Into the final stretch now as I only have today (which is a day on call) and the morning to work tomorrow before my flights begin tomorrow afternoon. Not the best schedule to be on call the day/night before you leave but this is the way it worked out.
I have had an exciting last week. It's been fairly busy and I'm not sure if that is because more folks came in off the land or there has just been a series of events. One night there was a kid who was 'jumping on the sticks' at 10 pm which translates as jumping on the bundles of construction material stacked up in a parking lot. One of those activities that when you walk by you think/say "that's not a good idea, someone's going to get hurt" and sure enough it was, as she fell and fractured her radius. That gets you and your mother a fight to Yellowknife for an ortho consult. There was also a 3 am call for someone who had wiped out on their bike "no, no you come in at 9 am" and when I said "what were you doing out at that hour?" the 12 year old says "riding my bike, it's not even dark" in a very indignant voice as if I'm the one confused as I asked him to come in at such an early time. I was most impressed when I had a little guy (about 3) in for an allergic reaction "playing with a bug" he says when I examine his swollen arm - must've been a bee - he shrugs when asked to describe it, again when I ask size, colour, did it fly? When I warn the benadryl I'm giving might make him sleepy his mother says "it's almost his bedtime anyway" so I look at the clock and think it must be at 11 pm as that's what's coming up.
There were some humorous situations this week such as when a nursing mother had to go out to have tests in Yellowknife. Since the plane crash in Nunavut last year where a baby (with a mother escorting a patient) was killed, the rule is that the only babies on flights with mother's are those coming back from being delivered or the baby is the patient. We tell the mother the nurses will get her a breast pump at Stanton. Of course it's busy and there aren't many pumps and so she only pumps once out there. Now from Nunavut to Yellowknife for tests is a two day turnaround because of the flights. You get in too late to have any tests, you have them the next day but all the flights back start out early so it's usually two nights and three days (if all goes well) before you're back in the community. She brought one of her older children over to be checked when she returned as he'd had a fever in her absence and I checked over the baby. "Please wake her up and she'll feed" she said as she was anxious to get herself back on track. As she nursed the baby she said "I was in the airport and a baby cried and I was so full I thought - I could feed that baby even if it isn't mine - I knew it was wrong to even think it but I didn't care", We both laughed as I well remember coming home from work and saying "give me that baby" a few decades ago. A patient I dealt with having slipped a few feet off a ladder was having intense back pain and came back twice on my call shift. We were concerned about caudal equine syndrome where there is saddle like paralysis as he had numbness. On his second trip (after he had NOT followed my instructions) he was brought in by his wife and a male I assumed to be a family member. I again reviewed the plan for what I thought was soft tissue injury. Ice (not heat) take the ibuprofen regularly and rest and I explained very patiently, simply and completely the anatomy and what I felt was going on. The patient moaned, his wife (who was supposed to be interpreting for him) kept saying "I hope he won't be paralyzed" and other such unhelpful things so clearly was not listening but….the young fellow kept nodding his head, asking appropriate questions and totally buying in to my theory. I assured them they could call/come back during the night as I was on call and the young fellow says "i could bring you any time" so I think 'what a caring family member'. The next day when the HomeCare vehicle won't start and the garage is called, the mechanic arrives to jumpstart the vehicle. And….it's him! The chauffeur of the night before - not in any way related to the back pain guy. Nurses can tell you about mechanical lower back pain, but this? My nerves.
We also had a very unfunny patient who was very upset, rude, screaming, supposedly had abdominal pain 10/10 and retching, gets morphine and gravol then her boyfriend comes in and she eats an entire hungry mans dinner in record time. Not anxious to go home she says "can I come back and get more morphine?" Hmmmm. As she's being medevaced the next day the flight paramedic shows us a trick - he checks her pupils while pressing very firmly on her abdomen in all areas - she doesn't flinch. What would that tell you? That when's distracted she forgets to have the pain. The paramedic is explaining what's going to happen on the flight and that he will take care of her. "If I get more pain can I have morphine?" she asks. "Is that what you want morphine?" he says and she nods happily. Hmmm.
Friday was pay day and I bought a car. It's a manual transmission Dart in blue streak. The dealer has to go pick it up from PEI for me and will have it ready when I get there on Wednesday. There was discussion about the colour - there's orange, red, laguna blue - which do you want? I say "anything but ugly purple or green" and the dealer says "even orange?" so I ask him if he thinks a woman of my age shouldn't drive an orange Dart? No, no he wasn't trying to offend but the laguna blue (sort of an easter egg blue) is one colour people either really love or really hate. I tell him that I'm going to be sitting inside it so I don't care and I'm only driving it for six months of the year anyway. Will be nice to have air conditioning again what with the weather reports I'm getting from home.
