Yeah, I made it to Boston. I had gone down to Argos on New Oxford, a store where you go in and look up your items in a catalog, enter the item number in a machine to see if it is on stock, pay for it, then have it brought out to you. So basically, you do not see the item until after paid for. To return the item, it has to be unused and in the original packaging. So anyway, I was needing a piece of luggage as the one I came with was broken. Long story short, the phrase you get what you paid for was resonating in my head the following day when I rolled my new piece of luggage to the Russell Square tube station as one of the wheels fell apart!! Basically, I drug that piece of luggage from London to Boston!! anyway.......
It is so good to be here. I checked into the Bulfinch Hotel here in Boston, and Kate and Leslie joined me. We ordered out pizza, pasta, supplied our own wine, and watched the academies. I did not make it to the end, though, and it is now 6am and I found out the final results online. I loved the movie, Slumdog. In my opinion, this years movies were all quite good.
I am going to Portland tomorrow, and I so look forward to seeing everyone!! Cheers!!
Monday, February 23, 2009
Sunday, February 22, 2009
Saturday, February 21, 2009
February 21, 2009
Yeah!!! Tomorrow I am flying to Boston and will stop over and watch the Oscars with Kate and Leslie!!!! Yeah!!!! Dow will come in on Monday, and we will both fly back to Portland on Tuesday!! Yeah!!
I just worked three long days on the unit. After doing a large work book first, I had a training moment on the PCA system, then I will have a test. One of the charge nurses just failed the test. Ok. PCAs are not through an IV site, but rather, through the subcutaneous route that I referred to earlier, usually in the upper arm.
Patients who are going for procedures such as a ct or xray are sent down in their bed with a porter and a nurse, along with an emergency bag with an ambu bag in it. When patients go to surgery, the nurse goes down with them and into the pre-surgical area. Then when they are ready to leave recovery, the nurse goes back down with the emergency bag, gets report from the recovery nurse, and brings them back up on the floor with the porter.
One clarification about the MRSA situation. Patients are nasally swabbed on admit and a week later in their nose. The patients who were negative initially, then positive later had it in their nose. Not in wounds.
I have seen several frontal/temporal lobectomies.
The weather in London today was fantastic. The sidewalks were crammed with people on the shopping streets. I am starting to look forward to more nice days.
I will see a lot of you in Portland. Cheers until then.
p.s. the elevator in my dorm will be out of order for 14 weeks!!! Let's just hope the plumbing does not go out next!
I just worked three long days on the unit. After doing a large work book first, I had a training moment on the PCA system, then I will have a test. One of the charge nurses just failed the test. Ok. PCAs are not through an IV site, but rather, through the subcutaneous route that I referred to earlier, usually in the upper arm.
Patients who are going for procedures such as a ct or xray are sent down in their bed with a porter and a nurse, along with an emergency bag with an ambu bag in it. When patients go to surgery, the nurse goes down with them and into the pre-surgical area. Then when they are ready to leave recovery, the nurse goes back down with the emergency bag, gets report from the recovery nurse, and brings them back up on the floor with the porter.
One clarification about the MRSA situation. Patients are nasally swabbed on admit and a week later in their nose. The patients who were negative initially, then positive later had it in their nose. Not in wounds.
I have seen several frontal/temporal lobectomies.
The weather in London today was fantastic. The sidewalks were crammed with people on the shopping streets. I am starting to look forward to more nice days.
I will see a lot of you in Portland. Cheers until then.
p.s. the elevator in my dorm will be out of order for 14 weeks!!! Let's just hope the plumbing does not go out next!
Tuesday, February 17, 2009
I am soon to come to the U.S.!!
February 16, 2009
Greetings to all!!! I have rallied from my four night shifts. It took a while, as they somewhat wiped me out. That is a long shift to endure through the night. It can be quite a surreal environment, with 24 sleeping or not bodies throughout the ward. There was one moment at about 10pm one evening when I wished I had my camera and permission to take the picture. The 6 Nation rugby tournament is going on, which apparently is a big deal here in the U.K. In one of the men’s bays a television was airing the game and about 5 men were all gathered around it, all of them with head bandages from their brain surgeries.
I have been seeing a lot of different types of surgery that are interesting to me, such as temporal and frontal lobectomies, that are done for people with seizures. I am looking forward to learning more about them.
