Nurse! Decode this Prescription!

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Doctors must obviously be intelligent people (well most of them anyway), but what’s with their handwriting? I was told once that because they do a lot of writing over the years, it makes it difficult to keep neat handwriting. I am not expecting beautifully constructed letters that would make my first grade teacher glow with pride, but can’t they manage having ugly handwriting while keeping it legible anyway? Of course if a nurse gave the wrong medication because she decoded the doctor's handwriting incorrectly, she’d be the one to take the fall. There are obviously some serious issues with illegible handwriting. Doctors usually refuse to help the situation, so the pharmacists at my hospital waste no time sending prescriptions back to the doctors with a note written boldly in red ink instructing the doctor to rewrite the prescription neatly.

Dr. Mathal is famous for having the worst handwriting and he would get extremely offended and defensive whenever the pharmacy would send him such notes. He’d kick a fuss and refuse to rewrite the script. He once even just walked right out of the consulting room and left the hospital. I wonder if he thinks he was making a point or something because in the end, it’s the patient that gets shoved about. First the patient gets sent back to the doctor with the illegible prescription to be rewritten and if the doc who wrote the script is no longer around, another doctor has to review the case from scratch (since he can't read the notes), then the patient goes back to the pharmacy again. It's a waste of time and it's frustrating for the ill and elderly.

But as karma would have it, one day Dr. Mathal had to write up a repeat prescription for a patient on chronic meds. He pulled out the previous script hoping he could copy it off from there so that he could finish up with the patient quickly and catch a ride home with one of his colleagues. The old script was illegible, and after studying it for a while, he couldn't decode the handwriting. The funniest part of it all was that it was his own handwriting! He look flustered and annoyed and had to interview and examine the patient all over again, which took him an extra half hour and he missed his ride home! I smiled inside.

Nurse should be paid to decode these!

If you can read this, you're a nurse!

Episode 4 – Bloody Portovac!

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Previously on Nursing Habits: Arkadia fits a 100kg dead body into a tiny body bag…
The last offices.

INT: ICU UNIT, DAY TWO. A GREY DAY, PUPIL NURSE, ARKADIA ENTERS THE 4-BEDDED ICU UNIT APPREHENSIVELY.

Day 2 on the job at ICU was a little less traumatizing than the previous one. The Intensive Care Unit felt quite intense, and intimidating. On this particular day, there were 3 patients. Mr. Duze had been in a coma for many months after a car accident and was on life support, unable to move or speak. I wondered where his mind was? Was he dreaming? Was he able to hear things around him? Would he want to be kept in a hospital bed with no control over his body? While euthanasia is a controversial subject, I think I’d rather be dead.

Angelic Male Nurse

If he wakes up, he would be oxygen dependent.

The second bed was occupied by a suicidal policeman, Mr. Rose, that had even went to the extent of putting himself inside a body bag before shooting himself in the head. I believe he had been airlifted and treated at another hospital before coming to our hospital to be stabilized. He was coming around okay but he was extremely violent and very determined to abscond. He eventually did escape, injuring two nurses in the process. His relatives were not too thrilled and they threatened to sue if he turned up dead, since he was still in a very suicidal state of mind. Police were sent on a search and they eventually found him running around town with his butt sticking out of his hospital gown. He never did return to the hospital and I wonder if he ended up pulling the plug on himself eventually.

The third patient was an elderly woman who had some op done (I can’t remember what), I just remember her having a portovac (a portable wound suction device, that allows fluid such as blood to be evacuated), because I was instructed to empty it with disastrous results. I just popped open the lid and the next thing I know, blood splattered out of the portovac right onto my face! I looked like I had just murdered someone and I was thoroughly mortified and writhing with terror. The nurses were not very supportive, knowing that it was only my second day in practical training, and I was pissed that they didn’t tell me that there was a special way to open the portovac.

Sr. Sterile

How did you make such a mess? Don’t you know how to open a portovac?
Go wash up and then come and change the linen!

I obliged, wondering to myself if the tone she used on me was uncalled for. Was it not her responsibility to warn me of things like these? I mean, it’s the first time in my life encountering a portovac. And for the first-time user it’s not blatantly obvious that it would splash unless you clamped the cord down. I washed my face about 5 times before I felt safe enough to continue. Then I wondered whether I should have been tested for HIV or any other infectious disease, but none of the staff seemed concerned, even though I later learnt that they should have reported it to the occupational health and safety nurse to make certain that I was okay. Luckily after checking for myself, there were no adverse effects. I was still feeling roughed up after Mrs. Khosa’s death, and now I was being reprimanded for something that really wasn’t my fault. Two days down and I was already feeling dejected and unsupported. So begins the rollercoaster ride through one crazy career.

