28 June 2013

OMG

I just couldn't go to bed without posting this Immediately!

So, there I was, out for a run (cuz I will decidedly apoptose in the air-less gym), when I see some sparkly bouncing bits off in the distance....what the?!  As I get closer I could hardly believe it...SPACESUITS!! Although it was difficult to maintain my composure, I stopped, complimented them profusely, and begged them to please let me take a picture!  Of course they were thrilled.  Not quite as good as in the flesh, but please enjoy : )



23 June 2013

The Honeymoon is over...

There is really nothing more to say without going overboard :)  It's a unique unit - not really a true ED & certainly not a typical in-patient ward.  It's like a mix between an ED, a chronic medical ward (Thank You OBC for my in-pt experience!) and an ICU.  We also see a lot of transplant pts...not usually fresh ones, but no shortage of kidneys here I guess.  I do try to remind myself this is a specialist/referral hospital so our pt population will be a little distorted.  Just like at home - too many days at work made you feel like 80% of the U.S. was either heroin addicted, drunk, diabetic or wanted to jump off a bridge.  Here, you feel like all Saudi's are either borrowing a kidney, have a congenital abnormality, have had cardiac surgery, are jaundiced or diabetic...obviously not true in either country - just a skewed perspective.  And rather fascinating of course!

Which is why it's important NOT to work too much!  I'm happy to have gotten off the beach (boring!) and into a boat.  A bunch of us booked a trip out on the Red Sea - a few went diving, the rest snorkeled.  Really cool coral reefs with Amazing fish - next time I'll try & get some underwater photos.  I will probably refresh my dive cert & hope to try some wind surfing....I've heard women are "not allowed" to do the latter.  More investigation will be conducted.



Last week a Filipino friend from work took us to the fish market - much cleaner than some I've seen and always more fun than buying seafood in the grocery store :)

  





Lesson of the day - choose boy crabs instead of girl crabs...


Actually, just stick to Oregon crabs & get regular fish - Yum!  After the market we went to another co-workers house (not in a compound!) and enjoyed a lovely meal & afternoon.

On my next stretch off we plan to take a trip to Taif - it's east of Jeddah, past Mecca, and quite a few clicks away.  Apparently there are mountains to hike & camels to ride & monkeys to see!  We may even visit a "flower water"/perfume distillery (not, for the record, my preferred type of distillery!)  We'll see what actually happens.  It's a hospital organized trip so all I know is that it is from 7:30 - 11pm.  Stay tuned...

As always, I hope all is well - wish I could send ya'll some of this hot, super sunny weather!
Thanks again for your comments - just when I feel "over it" (like after Blog Post #1 :))  I read your comments & am encouraged to post again!
Until next time,
k

PS:  Warren, I am dreaming of your...gorgeously....delicious...STOUT!  You bet your rokba you are saving me some!!

02 June 2013

White Scrubs?!

It probably goes without saying, but my appreciation for our uniform is quite opposite from that of the abaya.  First, they are semi see-through (scandalous!) and probably a reason we are required to have tops that cover our bum.  Second, I know I have a big mouth, but s'times I still miss it.  Lastly, did I mention they are WHITE?  The blue color of my folder even rubbed off on the pants while it was sitting on my lap.  Also, the powers that be obviously don't know what kind of substances are flying around the ED.  Enough said.

Sooo many potential comments about my first few shifts...I'll try & stick to the ones I can express "on air."   My preceptor is Very nice & has been gracious in showing me the ropes.  She's British so there are a few too many "darling's & lovely's & brilliant's" but I suppose it beats the alternative.  I tried to explain my need for a snack every few hrs and, I'm not sure why, but I think I freaked her out a little.  Now if I mention I'm going to grab a g-bar she says, "Do you need to sit down?  You should take a little break, are you ok?  Are you sure?"  I reassure her that all is well, I'm just going to shove a bite in my face & I'll be back in 2.  Apparently "The Look" that Jamie and Mo can see from across the room is acquired :)

I don't want to bore the non-medical folks reading this, but work is a huge chunk of life here...and there are some Crazy differences:

- Patients are OFTEN held/boarded in the ED for 3-4 days.  In my 5 shifts I have only D/C'd 2 pts and have sent Zero to the floor.  Clearly the concept of "Pt Flow" has yet to cross the Atlantic.  Are you sure you don't want to come over Dr. Strear?  Plenty of time to fix our flow problem AND watch heaps of TV!

