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 : )

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!!

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!

Well, there were no flying colors...

...but I survived the Dosage Calc test!  Let’s just hope I fair as well on the ECG & Blood Administration exams – apparently there is a fairly high re-do-over rate for both.  I realized today I’ve never been taught Junctional Rhythms…and have reaffirmed that I don’t care about Junctional Rhythms!! Are you having an MI? Yes, or No? Are you dying? Yes, or No? Let’s stick to the basics. :-

Other survival moments this week...the “blood extraction.”  Everyone kept asking if I had “done the blood extraction yet?”  Thankfully I was only subjected to a regular blood draw.  Plus 2 vaccinations and a PPD.  “Needles” to say (haha), not the best part of orientation.

On a more pleasant note, I bought some real, live, green plants!  Not sure if I’ll keep them alive, but for now they are a Great addition.  Speaking of…how are all my plant-sitters doing?  I didn’t give you all that free TP for nothing!  Status updates please.  Feel free to include photos :)

It also turns out that I LOVE my abaya!  The abaya is the long, black gown I have to wear every time I leave the compound (which includes all these orientation sessions.)  Cultural implications aside, it is Wonderful!  I don’t ever have to decide what to wear, I can wear the same thing q’day, I can wear very little underneath, it’s black so I can spill crap all over myself…besides being a little hot, it’s Awesome.

Also, there is something about it…In my naiveté, I feel there is some mystery behind the gown & veil. (Not all, but many women wear the full burqa.)  S’times I find myself wondering what she looks like under there. Only her husband, family and a few friends know.  According to more than one (male) Saudi instructor, they wear the gowns/veils "to protect them" from the stares & potential advances of other men.  Of course I recognize there is much more to it than that, and I’m not saying I necessarily agree, this is just a peripheral pondering.  We place so many judgments on someone’s face or body type, the way they dress or carry themselves.  They’re not all bad judgments – some are just cues to help us determine what type of person they are and what we may have in common, etc.  I guess I’m just still fascinated by it.  Intriguing thoughts to help balance all the negative things you hear…and many folks assume.

Sooooo much to learn here!  I’m anxious to see how my initial perceptions change with time & further exposure.  Hopefully I’ll make some Saudi friends and have opportunities for first-hand perspectives.  For now, I’m looking forward to getting my buns out of the sit-&-listen mode and into the ER!

Hope you are all doing well – I Love the messages, snaps, texts, email, comments here...except for trying to rotate pictures, it’s all Super Fun!  If all else weren't so different I’d hardly believe I was on the other side of the world!
Take care ya’ll,
k

Marhaba from The Kingdom!

After much deliberation, I've decided to attempt a blog.  I know, "Gasp!"  I hate the thought of shoving my banter down people's throats with mass emails...so I figured this was a more "optional" approach.  PLUS my technological prowess is progressing by such leaps & bounds I may as well ride the wave!  Anyhoo - keep your expectations at a minimum & this might work out fine :)

I am a fan of the bullet point, so let's try that...

* The Journey... It turns out zero good sleep for almost 2 days was a blessing.  I was so wiped by the time I arrived I slept like a champ & suffered practically no jet lag.  By the time we got from the airport to the compound it was after 6 pm...and we started orientation promptly at 07:30 the next morning.  Awesome.  But I get ahead of myself...

- The plane ride...obviously it was long.  Of course you had the obligatory screaming kids & folks trying to jam Super Large bags into the overhead bin - shove, twist, flip, try & shut the door, shove, flip, repeat...you know the drill.  There were also a number of men who were not happy with their assigned seats & were asking, while q'one was still boarding, why they couldn't move up into the better open seat - including the space where the flt attendants sit.  The incredulous look on their face was like telling the pt with abd pain in the WR that he shouldn't eat his Popeye's until after seeing the doctor.  Good times.  The lovely couple next to me apologized & begged me not to judge all Saudi's based on this.  I assured her this behavior was certainly not unique to their country.