Today I went to another new staff induction. I know I still have a few more days of induction. One part of the induction that has been the most impressive to me is the presentation that the fire safety manager does. It has been so informative and educational and has left an indelible mark on me in regards to fire awareness and procedure. The fire doors have never made more sense to me until now.
Yesterday I went to the opera La Boheme with my nurse friend, Jacqueline, at the Coliseum. What a beautiful theater, and the opera was very nice. We went to dinner afterwards. She is very interesting and I learn a lot from her about English ways in the medical field. As she is a neonatal nurse, she has a lot of interesting stories. One topic that she has talked about extensively is childbirth and the parent’s ability to totally call the shots regarding how the delivery goes, even if it leads to a poor outcome. According to her, the baby has no rights in the delivery scene, and that parents can refuse recommended treatment that would give the baby the safest delivery.
Afterwards we walked through Covent Garden and window-shopped.
I work three more long days, then head off for the states!!!!! Yeah!!! I am trying to see as many movies as I can to be ready for the Oscars!
Greetings to all!!! I have rallied from my four night shifts. It took a while, as they somewhat wiped me out. That is a long shift to endure through the night. It can be quite a surreal environment, with 24 sleeping or not bodies throughout the ward. There was one moment at about 10pm one evening when I wished I had my camera and permission to take the picture. The 6 Nation rugby tournament is going on, which apparently is a big deal here in the U.K. In one of the men’s bays a television was airing the game and about 5 men were all gathered around it, all of them with head bandages from their brain surgeries.
I have been seeing a lot of different types of surgery that are interesting to me, such as temporal and frontal lobectomies, that are done for people with seizures. I am looking forward to learning more about them.
Today I went to another new staff induction. I know I still have a few more days of induction. One part of the induction that has been the most impressive to me is the presentation that the fire safety manager does. It has been so informative and educational and has left an indelible mark on me in regards to fire awareness and procedure. The fire doors have never made more sense to me until now.
Yesterday I went to the opera La Boheme with my nurse friend, Jacqueline, at the Coliseum. What a beautiful theater, and the opera was very nice. We went to dinner afterwards. She is very interesting and I learn a lot from her about English ways in the medical field. As she is a neonatal nurse, she has a lot of interesting stories. One topic that she has talked about extensively is childbirth and the parent’s ability to totally call the shots regarding how the delivery goes, even if it leads to a poor outcome. According to her, the baby has no rights in the delivery scene, and that parents can refuse recommended treatment that would give the baby the safest delivery.
Afterwards we walked through Covent Garden and window-shopped.
I work three more long days, then head off for the states!!!!! Yeah!!! I am trying to see as many movies as I can to be ready for the Oscars!
Thursday, February 12, 2009
February 12, another cold, snowy day!
Greetings! I just worked 3 12.5 hour night shifts. I was worried about them dragging on forever, but they actually went by decently quickly. A very interesting environment, as you have a room filled with 24 people in various stages of sleep or not. As you walk around, the sounds of sleep are apparent, some people are just breathing in a very regular breathing pattern, while others are snoring, from quiet, gentle snoring, to loud snoring. Some patients are not asleep at all, as they may be reading, restless, and/or disturbing others. We as nurses work in a very dark environment, trying to keep everyone calm and quiet, and that can be a challenge. It is impressive to me to see some patients sleep through anything/everything that is going on around them. At 6am, the place starts coming to life again, as vital signs are started and medication passed out. By 730am, the lights are on and we start preparing for handover, where we go from bed to bed and do report.
I work with many nurses from Africa. Last night one of them was shopping for a 4-wheel drive vehicle to take to Malawi. He would have it shipped to a port, then drive it to his country, about 8 hours away. I offered to help him make the drive. Another nurse was planning her trip to her home in Japan. With 7 weeks of vacation a year, nurses are able to do some regular commuting home. One nurse is from the Philipines, and her husband and two young sons live there.
I have tonight off, then do another night shift tomorrow night. I am not minding it at all. There is one patient who I have been talking to who is very interesting. He has been a pub owner in Kent, England, and has some interesting stories to share. Last night I took in my ipod so that he could listen to the Robert Plantt and Allison Kraus cd, Raising Sand, that won 6 Grammys last week. Thank you, Mike, for loaning me your cd so that I could put it on my ipod!
I have attached pictures of the "sluice" machine that I described earlier. It always chuckles me when I use it. You use your foot to open it, slide in the bedpans/urinals, then start it. It sounds somewhat like a dishwasher, and then, there you go, clean items!!
