Sunday, June 29, 2014

IQ Day - no not measuring it, enjoying it!

As the final week in this contract rolls around on the calendar, I continue to be awe of the speed of eight weeks away. I have only two more sets of call and I'll be officially 'not working' for about three months as my return flights are September 25 and 26th. Hard to take, but someone has to do it. 

The past almost two weeks (since the previous update) have been busy as usual. The weather is starting to warm up and well it should as summer is officially here, with the following forecast for tonight which is typical of the weather this week :

A mix of sun and cloud. Wind northeast 20 km/h becoming light in the morning. High 10. UV index 4 or moderate.
Sunday night Mainly sunny. Low plus 3.

Don't you just love that Sunday night mainly sunny part? So do the locals, as with the 24 hrs of daylight there are kids playing out on the street at 2 am, overnight travel to go fishing at the cabin and just general 'staying up' as it is known. 

In fact the urge to go 'out on the land' is pervasive - as the dentist previously labelled it "spiritual" as in "I can't keep my appointment, I am going fishing". In fact I've been on the fringes of various 'get out of work' schemes this past week. One involved a boss showing up with a neatly written note claiming that a local employee 'went to see the nurse with back pain, was given medicine and told to not go to work'. This was a complete fabrication as the person hadn't been to the health centre for over a month and then not for back pain. The only reason the employer came to inquire was a concern that it was a workers compensation claim which must be reported. "No" I said "you have a problem but it's not related to healthcare" which elicited a big sigh from the foreman. I said to myself 'you had your common law partner write this note and you delivered it with a straight face knowing you had never sought treatment and had no back pain 'did you not consider you might get busted?' The second involved an actual injury where a labourer had a burn from molten metal on to the back of his hand which he worked the rest of the day with and hadn't reported. Slept in the next day and went to work to say he was injured so was brought over personally by the foreman for attention. The 2nd degree burn was fairly small and as I put polysporin and a band aid on it I said "so you're going back to work?". Very furtive look and reply of "not today". "Tomorrow?" Frantic look now and "I can't go back to work, it'll get dirty". Negotiation "do you work the weekend?". "No". Then you get tomorrow off, come here and get your burn checked and back to work Monday. Quick exit. Of course, no visit was made on Friday - how can you see the nurse if you're 'out on the land' getting your hand all dirty? 

The quote of the day is:
Your life is recorded by two dates and a dash - make the best of the dash

No one here has to be told that!

Ice fishing 
In fact, speaking of traditional ways and being out on the land….the staff at the health centre participated in IQ (Inuit Qaujimajatuqangi) day yesterday afternoon. This is where qablunaaq (literal translation - those with bushy eyebrow) or white people are educated in the traditional ways. We took the vehicles outside of the community to German Lake and did ice fishing, collected heather for a fire and boiled water for tea, ate bannock, cheese, pepperoni, biscuits, hotdogs cookies and had a birthday cake (carrot cake) as it was one of the staff's birthday. Traditional games were played and prizes won there and for the fishing
Louise the champ
 derby - Louise caught a lovely big trout and a smaller land locked char. One of the clerk interpreters mother and some other family members were out on the ice fishing and we got some photos of 
them on the Honda and her ice fishing from her wheelchair. Saw some birds and evidence of other critters - it was fun! There were musings as to whether there were duck eggs in the cliffs surrounding the lake as there were ancient inukshuks all around hills and evidence of birds. I was told that ravens eggs are blue. "Like over sized robins eggs?" I asked. "no sort of speckly". The most excitement of the day was generated by the appearance of a bumble bee. Now granted they are HUGE up here (golf ball size) and make a loud noise (as would be expected by their size) but when I questioned those screaming and running from it I was told that a) no one in the community was allergic to stings b) no one had ever known of anyone to be stung - likely related to the wild shenanigans when a buzz is heard. I would've made an easy target for the bee what with my laying over on the tundra laughing uncontrollably at the antics. We were tired, full and sun/wind burnt when we straggled home. 
love to see those lights coming
King Air - welcome sight
Apparently there are infrequent thunderstorms near the Arctic Ocean, but usually later in the summer. About 10 days ago there were a couple of days of really unsettled weather. The first night we were awaiting a medevac which had to divert to Gjoa Haven and wait out the front. Good thing they didn't try to land as it took two arms and one leg for me to get the door open on the vehicle when I got to the airport. Crazy windy, sheets of rain, crashes of thunder and big cracks of lightening. And the most amazing part of all this electrical activity was that everyone and I mean EVERYONE was either outside, up on their metal roof, looking out the window or generally trying to tempt the weather gods. The next day we had a hailstorm with big hail stones during the thunder storm 
hail storm
again everyone rushed to the window or outside. I was giving a little guy who isn't two years old an aerosol treatment and he stood in his diaper on a chair, with the mask on his face, in front of the window watching the storm. I'd say it's a good thing there aren't too many electrical storms up here or there would lots of defibrillation required!

