Posted in Health and Well-Being, Medical

Education is Key

Its the weekend and I’ve never been so glad to see the end of a work week. Everyone’s a bit tense, and I think we’re all bracing ourselves because it feels a little bit like the calm before the storm. We’re all waiting for the other shoe to drop, and anyone who says they’re not even a little bit terrified is either obtuse or lying.

I think everyone’s a bit frazzled in a controlled, productive sort of way. It’s the kind of mild anxiety that leads to contingency plans being sorted and people being mobilised. My personal belief in all of this is that we need to educate as many people as we can on precautions, and what type of personal protective equipment (PPE) to use.

Essentially, coronavirus is spread through droplet transmission, meaning you can get it directly if you’re within 6 feet of anyone who coughs or sneezes. You can also get it indirectly if you touch surfaces that have been contaminated by those droplets. It enters via our mucous membranes, so that’s eyes, nose and mouth. For health care workers, the risk is when we do aerosol-generating procedures like intubation or suctioning because then the virus becomes airborne and can then travel greater distances.

Masks are useful, but really standard precaution and good hand-washing are the gold standard. This is an enveloped virus that is susceptible to alcohol-based products, so hand sanitisers and Clinell wipes are effective against it. Soap and water will do just fine but it takes a bit longer to get rid of the virus that way. The FFP3 mask will give protection when the virus becomes airborne and should be worn by those that need it the most, especially when resources become scant. The virus can stay on surfaces for a few days unless you clean it. A lot of this information is available on Public Health England, and the guidelines are continuously updated.

Personally, I am exhausted from talking and training all day. I feel a bit drained from doing information boards and making grab bags that staff can take in case they need to respond rapidly in an emergency. But I feel like I need to do my part in all of this. I will not have the necessary skills for when patients become acutely unwell, but education and preparation I can do.

I’ve never felt the weight of being a health care professional more than I did the past couple of weeks. Someone texted me today to say he thought we’re all heroes, and I got a bit teary-eyed because most of the time I feel like we’re not doing enough, but actually just willing to be on the frontlines is probably more than enough. One of my colleagues said she thought I looked tired and was getting pulled into too many directions at once, and she thought we should have a meeting to plan how to support me in the next couple of weeks. Another was working side by side with me sorting out packs, laminating and putting up signs and doing what it takes to get the job done.

I’m not pretending everything’s all rosy in the NHS, but I don’t feel alone either. There’s people willing to help, and everyone’s genuinely trying their best. I think people are looking out for each other, and I know everyone will pull together so its all hands on deck if it gets crazy.

So yeah, I guess we are heroes. Heroes that also need to take care of themselves so we can do our jobs in the coming weeks. So I’m heading off to sleep now, tired, but feeling light-hearted and optimistic about our chances of getting though this.

Posted in family, Health and Well-Being, Medical

Home is where the heart is

As the Philippines goes on lockdown I find my thoughts straying to where it usually goes these days as news about the spread of coronavirus pile up daily: my family.

I’ve adjusted reasonably well to being an overseas worker, living far from home and being away from my parents and most of the people I love. But its times like these when the reality of being an OFW hits you the most, when you are helpless to do anything except give your parents advice through Facebook and hope to God they’re keeping themselves safe.

There is nothing more I want to do right now than take my dad’s vital signs and check if mum is taking her daily dose of Vitamin C. I want to make sure they have supplies of paracetamol and face masks. I’m torn between telling them to stay in the remote area where we live, where the risk for contracting the virus is lower but where medical care is laughably rubbish, or telling them to go to the city where I have more confidence in the health care system but also where the number of tourists (and the sheer number of people) makes me really twitchy.

Mum goes to church every day, it is an essential part of who she is. I want to advise her not to do that anymore until this passes, but at the same time I can’t help but feel like, at this point, prayers along with sensible hand washing will get us through the day. I found myself this week going to church every day after work. The other day there was an elderly couple there praying the rosary, the only other people apart from myself in that cavernous house of worship. I stayed a bit to join them. The whole time I can hear mum’s voice in my head telling me I’m doing the right thing.

This is a really rambling post, I know. It’s mostly borne out of worry, and this really strong urge I got this morning to jump on a plane and just be with family. I used to revel in my independence, and I loved the thought of being in the big city and making it on my own. But when push comes to shove, and the world goes to hell in a hand basket, home really is the only place where I want to be. And at the moment that is not a geographic location, its a facebook messenger group where all the members of my family gather to share bits and pieces of our separate lives.

