Tuesday, January 8, 2019

70N and Loving It

After a glorious but very busy Christmas and New Year’s filled with family, friends, food, travel and fun, lots of fun where we enjoyed having the eldest daughter home for what is looking like her last solo holidays as hopefully our son in law will join her this year. We all took turns entertaining the grandkids and ate too much. A complete success! Followed by a fairly quiet New Year’s, last minute visits and frantic packing with a January 2nd leave.

I’m somewhat settled into my new role as public health nurse in a new region, new community and transient apartment. And it looks like I’m able to update the blog on my laptop, save then insert the thumb drive into the network at the office to post. I’m working on transferring photos from my phone to the computer to USB as well…that might take some finagling. You’re not missing much as the pictures thus far would be dark, blizzard and more snow. This community is known for its inaccessibility with flights frequently cancelled and blizzards common. The routine of travel is only routine if you’re repeating the same route without weather/mechanical delays. The two day commute turned into three necessitating a dig through the duffel bags to find clean socks and and underwear for the run into Clyde River. Third times a charm apparently.

The commute started out well with a mid day flight meaning a reasonable arising time for the three hour drive which was shortened with dry pavement. I stopped at my nursing classmate’s as she stores my car. She also volunteers at the airport so she drove me in and we wrestled the bags from the vehicle into the terminal. The bags were obviously under 50 lb. as they were smoothly accepted and I was delighted to receive priority stickers for them. After a quick security clearance (thank you Nexus) I made a Starbucks stop for hot chocolate and bagel and was joined by my volunteer buddy so we caught up on the news until boarding. The flight to Ottawa was routine, my bags were first off the carousel, I called the Hilton Garden Inn shuttle and was efficiently deposited at the hotel. The only glitch being I had to pay for my room and will be reimbursed on my travel claim as there was no preauthorization by GN for the reservation, small issue. Daughter #1 joined me after work and we had a great supper at a lovely Italian restaurant. We celebrated our reunion with cocktails and I enjoyed a strawberry liquer/prosecco drink which was correctly named as a strawberry delight. The salads and pastas were delicious, leaving no room for dessert. We browsed Michael’s and I resisted yarn purchase due to space limitations in my luggage - most restrained I’ve ever been at Michael’s. Look out on the February return when I’ve eaten the food I’m carrying in. Back to the hotel to partake of mimosas and visit until sleep overtook us. 

Morning routine meant I headed out on the airport shuttle and the daughter made her way to work. Never long enough but wonderful to be able to visit along the way. A plan to extend my trip by changing the ticket on one of these runs out is on the list. A quick check in at First Air with bags tagged through to Clyde River and no need to prioritize one. As I waited at the gate with a South African GN policy analyst heading back to Iqaluit after a holiday vacation with his family in Manchester UK as well as his cousin, Iqaluit criminal justice clerk, from the same place, they entertained me with northern stories. The north is a haven for immigrants, especially taxi drivers, but lots of young professionals as well. The flight departed on time, it was a flawless three hour run and after breakfast I snuggled into my parka and had a great nap until we were approaching Iqaluit. The only negative being I missed the warm chocolate chip cookies which were served. We deplaned to the new airport which is stunning and I made my way to Gate 5 for the Clyde River departure. The plane arrived and….an announcement was made that the Clyde River segment was cancelled (blizzard there I’d seen when checking the weather). Over to the First Air counter to be told that tomorrow am was the likely rebook and given a customer service phone number. I called HR and was given a room at the Frobisher Inn for the night and told a 0745 departure to Clyde River was planned, to be at the airport 6 - 6:30am. Check in, dragging of bags to the room, regrouping and off to source wifi for my stay in Clyde River. The clerk has misdirected me to the wrong business so I walk in -34c to the Gas Stop on the corner for the SSi Micro outlet. It took a while and a bit of cash but the Inuit clerk manages to set me up with a new sim card meaning I have a new phone number for calls and texts and 3GB of data/month. Talk about same country, different planet…it’s like international travel. The clerk calls me a $7 taxi and I’m deposited back at the hotel. I am delighted to find there’s a cinema in the building with Mary Poppins and Bumblee playing, the same as at home but defer due to my early start in the morning. I source some arctic char and salad with a cup of tea for supper and then veg out. Ahhhh.