4 O’Clock? Cuppa Pee!

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In maternity, we routinely collect urine samples for which we keep plastic cups in the toilets. A very pregnant lady came in one morning thinking that she was in labor. We pointed her to the toilet and asked her to pee in a cup. She comes back after a while, with a coffee cup full of urine! She somehow got into the nurses tea room and peed in the clerks coffee mug. Not only did she pee in his mug, she did the deed right in the middle of the tearoom!

The distraught look on the clerks face was quiet hilarious, but I would love to open up that patient’s brain to check if her logic is screwed in properly. How the heck do you enter a room full of chairs, tables, microwaves, lunch boxes and coffee mugs and think to yourself… “hmmm, this looks like a room fit for collecting urine samples.” Whiz away whiz kid, you must be a whiz of a mom! :-/

Cuppa Pee

NB: I now keep my coffee mug in my bag at all times.

Should you quit nursing?

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I am on nightshift feeling a little down after being told that I would have to push back my resignation date by a few weeks. But the disappointment I feel is inconsequential in light of the joy I am feeling right now. Jash and I have great plans ahead of us and we are so totally in sync, that we both feel like there is a force within us that’s just pushing us forth. We’re unafraid and taking the risks we stopped ourselves from taking so many times before. I am feeling quiet invincible right now, so it would be a bummer if a boulder fell on my head right now and killed me dead because I am at a point in my life where I understand enough about myself to know that I have always been capable of seeing my dreams through.

It’s so ridiculous how dumb we are when we are younger. We complain about the silliest things and we are so busy whining about our little lives, that we don’t see the magic right in front of our eyes. It’s absolutely beautiful once you open your eyes! I could cry for the younger me for being so emo but I won’t, because I know that it was the perfect spot to be in back then, to get where I am right now.  I can’t help falling in love with life. I was told today by my good friend Vana that I am a romantic. I laughed so hard. I was never a romantic. Ask my sister Shady. I hated men, I hated life, I hated myself, I hated broccoli, I hated school and I’d just hate, hate, hate and hate everything.

I had this idea in my head that our planet is a prison and we’re doomed to suffer through it, without even knowing what we are being convicted for. I think one of the reasons we feel trapped is because society enforces rules that tell you that you have to live a certain way and achieve certain things by a certain age or you’d get labeled a failure. What they won’t tell you, is that your life is like a canvas and you’re the artist. You are allowed to do with it as you please without having to conform to the norms of society (save for being a psychotic murderer which will result in your own destruction). Right now, I constantly have projections of myself twirling in the freedom of my creativity. And I know for a sweet and solid fact that I am making the right decision and that I should quit nursing. I'm leaving it all behind, I'm gone!

Quit nursing! Arkadia has left the building!Image source: www.reviewjournal.com

People are always asking me why I want to quit nursing. What’s so bad about nursing? Well..everything..and nothing. It’s an awesomely challenging career and it’s not for the faint at heart. It’s for people that can handle the gruesome reality of life with a smile on their face and a skip in their step. You need to pull out an endless supply of energy from within you to be a supportive and solid force, guiding tormented people back to health or leading them peacefully to death, without losing your mind. I have met such people. They work hard, they put others first, they fight to keep the integrity of nursing in tact despite the many obstacles they are faced with. I would gladly name those nurses here if it weren’t for the fact that I am trying to keep the identity of my hospital quiet. Does that mean I didn’t have what it takes to be like them?

When I first started nursing, I was flooded with emotions and my mind was constantly stimulated. I was learning valuable life lessons. I cried when a patient died. I smiled when a patient got better. But as the years went by, a feeling of indifference began creeping over me and suddenly, no matter how hard I tried, I wasn’t feeling anything anymore.

I remember an elderly man I had nursed when I was a student. He told me all about his children and how much he loved them and he seemed to glow with pride as he spoke of them. He reminded me so much of my grandfather. Gentle and family orientated. He died that night. I felt like I had lost my own grandfather and I couldn’t bare it. I sat alone in the office and cried the whole night feeling that he had been wronged in some way. I know that as nurses, you grow to accept death as a norm, but recently I lost a patient and felt absolutely nothing. Is it okay to feel nothing? Maybe it’s time I moved on? Can you be a nurse when you can’t feel those basic emotions? Perhaps it’s necessary to become that way for the sake of your own sanity. Despite this, I would never be a sloppy nurse, I always take care to complete my tasks accurately and responsibly, but that feeling of indifference leads me to believe that I have given everything I could give and I have learnt everything I need to learn from this experience.

There are definitely other things about the job that I found frustrating, like the steady decline in the integrity of nursing, the way that nurses are undermined, the political upheaval in this country, the feeling of non-achievement when you have to do the same thing everyday and the general repugnance of the job itself. But all of those things are overcome by the nurse that’s driven by her love for the job. I am not that nurse.

