24/07/09

I am currently sitting in my flat on the compound listening to Neil Diamond sing September Morning. My mood is not down, just sedated. Today was good. It started bad as I stepped into the department to have my work questioned, even before Good Morning was said. But that is the rule of thumb. I will never again suggest that the Calvary Emergency Department was ever unfriendly. You guys are so lucky. It is not that people here are not nice, but it is about what you didn't do rather than what you did. Anyway I was responsible for checking the procedure room instrument bay. Simple enough check everything on the list is in the cupboard. Half the stuff was missing. I asked where to order from, was told the instruments get stolen so we don't replace them anymore. OK so as long as I have ticked the cupboard was checked all is well. This theory also applies to the crash cart and Resus Bay. I mean what is an ETT between friends.

Tomorrow morning I have a competency course on Conscious Sedation. The education department is really good. They are constantly running courses……useful courses that is. The only down side is that only American Heart Foundation Course are recognized, but hey another BLS and ACLS course could be fun and I get to go to the city up the road for ACLS. Al Ahsa, the city up the road, has a 3000 tree oasis and is the date capitol of Saudi Arabia and it is date season right now. Pity my ACLS course is not until March 2010. I guess I won't be on the MET team for a while.

Also, if someone feels up to sending me a survival pack, a tourniquet would be brilliant. Currently we use rubber gloves knotted around the limb or a Penrose drain if you can find one. It works but it is a b***** to undo with one hand while holding the cannula in place. Also we don't use bungs on the end of the extension. Just slide the clamp shut and leave the rest up to nature. After the cannula goes in, you hold the blood tubes under the open end and let the blood drip in. At 4 drops the patient becomes concerned about how much you are taking, by the end of the 1st tube (3mls) a ward translator is required to convince the patient that I really do need the blood. But as a contradiction, if you do not cannulate the patient and take bloods you obviously aren't doing your job properly.

It is a really challenging country, I know I will learn to cope, but the first few weeks are the hardest as you only have your home country skills to rely on, and often there just is not the equipment. In saying that we have had some successes. Today we picked up some critical blood results on a patient presenting with SOB for 2 weeks and were able to convince him to allow us to admit him into ICU with his previously undiagnosed CCF. Congrats came from the doctors to the nurses for spotting it and acting quickly. It was a really good feeling to have a team effort on something.

Saudi Arabia is a land of contradictions. A headline in the news paper today reads, by the way this is pretty tragic on several levels. "An SUV rolled over today on the Dhahran road. The father, mother and oldest son were killed. The 9 other occupants of the car were taken to hospital with serious injuries". 1 car, 12 people, 8 seats, 0 seat belts, 65,000 people killed in road accidents every year 1 Guinness Book record. The sad part is this is standard practice here. And given the flat roads and speeds not many people survive an accident.

I think I shall take up flying to the supermarket.

28/07/09

It is a few days after the pool party. It went well. Most of the people asked came and John bought his guitar. Penny's roommate Hani from Singapore thought she would not be welcome because she was not a Westerner. Penny pointed out this would not be the case. She came along for a while and I think she enjoyed herself. But it does bring up an interesting aspect about Saudi Arabia. The division between nationalities, or more correctly races is very clear. John and I have little in common but our employment country. John is actually Irish from Melbourne. Recently National Guard opened their new compound in the ever expanding Riyadh Hospital (1500 beds and growing) they have several compounds. On the bus to the newest compound built for Westerners, it was noticed there were some Muslims coming to pick their apartment. This in its self was not a problem, but it needed to be pointed out that Western dress codes and socializing was going to be accepted and that the Muslim residents would have to accept this. The Muslins are here on European passports and are not Saudi nationals. So the rule was modified for the residents. Muslins on Western passports would be allowed to live their but not other Muslims. This was a problem as many Egyptian, Jordanian, North Africa Muslims etc live very open lives with far closer to Western dress standards etc. It was pointed out that Africans are not Westerners, and therefore should not be allowed on the compound. Keep in mind these problems and solutions are not coming from the Westerners but from the Saudi Hospital execs. "Africans aren't Westerners" did not sit well with the South Africans of British, Dutch and German origin. You can now see where this is going; only white skinned Africans would be considered Westerners and be allowed to live on the compound. This of course would create confusion amongst Americans and Europeans of Africa origin. The simple solution would have been, "This compound will be Western in behaviour, dress code etc. This means a mixed gym, pool, shops etc and there is no mosque". And allow people to make the decision whether they wanted to live there or not. But the division between jobs, wages, promotion and responsibility, work hours etc is based on nationality and race. The Saudi offer each country what is required to get people to work here. Australians expect more money and similar working conditions. However a Filipinos will come for less and work 6 days a week outside nursing. At the end of the day we all spend the same to live here and the money we sent home buys the same. But I earn more because I am Australian, not because I am a nurse.

28/07/09

This evening was good. I was bored so I caught the bus to Tamimi and Al Issa Souk. I met Trudy and Kelly who arrived yesterday from Australia via Promesse. They had exactly the same experience I had. Arriving with no idea where to go, where to get food for their apartment and being pushed and pulled in all directions by the orientation crew. Anyway I chatted with them on the bus back from the shops and we are getting together tomorrow for coffee and make them feel a bit more welcome. Trudy said she wished she had an orientation book with tips etc. I think I shall get this together with Lyn as it really is a good idea. Even if Promesse don't give them out in Australia, we could have them here ready for new arrivals. I shall copy my bus, gym and pool timetables for them and invite them to Dhahran Mall and Hyperpanda on the bus tomorrow. They are in the same building as Penny and Hani which is good because they are next door as far as buildings go.

Also today I finally completed all my orientation assessments. This means that once Marieta is happy that I will cope with ER I shall officially finish my probation. It may happen more quickly as new staff have arrived in ED. Sijo from India and Rosalie from the Philippines. So I am no longer the newest person which will be nice. I am feeling comfortable with the basics of the department and feel I will be smooth at my job in about 2 weeks. But at least I won't feel like everyone is looking over my shoulder so closely anymore.

I am also going to put in a TRA for November so I can go to Dubai and see Pippa on her way to England. I am so looking forward to it. All I need now is pay, an Iqama and the internet in my room and all will be well.

29/07/09

Today is "National I Got My Iqama Day" This means I can travel, get internet, get an ATM etc very good day.