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.
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| Sachs Harbour Airport |
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| MOT/DOT Area |
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
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| 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.
