Freedom is a glass of wine

I’m not a fan of prohibition at all. Especially the prohibition of alcohol. And I’ve begun to equate alcohol with freedom. Freedom is a glass of wine… with friends… or family… or own my own!

I’m back in Saudi at the moment and all I really want is a glass of wine. A beautiful big full glass of red wine. Real red wine. From a bottle that I picked out  for myself at the shop… and then drove myself and my wine back home in my car…

Having a drink is more than just having a drink to me now. It means I’m free. It means I’m relaxed. It means I’m not in Saudi Arabia. It means I’m either on vacation. Or on a day or night off. It means I’m probably surrounded by family and friends. Or I’m on my own just enjoying a quiet night. That’s freedom to me. Freedom is a glass of wine. Or a bottle. Or a cool, refreshing G&T… or a good craft beer…

I probably sound like an alcoholic, but I’m not (and I’m not just in denial). Really. I just miss the simplicity of a lazy evening at home with a good book and a glass of good red wine. Or a beer on the patio in the late afternoon sunshine. I don’t get to do this stuff over here. I mean, not completely freely without any suggestion of repercussions.

I was so happy to be home during the end of summer and all the family BBQ’s and dinners we had… as well as being home for my aunt’s birthday party and hanging out with aunts, uncles and cousins… laughing a lot… drinking a lot of wine and whiskey… and dancing to a whole lot of country music… (country music never gets played in Saudi if you happen to be at an event where there is music and dancing!!) But now I really miss those family nights and events…

I love a night out with girlfriends… catching up… getting all the gossip… having a martini… and a lot of laughs over a shared bottle of wine. I get lots of girls nights in Saudi… but they don’t include a good martini 😥

Freedom is nipping out to the next city over in my car with all my favorite tunes blasting while I go to meet an old friend… who just happened to share 11 months with me in Saudi… someone who completely empathizes with me…

Freedom is a good night with one of my closest friends from high school and her Aussie husband… remembering good times back a few years ago when I went to visit them in Australia and we had the greatest night out in Sydney ever!!!! And now they’re living in North America instead of Australia, and I’m in Saudi… crazy how our lives change!!

Oh yeah… can’t forget… going out for dinner with a guy who is not my brother, or my father, or my husband, or my boyfriend either… just going out for dinner with an old guy friend. Having wine and beer and chatting for hours and hours about medicine – conventional and naturopathic… and generally just catching up on life… and no-one raises an eyebrow. There’s no fear that one might get caught by the muttawa (religious police). It’s just innocent and fun and free!

Anyways… that’s enough boozy talk now. I just really miss these days at home. I miss this freedom…

 Conflicted

This post has been sitting in my draft box for a long time… and I think it’s about time I shared it.

All my life I’ve generally had very clearly defined goals and dreams and hopes… I’ve always known what I wanted to do next in my life. Until I spent a year in Saudi Arabia, and then returned home for a few months… and then had to decide what I was going to do next. And then I realized that for the first time in my life, I didn’t have a clear plan or real goals on what I wanted to do next in life.

I didn’t feel like I’d finished the last chapter in my life… but I wasn’t sure I wanted to continue that chapter anyways?!

The first time I planned to leave Canada… my family… my home… and go to Saudi Arabia, I was desperately in need of a change, a getaway, an adventure. It was my first time living away from home and family… and I was so excited to see what the opportunity would bring me!! Leaving them the first time was difficult, but I had so much to look forward to that it wasn’t nearly as hard as I thought.

When I came back home on leave last February, I was just so happy to see them all… and I loved every minute of being home. With the exception of the times I cried just thinking of leaving them all again. It was much harder leaving that second time. Knowing exactly what I was going back to… not filled with quite as much excitement knowing some of the difficulties I’d have to deal with back in Saudi. And knowing exactly what I was leaving behind.

Well now, I’m home again. I’ve been home for a good month. And I’ve just been clinging onto my family for dear life. My niece has grown up to a vivacious little 2 year old who lights up my life with her laughter and chatter… I hug her and think of how I don’t know if I can even imagine being separated from her again. I snuggle my new niece and she’s such a tiny precious little bundle… and I think of how she’ll be a whole year old by the time I’d return again to Canada, and how I’ll miss the entire baby phase of her life and it devastating!

My sister and I were so close the year, and especially the summer before I moved to Saudi for the first time. But now… having been gone a year… she’s busy with her home and kids and life in general… and I feel things have changed. With all my family actually. And especially with my friends. Their lives all carry on and move on while I’m gone… nothing stays the same. They’ve changed. I’ve changed. Or maybe they’ve not changed that much it’s just me that’s changed so much??  Some things are exactly the same but so much is different… or my perspective on it is different.

