#notjustanurse

For a month or so in September/October 2015

By this time, I’d spent a good 4 weeks at home, just slothing (being a lazy bum) and vacationing… not being particularly productive with my life other than agonizing over what I’d do next with my life and whether i’d go back to Saudi or stay in North America.

I decided it was time to step out of my funk and get on with work. Things would eventually fall into place with a long-term plan again… but while I sorted it out, I was desperate for some good, proper, really hands-on nursing again. I was going through patient care withdrawls.

Also, Miss Colorado (in some pageant) just made a major statment in international entertainment news when she wore scrubs and a stethoscope and went onstage and talked about her role as a nurse. But what really caught the world’s attention, and especially the attention of nurses around the world, was when a few ignorant talk show hosts, specifically the ladies of The View, made mention of her “doctor’s stethoscope” wondering why she as a nurse was even wearing a “doctor’s stethoscope.” Obviously, we were all a little offended. Nurses united around the world, speaking out on social media against the ladies of the view, and promoting our profession in whatever way possible!

Miss Colorado: Not Just a Nurse

So, I returned to work with great pride as a nurse, wearing my “doctor’s stethoscope”, grateful that I’d chosen this wonderful profession and not medicine. Because I chose to be a nurse and not a doctor. Nursing was not my fallback. I didn’t go into it because I couldn’t get into med school. I could have gone to med school. But instead I chose to be a nurse, to spend more time working directly with patients, being their main point of contact, being that person to see them at and help them through their most vulnerable times!

I have my very own stethoscope, and I use my stethoscope to listen to my patients lungs to ensure they’re not filling with fluid/developing a pleural effusion/observe for signs of infection… to listen to their hearts to make sure they’re in a normal rhythm… to auscultate their bowels to ensure things are moving through properly and to detect when they’re not so that I can fix the problem. Unfortunately, part of my job is also to use my stethoscope to auscultate a heart that is silent and no longer pumping blood throughout the body, and lungs that are no longer breathing and filling blood with oxygen… and then to tell a patients family in the kindest but always most inadequate words, that I hear nothing anymore and confirm what they already suspected, that the one they love is deceased. And it’s me, the nurse, who has to do that, not the doctor, with my very own stethoscope. However… that being said, I don’t mind it, because next I get to hug them all, and do exactly what I went into nursing for… to offer comfort and support and care for people at the most difficult moment in their lives. So, I’m very proud to be a nurse and part of this very honorable profession. I can’t imagine being anything else!

When I first graduated from nursing school, I was blessed to get a fulltime job on the unit I did my final practicum on, a Tertiary Palliative Care Unit. I know I put the unit way up high on a pedastal, and I consider my colleagues on the unit to be the very best nurses I’ve ever worked with. Maybe it’s just because they’re the first nursing team I’ve really been a part of? Maybe it’s because they’re the team that raised me from a green, super fresh and young baby nurse to the nurse I am today? Maybe I’m just super biased?

But then I think about it a little more and remember how I saw them interact with patients and their families on a daily basis… their infinite care and compassion… seriously, the most caring group of individuals I’ve ever met. Nurses with a heart and passion for one of the most difficult fields of nursing practice… nurses who daily pull together as a team and are so supportive of each other as it’s the only way to survive in such an intensely emotional environment… nurses who advocate daily for nothing but the best for their patients and consistently put a patients needs and desires above their own… nurses who go to great lengths to ensure comfort of both a patient and their family… nurses who go above and beyond every single day, without ever asking for or needing recognition, because it’s just what they do, it’s what they love to do.

They’re not just nurses. They ARE nurses. They are the people you want spending 24 hours a day with the person you love and who is at the most vulnerable and difficult point in their life. They are the person who will ensure that the one you love, is loved and taken care of so that they want nothing but to spend time with you in comfort and peace!

Palliative care nurses are a special breed of nurses. We are faced with death and dying and sadness on a daily basis. Yet we are happy, not sad and gloomy. And our unit is suprisingly filled with light and laughter and happiness, not just from the nurses but from our patients and families also. We’ve learned to see the good in everything, to find the shiny silver lining to it all! If we couldn’t see the flip side, it would be come intensely overwhelming and we’d all crash and burn out for sure. But we have each other, we have the most lovely patients and families… people who are generally focused on the good things in their lives and have let go of the bad because who wants to hang onto the bad and nasty things when theyre so clearly faced with their mortality?

