Late!

The phone rang at 0706hr and the caller went "Faith ahhh"!!! Yes, for the first time in my nursing career, I overslept for morning shift!!! After washing up and some light makeup, I hailed a cab (waited for quite a while) and eventually showed up in the ward at 0750hr. Thank God for the gracious charge nurse (Sudha) who, despite being heavily pregnant, stood by the cubicle and receive the morning report on my behalf so that the night shift nurses can go home on time. Thank you so much!!! This is another of my 'first time' to remember.

Reflection

I had a very challenging October. Thank God I overcame weeks of upper respiratory tract infection, including the lost of voice. Then came the written exam for the first 2 modules I took for the uni programme. In between we celebrated the arrival of my niece, Rebecca, and my twin girls' 6th birthday, plus my mom-in-law, YaYa and my birthday. So much for a month but I'm finally getting a little break.

This week had been a week of rest and reflection, and a rather emotional one.  I reviewed the events in the last 3 months, and I'm beginning to wonder if doing my part-time degree is worth the sacrifices made.  I found myself less meticulous at work (i.e. checking on my preceptee's learning and auditing the work of other junior staff), unable to complete my Bible Study homework on a few occasions, and spending less quality time with the munchkins.  Well, with regards to the latter, I kind of expected that when I embark on the part-time study programme though.  But what hits me most, was when my husband told me "I felt like a stranger in this house, because you seemed no longer interested in what I do and what's going on in my life."  I was guilty, I must admit.  And this was probably the first time I felt like a total failure in my time management.  All of a sudden, my inadequacies as a wife, mother, daughter, sister, preceptor, employee, employer, etc. overwhelmed me.  And I was even too ashamed to turn to God because I knew I failed as a child of God too.

God, as always, is a merciful and gracious Father.  The reflection came timely, when I was still able to 'redeem' myself.  I confess to Him and ask for His forgiveness.  I had a good chat with my husband and we are working things out.  We realigned our visions and plans for the coming year, where we had to prepare ourselves for many adjustments like the munchkins starting primary one education, his new job offer starting in December, YaYa's impending return to Philippines for good, and my outstanding 3 semesters of part-time studies.

At work, I had to prepare myself for the launch of electronic medication management, CAMIE going full gear with the non-pharmacological interventions coming on board this month, and dealing with a rather "challenging" preceptee currently.  My mind is all choke up with information now...  To add to that, the semester two of my uni programme starts next week.

Dear Lord, I am so in need of help.  Please guard my heart and mind, watch over my steps to ensure I stay close to You.  For You alone keeps me going, save me from distress and guide my every move.  I may want to excel in every aspect of my life, but I don't want to lose sight of the most important stuff - my Lord, my family, my calling.  God, help me!  I know you want to.  I just have to ask.  Thank You, Lord.

Exhausted

So much had happened lately. I found myself struggling with work while precepting new staff, trying to cope with the numerous assignments at university, kids taking turns to fall sick, and even annoyed by the attention received from taking on the emcee role at the recent AH Forum in conjunction with Nursing Fest. Honestly, I totally enjoyed the role and encounter with my co-emcees but the stressful requirements at work soon over shadow that momentary joy I had.

Then my gracious Lord reminded me that I am saved, NOT BY good works but FOR good works, and that I do glorify Him in the course of delivering care to my patients or performing non-nursing tasks assigned to me. Hence I thank Him that I submitted my 2 essays in time, humbly ask for His guidance in completing the other 2 assignments, patience in dealing with co-workers and strength in nursing my 2 feverish munchkins.

While others hope for a better tomorrow, I have hope that my tomorrow is certainly a better one. Amen.

EHOR

I raised my first EHOR (Electronic Hospital Occurrence Report) after 13 months and 14 days on the job. A patient had an unwitnessed fall while I was on night duty with my preceptee. No one knew exactly what happened. Patient claimed she merely lowered herself to the floor very slowly from the side of the bed (both side rails were up!) and glided on the floor to the spot where she was found (next to her cardiac table). She claimed she was 'making a trip to the hospital to remove her colle's cast'. And that was 0240hr in the morning. Sigh...

While I'm relieved she's unhurt (i.e. no pain or signs and symptoms of fracture), subconsciously I fear it may be too early to tell. My preceptee, on the other hand, was close to tears for fear she may fail her posting because patient safety is a major component of her competency assessment.

Anyway, I can only pray and ask God for His hands to cover the nenek (a term for grandma in the Malay language) and keep her safe. In fact, God had already extended His mighty hands over the nenek (and me!) when the doctor on call refuses to sign her case as a fall. He wrote in the case notes "Impression: unlikely fall". Such grace and mercy from the Lord! Hence, I believe my preceptee will not be penalized for this case.

Nonetheless, both of us learned the importance of careful assessment of our seemingly not so confused patients, as well as passing on crucial information to our colleagues during hand-offs if our patients had been observed to be restless during our shift (because this valuable piece of information was not conveyed to us when we took over from the previous shift). I'm praying now for a peaceful third and last night shift tonight.

