Volunteering for Haiti, 3

When I was a kid, I had an uncle who held me down trapped under some sheets and blankets so I couldn't move. I started to panic a little. Does this cause claustrophobia or did that come first? Anyhow, whenever there are disasters that involve people trapped in rubble, I can't help think it would be about the worst thing to get stuck in the dark unable to move and not knowing how long you might go before being saved or not saved. Nurses don't clear rubble, but there are always injuries and psychological scars.

My vaccinations are up to date, and I've gotten permission for a leave of absence from work. Everything's set. My name is listed with the Fletcher Allen Health Care team, which said they would get back to me, but so far no call. I hope they do make a spot for me and don't close me out for FAHC staff.

I got another e-mail from the RNRN group asking for more info, but they don't seem very well organized to me. The groups most effective at getting non-governmental spur-of-the-moment volunteers down to Haiti are small ones like FAHC or the Dartmouth volunteers shown below.
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Volunteering for Haiti, 2


Been trying to contact more groups to find a placement in Haiti...

Partners in Health is not taking volunteers; neither is International Rescue Committee, although they have a blog you can follow.

Last night at my spinning class, I ran into our ICU pharmacist, who let me know about an e-mail circulated from the department of health asking for information on volunteers. They want people with surgical, pediatric, infection control, etc experience. Not a big demand for cardiac nurses. I signed up today in our Human Resources dept but don't expect anything to come of it.

The Vermont nurses union has sent a team in conjunction with the Red Cross. I don't know how that happened but there was already a Vermont-Haiti group, and someone connected with the union is from Haiti, so that might explain.
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About volunteering in Haiti


Recently, I’ve been living without a phone, TV, or much Internet access, so I just found out about the earthquake in Haiti not too long ago. Last night, a co-worker said he wanted to use his upcoming vacation to volunteer in Haiti. American Airlines, he said, is flying people to Haiti for free, and you can join the RNRN network to get placed properly in Haiti if you only have a valid US passport. Sounds great, right? Like the way the world should work?

Actually, you don’t need to know that Port-au-Prince has only one small airport, and that the US military is currently using it to land supplies. It would cost AA an enormous loss to fly people to Haiti when any current tourist travel has surely dried up. And, it turns out, the free flights for medical volunteers meme was a hoax, as per Snopes.com



RN Relief Network

However, volunteering for Haiti is not a hoax (I think). The RNRN network apparently did intend to send volunteer nurses on the US navy ship Comfort. The USNS Comfort is traveling to Haiti, as reported by Voice of America. Then the navy apparently decided to use only military personnel. That’s per an RNRN e-mail I received for potential volunteers, but you can read about it from the Contra Costa Times, and it accords with this Kitsap Sun article on naval personnel catching a red eye flight to Bethesda to meet up with the USNS Comfort.

Apparently, the RNRN network still wants to get their volunteers to Haiti, though. As reported by the LA Times, RNRN nurses traveled to Florida, where they met up with the Haitian-American Nurses Association and started scouting out sites and possibilities for volunteers.

Service organizations

So, you’re a nurse, and you still want to volunteer in Haiti (like I did)? Several possibilities come to mind: (1) the Red Cross is not accepting volunteers for Haiti per their website; (2) Doctors without Borders has a long-standing relationship with Haiti, but they want you to be able to carry on a conversation in French and be able to commit to 9-12 months at a time; (3) the American Nurses Association wants you to volunteer locally and get trained before you do anything crazy like going overseas.

The gov’ment

You could try the US Embassy in Haiti or USAID. Both of them ultimately direct you to the Center for International Disaster Information, which has a registration database but makes it clear that you aren’t likely to get a call back unless you have previous disaster relief experience (chicken vs. egg?).

Freelance volunteers

Who’s most desperate? Haitians. If you try contacting the Haitian Consulate in New York, they have a special contact e-mail for medical volunteers. You provide license and insurance information. But this is the Haitian government, now. I sent them my information, but I don’t expect to get a call back.