I miss palliative care. I think it’s the best of everything in all health care disciplines brought together to create the most holistic and collaborative and patient/family centered care possible, care that is dedicated purely to meeting a patient’s goals and ensuring their comfort in everything! Due to the culture, the lack of education on palliative care, and just general misconceptions, palliative care doesn’t really exist in Saudi, at least not at all in the way it does in North America, and it really is a shame. While I was home I read the most fantastic book by Atul Gawande called “Being Mortal” who suggested that patients who have palliative care services involed in their care, generally tend to live 25% longer. That’s an extremely significant result. Depending on the estimated time frame, it could be anywhere from extra days to extra years… but if it were me, I’d take anything I could get, especially when it only means that I’d be more comfortable and experience less symptoms and side effects…

Anyways. I was so happy to get back into palliative care and work with my favourite colleagues for a good month while home. I was worried that I would have lost a lot of my skills as I’d been out of inpatient care for well over a year by this time, and outpatients is much different! But… it was like riding a bike… but so much better!!!!

I probably drove my colleagues crazy with all my comparisons of Saudi to home. But i forgot how well stocked our supply room is at home… all the time!!! Like heaps of IV fluids in all sizes and all flvours… NS, D5W, 2/3 1/3, lactated ringers, NS with 10, 20 or 40 KCL… it’s amazing!! And we never run out of IV lines either like we do in Saudi!!!

And don’t even get me started on the narcotic prescribing and accessibility!!! Appropriate doses, with ranges for nurses to use base on patient needs… with normal time frames for administration (anywhere from q30min for a PRN to scheduled q4hourly analgesics)… and then all the adjuvants… gabapentin, citalopram, etc… and meds to manage all the side effects of narcotics… And a Pyxis (electronic drug cabinet) filed with everything from Tylenol #3 (shit) to Morphine/Hydromorphine/Fentanyl/Methadone!! It was amazing!! In Saudi we have Morphine (5:1, i’ve never seen anything more than 5mg IV prescibed unless palliative care services was somehow involved and the patient was recieving long acting morphine 10mg) Demoral (who still uses that crap except ER??!!) and Tramadol (even more ridiculous especially as it seems to be the drug of choice for oncology physicians in Saudi!).

And our doctors… oh my goodness… they’re so fabulous. They’ll just sit and spend anywhere from half an hour to an hour just talking through problems with patients and their familes. And they’re so open to suggestions from nursing!!!! I feel valued and respected! It’s wonderful!!! (and the feeling is very much mutual!)

Anyways… enough comparison… I’ll just mention again how much I adore my colleagues, how much I loved spending so many nightshifts just catching up with them, how much I loved working as a casual and picking up heaps of shifts in a two week period so that I manageed to work with almost every single nurse on the unit, and how much I loved our Thanksgiving night potluck… it was wonderful!!

Wearing colored scrubs with no repercussions… instead of shapeless/baggy white scrubs!! Personally I think they’re so much more cheerful and make me much more approachable… plus, hello?… white coat syndrome??!!!  Also, In Saudi, I’m not allowed to drink coffee on the unit unless i’m in the staffroom, and getting caught drinking coffee at the nurses desks can result in a serious talking to/written warning… so I very gleefully drank coffee on the unit/at my desk/in the lobby… all day long actually. I loved stopping at the Starbucks in the lobby for coffee breaks and drinking my coffee while looking out at the trees in the atrium… my seasonal “autumn” cup from Starbucks! And then… can’t forget stat holiday pay!!!!!! Working Thanksgiving night meant I got a couple hours of holiday pay… that’s another thing we don’t get in Saudi… (but considering we get 54 days vacation, i can’t really complain!!)

And then to top it all off.. breakfast with a few colleagues and a now moved on to Calgary colleague who came to visit with her adorable little munchkin…

 

And a wine night with one of my nursing school classmates who is now working on my old unit too…

I think it’s important to be able to sepearate our work and personal lives… but it is also amazing to be able to have a great relationship with your colleagues and spend time outside of work with them also!!!

