#5: Philippines 2018 (Helping Children Smile Medical Mission)

First of all – I have to make an apology for taking such a long time to write this blog! There’s been a whole lot of work, and a new tiny-pawed furry addition to the family since finally landing back in Australia last month, so my hands have been kept somewhat hostage…but more on that in my next blog!

Second of all – Philippines!

I’ve been really struggling to find the right word to describe my trip to the Philippines. In reply to most people, I use the word amazing with a gushing enthusiasm and a widen-eyed conviction of the word. But even then, I know this is still an understatement. Because it was just so much more than that.

For those that have been following Life, She Wrote, you will have known that this year’s addition to Bucket List #5 came with it’s own special purpose – but for those that are new to the story, you can read about it here.

Having looked forward to trip since finding out I would be apart of it back in September, I couldn’t believe it had come round so quickly. The end of February was nearing as we all met up at a hotel near the airport in preparation for the three flights ahead of us the next morning. I had met most people prior to trip, but there were a few I hadn’t and it was nice to sit down with everyone, putting faces to names over wine, cheese and Thai.

It was still dark when our early-morning alarms sounded at 4am and we eagerly threw on our team t-shirts (bright blue and not easily missed in a crowd), making our way to the airport. With thirty-something luggage bags in tow carrying various pieces of equipment and monitors, we hustled into the group check-in and busily set about labelling and weighing bags. If I thought the amount of bags we had then and there was extravagant, I had another thing coming for me when we finally did arrive in Vigan (but that’s getting ahead of myself).

The first leg of the trip was flying into Sydney, where we met up with the two surgeons and two anaesthetists, and one other member of the team. Choosing to go it alone at the Duty Free, I managed to get myself utterly lost between terminals an hour later – but I’ll blame that on the airlines changing the terminal departure and those big electronic boards displaying way too many flights to Manilla (was there really that many people departing to Manilla?). Nevertheless, we all boarded on time and I was quite happy not to be left sitting back at terminal 34 on my lonesome.

Touching down in Manilla was a relatively smooth process. We quickly caught a bus to the hotel, with our priorities set on food, sleep and a quick 7-Eleven pitstop. I don’t remember falling asleep that night, I just figured I must have switched out as soon as my head hit that pillow and woken up 6 hours later.

After a traditional buffet breakfast we checked out and made our way back to the Manilla airport to catch our next flight to Laoag. It was a quick flight, landing beside one of the smallest airports I’ve ever seen. The little brick building, covered in pink flowering vines, could be walked end-to-end in less than five minutes.  But with a large sign welcoming Helping Children Smile to the Philippines, we felt right at home.

We collected ourselves, and our many pieces of luggage, into a large coach bus which carted us on a two hour journey to Vigan – our final stop for the trip and the location of the hospital we would be performing surgery at. We stopped midway at a small village supplier for afternoon tea where we we lucky enough to try some local food. Any food at this point was a god-send after having only had a pork bun since breakfast!

We arrived at our hotel in Vigan late that afternoon and quickly changed before heading into town to see the hospital. Having never been on a mission before, I wasn’t really sure what to expect – but the hospital appeared in relatively good condition in comparison to pictures I’d seen from previous mission trips. We toured the theatre rooms, recovery and the shed-like room that would be our ward. Everyone seemed pretty happy with it’s prospects and so we went to check on the luggage. Well in addition to the bags we had brought over, there was at least a dozen more to fill three ward rooms full. How we could have ever needed this much, I’ll never quite know – but it was our way to ensuring we never had to place any cost upon the hospital by only using our own equipment and supplies.

It was still light out when we ventured back to the hotel, so we snuck in a quick swim in the pool and laughed hysterically at those game enough to take on the waterslide that ended at least a metre above the water. There were plenty bruises and red marks all round to tell the tale of that endevour.

