American Mobile Nursing

After being off work for 5 weeks from traveling overseas I decided to go with American Mobile Nursing (AMN) for my travel nurse assignment to California. It was quite possibly the worst mistake I made from beginning to end.

I applied to be a travel nurse back in March and within a day I had several voice messages on my phone. One of them was from American Mobile. I gave my references to two travel companies: AMN and Cross Country Trav Corp. Cross Country was able to get both of my references right away, but AMN couldn't reach them. I did not give permission to call my place of employment, and when they couldn't get my references they went behind my back and contacted the hospital I worked at and asked to speak to the charge nurse there that day. I did not give permission to contact the hospital and seriously did not want them to do it! While I was out on my first travel nurse assignment they were asking for which hospital and floor I was working on. I didn't give out that information because I did not want them calling that hospital. If after reading this you should decide to still go with AMN, do not give them phone numbers or info because they may go behind your back to get references.

I decided to go with Cross Country Trav Corp my first time around, and my contract was renewed 3 times with that hospital in Texas. They liked me a lot, but unfortunately their hospital did away with travel nurses at the end of September. It was perfect timing for me since I wanted to go to Haiti and was ready to go to another travel nurse location. The day I left the United States I talked to the AMN recruiter in the airport that day. She wanted to set up an interview for my overlay the day I returned to the US. I am so so glad I didn't do the interview now. That interview was long and required great thinking skills. I was exhausted from travel and wouldn't have been able to think that day.

I was awaiting my California nursing license to process and didn't want to wait until November 15th to start working, but I did because AMN offered me a bonus so I agreed. The day before heading out on the road to my travel nurse assignment in California I asked the office manager if there was anything else I needed to do while I had computer access. She said we need a chicken pox titre and it has to be done by Monday. It was a Thursday, and luckily I was in small town Iowa and could get into the doctors office that day, but the minimum time they needed to get the results back for the titre was 3 days. So I literally did this last minute. If I wouldn't have asked I would have never known. AMN did not keep me well informed or help me through the process of being ready to start on time.

I then had traveled 2300 miles from home when on the Monday the office manager sent me an email saying I wouldn't be able to start until Dec 6th, because my California RN license wasn't processed yet and the requirement was that I have it 1 week before starting my new assignment. I did not know this. I was sitting in my hotel on a Tuesday night before receiving this email. Email is not the route to find out this vital last minute information when you are traveling on the road. I was 2300 miles from home and my computer had gone out of my car in the mountains and my convertible top was broken and needed fixing. I hadn't worked for 7 weeks, how was I to afford living in a hotel for 3 weeks? I contacted my recruiter the next day about this, and she worked out something with the hospital. Together we put in 3 phone calls to the California Board of Nursing, none of which were returned. I drove an extra 12 hours and 1000 miles to Sacramento to get them to process my license only to find out that they had processed it 2 days before. My time, mileage on my car, and gas money was a waste!!!!

AMN had told me that I would know where I was living 2 weeks before the start of my assignment. I still didn't know a week and a half before starting, and they told me it was probably because the housing dept was behind due to so many people starting at the same time. They didn't do it because I didn't have a CA RN license yet. After calling my recruiter to tell her my license had went through in the morning, she said the housing department would contact me in a few hours. It was 5 in the afternoon and still hadn't heard from them, so I called and left my recruiter a message. I found out where I was going to live an hour before arriving to LA. The lack of communication is poor. When I got to my apartment there was no microwave or vacuum cleaner. My recruiter told me to go out and buy a little microwave, "They're real cheap" and to ask the apt office if I could borrow a vacuum cleaner. First of all travelers are supposed to have all of this set up for them. They are supposed to have the best of the best housing. Cross Country always accomodated me in anyway that I needed. I didn't buy a microwave, I have no room in my car for one more thing when traveling and the office didn't have a vacuum I could borrow. Incase you haven't read my whole entire blog let me recap what my apt with Cross Country was like: fitness center, swimming pool, BBQ grills, clubhouse, business center, racquetball, basketball, tennis, and sand volleyball courts. My own garage, fireplace, 750sq ft apt, gated community, on the major lake in Dallas, vacuum cleaner for my car, walkin closet, food pantry with washer/dryer optional hookup, on site laundry in my building. Now let me tell you about the dump AMN gave me: pool (too cold to use this time of year), hot tub, 500 sq ft apt, laundry room a block away, gated community not locked during business hours, no way of letting guests in when locked, and a car port. No fitness center!!!! AMN should've been paying for my fitness pass. The other AMN travelers and I discussed our housing benefits. They were giving one RN $1950/mo housing stipend. 2 of the other travelers were living together and they were giving them $2200/month between the 2 of them. This isn't right! They should have both received $1950 each. I'm not sure what my housing benefit was but my apartment was a $1100/month to rent! They are not consistent with their benefits. They will jip you if they can!

As far as getting the travel nurse position...... AMN bought the exclusive travel nurse rights to Kaiser system in California. They got these exclusive rights by quoting Kaiser travel nurse pay way below the other companies. I had no idea how much I was getting paid until I signed my contract. I had no idea that nurses in California usually make around $60/hr until moving here! I'm use to $30/hr in Chicago, so when I found out my travel nurse wages I found out how much we have been taken advantage of. AMN is only paying $17.77/hr versus $60. Travel nurses are supposed to be making the dough! AMN has their own staff interviewing you then lets you know which hospitals are willing to take you. I signed the contract and realized, wait a minute, I didn't get to ask the patient/nurse ratio, if my night shifts would be able to be kept together, etc. They are quick to slide you in the door without you realizing it.

Then on my first day of my job my recruiter called me at 8:45 in the morning to ask how things were going. At that time I asked her what time I was to report for work that night. She tells me, aren't you supposed to be at orientation at 9:30? She forgot to send me the email giving me all the details. Once again email communication versus telephone communication.

