Memoir of a Girl

The stories of my life

Mabuhay Philippines! October 26, 2012

Filed under: Adventures — krisedja @ 11:12 am
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When I announced to my friends and family that I was moving to the Philippines, with the littles, they thought I was absolutely insane. You’re going where? You’re doing what? A family member called my mother and suggested that she was the only one that could talk some sense into me; she had to do something.

Mid-summer of 2009 I was getting ready to take a vacation with my friend from Ohio. We were heading up to Maine for a week with the kids. In the midst of that, my (now ex) husband and I were trying to figure out how I was going to finish my BSN. It was getting to the point in the program where I wasn’t really going to be able to work because of the clinical hours, and with two infants that needed day care, we weren’t going to be able to support the family on his salary.

His two brothers were already in the Philippines; one of them was studying nursing. “It’s too bad you couldn’t just go to the Philippines,” he said to me one night while we were lying in bed. “Where were you with that idea four years ago,” I asked him. It started from there. I confessed to him that I had actually toyed with the idea of sending the girls to stay with his mother, in West Africa, while I finished the last 18 months of school. We talked about it more and more and eventually all the talking evolved into a plan.

Why did I think this was such a great idea you ask? Well….

We estimated it would cost somewhere in the vicinity of $30,000 (tuition only) to finish the BSN here in the US; in the Philippines, we were looking at roughly $100o per semester, or $3000.

We made plans for my mother-in-law to move to the Philippines and take care of the girls while I was in school. This was good for a lot of reasons. If not for this, it was unknown if/when she would be able to meet the girls. Lucy was already two and a half, and The Baby was soon to be 18 months. Not only would they meet her, but living with her, they would actually get to know her. At that time were were paying roughly $800/month for day care, and now day care would not be an issue.

The littles and I would also be living with his brothers and sister, so we would all really get a chance to know each other.

The stories my brother-in-law had from clinical gave me the idea that the hands-on clinical experience was not something I would ever have here. In the Philippines (depending on your school and the hospital/doctor you have duty at) it is not unusual for a student nurse to deliver a baby. Here in the U.S. student nurses stand back and observe, and might be considered lucky if they assist with the immediate newborn care.

The combination of my brothers-in-law already being there, and the cost of living being so low in the Philippines, it would not be much ‘extra’ for the littles and I to stay there, expense wise,

I imagined that the cultural experience would be amazing. The Manchild at that time was twelve years old, and though he dragged his feet most of the way, and complained most of the 18 months that we lived there, I know that someday he will reflect back on those times and be grateful. Even though today I am still reminded of how challenging that time was in my life, I know that it changed me forever, and I believe it was for the better.

Not much of anything worked out the way we had expected it to, and there were daily challenges. Sometimes friends or family will ask me if it was really worth it (the financial aspect) and I am quick to say no, because there were so many extra expenses related to the ‘project’ that we hadn’t anticipated, but when I really think about it, I can’t say with 100% certainty that it wasn’t still less costly than it would have been here. I am still facing daily challenges in waiting for my documents so that I can take the NCLEX, but I have to say that the overall experience was priceless.

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I’m a Filipino citizen, who knew? October 16, 2012

Filed under: Trials and Tribulations — krisedja @ 11:05 am
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In October of 2009 I packed up everything I could fit into twelve suitcases and four backpacks and boarded a plane with the littles. We flew out of JFK; after short stops in Anchorage and Taipei, we landed in Manila about 20 hours later. It was so hot when we exited the terminal that I couldn’t take pictures; the camera was still cold from the plane and I couldn’t keep the lens from fogging. And so it was the beginning of the adventure.

I spent eighteen months in the Philippines with my three littles. I went there to finish my nursing degree but the details of why will wait for later.

It’s been eighteen months since I’ve been home, and I am still waiting for the certification process to come to an end so that I can take the NCLEX.

