Thursday, 28 March 2013

A Tribute to the Clicky Pen

In my line of work, “if you didn’t document it, you didn’t do it,” is a true, if somewhat inconvenient phrase.  As such, contrary to popular belief, the pen not, the stethoscope, or alcohol swab, or needle is the nurse’s tool of choice.  I mean, what good is a stethoscope, if you can’t document what you heard with it? You might as well not have one.  Since the pen is such a valuable phenomenon, it is impossible to find one in the hospital without someone claiming you stole it.  As such, I am always on the lookout for pens in other settings.  However, not just any pen will suffice for a nurse. It must be a clicky pen with the tabby thing on the side still attached or it is no good, no good at all. 
You see when one uses a pen as much a nurse does, one becomes quite the pen connoisseur.  While other pens may be just as effective when it comes to actual documentation, they lack certain practicalities that the clicky pen with the tabby thing still attached possesses.  Take for example, the classic blue bic hexagonal pen with the lid.  A stable for any school child, comes in packs of twelve, cheap affordable, simple design and very rugged.  Sounds like an ideal pen for a nurse right?  Wrong.  The bic’s weakness comes in its lid, the lid is forever falling off with day to day activities like changing briefs, calming psychotic patients, rushing to codes, starting IV’s, etc.  And when the lid falls off, the pen falls into the deep recesses of your pocket.  Without fail, even though you used it moments ago, it somehow ends up beneath the alcohol swabs in your pocket, the cheat sheet you use to remember to do everything, the blue caps, the roll of tape and God only knows what else.  Obviously, this happens right before you are in a hurry and desperately need your pen, forcing you to demonstrate to yet another patient how much you can actually store in one scrub pant pocket.  The other downside to the classic bic model pen is that when the cap comes off you run the risk of it exploding, a more common problem for a nurse than you might think.  If this occurs in your pocket, you ruin a whole pair of scrubs.  And let me tell you folks, male version scrubs are hard to come by. 
“Ok,” you may say, “You’ve demonstrated why a capped pen is no good, but what about those twisty pens?  They deserve to be given a fair try don’t you think?” Touché sir, they do deserve to be given a fair shake.  On the surface a twisty pen may carry the same specs as a clicky pen, no cap means they can’t fall into your pocket, and the tip can be safely twisted away saving you the unfortunate risk of yet another pair of scrubs being ruined by exploding pen syndrome.  And, while on the surface this is all true, the twisty pen possesses one fatal flaw.  Its kryptonite, if you will, is in fact, its twisty feature.  Have you ever tried to open a twisty pen with one hand? It’s not easy.  And when your other hand is busy with so many other daunting tasks, a one handed operation is a requirement.  Particularly when, as every good nurse knows, using your mouth for any task is 100% out of the question. 
As I have demonstrated the clicky pen is the pen for any astute nurse, but does any clicky pen do? While there are so many makes and models of the clicky pen out there, I’ve come to appreciate the heftier versions.  You see, in the business of everyday tasks, one often forgets to put ones pen back where one got it from.  This in turn results in one frantically searching for ones pen.  In the larger model this frantic search ends more rapidly allowing one, to shrug off the incident as a mere twitch, or at worst a mild seizure.  With the smaller version, however the dance of the missing pen becomes a more arduous ordeal, and is thus less easily shrugged off.  The tabby thing on the side remaining intact is also an essential component for any nurses pen arsenal, allowing for a quick deposit and with drawl  from ones pocket and also ensuring the pen stays securely where it was left.  All this goes back to the cap pen, a clicky pen with no tabby thing is like a cap pen, it easily falls into the deep recesses of the pocket and is soon lost.  The added benefit of the clicky pen, as anyone who has ever sat next to “that guy” during an exam knows, is stress relief. And stress relief, however a nurse can get it, is essential to surviving the day.  Clicking a pen open and closed numerous times somehow alleviates stress.  It’s science. 
So aspiring nurses to be, people who have a nurse friend who is “impossible to shop for,” or anyone who just wants to appreciate their nurse for their hard work and dedication to the health care system, take a lesson that took me way longer than it should have to learn; when in doubt you can’t go wrong with a large clicky pen with the tabby thing still attached

Friday, 30 March 2012

The end is Near


So I realize that I haven’t blogged in a while.  I also realized that in a very strange way I actually miss it.  It’s hard to find things to blog about here in Canada, though it shouldn’t be.  To be honest I’ve had quite a few interesting experiences in my new Clinical position here, though most of them involve me being hit on in various ways by old ladies.  They love the hair, I think maybe I should rid myself of it and maybe rid myself of the problem. But who am i kidding.  It's a real confidence boost walking into work and being called a tall drink of water. 
I am now inches away from being done school.  A few clinical shifts, a couple assignments and some formalities to finish and I’m officially a university graduate.  It’s weird.  I’m not sure whether to be sad or ecstatic.  I think the problem is I’m  both and therefore neither.  I mean, don’t get me wrong, five years is plenty of time for an undergraduate degree.  And I am so happy to not have to be doing all those papers, assignments, exams, etc.  They were getting old.  But at the same time there’s something charming and wonderful about university.  Maybe the relative lack of responsibility, coupled with the independence has a bit to do with it.  I’m not sure. But on the other hand I sure am glad to be making money instead of spending it.  The problem with making money is that it involves selling your soul.  Something I’m not yet ready to do.
Perhaps the other problem I have is the unknown factor.  Beyond next Tuesday my life has relatively no definition.  Aside from the Registered Nurses entrance exam, I have no responsibility, and no structure to my life.  While there’s something exhilarating about that, there is also another word for it with far less positive connotations. It’s called limbo.  And, as a grad friend of mine was more than happy to point out,  Limbo is not that fun.  Since he’s getting a masters in engineering, I think he’s pretty smart guy. 
Whatever the cause, now is a time of turmoil in my ever interesting life (note the sarcasm).  I am excited for the new, possibilities and the freedom.  I fear the unknown and leaving the protective halls of academia behind.  Three months ago I was counting down the days until I was finished, now I’m wishing the days would go by a little more slowly so I can process it all. 
While the fear and the exhilaration intermingle, I can rest knowing that I have had a wonderful experience.  An opportunity many people can only dream about, and have made some wonderful friends along the way.  I am a blessed individual, whatever the future holds. 