Then after starting my assignment I get another email telling me that one of my assignment requirements is to take this LA Fire Class. The AMN website is so confusing that it's easy to miss the requirements. So once again it was dishing out more money for this cheap company. $45 for a LA Fire Class and $45 for a chicken pox titre! No reimbursement!

The final straw came when I reported to work the night after my LA Fire Class only to find out that I was taken off the schedule. Kaiser cancelled my contract which will be another post. AMN had once again another miscommunication, which I didn't find out about for 2 days. Had I known on time it would've been unnecessary to take that LA Fire Class and waste my money! I talked to the nurse liason who informed me that I should "Go back to Texas" or "Take a staff position" until I "gained more experience in basic nursing duties." They don't stand behind their nurses despite the fact that I had another contract inwhich there were never complaints, and I had staff nurse position in one of the best hospitals in the United States. They are so worried about making their money and not losing their contracts that they will do anything at YOUR expense.

Dealing with the Illinois, Texas, and California nursing boards.

First let me tell you that Illinois does not have a nursing board. Due to this fact everything takes wayyy longer there. This summer with only 6 weeks left to obtain a permanent license from Texas I found out that my license had not been verified from Illinois yet. Normally the verification process takes 4-6 weeks from Illinois. I called them, and they told me that it took at least 10-14 days to even get the info entered into their computers after receiving the verification form in the mail. Texas told me that once they received my verification it would take another 10 business days. If it took the maximum time then this could have taken 10 weeks, naturally I panicked, but here's what I did.........

I sent my verification form to Illinois by certified mail requiring a signature when they received it, inwhich the signature was scanned and sent to my email address. This way I had proof it was received, and who had received it incase I needed a contact person. I also sent a prepaid stamped and certified envelope for them to send my verification to Texas, so that I would know when Texas had received the mail from Illinois. Certified mail can always be looked up by a tracking number on the USPS website. It costs a $1 extra if you want the signature emailed to you. This process worked so fast! Forget the 10-14 days of entering it into the computer that they had told me on the phone. I sent it out on Monday, Illinois received it on Wed, and mailed it on Friday for Texas to receive it the following Monday. Within 3 weeks my license was verified to Texas.

Now let me address California......

If you have a conviction on your record of any kind. I don't care if it's a $300 speeding ticket have documentation sent from the court system. California does have a clause on doing an extended background check if you have a traffic ticket over $300. In my case I got caught with possession of alcohol 4 months before my 21st birthday while attending Iowa, the Big Ten party school. Once again make sure all stuff is sent certified!!!! They will send a letter that says it will take 4 weeks to process after receiving all documentation, but I talked to a lady that said it would be right away. Well after 10 days had passed it still hadn't been done. I made 2 phone calls and left a message, then my recruiter called and left a message as well. After 3 phone calls in 2 days they processed my license. Here's the catch. I drove 9 extra hours to show my face to the California Board and see what the hold up was to find out they had processed it 2 days before. I don't know how well it'd work, but maybe if you ever leave a message say something like "I will be driving 350 miles tomorrow to visit you if I don't hear back from you today!" You might save yourself a trip. Sometimes it requires showing your face to get them to move!

I had planned on my California licensure process going quickly and smoothly. I had called in advance and asked if I needed to send documentation regarding my possession of alcohol that happened 11 years ago and no longer applies to me since it's now legal for me to possess alcohol. The lady on the phone told me, "No, a simple explanation should be enough!" I found out 5 weeks later that they would need additional court documentation. So send it all up front. California is notorious for losing your application, so I asked for tips so this wouldn't be a problem. The lady told me that people often send all of their stuff separate, so it gets lost. So my advice is to send your application, check, fingerprints, and any necessary documentation all together and certified. While at the post office send your transcript form to your college. After doing that go home and do the online nursys verification from another state. Get it all done upfront and you will be issued a permanent instead of a temporary license. If you wait until last minute to complete the process I can guarantee you'll be frazzled! There are certain requirements for a temp, the transcript is not! You have 6 months after receiving the temp to get a perm license.

Fingerprints are also another issue. My recruiter sent me 2 California fingerprint cards that they had got extra from the board. You might check with your recruiter to see if they have any, because California may take awhile to send you some. Many people have had their fingerprints sent back for smudges, cards bent, etc. You can either go to a Livescan in California to have this done, which processes in 72 hours and no worries of your fingerprint card being denied. Since I was in Texas that was not a convenient option so I went to the local sheriff's office to have it done. I took 2 cards with me and was explicit in saying these have to be perfect with no smudges. Afterwards I slid them into an envelope, and the sheriff told me to let them dry for an hour before mailing them out. Voila! No return on my fingerprints. I still had a spare set of fingerprints incase they decided to deny the original set. If that would have been the case I wouldn't have had to wait until the next available fingerprinting day at the sheriff's office. I could have been to the post office with my spare set in 5 minutes had that been the case.

I hope this will help someone else with less stress than I've had in these licensure processes!

Long Beach

So I have finally arrived in California and residing 2 miles from the ocean in Long Beach. I had 5 long days of driving to get here. My first day of driving was from Iowa to Denver. I spent 3 days there with my nurse friends I met in Haiti. We went up to St Mary's Glacier. I had no idea that there were actually glaciers on the mainland. We went to Idaho Springs, Red Rocks park and ampitheater as well.

My next drive was from Colorado, across Utah, to Page, Arizona on the Utah/AZ border. If you have a GPS you may it programmed to show you the fastest route. The faster route might not be faster. I programmed my GPS to take me the shorter route, which was 70 miles shorter. 70 miles on an already long drive is an hour less of driving, and by

the end of the day you'll be thankful for that hour. I believe GPSs estimate that your highway driving time will be 55mph, most of the back highways

I drove had speeds limits of 65-70mph. In the end I honestly don't think the faster route was any faster, but I did save 70 miles worth of gas and saw some awesome scenic scenery I wouldn't have otherwise seen. All of my videos are posted on Youtube, just search "iahawkette" and all my public videos should pop up.