Lessons from this experience

So, here I sit, prepared to jump a free AA flight at a moments notice with just my klettersack with stethoscope, sphygmomanometer, trauma shears, iodine tablets, and clean socks. Yet nobody wants me. I signed up with RNRN and the Haitian Consulate, but I’m not holding my breath. I also e-mailed the Haitian-American Nurses Association.

The lesson I draw from this is that if you are really interested in disaster relief nursing, you best join the military. You second best get in on the ground floor of a smaller relief organization like your local Medical Reserve Corps, and start getting trained and getting experience. Formally established organizations are the best route to getting someplace. Plus, nursing is all about assessments and planning, right? You need to know things about disasters before you can do much good. Be honest: in a pinch, your ability to give a SQ or IM injection doesn’t qualify you to do much. Get specific knowledge.

And if you do get a call back from the Haitian Consulate, you might want to browse the CDC’s webpage of recommendations for volunteers in Haiti before you get malaria or Typhoid or something.

UPDATES:

Apparently, some nurses are going to Haiti via Canada, and also I read about nurses going in through Dominican Republic. There is a Haitian Nurses Assocation in Boston. E-mail correspondent Mary Crotty says to stick with RNRN, which has like 8000 nurses ready to go.
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H1N1 podcast round-up

With the H1N1 now making the rounds and a lot of misinformation or ignorance circulating about the flu and vaccines, I thought I would post some links to podcasts dealing with the flu. Do you like my grammaphone podcast symbol? No? Well, tough.

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NCLEX exam this Monday

Gentle readers,

I have not forgotten you, nor have I failed the NCLEX exam. Yet. The orientation process at work has been so stressful and so literally tiring that I simply gave up blogging and reading my GoogleReader for the time being. At work, they tell me I'm doing well, but it doesn't feel that way. I have yet to go through a day and finish everything satisfactorily.

Also, I have made some mistakes. My worst has been with a patient who was playing games with us on a day when I didn't have time for it, and starting spitting out oral meds, then refusing everything. I eventually got the patient to agree to take crushed the very needed pills at the end of my shift and crushed some extended release pills without thinking about it. Luckily, no advserse results, but you know that was one of the days when I did not feel good after work.

Actually, for a period of about 3 weeks, I started drinking every day and probably drank more in that period than the entire year previous. Not good.

I'm sure most new nurses have the same feelings of inadequacy I do, but it has been very rough.

Anyhow, I am scheduled to take the NCLEX this Monday at the Pearson VUE office. I'm planning on holing up for a while--maybe calling in tomorrow and Friday (Do I dare?) and spending those days and the weekend in a motel or bed and breakfast. So far, I have studied about a total of 4 hours. I do not have high hopes. I find it almost impossible to combine the stressful floor orientation and the book studying, so heinous is the book studying to me. I don't know about other people, but I measure out my time in spoonfuls of anxiety, not spoonfuls of chronology. I have had very little time to study in other words. I have spent some time staring out the window, doing laundry, cleaning the house...

And when I am formulated, sprawling on a pin,
When I am pinned and wriggling on the wall,
Then how should I begin
To spit out all the butt-ends of my days and ways?
And how should I presume?

Anyhow, if I don't pass, I'll have to stop orientation and then I'll be back in the situation I wanted originally, which was to pass the exam before taking a job. I mentioned this to the HR department at work when I went in, but they wouldn't give me a position unless I started orientation right away. Well, they got their way, and now we'll see how things go.

Wish me luck.
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Cath lab observation

For whatever reason, I was sent to do a cath lab observation today rather than the floor/ECCO routine. This is nice thing to do, but it wouldn't have been my first choice for the day.

Although the "main event" in the cath lab was an ablation, the most interesting was an ICD interrogation which afforded the first opportunities to see an actual defibrillation and real, live use of conscious sedation.

