Two years ago…

August 20, 2014 § 1 Comment

…we celebrated our first national holiday in Budapest! It was our third day living here and everything we did felt like an adventure. We made sure to see all of the events that happened that day: the air and water show, the food festival, Hungarian dancing and fireworks. It was an amazing induction into Hungarian culture and the beauty of Budapest. I documented nearly every second of that day in my blog post: Saint Stephen’s Day – Celebrating the Foundation of the Hungarian State. Worth a visit to relive those moments. Last year we were in Budapest, but instead of joining the crowds, we got take-out from a nearby restaurant and watched the fireworks from our kitchen island with some glasses of champagne.

Had we moved here this year, we would not have had anywhere near the same experience. The weather is poor, gloomy and wet. Miklós told me that they won’t do the fireworks if the weather is bad. Several years ago, there was a thunderstorm and people still flooded the bridges and streets encircling the Danube to watch the fireworks show. He said that a tree branch fell somewhere and ended up killing two people, and since then, they have decided to only carry out the show if the weather is good.

It’s my day off from work and I feel like my skull is shrinking. My sleeping pattern is so poor with this work schedule and I’m definitely feeling the consequences. My plan for today was to start off by going to the gym and then study the rest of the day, since the quiz for our Exercise Physiology class is due early Thursday morning. I haven’t been enjoying the class as much as I thought I would. The lectures aren’t very stimulating and my interest in the topic can only fuel my motivation so much. After talking a little bit to Skjalg, I decided to drop the class and instead give myself a break from studying until school starts up again in a couple of weeks. If I feel the urge to study, I can always watch a Dr. Najeeb video. Otherwise, I’d rather fill my time with some leisure reading. My brother Christian recommend a book called Not Entirely a Benign Procedure and I am really interested in it. He said it is a book of diary entries of a medical student during her four years of medical school in the US and that the author is very talented and witty. Skjalg told me that I have to finish one of the other 15 books I’m “reading” before I start a new one, but I’m going to sneak this one in anyway…

Work on Monday was terrible. We were there for 9 hours and all we did was make four beds and register three patients, so a total of 40 minutes of work. When we were in Neurology, they were good about letting us go if there wasn’t anything to do (though, it felt like there was more to do when we were there). The head nurse of the Gastroenterology department is oddly strict. We had a rush of patients between 9 and 11, and after that, there was nothing to do. There were four patients in the department, three nurses, three nurse interns and the three of us, and still, she said we weren’t allowed to leave until four. So, for the last three hours, we stood there, watching the nurses sit on their phones or quiz each other on dosages of medications. For one hour, I counted the paper butterflies on the walls according to their color scheme. We couldn’t help but get angry about it. It’s not that we were lazy and wanted to go home, just that we wanted to do something. Cleaning, organizing, any mundane task possible! As the hours ticked on without a task, I got frustrated at the thought of seconds of my life slipping away for no reason. I’m generally good at finding a reason to make any situation “worth it” but this was ridiculous.

We’d decided that, on Tuesday morning, we would talk to the head nurse of the hospital, the one organizing our practice. Another day like Monday would have driven us insane. (We wanted to do anything – anything! – other than just stand there. We’d change every bed in the hospital if we could.) I was alone when she emerged from her office that morning and approached me to say hello. When she asked how things were going I explained, in my best easy-to-understand English, “Yesterday, it was very slow. We only changed 4 beds and registered 3 patients. It was not very nice to only stand there.” She nodded in understanding, smiled and told me that we should probably take a half-day. She seems to care a lot about our experience here and has been really good about planning things for us to see and do, at least during the first two weeks.

After she left, the boys showed up and we headed towards the department. The head nurse of Gastroenterology, endearingly referred to as Big Red by us, raced up behind us, pressing on our heels and goading us to walk faster in Hungarian. At the entrance of the department, the head nurse of the hospital was waiting. The conversation that ensued was one that I really, really wish I had been able to understand. I picked up some words, but Miklós had to fill in the rest once we were alone and settled. Big Red had been told by the head nurse of the hospital that there was no point to keep us standing around, doing nothing, for hours on end and that we should be sent home if there is absolutely nothing for us to do. She was then criticized for something that didn’t have anything to do with us: there was only one patient staying in the department, only two schedule to come in for the entire day and she had three nurses working. Miklós said that she was told that the nurses shouldn’t be “in Hawaii” – a term for lounging around in Hungarian – and that she had to send someone home (which she never did).