The next day I drove to the Grand Canyon 140 miles further south. For reference it is $25 to drive through and they prefer debit/credit cards as form of payment. There are probably 12-15 scenic places you can get out of your car and look out into the canyon. I probably spent 2 hours at the most getting out of my car and driving around and through the canyon, but you could easily

spend 4-5 hours there. I was on the south brim of the canyon. The north brim is only 10 miles away from the south brim, but by car is over 250 miles away. The north brim is 1000 ft higher, but is closed October-May due to snow.

I drove next to the Hoover Dam on the Nevada/AZ border. It had construction done in 2005, and I arrived after dark. However the dam is lit up at night, and I would have been scared to drive over that bridge if I would have known what I was driving over in advance.

I stayed at Circus Circus in Vegas that night. I got the room for around $33/night, which included the resort fee. Of all the hotels I stayed in last week it was the cheapest and nicest room. The hotel not only has a casino and restaurants, but an amusement park, massages, on the roof pool, etc. Parking in Vegas is also free and easy to find. The one thing I have never done before is wait in a long line to check into my hotel room.

I will explain the licensure process for California and Illinois later, but as of Wed my California license still wasn't issued. My company had contacted me by email on Monday night and I didn't get the message until Tuesday night telling me that because my license hadn't processed I couldn't begin my new job until Dec 6th. I was like, "Nooooo, I've already driven 2000 miles, haven't worked in 7 weeks, and can't afford to stay in a hotel for 3 weeks!" So Thursday I spent driving an extra 9 hours to go to the Board of Nursing in Sacramento.

Once again I drove the back roads. It was scary for awhile, because it was just me and God. I might have drove for atleast an hour before I saw another car or person in sight. The little remote mountain towns had gas over $4/gallon. The plan was to drive through Yosemite National Park, but all the roads were closed due to snow. I did drive through a couple other national forests and parks. One forest looked like it had been in a forest fire.

A couple years ago I went skiing for the first time. Afterwards I thought it would be fun to take a ski trip to Lake Tahoe thinking it was in Utah. Much to my surprise I found myself driving by Lake Tahoe on the California/Nevada border. If you have never driven into California before be prepared to stop at checkpoints as you enter in the state. No fruits/vegetables, firewood, or things made of ash are allowed into the state. Be prepared to pop your trunk.

I spent a night in Sacramento and drove Friday to Long Beach where I checked into my new apartment.

Postcards from LA

My next travel position will be in Los Angeles. The key to getting a job as a travel nurse in California before having your license is going through the American Mobile company. 90% of travel positions are within in the Kaiser healthcare system, and American Mobile owns it. There are tons of forms, tests, and tons of online tests and competencies for me to do. If you get a job within the Kaiser system then you have to show 2 TB tests that are taken within 365 days of each other, so hang onto records of all former tests.

Final thoughts on trip to Haiti.......

What astonished me the most is the level of commitment of the Haitians to themselves. After coming upon the accident our Haitian doctor insisted on going to the hospital with one of the unconscious men. He said, "This is my country!" as if us Americans shouldn't be responsible for their people. The following day one of the translators who was dropped off before the accident thanked me for helping the Haitian people. I don't think you'd hear this from an American to an international. I didn't choose the country I was born in, nor did the Haitians. I don't understand why God chose for me to be born in the wealthiest country in the world, but regardless we are all part of the human race. God says that whether Jew or Gentile, slave or free we will all be judged the same. I would never say "They aren't an American! They aren't an Iowan! They are a Cyclone so I won't help them!" I don't perceive it as a choice. There is only one choice in the matter, even when you don't like that choice! I was put in a position inwhich I didn't want to be present. I could have stayed in the car and did nothing, but God is that conscience that lies inside of me that would never allow me to do such a thing!

Leaving on the next jet plane out.....

I'm now in the Port Au Prince airport waiting for a 10:50 am flight out to Miami. Last night we took the helicopter from the JAX beach base to the Global Outreach base flying 800ft in the air over the terrain and ocean. The GO base is a half hour from the airport, JAX beach is 2 hours. My stomach could appreciate not having a 2.5 hour ride in the car over bump after bump; however, after this trip I have decided nondrowsy Dramamine has to be a staple item in my travels.

Yesterday was our last day at the clinic. It was quite an eventful day. An I&D was done to a man's infected hand. A toddler gashed it's head open, so right there out in the open the doctor sewed her up. If you have FB all of my pictures will be there. The Haitians bought us food for lunch, which was quite the change since our lunch everyday has only been PB&J sandwiches. Of course with me being gluten free I usually took some yogurt from the kitchen in the mornings, and ate it along with my almonds and Bumble Bee bars. While in Africa they cooked with peanut sauce a lot. I can't stomach or smell it in any foods. The Haitians have something they cook with too! I taste the flavor in everything, their hamburger, pasta, rice, etc. I didn't mind it until I got car sick on some of it.

When I was 11 years old, one of our horses rared up, and flipped over on my little 90lb body. I was taken to the ER, and I walked away with a seriously bruised groin from the saddle horn. The next day my dad made me get back on a horse again, so that I wouldn't be scared of riding horses. I felt the same way again on Thursday. Wednesday we didn't drive by the accident site, but on Thursday and Friday we did. Wednesday we didn't go too far down the highway from base. We actually drove on a dirt path that day, but Thursday we took a highway trip again. I was actually fearing the ride after that accident on Tuesday. When we drove past the accident site all of the flour bags and spaghetti bundles were picked up. The only thing left is one of the trucks and flour dust on the side of the road. We were told that once they pulled the flour truck back up on its wheels that another dead body was found. The driver in the other truck who they guys worked hard to get out also died. I got a picture of that truck yesterday. I also videotaped our drive home yesterday. Just when I was trying to capture how unsafe it is to drive here is when all of the sudden everyone is driving slowly and safely. I'm not sure you will really be able to see in the video what my eyes saw! I forgot to mention that sometimes you will come around a corner and right there will be a car stopped right there in the lane, stalled and broke down. No one helps to get them to the shoulder of the road.