And that makes staying harder. I just feel lost a lot of days… not sure where I fit in, or what my role is, or what I’m even going to do anymore.

Fortunately, I’m not the only one who felt that way on returning home! One of my colleagues from home who moved to Saudi Arabia for a year also, and returned only a few weeks after me, was feeling very much the same way when she returned. There’s something about travel and having a completely incomparable, indescribable experience like living in Saudi Arabia that changes you in ways that other people will never understand… that makes assimilating back into life in North America, in our home communities, with the people we love more than anything… very difficult!

People ask about our experiences and want to know what life is like there, but it’s so completely foreign that they start to fade and glaze over before you’ve gotten more than a minute or two into the “general speech” you give everyone who asks. The have no way to relate to it at all. They can’t even begin to imagine why we even lived there in the first place or why I’d want to go back to it. I talk about my frustrations but they seem so simple, but yet they’re so complex. I talk about the fun and the parties, but again it’s completely foreign to them.

So now, there’s this entire year of my life that is so important to me, that’s changed me so much as a person, that no one at home understands. And that’s a difficult thing. So how do I fit back into normal life now?!!

Do I want to fit back into normal life or do I want to return to my Saudi life?

I think of my friends in Saudi and all the amazing experiences I had in that first year. Unique experiences. Incredibly positive experiences… and incredibly negative experiences… and a whole lot of crazy in between. With people who understand what it’s like. And I think of all the things I’d planned to do yet… and I feel that I’m not done. I’ll always feel like I left something unfinished there. I didn’t even say goodbye to everyone. Not like I meant it anyways. It was just a goodbye see you in month or two sort of thing!!!

But then I think of how much more I love my family and hate to leave them. And I’m so conflicted. I just really really don’t know what to do.

Travel? Adventure? Carry on crazy awesome life experience? Advance my career? Expand my incredible international community of friends and connections?

OR…

Family? Home? Mountains? Rivers? Oceans? Green lush gorgeousness? Active outdoorsy beautiful natural life? Freedom? A glass of wine every evening? Surround myself with the people I care most about in the whole world? The things in life that really matter at the end of the day?

It could be said that I’m having a lot of that in Saudi as well… and that some of those things could keep til I return to Canada… but we never know when our time is up or whether we will get a chance to return right? Nothing in life is certain or forever…

What to do now??

October 21, 2015

I made my decision. In a moment of weakness on a nightshift, my new contract offer had come in days before and had just been sitting in my inbox while I attempted to make a decision… and while I was tired and my defences were down, I made the leap and signed the papers. So on October 21st, 2015 I left home and headed back to the sandbox. Crazy fact is that I signed for 2 years instead of just one this time around. Don’t know exactly what I was thinking… but we’ll see how this scenario plays out.

My family didn’t think I’d actually make it on the plane to head back to Saudi… I didn’t think I would either. So I got the hospital to include a 24hr stop in Minneapolis so I could visit my best friend. That way I’d actually manage to get on the plane!

But… I strongly felt that Saudi was calling me to come back. At the time I didn’t know what it was yet… but something was calling me. There was a reason I needed to return to Saudi Arabia. A reason greater than travel and life experience and my international community of friends.

And as I write this bit… I now know what that reason was… and it’s amazing and I can’t wait to share it so I’m mad updating the blog! Stay tuuuuunnned!!!

 

#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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The Miracle of New Life

August 7, 2015

The miracle of new life… the birth of a child… one of God’s greatest gifts to us.

12 days ago I left Saudi, indefinitely, so that I could be home with my family for my brothers wedding and for the birth of my new niece or nephew.

Well, I’m so grateful I was home!! I am blessed beyond measure to have been able to witness the birth of my precious, beautiful, perfect new niece… Kaylia Brielle. Born August 7, 2015 at 8:49AM… she entered the world rapidly, opened her eyes wide, started to look around and cried… and now my heart belongs to two absolutely darling little nieces!

IMG_2469 IMG_2455 IMG_2471 Being a palliative care nurse, it is far too often that I see the opposite end of the life spectrum… and today was a breathtaking reminder of how precious new life is!

When I think of the science behind the creation of a child… the millions of cells the divide and replicate and grow to form the perfect little being that was born this morning… it fills me with awe. How blessed are we to have a healthy new child enter our lives?! Chances are so high that something could have gone wrong at some point in that delicate process… yet, thanks to God, she was healthy, and we pray she continues to stay healthy!