 

The next six days were a bit of a blur. But after setting up our recovery room on Monday, we were straight to work with two surgeries that afternoon. Back home, recovery spans across almost a whole floor catering for well over twenty patients. In Vigan, the recovery room was no more than 4 metres by 4 metres, perhaps smaller. It had two small beds either side of the room, with a cupboard in the corner and a cabinet full of drugs at the tail-end. We commandeered two small tables and set them up between each bed, tetras-packing them with our equipment. And we made-do. Theatre was much the same, simplistic, but functional – and from all accounts, better than expected.

It was such a rush to see it all play out, and then to be a part of it. Carrying the children in their hands, the anaesthetic nurse would rush out of the OT into our small recovery placing the child onto one of the beds. In a swift rush, the pulse oximeter and oxygen mask would be connected and we would intently monitor their small airways until they woke.

Waking up from the anaesthetic in the Philippines was a little rougher than at home, and so as soon as our little ones opened their eyes, we would whisk them off the trolleys and into our arms to rock and soothe. Their were plenty of wrigglers and plenty of tears, but that all got a little better as soon as mum arrived to hold there hands. After a quick dose of pain relief and a drink of water, we let them return to the ward.

Upstairs in the ward, it became a noisy collection of people after the third day. Families consisting of parents, siblings, uncles and aunties would squeeze into the same bed offering support to the children, becoming the ultimate nursing team. We would leave instructions for the parents in regards to pain relief; how much and how often, each night and return each morning to do a quick round and see how they had progressed.

The children were beautiful. And again, this too feels to be a rather large understatement. I fell in love with them the moment I met them. Their tiny faces that lit up the moment you gave them a smile, or handed them something as little as a toy car, had my heart bursting at it’s seams. These children were just so grateful for the things that many children here take for granted, and I couldn’t help but be in awe of their strength despite their circumstances.

Before each surgery we would adorn them with a little material cape made by volunteers here in Australia, and help them believe in superheroes. We would place little coins called ‘lucky money’ in their hands when they went to sleep, and would make sure they woke up with the lucky money still there. It was these little things that made surgery feel a little less frightening, and helped them feel a little more brave.

 

The differences to the their lips and palates were remarkable, and being a part of a process that changed each of their lives in the most unbelievable way has undoubtedly changed my perspective on my own world immensely.

After six days, we had performed over thirty operations. The hospital had kindly provided food each day and made every sacrifice possible to ensure our operations went smoothly. We were truly spoilt to have been able to work in Vigan, and were treated to dinner each night in the small town by different members of the Vigan Rotary Club.

On our last few days, we had enough downtime to do some exploring throughout the Provence of Vigan, a budding city on the tourist hot-spot list. From Dancing Fountain Shows to historical 17th Century walkways, monumental buildings to heritage listed sites – we were privileged to see so much in such a short time frame. And as we drunk a San Miguel (apple flavoured, for me) Beer at sunset on the beach, I think each one of us counted ourselves as lucky to have been on this trip.

After a heart wrenching clinic morning, checking up on the kids after their surgeries and waving goodbye to the children that had changed our lives perhaps even more so than we had changed theirs, we packed our bags and set off on the long journey home.

There aren’t enough words to describe the fullness of my heart, or the awe I have in the strength of these little ones and their parents. I am so proud to have been able to work alongside some of the most amazing clinicians and to have had the opportunity to utilise my own nursing career in a corner of the world that really needed it.

This trip has taught me that there is so much kindness, courage and generosity still to be shared in this world, and that it sometimes comes most from those who have far less than you.

For more information about the Helping Children Smile Organisation, or to donate to the cause for next year’s mission, click here. I cannot express how much of a difference surgery for these children makes in simple tasks such as eating and speaking, nor the happiness it brings to a part of the world who truely appreciate it.

For more details about visiting Vigan and Manilla, where to go and what to do – head over to The Travel Log!

And to have a sneak peak at the trip, the children we operated on and the places we managed to visit after-hours all in colour motion, you can head to my YouTube Channel!

This has been the most rewarding bucket list ‘check’ yet, and I really do hope to go again next year!

#5: Travel to a new place every year – check!

d x

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Christmas Day: Scrubbed + Gloved

It’s been a big two weeks for me over Christmas this year, and almost feel as if they have sailed right by me in the blink of an eye. Does this only get worse the older I get? Please comfort my heart and say no! Any faster and we might find ourselves skipping straight to January entirely next year.

