Five intensive and exhausting but awesome weeks have come to an end. I was pretty nervous about starting my rotation in internal medicine, mainly because my default reaction to any new situation seems to be perpetually stuck PANIC mode. But also because I had heard a lot about the clinical nurse and I wasn't sure that I would live up to her expectations.
The first couple of days were a bit of an uphill battle, I was still getting my bearings in the ward and I wasn't entirely sure how to approach or deal with my patients. I'm the kind of person that likes to rehearse uncomfortable situations in their head. Unfortunately, the person on the other side of the conversation doesn't always get my memos and the conversations never go quite the way I had planned.
On my third day in the ward I went into the room that I was assigned to and introduced myself to the patient in the first bed. Armed with two days of experience, I had things down to some semblance of a science and was feeling pretty confident. The patient glanced up for his phone for a minute and then noticing the blood pressure machine that I had with me, held out his arm.
As I wrapped the cuff around his arm I tried to introduce myself again. The patient gave a pitiful half-smile in return, I chose to take it as a good sign. When we were done with the blood pressure the patient thanked me and got up. I still had to take his temperature and ask him a few questions so I asked him to sit back down.
He looked at me quizzically and said "But you already took my blood pressure." . I smiled and said that I had just a few more questions and it wouldn't take long if he would be kind enough to sit back down and cooperate. Deciding that he had had enough pestering for one day he kindly informed that he was going to change his clothes now so I should probably leave.
I waited a few more moments trying to figure out what I was supposed to do. None of my rehearsed conversations or previous patient encounters had gone on this particular direction...
And that's the story of how I watched a 70 year old patient strip in an effort to avoid talking to me.
I was pretty determined not to let my clinical nurse down so I asked the semi undressed man the rest of my questions and realizing that I wasn't leaving without answers, he reluctantly gave them to me.
Things got easier as the days flew by. I learned more efficient and effective ways to gather the relevant information from my patients and by the end of the second week the clinical nurse trusted me to take care of a full room of patients (between 8-9 patients depending on the day).
During the first couple of week my clinical nurse stayed in the room with me while the doctors were doing their rounds. Deciding that she trusted me enough with the patients, the nurse left me alone with the doctors on days that we were understaffed. Seeing that my clinical nurse trusted me, the doctors relied on my information about the patients to help make decisions about the course of the treatments.
It felt great to be a part of the team and to feel like I was actually contributing rather than just standing on the side and watching other people work. The staff in the ward were warm and welcoming. They always made time to answer any questions that I had and help me when they could, and I tried my best to help them in return.
Overall it was a great experience and I can't believe that it's already over. I have lots more to learn but I think I'm off to a great start.
Saturday, July 30, 2016
Wednesday, July 6, 2016
A Beautiful Friendship
At the end of my shift on Monday afternoon a new patient arrived in the ward. Charlie had spent a good potion of the day sitting in the miyun and he was glad to finally be able to get some rest. The nurses bustled around and got Charlie settled into room number 4 for the night.
The next day a patient by the name Joe arrived in the ward and was wheeled into room number 4. He didn't know it yet, but life as he knew it was about to change. His bed was set up directly across the room from Charlie's bed. Tired and worn out from having a procedure done earlier that day, he drifted off into a troubled sleep.
Joe woke up a few hours later and sat up in his bed and surveyed his surroundings. He hadn't paid much attention when he had first arrived, he looked across the room and saw a man around the same age as him sitting in the bed across from him. The man looked up and smiled, Joe smiled back.
It was boring in the hospital, and lonely. Charlie sat in his bed wondering when his wife was going to come to visit. She had called earlier to say that she would be there after work but it was only 14:00 in the afternoon and she didn't finish work until 16:00. It seemed like time was barely moving.
Charlie sighed and looked across the room. The man in the bed across from him was starting to wake up. He watched as the man sat up and took in his surroundings. As their eyes met, Charlie smiled. The man smiled back.
A nurse came into the room with a glucometer to check the diabetic patients blood sugar levels. The nurse took Charlie's level first and then walked over to Joe's bed. "So we're both diabetic.." thought Joe as the nurse pricked his finger.