So, when my last day of work in Canada came again… i was really sad to leave everyone behind again. (Not sure why i keep torturing myself with goodbyes!!!) But… back to the adventure… let’s see where this crazy ride takes me again!! I’ll be back again… and if not back to this unit… at least back to palliative care because every time i work in palliative care I know that is where my heart is… So… one day again soon…

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Challenges, Decisions, Reflection…

July 15, 2015

After nearly a year in Saudi Arabia… it’s time for some reflection. For some serious thought about what to do next. Should I stay or should I go?

I love nursing… with everything that is in me… I can’t imagine what I’d be… or who I’d be if I wasn’t a nurse. I love the medical aspects and the science of nursing… the complexities of the human body and disease processes in the human body…

But mostly… the greatest reason why I went in to nursing was for people. To love people. To nurse them back to health… physical, mental, emotional health. To show them kindness and compassion when they’ve been dealt a heavy blow… a hard lot in life. To talk to them and get to know them and to understand their values and beliefs and how that impacts their illness experience and then to help them get through it!

“When I think about all the patients and their loved ones that I have worked with over the years,  I know most of them don’t remember me nor I them,  but I do know that I gave a little piece of myself  to each of them and they to me and those threads make up the beautiful tapestry that in my mind is my career in nursing.”     -Donna Wilk Cardillo

Working in Saudi Arabia challenges me as a nurse in infinitely more ways than I thought possible. I work with a patient population that rarely speaks the same language as me, a population that has a culture so different from my own, a religion with similarities but yet so many differences from my own.

The language barrier is one of the greatest challenges to me as a nurse. It stops me from being able to get to know my patients the way I’m used to… the way I want to! It stops me from being able to share information with them that could help them cope better with their disease and treatments. Showing kindness and compassion and loving people is something that can be done without words… but it is hard to do without words!!

So many days, I feel like I’m not nursing the way I love to, the way I should be. I’m not functioning in my full capacity. I’m just a fraction of myself as a nurse!

This is my greatest personal challenge.

But… I do my best to communicate caring and compassion… even without words!! In the words of Maya Angelou “They may forget your name but they will never forget how you made them feel.” It’s true. It doesn’t take words to make a patient feel comfortable and cared for!

Then comes the organizational challenges. Working in a hospital culture where nurses are not respected and valued the same way they are in the western world… especially in North American hospitals. Nurses are much further down in the medical hierarchy than doctors here in Saudi. We are not particularly valued. Our knowledge and input is rarely considered. We are pushed to not ask questions or consider all the options and potentially more beneficial scenarios for our patients. A doctor or a more senior staff members instructions should be taken and performed immediately without questioning it.

I was taught to provide rationale for everything I do. I was taught to question everything. Is this the right order, the right drug, the right surgery, the right treatment for my patient? The right course of action? If so… Why? What does the patient want? Is it going to potentially cause more harm for my patient? If so, does the risk outweigh the benefit? If not, what is a better option?

Here, incompleteness is a way of life. The culture is often reactive vs. proactive. There is little foresight. There is little holistic care. Quantity is often considered greater than quality. Relief of suffering has little value. Education is lacking. Education for doctors and nurses… for patients… significantly lacking! And the worst part… it doesn’t feel like many health care practitioners in this hospital even realize how much their education and skills are lacking!!

As a palliative care nurse at heart, this hurts me. I believe in holistic care. In caring for the whole person. Spiritual, mental, emotional, psychosocial distress make coping with any type of physical distress worse. We need to minister to all aspects of a person in order to ensure a successful transition through the disease process.

I believe in preventing problems before they get worse because I know what worse looks like… the very worst! Education helps with this. Education helps problems to be identified before they become particuarly problematic. Education helps people cope with problems by understanding the disease, their expected trajectory, the treatments and side effects and the best way to manage it all. Education helps doctors and nurses provide the best care for their patients and the information their patients need.

I belive in quality vs quantity always!! What is quantity if there is absolutely no quality?! Good quality often leads to a greater quantity anyways!!