On this trip I felt as if I was able to speak the French, but not understand when it was spoken to me. The last time overseas I could understand, but they couldn't understand me. I didn't feel like it was that stressful of a trip. We had all the luxuries of home........air conditioning, beds, American food, etc. The only thing I'm missing is my hot shower, and soaking my fingernails until all of the dirt is gone. Heather and Brittany, from Denver are on a different flight to Miami, but we all have a layover there until 5:00ish. So we may have time to meet up for lunch! I still don't have a new job offer for my next assignment. My recruiter has me in for Houston, Dallas, and Tucson. So I will fly back to Dallas today, get my car, and drive back to the Midwest tomorrow.

Haiti Accident! 4 casualties, Several More Injured!

How ironic that my blog last night was on traffic safety in Haiti, because our medical team stumbled upon our first accident today. We had finished our clinic today and was driving back to the base, a little later than usual, when our group was the first on the scene. We had 3 doctors in our Land Rover, 2 nurses (me and an ER nurse), the driver, the pastor, and a translator!

My first thoughts were I'm staying in the car while they check out the scene. I may be a nurse, but I don't do injuries with people fingle fangled every which way. I'm a tele nurse! I deal with heart attacks, strokes, and surgical wounds. People's hearts stop beating other ways that aren't caused by trauma! So there were 2 trucks on an incline, on a narrow road half covered by rocks from the mountain on the side of the road. One was a spaghetti truck, one was a flour truck! One truck was tipped on it's side, the other was standing straight up on its front nose! The first thing I saw was someone standing up covered head to toe with flour. The only thing I could see was their eyes! I'm thinking what is going on here! People are standing up on the side of the road covered in flour!

There was our team and then a few bystanders who were trying to dig the people out from beneath the 50-75lb flour bags, and 20-25lb bundles of spaghetti packages. There were 3 men in the spaghetti truck pinned in their seats, dangling over the metal frame at the waste, with another piece of metal over the top of them holding them in. They had blood all over their heads and coming from their mouths. There were fractures all over the place, and I saw the tibia/fibula broken completely through the skin at the ankle with the foot hanging on by skin. There was a couple people pinned under the flour truck! All too much for me. I was crying and freaking out, because I didn't know what to do! I knew I wasn't going to be helping the men trapped! I knew I couldn't deal with open fracture wounds, I'd faint! So I ran and got the dressing kits, IV kits, and water from our Land Rover. Then I put my 6 weeks of working out almost everyday to good use! I lifted package after package of a spaghetti mountain to look for people underneath. It was a 95 degree and exceedingly humid here in Haiti today. We already had sweat rolling off of us at the clinic. I just so happened to wear a t-shirt to clinic today, instead of a hot scrub top. My t-shirt was completely soaked, I was covered in flour, and tossing spaghetti bundles after being absolutely exhausted already from going to bed a tad later last night. I was shaking from the adrenaline rush, and continued to shake for awhile after we left. 1 Corinthians 10:13 I believe is "The Lord will never give you more than you are able to bear. For when you are tempted, he will provide a way out, so that you can rise up!"(Sorry NLW ladies that I didn't perfectly recite that one, since it was one of our memory verses!) Decapitation would have been more than what I could have handled. I was not made to be a paramedic nor an ER nurse. I have the vivid images in my head of the traumatic stuff. I've never seen bones through skin before, but I have seen blood being vomited. At the end of it all I saw 2 dead bodies, but what the Lord spared my eyes was seeing the decapitated people. That would have been more than I could have handled, and I know I would not be sleeping tonight if I saw that!

Samaritan's Purse has a safety activation system. Our doctor called the base to the head security officer, who then notified other NGOs, the ambulance, etc of the accident. She said that in past accidents no ambulances had come nor were the civilians willing to help take people to the hospital. Today civilians were driving by in their flatbed trucks hauling patients with fractures to the hospital for us! Ambulances came! There were other medical personnel arriving from other NGOs! The UN arrived! It was truly the Lord that so many people showed up to help! Several men were pulling and pulling on the metal that had the 3 men trapped in their truck, but were gaining no leverage when our driver came up with the idea of our jack. The jack is what got those men out of that truck. They were all conscious when we arrived to the scene, but do to losing blood and the heat they were unconscious when being hauled away. An IV was started on one and he was hauled away to the hospital, and arrived at the hospital still alive! One of the doctors said one had a trapped foot, and he was able to free the foot by pushing the seat back.

There were 100s of Haitians at the scene wailing and crying. They were standing in the way staring! Standing on the flour where people could have been under! We were told when arriving at the base that an accident would probably be an occurrence during our trip and that it was up to our own discretion if we stop. Riots can break out, even against those trying to help! I got worried for a moment when a few of the Haitians were fighting! Anything can trigger something larger! They were pulling back the sheets to take pictures of the deceased. It's crazy chaos!

As if this accident wasn't unbelievable enough as we drove home we drove by our usual gas station. The long gas truck that came in was leaking out the gas. The Haitians had their buckets and were collecting free gas. All the way down the road we saw person after person with bucket on their head carrying the gasoline home! As we continued to drive we saw people sitting on the edge of the highway that didn't have a shoulder in the pitch black dark! Safety around here is a concept that so many have no idea about. It's crazzzyyyyy!

http://www.youtube.com/watch?v=xYPQmDsctb0 The Accident Video

More Video Links

Scene from top of a mountain. http://www.youtube.com/watch?v=Jqx8MRC-XrM

Trip down the winding road through the mountains. http://www.youtube.com/watch?v=wU1aMXoasKI

Tour of the base we are at on Jax beach. The old resort right on the beach, very beautiful! http://www.youtube.com/watch?v=i_xR9X-erj4

Babies and mamas!