Thursday, 15 December 2011

An Overdue Update


It has a been a while since I have updated all you lovely people.  I have honestly been having a hard time finding inspiration.  A lot has happened (or so it feels) in the last three weeks or so, and as a result this post will be in the classic bullet format.  I see no way around it.
Since my last post I have:
-left Tanzania.  It was bitter sweet.  I was ready to go, but I will miss that country.  It is a beautiful place, with beautiful people, and holds a special place in my heart.  I would love to say more, but somehow the  words don’t seem to be coming.  If you want a place to visit sometime…. Go to Tanzania.
-I visited Mombassa with my Tanzanian wife J (this is an inside joke)/colleague/ and I would consider now good friend.  He is a wonderful travel companion, and I think has kept me from blowing my lid out of frustration on numerous occasions.  Sir, I thank you.  You know who you are.  If you want another cool place to visit Mombasa also gets the Daniel Barnhoorn seal of approval.  Cool infusion of culture, great beaches, and great climate.  If you do go, visit Diani Beach, and Ali Barbou’s Cave restaurant.  Both are well worth it. 
-I arrived Safely in Nigeria!  It was a terrible trip, but I made it.  It has been great to catch up with family, see the nephews and niece, bro out with my brother, and get some delicious home cooking.  Janice, it’s no wonder Jono slipped a bit after he married you J.
-Climbed a mountain.  Dave you probably wouldn’t agree, but I’m gonna count it. 
-Volunteered a couple days at Bingham University Teaching Hospital.  It has been a great experience.  I’ve also seen some pretty gross things, and learned a lot.  Burns are gross, don’t get third degree burns.  Don’t drive a motorcycle in Nigeria either, it’s a bad life choice.
-I was also lucky enough to be able to scrub in and assist with a surgery while I was here.  Cool Stuff.
- I know I am forgetting at least three things that I thought were important, maybe I will think of them later.  This post hasn’t been as long or as deep as I wanted it to be but I’ve been told by a few of my admiring fans that I need to lighten up my posts a bit.  So there you have it. 

Monday, 21 November 2011

Night Shift


I worked my first night shift the other night.  It took all my persuasive power to allow the Hospital administrator to let me do it.  She was concerned letting me stay out all night might cause me to get malaria.  I think I was spared from that plague by my prophylaxis.  It was an interesting experience.  For all of you that complain about grumpy nurses, try working a night shift.  It sucks and by the end you are… well, grumpy.  However, as the sun rose and I transferred accountability to the day nurse I had a distinct feeling that I may one day be a proficient nurse.  As my graduation day approaches there has been an increasing fear in me that I will not be ready to be a true full-fledged nurse.  Given that there was only one other nurse on  night shift  was given a certain degree of autonomy, a rarity in Tanzanian hospitals where all medical administrations must include at least a crowd of three other nurses for emotional support.  Since there was only one other nurse and she wasn’t all that keen to leave her chair, I was allowed to manage much of the patient care.  It was amazing to find that I was able to not only decipher the crazy Tanzanian documentation system but I was able to administer medications unaided, on time and safely.  No one died and a few people even seemed a little healthier at the end of my shift.  As I sank into an exhausted midday snooze I had a deep feeling of satisfaction, and proficiency.  For what it was worth, it didn’t last that long.  I still have feelings of inadequacy and probably one of the greatest fears of mine is that I will not be ready for the world of nursing by the time I graduate.  Still it’s nice to know that I might have the potential. 

Friday, 18 November 2011

Where Medications Flow like Wine and Doctors Instinctively Flock like the Salmon of Capstroma


I know there seems to be a lot about death the last little while on this venue but, if I am honest with myself, writing here really helps me to decompress and unload.  A patient died today.  There was nothing I or anyone could do.  She was brought into medical care far too late.  But maybe if she was brought into a proper hospital, where defibrillators exist, highly trained personnel, are within a couple minutes journey and medications flow like wine she would still be alive, she might be sitting in a hospital bed with her grandchildren bringing her hand made get well cards. Maybe if she wasn’t born in Tanzania. Maybe if her country had a higher ratio of nurses than 0.37 per 100,000 people.  To me she seemed young, about 60, but then in a country where a woman’s life expectancy is 49, according to the best WHO estimate, She must have lived a long full life.  It was still difficult to watch her pass from this life to the next.  I think it hurts my pride as a health care worker to see someone die. Everything you have been trained to do is to keep the grim reaper at bay, when he finally shows his hooded head and sickle you don’t know what to do.    I guess what it boils down to is, in a system, such as health care, where there is a limited amount of resources you can’t save everybody.   Yes, that woman given the right set of circumstances, could still be alive today, but she wasn’t given the right set of circumstances.  I have to rest in the knowledge that I tried, and given what I had, it was a damn good attempt.  I can also look forward to returning to a system where, medications do flow like wine, defibrillators do exist, and highly trained personnel can be conjured seemingly from the walls if the need arises. However even then, it is a good lesson to learn; that even in our system, resources are limited, people who need it can’t always receive the care they need, imbalances exist, and despite your best efforts you can’t always save everybody.  In the words of a man I highly respect: that doesn’t mean you can’t give it all you’ve got and try anyway.