Isoproterenol: I had a frustrating experience of not being familiar with this med today. I've been reviewing meds every day trying to relearn (a) things I've forgotten and (b) things I learned in a warped, half-assed fashion in school. I had skipped isoproterenol because I never remembered hearing of its use in school or while working as a ward clerk. Today, I couldn't remember what class of drug it was. Sure, go ahead and yell it out: β1,2-agonist. Embarassing to have to look it up.

All day observation was a real downer. I felt like I was being punished by not being allowed to really participate. Like I had been sent back to school. It didn't help that one of the techs was ribbing me about it.

At the end of the day, I helped pick up a patient from ICU for a procedure and got to see excellent Lori (right), who I haven't seen but fleetingly since she left PCU and not at all since I graduated. I got a graduation fist pound. Cool.

The rest of this week is the cardiac arrhythmia class, which I feel pretty good about. But I'm anxious about being back on the floor after that. There's still a lot to learn, not just cardiac-specific but basic nursing. I don't know what I'm supposed to know. They kept telling us in school not to worry about things because we would pick up skills on the job, but when I'm getting ribbed by the cath lab techs about shit it makes me wonder...
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Floor Orientation: 1st day

I was fairly anxious all weekend about my first day on the floor, today. My clinical immersion in April, at the end of school, didn't exactly go textbook. From managing 2 patients to managing 5-6 over night was not easy for me. I was worried that today might also be getting thrown into a 5-6 patient assignment.

Actually, it went fairly well, or I should say easily. Patients were not complex, and there weren't that many of them. At 11:00, I left for the computer room to do computerized education and orientation. My unit has purchased AACN's Essential's of Critical Care Orientation (ECCO) program for new nurse orientees. I guess orientation will generally involve a few hours on the floor and then a few hours of ECCO each day until orientation is over. ECCO looks like it'll be a good review for the NCLEX, too.

Re-living Bush vs. Gore

At 13:15, I filmed a TV spot for public relations. A cameraman/producer came from the local NBC affiliate and taped me describing how I came to be a nurse at the hospital. The spot features new grads who have previously worked at the hospital in other jobs. I had tried to plan a statement that'd make all parties look good, but I had trouble remembering it in the blazing lights of the camera. I thought it sort of stumbled out rather than coming out velvety smooth. However, the pro said I was a "one-take kind of guy," which I think is praise in TV speak.

I'm eager to see how it turns out as I have a complex about appearing on TV. During Bush vs. Gore in 2000, I was living in DC and stayed up all night outside the Supreme Court so I could get a chance to watch the proceedings. It was quite an experience. After I came out, I was pulled aside by television crews and asked about what I saw and what was going on. I gave some lame answers that never aired on TV. I blew my 15 minutes! Can you believe it! I realized later that they must have pulled me aside because I was a wearing a nice suit, and they probably assumed I was a lawyer rather than a jobless undergrad. In the grand theme, it doesn't matter, but I can see still the disappointed look on the face of the pretty reporter who was expecting not to waste her time on me.
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Orientation: order entry

Back in the computer room today to go over the "order entry" system. This was a little redundant for me since I've been working as a ward clerk, but it was relaxing. The new tele/clerk/aide was with me, so I tried to give some pointers.
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Orientation: MAK, allergies, hx

Okay, so yesterday I felt guilty for being one of two people taking up hospital education resources. Today, it was just me. I spent the day in a computer class going over the hospital's "Medication Administration Check" system. This is a computerized med pass. Apparently, the company wasn't able to call their system MAC due to Apple, so it's called MAK. This has led to jokes about "med k'checking". But I guess you got what you wanted, Steve Jobs. Also covered was the computerized allergy and administration history systems.

My educator for this part of orientation is a former ob nurse who I remember from float ward clerk days as having a super short buzz cut, but not being willing to give me the time of day. Sheesh. What's a guy gotta do to get attention from a woman with a buzz cut? Oh well, water under the bridge.