Having had the last two years off from work over my favourite holiday season, it was well and truely my turn to pull on the Christmas-owl scrubs and latex gloves, and hit the ground running on the surgical floor this year. I worked eight days straight over Christmas and felt it pinch at my heart a little at first. For a girl who adores everything covered in tinsel and sparkling fairy lights, it was hard to be inside the walls of the hospital and not with family.

But the reward of bursting in the ward’s doors with jingling reindeer ears on Christmas day morning and putting a smile on the patient’s faces there was more than I could ever have deserved for dreading in the first place. In fact, if I’m honest, I rather enjoyed spending Christmas day at work (and that’s not just the one too many rum balls clouding my memory!).

It was as if everyone brought in a bit of Christmas in with them, and shared it with those that thought they wouldn’t feel it this year. It was a day full of so many smiles, and so much warmth. It was as if we all came together to spread a special sort of cheer as far and wide across the ward as we could. I can’t really explain it any more than that, but it was like nothing else and there was this underlying understanding of the immense need for kindness.

I walked out of the hospital on Christmas afternoon with a heart so thankful for being able to bring a little happiness into the hearts of the patients I cared for. It made me realise how much I really love being a nurse. Despite the exploding stomas, the leaking drains, and the confused little old men who magically harness the strength of ten horses as they take a swing at you – I wouldn’t have chosen to do anything else.

And I’ve come to realise that you have to learn to love all these moments in your life. Even the ones spent in the hospital on Christmas day. Because it’s not about what you’re doing on days like this, or any normal day of the year for that matter – it’s about what you turn it into and what you take away from it.

I think this next year is going to be about enjoying the little things. About be present in every moment, and truely aware of the beauty that surrounds me. I already know its there, but in 2018, I want to feel it. I want to turn it into a happiness others can share in.

For me, I think this means finding peace of mind. All too often, I find myself worrying and getting stressed over the smallest of things. I let it shape how I feel, I let dictate how I act and the words that I construct. I don’t want to spend any more moments from here on feeling frustrated by the all the things I can’t change and the circumstances I once thought were less than ideal. I don’t want to feel clouded over in my mind, blind to good things. I want want my happy-heart moments to be present in every day I breathe.

Working this year over Christmas taught me a lot about what really matters. It’s not about things going to plan, or having the picture perfect day. It’s not about being task-orientated to point that the to-do lists takeover, or being organised at every turn. It’s about learning to laugh at the things that didn’t go to plan, and the days where it rained on your picnic. It’s about putting the to-do list on hold to lookup and smile at downpour instead. And I plan to bring this new-turn-old-proverb-epiphany into the New Year.

I hope everybody had such a wonderful Christmas and enjoyed it thoroughly however it was spent. Stay safe and loved as we turn our eyes to 2018, I have a feeling it’s going to be a big year!

d x

A nurse’s wish

How we treat each other is important.

We may look or speak differently, we may like different things. We may fill our glasses to the brim, or leave them permanently half-full, but the simple fact we all have in common, is that we are human.

We are all just trying to live life the best way we know how, and what separates us shouldn’t define how we treat each other.

But you see, as humans we have somehow lost this concept beneath the opinions and judgement, and we have fumbled with the objective of being kind. Undoubtedly, I think many of us have at some point in our lives been made to feel as if all the kindness in the world had already been used up. Or at least, I know I have.

As a nurse, feeling like people have forgotten how to be kind is sometimes all too common. We understand the heartache that is encased between the walls of our hospitals, we have seen life cease and felt broken at the loss of the ones we have nursed. You may not see the tears, but our own love ones do the moment we set foot inside the door at home and let it overpower us in a way you’ll never quite understand. We grasp the concept that while we see broken people and sickness every day, that you have not and that it is frightening to watch a love one, or be the one, to battle through it. We get it. It’s scary.