The nurse left the room and Charlie realized that it had been a while since he'd last visited the little boys room. He tried to stand up but got tangled in his IV line. Those damn nurses seemed intent on pumping him full of fluids.
Joe watched the man in the bed across from him flounder as he struggled to free himself from his IV line. The man lost his balance and the IV stand began to sway dangerously. Joe jumped up to the rescue and ran to grab the man before he fell.
Charlie panicked as he lost his footing. Just as he thought that he was a goner, he felt a firm grasp around his arm and steadied himself with the help of his rescuer. The two men worked together to free Charlie from his IV line.
As the line came untangled the two men smiled at each other. They stood there like that for a while until Charlie remembered his manners.
"I'm Charlie, thanks for saving me there.." said Charlie as he stuck out his hand. "Ya, no problem." said Joe as he shook the outstretched hand "Names Joe". Charlie nodded towards the spot of dried blood on Joe's finger from where the nurse had checked his blood sugar level . "Watchya in for?" he asked. Joe sighed and answered "Chest pains. You?" Charlie smiled and said "Same.".
Joe let out a little laugh "Two diabetics administered for chest pains... What are the odds?" Charlie thought for a moment and said "It's like it was meant to be.". Happy to finally have a distraction Charlie offered to show Joe around the ward. Joe had been pretty out of it when they brought him in earlier and thought his legs could definitely do with a stretch.
The two men spent the remainder of the day together. By the next morning, they were inseparable.
At the beginning of the shift my clinical nurse divided the room into two, assigning me with left side and the other student with the right. When I went to take Charlie's blood pressure before breakfast he asked me to take Joe's as well so they could go to breakfast together. I explained to him that the other student was in charge of Joe's side of the room and she would take his blood pressure for him.
Later in the day I found the generally bubbly and outgoing Charlie lying in his bed "How are you feeling?" I asked him. "Oh you know... Alright I suppose." said Charlie with a sigh. Twenty minutes later Joe was wheeled back into the room after having had an X-ray done. Charlie jumped out of bed eager to welcome his friend back to his room.
"I was worried that you might miss lunch!" Charlie exclaimed. "I never miss lunch" Joe answered with a smile.
When I went to check Charlie's blood sugar level before lunch he hesitantly asked if I could check Joe's as well. I explained again that he wasn't my patient and he would have to wait for the other student. They looked at each other longingly across the room and sighed. Charlie pulled a chair up to Joe's bed. "I'll wait with you.".
During lunch I watched them sitting across the table from one and other telling tales as they ate. Joe gestured about wildly as he excitedly described his adventure around the hospital on the way to get his X-ray. His hand knocked over a bowl of apples on the counter behind him. The two watched as the apples bounced to the floor. The head of the kitchen staff watched them with a stern look on her face as they chased the apples about the room giggling with glee like a pair of young boys.
Later that day, the two men sat outside in the courtyard off the ward. They introduced each other to their spouses and children. It was a day full of laughter and bonding in an otherwise bleak ward.
Charlie was released from the ward later in the afternoon. Joe was sad to see him go but they promised to stay in touch.
Who knows what it was that brought them together... A mere coincidence or perhaps fate?
At the beginning of the shift my clinical nurse divided the room into two, assigning me with left side and the other student with the right. When I went to take Charlie's blood pressure before breakfast he asked me to take Joe's as well so they could go to breakfast together. I explained to him that the other student was in charge of Joe's side of the room and she would take his blood pressure for him.
Later in the day I found the generally bubbly and outgoing Charlie lying in his bed "How are you feeling?" I asked him. "Oh you know... Alright I suppose." said Charlie with a sigh. Twenty minutes later Joe was wheeled back into the room after having had an X-ray done. Charlie jumped out of bed eager to welcome his friend back to his room.
"I was worried that you might miss lunch!" Charlie exclaimed. "I never miss lunch" Joe answered with a smile.
When I went to check Charlie's blood sugar level before lunch he hesitantly asked if I could check Joe's as well. I explained again that he wasn't my patient and he would have to wait for the other student. They looked at each other longingly across the room and sighed. Charlie pulled a chair up to Joe's bed. "I'll wait with you.".
