RTW/2009 - RTW2009

June 2009

RTW2009 — Sat, 27 Jun 2009 00:00:00 GMT

Every one can guess where I am headed with my good intentions of more frequent blog posts!!! I think of it is there is so much I want to share and my typing is waaay slower than my head that it is a bit daunting to start, howevere her I am and will be as much as i can!

It has been more than a month-I honestly don't know where the time goes. As I write I am listening to Randy Bachman's Vinyl tap on CBC. Just heard a comedy routine about a Canadian who is asked to say Oot (out) and Aboot (about) wherever he goes. This has actually only happened to me once but our peculiar and "cute" pronunciation is well known world wide!
So we are well into a NZ winter and the city is transplanting annuals in the public beds, on frosty COLD nights (of 1-- -2 )people head out to their cars with a jug of warm water to defrost their windshields (no winter washer here!), lawns continue to be mowed, Road works are in full forces- and just as slow as at home, Best of all there is no need what so ever for boots.

Despite dire warnings every week that this is the coldest winter in years (daytime average so far 8-14 and night -2 to 4-5) Afterall it is what you are used to right!! On sat afternoon and most evenings in the dark there are close to 200 young women in bare legs and very short shorts/skirts playing a game called netball. Like basketball but no travelling. VERY big this side of the world and almost always played outdoors it seems except at the pro level of course.

(early morning rain GL on now) "I am a long way from home and I miss my loved ones so" which of course is true but i cannot say I am homesick a such because with the technology it has been so easy to stay in touch. I see Mom and Dad every week on the cam and have joined my book club via phone and webcam as well. Long distance calling is dirt cheap with the phone cards so i call friends and family fairly regularly (esp favourite son and daughter) once the time difference get sorted out! I kep a clock here set to Hfx time ( I am currently 15 hours ahead of Hfx) and now I have to figure 9 hours ahead of Italy where Lesley is for the summer.

It would be much different if not for being able to stay in touch via phone, email, cam and now i am playing with facebook a bit but i think i am too old to really get it. One of the younger nurses at work Debs -she is a Brit or pom- and she is determined to make me facebook savvy and has promised me a lesson! Don't hold your breath facebook fans- still more likely to repond to emails. I have to{ suzanne by Leonard Cohen now} admit it is fun looking at walls!!

Have read about a zillion books- I guess that is an exaggeration! but i am making up for lost time when I was studying the last 6 years. ( maybe that is why I never get around to doing the blog??) Just finished "still Alice" a great read- very quick- about Azhiemers from the persons pint of view. Thanks Francoise! I hadn't cried at abook for years and was afraid I'd become untouchable but this one bilndsided me twice.

Although I am not in a palliative setting we do have patients who die and as is the case the nurses are the advocates for patients alot of nurses here want to do abetter job this way and It surprises me when they acknowledge I do a good job because it seems second nature to me. I received a real complement the other last week when they let me look after a patient they ahd known and loved for years as he was being discharged home to die. It meant a lot that they trusted me to care for him. Of course they still don't trust me to care for brand new transpalnts and that is JUST fine with me.

I ahve connected by phone with the community palliatve care team and will spend a day with them sometime this summer.
My half hour is up! I have to get ready to go work. An evening shift. Colin si away this weekend with his hockey team in Aukland. I would have gone but my schedule was done before his! So I'll go in August. His expenses are all covered and domestic flights are quite cheap so should be fun.

NZ life:
Outsider is a workmate
slice is what we call a square(a sweet)
you can order a bowl of fries and fish and chips are really good, dirt cheap and on every corner

What we get up to!

RTW2009 — Mon, 25 May 2009 00:00:00 GMT

We have been here 3 1/2 months and posted a few entries. I have decided to try some with just text and forego the pictures everytime. I may be more likely to do this that way.
We made a list one night at our local ( down the road) pub called the Celtic Arms. The list was topics for blogs. So i am making a start tonight.