At the moment that will have to be enough…

Posted in Health and Well-Being, london, Medical

Err on the side of caution…

I’ve been glued to Twitter and the news for any updates on the so-called ‘delay’ measures that the British government is supposedly announcing today. So far all I’ve got is a bunch of tweets criticising the Tory government (elected by the majority of the people. Just saying) and soundbites from our fearless leader that, if true, makes me really scared about how this country is going to cope when things take a turn for the worse.

Meanwhile in the Philippines, our President has shut down travel by land, air or sea to and from the capital, an unpopular decision but one that will hopefully help contain the virus. President Trump has issued a lockdown on all travel to and from Europe, except the UK. Other countries will no doubt follow suit. One can’t help but think, well what about us? Apart from the heightened paranoia there hasn’t been a drastic change in the daily lives of the British public; at least, not in London.

I made the decision today to cancel my planned trip to Greece. I’m pretty sure I’d be fine travelling, and I’d probably be able to get back into the country without being placed on quarantine. But I just feel like things are changing so much at the moment and everything is so up in the air that now really isn’t the time to be visiting instagram-worthy tourist sites. Besides, as much as visions of being stranded in Athens and eating gyros and pitas for a couple of weeks might be appealing to some, if the worst happens I’d much rather be in a familiar environment, close to my beloved NHS.

I guess the point of all of this is that I would much rather err on the side of caution rather than take unnecessary risks. I love travelling as much as the next person, and it pains me to think about all the disruptions this might potentially cause to planned family trips and get-togethers. But I’d much rather be alive to travel without worrying about the threat of severe illness next year when this would have all boiled over (fingers crossed).

I’ve also decided not to put too much stock on what they say in the news. I mean I’d keep myself updated about travel bans and government measures and whatnot, but for every expert that says we’re all doomed there’s another one that says we’re all going to be fine. I think the thing to do is focus on the things that we can control, like personal hygiene and cleaning of surfaces and taking our daily vitamins. We can try to be reasonable and sensible about social distancing, and we should definitely think about how our actions could affect others. Like I said in a previous post, a crisis is not an excuse to forget basic human decency.

I think this coronavirus outbreak has the potential to change the world forever, but I also think people have short memories. Whatever lesson we learn from this I doubt half the world’s population will remember it when the world starts to turn again and we’re all taking selfies before the Trevi fountain once more. Still, its hard to imagine what the outcome of all this will be and where we’ll stand in three months time. It keeps me up at night, wondering if the world will ever be normal again….

Posted in Health and Well-Being, Medical, Nursing

Is it really business as usual?

I sit here having just had several meetings and training sessions to prepare our staff for an outbreak of coronavirus, a day after Italy imposed a lockdown on the entire country, and I find myself feeling more confused than fearful.

On one hand the news coming out from health care professionals in Bergamo and other regions of Italy that were most affected by coronavirus paint a picture of something almost akin to a war zone. It’s scary to think that in 14 days that could be us.

But of course no one really thinks this will happen to us until it happens. The Prime Minister apparently advised the public to just ‘take it on the chin’, other newspapers still say not to panic, its just another strain of the flu; thousands of people die of the flu each year and no one’s ever made a fuss.

And on the opposite end of the spectrum there’s the doomsday proclaimers who are predicting the apocalypse every chance they get, causing mass hysteria and an ongoing panic buying of – of all things – pasta, paracetamol and bloody toilet paper. If you ask these people we might as well give up on any semblance of normal life right now and accept that we will all be stuck in our homes, quarantined, within the fortnight.

I personally think that an ounce of prevention is worth a pound of cure. I’m glad that I work for an organisation that seems to be taking the risk very seriously and is doing all that could be done to protect patients and staff.

I had a moment where I imagined what life is going to be like if what happened in Italy does happen to the UK. What will it be like when the call to arms is sounded and its all hands on deck because we have more patients than medics?

Its scary to think about the kind of responsibility I will potentially have by virtue of my profession, and that I don’t have the luxury of refusing to come to duty because I want to look out for myself. I will have to take a backseat to my patients, my needs will be secondary to theirs. To be honest with you I’m not sure I have that kind of selflessness in me, I’m not sure whether I won’t have a moment of selfishness where I question why I have to do these things.