Health care workers are often plagued by the problem of becoming desensitized to the things they deal with on a daily basis. There is a word for that condition but the “word gnome” stole it out of my head. My question is, is that desensitization good for you and your patient? Should you continue in the “caring profession” when you reach that point? I chose not to. I want to feel things, and after making a risky change by quitting nursing, I am feeling again. I am feeling good!
 
I apologize for the lengthiness of this entry but I thank all two of you that managed to stay with me right up to this point (which I am sure has nothing to do with the fact that you are my unpaid editors). You are loved! 🙂
 

Penis Party Protecting People!

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South Africa is hosting a new type of party. It’s an exclusive party but if you have a penis with foreskin intact, you stand a good chance of getting invited. Bring your sleeping bag with you because it’s going to be an all-nighter and loads of fun for every man! When you arrive at the party, you will be slightly alarmed by the sign on the door that says “Circumcision Camp” but you will quickly forget about it once a nurse finds you and leads you to a room with beds in it. Music playing in the background, a nurse asking you very personal questions about your sex life, this must be your lucky day! But in comes a doctor wielding a scalpel and suddenly the sign on the door comes rushing back to the foreground of your mind. The next thing you know, your foreskin has become your dearly departed and you’re feeling really terrified, which probably has to do with the fact that you’re bleeding from down there than anything else. Circumcision camp! A camp in which teams from different hospitals gather together in one centralized location and race each other to try and cut as many penises as they possibly can in 12 hours. I was elected to be one of the team members representing my hospital. On that particular day we cut 150 penises and rather distastefully celebrated with a feast catered by KFC.

 Now why would we do such a horrid thing? Perhaps to disprove the stereotype that boys don’t cry? I can safely say that the stereotype is broken. 149 boys cried that day (1 fainted) and I didn’t know what to do for them except offer to wrap their penises in bandages and send them off to their sleeping bags with a ton of painkillers and a teddy.

 Anyway, apparently studies have shown that circumcision reduces the risk of contracting HIV by 60%. Now how effective this really is, is not something I will pretend to know a lot about. What I do know, is that there seems to be a lot of confusion among our boys here. Especially those who aren’t well educated and who don’t understand English well enough to understand the difference between the words “reduce” and “prevent”.

 So the camp went like this, my team had set up 6 beds in a classroom on a college campus. One of the doctors brought along his radio to make the “party” all the more exciting. Boys from the age of 13 and older came to the camp. If you walked through the room, all you’d see is doctors and nurses working on penises that were sticking out of sterile towels that had holes cut in the center of them. I felt like I was at a penis farm and I was quiet terrified by the messy idea of slaughtering penises. Inevitably foreskins would get away from the “foreskin bin” and fall out onto the floor. I did my best not to step on one, but when I eventually did, I felt a shudder, the kind of shudder you feel when you squish a big cockroach under your shoe. There was blood everywhere and my darling nurses and doctors were ever so comfortable working with human flesh, that they were even eating and drinking in the same room (a talent I have yet to develop and actually don’t wish to develop). When the boys were done, they were told to have their blood pressures checked and sit in the makeshift “recovery room” we had set up in the corridor. They would spend an hour in recovery being observed. Many of them felt faint because they had bloody crotches and most of them sat there crying or squealing. Once they were okay, they were sent down to a large hall, armed with painkillers, and they’d make a bed on the floor and spend the night together in pain and sorrow over their lost foreskins.

circumcision terror

I had to interview each patient 3 times over to make sure that they understood the reasons why the government is promoting circumcision. There were a good amount of bright boys who understood that circumcision is by no means a preventative measure against HIV, but there was also an alarming number of boys that could not understand this. Some felt short-changed when they learned that it was not a preventative measure, but more worrying are those that still believe that it does in fact prevent HIV, even after several nurses explained to them in several languages that circumcision by no means renders you immune to the virus. These magnificent boys now believe that they are special and protected from HIV, so they go out into the world and “spread their love” – and that’s how an epidemic becomes a pandemic – stupid people.

EDIT: Clearly circumcision is a very sensitive topic to discuss. This post was simply meant to share my experience at this circumcision camp. I usually worked in Maternity – they reassigned me to the camp for a day because they needed extra hands. I did not have any heads up for this camp, I was asked to join on the morning of the camp. I was blissfully ignorant about circumcision and only knew that it was what the government was promoting to reduce HIV infection rates. All the parents had already signed consent forms and were apparently informed about the ups and downs of circumcision before they signed. I was there to do the job that my supervisors had assigned to me and as far as I knew, it was all an informed decision. Who was I to protest something that everyone agreed to do? So please, read the post for what it is – there are circumcision camps being promoted by some governments (South Africa being one of them), the parents give consent after being informed about the risks and benefits, the kids should maybe have more say in it. If anyone is interested in stopping these camps, please feel free to write to or call the relevant authorities at the various governments that get behind this. I’m leaving the post up to allow for healthy debate. Please, there’s no need for vulgar words or insults. We’re all grown ups here. 🙂

ADVICE TO ALL: If you are about to have any medical procedure done on yourself or your child, please make sure you read about it and research and you can even get second and third opinions from other doctors and nurses before you sign a consent form. Do not be afraid to ask a thousand questions. Your doctor and nurse is obligated to answer all of them in detail. Be informed about your body.

