Wednesday, April 29, 2009

Maybe or Maybe Not.

maybe i am trying too much. maybe i am pushing too hard. maybe i am rushing too much.

maybe i need to accept things as they are. maybe i need to keep my cool. maybe i need to pray harder.

maybe i was wrong. maybe i was doing nothing. maybe i was missing the whole point.

maybe or maybe not.

Haste Will Not Make Waste

of course i got rejected again. expected? mejo. depressed? oo kasi babalik na naman ako sa umpisa. mag-aapply ulit at gagastos naman. inis? oo naman at kung bakit kasi may mga tao na napakakitid ng utak at pang-unawa sa kapakanan ng iba.

ayaw kong magrisk at magbigay ng fake documents. i might as well go the hard way and try my luck to find my place in australia.

haste will not make waste. it will just lead me to other options. i believe everything happens for a reason.

Saturday, April 18, 2009

One Last Try

im going to cairo today to fix the registration details that i need for my application in australia. this would be my last try after all the rejection that i got from all those selfish organizations controlled by the most selfish organization of all- the place where i work for.

wish me luck.

The Right To Be Immature

blame it on my immaturity.

the lack of drive. the constant whining. the lack of conviction. then there's the absences.

it started last november. after a month of completing my 19 shifts, i started to feel the pressure. the emotional torture. the physical stress. the everyday psychological torture.

feeling the need to break out from all these, i had my first self-proclaimed off or more popularly known as absence from work.

it felt good but it felt bad as well. it is like you have wasted the other shifts that you have worked for. money? i do not really care for now. i just need to feel that i am alive and the way to do this is to escape.

immature? maybe. i just thought that at some point in our lives, we can be immature.

Wednesday, April 15, 2009

Of Handling and Passing Death

this month, i had the privilege of handling two patients who are dying and was able to endorse them to next shift. and after endorsing, they passed away.

also, i was able to handle a patient who had coded twice and tried to insert a pacemaker but failed.

am i privileged? i don't feel that way.

the touch of death. yes, that is the way i view myself. most often than not, the patients that i handle are really critical but then again, there is this thought that makes me succumb to self-doubt if i am really a good nurse. my friends and my colleagues tell me that it is just their time to go away. but is it? oh well, this must be really the essence of being a nurse- being able to handle and pass death.

My Work Part 2

so sa morning shift, andyan ang mga relatives, ang infection control, ang pagreceive ng mga gamot mula sa pharmacist at ang rounds ng mga senior residents ng ccu. lahat nito, nakakadagdag sa pressure tsaka sa pagkawala mo ng control sa oras mo to finish your work. eto ang ayaw ko sa morning shift- ang mga asungot. pero once na natapos na ang mga asungot sa pang-aasar sayo, medyo light na ang shift unless you are really handling dying patients. at 7:00, you have to balance now the intake and output then finish your documentation.

ganito rin usually pag night shift kaso sa night, mas relaxed ka i guess kasi alang relatives, infection control and senior residents. though pag night, the work is harder kasi you have to extract samples for the routine laboratory tests, you have to do ecg and the morning care. physically taxing ang care especially if you are handling a patient who is 3 times your body weight. i guess dito ako pumapayat ng husto.

i can handle the work and the pressure but the thing is, nakakasuka ang mga katrabaho mong locals. alang professionalism and they are suckers for titles and seniority even if alam mong ala silang alam. they may have the skills but the knowledge and the care aren't there kaya narealize ko din how Filipinos work. we are really different.

admissions to the unit can be taxing din especially if critical talaga. meron kasing mga patients na na-admit samen na hindi naman talaga critical (e.g. chest pain). so pag may admission, andyan ang paginsert ng central venous line, arterial line, ryle, urinary cath at kung anu ano pa like measures how to keep the bp up and the oxygen saturation fine.

it will sometimes depend on the doctor on duty kung matotoxic ka. meron kasi dyan na napaka-aggressive na mapapagod ka talaga sa pagcarry out ng orders niya. sometimes ang work e fun but mostly not. now it makes me think why i decided to be a nurse.

Tuesday, April 7, 2009

My Work Part 1

i have not written much about my work. all i can remember is that i have written tons of my whining.

so now, i might as well give you a picture of how my work is.

our work is a 16-hour shifting, from 8am-8pm and vice versa. mostly night duty ako and i like it that way kasi konti ang asungot and less ang pressure. you will find out later kung bakit. iba rin kasi ang routine pag day at night shift.

sa morning shift, mas okay kung papasok ka ng mga 10 minutes before ng shift mo. kadalasan kasi pag night duty, pumapasok ako ng ten minutes late dahil pag ako naman ang nirereceive ng day nurse, laging late kaya nakakapagendorse ako mga 830 na. that's how things work here. ang mga locals, hindi agad dumadating pero ang gusto nilang magreceive come endorsement time e mga pinoy since on time tayo lagi. not anymore! haha. pag pasok sa ccu, tingin agad ng board kung ano assignment tska kung may extra duty. ganito lagi mapa day or night duty. ang extra duty would include emergency/crash cart, inventory, intubation tray, procedure trolley, insertion trolley at ecg machine.


ang mga gamit ng tubero



ang cart ng buhay at kamatayan


ang ecart okay pag hindi yan bukas kasi ichecheck lang ang lock number and ipanalangin mo na lang na wala sanang magcode blue dahil kung hindi, patay ka sa pagcheck at pagrefill ng lahat ng laman ng ecart. ang inventory naman, kaasar usually. ikaw kasi in charge sa lahat ng cbg machines, cbg bottles and strips, stethoscopes, digital thermometers, portable monitor, hemochron tubes at kung anu ano pang mga gamit sa loob ng ccu. ikaw ang may responsibility kung lahat ng gamit ay kumpleto, working at hindi sira.

ang intubation tray naman madali lang. ang importante dun e working ang laryngoscope at kumpleto ang mga gamit like endotracheal tubes. ang procedure trolley naman e madali lang din as long as kumpleto ang supplies sa store room. eto ung dala-dala sa loob ng room kapag may procedure na gagawin hence the name procedure trolley. examples ng procedure sa ccu e cenral venous line insertion, femoral sheath insertion at temporary pacemaker insertion. ang insertion na extra duty naman e would cater sa mga less invasive na procedures like insertion of nasogastric tubes at urinary catheter. ang ecg na siguro ang pinakamadaling extra duty kasi ichecheck mo lang naman kung kumpleto ang pumps, may ecg paper at fully charged.

ang ecart, inventory at intubation tray, right away ginagawa kasi siyempre madalas yan ginagamit especially sa area namin na kung saan, pinakamarami ang nagcocode at namamatay. so after nun, receive na ng patient. ieendorse sayo siyempre the usual-name, age, diagnosis, date of admission, weight at kung may pre-existing conditions like htn, dm at hepatitis. then ang vitals signs, ang input-ang mga infusions at ang kanilang rate, kung by ryle feeding ang patient o kaya nya ng regular feeding tas output-mga drain sa ngt, chest tubes, urinary cath o kung anu-ano pang tumutulo o lumalabas sa patient. then ang ventilation ng patient. kung by room air, nasal cannula, face mask, non-rebreathing mask o kung ventilated. at kung ventilated, ang settings ng ventilator.

here comes now the assessment part utilizing the systems review. then ang mga routine checks mo like positioning, ambulation, feeding, pulse checks, safety aspect ng patient atbp. tapos ung huling part na i-eendorse sayo e yung mga nursing considerations like ang mga standing orders ng doctor like cbg every one hour, blood gas every 2/4/6/12 hours, mga labs to be taken, diagnostic procedures to be done at mga dapat pang ifollow up na results.

after nun, syempre ichecheck ang mga contraptions, ang vascular access, ang room ng patient tapos ang mga gamot. kung available sa cabinet ng patient at kung may pangendorse ka pa. chechekan din ang mga emergency equipments-ambu bag with connection sa oxygen, suction bottle with suction catheters, face mask, nasal cannula at iba pa. pipirma ka rin sa insertion date ng mga contraptions ng patient. checkan din kung may mga supplies ka na gagamitin like syringes, gloves, stop cocks at mga dressings.

ganung ang gagawin mo din sa isa mo pang patient. whew! ang ideal na one is to one patient to nurse ratio e hindi nasusunod dito. kahit sabihin pa nating jci accredited ito kaya bugbog talaga sa work. pag natapos na yung mga yun, pwede ka nang magstart ng documentation mo. eto basically ang pinakaroutine kaso kapag unstable ang patient, hindi ka agad makakapagdocument kasi siyempre kailangan na may pansunod ka na sa mga infusions mo at sure ka na walang magiging problema within the next few minutes. day o night heto usually ang ginagawa ko. after kong makapagdocument partially, magoorder na ako sa system ng mga missing na gamot at mga laboratory tests na kailangan ng patients.

next nun, magprepare na ako ng mga gamot tapos un na. hourly monitoring ng vital signs, input and output at kung anu-ano pa. pag day, mataas ang pressure kasi kailangan nakapagstart agad ang documentation mo before the rounds tas dapat printed ang lab results.

to be continued...

Monday, April 6, 2009

Present sa Galaan!

every month i have 19 shifts at work pero ako na mismo ang nagbabawas nun kaya ang mga susunod na larawan ay bunga ng aking matinding pagnanais na mapagaan ang buhay ko. in short, bunga ng aking pag-aabsent.

ako sa likod ng fountain


si ate jen, sheila at ako at the lakeside


ako paakyat sa tagumpay (?)


under the egyptian heat


the very old cairo city...



thanks to sheila for coming up with the idea to explore the city, lonely planet guide to egypt for giving us directions and to ate jen for being adventurous enough to come with us.

next target: alexandria!

Please Take Control

a lot of things happened in the first quarter of the year.

-january was a good month for me. medyo light ang mga cases namen and nagsurvive naman ako.

-i bought my laptop with my own money! yay!

-i was the best nurse last february. but it is not good kasi it is a title na nagsasabing "you can give all the hard cases to me" na kung saan hindi ko gusto dahil sobrang nakakapagod.

-i moved out from our old flat and moved in with three new friends.

-yesterday just marked our seventh month of hard labor here in egypt.

-absent ako kagabi from work kasi burned out nako. every month, may absent ako from work just to take the much needed break.

-hindi ko pa rin naayos ang mga papers ko sa australia and malapit na ang deadline ko para dito.

minsan, ang pakiramdam ko, hindi ko napapansin yung ilang bagay na nangyayari sa paligid ko. masyado ata akong focused on how to get by sa work and how to keep up with all the demands. though partly hindi ko masisi ang sarili ko just because i feel and think that my work is so damn hard, hindi naman din ata tama to miss all the good things beyond my work.

actually, that is how i would like to begin this month. to see beyond my circumstance. to see beyond my plans and to see GOD's perspective even a glimpse lang dahil in reality, i could only thank GOD and have Him control my life. hindi ko kasi kaya pero Siya, He is the Master of the Universe kaya this somehow messed up life of mine e kayang kaya niyang icontrol once i let Him.

so GOD, take control of my life...