My oldest niece, not sure what to think of her little baby sister at first… rapidly adjusted to the big sister role. Although she hasn’t fully grasped how fragile the little darling is compared to her!

Love my family… more than words!

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Eid Mubarak

My sincerest apologies that this is a little late… I have a really bad habit of starting a post and leaving it in my draft box…

So I actually began this on the first day of Eid… And Eid is over now… But…

Eid Mubarak to all my Muslim friends around the world! I hope you had a blessed Ramadan and had a blessed Eid al-Fitr!  

It’s 3am in Riyadh right now and I’m wide awake, sitting in the blissful warmth outdoors, letting it bake into my bones… Listening to gentle water movements from the pool… And all I feel is gratefulness.

Earlier today I was so upset with Saudi Arabia… I felt like nothing was going right all day and all the little frustrations built up to a point where I was just raging!

But a couple hours later… A beautiful dinner with friends at a gorgeous gem of a hidden Riyadh restaurant… Several very intense games of mafia… A lot of laughter… And my mood completely reversed!

How much you enjoy life in Riyadh is absolutely all about the company you place yourself in and the people you surround yourself with. I am so blessed to have a multinational and multicultural group of friends who I’ve shared some incredible experiences with!!  Dinner conversations are stimulating and thought provoking… And filled with laughter and fun and completely trivial discussions as well! They open my mind to new ways of thinking… To new opinions and beliefs… They’ve helped me to grow as an individual in so many ways!

And as far as religion goes… Ramadan has officially come to an end. The last month has been filled with many discussions about Islam and the purpose of Ramadan… I’ve learned so much!!! For those of you who don’t know, I’ll include a couple links to sites with more information about Ramadan… but briefly: Ramadan is the 9th month of the lunar calender and a month of fasting for Muslims around the world. Ramadan begins on the first sighting of the new moon, and ends 30 days later with the next sighting of the crescent moon. So as you can imagine the crescent moon is hugely symbolic of Ramadan and Eid.

However, Ramadan is not just fasting, it is abstaining from smoking, sex, drinking and from anything excessive or inappropriate. Muslims fast from sunrise to sunset, about 17 hours depending on the time of year and the location one lives in. Pregnant women, the elderly and the very young and the sick are excused from fasting. As a nurse, especially an oncology nurse, we have to check with our patients to ensure they are not fasting. It is a difficult thing to tell them not to fast as we know how important it is for them. However, for patients going through chemotherapy, they’re very sick and need to eat to keep up their energy, and especially they need to drink a lot of water as chemotherapy is very toxic and needs to be flushed from the body!

The purpose of Ramadan and of fasting in general is to cleanse the soul and the mind, focus on God. Fasting (sawm) teaches spirituality, humility and patience. Spiritual rewards for fasting, especially during Ramadan are multiplied. Fasting and restraint from everyday enjoyment and curbing wicked intentions and cravings are considered to show obedience to God, and amend for past sins, and mistakes.

During Ramadan, Muslims request forgiveness from sins and pray for direction and guidance for the future, and try to cleanse themselves through self control, prayer, fasting and acts of faith and charity.

Fasting begins at sunrise and the last meal before fasting begins is called suhoor. The first meal that breaks the fast at sunset is called iftar. Prayers are called salet, and Muslims pray at least the 5 prayers a day if not more. Towards the end of Ramadan in Riyadh, the prayer call goes out much more frequently than usual and prayers last for much longer than usual also.

The mood here during Ramadan is special. Everyone is in vacation/holiday mode.  From friends who have fasted in other places in the world and are now here in Saudi fasting during Ramadan, they say it is actually much easier here than elsewhere. Muslim staff work reduced hours during Ramadan, making life easier for them! Working a 12 hour shift while fasting would not be easy! Especially as many people tend to spend a lot more time sleeping during the day, and are awake a lot more at night, so having to be awake all day to work would be additionally challenging. It is an entire month of the year when families spend a lot of additional time together visiting, sharing meals, etc.

While I did not fast during Ramadan, I had many friends who did, and I had the pleasure of breaking fast with them on more than one occasion… many hotels and restaurants here have large buffets for iftar… like the Ritz-Carlton and the Narcissus Hotel… I enjoyed a few of these meals with my Arabic/Muslim friends or with my Western friends…

Now it is the end of Ramadan, and the Eid celebrations had begun. The mood is so upbeat and happy in Riyadh and around the world. Seeing the Eid al-fitr live feed on snapchat was amazing… But even more than that… Being surrounded by people celebrating Eid… It’s wonderful!