After their little talk, Big Red ignored us for the rest of the day. She complained to the other nurses for a while and then disappeared to the back. We, of course, care about making a good impression and are doing our best to be respectful, but it had just reached a point where we needed to stand up for ourselves. Jun and I, as English students, are paying $350 for this practice. If there is nothing for us to do in one department, we will gladly go to another or honestly anywhere where we can do/learn something. But if they are just going to have us stand around and doing nothing for hours, well, then they are also making us pay with our time in addition to our money. Big Red is honestly the only person who has made that an issue and for what reason, we’ll probably never know.

The shift on Tuesday ended up being a little better. Some doctors stopped by for lactose intolerance testing and we were allowed by one of the nurses to complete the test. For the test, they are asked to swallow a solution containing lactose and then the hydrogen content of their breath is measured every 30 minutes for 3 hours. People who are intolerant of lactose (like me!) lack the enzyme that breaks down the sugar in the intestine. As a result, the lactose continues until it reaches the gut flora (bacteria) which do have the enzyme. When they break it down, they produce hydrogen and sometimes methane, which appear in the subjects breath. For people who are not lactose intolerant, we would expect their breath values to be 0, whereas those who are, can have really any value other than 0. So, every thirty minutes, we had them breathe into a plastic bag attached to a large syringe. When the bag was inflated, we opened the syringe, filled it with the air from the bag, and then closed it again. We then attached the syringe to a H2 reader, injected the air into it and waited for the result. The results were interesting: one patient had 0, 5, 0, 9, 0, 5, 0, whereas the other had 0, 0, 0, 0, 11, 38, 54.

A more advanced version of the one we used. Credit: USF Health's website.

A more advanced version of the one we used. Credit: USF Health’s website.

At 11:00, the department entry was empty again and there were only two patients checked-in. The three of us and the three nurse interns sat in the waiting area, watching the nurses sit in the nursing station on their phones and chatting. Big Red had been marching back and forth in the hall on the phone, loudly remarking various things to the nurses. Miklós told me earlier that she some of the things she says are pretty rude. One of her phone calls was more intense and I asked Miklós to translate it. He said that she had been informed that they would be closing the department since there were only two patients and that the patients would be moved up to hematology until Thursday. She didn’t want to close the department, so she was calling around trying to find another patient to put in the department so that they wouldn’t have to close. With so little to do that they are being told to close the department and you’d think she’d let us go, right? Nope. She told us we couldn’t leave until 1:00 – exactly a half-shift. I’m sure there are more logical reasons for keeping the department open – i.e. making sure the nurses get paid – but when it came to keeping us, especially after her conversation with the head nurse, I just didn’t understand. At 12:45, she told us to go and change and then didn’t return our goodbyes when we left. I have such fond memories of the first two weeks that it is unfortunate that it may end on a more sour note. There are still three days, but two of those leave Jun and I without a translator! Tomorrow we’re planning on asking the head nurse of the hospital if there is another department we can visit. We’ll see how that goes…

On a lighter note, I tried overnight chia oats for the first time! Oats, chia seeds, banana protein powder, coconut flakes, light coconut milk and some splenda overnight in the fridge and then topped with some berries in the morning. Will be a quick and refreshing treat to have in the mornings once school starts.

ChiaOats2 ChiaOats1

 

8 down, 5 to go!

August 17, 2014 § 4 Comments

Only 5 more shifts left of nursing practice and I can’t wait for it to be over. I have learned a lot, but in the end, there is so little that we are qualified to do – especially with such limited Hungarian. Most of the time, I feel like we are just in the way.

Our night shift went well – at least for the first 6 hours. Instead of doing it in Neurology, we were transferred to Gastroenterology. We’d never met any of the nurses there, but once they got over the surprise that there were three of us, they were pretty nice. We started by changing some beds, checking the soap and tissue dispensers in the department and checking that the emergency bag was up-to-date. Poor Miklós, we are pretty much completely handicapped without him. Checking the medications was fine, but when it came to checking different tools and gadgets that weren’t labeled with a name, we were helpless. I know this all doesn’t sound very exciting, but that’s part of my plan. I wanted to bore you before telling you what made the whole night worth it: we got to practice drawing each other’s blood! I know nurses do it all the time, but it was still so exciting for me. We learned which areas to check for veins, how to identify a good vein, veins to avoid and the techniques for inserting/withdrawing the needle.