During lunch I watched them sitting across the table from one and other telling tales as they ate. Joe gestured about wildly as he excitedly described his adventure around the hospital on the way to get his X-ray. His hand knocked over a bowl of apples on the counter behind him. The two watched as the apples bounced to the floor. The head of the kitchen staff watched them with a stern look on her face as they chased the apples about the room giggling with glee like a pair of young boys.
Later that day, the two men sat outside in the courtyard off the ward. They introduced each other to their spouses and children. It was a day full of laughter and bonding in an otherwise bleak ward.
Charlie was released from the ward later in the afternoon. Joe was sad to see him go but they promised to stay in touch.
Who knows what it was that brought them together... A mere coincidence or perhaps fate?
Thursday, June 23, 2016
The Tale Of The Forgotten Sweater
Things have been kind of boring lately. Mostly I've been studying for finals and taking driving lessons. Riveting stuff, I know...
I took my last final yesterday morning and now I'm just waiting for grades (fingers crossed that I passed all of them!). Finals actually weren't to bad this semester and I'm feeling good about things.
Yesterday I picked Hadassah up from gan. Getting her from gan wasn't much of a problem but things went south on the way home. We got about two blocks away from the gan before Hadassah stopped walking and began to frantically search through her bag. Unable to find whatever treasure she had been looking for, she promptly burst into tears.
Hadassah: I have a thing for my arms so I'm not be cold!
Me: You're cold!? *stares at her in disbelief as sweat drips off my face*
Hadassah: Nooooo! In gan! *burts into tears* I am have sometin so I'm not be cold!
Me: You have a sweater in gan?
Hadassah: *nods head*
Me: Um, OK....
Hadassah: We need to go get it! *still crying*
Me: Uhhhh, maybe we'll get it tomorrow
Lavi: EEEEEEEE! *sees bird and shrieks in delight*
Hadassah: Noooo! We need to go now!
Me: OK but we're almost home now so they'll save it for you and we'll get it tomorrow.
Hadassah: I need it now! *continues crying uncontrollably*
Me: Are you cold now?
Hadassah: No. *still crying*
Lavi: *still shrieking at presumably deaf bird*
Lavi: *still shrieking at presumably deaf bird*
Me: So how about we go home and watch a nice movie and tomorrow we'll get the sweater from gan?
Hadassah: *sniffles* ok... The princess with the long hair?
Hadassah: *sniffles* ok... The princess with the long hair?
Me: Sure...
Hadassah: Ok
We made it home without any further mentions of the forgotten sweater. Hadassah went straight to the couch when we walked in and reminded me to put on the movie about the princess with the long hair. She also said we should put the air conditioning on because apparently, it was hot outside.
Next week I start my second rotation in the hospital. This time I'll be working in internal medicine which I've been assured is much more interesting than E.N.T. and I've heard only good things about the staff.
I'm pretty excited to be in a ward where I can learn a lot and really be hands on with the patients.
Maybe we'll even get some good stories out of it!
Friday, June 17, 2016
The Trials And Tribulations Of Traffic Circles
I'd like to take a moment to share my feelings about traffic circles...
I don't get them.
My driving instructor has gone to great lengths to try and explain them to me, including drawing some diagrams and raising his arms in frustration and despair almost every time I unsuccessfully try and use one. But I just can't seem to figure them out.
The idea is simple enough in itself. You slow down as you approach the circle and if there are no cars coming at you, you enter the circle and somehow maneuver the wheel in a complex series of twists and turns to magically get the car to come out of the circle where you want it to.
I've discovered that the most important part of this delicate procedure is to NOT use the blinkers (or as my Israeli driving instructor likes to call them, winkers). Using the blinkers helps the other drivers know where you want to go and we can't have them knowing that because apparently, its a secret.
Aside from my difficulty using traffic circles, driving lessons are going all right. I've been told that learning how to drive is a bit of a learning curve.
Between you and me, I'm just glad that its not a traffic circle.
I don't get them.
My driving instructor has gone to great lengths to try and explain them to me, including drawing some diagrams and raising his arms in frustration and despair almost every time I unsuccessfully try and use one. But I just can't seem to figure them out.
The idea is simple enough in itself. You slow down as you approach the circle and if there are no cars coming at you, you enter the circle and somehow maneuver the wheel in a complex series of twists and turns to magically get the car to come out of the circle where you want it to.