But some situations are the same regardless of the culture. A mother stopped by the health centre to pick up her travel itinerary for a flight out to a medical appointment and was packing her toddler. This little girl has four older brothers and when I asked the mom if she'd cut her hair as she had an unusual coiffure she said "no, her brother did". When I asked if it was the one who had pulled the TV over on himself a couple of years ago, the one who had a BB in his arm or the one who jumped off the dock and broke his leg she said "no the one who's usually not too much trouble". 

My roommate has gone back east for two weeks to get her children graduated and will be returning this week. In her absence I had an apartment guest in the form of a medical student for four days. The physician who comes in monthly to do a clinic brought his third year medical student daughter with him to give her a clinical experience and she sure got to see lots of unusual patients, experience a new culture, do things she wouldn't have a chance 'down south' and learn to practice medicine without all the technology and resources. She was a great roommie who was well received by the community as she was very approachable and keen. Will make a great Doc. Her Dad I think was proud of her and they had a nice father/daughter trip of it. I am waiting for my roommate to return in a couple of days as I'm rattling around in the apartment with no one to cook for. 

As I get most of my unofficial news from the land of FaceBook (which is sometimes like saying you get serious news from The National Enquirer vs The Globe and Mail) I found the following exchange between two paramedic crews at home a few evenings ago: 

EHS - Halifax Infirmary 
One raccoon later we have arrived!
Go big or go home. Deer is the hunt of choice
Deer are too much paper work!

And speaking of hunting….the moose hunt of last fall which was supposed to be the trip of a lifetime…..has had a deja vu moment. Apparently the shore captain's employee (he who actually shot the moose) won a tag in this years draw. The shore captain being prevented from applying for the next five years. Mancation planning has begun. 

So as I head into the final days of the contract and start my travel plans for heading home I noted that with Air Canada you can now check online to see which movies are being screened on your flight. For those who need time to decide, or who plan excessively, this is a welcome feature. I have already chosen The Grand Budapest Hotel, based on the trailers provided (as I fit into the planner category).  

While on the topic of travel - here is a link to something called smash books - they can be used to document your travels vs the travel scrapbook on return:

$6 for water??
Disneyland from above
Nunavut summer 
So, since I was out tromping around on the hill overlooking the community this afternoon and then visiting both grocery stores looking for cream - going to treat the other Nova Scotian employee here to creamed lobster tomorrow for supper. Now that the 10 pm siren for curfew (which all the kids under age 14 ignore) has sounded…. I am crawling into bed early with my book. 
tundra flowers are small

Sunday, June 15, 2014

Sealskin Pulpit and Plastic Flowers

Just finished a brunch of bacon and banana pancakes. Yum. The reward for being only second call today. Paid my dues yesterday with a steady day of calls from sick babies to adults (lots of respiratory viruses on the go this past few weeks) dental abscess, laryngitis, to someone who thought there was a glass splinter in the thumb. If there is anything harder to find/remove I can't think of it. I froze it and probed around unsuccessfully. I suggested a poultice - is that Inuit folklore? Nope, apparently tying a lemming skin on to draw out infection/foreign bodies was though. I was fresh out of those so instructed to soak in epsom salts and it would hopefully work its way out. Couldn't have been too much of a problem with a score of three arctic char fished this weekend. The calls continued throughout the night - not surprising as I had to close the window to the sounds of kids playing at 1:30 a.m. - is benadryl still good from April? "Um, yes but why are you asking?" and "Is this the RCMP?" to the accompaniment of crying children in the background. "No, this is the nurse, you have to call 111 - are you ok?" reply of "Yes, I just need the police" to "my baby is hot and crying" which translated to otitis media and no tylenol when they arrived. Up at 9 am. to unplug the health centre phone as my colleague is now answering. Only five more first calls until I'm homeward bound. I smiled when my co-worker mentioned her countdown, I'm not the only one who does that. Mind you, I've gotten into larger difficulties while being the second call this past week. 