Suffering does not necessarily make you stronger. How can you focus on God or Allah or on your family when you are out of your mind with blinding shards of hot white pain? Or when you can do nothing more than retch and vomit until blood vessels burst in your eyes and your abdominal muscles are distraught with discomfort from heaving? When each breath is the greatest challenge of your life and your only thought is how you can suck in the next one?

Yes it can make you more dependent on God or Allah… but it is far too often used as an excuse here to not provide appropriate analgesia or symptom management of any type… And that hurts my heart!

The challenges of life here… all the many little things that are so easy anywhere else in the world are just infinitely more challenging here… and having to fight for every little thing you need… it’s exhausting. It depletes your emotional reservoirs. As an expat, you need to know that you’re leaving at some point. Whether it is just a visit home for special events, or even just to be with family for a brief time of heartwarming solace. It makes it easier to deal with the hardships and challenges of Saudi life.

Not knowing for months and months when my next chance to leave would be made it very hard to cope with the frustrations of life in Saudi and I worry it was starting to turn me into a cynical, negative person.

I started this post on my dad’s birthday nearly a month ago… A day when I was reflecting on my family… wishing I could be home with them and especially my dad on his birthday… stressing about leave… I’d been facing a significant dilemma regarding leave. I needed leave to go home for my brothers wedding at the end of July. But it was to be right at the end of Ramadan during Eid when it is nearly impossible to get leave in my clinic due to the large amount of staff wanting off then. Also… it was to be right at the end of my contract so the only way I could get leave was to renew my contract.

I was so stressed trying to sort out what to do. I like to think I’m a relatively strong individual with pretty decent coping skills… but the last few weeks have really tested my strength and pushed me to my limits of what I can handle emotionally!!! All the cumulative challenges have made it hard for me to cope with life in Saudi Arabia. Add to that the uncertainty of not knowing whether or not I’ll be able to be with my family during a very important time in my family… and just being so far away from family during a stressful period in my life… it’s been hard. Very very hard. I thought about leaving. I thought about not signing a second year contract and leaving Saudi Arabia for good!

My leave was eventually granted… for which I was very grateful. But new issues arose…

So, I came to the decision that my best option would be to “pretend to leave”. I handed in my resignation. I will be taking terminal leave and making a final exit out of Saudi Arabia. But… with an exit/re-entry visa which will allow me to return if I want to, within the next 6 months.

I was ecstatic typing up that resignation email actually. I felt like a huge weight had been lifted off my shoulders. All the stress of the last couple months disappeared as thoughts of home, cuddles with my niece, hugs from my parents and siblings, days at the lake wakeboarding, hiking in the beautiful green forest, beautiful bottles of wine picked from the liquor store by me, motorbike rides with my dad and wine tours, my brothers wedding… and the best part, now being able to be home for the birth of my new niece or nephew. So many things I would have missed otherwise by only being able to be home for 3 weeks… I’ll now get to experience blissful, beautiful summertime weeks at home to relax and rejuvinate my soul…  surround myself with people I love more than anything in the world! People I miss every day while I’m away… People who, life here has taught me to appreciate so much more than I did before!.

It was very upsetting for my parents and for the rest of my family when I decided to move away from them and across the world to Saudi Arabia. I sincerely appreciate how supportive and understanding they’ve all been for the past year. And I know that they’re just as excited as me that I’m coming home potentially for good.

I may get home, go back to work, cuddle my new niece/nephew and decide that there’s no way I can come back to Saudi Arabia. There is a strong possibility that happen.

But, at the same time, I currently enjoy my life in Saudi Arabia ALOT. Like seriously ALOT!! My year is nearly up and it has been amazing beyond my most optimistic dreams. I’ve learned so much and had some phenomenal experiences here in Saudi and in my travels while I’ve been living in the Middle East. There are so many things I love about the people, the culture, the community, the religion, the desert, the weather, and especially the genuinely wonderful people I’ve met here in the expat community.

I’ve made some beautiful friendships here… with people just like me… people who love travel and adventure and experiencing the world and new cultures… people who understand the addiction to the expat life. And… I have plans for the next year here yet. A weekend in Sharm El-Sheikh with friends. Dubai for the Formula 1 races and the Rugby 7s. Talk of an India trip with one of my closest friends. A wedding in France and one in the UK. So much to do. And my travel list is SO far from complete. Plus, I originally came to Saudi Arabia to work at the King Abdullah Center for Oncology and Liver Disease. It hasn’t even opened yet. And I’d really like to be here when it does open. So I have a lot to do yet here in the Middle East. I’m really not done yet.