Out of interest we are officially in winter and have just come through a full week of heavy rain and wind. It is surprising how many trees still have leaves and that the rose trees outside the hospital are still blooming. There are trees that have turned yellow and those leaves are all over the sidewalks! I was told by a young lady on the bus one afternoon that NZ trees original to the counrty do not loose leaves- only trees brought here from somewhere else.

Back in April we were out walking and came across a poster about a concert coming up in Lyttleton (the town over the hills where the port is). The artist, Andrew White apparently from NZ, grew up in Scotland and currently lives in Halifax. He is well known around the world as guitar stylist. As we had not heard of him and really didn't know what a stylist was we decided to go. We booked tickets and a plate of food to await us at the old theatre.

Caught the bus on time and had time to walk around the lower town of Lytlleton which is built on the side of hills. The people who live here must have thighs like horses! When we got to the theatre we found we had a front row table- In fact I was able to rest my feet on the lower step of the stage!

The concert itself was interesting at the start but a bit musically complicated for my taste. I'll try and include a link to his website for anyone interested in checking him out.

Colin did talk to him after but as he was about to embark on a divorce from his wife in Halifax who had apparently cheated on him, he was not inclined to be too interested in meeting 2 ex-pat Haligonians!

Caught the bus home and somehow endedup with an hour to kill before our last bus so had a pint at The Bog (an irish pub downtown).

www.andrewwhitemusic.com He has played at the Music Room which some people would know used to be our home! Funny coincidence, eh!

Thought I would include a few NZ terms with each blog.

Thanks is ta
Most people say good day instead of hello
Squash is pumpkin
turnips are swedes and only recently for human consumption as they were cattle fodder

First kiwi Home

RTW2009 — Mon, 04 May 2009 00:00:00 GMT

We left the Big Red House on Barbadoes St on a sunny morning early in March with 2 more bags than we arrived with! We were at a loss to expalin the extra "stuff" acquired in only one month and doesn't bode well for when we leave and may need a container at that point!
However as I write this people in Purcells cove have lost their homes and the H1N1 virus is stalking the world so i have little to complain about. Our 1/3 of a 3 port gagage is a relatively new bed sit. it is ~ 12x18 with a small bath across one end. Simple and basic but meets our needs.

Colin bought and attached the bedframe as it was only 4 in off the floor initially and though we are fitter than when we arrived it was still achallenge to rise from the bed.

Housework takes very little time and as you know this can only be a good thing for me!

We are next to a forecourt off the street and the path to the main house is through the woods and over the bridge.

The house is small and 100 years old and slowly being restored. Lovely leaded window in the door. Large Rosemary tree to one side and a lovely planting of lavendar in front.

The front door opens in to a central hall with a bath at the end (no toilet here)

The 2 rooms on the right of the hall are private for the owners but have back to back fireplaces. On the room at front on the left is rented to Julia who is here from Ohio to do a Phd. the backroom on the left is the sitting room where we connected to the internet til we had our own connection.

Through an open door way to the small kitcen across the back

Lots of wee little rooms at the back. One of which is mud/laundry ( dryer vents into the room through the door hence +++ steam if used) off that room is a step down to the sink and then toilet through another door. Seperate toilets from bathrooms are very common here. Actually if you say you are going to the washroom peole look at you strangely. it is the toilet or loo.

Through the door on right you go out to the backyard, one side ordinary,

the other has a greenhouse, chicken coop and clothesline (yeah!!!)

Behind the chicken coop toward the front of the yard is ashed and in front of that a patio about to become. Landlady had dug a pond and bought fish but the fish are housed in an old bathtub beyond the clothesline for now with a hose constantly running into it.

We are a 5 minute walk from 3 bus routes and although there is asmall commercial area around us it is surprisingly quiet on our deadend street.

Recycling has taken off in abig way and they have just revamped their waste system to 3 wheelie bins per household. A small green one for organics picked up weekly, a larger red one for rubbish and a big yellow one for recycling. The red and yellow are picked up bi-weekly alternately.

Colin store his bike and hockey gear in a small lean to at the end of the garage.

