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

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

A Brief Intro to Radiation Clinic

August 27, 2014.

Orientation done. Well sort of.

And I’m off to start working in my new department, in a new hospital, in a new country… half way around the world… So I’m taking my amazing work family from back home with me for moral support on this first day of my new job!

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Today starts the beginning of my orientation to the Radiation Clinic. 4-5weeks of preceptorship and learning the ropes in a new department!

Fortunately, I have my radiation therapy nursing certification, so the science of it all is no different. What is different is how the department is run. And my role here!

When I visited the unit last week, everyone was supremely welcoming and friendly. But it’s all a bit of a blur now and I really don’t remember many peoples names… Or much of where anything is!

So… I arrived at work… And met my new work momma… Shiny, my orientation preceptor. And she is absolutely the sweetest!!! I’m really going to love working with her.

And everyone is absolutely so kind and friendly… I feel like I got a giant hug today from everyone! Just scooped up and cuddled like a sad and lonely little puppy!

One of the Radiation Therapists, a beautifully vibrant and energetic and outgoing individual, shortly after meeting me, invited me along to a bunch of events this weekend as I had nothing planned due to all the other girls from my GNO group working the weekend. It was so nice to feel so welcomed and to have something to look forward to on the weekend… which is only a day away now.

Now… my first day of work was interesting. It is going to take a while to wrap my head around the differences here. I’ll go into great detail on it at some point… but for now…

The basics are that the Radiation Clinic consists of 6 treatment units for various types of radiation therapy… of which I have nothing to do with. That is where the Radiation Therapists come to play.

Then, there is the Recovery Room (nursing domain) where patients are monitored post General Anesthesia for Radiation Therapy, patients also recieve IV fluids, blood products and various other treatments if necessary.

In another corner of the department is the Nurse Clinic, where nurses see patients requiring hydration, blood products, IV starts for CT sim, medications for symptom management, and other treatments also that might be scheduled or for drop in patients.

This is all very much like home.

What is different, are the various clinics where nurses and doctors see patients throughout the week. Rooms 2&3, 4&5, 7&8… all contain different clinics depending on the day of the week. All the doctors hold clinics – stereotactic clinic, head and neck clinic, sarcoma and miscellaneous clinic, lymphoma clinic, pediatric clinic, gyne clinic, breast clinic, etc.

And the nursing role in these clinics is… well… hmm… different!

My first day was in rooms 2&3 in the Gyne/GI/GU clinic. We start out by checking charts… prepping charts (stamping and dating progress notes) … checking the rooms and schedules to make sure everything is ok. And then we start to see patients… as in we check their vital signs. Maybe assess their skin to make sure they are not developing radiation dermatitis. Obviously generally assessing the patient to ensure that they’re doing ok. But then we seat them in the room and get them ready for the doctor.

Then the doctor sees the patient and assesses how they are doing. Writes in the progress notes and maybe orders some labs or a cream or a medication.

We enter the orders. Sign off on the chart. And send the patient merrily on their way. The end.

Minimal education on side effects. Minimal assessment of side effects by nursing. No handouts on constipation management or skin care or pain managment or maintaining nutritional or hydration status…

Very different from back home where nurses do the majority of assessment and monitoring of radiation side effects and definitely the vast majority of teaching on preventing radiation side effects and how to manage side effects if they develop. At home the doctors do all this also, but a large portion of that role falls to the nurses.

Obviously a significant reason for this difference is due to language barrier. It easy enough to look at a patients radiation site and physicially assess the skin. But it is much harder to ask them about nausea, pain, constipation, fatigue, etc. and get good information if you don’t speak their language fluently. It is even harder to provide them with clear, consise information on how to manage all those symptoms if you don’t speak their language. So the majority of patient teaching falls to the Arabic speaking nurse educator.

So… learning Arabic as rapidly as possible is going to be extremely important!!! Yalla yalla Annemarie!!!

And that is the beginning of my nursing career here in Saudi Arabia. Prepare yourself for a lot more discussion on the differences on nursing care here vs. home… the benefits… the downsides… the challenges… the beauty of it all…

Until next time…

xx

Annemarie