Saturday, April 25, 2015

A Minister at the Airport?

Just finished my supper of scalloped potatoes, baked squash and ham - yes I am eating my way out of the community - so I shall update this blog. I am on call today which has meant one prearranged visit and an otherwise undisturbed day. As I ate my meal, I thought of first call days in other communities where I have been careful to eat breakfast before starting call at 9 am and ensured I have snacks in the desk drawer of the office and leftovers to heat in the microwave should I get a few minutes to eat during the day. Here I've managed all sorts of domestic chores, crafts and baking while on call. Most certainly not complaining. 

The weather here has been milder (for the most part) and although still snow covered there are streaks of dirt showing through on the roads. With the longer days the snow is beginning
Main St in the spring
to shrink a bit. Today it is -13c with sunrise at 5 am and sunset at 11:30 pm. To insert a little science to this blog I'll paste some data from Nav Canada here……At Sachs Harbour (72ยบ N), the sun rises on May 8th and does not set again until August 3rd. The sun sets about November 15th and does not rise again until around January 26th. However, even around December 21st, there are still two hours of civil twilight.  Civil twilight is defined to begin in the morning, and to end in the evening when the center of the Sun is geometrically 6 degrees below the horizon. This is the limit at which twilight illumination is sufficient, under good weather conditions, for terrestrial objects to be clearly distinguished…...So there you go, civil twilight is the official name for that weird dusk about noon in the high arctic during the 24 hours of darkness. 

Since I'm on the subject of air travel and when you live in fly in communities, it is a matter of interest / reality to all, some connected comments. A senior manager told me that he had to "go open up the airport as no one came to work in the hamlet office". Well, it was Monday, in the spring and the sun was shining so….not really a surprise. He unlocked the terminal door and the flight doesn't land until afternoon, by then someone showed up to check the runway. As the boss was expected back on Thursday we were discussing her route to BC and I hadn't considered that she flew through the Yukon, but it does make geographic sense. The airline which flies in Yukon is called North Air and the route from Inuvik to Whitehorse is via Old Crow and Dawson City. Flights from Dawson City to Vancouver aren't a problem. The replacement nurse and clerk were discussing the old DC3s but the website boasts new planes so hopefully their stories are from 'back in the day'. Duct tape holding up rattling overhead bins and freight in front of the seats under a non secured net, stacks of boxes which would've tumbled backwards but a passenger in the front row got up and fastened the net to the floor as they taxied to takeoff. My coworker thanked the good samaritan and said "I didn't want to die by freight today". He agreed. This week the very large Anglican minister was in community. He used to belong to a biker gang and looked like a DOT employee in his XXXL reflective jacket. He had introduced himself to an elder who said "do you work at the airport?" and he explained he was a minister "a minister at the airport?" she asked and was perplexed. 

On Thursday, when the boss, her hubby and dog were to return home and the clerk's husband as well as a few others, it was windy, blowing snow and low visibility.  Aklak Air flew to Sachs Hbr and could only see the road not the runway - back to Inuvik to try the next day. The COOP driver told the replacement nurse who was trying to get out and on to Paulutuk that you can usually see the belly of the plane when they overfly but could just hear them this time.  The clerk received a text from her hubby as they flew over the runway so we knew they were turning back, as you can call and text on the plane - oh yeah, no electronic navigation equipment to interfere with - is that a good thing?

Her husband is a resource officer of some sort - I'm not sure there is a direct correlation in other areas as he deals with all sorts of wildlife and resources. He travels frequently and is heading off to Durban, South Africa in June for a meeting. I asked what animal and she replied "probably polar bears" which I questioned as to the amount of in Africa. "Oh they talk about bears all over the world" she said. When I shared the information I'd read online on one of the adventure sites (you know the ones written by someone under age 30 who is a self professed expert) about what to do if you encountered a polar bear - because I didn't believe it - she was appalled. I reported "you're supposed to roll into a ball and play dead".  She said "absolutely not, where did you read that?" When I questioned the best plan, she was thoughtful and said "well, you could try to run and…..pray". Reassuring. I sure hope those mister polar bears are still looking for ladies out on the ice until May 7th. 