It's been a busy spell here at work in what is usually a bit quieter time of the year. We had a fatality last week where an elder out on the sea ice on his snow machine making his way to the cabin, hit a ridge and was thrown off the skidoo, then run over with the qamatik (sled) which was carrying his 10 yr. old grandson. He was killed instantly apparently. Extreme living in its essence. A large grieving gathering arrived at the health centre as the RCMP went out to meet the local men who had wrapped the body in caribou hides and brought him back to the community. The grieving lasted well into the morning hours and there was little to
Water on the ice
do but support the assembled. I have asked myself before (having lived north decades ago) and recently again 'what kind of place is it that 10 year olds witness such shocking deaths? go caribou or seal hunting and 'catch' (local term for shoot) their first one at age 6 yrs? care for younger siblings and keep them safe? yet wander around during a funeral or go play outside?' I attended the funeral on Friday afternoon as I was the nurse not on call. The Roman Catholic church was full and the MH worker and myself leaned against the wall.
Ready for hunting
The white painted wooden casket was placed in front of the sealskin pulpit and during the service which was conducted completely in Inuktitut (except for one English reading) people made trips to place plastic flowers on the top. It was a long service (over an hour and twenty minutes) of readings, prayers, hymns and eulogies (all in Inuktitut) from family and friends - tears as the accident was described and the grandson was given a token from his Grandpa's jacket pocket, for being so brave. There were large numbers of children wandering, talking, playing, yelling and restless during the service - much as at any northern gathering - I have attended rock concerts which weren't as rowdy. 

Interior of King Air
I also had a 2.5 hrs of sleep night while we awaited a medevac one evening. They left from Yellowknife, flight crew timed out, they flew to Cambridge Bay and exchanged for a new crew and I picked them up at 1:30 am. One of the pilots was an ex- RCMP pilot who knew the pilots I
Early am landing
did from our late 70s posting in Labrador. He had asked to come in from the airport to see the health centre and community as he'd visited Spence Bay last in 1979 just before the present health centre was built. Finally got them underway and back to the King Air and off by 4 am and put away the SUV. Took a bit to get settled down from the adrenalin rush. And just to confirm that I have never had any interest in flight nursing but looking inside the workspace of the King Air confirms it. Seen here above on the right and remember this is going to include a stretcher, a flight nurse and flight paramedic and a parent plus equipment and luggage. 

Just waiting to have a FaceTime chat with the life partner who I am sure has had some calls from his girls on this Fathers Day. The youngest is spending the day at the Toronto Zoo as she is in the city visiting friends and celebrating her quarter of century birthday tomorrow. Can't imagine that it was 25 years ago that we welcomed her to the family. The middle daughter is likely busy with the new addition to her household as I was tickled to see photos of the new yellow lab puppy - Pete - who has come to live with the daughter and son-in-law this weekend. He has grown so much in just a few weeks…..The oldest will have been in touch as she tends to be the one able to read the calendar and make contact on the day of celebration - not that her sisters don't wish happy birthdays etc. but their timing can be a tad off - daughter #1  must have her fathers math skills and her mothers memory. 

So in the spirit of summer planning / projects I offer the following links:

And to close on a positive note, I am posting a cute online link which reminds me of those media stories where someone breaks into a liquor store or grow up and is found there in the morning by the police:

Sunday, June 8, 2014

Alcohol was Involved

Time to update on all the news I feel comfortable sharing which means that as a nurse it's information which is non identifying and also because not all readers are healthcare professionals means I won't describe or post photos of the gory bits which nurses revel in. Details to follow. I could at this point make apologies about being sick last week with a really rotten cold - I usually get one on week two of my contract but when I escaped that milestone and thought I was in the clear, I was ambushed in week three, or the fact that we were working with only two nurses (both of us struggling with the virus) instead of three while one of the co-workers attended her daughter's graduation. But no one likes a whiner….

Lots of exciting news to announce this post. The teacher daughter, someone who has wanted to be nothing else but an elementary school teacher, since she came home from school in grade two and announced it, the one who graduated with her BEd in 2010, has begun work on her MEd, has been working a series of assignments of split classes in various schools while awaiting her permanent teaching contract and hoping to stay at the great school she works at this year…..Well, she was not only awarded her permanent contract but went to job fair and scored grade primary at 'her' school. Over the moon is an apt description. This is good for her, but also for her employer as she is an excellent teacher and puts her heart into her work (as do all my children) but mind you, many bright young teachers do and the average length of time from education degree to permanent contract in my home province is 10+ years. So hard work + luck = happy ending. 