It is our home for now but we expect to move midwinter to something larger that will accomodate the hoards who plan to visit. Come one, come all!!

Nursing in New Zealand

RTW2009 — Wed, 25 Mar 2009 00:00:00 GMT

It is Wed. pm and Colin is off to his weekly hockey game, so I will put down a few thoughts about my job. It is a strange time to start a job in a field I know relatively nothing about. I am hopeful that my brain has been exercised by doing my degree and I can absorb all the new things I am learning.
First a few facts-The BMTU (bone marrow transplant unit) at Christchurch Public Hospital (there are smaller private ones) is about 20 years old and built with public donations so that peolple on South Island wouldn't have to go to Auckland. Interestingly we are now accepting Auckland patients because their wait list is so long Patients are relapsing before they can get the transplant. The unit has 15 beds, 9 are private isolation rooms with airlock,. 1 semi, and 1 4-bed ward for non isolation patients. We frequently have overflow oncology patients +/- float to the oncology ward. There is aday ward attached to the unit and we see outpts for chemo, blood products and bone marrow aspirations. The line between outpatient and inpatient blurs a great deal- to the patients benefit, I think. There is an apartment building Ranui House which is for family of patients who are from out of town, and they have the use of this apartment as long as they need it. Once patients are no longer neutropenic (either after chemo or transplant they are encouraged to get out and only return for meds etc.

It does make it confusing for me at times sorting out who is coming and going but it is beginning to make sense. The nurses have the same issues with the hematologists not letting go. it seems it is world wide problem!
Palliative care is often consulted for pain management and does see pats. I am still sorting out how this works.

So I started with hospital orientation Feb.26 you know-fire safety-infection control-vision-strategy etc. Pretty generic stuff but a good overview. Nursing orientation was a day long then I went to the unit. A day with the nurse specialist Wendy who is lovely and keen to do things for a reason and not just beacuse that is how it is always done.Since then I have been buddied with a senior nurse Mon-Fri and mostly days (0645-groan to 1515) and a couple of afternoons (1430-1100). I won't have to do nights (1030-0700) for a few months. The shifts are 8.5 hours, full time is 40 hours, not 37.5. The overlap makes for a smoother handover (report) because someone is always on the unit while the next shift is checking charts and meds. There are hospital uniforms of shortsleeved blue tops and navy blue shorts, pants or skirt. The head nurse is called Charge nurse and wears a white top instead of blue. The BMTU also has the option of scrubs which most of us wear. ( therefore need to be there earlier to allow time to change- not so good for me who likes to hug the pillow as long as possible!!)

So I get up at 5:45 have breakfast, dress and walk~20 minutes to the hospital. Change, listen to handover while drinking tea provided by the hospital. Then out to review charts after patients assigned. There are usually 5 nurses at least on days, 4 on afternoons and 2 on nights. The charts are divided in two. One is like the med kardex and holds the vital sign sheets, med kardex which the doctors write the orders directly on-so there is no transcription at all. All the iv fluids, blood products and meds are "charted" (ordered) on these sheets which fold over.Some patients have up to four sheets. When the spaces are filled up on one page the DOCTORS have to rewrite the whole thing. This is usually done by the house surgeon (our old intern and not a surgeon at all !) We also have a registrar (resident) and consultant ( staffman) assigned to the unit all the time. There are 5 consultants who rotate to various parts of the service on a monthly basis (sounds familiar). Diagnostic tests aren't actually written as orders-the md just fills out the requisition and faxes it himself and files the req on the chart. The doctors are much more self sufficient here. I was actually discouraged from bringing the iv cart to a patients room so they would be used to getting it themselves even thoiugh I was going right there!