- In-flight movies...of course the "inappropriate scenes" had been cut out, but they had also made all the women's bare skin blurry on the screen.  Upper arms, chest (cleavage of course) and bare legs were all fuzzy!  They put black boxes over the same bits in the imported magazines as well - quite distracting. 

- The hype about customs proved anti-climactic.  They didn't even open my bag let alone plug USBs into my computer or pod...this time :)

* The Compound... I could say more, but basically it's just a HUGE apartment complex.  There are probably thousands of ppl living here divided into sections:  Single Women, Single Men & Families.  My room/studio is a bit beat up but despite the rusty bathroom light (with water actively dripping from the bulb?!) it suits me well. Definitely an upgrade from my mud & thatch in Zambia.  There are also little shuttle buses that take you places - to & from the hospital, grocery stores, markets, Ridiculously Massive malls...Melissa C. you would be in heaven!

* When Saudi chooses your friends... Again I will refrain from too much description (online at least :)) There were 2 other American women who arrived at the same time, both from Florida:

Keisha is originally from Jamaica, lived & worked in Riyadh last Dec-Dec & is trying Jeddah after finding return to work in the US...distasteful.  She loves lipstick, has a long reddish wig & listens to Kenny G.  Very nice & not shy at all. 

Rohini is originally from India & is having a rough transition.  She was very dependent on her husband & children in the US & is finding it difficult to function (At All) on her own.  She requires constant reassurance & hand holding...but slowly I think she will find her own routine. Needless to say, this Mama Bear is being tested...thank Allah Keisha is more patient that I :)

The rest of my orientation group is comprised of an Irish lady, a girl from Malaysia, one from Jeddah, a large contingent from the Philippines and 1 dude from Lebanon who could pass as George's younger brother :) There are also many ppl here from South Africa & India with a small handful of Europeans, Australians & Kiwis.

Side Bar:  I have challenged myself to try & be a little more soft-spoken...you chuckle, as do I!  By "soft" I mean "lower volume"...and probably less cussing.  The rest will have to stay :)  We Americans, myself in particular, are embarrassingly loud.

* Death by Orientation... It may be worth NEVER having a new job again...just to avoid having to sit through another hospital orientation.  I am not joking.  Between the plane ride & this 1st wk my pressure ulcer can now be considered Stage 2.  Besides the expected redundancy of paperwork, it's Organizational Structure, Ergonomics, Infection Control, Fire Safety...you've all been there.  Actually, considering the state of my bathroom light, and the fact there have been 3 recent & major fires in the housing complex, I probably should've stayed awake for that last one.

We are now suffering through 2 wks of general nrsg orientation, which is at least more relevant...all the way down to BLS & the Dosage Calc test - UG.  That bears repeating.  UG!  I won't bore you with more details.  I will say, proudly, that I made it 4 full days before coming home & really feeling like I needed a drink - Warren, where is your stout?!!

* TGIF... I never thought I'd be so happy for a Wednesday afternoon!  Thurs & Fri is the wkend here & I'm ready for a wee break.  It'll be nice to settle in & grab a few more bits for the apt...hangers, a non-stick pan, a giant H2O jug, hand towel (I'm using the sock from the plane right now)...maybe I'll check out a souk downtown & chill a bit before orientation starts again Sat morning.

Well gang, there's an initial update for ya - here safe & sound, internet's set up, haven't melted yet - it's supposed to be 102 F on Sat!  I don't expect future posts to be so long-winded...soon the new interesting bits will peter out :)  I hope q'thing is going well on the home front.  Feel free to pass this link on to whomever I've forgotten...it's a work in process.  Please also forgive the learning curve - I've only smacked my computer twice!  Keep me informed on the latest...I have a feeling I'm going to miss those heroin addicted alcoholic psych pts!  There is a +10 hr time change & I'm SUPER connected...Skype, Face Time, email...for those who didn't get my Magic Jack #, it's: (503) 568-8454.

Take care & I'll write more soon!
Assallamu Aalaykom,
k