Today we went to a clinic at a church inwhich there was an obscene amount of babies, mothers, and pregnant women. We see lots of children in the clinics, but never so many babies and pregnant women in one day with NO men. Most of them were in for dehydration, fever, and antibiotics, but nothing too exciting noted!

My sister and I were talking about the highway system here. So I've mentioned before that there are no road rules. I should tape how ludicrous it is at times! There is the yellow line that goes down the middle of the highway, but the Haitians still drive in the middle of the road over the line. In the States we use our horns to alert another driver. I know I began using my horn a million times in Texas this summer to prevent my new little ride from getting all smashed up! I don't use it on a daily basis though! Here it's like an essential for a car, being used a million times on a daily basis. Whenever we go around a curve the horn is on to warn any oncoming cars that we are coming around the corner and probably over the middle line. You know how you would walk through a crowd of people? Cars become the same way here, passing each other on the right and left side. In the US when there is traffic jams cars are usually in lines on the road or interstate. Here they are going every which way, it's crazy! You know how if we are take a left turn and have to cross the lane in oncoming traffic we turn on our blinker and wait for any oncoming cars, and all cars behind us stop and wait on us, right? Here they get off on the shoulder of the road, let all cars that are behind pass, and once it's clear from both directions make the turn. I ride in the front everyday due to my car sickness, and I am the front seat driver to our drivers. I have squealed a few times already! I have told them that I have been driving every since my feet could reach the tractor pedals. I think my dad had me drive the tractor for the first time when I was 8. My #1 rule is No passing on hills or curves. I'm not sure what makes them think they can possibly complete this safely. It's a game of hit and miss. While I'm in the car there is going to be no chancing a hit! My #2 rule, NO grinding the gears! I'm teaching proper technique to driving a stick shift. I guess a couple sticks have already been replaced due to grinding of gears. I learned to drive on a stick, and I also paid for my clutch to be replaced after the grinding of the gears! Yesterday while I was in the car, the driver killed the stick shift 3 times before getting the car to go. He said he had just started driving again recently! So reassuring! My #3 rule, Make sure the car is in 4 wheel drive before crossing the river or going through holes on the muddy roads. One driver lied to me and told me the car was in 4 wheel drive! I looked at the shift in the Land Rover and it said 2W, but he said it was 4W. The car was in 2 wheel drive. I could feel the front wheels grabbing, while the back were spinning out! Leave it to the farmer's daughters to keep the rules of the road! I said I have my rainboots, and if we get stuck they are for you to push us out while I drive. lol!

I'm keeping my eye on that storm on the National Hurricane Center's website. It's now entering the island of Hispanola traveling at 10mph. Hispanola is 360 miles long; therefore, we are about 360 miles away from the storm. It'll take 36 hours to get here. The whole entire time I've been here I haven't seen a tide in the bay at JAX beach. Tonight there is a tide, and a storm coming in!

Petite Guave Clinic http://www.youtube.com/watch?v=Wup_Qfg9Ohk

Coconuts Coconuts Coconuts

Today we took this large motor boat from Petit Guave Bay to a remote beach an hour away along the southern Haiti coast line only accessible by boat. There were many Haitians living there on the island and I had one climb up a large coconut tree to get coconuts for us to drink the juice from. $3 for 4 coconuts! Watch my video it's truly amazing how they get up and down the trees to get the coconuts.

http://www.youtube.com/watch?v=EIXLNkvBfgI

Cracking open the coconut!http://www.youtube.com/watch?v=BeLSwThV4rI

I saw a couple little Haitian boys sitting in the dark, so I smiled at them. When someone with our group started playing music I started wiggling my shoulders and neck around, and the little boys copied. Then I video taped them, then I showed them the video, and that's when it all started.......all the kids gravitated towards me. Before I knew it I was taking picture after picture with them. Whenever I'd get my camera out the girls would jump up and pose. After I moved back to my spot on the beach, they gradually moved their little clan to sit by me. Then I took a walk down the beach with them, as they all jumped

up to touch my hair and my skin. They are so curious about the white man! One thing I've noticed about the Haitians is that they all have pearly white teeth and long eyelashes. Many Africans have dental fluorosis, something I don't see here.

I swam in the Carribean and laid out on the white sandy beach all day. Sunscreen was a need indeed! Everyone came back fried lobsters! The ocean was so crystal blue especially next to the beach where there was no coral.

In other news I'm keeping my eye on the storm system in the Carribean right now that is coming towards Hispanola, the island of which the Dominican Republic and Haiti is on. It's moving at a slow 12mph, and isn't expected to develop into a hurricane in the next 48 hours, nor has it even developed into a tropical depression yet. It has yet to hit Puerto Rico, which is east of Hispanola.

One other notice of Haiti is their love for Celine Dion. Songs that she sang 15 years ago are still being played here. I've heard the Titanic Song a couple of times blasting in shops. One of the guy translators started singing that song to me one day in the car. I turned the radio on one day and she was singing a song in French. The girl sleeping in my tent says that one of her Haitian coworkers here has "I'm Your Lady" as his ringtone. The obcession is funny!

Jacmel Beach

We have the weekend off. I guess they usually work half days on Saturdays, except there was no doctor this week. So we took an hour trip on a windy twisty road up the mountain to a resort town called Jacmel. I can't exclaim enough how beautiful Haiti is. Overlooking the edge of the mountain and seeing valley after valley, towns below, and mountains beyond mountains often times with the Alantic ocean in the backdrop.