But just because that scares you, and just because it becomes difficult to express your emotions in times like these, please do not make us the enemy. We have only ever come to work to care for others. And I promise you that there is no one who woke up in the morning and thought, how could I make my patient’s feel terrible today?

We became nurses, doctors and members of the healthcare system because we wanted to help and because we cared. We didn’t do it because we thought it would be an easy job, because its not. And whether you’re a patient or a family member, it has never been okay to abuse us as if it is, and as if we haven’t given our all to make a difference in your life.

Last week, I looked after a lady who had underwent a rather large surgery on her bowel. These kind of surgeries are always tricky in their recovery and pose an increased risk for complications. Unfortunately, this lady experienced at least three of the complications we predicted, prolonging her stay with us in hospital.

After two weeks in hospital, the drugs we had been giving her had begun to take their toll. Along with not being able to eat proper food just yet, she had lost a considerable amount of weight becoming the shadow of the woman she was on admission.

But yet, she continued to smile. Through her bad days, she laughed deliberately as if to convince herself that sadness was unachievable. And I admired her for it.

Her eldest son came to visit her for the first time on day 10 of her recovery. He had not been there at the day of surgery, and had not visited his mother for months prior. Nevertheless, he had decided to visit and that had made day 10 more bearable for his mother than he would ever know. 

However, when he walked into the hospital ward, he brought with him anger. From the moment he announced his arrival at the nurse’s station, he made it very clear that there was nothing I could have ever done in his mother’s care that would have been good enough.

My smiles and polite welcomes were met with a hostility and doubt in my ability. He was aggressive, and quick to speak negatively in reply to my answers. He frowned so much it seemed that his face had altogether forgotten how to smile. There was seemingly no muscle memory for happiness.

He demanded rather than asking, and he expected people to part in the corridor for him. He was threatening and lumped his weight around as if to beat his chest in a gorilla-like claim to the jungle throne. He was the kind of person I struggled to warm to, but then he never made it easy.

I spent the next four days being berated by this man. Nothing I had done to help his mother was enough. He was rude, and arrogant towards me as if trying to pull me up on something I may have overlooked or not done. He became somewhat child-like in his exasperation, trying to make the entire hospital bend to his will and becoming furious when he felt we did not.

He didn’t like the way the tape was stuck down to his mother’s drains – it made him feel uncomfortable. He didn’t like that there wasn’t enough cutlery on the bedside table and thought there should have been a separate spoon for each container on the dinner tray. He didn’t like that there wasn’t a supplies caddy in each patient’s room and requested that 55 pads be brought to his mother’s room immediately ‘just in case’. The list was relentless.

His final complaint came on day four. He had not liked seeing his mother in a hospital gown stating that it had made him feel uncomfortable for her to not look like his mother. As it was explained, there were prominent medical reasons as to why she could no longer be dressed in her own night clothes that pertained to the protection of the central lines now used to deliver life-prolonging medication. For most people, this would suffice as an explanation. But for this man, it became the pump his anger fuelled on.

In reply to my explanation, his volatile nature exploded. In the hallway, he aggressively placed his face centimetres away from mine whilst repeatedly quoting his chosen sentence without intermission. It was an intimidating tactic that I was sure was meant to shake me to my boots, but I held strong, fuelled by my own internal anger that someone could be treating me this way when all I had done was try to care for his mother in the very best way I could.

He continued his childish tantrum for over an hour, aiming to pull me down with his cruel words. When finally asked to refrain from being rude his reply formed as a taunt a school child might have used, stating that while I thought he was rude, he thought I was unhelpful and a poor excuse for a nurse, concluding the argument with “So, checkmate!”.

I couldn’t help but shake my head in disbelief that a grown man could let anger control him so profoundly that this was the most appropriate retort he could find. And so I left it at that, no longer seeing the point in any further conversation with this man.

But that didn’t stop him from calling back to the ward once he had left to further harass me, telling the administration officer that he was my husband in the attempt to be put through directly to my dect phone. It was an onslaught of never-ending aggressive intimidation, as if he thought he could make me break to his will.

And all over a hospital gown? I was speechless at the stupidity of it all, and how it had escalated to needing security to scan incoming phone calls.