I hope this finds everyone well. I have been here a month and a half, and despite the fact that I am marveling at what I am doing, I always have a moment of the day where I long for Portland and everyone who goes along with it!! Cheers to all!!!
I work with many nurses from Africa. Last night one of them was shopping for a 4-wheel drive vehicle to take to Malawi. He would have it shipped to a port, then drive it to his country, about 8 hours away. I offered to help him make the drive. Another nurse was planning her trip to her home in Japan. With 7 weeks of vacation a year, nurses are able to do some regular commuting home. One nurse is from the Philipines, and her husband and two young sons live there.
I have tonight off, then do another night shift tomorrow night. I am not minding it at all. There is one patient who I have been talking to who is very interesting. He has been a pub owner in Kent, England, and has some interesting stories to share. Last night I took in my ipod so that he could listen to the Robert Plantt and Allison Kraus cd, Raising Sand, that won 6 Grammys last week. Thank you, Mike, for loaning me your cd so that I could put it on my ipod!
I have attached pictures of the "sluice" machine that I described earlier. It always chuckles me when I use it. You use your foot to open it, slide in the bedpans/urinals, then start it. It sounds somewhat like a dishwasher, and then, there you go, clean items!!
I hope this finds everyone well. I have been here a month and a half, and despite the fact that I am marveling at what I am doing, I always have a moment of the day where I long for Portland and everyone who goes along with it!! Cheers to all!!!
Sunday, February 8, 2009
A good day!
Television update. I am on my fifth antennae. I think this one is a keeper. I have my shadows down to 5, and I am not having to constantly move it around!! Yeah!!
Also, I finally bought a bongle, a stick to put into my computer that enables me to access internet in my room!!! yeah!! So it will be interesting to see how long it lasts. It is a program where you pay as you go.
I went and saw Benjamin Button with my nurse friend from Scotland. Good movie. We then stopped and had a burger and talked. She would like to come to the US with me and see an American hospital. I told her that I was somewhat dreading the night shifts that I have coming up, afraid that they are going to drag on forever. She suggested I bring in a book to read!!
Cheers!
Also, I finally bought a bongle, a stick to put into my computer that enables me to access internet in my room!!! yeah!! So it will be interesting to see how long it lasts. It is a program where you pay as you go.
I went and saw Benjamin Button with my nurse friend from Scotland. Good movie. We then stopped and had a burger and talked. She would like to come to the US with me and see an American hospital. I told her that I was somewhat dreading the night shifts that I have coming up, afraid that they are going to drag on forever. She suggested I bring in a book to read!!
Cheers!
February 8, Still cold!
February 7, 2009
After working 3, 12.5-hour shifts, I find myself exhausted. I did get myself up, though, and found another market today. Shepard’s Bush Market. It was a decent market and I enjoyed browsing around. Afterwards, I treated myself to an all-you-can-eat Thai restaurant, and to the movie, Doubt. The subject matter of the movie caught me by surprise, as I had not heard anything about the content. It was quite good. I am also planning on going to another movie tomorrow with my new friend, Jacqueline, so this will be a double-header weekend.
Work is going quite well. I really enjoy the people I work with, and find them to be a lot of fun. I find the amenities to be challenging, though. For those of us who have grumbled about our break room in the new tower, believe me, it is spacious compared to what we have at the National. There is no kitchen facility for the staff, and we are at the mercy of using a kitchen that is used for the patients, and the staff who run it. I find myself constantly in trouble with the caterer, Rita, but I have to admit that I have dug in my heels on this one. There are four microwaves, but we can use only one, and it is in a corner that is usually inaccessible. The other three for some reason are not to be used by us. Well, when you are the third person in line and looking at three other microwaves, it is just too tempting to not use one!! So I did and I will, despite being yelled at! Then the only sink that is accessible to use I have been told I cannot use, as supposedly it needs to be bleached out after every use! No, Donna, you cannot borrow that fork or a teacup, even though you plan on returning them. (Now, I have just gotten to where I sneak out a fork or a teacup!!) Anyway, I guess you can say I have chosen this battle. I have been trying to butter up Rita, but it is going to be a long, slow process.