Since I've been here I've seen the UN a few times. UN officials from Sri Lanka to patrol the crossing where we drive through the river, because apparently the bridge above isn't safe anymore. Yesterday Korea was patrolling the area of the mountain inwhich there had been a mudslide. Haiti is the only country in the world inwhich the UN is present that there is no civil war, because it is a collapsed country. Like I mentioned before everything here is corrupt. One person here had to pay $100 to get the birthday present someone sent from the US. They also charged SP $2000 for a few boxes of papers of copies made at the main headquarters in Boone, North Carolina. There is no postal service here, but there is FedEx. Someone at the base had mentioned that they had bribed with food or in one particular case the officials wanted a couple pregnancy tests for their wives to get stuff through customs cheaper.

Jacmel was a one stoplight town. We haven't seen any other stoplights while being here. Apparently the stoplight doesn't apply to motorcycles. Finally we found the beach at the nice hotel. It was the first time since being here that I saw any buildings or houses that looked closer to civilization. Beautiful courtyards with fruit trees and a hammock, and an outdoor restaurant and bar. Down the staircase led to the most beautiful beach on a cove of crystal blue Alantic beach water. Breath taking! Up the staircase, at the top of the cliff sits the restaurant that overlooks the sea. We saw Americans and the French there at the beach and restaurant. We ate our lunch and then bought a few souvenirs at the vendor on the beach.

Unfortunately on the way down the mountain my stomach did not fare! About 10 minutes away from home and upchuck #2 on this trip. Sooo not pleasant for me! After all the motion sickness I was totally wiped out. We got home, ate supper, I showered, checked my email and went to bed at 8:30pm, but then like every other night I wake up in the middle of the night. I'm now awake at 1:30am and typing.

Tomorrow we are supposed to take a boating trip to an island and perhaps go to church if anyone is going to take us! Off the coast of JAX beach where we are staying is another inhabited island that we can see from the beach. It's called Ile De La Gonave in the Gulf of Gonave. It's the largest satellite island of Haiti.

Back up and running!

Well folks I was out of commission for a day. My computer froze up, and was nonfunctioning. Thank God there is someone here who was able to run diagnostics and software on my computer to fix it. It literally was going to become a nightmare if it didn't work, because I rely on my computer for so many things......checking the weather, paying bills, email to get important info from home, uploading pictures from my camera to free up its space, and most of all I need it to Skype an interview to line up a job when I return to the states.

A couple more clinic days and we've seen a couple hundred more people. Thursday I had a nagging headache, but began to learn how to do the pharmaceutical part of our trip. In that department we hand out the meds the doctors prescribe, give shots, do dressing changes, give babies their first dose of elixirs, give BP meds out for high BPs and recheck the pressure after the pill has taken effect, etc. Lots of wounds seen with bugs crawling over them. It sounded more disgusting when our physician's assistant used the M word, "Maggots!" But yes wounds with maggots. Many of them from children playing soccer. One boy had an infected foot. You could see it all swollen up around the wound in his foot, where infected lied. We also do malaria tests. In a way those tests are like pregnancy tests. We poke the finger, get a drop of blood that goes on the pregnancy test like gadget, add the developer, and within 10 minutes two stripes mean malaria. Fortunately for people it's like getting the flue in these parts of the world where malaria is more prevalent. For Americans it can be deadly. I was told by the African doctor here that many people don't have sickle cell anemia, but carry the gene on their DNA. Sickle cell anemia is often found in African Americans in the States, because it's a blood cell that is able to mutate itself in a way that malaria doesn't recognize it. It is an adaptive way coming from Africa to prevent from getting malaria or at least not as sick!

As far as language, I have been able to fluently give medication instructions in French. I had 4 years of French in high school. Most of the Haitians we see speak Creole, but it is broken French. It was developed to have a separate language from the French captors who brought them to Haiti from Africa for slavery. I laugh a bit, because it's like they are trying to speak in code, but there's really no code to it at all. The majority of the time the only thing that changes between French and Creole is the spelling of the words. For example in French it's "attention," in creole "atansyon," but pronounced the same way. In French, "soir," in creole "swar," but pronounced the same way. So most of the time when I speak French with them they understand.

Today is now the weekend! I won't get to watch the Iowa/Penn St game, but we do take the weekend off. The doctors on Saturdays take the helicopter and go up into the mountains where it would take a couple days by horse to get to. For the rest of us, we have to beg and plead for someone to take us off the base to go out to eat, the beach, the market, etc. On Sundays there are groups that go out into the community to a church service. I'm looking forward to worship in the Haitian churches. That's the news for now!

Video on Vodoo Being Practice in Haiti

http://www.youtube.com/watch?v=oQpzMjtMeCA&feature=related

The Harvest is Plentiful but the Workers are Few

Today our day was delayed a little by the rain. We have 2 medical teams at our base. Today we all went out together, because it was too muddy to get up into the mountains to see the patients at one clinic. Then we came home early because it turned super sticky humid hot.

Didn't see anything too exciting, but there was the 2 month baby brought in that I saw with a 102.8 temp swaddled in a blanket, with rapid respirations and heartrate. The baby was dehydrated and needed to go to the hospital, and was failing to thrive for his age.
http://www.youtube.com/watch?v=MYVOuYZyq2k


I can't say too much more about today, but what I can talk about is the needs. If you have any ideas or would like to help with a solution let me know. The most common drugs we handout are vitamins and Tylenol. There is always a huge need for that. The oral thermometers we have don't work the best, and it would be a good idea to get a bunch of temporal thermometers. But the thing that came to my mind first was when we were talking about a man that probably had prostrate cancer. There was no way to confirm the cancer without proper tests being run like the ones we do in the States. The man had a distended abdomen and was probably full of urine due to the inability to void. I know how uncomfortable it is when you need to void, but can't. I have Shy Bladder Syndrome, and in certain situations can't go no matter how much I need to go. There is also a need for an ultrasound machine. An ultrasound machine has the ability to see the fetus in utero and the measure the amount of the urine in the bladder, so if the bladder was too full the patient could be cathed. On that note, for extra full bladders would require straight cath kits, which the clinic doesn't have. I don't know how feesible it would be to have foley catheter kits in this type of living conditions. The challenge that comes with all of this is actually performing the catherization, there is no privacy in the clinics. All the patients are examined out in the open. If you have any ideas on solutions or how to obtain equipment please let me know. I'm going to do research, and see if I can't contact some of these companies about getting stuff at a discounted rate.