But while I sit here and struggle to comprehend how it became the biggest event of the day, I have enough clarity of thought to understand where this outburst stems from. Having never seen his mother so sick before, having not been there for the operation in the first place, and having so little medical knowledge, there is a certain fear that envelopes him. It’s like a vine slowing climbing through his entire body, outgrowing logical reasoning. He can’t think beyond the fear, and all it threatens to take from him. The fear leaves him with no control over the situation, and that becomes frightening for a man who quite obviously has little experience with being in such a state. So he resorts to anger, and I became the punching bag.

It’s not an excuse, but I have to believe that in a different circumstance he could practice human interaction with a little more humanity and kindness than he bestowed upon me. His words, though I know to be untrue, have still had an impact on me. They’ve left me to question how I could spend so much time caring for someone, only to have it thrown back in my face as not being good enough? How is there people out there in the world who think treating others this way to get what you want is okay? When did the world become a place where we hurt the ones who have only ever endeavoured to do good?

And sadly, this man isn’t the only one to have ever treated me in this way over the last three years I have been a nurse.

The bottom line is that we have lost an element of kindness I think we used to have. And the very fact that we are human means that we are going to let our emotions dictate our actions, so I will always understand why. But please, before you cave to the fear, think about the journey others are facing.  Try to harness a little kindness first, see it from someone else’s point of view before you open your mouth. How you treat others has more of an impact on them than you could ever really know.

I am a nurse. My whole life is centred on caring. I only have your best interests at heart. So please, be kind. This is my nurse’s wish.

d x


 

Change of plans

I’m a planner. I always have been. In fact when I look back, I had my entire life planned out by the age of thirteen, in more detail than was really ever necessary.

I suppose it had a little bit to do with ‘finding myself’ at the time. As any thirteen-year-old does, I was trying to establish my identity. Trying to figure out what made me, me and what on earth I was trying to accomplish in this lifetime.

I remember comprising a documents folder on the family computer entitled ‘My Life’, and filled it with pictures of the things I thought would make my adult life complete. It was a photo-list of goals for that miraculous day I no longer had to to school, and got to be a real person.

I look back now, and I have nothing of what I put in that little photo folder. But that’s mostly because the things I thought I wanted at thirteen have somewhat changed (although, I do think a front garden entirely covered in purple orchids, and mermaid blue hair would have made for an interesting life thats for sure).

The point was however, that no matter how crazy my thirteen year old whims were – I had made a life plan.

From there I became a little older and thankfully, my taste in lifestyle ambitions altered. By the time I was fifteen, I had developed a much more sensible plan that mostly focussed on work and study goals (how boring, right?).

It was about this age that I really started to hone in on the idea of being a nurse. It was something I always thought I would be good at from the time I used my friends t-shirt and her hair tie to make a sling for her broken arm in PE in grade six. The ambulance officers were so impressed at my make-shift first aid appliance that they gave me a whole jar of jellybeans and well, that sold me on the career itself.

I remember so clearly the feeling I got that day, how rewarding it had been to just help out in the rush of the moment. Everyone had made me feel like a hero. I knew I wasn’t, but there was nothing quite like it. The feeling of helping someone out when they needed it most, it was addictive.

So when I was asked in my year nine class three years later what it was that I wanted to do when I got older, I really never gave it a second thought. Nursing had always been at the forefront, and it never really budged.

I researched nursing for almost two weeks straight. I wanted to know everything about it and exactly what I needed to do to get there. I liked the idea of midwifery in particular after talking to my cousin who was one, and it set a plan into motion.

I mapped out everything on a giant poster that required to fold outwards three times to sufficiently store the information. I knew what classes I needed to take in high school the following year, I knew what score I would need in grade twelve to be excepted into university, and I knew exactly what course I would need to take once I got there. Like I said, I’m a planner.

Well, my little five year plan worked to a T. Life seemed to find harmony with my oversized poster and before I knew it, I had graduated as a registered nurse and it was time for phase two. You see, the way it worked at my university was that I needed to complete my Bachelor in Nursing, then work for a year as a RN before I could apply to study a Masters of Midwifery.