I've discovered that the most important part of this delicate procedure is to NOT use the blinkers (or as my Israeli driving instructor likes to call them, winkers). Using the blinkers helps the other drivers know where you want to go and we can't have them knowing that because apparently, its a secret.
Aside from my difficulty using traffic circles, driving lessons are going all right. I've been told that learning how to drive is a bit of a learning curve.
Between you and me, I'm just glad that its not a traffic circle.
Wednesday, May 25, 2016
The Unsuspecting Passenger
After years of avoiding and pushing it off, I have finally begun the ever so tedious process of getting my drivers licence. This country sure doesn't make it easy.
Last week I went to take theory and passed (if only my finals at university could go by as smoothly!) and this week I had my first driving lesson. It was a bright and sunny afternoon as I stood in the sunshine anxiously awaiting for the driving instructor to pull up.
In the distance I saw a car with one of those triangles on top signifying that it was an instructors car. I briefly considered hiding behind a tree and letting them drive by without me but the tree wasn't very wide and it just looked like I was standing behind it to get out of the sun.
The car pulled up and I noticed that there was already a student in the drivers seat. I waved at the instructor and introduced myself. She smiled and gestured for me to get into the car. I happily started to make my way to the back seat of the car when the other student got out of the drivers seat and climbed into what I presumed was my seat.
I looked to the instructor for guidance and saw her patting the drivers seat. When she didn't make a move to get out of the car I succumbed to the inevitable and got into the drivers seat. I had spoken to a bunch of my friends before my lesson and they had all assured me that I probably wouldn't do much driving. They said that the instructor would probably drive me to an empty parking lot to point out the different car parts and maybe let me drive in a straight line.
The instructor began to point out the important things in the car that I would supposedly need in order to drive and I relaxed a little bit thinking that my friends were right, I probably wouldn't have to drive. When she was done explaining she asked if I had understood and mentioned that we had to get the other student home. I nodded enthusiastically and opened the door to get out of the car so we could switch spots.
Before I managed to get out of the car, the instructor asked me where I was going and told me to sit back down. I sat back down, and put on my seat belt. The instructor told me to adjust the seat and mirrors. When I looked up into the mirror I saw the student in the back looking a little uncertain, I didn't blame her.
And thus began the drive to the other students house on the other side of town. I'm pretty sure she wished she had walked.
We got there without too much trouble. The instructor has total control over the car from her seat so I mostly pretended to control the wheel and played with the blinkers.
After dropping the other student off we turned around and drove back to my apartment to drop me off. I happily relinquished control of the drivers seat and went on my merry way.
All in all, not the worst experience (although it is a rather costly one!). Hopefully the process continues to go smoothly and next year I'll be able drive myself to whatever hospital I get put in!
Last week I went to take theory and passed (if only my finals at university could go by as smoothly!) and this week I had my first driving lesson. It was a bright and sunny afternoon as I stood in the sunshine anxiously awaiting for the driving instructor to pull up.
In the distance I saw a car with one of those triangles on top signifying that it was an instructors car. I briefly considered hiding behind a tree and letting them drive by without me but the tree wasn't very wide and it just looked like I was standing behind it to get out of the sun.
The car pulled up and I noticed that there was already a student in the drivers seat. I waved at the instructor and introduced myself. She smiled and gestured for me to get into the car. I happily started to make my way to the back seat of the car when the other student got out of the drivers seat and climbed into what I presumed was my seat.
I looked to the instructor for guidance and saw her patting the drivers seat. When she didn't make a move to get out of the car I succumbed to the inevitable and got into the drivers seat. I had spoken to a bunch of my friends before my lesson and they had all assured me that I probably wouldn't do much driving. They said that the instructor would probably drive me to an empty parking lot to point out the different car parts and maybe let me drive in a straight line.
The instructor began to point out the important things in the car that I would supposedly need in order to drive and I relaxed a little bit thinking that my friends were right, I probably wouldn't have to drive. When she was done explaining she asked if I had understood and mentioned that we had to get the other student home. I nodded enthusiastically and opened the door to get out of the car so we could switch spots.
Before I managed to get out of the car, the instructor asked me where I was going and told me to sit back down. I sat back down, and put on my seat belt. The instructor told me to adjust the seat and mirrors. When I looked up into the mirror I saw the student in the back looking a little uncertain, I didn't blame her.