This past Friday I received an email from CGFNS (the agency that does the certification) with great news; they had received the last official document that I need from the Philippines. The excitement was overwhelming, and just as it was beginning to dissipate, I received the second email; the document was incomplete, my birth date was missing. After circles of telephone conversations I found out it wasn’t that simple.

You see, what I needed from the Philippines was a letter from the PRC (Professional Regulation Commission), stating that I was not eligible to sit for the nursing licensure exam in the Philippines because I am not a citizen. What CGFNS received was a latter stating that I, a citizen of the Philippines, holding a Bachelor of Science in Nursing, did not sit for the nursing licensure exam, though I was eligible.

It took over three months for the PRC to send that letter, and now I will wait again. Will I be able to complete this before my twelve month CGFNS application expiration date?

 

Yeah. It’s Like That. January 6, 2011

Filed under: Rants and Raves — krisedja @ 2:41 am
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Last night I just could not fall asleep no matter what. I was awake until 5 am, I’m sure, before I finally hit the pillow. I set my cellphone for an alarm, but was pretty convinced when I did that that it would be a useless gesture as I was likely to sleep right through it. I was right. I was determined that I would make it to class today, on time. I was about ten minutes late. And there was no class. Surprise surprise.

I have to gather some signatures for my application for graduation, so I started that process and then decided to go wait for the dean of nursing because I had some questions. On my research. On my tuition fees that continuously increase. On my duty assignment when the other seniors begin their intense board reviews.

I spoke to our level coordinator the other day about my duty assignment. I explained that I really had two options that were preferable to me. One being go to a smaller comunity hospital with CI ‘A’, and the second, staying in the medical ward at a regional hospital with CI ‘B’. She was supposed to talk to the others involved in this process of decision making and let me know today. She was not at school. Surprise surprise.

I was informed this morning that we had a meeting for all graduating seniors regarding officer elections for graduation and I should be there. As a rule, I never go to those meetings, and I don’t plan on sticking around to partake in the commencement ceremony, so I didn’t join in the festivities. While I was waiting in the nursing office, a classmate came in and advised me that I was being called there because I was nominated as an officer. You see there are ten positions to be filled, and exactly ten people that are eligible to fill said positions based on their GPA. I asked him to please let them know that I would not be joining as I will not be here for the commencement.

And what’s up with me being eligible based on my GPA? Someone else mentioned to me later in the day that I was a candidate for cum laude and all I could do was give a blank stare since my GPA is lingering only slightly above 3.1 due to the wonderful grading system that they have here, which seems to be 100% subjective.

At any rate, everyone seems to be devastated that I will not be staying for commencement, but I have to say, I still have no interest in joining. This is number three for me now and it has been a long hard road living away from my loved ones, in an unknown, unfamiliar world. I know that should make all the more reason to make a big deal and go through the traditional motions, but really, I am in some kind of survival coping mode, where the only thing I can think about is finishing my requirements and getting home, to the place that I know. Yeah. It’s like that.

 
 

Blank September 16, 2010

Filed under: Inside My Mind — krisedja @ 2:05 pm
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Blank. That’s the only word I can come up with to describe my week. I have just been lethargic and lazy and… well… blank. Zero motivation.

I described it to someone yesterday as if I almost feel like I am falling into a depression, but I don’t feel ‘depressed’. It’s just the feeling of not wanting to do anything.

I have had a lot of news from home recently that has really stressed me out. At the same time, last week’s duty experience left me feeling like a glorified vital signs taker, and in addition to that, a teacher basically told me that even if I deserved it, I would never get an ‘A’ at this school. Even.if.I.deserved.it.

My classmates get away with murder here compared to the expectations and practices back home, and until now, I have really been working hard to do the right thing, be a good student, set a good example.

But that is hard when you can see the work that you put into something would be an A- at the least, but probably an A back home and here they are telling you you got a B+/A-. They won’t give me my actual grade. They said something about it not being fair until everyone is finished. It’s not fair that I have to wait for people who aren’t ready when they are supposed to be, and don’t care.  We are coming up on only four weeks left in this semester, and out of 70+/- students, more than half still need to make their presentations.

