As I sit snuggled under the LL Bean down filled throw to counteract the -54c temperature which is trying its best to get in through the 1980 windows of the apartment, with the on call phone at my elbow….I shall update the goings on of my January / February location life. Hard to believe that I'm looking at my through the third week of this two month contract. Fairly steady day of call - about seven hours of routine visits and calls. I spent a couple of extra hours clearing out the 150 emails which accumulated in my work email in my absence. The only call since 7 pm has involved a transaction for a lovely filleted arctic char.
The big news of the weather locally isn't the frigid temperature as they are expected although, when a local said "it's cold, really cold" today, I was pleased to be on call and not expected to venture outside. Rather, the weather site is predicting a sunny week as the sun rises above the horizon here again. Albeit for a brief appearance, but every day the light will remain for half an hour longer. This I have on authority of one of the CARS operators, who I have until now understood to be a version of local air traffic controllers. I was alarmed to discover their priority is recording the weather. I have apparently had a false sense of security that they were assisting the planes to land on these high arctic air strips. Obviously current weather conditions are extremely important but…..it is simply those pilots peering through the windshields and at the instruments of those turbo prop or jet planes in rapidly environmentally changing remote locations who ensure we take off and land safely. Nice to know.
This past week I survived what has become my traditional second week of contract viral illness. I am guessing the usual head cold is a combo of airplane travel - recirculated germs, large numbers of people, not enough sleep and the change from the moist maritime air to the arctic desert devoid of free humidity. Add to this the examining of large numbers of ill children bearing a cold virus I haven't been exposed to and it's a perfect storm. The fact of simply have to work again after being a free agent for two months is enough to cause the body to rebel.
This week through a period of trial and error (and need to do it myself as my junior sidekick who enjoyed doing them and was good at them has abandoned me for another area this contract) I finally wrapped my head around doing manual white blood counts. It's not something we do regularly so you have to follow the 'recipe' but I have finally mastered the concept and when I practiced on myself with a fingerprick (glad I don't have to do that regularly) I got a 9.3 - which is likely pretty accurate for an old nurse with a cold.
Oh, and I also had a bit of a stress test last week. I had examined a two year old and his mother who then followed me out to sit in the waiting room while I dispensed the medicine I was treating them with. As I walked back from the pharmacy I handed the mother (who was chatting with a friend) the bag of medication, repeated my instructions for yet another time and returned to my desk. I sat down and started the process of lengthy documentation - for any nurses reading this we use the SOAP charting method and record a complete head to toe exam including vital signs - so it takes a few minutes of steady concentration. I was a few words into my note when the little imp (who had apparently hidden himself next to the bookcase) jumped out at me and yelled "RAHR". Those who know how easily I'm startled will not be surprised to learn that I screamed loudly, jumped up out of my chair, then fell back into it with a loud thump hyperventilating while grabbing my chest as I tried to catch my breath. The little fellow was very pleased with himself and doubled over at the waist giggling. By then I had a good chuckle myself. I took him out to his mother and told her that he was lucky a woman of my age with four children hadn't wet herself in the office chair. "Oh he's learning to scare people like that" she said smiling. I am sure he'll repeat this as it worked so well and he was very entertained. And, true to form in healthcare, the screaming did not lead anyone to investigate if there was a problem. Takes more than that to get attention.
Speaking of getting attention….I can tell you that if you are a CHN on first call and you hear loud yelling outside your window as you're settling for the night - you pay attention. The health centre with apartments is next door to the arena which is a busy spot for many months of the year. As I looked out the window I saw the zamboni which had been driven out through the back door surrounded by a group of at least eight people, lots of yelling, running around, jumping on and off the machine and arms waving. First thought 'oh no, someone has been run over by the machine or a body part is stuck in it' but a few seconds of voyeurism caused me to realize that the zamboni had been too vigorously driven out to dump the ice shavings was embedded in a snow pile and quickly frozen there. It was the equivalent of a crowd of teenagers lifting up a volkswagen. A large cheer arose when the machine was freed and steered back through the doors. Whew.
If I was tempted to use the descriptor 'very' there are always lots of occasions up here. However the chart on the right outlines lots of options for the writers amongst us. Which is the reverse of the Mark Twain quote "never use a five dollar word when a fifty cent one will do". Less syllables are better when dealing with a population using English as their second language and basic concepts are easier for the clerk interpreters too. As I listened to the clerk relaying my instructions to a patient I asked "what does the word that sounds like pee mean?" and she thought for a moment then said "it means umm, like I'm thinking of what to say next" and we both smiled. We had an interesting appointment this week where an elder (who is usually quite chatty and smiley) was extremely angry about a situation and the eyes were just snapping. You don't have to understand the words to grasp the emotion. We went through the "tell me what the problem is to I understand your frustration, this is how it has to be just for now, I would be frustrated too if it was me, is there anything I can do for you?" scenario. All this through an interpreter, who was clearly NOT interpreting the entire blast and was quite flustered at how I was being talked to. As we concluded I instructed her to tell the patient that I did not take this personally, that I understood it wasn't about me and that this situation would be dealt with. The final translated statement from the patient was "you took this very well and I appreciate it" and I instructed the clerk to say "I'm a nurse, this isn't the first time I've been in the line of fire, I've had lots of practice" and I added "I know you were just worked up and I'm not writing down your blood pressure because if I do you'll find yourself in here for weekly B/P checks"! That was something we could both agree on.
I was pleased to receive a conditional acceptance to my query about the diploma in tropical nursing program I'd applied to for December 1 - 19, 2014 in Liverpool, England. Will have to save my pennies from these contracts for airfare. A little bump in the road with the plans to do a mission in Honduras as the dates for the Oparato trip had to be moved to later in May (I'll be back to work) but I am hoping to transfer over to the Los Encinitos trip which is April 26 - May 3rd. This is the original date I looked at and scheduled my northern contract return for but….it'll be a bit tighter than Oparato. I leave a lot of things here now and the commute is getting more routine so… I really must study Spanish more diligently.
Hopefully I will get some shut eye tonight although on the weekend there isn't a full workday awaiting. And should the sun return about noon I may even manage to sneak out for a photo as I'll only be second call. No good to make plans in a small health centre as there are only three nurses to manage whatever comes through the door and even on an evening 'off' there can be one of those "all hands on deck" calls - have been involved in a few of those. I had an online chat with a former high school classmate who has gone on to be a paramedic and is now heading in to northern Alberta to do camp work. I asked about the number of employees and he responded that it was about the same size as this community. When I enquired about how many medics he advised there were two ACPs (advance care) and four EMTs (emergency medicine techs) so….exactly double the number of nurses we have here to handle a different culture north of the arctic circle with limited resources, prenatals, babies and children, chronic diseases, trauma, communicable diseases, immunizations, lab work, x-rays, casts, dental issues, suturing etc all without ground transport, first responders or medics and medevacs weather and logistically dependent. So, I assured him that he was extremely well staffed for a working population of essentially well employees.
FaceTime date with the life partner is the highlight of the week tomorrow. One of the staff who had gone out on vacation for six weeks had lost some plants in her absence due to house sitter neglect and I told her that I make the shore captain show me the animals and plants on video chat. Not that I don't trust him but ….the cleaning lady is still making a good post op recovery and thus isn't doing the weekly checks on him. Hasta.