With the securing of a Grad Position as an RN, I was ecstatic to only be 12 months away from actually achieving everything I planned. Then life decided differently.

They closed the option to study a Masters in Midwifery at my university halfway through my Grad Year. Now it was only open for people that were already qualified as a midwife. The next closest university that offered the course was at least an hour and half away, and with my shiny new graduate position, I just couldn’t see the long distance travel thing working.

And I remember that moment, because it was the first time that something didn’t go to plan for me. I remember feeling like someone had taken the wind out from my sails, not really knowing what I should do next. I wasn’t used to having to start from scratch. After all, this was my life plan and I’d been following it for the past seven years. Now I needed a new one.

When I went back to the drawing board, there was a lot of options. To study to be a doctor was the first one I fell in love with. So that’s what I set out to do, as most of you will already know. But halfway through this year, I guess I’ve had a change of heart.

I’ve been watching the surgical interns so closely at my work. Trying to see myself as one of them, and I can. But I’m not sure that I would want to once I would find myself in their shoes. If you were to ever ask any one of them whether they loved what they do, they would say no. They are worked so hard and given so little in return.

If I was to become one of them, it’s not the seven long years of study on minimal income that bothers me. It would be studying seven long years to end up in a job that pays less than what I’m earning now, examinations every single weekend to keep up with the internship, being yelled at rudely by the consultant for not having the ability to be in three places at the one time and having hardly any time to myself just to breathe.

The more I thought about it, the more I realised I preferred a quality of life. Realistically, in the next five years, my plan incorporates a family (with any luck). And I just couldn’t have that being a doctor.

So again, my plan changed and I’ve really never felt so fickle in my life!

I decided once I had finished my second degree in nursing that I wanted to be a Nurse Practitioner. Almost like a doctor, but without having to say goodbye to every other aspect of my life in order to achieve it (I think I’m allowed to be a little selfish in that regard).

However in July, when I went to apply to study, I was met with some pretty stiff prerequisites and I must admit I was a little disheartened.

  1. Must be a registered nurse for a minimum of five years – well, I’ve barely scratched the surface of my third, so I have somewhat a way to go.
  2. Must have worked in an advanced role position for a minimum of two years – well, I’ve been acting as a CN, but as you know I missed that train with the permanent position just last month.
  3. Must work in a specialised sector of the healthcare system for a minimum of one year – well, generalised surgical nursing really can’t be classified as a “Specialised” sector, hence the title “general”.

So, here I am. Facing a brick wall head-on, and trying to figure my way over it. It’s been the first time that I’ve felt like even with so many options, I’m stuck in a wading pool waiting for the waves.

I’m in the making of a new plan, but this one is taking it’s time to map out. And there’s no  elaborate poster yet. For now, a nurse practitioner is still the direction I’m going in. But the next two years aren’t looking as on track as I would have really liked them to have been.

Perhaps I’m expecting too much of myself? I mean, most people don’t become nurse practitioners until they are well into their mid-life crisis, and here I am at 23 wanting to click my fingers and have it all fall into place.

Perhaps I was a bit naive in thinking it would happen just because that was my plan. Maybe not getting the CN position was the world’s way of letting me know I need to slow down. Let myself grow, and not force it?

I guess I am slowly learning that things don’t always go to plan, and that it’s okay when they don’t. Because I think that sometimes you have to make adjustments to the plan in order to reevaluate whether you’re following a poster plan, or following your heart.

I’m not used to things not following the plan, but I know I’ll get better at it. Because sometimes, that’s just how it’s going to be. And I’ll learn from that as I go.

All you can do, is just keep moving forward. Chip away at the brick wall, find your way through it. My life plan hasn’t played out exactly like I thought it might have, but thats all part and parcel of what it means to survive in this world.

Plan 2.0 is in the making, and it starts with a move to the brand new hospital next year. But at the end of the day, if life takes me elsewhere, I know I’ll be okay. I land on my feet.

d x

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