Eid is basically a celebration, and Eid al-Fitr is a feast/festival to celebrate breaking of the fast. It is the first Eid of the year and occurs after Ramadan. The religious Eid is a single day that occurs on the conclusion of 29/30 days of fasting. Special Eid prayers are performed on the day of Eid. But the celebration continues for 3 days in most Arabic countries. Many charitable gifts and donations are given at this time. People celebrate with many dinners and special events with family and friends. It is a happy time of year… and I don’t mean this offensively at all but the it reminds me a lot of Christmas at home!

The city is decorated with hundreds of flags for Eid on all the overpasses on onramps… there are beautiful purple and green and white trees everywhere… lanterns and beautiful cresent moons everywhere for decoration…

And people everywhere wishing you “Eid Mubarak” which is the traditional greeting. Mubarak means blessed and Eid is celebration. So: blessed celebration!

People appreciate it so much when we say Eid Mubarak to them! My friend and I were going to the DQ on Friday afternoon and when we said Eid Mubarak to the guards at the entrance they were so happy and excited, saying Eid Mubarak sisters back to us!

So… I wish peace and happiness, grace and forgiveness to all my Muslim friends around the world, and all my friends actually!! This is a special time of year for Muslims… But it really is a time for peace and respect all around the world. It’s a time for us all to open our eyes and appreciate the different cultures and religions around us…

So Thankyou Saudi for giving me the experience to really experience Ramadan and Eid… For opening my eyes to this beautiful culture…  

Iftar Buffets: Perks of Ramadan

Ramadan… the holy month of fasting in Islam.

Days of depriving oneself during the day… Followed by nights of family time and friendship… and food and drink that is much more appreciated than usual.

Being non-Muslim, I didn’t participate in fasting. But I was somewhat deprived of food and water during the day as I couldn’t openly eat or drink at work.

Iftar is the meal that breaks the fast… the first meal Muslims eat after fasting all day long. It starts immediately after Maghrib prayer, the sunset prayer. (Almost sunset below… over the fountains at the Ritz-Carlton Riyadh).

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Riyadh has many beautiful hotels which hold large Iftar buffets. The Ritz-Carlton is supposed to have one of the best. This was the first Iftar buffet I experienced with friends.

So much food. It was unbelievable! Salads, seafood, hummus etc. Huge platters of kabsa and a full roasted lamb… a pasta station… traditional arabic foods… and a massive dessert buffet with traditional Arabic sweets, heaps of baklava, fresh fruit and a massive chocolate fountain… it was SO good!!

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I ate dinner with a few of my Western and Arabic friends… it was a beautiful evening of laughter and food and just enjoying the opportunity that Saudi has given us to celebrate together… this religious and cultural holiday!

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The next Iftar buffet I went to blew the Ritz out of the water! The Narcissus hotel… probably one of the most gorgeous hotels in Riyadh… smaller than the Ritz… but it smells amazing inside… florally… I couldn’t place the scent initially… but then I clued in… the Narcissus is a flower… obviously they’d make the hotel smell like the flower it is named after!

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I went with a group of girlfriends… one last supper together before I move back to Canada… one last Iftar buffet as Ramadan was due to end the next day. The East meets West buffet. Initially we were seated outside, but when we requested to be moved inside as it was too noisy outside with all the air conditioning… they seated us at a long table in a beautiful private dinning room.


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The food was absolutely heavenly. Tempura prawns… the best item on the menu. Beautiful scallop salad. Sushi. Traditional Arabic food. Indian food. Italian. Salads. Beautiful meats. Fresh fish. Fried goodness. And then… beautiful deserts… more chocolate fondue… And then… Saudi Champagne, arabic coffee and dates… peppermint tea after dinner…

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The food was INCREDIBLE!! Definitely the best buffet I’ve ever had in Riyadh… but it was really the company that made the night so special! We arrived around 630 for dinner and definitely didn’t leave until almost 9. I’ve never spent so much time over dinner as I do here in Riyadh! But generally, you get into conversation and enjoy the time with friends and before you know it you’ve spent a few hours over dinner.

imageimageimageAnd then… probably one of the highlights of the evening… a beautiful baby grand piano in the lobby of the hotel… I couldn’t resist sitting behind it and stroking the keys… couldn’t play it though because I’m pretty sure that would have offended more than a few people! Music is almost never played in public in Riyadh… and especially not during Ramadan. So I’ll have to wait to play a real piano for another week or so until I’m back home…

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So Ramadan for me hasn’t been about fasting… but it has been about family… my Saudi family. It’s been about culture. About educating myself on Islam and the traditions and beliefs and values. It has been really wonderful.

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