Links

http://www.youtube.com/watch?v=QtQyCWBm55I Tour of Haitian Nurse's Home

http://www.youtube.com/watch?v=aIB9j-9bSqo The Clinic and Wengi dancing

Baylor Garland

I have been meaning to give my last thoughts on my first nursing assignment.

Baylor Garland is not like the big 700+ bed hospitals I am used to working in, but they do a lot to cater to the happiness of their employees. Their employees get to take vacation time for a month at a time. Each month they provide a mid month meal on Thursdays and Saturdays for their employees, which I found to be nice to not have to make supper for a night. When I locked myself out of my car in the parking lot, Baylor picked up the tab.

The nurse manager that hired me retired, but was the sweetest boss I had ever known. I didn't think anyone would come close to filling her shoes. My experience is that most bosses aren't that nice. Then when the 2nd one came along she was just as pleasant. She was very nice to me upon my exit!!!!

Overall I found most of the patients to be very pleasant! Maybe its the southern hospitality, but Texas was very nice this summer!

All the Colors of the Rainbow

Our days begin with breakfast at 6:30am. The classic staple to most of our meals has been avocados and some type of mango juice. I have not seen yet but am told the avocados are gigantic. After breakfast we have 15 minutes of devotion before we hit the road for the day. The Haitian ladies sing one of their songs in Creole, here's the link: http://www.youtube.com/watch?v=G5B13JNy17c There are several different types of teams staying here at JAX beach, construction, rubble, water sanitation, medical teams, etc. As you've probably already seen on my Facebook pictures I also encountered my first tarantula today.

Today I got a few pictures of some of the vehicles I have encountered here there are all the colors of the rainbow, and usually say something about Jesus.

As I read Isaiah 46 today it was very fitting for the Vodoo conversation I had last night. The commentary I read was saying how God made us and works for our good, not to harm us. A message those imeshed in Vodoo don't understand. Jesus values and loves us all no matter our sin and circumstances.

Another day at the clinic and more interesting things. There was a 3 year old boy, Wengi, that hung around the clinic all day. When we arrived he was there, no mother in site. I saw no mother all day long. I know that there is no way we would have been able to leave my nephew at home alone when he was 3 years old, but Wenji although I'm sure a trouble maker seemed very independent and mature for his age. He was also my parrakeet and I taught him a line of English. After awhile he was mimmicking everything I said. http://www.youtube.com/watch?v=hfUXwUQNwBw We also had a set of baby twins with malaria and 2 other children. We have malaria tests for that are like pregnancy tests. Something American nurses usually don't see!

After clinic today we went to our Haitian nurse's, Sherline, and Mark Elie our Haitian translator's home. Mark Elie's mother died in the earthquake when the wall of their house fell on her. We saw the spot she was killed. He now lives in a large tent with a king sized bed and a twin bed with 8 people. Cooking is all done outside on a grill. Sherline had an actual structure for her one bedroom house, but she sleeps on a twin mattress on the floor of a tent. It's sad to see their living conditions and know they will live like this the rest of their lives, especially when relationships are built with these people. Then I stop to think, "They don't know what they are missing out on. They don't know anything else. The only reason we get sad is because we know what they are missing out on!" As I learned in Africa that they are more rich in family and relationships. Americans are more rich with materialistic possessions, and often times live much lonelier lives. Which really is the more sad way of life? They were so proud to show us their homes and where they lived. They had no shame, why should we feel shame?

Today a few of the Haitian's were wearing American clothing. I asked how they got it. One told me that their American families send them the clothes. The other had Puma shoes like mine, and said that he bought them in the market in Haiti. Who knew they'd sell such items in such a poor country.

At my base there are something like 301 Haitian workers. Samaritan's Purse gives out many different jobs: translators, doctors, nurses, drivers, guards, and cooks. It gives the opportunities to so many who were effected by the earthquake, and I love that this organization is able to do that.

Every day I try to remember all the details of the culture to report them. I forgot to mention that we are living like we are in Mexico. Our toilets flush, but the paper goes in the trash. So I apologize in advance that if I put my TP in your trash upon my return to the U.S.

I'll post the rest of my videos when they finish uploading. Also if you are reading this feel free to leave a comment as a guest below.

First Day in the Clinic

I am doing a mobile clinic here in Haiti, which means each day we will be going to a different site. Today we conducted the clinic at a church/school. I have two options, which is triage or pharmacy. In triage I take the patient's vital signs and then send them to see the doctor. In pharmacy the nurse distributes the medications the doctor has prescribed and explains how and when to take the meds. Resources are limited with what the doctor is able to do. There are a couple cots in the exam room, but the doctors ask the patients about their chief complaint and prescribe them antibiotics, vitamins, or Tylenol accordingly. Most of the people go home with Tylenol for a fever or pain. Common things seen were high blood pressure, vitamin deficiencies, pain, and worms. Thankfully no TB today, because we are not wearing masks to safe guard us. Many of the medications being distrubuted are meds not commonly used in the US anymore. They are probably meds that were donated, because they are no longer being used. After getting the medications the patient goes to see the pastor, who inturn prays with them or shares the gospel if spirit led.

The things I saw today........