I am pleased to share that I have been officially conditionally accepted (meaning send your money) to the Liverpool School of Tropical Medicine and Hygiene for the Diploma of Tropical Health Nursing. This is an intensive eight week program with two weeks pre-course work, three weeks on site at LSTMH in Liverpool, UK (December 1 - 19) and three weeks post evaluation work. My colleague and I are both accepted so it'll be nice to have a study buddy, especially one with connections across the pond. Sounds like we won't have to evoke the Plan B of Cyprus. And my occasional travel partner (non student) is planning to come along as well to share accommodations which will be good company and fun. So, I must dig out my resources and do some online research into the tropical health world when I'm home for the next 'break' beginning July 4th, but who's counting? 

I have passed the contract milestone of the halfway point and although things move quickly every day, they move at warp speed after the mid-point. Make it so, Mr. Spock. My roommate is going home to get her oldest daughter graduated from high school and pointed in the right direction for UNB in September. She leaves on Thursday for two weeks and I'll be solo except for about four days when the Dr. comes in to do his clinic and brings his second year medical student daughter up with him to "show her that you can practice medicine without a lot of resources" and she'll bunk with me. I might get some reading/writing done if I'm on my own as my roommie (who arrived with the 360+ movies) is a bad influence on me - as if I needed an excuse. Since Wednesday we've watched 12 Years a Slave, Unclaimed Baggage, Promised Land, The Sessions and Thanks for Sharing. They were all worth watching. After reading the book 12 Years a Slave I found the movie had been shortened but mainly followed the story, Unclaimed Baggage is a light comedy, Promised Land was about oil companies buying up land in the midwest but Matt Damon is always easy to watch, The Sessions was about a guy in an iron lung machine and his sex therapist and Thanks for Sharing was about sex addicts - now why did we think those last two would be light watching? I'm going to do more research on the subject matter next time I told the movie holder.  

I had a FaceTime chat with the life partner on my 'day off' and he was sharing the news on the home / seafood industry front. The second daughter and son-in-law had taken him out for supper for his birthday to a local restaurant which has changed hands from our German friends to a young couple who have just moved to the area. The shore captain described it as 'yuppie' and also disclosed that he'd been wholesaling lobsters to them (he keeps crustaceans until end of July in his holding tanks). Mister said he'd delivered lobsters a couple of times to the restaurant but on the last day of the season he'd tasked the boy captain with the delivery - makes sense as the lad lives in the same town as the eatery. When he received a call for another order this week, the owner/chef mentioned that the seafood should be delivered to the side door and the shore captain assured him that he always did. The chef chuckled and said "well the young fellow who delivered them last week came through the front door and dining room and some of the 'up there' ladies didn't care for it". I had visions of our lanky, six ft tall son with a tired, sun/wind burned face with dark scruffy facial hair, ripped pyjama pants, torn and paint stained weathered t-shirt with holes from battery acid or bleach, grubby rubber boots  covered in salt water stains / fish scales, long tanned forearms ending in large likely grimy black hands from fixing something in the engine room, smelling of bait and diesel fuel, carrying a plastic bucket of lobsters. I chuckled to myself and thought….it's okay to see where your food comes from and what the person who catches it looks like in his natural habitat ladies. As my late father-in-law used to say when someone wrinkled their nose at the smell if he stopped at the bank on his way from baiting trawl "smells like money to me". 