Suppository goes where?

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Communication…I cannot stress how important communication is in nursing. English is complex in the sense that one word has many meanings. It can really confuse some people.

Like Mr. Ram who came in complaining that his regular dosage of ibuprofen was no longer helping his arthritis. The doctor added indocid suppositories to his monthly prescription chart. “Okay, Mr. Ram, I’ve added a suppository to your chronic chart. Just put it into your back passage and you should be fine.” The next week Mr. Ram comes back to the hospital looking very dissatisfied.  “Doctor, it did not work. I put it at the back of my passage at home and I still have so much pain!” It turned out the patient had been planting the suppositories into a pot plant at the end of the passage at his house. Yeah I couldn’t believe it either!

So after having learnt a lesson about the importance of clear communication, I decided to use as little euphemisms as possible. It was 4PM in the maternity ward.  Just as I was handing out the supper, I remembered that I was supposed to give an indocid suppository to a patient 2 hours ago! I quickly got a suppository, and placed it on the cardiac trolley next to the patient's soup.

“Put this is in your bum.” I said. Trying to keep my English as simple as possible. The patient looked bewildered but she agreed, reached for her soup, stared at it and softly asked, “How must I put it in?” (>_<)

the suppository goes where?

U2 coming to South Africa!

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I just got word that U2 are coming to South Africa and I am so amped up! Tickets go on sale on Saturday and I am nervous about whether I will get to be in the inner circle or not(The inner circle is the same as the golden circle in regular concerts, except this concert has a circular "360 degree" stage) . It's four months away, 13 February 2011.  

        
By then I should be a full time web designer and an ex-nurse! The thought of that is both intimidating and exciting. No more supervision or rules forcing me to stick to working hours, no guaranteed paycheck at the end of the month, no more government-supplemented medical aid. I have to rely on myself to manage my time and business or there will be trouble on the horizon. Though I must have complete faith in my ability to make a success out of my dream.

At least for now I can afford to secure my U2 ticket! I will deal with how to get to Johannesburg when the time comes. It's a four hour drive and I plan on getting there really early. I gather from online buzz that there will be a sprint to get into the inner circle which will accommodate the first 2000 people or so! My running shoes will be on, just hope I don't get stampeded upon! To each his own but I am stunned by my colleagues ignorance, most of them have never heard of U2! Not everyone loves rock but this is U2 we're talking about! Love em or hate em, you should still have heard about them? Then again allot of small towns in South Africa consist of people who don't own computers and don't care much for the internet or anything beyond their own little world.

This will most likely be the last time U2 tours South Africa. I am ever grateful that my job as a nurse enabled me to afford many great opportunities, with this concert being the perfect farewell gift from my nursing career. 🙂

Hospital Signage – Funny or Fatal?

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Hospital signage errors can cause allot of trouble, even more so if you don’t exactly have a knack for common sense which is a disturbingly common phenomenon in my hospital.

funny sign
(This sign) + (demised babies) – (common sense) = scary.

Share pics you have of funny/dangerous hospital signs and I'll feature it on the site. 🙂 Email your images to arkadialove@gmail.com

Dead Rising!

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[Posts you may want to read first: My first day and the dead woman, The last offices]

It’s very intriguing indeed, the number of ghost stories I have heard! Many of them are about patients that wake up from the dead. Once there was this Asian guy frantically searching for his dead relative who was apparently axed but woke up in the mortuary and walked away. I didn’t know whether it was a joke or not but from the look his face, it seemed as though he was telling the truth or at least he thought he was. My guess is that the poor Asian guy was having his leg pulled by one very evil prankster.

  Zombie romance

Other than that there have been several reported cases of patients being certified dead who later wake up and walk right out of their body bags as dandy as can be. It sounds impossible. I am still not convinced that any of the stories I have heard have ever really occurred. But it always remains a mystery to me because I’ve heard these stories from respectable nurses who really have nothing to gain from lying. It’s always an alluring subject and I’d love to hear if you guys have ever witnessed people rising from the dead. Until the day comes were I see it for myself, I remain sceptical but creeped out nonetheless. Wonder if that Asian guy ever found his axed relative? She must have a splitting headache!