Around midnight, we got a call saying that a new patient would be arriving: a four-year-old boy with stomach pain and vomiting. We were allowed to check him in, something that made us feel accomplished. Miklós had to take the history, so Jun and I took his head and chest measurements, weight, height and blood pressure. Once he was shown to his room, I was tasked with taking his temperature. He’d been a little grumpy when he first arrived and had escalated to near impossible by the time we got to his room. Every time I tried to bring the thermometer to his ear, he became hysterical, tossing his head back and forth so that I couldn’t get near him. When I did manage to get close, he screamed and hit my hand. His mom was trying to calm him down the best she could, but there wasn’t much that could be done. With the language/culture barrier, I didn’t feel comfortable forcefully grabbing his head and holding it still while I took the measurement. Had it been a situation where I could have spoken English, I would have handled the situation differently. I would have explained what I was going to do, maybe let him try doing it on me, and if none of that had worked, calmly explained to the mom that I was going to need to hold his head down. Eventually the nurse came in and told us that we should just try to do it later – thankfully!

After the thermometer incident, the night quickly transitioned to a game of “who can keep their eyelids open the longest”. At 1, one of the nurses asked us if we were curious about the patients in the department. The one I remember most was a boy, not even 10 years old, suffering from a brain tumor. She told us that his brother had died of the same condition last year and that he didn’t have more than a couple of months to live himself. It made me so sad to think that such a young boy was given such little time on this earth. In addition to the tumor, he’d had a right atrial infarction (heart attack in his right atria) and stomach pain. Later on, the other nurse walked us through how to hook up the oxygen in case his condition worsened over the night. When I asked why he was in Gastroenterology and not Oncology, the nurse answered that even she didn’t really understand the reason, but that it had something to do with statistics/bureaucratic nonsense concerning his nationality (non-Hungarian).

On Friday, we expected to do our practice in Gastroenterology. We had been told that we would be doing the remaining shifts there instead of Neurology (apparently so that Jun and I could experience more of the hospital). When I showed up Friday morning, I tried my best to communicate why I was there, but communication proved impossible. I ended up sitting and waiting for Jun and Miklós, since I didn’t want to just help myself to the changing room and start fiddling around with the soap boxes. Before the boys showed up, the head nurse arrived. After cordial greetings, I explained that I wasn’t able to tell the nurses that I would be working there that day. I was careful to use English appropriate for the situation and yet she still needed 3 minutes alone to understand what I’d said. She then told me that we would instead be going to Pulmonology for the day, since there were residents there that spoke English (whom we never ended up meeting).

Our stint in Pulmonology was the slowest yet. We were introduced to all the cases and then took the temperatures of a few of the patients. After that? Nothing! I didn’t want to totally waste my time, so I decided to harass Miklós with questions about Hungarian. He will be finishing his practice on Thursday, which leaves Jun and I to fend for ourselves for two days. Two days without a translator! In anticipation of this, I tried to think of some questions/statements that we could have translated beforehand. I carry around a little book for notes, some Hungarian terms/words and some diagnoses that we are told about so that I can look them up at home.

These are examples of words I noted down before I started the practice:

NursingVocab2 NursingVocab

Here are some of the questions that Miklós translated:

NursingSentences

After the question-translating and a little lesson on how to conjugate verbs in different tenses, we moved on to Hungarian vowels. Miklós had been stressing the importance of them and how they were each their own letter and not variations on the original vowels. I told him about similar vowels in Norwegian – æ ø å – but that didn’t seem to matter…

I was having a hard time with them – there are 14! – so I made up a little game: Miklós would say a word in Hungarian that started with a vowel and I had to guess which vowel it was. From the results, you can see where my weaknesses lie.