But then I think about soldiers going to war for their country, and where we would be if they refused to fight because they’re scared and they want to look out for themselves. They don’t have the luxury to run, and I’m sure they have selfish moments too, but they somehow find the mental fortitude and courage to be on the frontlines of a war, fighting for freedom and fighting for people they love as well as virtual strangers who might not even remember their names when they die.

I know its a morbid thought, but I guess my main point is only that I hope I find that same fortitude and compassion to do my duty anyway, whether I’m willing or not. I don’t think its wrong to reflect on a very real, very human instinct to run away from it all and survive. But I’m hoping that the instinct to care and to help will prevail.

These are not the kind of thoughts I would normally have on a daily basis. There would normally be more people on the Underground, its unusual to find people who are not Asian tourists walking around Oxford Street with masks on. The overarching feeling seems to be that of paranoia. People are actually being stopped on the street. If you look even remotely Asian, random people will suddenly shout ‘Wuhan!’ and be rude to you, as if you’ve single-handedly brought this virus into the country.

Its day one after Italy made the unprecedented decision to lockdown the country, and even in skeptical UK its not business as usual. I suspect it will get worse before it gets better. I’m probably going to write about unfolding events from my personal perspective in the days to come. In the meantime, keep calm, take reasonable precautions, wash your hands and keep safe everyone!

Posted in bloggers, Celebrities, london, Medical, Movies

A Day in The Life of a Wannabe Film Star

Lights. Camera. Action.

Yesterday I had the opportunity to work with the crew at BBC to do some test shots on a documentary that they’re planning to pitch to Netflix. The idea is to go into operating theatres around the world and follow surgeons around to give viewers some insight of what they see and go through on a daily basis. Needless to say, they needed the perspective of a subject matter expert, which I just happen to be.

The production team emailed us to say that call time was at 8am, far too early to be out of bed on a Saturday morning when you’ve been drinking the night before, but what do you do when the promise of fame awaits? My friend (another subject matter expert) and I arrived at the mock operating theatre to find it mostly empty because the crew were still figuring out how to get all their fancy expensive equipment into the building.

So, just like Robert Downey Jr probably does when he’s on the set for a Marvel Film, we said we were going to get coffee and breakfast and asked them to please give us a ring when they were ready for us. Only, unlike RDJ, we actually had to pay for our coffee and breakfast.

Around 9am we got back to the “set” and met the producers, our director, and the very intimidating director of photography. We also met the. man who designed and made the body we were going to pretend to be operating on for the day, a body that was an eerily accurate and anatomically correct replica I might add.

We got into our costumes. I say that as if this was a special moment but what it actually entailed was putting on scrub suits and caps, the same thing we do day in and day out for work. The other extras (production managers who got roped into playing some of the roles because they didn’t have the budget as yet for real actors) got a huge kick out of it though, and they were really chuffed at the thought of being part of the surgical team for the day. It came as no surprise to me when they admitted to being huge fans of Grey’s Anatomy.

Thank you Shonda Rhimes for single-handedly making our profession more attractive than it probably is.

We didn’t get a script so my friend and I sort of had to make things up as we went along. He had the starring role because I volunteered to be the nurse, so he ended up playing the surgeon. They took lots of shots of him walking in corridors, gazing at the horizon and scrubbing up. I spent a lot of time tweeting and facebooking the entire experience while I waited for my five minutes of screen time.

I imagined that was how Jeremy ‘Hawkeye’ Renner probably felt on the set of the Avengers movies, constantly waiting for them to finish capturing yet another shot of Captain America and his shield. Lol.

I have to say, from watching behind-the-scenes footage and documentaries, I already had the vague impression of the amount of hard work that goes into making any kind of tv episode or feature length film. I mean, the Game of Thrones crew subjected themselves to doing 55 night shifts just to give us the Battle of Winterfell.

Talk about dedication. I’ve done night shifts and at the end of three nights you almost start to lose your sense of self. I really could not imagine doing 55 of them. I don’t care if I get to work with Jon Snow or dragons, night shifts are brutal.