Awake with the 5am alarm, repack, dress in winter gear…as my buddy used to say…how do you dress for a northern flight? put on all the clothes you have and head to the airport…and call a taxi. I find the doors locked when arriving at 6am and no First Air staff in sight. Security guard lets me (and a Clyde River resident) in and by 6:30 the First Air staff arrive, quickly ignoring the assembled passengers. At 0645 I attempt to check in and am advised that the flight to Clyde River was cancelled this am. Nice. We’re being put on the flight to Pond Inlet this afternoon and will be dropped off on the way, leaving at 1:30pm, be at the airport by noon. I call the  hotel and ask to reclaim my room for a few hours - no problem then share a taxi with a family of four and their mounds of luggage back to the Frobisher Inn. We actually stop and pick another passenger up on the way in town. I have graciously been given the front seat and don’t dare look over my shoulder to see how a fifth body was added to the back seat. We explode from the cab, I drag my bags up the steps, retrieve my key, struggle to the room, deposit the perishables in the fridge and flop in the chair. After collecting myself I mosey on down to breakfast and enjoy a smoked arctic char eggs benedict with home fries and a tea for breakfast. A quiet morning with my book, a call to First Air to ensure the flight is still on before I repeat the process again. I share the hotel shuttle with a BC student who is applying to med schools in the hope of returning to the north, I wish her well. Check in and finally free of the bags. I wait at the gate with the various community members I’ve already met and my newfound friend of the early morning plays a mean harmonica concert for us. I forgot how much I enjoyed Nunavut, with all its rough edges it’s still a wonderful place of authentic people who are managing to retain their Inuit language and customs, albeit with terrible dental health, large numbers of children and beautiful chubby dark eyed babies with full heads of black hair, folks with very shy helpful ways and lots of giggles. It’s been four years since I’ve been in the territory and it’s a wonderful feeling to return. The flight departs on time with 12 passengers for the two communities as we leave the midday light of Iqaluit and fly into the arctic darkness. After two hours a final approach is announced and the lights of Clyde River pop. 1004 appear along the hillsides. As we approach the airstrip I notice the locals looking out the window and bracing, so I do the same as I assume we are coming in more quickly than usual. Momentarily we are down onto the runway with a firm bang and a couple of bounces and then taxi to the small airport. We’re quickly off the plane and into the crowded terminal. I’m sought out by health centre staff who are waiting for me “are you the TB nurse?” We retrieve my duffels from the back of the cube truck and are off to pick up the apartment keys. Hard to get a sense of the place in the dark and moving so quickly. It’s already 4pm but the acting nurse in charge suggests I come back to get started so we drop the bags, I stuff the perishables in the fridge and return to the health centre. Getting onto the network for email (have 3578 messages since 2014 when I was last employed by GN) and logged in to Meditech are the priority. I try to get my head around the charts and notes stacked on the desk but I don’t know this community, the program or any of the parameters. At 5:30 pm the mental health nurse is leaving and I hitch a ride with her, making plans for a grocery run the following day. It’s been a long day. I unpack my food, clothes and supplies into the cozy apartment, take a much needed shower and fall into bed.

Things look better after a good sleep and a breakfast of lobster and scrambled eggs - due to the kindness of a previous occupant who left a few groceries in the fridge and cupboards. After lunch my coworker arrives and we make our way to the Northern store which is the only shop in town which likely accounts for the atrocious prices (even by northern standards) and mediocre quality on the shelves. The place is new and clean with helpful staff but it isn’t hard to spend $60 for a small bag of food. There is even a Tim Hortons express kiosk at the entrance. I’m dropped off with my groceries as my co-worker takes the vehicle promising to return in time for me to head in to the health centre for an arranged visit. A large part of TB treatment is ensuring that medication is taken and this is accomplished by something called DOT (directly observed therapy) meaning…watching a patient swallow the pills as ordered - daily in the initial phase, then three times per week for the continuation. A major problem being discontinuation of treatment or more than two missed doses in a row. If the patient doesn’t attend the appointment as arranged then they are located at home, work, school etc and the medication administered. The 4pm appointment isn’t kept as the patient doesn’t get up until 5pm, I have to phone the TB assistant as I have no idea where the patient lives and she comes to the health centre to accompany me, navigating for me as I drive. There are various complications to the visit which necessitates my return three times to the health centre and I’m flustered. I collect my coworker and as we head back to the office I suggest that it’s difficult to have nurses coming in and out of the community. She agrees adding “you’re never sure if they know what they’re doing” to which I respond that although I haven’t gotten off on a great start, I’ll do better. She shows me how to record the visits on Meditech and in the TB binders. I promise to do the visit the next day without messing up and definitely not calling her - she nods approval and heads home.  As I drive home in the darkness, all the roads/housing looks the same and it takes a couple of tries to find the correct street. If the guys delivering water on the truck had called the RCMP when I couldn’t find my place and was trying to enter the wrong apartment, then fled when the key didn’t work…I’d have had some explaining to do. Hard to be the new kid on the block.