So… I’m aiming for 6-8 weeks at home… and then hope to return to Saudi Arabia, Inshallah. So… you haven’t seen the last of me yet!!!

Thank you to all of you who have supported me through this experience… championed and encouraged me… hugged me and loved me when I felt broken by the challenges of life here… and laughed and danced away not only the sadness and frustration with me, but also the sheer joy and pleasure that is life with people you love!!! I love you all more than I can ever express and my heart is so full from knowing you. I really really do hope that this is only a temporary goodbye!!!

Forever with love,

Annemarie

Changing Departments: Off to Oncology Clinic

October 23, 2014

So I’ve been in Saudi Arabia, in Riyadh, at King Faisal Specialist Hospital & Research Center for about 2.5 months now.

I had originally applied to KFSH&RC because I wanted to become an oncology nurse and learn chemotherapy. At home, it is fairly difficult to get into chemotherapy clinics as positions are usually snatched up by staff with much more seniority.

So learning that KFSH&RC was opening a big a new cancer center and looking to train new staff… I jumped at the opportunity to come here and learn new skills.

Unfortunately… but not really… I ended up in the Radiation Clinic for a few months initially as this is where I had some background experience back home. But after 2.5 months… of really not utilizing my Radiation Therapy nursing skills… and not much of my nursing skills in general… I realized I had to switch departments. To something a little more intense… where I’d actually learn what I’d come out to Saudi Arabia to do!

I requested a department transfer to the Oncology Clinic… and after a few weeks of following through the appropriate chanels… I landed an interview with the head nurse… who then offered me a job in the Oncology Clinic. YAY!! I would be trained in chemotherapy administration and also would take a basic oncology course to gain a greater understanding of oncology nursing.

Fortunately, between my Palliative ICU background and my Radiation Clinic experience from Canada… Oncology nursing isn’t completely new for me so I’ll have a bit of a leg to stand on… I hope!!

Anyways. Today is my last day in Radiation Clinic. I’ve loved getting to know a lot of the staff there and building relationships with them and some of the patients… However… it is time already … to move onto what I came out here to do…

Masalama Radiation Clinic… I’ll just be a couple floors above you now 😀

Nerd Alert: Can’t wait to start learning heaps of new things again!! I seriously love cancer care… it’s fascinating!! I could talk about it for ages… but I won’t bore you with my jabber of that at the moment.

So… enjoy this video… love the app… it had myself and my coworker Vivian, from back home, laughing hysterically for ages at work!! Stress relief!!

Enjoy…

 

Breast Cancer Awareness Day

October 21, 2014

October is National Breast Cancer Awareness Month… especially in North America. Follow the link below to learn more about how you can become more aware about Breast Cancer.

http://www.nationalbreastcancer.org/breast-cancer-awareness-month

Today is Breast Cancer Awareness Day at KFSH&RC

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Breast Cancer is a devastating disease that affects many women and also men all around the world. It is a disease that the majority of us can relate to as we have most likely somehow been affected by it, whether we ourselves have had breast cancer, our mother, auntie, sister, friend, grandmother… or maybe we are cancer nurses and have had significant exposure to the impact of breast cancer on individuals and their families. It is one of the leading causes of cancer related deaths worldwide, and although there have been significant advances made in the treatment of breast cancer, it is still a devastating disease.

In Saudi Arabia, breast cancer rates are high and similar to what they are in the rest of the world. However, the average age of diagnosis of Breast Cancer for women in Saudi Arabia is age 48 years old, an entire decade earlier than in North America! http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370407/

One significant disadvantage is a lack or primary care and awareness about breast cancer and how to detect it early. Many women do not have a family doctor. They are not regularly assessed for their risk. Many women are unaware of how to perform breast self exams. There is no regular screening program either where women of a certain age regularly receive mammograms.

This all leads to later detection where the disease is further advanced and treatment options are not as easy or as simple as they are when the cancer is detected at a very early stage.