The cameramen, the grips, the lighting director and all the rest of the people who are basically in charge of making the actors look good really are the unsung heroes of the film industry. I’ve seen a small sliver of the precision and attention to detail that goes into making these things and I was very impressed. A bit annoyed that they were nitpicking over each and every shot so much that we overran by about an hour, but impressed nonetheless.

Every shot had to be perfect and stylised. It took about ten takes just to shoot a sequence of Russel washing his hands, and another ten of me dropping a scalpel into a kidney dish. They were using lingo that I didn’t really understand, talking about how the shot needs to be sharp and the camera needs to be slanted and they needed more than a thousand frames – they might as well have been talking Latin for all I knew.

There was also a bit of tension and drama. Artistic people have an artistic temperament. Also, put a bunch of perfectionists in the room and you will inevitably end up with an argument or two, but its the kind of professional bickering that leads to something productive.

I didn’t realise how drained I was until the director finally said “Cut!” on that lost shot and I realised we were done for the day. I wasn’t even really acting, just miming something I did and have done for so long now that I can probably do it in my sleep. Can you imagine having to shoot an emotional scene, (or a love scene! lol) over and over again because the lighting was wrong or the director didn’t get the angle he wanted? I don’t know how actors do it.

We packed up, said our goodbyes to the crew, and made our way to Leicester Square and ended our short-lived stint in the entertainment industry over Chinese food. We looked back on the day and laughed over the experience. It was a glimpse into a world that is beyond our reach, a taste of what life would have been like if we’d been blessed with the self-confidence and talent of a movie star.

We came to the conclusion that there was a reason why we weren’t Hollywood stars, and we had better stick to our day jobs.

So, that’s a wrap on Angela the actress, folks. Thank you BBC for the experience and good luck on the documentary!

Posted in bloggers, Careers, Medical, Nursing

Goodbye, Teacher

My whole life, I have always wanted to become a teacher.

When I was younger, I used to help my brother and sister with their schoolwork, in addition to doing my own. I was the go-to person at school for any classmate who would need extra support or tutoring on any subject.

In addition, just for kicks, my uncles would allot an hour each day for me to help my brother learn to read. For some reason we chose to pick up a hardbound edition of Disney’s Pocahontas, which, in hindsight, may not have been the most appropriate choice for encouraging an 8-year-old boy to read.

I went into Nursing because it was my best shot to get out of the country and try and make a better life for myself abroad. Had I been given a choice, and if the financial rewards were taken out of the equation, I probably would have become a History or English teacher or something.

Anyway, its true what they say that life always has a way of sorting itself out. And all you have to do is not get in the way of it while it does. I graduated Nursing and ended up becoming a Clinical Instructors in my alma mater for two years anyway.

I left that post after two years because I had an opportunity to work abroad as a theatre nurse. But after two years of doing that, I then applied for an education post in my trust and here I’ve been ever since.

This week, I lost a person who started out as a mentor and eventually became a colleague and friend. We both worked together as Clinical Instructors in Velez College, and her passing has made me reflect on what it means to be a good teacher, and what it means to be a good person.

I don’t think both are synonymous with each other, but I also think that they’re not mutually exclusive. Being a good person makes you a better teacher, and learning to be a good teacher will help you learn to become a better person.

There are so many qualities that you need to become a teacher that people don’t think about. There’s the easily definable and measurable qualities like time management and organisational skills, writing skills, the ability to speak eloquently and clearly. You also need a really good grasp of what it is you’re meant to be teaching, be subject matter experts so to speak.

But there are the qualities that are more difficult to quantify, the ones beneath the surface that people don’t always see.

Being a teacher takes a lot of patience. There are moments when I lose the will to live when I have to repeat something over and over again because someone just doesn’t get it. But when you manage to get through even one person who’s been struggling for so long, it feels like more of an achievement than when you teach a class of twenty intelligent people.

Being a teacher requires a lot of compassion. We all learn in different ways, some struggle more than others. I have always felt an affinity for those who need more support than the rest of their peers, for those who feel like they’ll always be a failure no matter what they do. As a teacher, I want them to believe in themselves because, even when I’ve hated my students, I’ve always believed in their potential.

Students and learners just need a little push, for someone to tell them to keep going no matter how many times they have to go to the dean’s office to submit a promissory letter because they’ve once again managed to acquire only the bare minimum grade required to pass a subject. It doesn’t matter. What matters is they did pass.