And thus began the drive to the other students house on the other side of town. I'm pretty sure she wished she had walked.
We got there without too much trouble. The instructor has total control over the car from her seat so I mostly pretended to control the wheel and played with the blinkers.
After dropping the other student off we turned around and drove back to my apartment to drop me off. I happily relinquished control of the drivers seat and went on my merry way.
All in all, not the worst experience (although it is a rather costly one!). Hopefully the process continues to go smoothly and next year I'll be able drive myself to whatever hospital I get put in!
Tuesday, April 5, 2016
Just Like Chicken
This week I moved from my quiet little ward into the operating rooms.
My ward had been small and at times boring but I was comfortable there. The staff was always nice to me and the patients were more or less happy to let me treat them, except for that one really quiet day where I spent so much time playing nurse with one patient that he started to pretend to be asleep whenever he heard me come back into the room.
I've never really been a fan of blood and gore. I'm the type of person that gets queasy and fast-forwards through the surgery scenes in tv shows and movies. I wasn't thrilled at the thought of having to stand in an OR and watch someone preform surgery right in front of me.
As you can probably imagine, it wasn't the most flawless transition.
Things didn't go exactly as planned on my first day. Or rather, they didn't go quite the way that the nurse in charge of me had planned. I picked up my scrubs on the way into the hospital and was ready and dressed by 7:10am. Unfortunately surgeries don't start until closer to 9am so I had almost two hours to sit in the staff room panicking and trying to come up with a plan on how to get out of there.
My OR nurse came in at around 9 to find us and give us a quick little tour of the place. As we walked farther away from the staff room and deeper into the OR I noticed the drastic change in temperature. The next thing I noticed was the distinctive smell and then, the nausea hit.
Everyone had finished eating and the OR had come to life. Doctors, nurses and anesthesiologists rushed around shouting orders and double checking that everything was ready. My nurse started to explain the types of surgeries scheduled for the day, my insides churned in protest.
Feeling like a ticking time bomb I desperately tried to explain that I needed to get out of there. After a difficult five minutes of arguing I was sent to the head nurse that's in charge of all of the nursing students. I tried to calm my insides down and went to present my case. Twenty minutes later I was introduced to the nurses in the recovery room where I spent the day hooking patients up to monitors and taking their vitals while they waited for the anesthetics to wear off.
Today I got to the recovery room bright and early only to find that this mornings surgeries were all "big" surgeries that would take at least 2 hours per surgery. After sitting for an hour and a half in recovery with no patients to hook up to monitors I started to get really bored.
I saw the nursing student that I'm supposed to be watching surgeries with hurry down the hall. She stopped by the sinks to grab a face mask and then walked into one of the OR rooms. Curiosity got the best of me and five minutes later I was standing next to her watching a gastric sleeve surgery.
The surgery was laparoscopic so we could see everything on a big screen. They were just beginning to cut the stomach when I went in, my insides panicked in sympathy. I felt like throwing up but then I noticed the liver and the spleen and then I noticed that it was kind of like cutting up raw chicken.
I don't know if it was an adrenaline rush or a miracle but my insides calmed down and I couldn't look away. It may sound kind of gross but I just kept thinking of chicken and steak and it made me really hungry.
The other nursing student kept checking on me to make sure that I was feeling ok. Towards the end of the surgery I told her that I was going to go out and she asked me if I was ok I said "Ya, I'm just going to go grab something to eat. I'm starving!".
After eating a quick snack we went in to see someone have their hemorrhoids removed and then finished off the day with a bilateral hernia repair.
I'm pretty proud of myself for actually going into the OR and watching some surgeries. I'm also really glad that I didn't throw up or pass out!
Tomorrow is the last day that we're allowed to watch surgeries and then its back to hooking people up to monitors in recovery.
My ward had been small and at times boring but I was comfortable there. The staff was always nice to me and the patients were more or less happy to let me treat them, except for that one really quiet day where I spent so much time playing nurse with one patient that he started to pretend to be asleep whenever he heard me come back into the room.