I phoned the school and asked them to send three students over for immunization after class. In about five minutes, two giggling students arrived saying "I'd rather have a poke than do math" which I had to agree I would've chosen as well. They were checking their pulse rate and it was up. Their cheeks were pink with cold and exertion so I explained the physiology of tachycardia and one offered that "we were being baby reindeer". The third who came after school was less brave about the needle and apparently chose math to delay the visit. 

I found a beige curtain panel in the linen closet and thumb tacked (no curtain road) it over the bedroom window blinds. It gives a rather strange shade which is reminiscent of backyard camping in a canvas tent, but does block out the light as it increases. More attractive than the usual aluminum foil look, although that is an alternative next to the glass as an additional help for May/June. 

Such sad news throughout he world with an earthquake in Nepal. I posted on the LSTM FaceBook group as one of the young students in our diploma of tropical nursing class was posting photos from there this week. She is safe, although the fatality count is climbing and it looks like a major disaster is unfolding there. I thought of the class as well this week with the article below written by someone from Doctors Without Borders. We are so spoiled and fortunate in our first world existence. Please try to help.

Sunday, April 19, 2015

Escorts are always the question……

Well another week in my rotation has whooshed by and when Thursday rolls around I'll be looking at only two weeks remaining. The Nurse in Charge will fly in and my co-worker will fly out on Thursday. This gives me four days to get my act together in the NIC office. I have had a taste of the NIC role with a travel issue. Patients in the north with benefits (FNHIB - first nations health insured benefits) are covered for their travel and accommodation when accessing care not available in their community - for example if they need to travel to Yellowknife for surgery. A battle of wills ensued as a patient (who had been approved in a previous situation) to have an escort - family member, not that kind of escort - to travel with him when he'd had an operation. This time medical travel (a large department in each of the territories) denied him an escort to travel out. After several calls and emails back and forth to medical travel I discovered that when the patient had his surgery they would fly out the escort to travel home and assist with lifting the bags etc. Why did it matter which day they sent the escort as the ticket is $1500 return from here to Inuvik every day? It didn't. The problem was…if the escort travelled out with the patient and the OR was cancelled (which happens fairly frequently) then they both had to be returned and sent down again, but if only the patient was there, they would just be sent home. There was no way to justify that the patient needed an escort on the way out as the Dr had clearly written in his chart that he was out on the land recently and managing well. The patient was annoyed and told the clerk that he would cancel and not have his surgery. I spoke to him and said "if I sign your travel form stating you need an escort and conjure up some medical proof, we'll both be up for fraud if they check up on us and read your chart". He acknowledged this and agreed to go. I spoke to his escort when the itinerary was picked up and explained the reasoning behind the situation. Always important in small places (home or here) where you will see folks again to ensure they realize that decisions are often made at a distance and out of local control. No one was happy, but it seemed to be a settled situation. In hindsight someone was looking after me because……after all the posturing and chest beating the drama unfolded a few days later. The patient didn't appear for the pre-op appointment in Yellowknife and the search was on. Detective work (good to have a local clerk with connections) revealed that the patient had not left Inuvik but was staying in his wife's hotel room while she went to meetings. Wait a minute…w-h-a-t??? Yep, you heard me. When not approved to travel as an escort his wife went over to meetings, the patient went on a bender and I would've sure looked like a schmoo with medical travel if I'd advocated for an escort! Medical travel said they would not pay for the patient to return without a rebooked appointment. Not sure who that is punishing - he'd get two trips if they couldn't fit him in for surgery. In the end it was agreed that the patient would travel down to Yellowknife the next day and go to OR without a pre-op appointment. There are agreement forms to sign stating that patients (and escorts) will behave, not drink, attend appointments and return when booked or medical travel won't pay but they don't really seem to install any fear, just make work for staff. 

Speaking of travel….I was checking my Aurora points - loyalty points from Canadian North - and discovered that in addition to travel rewards you could redeem for Bass Pro Shop prepaid cards, berry picking scoops, fishing lures etc. Clearly a northern airline despite their charters to cruises in Miami. After my small airplane experience on my way home where it will take me three hours to get to Inuvik as the flight goes to Uluhuktuk on Victoria Island and then back to Inuvik where I overnight and the next afternoon I will fly First Air (they have great cookies) from Inuvik (likely via Norman Wells) to Yellowknife and then down to Edmonton and spend the weekend there. Funny to be looking forward to three travel days.