They need someone who won’t give up on them even when they’ve given up on themselves. I don’t know whether I’ve achieved this or not in the course of my career, but its something that I will continue to aim to do as an educator.

Being  teacher requires courage. I don’t know about my colleagues, but I always feel like I’m putting so much of myself on display whenever I have to get up in front of a class or group of people to present something. I feel intensely vulnerable, and I feel like everyone’s cataloguing all my faults and waiting for me to slip up so they can pounce and take advantage of my moment of weakness.

It takes strength and bravery to put yourself out there, and we do it each and every time because we believe in the payoff. We believe that its worth it. 

This week, our hospital is trying to introduce a new system of care planning as part of our new electronic health records system. The NANDA, or nursing diagnoses, is something that we’ve always taught and drilled into our Velez College students from the time they first step into the wards and care for patients. We have them do it every time they’re on shift; they do an extensive one at the beginning of the month as part of their OPTs and again at the end of the month when they have to do a case study.

I am incredibly pleased that the students we’ve taught as a faculty, who are now working in London, will finally be able to apply their training to the care of actual patients (I don’t know if THEY’RE pleased, because most of them hated the NANDA, but I am! lol).

Moreover, I feel so chuffed that something we implemented as part of their curriculum will now actually give them an advantage leading up to the planned change, and they will be able to support their colleagues who may not be as familiar with the system, in the same way that we supported them when they were students.

It is the best sort of validation for a teacher when she sees the actual fruit of her labours, to realise that she’s helped to equip her students with the tools they need to be globally competitive in the nursing field, and to see students that she’s personally taught become great and responsible nurses.

Ma’am Mira, you are everything that is good in a Velezian, and you exemplify some of the best values that the college has always taught us. I can only hope to be as brave and courageous as you have been when life has knocked you on your feet, and I can only pray to have your optimism and faith in difficult times, and even all the way through to the end.

Rest in peace, we will miss you very much, and this blog is for you. 

 

Posted in bloggers, Medical, Politics, Reviews

Book Review: This Is Going To Hurt – Adam Kay (and also, A Love Letter to the NHS)

As someone who will officially become British in the next 6 months (after dropping a whopping £5000 on residency and naturalisation fees of course), I now feel like I have the authority to list some of the things from my adopted country that I’m most proud of.

1. Harry Potter

2. The very commendable ability to insult someone while still managing to sound polite

3. Scones, clotted cream and jam (yum!)

4. Intermediate rent for key workers

5. The Tube (believe me, I’ve travelled a lot and I’ve yet to find a more extensive or well-run transportation service)

6. That damned accent that makes everything sound like a Shakespearean play, even when someone is telling you to sod off

7. The NHS

This post, and this book review, is really an ode to number 7. I freakin’ love the NHS. Call me naive, but I think its a modern miracle. And I say this both from the perspective of working in it, and from having been a patient needing its services.

I arrived in London seven years ago, and within the first four months I managed to get myself bitten by my landlady’s dog to such an extent that it necessitated actual surgery.

Up to this point I had never been admitted to a hospital, never had a cannula put in and have never had to take anything more serious than the occasional antibiotic. Unless you count the cholesterol-lowering medications but hey, I blame genetics for that.

ANYWAY. I was totally unfamiliar with the country’s health system. Heck, I didn’t even know where or what my nearest hospital was. I had to take a bus to a certain hospital in North London and hoped someone there would know what the hell needed to be done with me and my gaping leg wound.

I arrived at the A and E and was seen within the hour (I was later to learn that this was an exception rather than the rule). I had a line put in for the first time in my life, was given antibiotics and was asked, quite stupidly in my opinion, if I cared about the appearance of the leg.

Being somewhat vain about my legs, I said of course with an admirably controlled level of incredulity that such a thing needed to even be asked. I was then informed that in that case I would need to head to another hospital which specialised in plastics and that I would most likely need surgery.

Off I go, taking the Victoria Line and changing at Green Park to take the Jubilee line, stopping somewhere in the general vicinity of Hampstead before taking the bus to get to where I needed to go. I got to the hospital and was scheduled for a day surgery procedure the next day.