HungarianVowelGame

So that was Friday! Exciting stuff…

Now, it’s late Sunday night and I’m trying to trick my body into falling asleep before midnight so that I don’t only get 5 hours of sleep. By tricking it, I mean getting into bed before 21:00. I’m looking forward to this being done so that my sleep cycle becomes more regular…right now it’s a bit manic. Can you spot the nights before work and the nights before a day off? I feel like a sloth-robot hybrid!

SleepBot

Off to the Night Shift I go

August 12, 2014 § 6 Comments

Whoa, time is going by fast! It’s been almost a month since my last post and it feels more like a week. In that time, we had one last trip to Halsa with almost Skjalg’s entire family on his dad’s side – everyone except his sister, Kaja, who had to work. Then there were a few days back in Bodø before I hopped my flight(s) home to Budapest for summer practice (which I am doing in the pediatrics hospital). I had a couple days back here before practice started, but I don’t remember what I did. I think there was a lot of sleeping. It was so, so nice to be back home in my own space, in the middle of this beautiful, bustling city.

I was really nervous for the first day of nursing practice. I had no idea what to expect, save for a few tips I got from our friend Mads, who did the practice in July:

You have to work 120 hours, max 12 hours in a day. You can’t work weekends and you have to work one night shift. This means that you can finish it in 10 working days (9 day shifts and 1 night shift). The earliest you start is 6 am and the latest you work until is 6 pm. Our night shift was from 6pm to 6am.

You are not gonna be working with any english students. You get paired together with a hungarian student and the two of you go to a specific ward and you never see the other students again. I worked in the rheumatology/nephrology/immunology ward by the way. You have to work at the same times as your hungarian partner because he/she needs to translate (the nurses don’t know a single word of english and the doctors don’t work with you). So you have to agree with him/her when you can work. It’s normal to just bang it out in 10 working days.

All in all, I thought it was really worthwhile. Ok, there’s no money, but I learned a lot in those 6 days i worked… more than if I had worked in Norway at a sykehjem. It started getting repetitive towards the end and the days get longer though, but that’s just how it is with jobs like these.

The morning of, I was expecting to be met with a crowd of students in front of the head nurse’s office door. Instead, it was empty. I checked the clock a couple 100 times, just to be sure that I hadn’t made some big mistake (i.e. wrong day, wrong time, possible time change). At 7 on the dot, I just decided to go with it and knocked on her door. It ended up that Jun, the younger brother of my friend and groupmate Rina, was the only other English student doing practice there. Jun and Rina were raised partly in the US, in Tennessee, and partly in Japan. Jun also attended college in Minnesota. They both speak perfect American English, so I have to remind myself that they live in Japan and not the states.

The head nurse led us down a long hallway and on the way, explained that we would be working the first week in the gastroenterology department and then after that, the Neurology department. Since the nurses of Gastroenterology were all on vacation, they had temporarily moved Neurology down to the Gastroenterology department and combined the two. Once we entered the department, we were introduced to the head nurse (of neurology) and our Hungarian partner, Miklós (pronounced: meek-lowsh). After the introductions, we were led to a restroom where we could change. Jun and I exchanged glances of panic and then informed them that we hadn’t been told of any uniform and only had what we had on us. In the past, when we have visited hospitals where we need special clothing, we were given scrubs/lab coats. I was wearing a white t-shirt, black pants and shoes and Jun was wearing grey pants and a white shirt. There was half an hour or so of bureaucratic drama (we weren’t allowed to loan scrubs without a signed note from the university) and finally we ended up with some plastic booties and long white lab coats. Once we got off work that day, it was off to the malls to buy some all white shirts, pants and shoes.

A week has gone by since we started our practice and the days have been full with work, working out and studying for my courses on Coursera. On Wednesday, I spent the day studying for, and then taking my quiz, in Exercise Physiology. Then, this past weekend, I had my final in Programmed Cell Death. I was slacking a bit on the lectures, so I didn’t turn in my final until late Sunday night. I ended up with a 95% in the course, with which I am pretty satisfied. It wasn’t always extremely exciting material to cover, but I feel that I have learned a lot that will help me this coming year. If anything, I’m happy that I understand the mechanisms behind some current cancer treatments.

Tonight we will be having our first and only night shift. I tried to sleep in as long as possible, since I will be working from 18:00-6:00. I’ll be bringing some movies and a book, since I know there will be nothing to do. Hopefully it’s not too terrible!

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