However, advances are being made in educating the public. And days like today, breast cancer awareness days, help to advance knowledge about Breast Cancer among women in the Kingdom of Saudi Arabia. And hopefully, one day there will be excellent screening programs in place for women and cancers will be detected more frequently at an early stage rather than at a more advanced stage.

Follow this link below to read an article from the Middle East Journal of Scientific Research… “A Review on Breast Cancer in the Kingdom of Saudi Arabia”

http://www.idosi.org/mejsr/mejsr14%284%2913/14.pdf.

I hope one day women and men around the world will be fully aware of their risks,  and pray that one day everyone will have equal opportunites for monitoring for this terrible disease and treatment if required. I wish I was positive enough to believe that one day there will be a cure for this deadly disease, but the realist in me says that it is impossible as genetics deteriorate and we continue to lead unhealthy lives.

So please, be responsible for your heath. Do your BSE’s regularly (Breast Self Exams)… eat healthy… a diet with minimal fats and high in nutrients and colorful fruits and veggies containing heaps of antioxidants (cancer fighting molecules)… and exercise regularly! These things might not prevent you from getting breast cancer, but at least you know that they are less likely to be a factor in the development of cancer.

Much love to you all… I pray you are never affected by this terrible disease!

Love from your Oncology Nurse in Saudi Arabia…

xo

Annemarie

Welcome to the Radiation Team

September 18, 2014

Today is Thursday. And Thursday means it is a relatively quiet and lazy day in the Radiation Clinic. No doctors clinics. Just a few drop in patients who might need to see a nurse/doctor before the weekend but nothing scheduled.

So it is generally a day where we have inservices and various presentations for “staff development” and such.

And we also get to have parties!!!

I’ve been in Radiation Clinic for almost a month now, and Vivian has just arrived. So the unit held a welcome party for us… and a masalama (goodbye) party for Esperenza who is leaving us for another department.

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The great thing about Thursdays here in Radiation Clinic is that there are no official clinics so it is so much less busy… Although it does get a little boring! But today it’s a good thing because we could easily spend some time decorating the staff room…

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And easily spend an hour or so at lunch hanging out with the whole radiation interdisciplinary team… The radiation therapists, the nurses, even our head nurse and the doctors. I really really enjoy this group of people actually… and coming from a region in Canada, just outside Vancouver, where the majority of my coworkers were Caucasian as well as the majority of our patients… it is a wonderful experience to work with people from all around the world!!

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I must say… it is absolutely wonderful to have a coworker from back home here with me… it helps you gain perspective one days when its a little hard to find a positive perspective… or when you’re feeling particularly challenged by the differences in practice between Saudi Arabia and Canada… It’s nice to have a friend who understands where you come from and what it was like back home… So, I’m very happy to have Vivian here with me!

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There was so much food there it was a little ridiculous almost!! Asking everyone to bring a dish for a potluck results in excessive amounts of food. But in this extremely multicultural workplace, it’s great because we get to sample food from all over the world! Homemade sushi, Saudi dishes, Indian food, ceasar salad (my contribution as requested… Tried to make it with turkey bacon but it just doesn’t crisp up or taste as delicious on top of ceasar salad as the real stuff!!)

Anyways…. It was a really great way to end the workweek… especially because after the potluck, all of us nurses just sat around chit chatting and building friendships with each other!

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The end. Have a wonderful weekend everyone!!!

xx

Annemarie

The Process… including BLS class

September 18, 2014

One thing I’ve learned about Saudi Arabia… everything is a process… a generally fairly lengthy and slow moving process… and there’s a process for the process for the process!

In order to technically work and stay in Saudi Arabia, I’m required to have a Saudi Arabian nursing license… like I would back home in Canadian (except that’s a Canadian nursing license obviously!). And in order to get my Saudi Council for Health Specialities license… I need to be BLS certified.

Of course I just renewed my CPR/BLS back home… but apparently Canadian CPR isn’t good enough?! Only American Heart Association BLS is accepted… So I signed up for the course… along with a bunch of girls from my GNO group…

It was actually a rather fun class. For starters… my friend Yin taught the class… and there was plenty of practice and laughs…

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Here I go… going deep… giving good, quality CPR!!
imageIt was a warm classroom and we definitely got a decent workout in!!! Those 30 compressions to 2 breaths definitely are a good cardio workout… hahaha. No pun intended. But really. Both for the giver of BLS and the reciever who is getting some good cardiac massage and such.

