a quick shower. Changed to a another dress.

 

0645pm. Catched the bus going to town.

 

0725pm. Arrived at China Wall Chinese Restaurant for the dedication reception. Met new friends again. Was feeling high already, as if I took a drug! Nice food also! Ate a lot!

 

0900pm. Picture-taking beside the Dancing Fountain at the Park Square.

 

0930pm. Home at last. Cleaned self. Prepared to see a buddy who called me earlier to see him.

 

1000pm.  Night cap with Remyr and Miller at Miller’s flat. Remyr prepared some melon shake.

 

1015pm.  Went back to my own flat. Checked emails again.

 

1030pm.  Crashed on bed!

 

Whew! I could not imagine I was awake for 30 hours. I woke up this morning after an eight-hour sleep, but I was still feeling so sleepy. After I had breakfast and made some email updates, I crashed again on bed and slept for another 6 hours.

 

What happened was basically an abuse of one’s body. It was just that I couldn’t break previous commitments. I had fun with my new acquaintances though.

 

 The good news is, I have started recharging while writing this 🙂

 

Missed call. Missed chances.

I am so depressed today. I have to write it down.

 

I missed that golden opportunity of finally seeing my son in the Philippines just because I was not able to answer my mobile yesterday morning.

 

We have a critically-ill Filipino patient in our unit, and for the last months, there has been a plan to send him back to the Philippines so he could retire there. He needed a nurse to accompany him on his flight going back to the country.

 

My co-nurses in the unit felt that, in case the patient will be transported, I can escort the patient going to the Philippines because they all know about my story of me having a son born after I came here. They sympathize with me, and although everyone wants to escort the patient because it’s a rare opportunity of going home to the Philippines for free, they gave way to me so that I will be able to see my first-born son.

 

I was out in the town yesterday evening buying some grocery when one of my co-nurses, X, called me and told me that the patient will be transported on Friday, but somebody else is escorting the patient. He asked me what was happening coz everybody knew that I was the one chosen to accompany the patient. I told him that nobody informed me about it. He said that our unit manager has arranged in the morning for the flight of my other colleague, Y.

 

X was so concerned that if I am not going with the patient, then he should be the one to transport the patient because they have some unwritten policy in the unit that Filipinos in the unit should take turns escorting a patient going to the Philippines. But since I have a reason for coming home, my co-nurses was giving way to me even if I am just a newcomer in the unit. X argued that Y should not be the one who should transport the patient because he was the last one who just recently escorted a patient going to the Philippines.

 

I told X that I do not know anything about the arrangements done in the morning. X said that he’ll speak to our unit manager and get back to me in the morning.

 

This morning, I called X. He said he was able to speak to our unit manager and he found out the story. Our UM was trying to call me in the morning because she knew that I was the one chosen to accompany the patient. But apparently, I was not picking up the phone. I was just home yesterday morning and I don’t know why I did not hear my mobile ringing. I was probably in the bathroom or in the kitchen. I saw the “missed call” sign later during the day but the number registered a landline I did not know from where.

 

And since our UM was in a hurry to get somebody because she needed the passport details of the person who’s going to accompany the patient, so they could book the plane tickets. She was unaware of the “escorting turns” policy so she just called Y, who gladly accepted the offer.

 

X was disappointed that Y accepted the offer without question, knowing the he just escorted a patient, and that he needs to give way to others who have not done it.  Anyways, that’s another side of the story.

 

After the phone conversations with X, I decided to call our UM. My call was not to insist myself that I should be the one to go with the patient. I called her to apologize for me missing her calls yesterday morning. She said she was sorry too.

 

It was a depressing morning for me. If I did not miss the call yesterday, I could have been the one escorting the patient on Friday. I could have been the one who’s going to the Philippines. It could have been my chance to see my family, especially my son. It could have been a rare opportunity to finally embrace my baby even for a short time.

 

But I missed that chance. I usually answer my phone calls and try not to miss them. So for me to miss a very important call was a rare instance.

 

For now, I just try to make myself believe that the trip was not meant for me. I guess I should do something to keep myself busy today, since I am still off and I am only working tomorrow evening. I do not want to dwell on these negative feelings.

 

I think I’ll just go to downtown and get myself a nice haircut 🙂

 

My Probationary Period Ends

Time flies so fast! I had finished three months here in my new workplace! And yes, my 90-day probationary period ends today. I will now just wait for the evaluation that will be handed over to me by my unit manager.

 

Looking back, I feel I have grown a lot in terms of career. As a neurosurgery nurse, I was initially scared of my specialty being lost in a general surgery set up. I was forced to learn more cases beyond my specialization. Now, I am able to deal not only with neuro cases, but with other gen surg cases as well, such as plastics, vascular, orthopedics, optha, ENT, and urology.

 

I also feel that although I am still adjusting to the new work environment, I have started settling in. I am able to work comfortably with most of my colleagues (not all of them though coz there are still some whom I still need to really relate to). But I guess in general, my colleagues has started to consider me as a useful staff. When I was just starting, I felt I was a pain-in-the-ass coz I asked a lot of questions. But now I can say that I am able to perform my job independently (with lesser questions :)).

 

My flat has slowly transformed into a “home” over the last three months. When I came in here last June, my unit was just a place where I could sleep and rest on my offs. But now,  my flat has a tv, an internet connection, a videoke system with speakers. There are picture frames, candles, clocks and throw pillows. The kitchen is complete with the utensils, and I have bought a rice cooker and a microwave oven. My place is now a place where one can relax, unwind and live comfortably.

 

I have also gained new friends here. My list of friends and acquaintances gets longer and longer everyday. I feel that the world will not run out of nice friends as long as I try to be nice to other people, too.

 

I can only hope that my evaluation report comes out well. Personally, I feel that I did well in my first three months here, not only work wise but in terms of adjusting to the new environment in general. According to my self evaluation, I passed! And that counts a lot! 

 

A Nurse’s Pockets

 

3am. Night Shift. Patients are sleeping. Charts reviewed. Documentations done. Extra duties performed.

 

Here’s to list down what’s inside my pockets right now. Just to keep me awake, otherwise, I’ll doze off.

 

1. a multicolored pen – I use three different pen colors on my endorsement sheets.
2. a yellow highlighter – This is to highlight the important tasks in my endorsement sheets.
3. a penlight – to check pupils in neuro patients and also to use as a light when entering patients’ rooms when patients don’t want to be disturbed by opening the lights.
4. my hospital ID clipped on the pocket – of course.
5. a pair of scissors – very dependable, should not go out on duty without.
6. 6 gauge 23 disposable needles – I need this to put an air vent when IV medications in glass bottles don’t infuse well.
7. my folded endorsement sheet – I might go crazy if I loose this while on duty.
8. my wallet – just in case I need money
9. my cellphone – somebody might call me
10. a hanky – to clean my oily face in the later part of the shift.
11. medication trolley key – each nurse has their own key
12. disaster pager – tonight I was the one assigned to hold the pager
13. 2 3-cc syringe – to aspirate normal saline for flushing IVs
14. 1 normal saline plastic ampule – for flushing tubings before administering IV medications
15. micropore tape – always needed
16. my USB flash drive – co I could copy a document quickly
17. my pocket notebook – where I write step-by-step procedures, and phone numbers
18. a couple of alcohol swabs – to wipe vials, tubing ports
19. 2 tape removing swabs – used when removing tapes of infiltrated cannulas
20. some blank stickers – to label tubings
21. some garbage – caps of needles, and tubings

 

That’s all folks.

 

The stethoscope is on my neck, not on my pockets, just in case you’re looking for it…