I go to a Christian school where there is absolutely zero academic integrity. ZERO.

Some of the faculty have said that it’s because the school has a redemptive philosophy, that is why they are so accommodating, and always giving ‘special considerations.’

But I wonder, what is that really teaching the student population here?

To me it seems like a message that it’s OK if you are irresponsible, simply because you feel like it.

I haven’t been to duty or class all week this week, and right now iI feel like skipping out on the next three weeks because, you know, hey, it doesn’t matter, because nobody fails at this school. That’s the motto, it seems, among my classmates and others.

I have lost my drive to become better.

Not better than everyone else, but better than I was yesterday or the day before.

I don’t have a desire to be challenged anymore.

I have lost my fire.

Today I got out of bed and decided I must go over to the school and get some things done. I tried to do it the other day, but there was no power, and while classes hadn’t been canceled, there was nobody to be found in any of the administrative offices. Today was better. I did take care of many of the things that were on my list for school, and I have a reason to be awake and ready for the day early tomorrow morning. It’s hard to do anything when there is just no feeling of purpose. How can you be the change you want to see when you see there just will not be change?

I know this is just complete babble to you. I’m just trying to clear some mental clutter and end my day with some motivation in my belly for tomorrow. I’m trying to decide that tomorrow will be a good day. I want to have fire again. I’m trying to get back to that place. Since tomorrow is Friday, and it is only a half day of classes, I’m hoping that I will use that motivation I am trying to gather and keep it going, even if only simmering on a back burner. It think I should just take this weekend as connection time with my littles and be reminded of why I am here and what is really important to me. I am going to stop thinking and just do it.

 

Mr. Lizardo September 5, 2010

Filed under: Adventures,Inside My Mind,Mabuhay Philippines — krisedja @ 5:04 am
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This is going to be a rambling post. A distraction of sorts for myself as I am breaking from answering assignment questions about the right to life being fundamental and ‘alienable’. Yes, that is the word used in the question; ‘alienable’. I, however, took it upon myself to use the word ‘inalienable’ in my answer. I hope I don’t lose points.

I have a tendency to be easily startled. I am not fond of insects or any kind of breathing thing that has more than two legs, or no legs at all, and is not considered to be a four-legged-family-member (read dog or cat). So here I was a few minutes ago writing away, shaking the $10 plastic table that serves as our eating and meeting place in the house, when an opened package of cookies was jiggling in such a way that the little torn piece looked like some kind of living thing that might eat me. Even though it was smaller than my thumb. Can you see why my husband likes to jump out and scare me? I would be entertained too, I can’t lie.

I get up and take said package to the small bag serving as a garbage can for the evening, when all of a sudden something in the bag jumps and scares the life out of me for at least an hour   30 seconds. You see, internet, we have a plethora of ‘house lizards’ here in this part of the world that I am calling home these days. They are really just little geckos, like the famous Geico gecko, but they are still not my favorite friends. As a matter of fact, when I first relocated here, if there was a lizard anywhere in the house, you would likely find me standing on a chair screaming. Because surely, the lizard was going to come and eat me.

That was then.

Now, I am a lot less fearful of these little creatures, and I will even go so far as to say that I might be able to actually shoo one out of the house without any equipment in the coming days. Just not yet. But seriously, they are everywhere here, and I had to make the decision to be gecko-friendly, or have an all night long fear-fest. I chose to get friendly. But, I am still easily startled, and this little guy hiding in the bag scared me.

I can see I am going to have a long night ahead of me because I slept until about 2:00 this afternoon in anticipation for my noc duty (3rd shift) that is actually a PM duty (3p-11p) tomorrow. I love it when they post schedules the same day that they become effective.

 

No Comment August 20, 2010

Or in other words, more. culture. shock.

A few weeks ago I did my first rotation in a surgical ward at a government hospital. When I say ward, I mean what we typical Americans think of if someone said, “you know, like the hospitals in the 1950′s,” or at least, for those of us who never experienced it, what we see on TV.

