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!
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!