I also stitched up a young fellow's face as he was cutting up a caribou and the knife slipped and struck him just between the eyebrow and bridge of the nose. I froze it with xylocaine and put five, 5-0 prolene sutures in to close it. A plastic surgeon I am not. Down south he would likely have had steristrips put on but……down there people don't use their eyebrows to say yes and no. He was satisfied and I was pleased with myself as he had to hold a gauze to cover his eye and I had to work around his hand, nose and eyebrow. The suturing reminded me of everyone asking about the son's fingers etc. when I shared the photo of the deck he had constructed. Proving he had carpentry skills after all.
The afternoon was routine as I wrote a summary letter then medicated a patient I'd dealt with while on call who was going out schedvac for testing in Yellowknife. Then things break loose. A female comes down the hall calling me by name and when I acknowledge her turns on me accusing me of not believing her sister, sending her home, telling her to see the mental health worker, being stupid and unprofessional and that I could've killed her - am I happy? I am stunned, try to defend myself, attempt to find out what she's talking about and calm her down. She is referring to the morphine requesting, hungry man dinner consumer. The nurse in charge (Nellie) appears behind me and shows me a discharge form with no findings on it. The screaming and abuse continues and the mental health worker appears and attempts to calm the situation. The staff of the health centre (thankfully no patients in the waiting room) scuttle off and turn their heads as we are herded to the empty Dr. exam room. More abuse and anger heaped on me and then a quick departure. I am shaken. Nellie says "it was just you who got singled out this time" and is supportive. I try to carry on but I am so angry I feel the tears and tell my coworker I'm taking a short break and head upstairs to the apartment to compose myself for about 10 minutes. I return and start some mindless paperwork when Nellie pops her head around my office door and says "pick up line one she has something to say to you" and it is the screamer who is calm, apologizes sincerely saying she was out of control and doesn't want me to think she doesn't like me". I tell her that I have a sister so I understand her concern and feel much better. A few moments later Nellie pops back and says "I told her it was me who suggested her sister talk to the mental health worker". I was absolutely gobsmacked. I have worked in health care many years and i have been unjustly attacked a number of times but….I have never had a patient apologize or a manager both defend me and take ownership of something she did. I realize that was the gift in the whole nasty situation. I would be very sad if I didn't come back to this community. Nellie is not a touchy feely kind of person but she said after work "let's go for a walk" and brought me a nectarine - knowing that I needed to clear my head. Waited a long time for that kind of management support. Nellie reminds me of a quote I read:
“It is a thousand times better to have common sense without education than to have education without common sense.”
-Robert G. Ingersoll
Yesterday morning when my much younger coworker (who I call my adopted daughter) was on call she received a 6 a.m. wake up with a fellow asking if he could come pick up some condoms. She (who is a morning person) was wide awake and said very enthusiastically "yes, yes you can!" which surprised him a bit as the community does know the rules about not coming for routine requests in off hours. When he arrived shortly at the door he was wearing sunglasses and had a huge smile on his face. He quickly trotted off with his bag of condoms. Much better than dealing with the lack of them in the form of unwanted pregnancy or sexually transmitted diseases.
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| determined - growing in a rock |
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| really tiny but close up |
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| beauty of a day but ice still |
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| look like hyacinth |
Yesterday was my last walk of the season due to work constraints. II watched the First Air flight ready and take off and
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| Soon to be me |
then hiked to Sandy Point (yes that is the name of the beach I have been frequenting believe it or not) and around the shore to take some photos of the ice.
Then I had to climb what felt like Kilimanjaro to get back as the ice at the sand was too thick. I was hot and bothered and then I noticed the……flies were out. Time to leave when the bugs come to your community.
Last evening we were invited out for homemade pizza and wine from a box at a coworkers and that was lovely. Good people, good conversation. The other two have bedtimes at about 9 pm so they called it in first and my coworker and I headed up the hill to the health centre in the bright sunlight of 10 pm. As I said "isn't it amazing to get a sunburn at 3 am?" Will have to get used to the dark at night now when I go home.
Today on call has been a series of sick babies, 7 sutures in a knuckle of an elder filleting char from his nets, lots of calls for calamine lotion as the mosquitoes are biting the kids who are allergic of course and the back pain patient who was still not following directions and taking his ibuprofen. Sigh. But at least the x-ray did rule out a fracture so this old nurse was right with the soft tissue diagnosis.
I am for the most part packed with one bag which can be left depending on where my next contract will be. The bag of 'to be left' stuff is larger than the 'to take home' stuff. Not going to be looking at uniforms for two months because….it's just wrong to work in the summer.