We had in interesting situation on our unit. All patients are screened for MRSA on admit and every seven days thereafter. A lot of patients stay a long time, a very long time, sometimes, a non-understandably long time from my view (lumbar lami with no complications for 3 weeks because he felt like he needed to stay there?) So anyway, we had seven patients who came in with MRSA, and then we had two more with MRSA who did not come in with it. (MRSA is a bacteria that is resistant to antibiotics and can be devastating if entered into a body system where it does not normally live, such as wounds. It can be spread between patients by staff when good hand washing is not done.) So our unit was closed to new patients, and the ward was strip cleaned and patients moved around. We ended up having bays with “clean girls”, “dirty girls”, “clean boys”, and “dirty boys”. It was quite an interesting process to observe. There are 24 rooms with the curtains, and three private rooms. Some of the dirty people were put in the private rooms, and it was very surprising to me that they complained about having a private room!! One of them was an elderly woman with a halo brace, who could barely walk without swaying side to side, and she kept getting up and leaving her room crying about how lonely she was!
Oh, big news. I passed my medication-passing test!!!!!! I guess I am somewhat of an overachiever when it comes to passing this test, as most people fail it a couple of times first. The first part of the process was to do a workbook. I had to resubmit it twice before it passed, as I was having a hard time getting my answers exactly like they wanted them. Then I was observed and drilled with medication passing. I have to say, it was quite a thorough assessment. Medication passing is quite different. The meds are kept in a locked trolley full of boxes and bottles, and you have to hunt and search through them to find them. I learned that the word dispersible means dissolvable. Almost everyone there gets paracatemol (Tylenol), 1,000 mg every 5 hours. So I was so happy that I passed the test!!!! Until then, I was considered as a new grad! I hope this moves me up a grade in the tier of nursing!
Update on my TV. I took back the fourth antennae today. I was having a hard time getting fewer than 10 shadows regardless of where I stood in the room. I took it back to one store with the plan on getting another one at a different store. But by the time I got to it, it was closed!!!! Darn. So tomorrow, another antennae will need to be purchased.
Julie F., today’s picture is for your benefit!! Enjoy.
I am hearing from some of you that you are not able to post comments! Sad~~
Wednesday, February 4, 2009
Short update.
Feb 2, 2009
Today we woke up to London covered in snow. They said it was the most snowfall in 18 years! No buses were running and the tube and train were very delayed. The airlines also had cancellations and delays. I was to have gone in for a “moving and handling” inservice, but offered to go onto the ward instead, and was quickly taken up on my offer. The walk in was quite surreal, as London without buses is an odd sensation.
Ok, I am still struggling with this experience. I need a debriefing; I need to discuss the patient cases that I have seen. I need to talk. Our ward is closed to taking new patients because of a mrsa spread. I had a patient who we were giving peripheral iv phenytoin while her iv site was painful. Just a myriad of events that I need to discuss.
I have tomorrow off, then head in for a 3-day stint.
Enjoy the pictures!!
Today we woke up to London covered in snow. They said it was the most snowfall in 18 years! No buses were running and the tube and train were very delayed. The airlines also had cancellations and delays. I was to have gone in for a “moving and handling” inservice, but offered to go onto the ward instead, and was quickly taken up on my offer. The walk in was quite surreal, as London without buses is an odd sensation.
Ok, I am still struggling with this experience. I need a debriefing; I need to discuss the patient cases that I have seen. I need to talk. Our ward is closed to taking new patients because of a mrsa spread. I had a patient who we were giving peripheral iv phenytoin while her iv site was painful. Just a myriad of events that I need to discuss.
I have tomorrow off, then head in for a 3-day stint.
Enjoy the pictures!!
Sunday, February 1, 2009
February 1, 2009. A cold, snowy day!
February 1, 2009
I just worked 3 long days, laced with outings in London with Dow. It is quite cold, windy, and there are snow showers. Dow and I spent the morning helping a girl move into her dorm room with the help of her parents. The elevator is not working, and it is 72 steps up to the fourth floor, or there is another route with a long walk and many fire doors to another elevator. Between the two choices, we helped them move her things into her room. She had enough belongings to completely fill up the space of her room. She is separated from her husband, but there is a 2-year waiting time before they can divorce! She told me this building is to have cable TV access this month!!!!!