There is one large room with let’s say, maybe 30 beds. Not the hospital beds we know with buttons and heads/feet that go up and down. No, more like dorm room beds, with hard vinyl mattresses, a hospital sheet that is as thin as paper and doesn’t stay on, and you have to bring a pillow from home. There might be a large electric fan on the other side of the room, but you should bring one from home because there is no such luxury as air conditioning in this room. There is one bathroom. I’m not sure, but maybe it has three toilets in it, and everyone in the ward, including the “watchers” share it.

There are actually rooms like this, one for the men, and one for the women. Have I said enough?

While I was on this rotation, I did a lot of preparing of medications. Lucky for me my patients, math has always been a strong subject for me; I’ve never had trouble doing math for medication dosages. I was preparing a simple medication; let’s say the patient needed 100 mg of this med, and it came in a 2 ml ampule labeled 50 mg/ml. I quickly determined that I need to give the patient 2 ml in order for him to get the correct dose of 100 mg.

My clinical instructor looked at me and couldn’t figure out how I could get that amount in my head, but just went with it.

The following week, the clinical instructor gave us a quiz. On the quiz were things like the 10 rights of giving medication, the color coding for the medication cards, and some IV flow rates/dosage problems.

We went over the answers after finishing and turning the quizzes in, but I wasn’t paying much attention because I didn’t remember what I wrote for all of the dosages. Until. Someone asked him to explain further, because they got a different answer than the instructor, and wanted to know how he came up with the dose.

To make a long story short, the clinical instructor indicated that the correct answer was really double the amount of the correct dosage. We went over and over and round and round, and finally he understood where the problem was. Later in the week I asked another instructor to complete the same problem, and he also answered with double the correct amount. He suggested that I talk to the dean, because the instructors learned this formula they were using for figuring meds, and as I had already concluded, this is a serious problem.

I followed his advice and spoke to the dean who immediately understood the problem, however… The reaction was not quite what I was expecting. I was expecting to hear something to the effect of  ‘we really need to address this with the person who is teaching medication dosages, and be sure that all of the clinical instructors in the hospital are aware of this’. What I heard was something more to the tune of how they use a standard formula here [in the Philippines]; the pharmacists, the doctors, and the nurses, and how this, that, and the other agency and person need to have this brought to their attention. There was also a comment about speaking to the doctors, who are ultimately responsible for this…(?). Say whaaaa…?

In another class, I received handouts about nursing as a profession, patient’s rights, and nurse’s rights. The bottom line is that nursing is a profession. Nurses are professionals. Nurses have the right to be respected and trusted, not only by patients, but also by colleagues. I think doctors count as colleagues. Here, they don’t agree.

Here, doctors are Gods, and if you question an order, you might “hurt their ego.” Yes. You understood that correctly. If you are a nurse in this country, you follow the doctors orders even if they are questionable; even if you know there are additional things that should be done for the patient (let’s say a daily weight/abdominal girth on an ascites patient), you do not take the initiative and do these things if the doctor forgot to write it in the orders. You do not ask the doctor if these things should be done. Apparently, here, the doctor’s ego is more important than quality care, or possibly life.

I’m having a hard time right now, as I have more and more hours of duty logged in. I’m being exposed to more and more eye openers every time I have a new rotation. I am trying to find some kind of balance, a way that I can somehow ask questions without getting into trouble while I am representing my school. I’m trying to ask questions more in an ‘I’m just wondering kind of way’, hoping that I am bringing something that needs to be addressed  to someone’s attention. Something that needs to be changed, desperately.

I’m trying to be the change I want to see.

How can I be that change and culturally sensitive at the same time?

 
 

Culture. Shock August 4, 2010

Filed under: Adventures,Mabuhay Philippines,Savoir faire — krisedja @ 12:13 am
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Where I am here, on the other side of the earth, things are different. I was expecting different when I got here, and I think I adjusted well, but there is still something weekly, if not daily, that just shocks me for at least a second. This last week it was more than one, and it was day after day after day.