Some references to prove what itinerant folks like myself believe…that travel is good for you:

Both of the replacement nurses had worked here before years ago and both have commented that it is much busier here than previously - how slow was it?? Mind you, we have been kept busy with various educational pursuits - a new immunization program (which my coworker is going to ask to have a PhD awarded from she says) various quality control for POCT (point of care testing) lab tests - urine dipsticks, glucometer etc. as accreditation is coming up shortly, new well child forms, I participated in the hypertension in pregnancy telethealth on Friday (a review but always learn new things) and of course all my orientation requirements such as WHMIS, TDG, online incident reporting, health net viewer (online records) which it will be good to NOT have to do my next rotation. I'm sure that the powers which be will design some new form of punishment by then - such is the lot of the nurse vs bureaucrats struggle. 

Sachs Harbour Airport
I did a little drive of the area, under guise of checking out the vehicle which has been noted to have a "burnt smell" so I drove up the hill to the airport, seen here on the left, over to the 
Beaufort Sea
MOT/DOT area which needs remediation, past the muskox harvest area which hasn't been held for a few years, the water treatment plant, sewage lagoon and the dump. Beautiful vistas over the frozen Beaufort Sea. Makes you want to sing the Stan Rogers song Northwest Passage when you're looking at it. Opens up before the passage itself so will be a different view by July. 

I have been holding crochet college here for the other RCMP wife who is a quick study and has already mastered a scarf and a hat. She is thrilled to come to this large quiet apartment (versus her small RCMP housing bungalow which she shares with her husband and active, very cute 14 month old) so the crochet instruction is a bonus. Last night her hubby arrived with warm cinnamon buns to go with our tea. They have visited the health centre with baked goods a few times for coffee break - mice being away and all.  The replacement to my boss' husband is one of those charming African men who answered that he had two children, one in Ghana and one in Winnipeg when I asked. I said "that you know of" jokingly and he responded with "that's why I don't answer the phone on father's day". He and the blonde haired, blue eyed toddler have formed a bond and Zach puts his arms up to him first - they make a very cute, if stark contrast pair - and both Zach and his mother will miss Charles when he moves on. There is a relief pool of RCMP who just fill for vacations, courses etc. For the most part single folks who don't mind moving around. I was surprised to learn that the RCMP require they keep (and pay rent for) a house and so Charles has a house in Inuvik that he's slept in a total of six nights since last fall. Bureaucracy at its best.

You know when your children were young (especially if you lived in an old house with heavy wooden doors) and there would be slamming and you'd yell "stop that or someone is going to lose a finger!"? Well thankfully we made it through the four offspring with their digits all intact but that doesn't mean it doesn't happen. Got called down to assist my coworker with bandaging the end of a toddler's finger back on which turned out to be a four person job - attempting any kind of reattachment would've made it worse for sure and the physician on call today agreed with me when I phoned to say they were heading over on a charter so would drop in to ER. Should've worn ear plugs as I think we're in line for a noise induced hearing loss claim from Workers Compensation. 
And to add to your education, should you be of a certain age, here are some new terms:

Off to get ready for the workweek ahead. 

Saturday, April 11, 2015

Umm….the shorter one

Well, hello there. It's Saturday and I'm on call which means I have time to update the blog as my one phone call so far has been to give an elder the number for the dental team who are in for the week and a call from them to dispense some antibiotics. I hope it's a situation where they are very good at work but not so much with life skills because it's a constant battle to keep the bathroom doors unlocked. There is a note above the knob in both the public and staff washrooms reminding you to unlock the door before leaving but….at least four or five times a day someone announces they can't get in to the BR. sigh. The dental health is MUCH better in this area than western Nunavut and the smiles here are very complete which is a good thing. I have seen only one patient with dental pain in over a month and it was just that a filling had fallen out. 