CAMIE

CAMIE, an acronym that will be stuck with me for a long time, is kind of driving me crazy. CAMIE stands for Caring for the Acute Mentally Infirmed Elderly. Together with a few of my other colleagues, I have been selected to nurse elderly patients who are deemed mentally infirmed, for example, suffering from dementia or delirium, with effect from 1 August under the project name CAMIE.

While I am fine with the idea of nursing demented and delirious patients, the whole idea that I will be placed in the team for no definite duration drives me nuts.  As much as I understand that this group of patients requires an environment that is constant (i.e. they need to see familiar faces hence nurses caring for them will always remain in the same team), I am disappointed that I may be able to nurse patients with other common geriatric conditions.  I want to be in touch with "reality" (exposure to the various geriatric medical conditions) in order to be a better nurse, not just a CAMIE nurse.  So while I hope for the best in my new endeavour, I pray I can still get to be rotated to the other teams once in a while.

One of the reasons why I have been shortlisted for the role of CAMIE nurse is my ability to speak 3 other local dialects apart from English and Mandarin  Communication with demented elderly is crucial.  Yet, I am appalled by the fact that some of those shortlisted for this role was simply singled out because their preceptor (or mentor) was selected.  They had neither interest  in CAMIE nor ability to speak the elderly's language.  How challenging!  And to top it up, most of us selected for this assignment had not been given the opportunity to attend the necessary training or given a detailed briefing of what to expect when the CAMIE project officially kick off.

Now, for any projects to be successful, I believed participants involved must know what they are in for, understand what is the expected of its team members, and be educated on what is the ultimate goal of the team.  There is a Chinese saying 工欲善其事，必先利其器。 It means you need to sharpen your tools if you wish to succeed in whatever you do.  Simple as that.

My first training was a one-hour session with the senior occupational therapist yesterday who covered the theories of organising therapeutic activities for demented patients.  Well, I had no idea nurses in the CAMIE team had to organise therapeutic activities until yesterday (yes, that's how bad the communication channel was).  The session was held at 1515hr, when all the trainees (except one) was dead beat after a whole morning shift of showering, changing and feeding patients, on top of many other nursing activities.  Not quite effective for a start, I should say.  And only one participant had attended a formal training on Person Centered Care (PCC) which is crucial to nursing this group of vulnerable patients.  That spells knowledge deficit!  The even more shocking news was - there isn't another training session on PCC scheduled for the rest of the year.  It is held annually and we had "missed the boat" this year.  How "encouraging"!

What I am trying to bring across is the need to bridge the knowledge deficit chasm if we were to deliver the vision of the CAMIE team.  Trial and errors are expected when a team embark on a road less travelled but this is real patients we are talking about!  Nope, no patient's safety is going to be at risk because we are all trained nurses and healthcare professionals.  But we could expect better nursing care and improved patient outcome if we get things done right the first time.  So imparting the right knowledge to the right group of people just so that we could do the right things is paramount to the project.  CAMIE project did not just surfaced recently.  It had been month since it was first conceptualised.  Though nursing staff work on 3-rotating shifts, hence a challenge to gather all of us together for proper training session, majority of the staff would have been briefed and educated by now if we had started planning way ahead.  The truth is, I can tell my superiors are not quite enthusiastic about the project themselves.  Sad...

Nonetheless, I am looking forward to the challenges God had prepared for me.  I have been asking God for clear direction in my career options, so this could well be the first step in His itinerary for me.  I pray for joy and peace as I take the step of faith forward, so CAMIE - here I come!

"Even to your old age and grey hairs I am he, I am he who will sustain you. I have made you and I will carry you; I will sustain you and I will rescue you." - Isaiah 46:4 (NIV)

Compassion or Callous

I am disillusioned, once again, with the people I worked with.  A few days ago, a colleague's grandmother (who happened to be hospitalised in my ward) collapsed during her shift and had to be resuscitated.  The colleague, due to manpower shortage, had to be called in to help and she ended up doing CPR on her grandmother while crying like nobody's business.

Now, my heart truly goes out to her because no one deserves to be placed under such a situation.  There is a reason why police officers aren't allowed to be investigate cases where their family members are involved; lawyers aren't allowed to represent their family members in court; surgeons weren't encourage to operate on their loved ones.  All because our emotions get in the way of our clinical judgement.  And so, my dear friend, whose heart wrenched with every forceful press she delivered to her granny's ribcage, was told to stop and the CPR taken over by a senior staff when she walked in to the room.

Subsequently, I was told that my colleague did request for family care leave earlier that morning when she found out the vital signs of her granny were going downhill.  Her request was, however, rejected by that senior staff because her granny is in warded in the same hospital where she worked (i.e. she would have been granted the leave if her granny is warded in another hospital). Duh???  What is the rationale behind granting family care leave then?  I am puzzled.