Over the course of the weekend I watch the final season of the series A Place to Call Home which is the Australian series a buddy recorded for me (and my former job share partner) and it’s very well done, although I’m sad it’s over. I crochet some dishcloths, start the shrug I’m doing for one of the daughters and make a lobster sandwich for the TB assistant as she expressed a love of the crustaceans. Bribery is my only resource at this point. I work on my Spanish studies as those pesky verbs don’t stick if you don’t practice! I’m surprised that there is as much light here at this time of year with 10:30am to 2:30pm being a bright twilight, more than I’d expected. The DOT visit requires a home visit and I’m wished “good morning” at 5pm but it is more efficiently conducted and I even manage to enter the details into Meditech. Bit of trouble with the printer setup but all in all a better day. I wander the health centre finding my way around the pharmacy, treatment rooms, lab, store room etc. while it’s empty. The weather is deteriorating with a blizzard predicted, the flight is cancelled and the Dr will not be in, there is talk of a weather closure in the morning. The Dr will be bunking with me so that means washing those dishes in the sink and thinking of something for supper for us. I finally got in contact with the shore captain as it turns out he had his phone set to ‘auto reject’ for any unknown number or at least one not in his contact list so he hadn’t been receiving my texts or calls from my northern number. We had a short chat (he has a man cold) after sorting it all out. In the to and fro I discovered I have voicemail on my new number but no way to access it so a call for Qiniq support is in order.

The morning’s phone call yesterday from the A/NIC is to inform that the health centre is closed due to the blizzard so I spend my 15 minutes with the blue light, check online, source some breakfast, dress for work, pack a lunch and crochet a bit. I shovel my way off the porch/steps - Mathew arrives at 11am and we pound our way through drifted snow banks on the main road with reduced visibility as snow removal is ongoing - exciting run. I spend the quiet time reviewing the well child program, wrapping my head around the program and answering the door as people have noticed the vehicle. By 1pm the health centre is open and the staff is in. The TB assistant does her best to get me in line and even reassures me that I’ll ‘get the hang of it’ so the lobster must be doing the trick. I manage to administer DOT, draw bloods, order them on Meditech, print the labels, register the visit, consult the physician for the clinic and write a nursing note. I’m slow, got to ask all kinds of questions, don’t know the people and even the simplest tasks are painful but…things are getting better. The staff are all great, even the caretaker who pretended he needed a TST (TB test) after lunch and of course I went along with it until the TB assistant said with a sigh “he works here!” as I’m guessing this isn’t the first time he’s pulled the stunt on a new nurse. The major annoyance of the day was when the TB assistant told me that as of last month there is Bell service in Clyde River. I could’ve screamed! I’d asked Bell and was told ‘nope’ and thus jumped through all the Qiniq hoops. Sigh. At least I now have it setup for other communities should it be required.

Before lunch today the TB assistant and I headed across the road to the school in the twilight to administer DOT meds. There are 400+ students in the K – 12 school with 24 in kindergarten. It looks like a busy place with kids of all ages wandering and lots of local artifacts. The steps aren’t cleared and I take a slide down the hill on exit. That’s the problem with the blizzards depositing so much snow. I spent part of lunch hour clearing out a path to the water and sewage fixtures on the side of the house as they won’t service either if not accessible. After commenting on the beautiful community my co-worker is already trying to convince me to return in the summer as it’s “really pretty then” and shows me wonderful photos/videos of rivers, waterfalls, arctic char fishing etc. Ahhh

So I made hamburger soup for supper tonight, with fingers crossed the Dr isn’t a vegetarian and will bake biscuits on the one pizza pan I found. Honestly seven (count em) muffin tins and no baking sheet? When the young Doc arrived I thought for a moment she was a local but is a youngish, slight Asian physicianwho is making her way efficiently through the patient list with an expected 14 office visits per day. I’m reviewing all the documentation for well child, TB, STIs, depot provera injections and feeling the weight as all this brain stretching is hard work. By the time I catch on it’ll be time to leave. Stay tuned!