My namesake left to go home on Thursday as she is preparing for a trip to France. They are doing a home exchange in Bordeaux (likely no wine imbibed there) and visiting various regions for a few weeks. She diligently studied her French over her time here so it should go well. We received a new EKG machine this week and it is a beauty. We convinced Terrance (the DPW maintenance dude) to assemble the cart and then it took both of us to read the instructions and set it up. The dialogue ran to "what's a WAM? do we need it? oh excuse me I think my WAM is in the way" with accompanying hysteria as the leads were wrapped around my neck and I snorted. The clerk did some photos and videos of the shenanigans which if shown to the boss would get both of us canned. The machine was very user friendly and we found the one page of the manual with useful information, copied it and put it in a plastic sleeve. 

With two of us sharing the same first name it did lead to some 'situations' and I am unable now to say "it was the other one" when confronted with issues. Last week someone called to follow up with some paperwork and asked for the nurse by first name. When the clerk asked him to clarify which one, he replied thoughtfully "well….it's not the skinny one, it's the……shorter one". I asked the clerk if he was a politician or just a married guy and she confirmed it was the latter. When the clerk and I were discussing body types and family traits she shared that her family were all large and she "had to work at it to be this size" so I showed her my much slimmer self in my wedding photo and said "my family is skinny, I have to work to be this size now too" and we both chuckled. She'd given up food for lent and survived on strange blender created juices so had lost 26 lbs. Clearly I'm not in her league - nor do I wish to be. In my mind the term cleanses fits with soap not drinks. 

The replacement nurse who came in on Thursday lives in my home province as well and does casual contracts. She works on coast guard ships such as scientific research vessels and icebreakers, usually in the summer. She mentioned that CGS is crying for electricians when I disclosed I have an electrician daughter. Will have to track down just how to apply as it sounds like a good lead where they do four to five week contracts with the same amount of 'lay days' and are paid for both work (12 hr days)  and non work times. Would allow for travel when off - obviously something I consider a perk.  My coworker offered to do call every day (something she had apparently done here years ago when there was one nurse and she was brought in to give her a break) which I graciously declined. She got that 'this is my not impressed look' on her face and tried to convince me but I've raised four kids and so ….I smiled and said I'd "let her know if I changed my mind". Call is not busy, no worrying it's going to be and it adds to the base salary so….not gonna happen. Glad that my outgoing co-worker suggested I do the acting nurse in charge position these two weeks so there wasn't a challenge. Not like I'm anyone's boss as there's not enough work here for one nurse but we are going to share call… I spent the afternoon attempting to find my way around the binders and computer in the NIC office. We checked the crash cart and the lab, ordered supplies and attempted to have the cleaner actually clean. Well that part was the largest struggle. Today I noticed that after my insistence he had emptied the garbage cans but…. hadn't replaced garbage bags. sigh

The SUV had a "burning smell" according to the clerk who had taken it to pick up the mail - post office is open for 90 minutes two days a week so you need to be on your game for the timing. We called Terrance (our go-to DPW guy) and he said it was low on coolant and it took a couple of days to locate the person in the hamlet garage who had some. The most amusing part of our service call was that Terrance used the command start for the vehicle. The Equinox has been here since last fall when it came in on the barge and the clerk had no idea it had an automatic start! When she was going out to start her skidoo (her Bravo as she calls it because they are often named by brand vs 'my machine' in Nunavut) before lunch I asked if she used the command start and she grinned before heading out to pull the cord. Terrance (the clerks nephew because everyone here is as related as rural NS communities) had gotten a polar bear this week which she showed me a iPhone photo of - nice fat one it was too. So with 26 community tags and only 80 residents the odds are much better here than in my last Nunavut community with pop. 850 and four polar bear tags. 

And while on the subject of the post office I decided to give northern mail a shot. I haven't bothered in the past as am never sure if I've been returning to the same community but this time with my residency established and general talk about online ordering from various companies coming with an additional surcharge (even Amazon and Walmart which had previously not put limits) I have chanced it. I noticed that MEC (Mountain Equipment Coop) had a free shipping deal on. I ordered some trekking poles and backpacking food to be shipped here because who wants to schlepp more stuff than you have to 3/4 of the way across Canada when you commute to work? The order has been shipped without shipping fees on the invoice and with an anticipated delivery date of April 29th which will be good for me to examine it if so, if not it can be stored here in the apartment.  Not sure how the shipping date relates to three (possible) flights per week.  There was no milk at the COOP so the clerk kindly added a carton of milk to her food mail order and even delivered it to me on Thursday pm from the flight before they headed out on the land to the cabin for the weekend. She looks after me well at and outside of work. 