Anyhow, we got to discussing certification and continuing ed today, and she convinced me to sign up for Medscape, from which you can acquire CE's.
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Orientation: module 2

On day 1 of general orientation, you're in with everybody in your GO class, from administrators to nurses and food service workers. On day 2, you get just those people doing direct patient care. We were down to four yesterday. On day 3, we start something called "module 2," which is just for nurses. This brought us down to two people: myself and an LPN going to work in the renal center. I feel pretty guilty about this. There's a lot of resources in time that get expended on orientation. I guess they expect they'll have to do module 2 only a couple times a year. Since I wanted to pass the NCLEX first, I guess I screwed things up. Thank goodness for the LPN.

Module 2 is an introduction to IV therapy, beginning Healthstream (computerized) education, etc
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GO day 2

General Orientation day two, today. CPR, mandatory reporting of abuse, back safety, etc...

After lunch was a medication usage and calculation test. As I always performed well--and well ahead of the rest of the class--on med calc in school, I thought I was prepared. Plus, last Sunday, I went to the food court at the mall and did the practice exams provided by HR just to be sure. But there ended up being a lot more on the exam about general medication knowledge. Luckily, it was open-book and a Lippincott's nursing drug book was available. Even as an open-book test, I got a couple wrong. However, I did get right a dopamine gtt calc question that George said a lot of people miss.

Listen, nursing students. To do medication calculation, you just have to lay out the formulas and plug in the numbers. It's all ratios; don't sweat it, just do it methodically.

Following the med calc test was competencies in the glucometer, occult blood testing, and a couple other things. There were four of us: myself, an LPN who will be working in the renal center, a new tele/clerk/aide for the PCU, and a new aide for another floor.
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GO day 1 (p.s., I got a job)



Monday morning saw me in my first day of General Orientation (or, GO).

Oh, yeah, I got a job. I was worried about this for a while, but when I talked to my director she said there was an opening I could have. This was about two weeks ago. Actually, I believe I signed the H.R. job transfer form (P-5) on exactly the same date I signed my original employment papers some years ago.

I hadn't wanted to be in General Orientation today. My original plan had been to pass the NCLEX before starting any job so that I could forget pediatrics and maternity and just concentrate on wherever I was at the time. However, H.R. wouldn't let me sign the P-5 and not start orientation, so here I was today.

Since I went through GO once before, a lot was repetition today. Fire, hygiene, etc. It was all run by our educator, George (of ACLS fame).
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4th annual R-3 barbeque

Although I've been working on the same hospital floor for four years, I've somehow only been to two of the four annual barbeques. This year I tried to provide something tasty by bringing Tanqueray No.10 gin and the fixings for martinis (Vermouth, olives, ice) and tonics (tonic, limes, ice). Unfortunately, nobody seemed to really like these. Who doesn't like a strong drink? Oh well. I left in the middle of the day to do some studying, then went back this evening and cleared up my stuff. At least I got a bottle of good gin out of it.

I enjoyed myself, although I don't enjoy being told that I'm stuck up because I wear a sweater vest sometimes. Give me a break.







Mice grown from skin cells



Luckily, they were grown from mice skin cells. Phew!

Seriously, as the WIRED article says:
The goal was to create an animal made entirely from reprogrammed cells, and to confirm that reprogrammed cells “are as good as embryonic stem cells,” said Beijing National Stem Cell Bank director Qi Zhou, co-author of the study published Thursday in Nature.

Much more research is needed to meet the second of Zhou’s criteria, but fulfilling the first is remarkable enough. Just three years ago, it would have been inconceivable.

This "inconceivable" is a bunch of crap. Political crap. When they say "inconceivable," they really just mean the technology wasn't there 3 years ago. Let us be frank. Matter has an essential mechanical character due to its Lego-like atomic structure that makes it manipulable. Eventually, we will be able to build cells and genetic systems from the atom up if not from the subatomic level up. This idea that we "must" have access to embryonic stem cells because we "can't" use anything else is not only crap, it's silly, and it's disingenuous for anyone to say otherwise.

Hopefully, Zhou's protocols will be easily adapted. It's sad that this technology is being brought out by communists rather than western democracies.
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