I've never really been a fan of blood and gore. I'm the type of person that gets queasy and fast-forwards through the surgery scenes in tv shows and movies. I wasn't thrilled at the thought of having to stand in an OR and watch someone preform surgery right in front of me.
As you can probably imagine, it wasn't the most flawless transition.
Things didn't go exactly as planned on my first day. Or rather, they didn't go quite the way that the nurse in charge of me had planned. I picked up my scrubs on the way into the hospital and was ready and dressed by 7:10am. Unfortunately surgeries don't start until closer to 9am so I had almost two hours to sit in the staff room panicking and trying to come up with a plan on how to get out of there.
My OR nurse came in at around 9 to find us and give us a quick little tour of the place. As we walked farther away from the staff room and deeper into the OR I noticed the drastic change in temperature. The next thing I noticed was the distinctive smell and then, the nausea hit.
Everyone had finished eating and the OR had come to life. Doctors, nurses and anesthesiologists rushed around shouting orders and double checking that everything was ready. My nurse started to explain the types of surgeries scheduled for the day, my insides churned in protest.
Feeling like a ticking time bomb I desperately tried to explain that I needed to get out of there. After a difficult five minutes of arguing I was sent to the head nurse that's in charge of all of the nursing students. I tried to calm my insides down and went to present my case. Twenty minutes later I was introduced to the nurses in the recovery room where I spent the day hooking patients up to monitors and taking their vitals while they waited for the anesthetics to wear off.
Today I got to the recovery room bright and early only to find that this mornings surgeries were all "big" surgeries that would take at least 2 hours per surgery. After sitting for an hour and a half in recovery with no patients to hook up to monitors I started to get really bored.
I saw the nursing student that I'm supposed to be watching surgeries with hurry down the hall. She stopped by the sinks to grab a face mask and then walked into one of the OR rooms. Curiosity got the best of me and five minutes later I was standing next to her watching a gastric sleeve surgery.
The surgery was laparoscopic so we could see everything on a big screen. They were just beginning to cut the stomach when I went in, my insides panicked in sympathy. I felt like throwing up but then I noticed the liver and the spleen and then I noticed that it was kind of like cutting up raw chicken.
I don't know if it was an adrenaline rush or a miracle but my insides calmed down and I couldn't look away. It may sound kind of gross but I just kept thinking of chicken and steak and it made me really hungry.
The other nursing student kept checking on me to make sure that I was feeling ok. Towards the end of the surgery I told her that I was going to go out and she asked me if I was ok I said "Ya, I'm just going to go grab something to eat. I'm starving!".
After eating a quick snack we went in to see someone have their hemorrhoids removed and then finished off the day with a bilateral hernia repair.
I'm pretty proud of myself for actually going into the OR and watching some surgeries. I'm also really glad that I didn't throw up or pass out!
Tomorrow is the last day that we're allowed to watch surgeries and then its back to hooking people up to monitors in recovery.
Monday, March 28, 2016
The Power Of Determination
Learning in the hospital has been interesting. My ward is pretty quiet so I spend a lot of my time making small talk with the patients and their families. One of the questions that they love to ask is "So, why nursing?" and I'm never quite sure how to answer.
Today I was treating a patient that had undergone a surgery earlier in the day. When I was done talking to her and taking her blood pressure she informed me that she really needed to smoke. I smiled and did my best to explain to her that she was still under the influence of the drugs that she had gotten during surgery and wouldn't be able to leave the ward on her own until the following day.
She patiently listened to my explanation and told me that she understood completely. Relieved that it had been so easy I asked her if there was anything else she needed before I left. She stared back at me blankly and then reiterated that she really really needed to smoke.
I explained to her again that there was no way for her to leave the ward to smoke and that smoking in the building is illegal. She smiled and nodded before giving me a wink and telling me that she understood. I stood there staring at her for a minute wondering what the wink was supposed to mean, she offered no explanation but gestured towards the door and waited for me to leave.
Slightly perturbed I slowly backed out of the room. She took out a cigarette and wrestled the window open. Realizing that there was not much else that I could do I sighed and went to make sure that she didn't fall out of the window or get the drain from her surgery stuck on anything.
As I stood there holding the back of my patients robe shut while she enjoyed her precious cigarette, I couldn't help but wonder to myself "So, why nursing?".
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