As I have climbed to the midpoint of my contract and am now sliding down to the home stretch with less than four weeks remaining I am always amazed at how quickly the time passes in the north. I am looking forward to my travel home (even though it involves three travel days and two overnight stays (you can get back to the Maritimes from Asia quicker than that) and have been thinking about the small plane and how much better prepared I'll be for the experience. With my infection control experience, I abhor airplane bathrooms so always make a trek to the terminal facilities before departure, but I will make sure to pick up a beverage as well as I coveted my neighbours orange juice on the flight over. When the Dr. visited he shared the story of having flown over to Inuvik one fall with some local folks, including two elders who were taking their crafts to the Christmas market to sell. It was a very rough flight and as he looked out the window he realized that with the blowing snow he had no idea where they were as the small plane smoothly landed at the airport. Everyone on the flight exhaled a sigh of relief and one of the grannies leaned over and said quietly to the other "some good pilot" in a moment of clear understatement. "Spiritual" he said. Even in an extremely quiet spot such as this the days unfold in rapid succession. I continue with my crocheting and have offered to help the RCMP wife learn. She does lovely sewing so will be a quick study I'm sure. My sealskin slippers are languishing in my bag at present but perhaps I'll sew while she stitches and get more done. Haven't done much writing (although I promise myself I will) but I always do some entries in the Mom Journal my firstborn gave me at my birthday celebration in Edmonton as I left for my initial Nunavut contract. I do keep a daily journal when working (how else can I record material for the Same Country Different Planet memoir I'm going to write) but am considering doing a daily one line recording for my busier at home times as per Gretchin Rubin of The Happiness Project:

Before the coworker with the social life left we watched a borrowed copy of The Theory of Everything about Stephen Hawkings life which was a great flick. I've watched a few of the movies I downloaded and enjoyed Paddington, St. Vincent, Wild and Stand Up Guys (even though it was silly) and The Hangover Part 3 and Anchorman 2 were as expected - a diversion. 

I had started to do an online course from Future Learn called Medical Arts and Humanities, which I really enjoyed but….it ate up my bandwidth as we pay for satellite internet service measured in GB of data so….those courses aren't ones I'll be able to do north. My coworker had tried to use Rosetta Stone and it chewed up 1 GB/day of my 10GB per month account so she was cut off too. Netflix or any kind of streaming and excessive videos of any type are on the banned list. Likely most of those in this list would meet only my 'down south' criteria:

Thinking of taking the vehicle out for a little spin tomorrow to check out the area as the coworker was contemplating that today. With more hours of sunlight and a 10:30 pm sunset 
and continued dusk until midnight, the locals are gearing up for springtime (although at -22c with a wind chill it's not top of my mind). They approach this season (which is a combo of east coast summer camping/fall hunting) with an almost manic fervour and head out 'on the land' to cabins or those large white tents en masse. By the end of May there will not be much 'in community' activity on the go. Never enough hours on the clock….how can anyone say they are bored? So I leave you with a quote for the day:

“Any pleasure that does no harm to other people is to be valued.”
- Bertrand Russell,

Monday, April 6, 2015

Around the Horn it is….

My chauffeur to supper
Gizmo post workout
The end of a four day weekend seems a good point to update you from. The Easter weekend is one of those holidays which gives you two four day weeks and completely disorientates you. It's quiet enough here in this spot that it is difficult enough to keep track of which one of us in on call to begin without adding in long weekends. My coworker seems to have more issues with finding things to occupy herself than moi - I told her that she needs to get a hobby, or maybe a few hobbies. She has been having those 'bored, bored, bored' with long sigh conversations with me on a regular basis but I can't help her as I've been working my way through various crocheted projects. I've crocheted boot cuffs for the second daughter's birthday - she was 29 today imagine!  Working on her Masters course. Yesterday I made sweet potato pancakes - yummy - I thought I'd invented them until I Googled them. Baked sweet potato rolls which were delicious and roasted sweet potatoes with onion soup mix to take to Easter supper. A nice outing at the RCMP house - ham, turkey, scalloped potatoes, salads oh and the desserts. ahhhhh. I got to ride in the back of the RCMP truck but I knew they'd let me out as I sat with the food. I don't think there has been anyone but me in the back of the truck (seen above) as they've had one call this month which was apparently very minor. 