Our outing today was to go have Sunday dinner at the pub where we went last week. That dinner is so incredible!! Again, anyone coming over to London, I will treat you to this dinner!!! It is cold and windy today, and has actually snowed enough to cover the ground. Therefore, we have had a quiet day in the room, watching some good TV. Yesterday we took a bus to Greenwich and had a pub meal, as it was too cold to do much else. But it was a nice, long bus ride that we enjoyed. On the way back we got caught up in a traffic jam because of a demonstration related to Gaza, but it was actually a good thing, because the bus went slowly over the river Thames, and we were able to look out at the sites, including the buildings of parliament and Big Ben.
Tomorrow I have my mandatory, moving and handling class. I am now off of supernumerary (being with a preceptor), but I have yet to take my drug-passing test before I can pass medication on my own. I believe this involves being with an instructor and demonstrating my competency to be able to pass medication by following the 5 rights. I have completed a workbook with questions regarding medication knowledge. They have pca’s, but that requires another workbook and test. The attitude towards pca’s seems to be quite different than what I am used to. The policy is that there needs to be nursing one to one to assure safety for patients with pca’s. There is only one medication, morphine, and there is only one setting.
I now have my uniform and identification, so I am feeling quite equipped for the job. I also have black shoes, but I wore them 2 days in a row, and I had to take a break from them because I could hardly walk by the end of the second shift! So it was back to my white Keds for a while.
I absolutely love going to work; however, there are a few issues that I am having a hard time with, and they basically center around medical care. I am looking forward to talking to colleagues in Portland and see if I can make sense of my observations. When a nurse has worked in a specialty for years, there is an expected course of medical care that she would expect for patients. What I am seeing here does not necessarily match those expectations, but again, different is different.
Some observations. Medication boxes also have Braille on them. No filter needles and a lot of glass ampules. Sharp containers are infrequent, and the hole to drop the sharp in is gaping.
Oh by the way, have I mentioned that I have 7 weeks of vacation a year? Yep, true story. They are already pushing vacation on me. This is enabling me to come home to Portland for a week the end of February!!
I just worked 3 long days, laced with outings in London with Dow. It is quite cold, windy, and there are snow showers. Dow and I spent the morning helping a girl move into her dorm room with the help of her parents. The elevator is not working, and it is 72 steps up to the fourth floor, or there is another route with a long walk and many fire doors to another elevator. Between the two choices, we helped them move her things into her room. She had enough belongings to completely fill up the space of her room. She is separated from her husband, but there is a 2-year waiting time before they can divorce! She told me this building is to have cable TV access this month!!!!!
Our outing today was to go have Sunday dinner at the pub where we went last week. That dinner is so incredible!! Again, anyone coming over to London, I will treat you to this dinner!!! It is cold and windy today, and has actually snowed enough to cover the ground. Therefore, we have had a quiet day in the room, watching some good TV. Yesterday we took a bus to Greenwich and had a pub meal, as it was too cold to do much else. But it was a nice, long bus ride that we enjoyed. On the way back we got caught up in a traffic jam because of a demonstration related to Gaza, but it was actually a good thing, because the bus went slowly over the river Thames, and we were able to look out at the sites, including the buildings of parliament and Big Ben.
Tomorrow I have my mandatory, moving and handling class. I am now off of supernumerary (being with a preceptor), but I have yet to take my drug-passing test before I can pass medication on my own. I believe this involves being with an instructor and demonstrating my competency to be able to pass medication by following the 5 rights. I have completed a workbook with questions regarding medication knowledge. They have pca’s, but that requires another workbook and test. The attitude towards pca’s seems to be quite different than what I am used to. The policy is that there needs to be nursing one to one to assure safety for patients with pca’s. There is only one medication, morphine, and there is only one setting.
I now have my uniform and identification, so I am feeling quite equipped for the job. I also have black shoes, but I wore them 2 days in a row, and I had to take a break from them because I could hardly walk by the end of the second shift! So it was back to my white Keds for a while.
I absolutely love going to work; however, there are a few issues that I am having a hard time with, and they basically center around medical care. I am looking forward to talking to colleagues in Portland and see if I can make sense of my observations. When a nurse has worked in a specialty for years, there is an expected course of medical care that she would expect for patients. What I am seeing here does not necessarily match those expectations, but again, different is different.
Some observations. Medication boxes also have Braille on them. No filter needles and a lot of glass ampules. Sharp containers are infrequent, and the hole to drop the sharp in is gaping.
Oh by the way, have I mentioned that I have 7 weeks of vacation a year? Yep, true story. They are already pushing vacation on me. This is enabling me to come home to Portland for a week the end of February!!
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