First, a friend/neighbor was sick and had to be admitted to the hospital. Since there was nobody else volunteering to go, or even one that said yes when asked directly, I was the ‘watcher’ as they call them here. That means that I was at the hospital for a great amount of time during the admission, running here and there to get food and more supplies from home. This is in addition to having duty, and although the hospital I had duty at happened to be the same as friend was admitted to, said hospital is about 1-1.5 hours away from where I live, depending on how I am traveling.

Now, this was all good, and I am not complaining, but I just have to say that what bothered me has bothered me before. It is times like these that we see who people really are. Who is really a friend, and who really gots-your-back. Lots of people knew this friend was sick. Lots of people knew I slept not a wink in over 24 hours and have 3 littles I would love to see for at least a minute in the craziness that can be my life, and lots of people knew that I was traveling back and forth sometimes twice a day between duty and keeping this friend company. But do you think that anyone offered to trade places with me? Even for just the afternoon? Enough said, I just needed to vent and now I can move on.

The next thing that got me is the difference between what a private room and the ward patients experience. I have put many an hour into the medical ward at this hospital, and I’ll just say that it is not a place I would like to be in when needing any kind of medical care.

Ward equals up to six beds in one room with noises, lots of people in and out, and could be lights on for 24 hours… mostly student nurses attending to your needs, which typically equals a visit every two hours for vital signs depending on what the good doctor ordered. The CR (or bathroom as we like to call it in the west) is shared by everyone, might not have a shower, typically has not been cleaned since Moses was breathing, and has only a hole where there may have at one time been a door knob. Sheets and gowns are not typically changed during the entire hospital stay, and you may have an additional fee if they are.

Private room equals two sheets on the bed, two pillows, a TV, a fridge, and a private CR with a shower. They get better food for meals, better dishes, and they even get a snack. The sheets were changed while we were there without any request being made. There were three staff nurses for no more than 10 patients, while in the ward they could have three nurses with as many as 60 patients.

Big.difference.

On a general note, I have to say that I was shocked, but not really, when I noticed that the stretcher in the ER that my friend was placed on had a sheet that had not been changed since the last patient, or who knows how much longer. How do I know that you ask? There was a little blood stain that I noticed. My observant self also noticed some blood stains on the floor that had not been cleaned up.

That was Friday. Fast forward to Monday, 3 pm -11 pm shift duty. To make a long story short, I observed a male patient with feces draining from an abdominal wound that had dehisced, a colostomy bag made out of what appeared to be a tube normally used for suctioning and a rubber glove, and a decubitus ulcer. I haven’t been impressed with the care I have generally observed since I have been here, but this one just made my jaw drop.

Fast forward again to Tuesday 3 pm – 11 pm shift, different hospital. I got my patient assignment, which was nothing too terribly toxic. Went to take the vital signs, and my classmate is waving at me and speaking lip. I went out to the hall and asked her what she was trying to tell me, and the answer was, “you might want to put a mask on because there is a patient in there who has PTB.” Enough. said. I asked to be reassigned because I am not really sure if my reaction from the BCG vaccine was really positive, and The Baby has now had two doses that were definitely not reactive. My choice was a patient in the other ward room, but there was another PTB patient in there as well. Aren’t these patients supposed to be in isolation? Why weren’t they at least sharing a room while the other non PTB patients shared another room? I’ll never know the answer to that one, that’s just the way they roll here.

So. Really. All I wanted to do here was make a note so that I would never forget this past week, and be reminded of how little we really have to complain about living in such a rich, developed country.

By the way, another thing that has been nagging at me… Um… if you live in the U.S. and you are not a Native American Indian (or whatever the politically correct term that we are using these days is), you my dear are really an immigrant too… Maybe not directly, but somewhere along the line one of your family members traveled to the U.S. from another country. Stop bitching about immigrants. Please.