On the day of the surgery I was seen by a very lovely and good-looking plastic registrar. I would have given him consent to do anything and everything but all he wanted was my ok to do a washout +/- skin graft procedure. I was wheeled into the anaesthetic room and asked to count backwards from 10. And that was the last thing I remembered before waking up in the recovery room an hour later.

After a couple of hours, I was discharged with take-home meds, dressing instructions and a smile. I then took my very stressed mother and aunt (who were supposed to be on holiday to visit me in London) to eat some peri-peri chicken at Nando’s.

I did all these without having to pay a single penny, and without having to worry about insurance, or my lack thereof.

I don’t know any other country where anxious patients, especially those new to the country like myself, would be able to expect this kind of service. Its a privilege that we take for granted everyday because we are so immersed in it, but that’s exactly what it is: a privilege.

Its a privilege to have the services that the NHS provides, and its a privilege to be a part of those services.

I haven’t read other reviews of Adam Kay’s book and I don’t give a fig what other people say. To me, what I got from it was a love for the NHS, despite the stress, the understaffing, the unbelievable pressure to meet somewhat unrealistic targets and the perpetual financial crises that meant you rely on the goodwill of the staff most of the time.

This Is Going to Hurt is in turns funny, poignant, frustrating, touching, and above all things, wonderfully and painfully accurate. I laughed at the bits I recognised (because I experience it day in and day out) and teared up over the things that, despite our best efforts, we health professionals can’t do anything about.

There were moments that seemed so absurd that non-medics would think its fiction. But believe me, the number of times I’ve gone to work and been in a situation where I’ve said after “You cannot make this shit up” cannot be counted on both hands.

I bitch and moan about work as much as the next person, but it only takes me 5 minutes to remember that without the NHS I will not have a career, nor would I have had the experiences, opportunities and relationships that I’m blessed with today.

The NHS is neither good or bad. It simply IS. At the end of the day, one learns to suck it up during the bad days because inevitably, there will be good days that make all the effort worth it.

Like when someone is walking pain free for the first time in their life because of a well-done knee replacement. Or when you help deliver a couple’s firstborn after they’ve experienced more than one miscarriage.

These moments are everything. And for the cynics who say that the NHS provides sub-par services and that I’m idealising the whole situation, believe me, I’M NOT.

I’ve had days where, just like Adam, I felt like throwing in the towel and maybe moving to the private sector where I will at least be paid more. But something keeps me staying and sticking with the NHS. I really truly believe we get it right more times than we get it wrong.

I, for one, am glad that someone finally made the effort to make the general public more aware of what really goes on within the four walls of the hospital.

Once, someone I knew who worked in a different country shared an article written by a nurse who used to work for the NHS, and who had quit because she had gotten traumatised over the deteriorating quality of services in her hospital.

This nurse highlighted a lot of things that are true in most hospitals in the country. Its a tale of a health system that’s on its knees and a government that continues to be ignorant about its plight.

We get daily updates about Brexit negotiations but no one thinks it important to point out that patients with serious health conditions are delayed in seeing a doctor because of an A and E that’s full to bursting? Ridiculous.

Anyway, this person sharing the article erroneously thought that the nurse didn’t have the right to complain because third-world countries have the same problems and the nurses get paid even less, the message being that NHS nurses should just suck it up and get on with it like the rest of the world do.

While I acknowledge that the UK still have it better than, say, the Philippines, the fact is that the point of the article was not about salary or any kind of compensation. The article made an effort to bring to light some of the very real issues the NHS faces, and to bring it the level of something as crude as money is to take away the power of the message it was trying to get across.

What can we do to help?

That’s a question Adam Kay got asked a lot during his book tour apparently. The answer is as varied as the medical field itself.

Maybe next time you see a junior doctor who’s spent more than 24 hours on shift answering bleep after bleep after bleep, or a nurse at the end of the operating list who cannot decide whether she’s more tired or hungry, you’ll find it in your heart to offer them a KitKat.

Maybe during the next election think long and hard about who you’re voting for and ask yourself whether they are the once in a lifetime politicians that will actually care about our health services. (Something to keep in mind now that I can actually vote).

Or if you are part of the noble majority of the population that work for the NHS, maybe be a bit kinder to your colleagues. We are all on this (sinking) boat together, and we’ll hold on to it until they tell us we need to jump ship and swim.

I am extremely proud to work for the NHS, and I am extremely overjoyed that books like these exist.

5 stars.