- That being said, I have yet to see a pt that doesn't need to be here.  This is a specialty hospital so there are a lot of oncology, renal, diabetic, chronically sick pts.  So far most of the pts & families have been pleasant & grateful for the care you are providing (weird, I know!)  Although communication will definitely continue to be one of the greatest frustrations, the charades that inevitably occur can be Hilarious!  Jamie, you would do wonderfully! :)   I'm almost reluctant to learn the Arabic words for vomit, diarrhea, dizzy, CT/XR, pee in the cup...because it is so fun to act them out.

- Narcotics.  Perplexing...in good & not so good ways.  In these 5 shifts I have given 2 mg of Morphine, twice, to one patient.  No joke.  I don't think they even have "...what's that one that starts with a D?" here.  Also interesting is that in order to give that snifter of MS I had to go to the med room with the charge RN who had the keys to the double-locked Narc Cabinet.  We took a vial, both of us recorded how much we were giving and wasting in 2 different spots on the paper flowsheet...and then the empty vial was returned to pharmacy for further counting and documentation.  I'm just going to pause here & let all that sink in.

I'm also going to refrain from describing the process for getting REGULAR meds from the Pharmacy...I am still baffled and you wouldn't believe it anyway.  I'll just say, Julie & Spencer & Pyxis I love you and miss you all terribly!!  And the tube system...Oh, how I miss you too!  Folks, if you ever find yourself complaining about work - ANY aspect of it (docs, colleagues/communication, "the system"), call me & I'll gladly make you feel better :)

What else...they call Vital Signs "Observations" and "Endorsing" is giving report to each other...the CBGs are in mmol/L so the normal range is 3.5 - 6.2...they love IV Tylenol...1/2 the pts are on Heparin...each lab test needs it's own tube...oh yeah.

Enough shop talk!



For FUN...we (my friends from England, NZ, Ireland, Australia, Portugal) have been to the beach a few times.  The hospital provides a free cab & you usually spend the day.  Most beaches are private & associated with a hotel so you have to pay to get in.  Once there you can take off your abaya & wear "normal" clothes, including normal swimsuits (quiet peanut gallery!)  It's a little "canned" but it's a good opp to get out & chill.  It's also nice to see men, women & children talking and interacting together - most are expats or rich Saudis.

A few of us also went to another (much nicer!) compound to watch a play.  There are 2 theater groups in Jeddah that put on productions q' few months.  It was another non-abaya event & dinner was included.  It sounds like there are occasionally "parties" at other compounds too...I'll keep you posted.



I'll conclude with a blurb about prayer time.  Most Muslims pray 5 times a day, signaled with a loud public "call to prayer" called Athan.  (Think tornado or tsunami siren but with pleasant singing instead.)  Almost q'thing stops or closes during prayer time - some grocery stores/shops let you continue shopping & just close the checkout line, some will require you to leave the store mid-shopping.  Restaurants don't make you leave, but "service" will be paused for 20-40 minutes.  At the hospital, some procedures (meds, CT, even surgery) can be delayed if the pt or family is praying.  The precise prayer times vary a little each day & they are slightly different in each city.  So far I have only been foiled by prayer time a few times.  I missed a bus while waiting in the check out line at the grocery store, I missed lunch once, and we all had to leave the 5 Riyal ($1.33) Store after 10 min d/t prayer time.  No biggie, just s'thing to be aware of...I'm totally golden now cuz I have an APP on my pod that tells me when prayer times are going to be :)

Sorry gang, that was long-winded!  I reassure myself that reading this mess is optional & I won't be offended if you don't!  I hope life is going well for everyone.  Keep me posted on the happenings & drop me a line if you get bored!
Love ya,
k

PS:  The highlight of my week, besides barely passing my blood administration exam, was Face Timing with my work peeps!  So Freaking Awesome!  Despite it's challenges, even I have to admit technology is pretty amazing!