Then the part that got me totally thrown off my seat was - she was reprimanded afterward, by the same senior staff, for crying while doing CPR on her granny because that was NOT professional as she was still in her nurse uniform!  And hear this, this took place on the same day, shortly after her granny was pronounced dead in the medical ICU.  Can you beat that?  Whatever happened to that compassionate and caring trait in nurses?  Did her years of nursing left her a callous heart???  I genuinely want to find out.

Underneath that white uniform of mine is still a human heart.  I put myself in her shoes and asked myself (and my family members today) various times.  Yes, I'd have done the same thing and cried both my lungs and heart out if I had to resuscitate my loved ones, whether or not I am in my uniform.  If that scene irritates you or is deemed unprofessional in your opinion, it probably boils down to poor manpower planning and ineffective handling of situation on the senior management's end as well.

Lesson learnt - quit my job if I should turn callous one day.  I never, ever, want to be like her.  Lord, I'm so sorry I sounded so unforgiving.  Keep my heart burning with your compassion, so that I can continue to love the unlovable, because this is so, so, so hard...  Please continue to stay with me as I stay on in this job, okay?  Show me signs and give me hope, and the wisdom to identify them.  And embrace me when I am down, because no one else will love the unlovable me the way you do.  Thank you!

Letting go

I can now fully appreciate the challenges my preceptor had to go through as she prepares me for my role as a staff nurse 18 months ago. With a nursing student training under me, I experience the same joy, dilemma and frustration that my mentor faced then. To help her along so that we can go home on time together? Or let go partially and help her a little but be prepared to go home later than usual? Or let go totally and just provide guidance when necessary so she'll have an idea what it is like to be an independent nurse? It's a difficult decision which I have to make every day.

For now, I guess I'll continue with the first option until such time she's ready to break free from me. I hope I don't have to wait too long for that day to come. Anyway, I don't have 'forever' to guide her. 9 more weeks and her internship will come to an end. Dear God, please help me and teach me how to let go! I am still 'work in progress' as a preceptor and I am learning too. Grant me the wisdom to know the difference between guiding with supervision, and completing work on her behalf without learning taking place. *Yawn* And there's more to come tomorrow. Be there with me, dear Lord. It's all yours... Goodnight!

"Some of us think holding on makes us strong; but sometimes it is letting go." - Herman Hesse (1877-1962).

Missy gathering

I had a fabulous brunch gathering with a few of the nurses in my ward yesterday (as well as Calene, who had been recently transferred to multi-disciplinary ward).  Thank God for this unplanned occasion where we happened to be off duty on the same day!  I'm sure it was part of your plan, though, for us to get together, Lord.  And thank You, too, for these ladies who had been a source of encouragement as well as an avenue for ventilation at times.  They may be a lot younger than me, but they do share my joy and woes at work.  Love them all!!!

Preceptorship

The last 3 days had been great. It was tremendous joy to work with a student nurse who is also my mentee (or what we call a preceptee in the healthcare industry), as well as a newly recruited nurse who is currently on probation (or rather, on-the-job training).

It was great joy because I get to share my knowledge with someone, and I thank God they are both very 'teachable' which makes sharing with them a delightful experience. For a rather impatient (yes, I admit I'm one) person like me, I am quite resistant to the idea of having to mentor new nurses. Because teaching takes up precious time which translates into delay in completing my tasks at work. This sounds extremely selfish, I know, but there is really no time to waste in an acute setting where work has to be completed and handed over to the in-coming shift on time. Nonetheless, I was 'forced' to take up the 'challenge' of preceptorship and the journey began last week, 4 June 2011. A week gone by and I thank God for His provision of a good student and the opportunity for me to learn.

Thank you God for your reassurance. I know that I am an instrument of your hands, so please continue to use me in ways you deem fit, even though I may beg to differ, because You are always right!

So count down with me on my journey as a preceptor for the next 11 weeks...

A reason to blog

I used to blog frequently about my parenting journey until last year, when my do-list got longer and the time I had with my family seemed little.  I reckoned its because I embarked on my nursing career in a local government hospital, working 3 rotating shifts with only 3 days off every 2 weeks.

Then less than a week ago, when I completed a year of service with the hospital, I did a little reflection on what I had done and how far I've come.  Well, I am thankful to God, and I must say I'm a little proud of myself, yet very disappointed at how the quality of life (for my family, myself and my patients) had been compromised.  I read through my parenting blog a few nights ago, and I found myself reading them over and over again.  They were such a wonderful source of encouragement to myself!  I found strength when I went through those posts I wrote during difficult times, and realised how much I had depended on God on those occasions and how God answered my prayers timely and graciously.  Hence, I decided to start a blog to document my journey as a working mother.  And not just any working mother.  I am a mother at home, a mother (to all my young colleagues) at work, as well as a mother to some of my patients at times.

So journey with me, read my stories, share my joy, my laughter, frustrations and occasional disappointments.  And drop me a words of encouragement if you wish.  I'd greatly appreciate it!