Early mornings are busy with Bloods to be taken form hickman lines (all pts undergoing chemo / transplants have these put in), they have to be flushed, all lines changed, Then check blood reports on computer to know who will need platlets or blood products thatt day and get those ordered and running. Everything is run on a pump but I had to learn how to calculate drops in the iv test I did. I always seem to make the pump alarm at least once an hour!!. One poor fellow had a pump for fluids, one for TPN (severe stomatitis), a morphine pump (the syringes are mixed by pharmacy and kept in narcotics cupboard) like a syringe driver but larger and locks so it has to be unlocked to change the rate, also a similar syringe driver but not lockable for his immunosupressant. The nice thing about the Hickman of course is that it can all be disconnected when necessary.

I am getting comfortable with the flushing and management of theses lines but it is nerve wracking at times to keep it straight the order you do things. We do have Graseby's here as well but apparently they have to be taken out of service by the end of the year because they don't meet some standard which I think has to do with them not being lockable. I am not sure if this is the case in Canada as well.

I am not sure what happens at home on the unit but here we double check and sign every IV fluid, blood product, IV medication and oral narcotics, ativan and potassium. But we don't have to double sign Blood group and Cross stuff!! that may come though because I heard today that the Blood service had to request 480 repeat samples last year because of improper labeling.

So that is a start. I'll follow up with a few more lines on the weekend.

Friday Afternoon

RTW2009 — Tue, 24 Mar 2009 00:00:00 GMT

Glenna and I sat in the Sun and shared a few beer at Christchurchs favoutite brew pub.
About a five minute walk from the hospital and a Stone's throw from center of town. Nice breeze as usual and temperature near 24. Just in case anyone thought we've got caught up in a never ending whirlwind of museums, tourist attractions, and blessed
cultural showcases, please note, we've done the hard work and can honestly say that we can steer any Nova Scotians to the finer watering holes in Christchurch. We have checked out Kaikoura and expect to publish the definitive Maritimers guide
to New Zealand's top public houses. To qualify there must be outdoor seating, plenty of sunshine, wonderfully cooling breezes, and
of course glorious beer.

Apology to the author of Trees

I think that I shall never hear
A poem as lovely as a beer
The stuff that Lord's pub has on tap
With golden base and snowy cap
To sit outside and drink all day
Until my mem'ry melts away.
Canada's much too cold, I fear
For Kiwi style drinking beer.

Week End

RTW2009 — Sun, 08 Mar 2009 00:00:00 GMT

Our first trip out of Christchurch by car. We picked up a little Suzuki Swift, the last car available, as it was a stick shift. Last minute bookers who can only drive automatics, walk or take the bus. The route took us through the Waipara Valley noted for regional Sauvignon Blanc. Literally dozens of vinyards en route but we gave them a miss this trip as the temperature hovered near 27 and it was beach weather. There are as many beaches as vinyards some named and some not. The scenery is spectacular. What to photograph and what not becomes a joke after a while, because it is ever changing and
makes you think that someone has painted a hugh back drop for a movie set following instructions to make the background as inspirational as possible. When we returned to Christchurch our room mates commented that we should have gone south for real scenery
as there is not much to see around Kaikoura. Can't wait. The little Suzuki got a work out, up and down mountains passes, back and forth through swichbacks, and of course the narrow roads with a posted speed limit of 100 KMH were lots of fun. I can't imagine anyone other than Michael Shumacher possibly averaging this speed particularly while dodging the natural obstacles like unfenced sheep and cattle. We spent most of afternoon at beach and checked into the Adelpi Hotel. Its glory days are gone as it is now essentially set up for backpackers. Backpacking is a real industry. Buses sheppard travellers all over the island from one destination to another.

Had a few beer in the local pub before bed. The waitress would not take my money and I assumed we were running a tab, only to find out later drinks were free. The bar had bet $ 1000.00 of free drinks that the rugby game between Christchurch and Dunedin would not be tied at half time. Of course it was. It explained why even sunburned old working stiffs were lined up ordering every odd exotic liqueur and glasses of the most expensive wine. More than one sadly commented at the start of second half " It's back to the beer now" Glenna enjoys the seat closes to the cliff edge on the narrow high pass roads. It's a real treat when making room for passing cars.

Bone Marrow Transplant Unit