And then we moved onto the kiddies… the glee on my friend Moira’s face as she pounded that kids back… haha

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Anyways… the class was fun… we all passed. Fortunately, I’ve already been approved for my Saudi Council license already (my BLS booking was enough…) but for the rest of the girls… now they can move onto the next phase of their license application process.

Also… another reason this license is so important… we need it in order to get our iqama (our Saudi Residency Permit)… and we need an iqama in order to stay in Saudi…

And so… off I go to apply for my iqama…

Ma’asalama

Annemarie

We do work some days…

September 2014

So… I know it seems like all I do is have fun out here (and that would be pretty accurate!!), but I do also do some work!!

I’ve finished a couple weeks of orientation now and I’m really enjoying a lot of things about my new workplace… My radiation clinic coworkers are absolutely lovely human beings with such warm and loving hearts!! I feel extremely welcomed into the department and it’s a wonderful feeling.

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We have plenty of time to chit chat and build rapport and it is really really nice to build relationships with my new work family! I am going to spend the majority of my time here in Saudi with them… a minimum of 44hours a week… so it is a good thing that we all get along well!!

The actual nursing… I’m not going to go into much detail… but as I think I’ve mentioned… it is much different from back home. I don’t do a lot of nursey-nursey stuff… and I do really miss the nursey stuff!!!

Although I did have a couple hours in the recovery room today with the little kiddies as they recover post Ggeneral anesthesia for radiation treatment… Definitely more “nursey” skills involved!!!

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(one half of our recovery room… shown above)

One of the biggest challenges I’m facing now, is the language barrier!! I knew it would be a challenge before I even moved to Saudi, but a couple weeks of general orientation and being constantly surrounded by English speaking people, put me in a slightly delusional state, forgetting that it wouldn’t always be that way!

So now, when I do happen to have a patient who actually speaks English enough to communicate with me or to understand me fairly well (when combined with an excessive amount of hand guestures), I feel this overwhelming sense of joy as I can really get into nurse mode and ask them questions and assess them properly and teach them things about managing their side effects! It’s wonderful!

I had a patient with breast cancer one day… and she showed up in the clinic with her daughter. They were both very well dressed individuals and spoke remarkably beautiful English, and seemed like highly intelligent and knowledgable people. It was only the beginning of this woman’s cancer treatments, so she asked me what she could do to prevent her skin from breaking down. (Note: one of the most common side effects of Radiation Therapy is Radiation Dermatitis… where the skin breaks down due to the radiation damaging the poor little surface and deeper cells).

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This is when I’m in my element… Educating patients!! (Very very rarely get to do that here as it is generally not our role… again, largely due to the language barrier.) So I got to tell this lovely lady and her daughter all about how to keep the skin clean and moist and to moisturize regularly and what type of products to use and things to avoid in the products. And they soaked it all up, and asked lots of questions. It was wonderful. I felt like I actually was able to fully do my job for the first time in a while!! Hopefully, this patient will have learned from what I taught her, and be able to take measures to prevent Boxes, B,C or D (above) from happening!!!

At home, at the BC Cancer Agency, we have well developed policies and protocols for managing side effects such as Radiation Dermatitis, plenty of handouts and leaflets and information sources for patients to help them prevent and manage these side effects. However, here at King Faisal Specialist Hospital & Research Center, these policies and protocols haven’t been developed yet, although they are working on some of them. So I hope that myself and my colleague from home will be able to help them implement some strategies and information sources in order to reduce the risk of side effects in patients undergoing Radiation Therapy here. Prevention is key!!!

Anyways… enough jabbering… this turned out to be a long-ish post. But I figured I needed to put something up for once that wasn’t about parties and fun. Although as you can see, we do still have a lot of fun even at work!!

And we have lovely patients who bring us all sorts of deliciousness… just like at home. Like Reese’s Peanut Butter cups… Om nom nom!!

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So…

Ma’asalama

xo

Annemarie