Was a full week at the health centre as the Dr. came over to do clinic for us - we have a physician here every six weeks or so - and that went smoothly. We shared suppers and knew he'd been educated well when he asked about amounts and brands of foodstuffs on our list. He said "Shirley trained me well" when he disclosed his marital status of 45 + years. He not only brought fresh food but nice wine - we got along well. My contribution was creamed lobster and fried halibut cheeks - with cranberry pudding for dessert all of which were well received. I traded my last package of halibut for musk ox steak and ground musk ox burger from the clerk. I think I need a (free) permit to export it out of Northwest Territories which I shall investigate - don't want anything holding me back when the time for heading home comes around. 

The oldest daughter returned this week from a vacation in Cuba with news of all our friends and lots of photos. She had a wonderful time (of course) and was sporting photos of a handsome new friend. He had been intensely interrogated by her surrogate parents (both city and country) and so passed the test - her Canadian parents are the least of his worries. She has settled herself in for the final course of her electrician apprenticeship which means three months in Medicine Hat as that was the nearest seat in the program. Her journeyman (person) designation will open doors - perhaps even a chance to work in Cuba as there is a cooperative arrangement to train Cuban apprentices - she would be an obvious choice with fluency both linguistic and cultural. A goal to work towards. At present establishing email connection with the guy left behind in the land of fun, sun and rum would be good. Although there are cell phones, the technology is iffy and the bureaucracy is still cumbersome - there are only so many days you can wait in a line to be told '"sorry not today". 

The best recent news was that the life partner has booked us a cruise! We were watching a sale on a 14 day South American cruise 'around Cape Horn' from Santiago to Buenos Aires
on the Norwegian Sun for a while now and the price dropped over the weekend. Of course, being spoiled the last time with the great sale on the suite he felt the need to indulge again. Hope he's not disappointed as this category of suite isn't as luxurious as Costa but it is larger than the standard balcony room. I had a credit from a previous cruise, there was a free drinks package offered, Norwegian is very casual with wonderful food and he chose a port side cabin (having done his research on the itinerary - he is getting to be quite the booking pro working with Vacations to Go. The intent of heading to South American (first return since 1994) is to visit an Argentine friend and her family after the cruise so we will take a week post cruise in Mar del Plata. My job share partner confirmed that we can move the date for my February 2016 return to work ahead so that is all that mattered to me. Mister is now making noises about a pre-cruise junket to Easter Island so I have left that to him to investigate. I will be home just before Christmas from work so leaving mid January to summer south of the equator suits me fine. 

Most of the community has been out 'near the lakes' in their cabins or tenting for the weekend. It's cold and windy but spring is coming so they're getting ready. Apparently there are 26 polar bear tags for Sachs Harbour (don't tell WWF) annually so lots of hunting going on until end of April for the white bears. I have been doing hunting research for the various seasons should the shore captain find time to visit me. Unfortunately the most productive bird hunting takes place the end of the lobster season which is a busy time for him. We shall see. 

It has been a steady day with having seen two patients, had two phone calls, the dental team arrived and drugs were delivered. Life in the fast lane. The (too handsome for his own good) young dentist from Montreal asked me if there was a gym here and although the sarcastic reply would've been "do I look like I go to the gym?" I said "I'm sure you can use the school gym - ask the RCMP". When he asked if they worked out I said "I don't think so but they go to the school" and smiled. Heading over to the coworkers to watch a movie (which she borrowed from the RCMP wife) this pm. I have some downloaded on my laptop but that means they are solo viewing. I watched St. Vincent (with Bill Murray and Melissa McCarthy - I love them both) which was excellent - very irreverent but funny and a great story. Highly recommend it. Had a chat with a coworker heading north as I fly out. We'll both be in Edmonton on May 8th so have set a supper date. The north although geographically large is a small place people wise.