Speaking of which….the O/T vs sleep deprivation balance is in the positive monetary balance. When questioning locals on situations/injuries etc. they will often say "alcohol was involved" sort of like the police PR in the media, thus the title of this post. Call on Thursday night resulted in two and a half hours of broken sleep - from 0245 to 0345 and 0600 to 0730 just doesn't cut it. Started out reassessing /fixing up a baby with bronchiolitis about midnight (been a little outbreak in the region this past two weeks) and getting ready to crawl into bed when a phone call came from the front entry from two hysterical females yelling that they were "being chased by drunkers and I should call the police". Nope, but I'll let you in and you can speak to the dispatcher. "Ok". I head down the stairs and hear a commotion in the porch with yelling and thumps and find no one there. I open the locked interior door, keep my foot in the door and open the outside door to look on the steps when a group of males rushes up over the stairs towards me. I manage to retreat back through the door and slam it just as a hand grabs the door. Lots of swearing, yelling, threats to open the door, banging and kicking on the door. Okay, now you got it, I AM going to call the police. I phone the 10 digit emergency number (no 911 here) which forwards to dispatch (two time zones and thousands of km away in Iqaluit) and speak to the dispatcher. He asks if I know who it is "no, and I'm not going to open the door to find out". He agrees and tells me that he'll dispatch the two local officers. I share that this is unusual behaviour for this community in my almost two years experience here. The RCMP were actually out on patrol and drive by shortly after the visitors have absconded. The community is just hopping. I consider attempting bed again and a call for sterile water for a tube feed from someone who "was busy all day". I leave the litre of water in the front entry. I'm in bed reading to wind down at 2 am when the phone call for a sick baby takes me downstairs. My one hour nap is ended by a call from the lobby phone "my friend had a bike accident I think she fractured something". Dressed and downstairs to find a 13 yr old who was riding her bike down the outside steps of the school and holding her elbow "did you tip over or did you mean to ride down the stairs?". She freely shares that she was intending to ride down the steps. Warning - this does NOT endear you to a sleep deprived old nurse. It does get you examined - full motion, circulation, and sensation - motrin, now and to go, an ice pack and return later (which she didn't)  for a reassessment / x-ray if needed and instructions to GO TO BED!!! Another sick baby with respirations of 72/min, temperature and low oxygen sats - fixed and home for recheck later and fall into bed until the alarm. I made it through the busy morning without being too cranky and only started to fade by the 'admin afternoon'. 

My roommate made us shrimp alfredo with noodles for supper and we watched a movie to distract ourselves as I was only second call (backup) with an early bedtime scheduled. Sound asleep by 10:30 pm and when the phone rang in my darkened room I thought 'must be about 4 am and she needs a hand'. My coworker says "I need your help, I've got someone with quite a cut" so I look at the clock and I've been asleep an hour. Downstairs to find a seriously inebriated patient with a below the knee gash measuring 17 cm across, 3 cm wide and deeper than a nurses finger (as in you can see the muscles like an anatomy diagram). Some photos emailed and phone discussion with the on call physician about an hour flight away who reassures that we can do this surgery or he can have the patient sent over to him (meaning he'll send the medevac plane over to pick them up, he'll suture and return) Good thing we didn't opt for that plan as thick as pea soup fog appeared from nowhere about 15 min. after the first phone call. The first call nurse sets up to suture, we flush with 2L of saline, I provide security and assistance to the surgeon and long story short about four hours, three reels of vicryl for interior closing and 32 prolene sutures on the exterior, a couple of photos/phone consults later and two very tired nurses it is all finished. We send the final photo to the Dr. and head to bed. When I open my email in the a.m. there is a message from him reading "great work, you two did a great job". Not often you get that kind of support from physicians. We agree that we'd tackle something like this again if we had to and head to bed. 

Sandy Point
I slept until the noon siren (no church bells here) wakes me. Out for a nice walk to find sik siks, snow
and Canada geese, song birds, ducks, gulls, ravens and the snow retreating quickly. Was nice to not wear my winter jacket thinking 'spring has arrived' until it snowed again last night and this morning. It's -1c which is prime snow weather today.

It's been a stressful week for my roommate who is from Moncton where there was a shooting rampage which resulted in the death of three RCMP officer and injury of two more. Brought back memories of 35 years ago when the shore captain was RCMP for three years and I worried every shift he worked. Haven't worried about him on the water over the years as it seems safer to be dealing with mother nature than cop haters. Sad story. 

Nevada tickets
I am first call again today but it's been a more manageable so far with just a sick baby to deal with. It's 4 pm here now and the community for the most part has been sleeping until just now. Not just drinking but lots of gambling not sure if those are goes on so the comment "I've been sleeping late" pertains to not just the 24 hours of darkness when you might as well sleep but to the 24 hours of sunlight when your schedule is not constrained by hours of daylight - as in you can just as easily ride your bike at 4 am as 4 pm if it looks the same. The nevada tickets here on the left are an indicator of the clash of two cultures. 

Time to wrap up and think of some supper and I'll leave you with two links to explore: