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.

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...

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...

in search for answers

how do you know that it is time to give up? how will you know that enough is enough?

these questions have been living in my mind and my heart for these past months of my life here in egypt.

how are you supposed to endure all the beating that you get from work? please tell me because i feel like giving up now even with the best nurse that i got last month...

Good and Bad

changes. transitions. alterations. modifications.

all seem to bring new things into one's life. i have been asking myself these past few days about the changes that have transpired within the months that i have been working here in egypt.

weight is one as i have lost 10 kgs since september. quite an amazing achievement as i have worn the pair of jeans that i bought from the philippines which i was not able to close the zipper properly back then.

maturity? well i guess. i dont complain much and i am more congenial than before.

but then again, i felt that i have lost my passion for learning. my work has offered me a lot in terms of skills and attitude. but the knowledge, very minimal. i guess i have to brush off the dust that have been lingering in the cover of the books that i brought from the philippines.

most importantly, i forgot about those whom i have in my life. i have become so concerned about myself that i lost them in my life...

changes. transitions. alterations. modifications. they can be so good and bad...

Of Pomises and New Beginnings

i find it amusing that people start to think about changes and starting right when the new year comes. more amusing is that they only think about those would-be changes but never really implement them in their own system. most amusing of all these is that i succumb to this phenemenon...

try as i could when the new year comes but, i always fail. i fail in starting up and being the best that i can be. so this year, i won't make any list of the things i need to do.

but again, i am posed to break that as i would try not to be an asshole at work haha

Sulat

Dear Charltoninho,

alam ko na hindi biro ang pinagdadaanan mo sa bawat araw na ikaw ay pumapasok sa trabaho. mahirap. minsan nakakasauka. delikado. madalas nakakainis ang mga katrabaho. minsan sumasama pa sa kadiwaraan ang mga pasyente. tiis lang at tingin sa itaas dahil siguradong may umaalalay sa iyo sa bawat minuto na ikaw ay malayo sa iyong pamilya at nasa gitna ka ng karagatan ng walang kasiguraduhan.

simulan mo ang iyong araw na may ngiti at pasasalamat sa Diyos. lubos kang pinagpala dahil sa libu-libong nars na nasa Pilipinas, may trabaho ka. kung tutuusin, hindi lang basta-basta nars. isa ka sa mga nars na nasa espesyal na lugar kaya ituring mo ito bilang isang napakagandang pribilehiyo.

walang nagsimula na hindi nahirapan. lahat dumadaan sa yugto ng pagsang-ayon sa agos ng iyong paligid. huwag mong madaliin ang iyong pagtungtong sa mundo ng isang propesyunal.

charltoninho, matuto kang tumanggap ng kung ano ang ipinagkaloob ng Maykapal. alam ko na ikaw ay naniniwala na ang lahat ay may dahilan kung bakit ito naganap. manalig ka at itanim sa isip kung ano ang iyong pakay kung bakit ka nandito. tanungin ang iyong sarili kung nasa tamang landas ka pa. maging matalino sa bawat hakbang at matatag sa iyong paglalakbay.

hanggang sa muling pagbibigay ng panahon sa kung ano ang dapat mapagtanto ng iyong sarili.....

Charltoninho

The Good Side

mukha raw akong masaya dito sa egypt sabi ng mga friends ko. ang sabi ko sa sarili ko, talaga lang ha.

sarcastic? not really. i am just not that convinced with the way people perceive how i am doing here in egypt. the thing is, siyempre sa mga pictures kailangan kong magsmile e pangit naman kung nakasimangot ako so un siguro ung dahilan kung bakit tingin nila, ok na ok ako dito sa ehipto.

it is not that life is so bad here in egypt but the things is, i came here for work and if you are to talk about my work, it is not that nice. well it is because partly of the local nurses here are unprofessional and we filipino nurses in this area are few. most of the time, the patients that we handle are pangit. i mean you can't do anything but just to deal with them.

but, enough for this bad side of my life in egypt. little by little, i feel that i am comfortable with my area except when i am alone in a particular shift with no filipino nurses around. i think that i am gaining some pounds also since i do not let myself get hungry at work. i am also starting to grow as a person with all these things that i have endured these past 3 months.

i try to think that i am more lucky than other nurses in the philippines. i have work and i get paid for it. hindi nga lang kalakihan pero it is still good. maraming nalalaman pero it is up to me pa rin kung pano ku pagiibayuhin ang knowledge ko. people here kasi do things without really knowing why they are doing it. scary di ba? but God is gracious.

kahapon nagcity stars kami and today, carrefour. gala talaga kasi kailangan mong magrelax talaga since it is your off and it should be spent wisely. somehow, i sound mature diba? hehe well that is good news kung ganon. kaya sa ngayon, tiis muna and try to see the good side of everything.

Ang Buhay ay Parang Life

malapit nakong magthree months working as a real nurse and all i can say is to hell with witch, putla and bulinggit!

haha. that felt really good. after ilang days of duty, you really need to let it out and feel that all emotions come and go. they are real and it is never too good to let them creep in the innermost part of your humanity. real sila pero just let them come and go.

somehow, i feel the truth na kapag nagtrabaho ka or nag-abroad, you will be changed in a tremendous way. bukod sa parang nagkawrinkles ako at naglose ng 10 kilos within two months, i felt na ibang tao ako each passing day.

before, i easily complain. mabilis akong maburyong sa mga simpleng bagay na minsan, ala namang kuwenta kung pagtutuunan ko ng pansin. mabilis din akong mastress and maapektuhan ng ibang tao.

i am not saying na hindi nako nagcocomplain ngayon nor hindi nako nai-istress at naapektuhan ng ibang tao pero, i now have this tendency to just ignore them. i always say bahala sila or bahala kayo basta ako buhay and nagtatrabaho.

mataas ang pressure sa work and if i will put myself in the same level, bibigay ako. that's the good thing now. little by little, i get the hang of it. nakukuha ko nang maging numb sa kung ano ang mga nangyayari saken. sometimes, maganda to pero minsan din, napapaisip ako kung nagiging soul-less ako at cold as a stone.

ang work namin, ganun pa rin. maraming asungot at maraming buwisit sa buhay. ganon naman ata sa work diba? eto, andito pa rin kami ni mark sa ccu and it seems na pinapabayaan na lang naming ung mga nangyayari samen. medyo nabawasan na yung yearning namin to leave ccu and go to the other side of the fence dahil sa totoo lang, hindi naman namin alam kung mas green ba ang pasture don kaya ngayon, ganito lang muna.

may ilang days na naghawak ako ng pasyenteng ventilated and mind you, mag-isa ako. kakatakot ba? well para samen, normal na lang kaso at the rate of these happenings, di ba mabilis? kasi kung sa pnas ako nagwork, malamang vital signs at pagbibigay lang ng gamot ang alam ko ngayon. sa totoo lang, madaming experience and learning sa area namin. sobrang varied and sobrang complicated. sobrang nakakapagod din and minsan, emotionally draining.

narealize ko rin kung gano kaikli ang buhay for the nth time. may pasyente akong ieendorse sa o.r mamaya namatay na pala siya. minsan sa duty mo, hawak mo siya, the next day, patay na pala siya. life is so fleeting. mabilis lang. dumadaaan lang talaga tayo dito sa mundo. kaya in as much effort to be the best nurse that i can be, kinakaya ko pero madalas hindi hehe.

ang tagal pala ng two years no? kasi two years akong dadanas ng hirap sa ccu hehe pero by God's grace e makakaya ko.

nga pala, nakapagpyramids nako kaya bawi naman ang pagod kaso di pa ko makapagupload kasi ala naman ako camera and kailangan ko pang kunin yun sa mga kasama ko sa trip. hay buhay parang life