There was a lady pretty much wearing a rag. Her shirt had holes and covering her barely. The people down the hill were living in tents. Making food with dirty hands that don't have the proper hygiene. They were frying food over a flame from firewood underneath the pan, cooking in oil who knows how many times it had been used. It rained twice today, and there were children walking around barefooted with mud squished between their toes because they had no shoes. I saw many children along the roadside with no pants or underwear or only underwear. I've seen dogs and a dead donkey (whole new meaning to "dead donkey")laying in the middle of the road. Donkeys and horses grazing everywhere without being tied up or fenced in. Many of the vehicles here are painted multiple colors of grafitti and in one instance a car had bling on it. Many of these vehicles I see on a daily basis seem to be Godmobiles taking people to church, because they always say something about God on them. 'Papa Nu' is the word for 'Father God' in creole! Finally my shower room is outside, when I look above my shower I see palm trees. These are just a few of the cultural and ways of life that I can think of that are different from America.

Franklin Graham also has a helicopter. The helicopter flies the doctors up into the mountains on Saturdays. It's a 2 hour drive between the 2 Samaritan's Purse bases here in Haiti, but a 14 minute flight. We would have taken it to get here, but it doesn't fly on Sundays. The helicopter flies between bases atleast once a day, and there is a high estimate on how many lives it has saved from not driving. Driving is dangerous here! I still have to somehow manuever a ride on the chopper, and it's more difficult now that I'm on the base where the helicopter is not parked. But when I do I will make an aerial video.

The Haitian doctor tonight explained what Vodoo is. I didn't have a good understanding of it before. I wasn't sure how it was different from Christianity. Vodoo came about because Catholicism was forced upon the Haitians, which they knew nothing about. Many Haitians know that Jesus doesn't accept vodoo, and don't want his name around in the midst of their practices for fear Jesus may bring harm upon them. They don't understand that Jesus is love. The will attribute death to a spirit they follow in Vodoo, because of something they did bad. These people need a lot of prayer to be released from the bondage and fear that these Vodoo spirits have over them!!!

Link to the Compound Tour

http://www.youtube.com/watch?v=6Y8wKkOrBKA

First complete day in Haiti

Samaritan's Purse has 2 bases, one at the Global Outreach campus, and the other at all old resort called JAX beach. Today we took the 2 hour voyage from the GO campus to JAX beach. With every trip I mark my territory, and I did again today! I got motion sick. I have got sick every place I have visited for the last 6 years, Burkina Faso, Hawaii, Detroit just to name a few. I took an anti nausea and it has sedated me for the whole entire day. I guess when I jumped out of the van to puke on the road side the Haitians were running up to me to see stuff until they saw the results! lol!

We arrived to JAX beach at it's quite the upgrade to where we stayed last night. We are now staying in air conditioned tents, with the Alantic Ocean in the backyard. Today since I was already tired I splurged on a gluten diet. Tomorrow I will take my almonds and Bumble Bee bars out with me to eat. My prayer requests right now are for my physical well being. I get motions sickness horribly, and the pot hole roads make it worse. Up until lunch today there were always lots of gluten free things for me to eat. Unlucky for me, they served chicken on the bone today. I love chicken, but I am a very picky finicky meat eater, and I can't do meat on the bone. Finally with my body trying to reorient it to a day shift has posed it's challenges since I woke up at 1am last night and laid there for atleast a couple hours, and then slept all day today due to the sedative I was on. I pray I get a good nights sleep tonight.

As I've gone through the day I've remembered the little things I've learned since I've been here that I want to mention, so that I don't forget the details of this trip later. Cite Du Soleil is a place where there is a clinic, and it's the 3rd most dangerous city in the world. We also drove by a cruise ship port today. We were told that cruise ships drop people off and tell them that it's a different island than it really is. Maybe I mentioned this before, but they said that since there are no road laws buses loads of people will be going down the highway 60mph going through a city holding down the horn for other cars and people to move out of the way and don't give any way themselves. 2 buses before have collided with each other at these speeds and dead bodies flew everywhere, because neither bus would give way to the other. We have been told that if we come upon an accident to flee the scene, especially if we are involved, because riots can start. In America we are taught this is wrong, but here it's for our safety. Also Haiti is expected to have another earthquake in the next 90 days with a magnitude of 5.1 or above. There is an excellent safety and security team here that have a good handle on what is going on around us.

Overall Haiti is a very beautiful country with great potential for tourism. Unfortunately it's the poorest country in the Western Hemisphere and all systems here have collapsed. My question is where would anyone begin to straighten out the problems when every single system is corrupt in this country?

I'll post the link to the tour of the compound later.

Lessons to Be Learned

http://www.youtube.com/watch?v=RfqigNTNRsw

Today I arrived in Haiti at 1:40pm. I was the first to get on the plane, and first to go through the entrance gate for my stamp! I got motion sickness on the runway, which is my staple reaction to every place that I visit. At the airport I was bombarded with a Haitian wanting to carry my bags for me. I was like, “No, no it's okay!” He kept walking with us to the Samaritan's Purse van so I thought he was with SP, until he asked for money for helping him. There was no way I was going to whip out my money pouch, with all of my cash to get him money. The woman that picked me up had some dollars on her. Lesson #1 Never let a stranger carry your bags.

On the drive over we went by the tents, and a rough rough road. I'll uploaded a clip of the road trip above. People are mad drivers around here, since there are no road laws and no traffic tickets. I was oriented to the compound, only to find out that I will be going over to the JAX resort compound tomorrow. Currently there is an air conditioned tent with a tv, food, and internet service of which I am able to do this. There is a mountain on the backside I'd be able to hike up if I were to stay.

Then we got our orientation tonight! I knew it was unsafe here, but I didn't realize how unsafe until the talk. Lesson #2 Be much more scared, because it's more dangerous than previously thought! Corruption is so corrupt that there are things that I have never even thought of! For instance, the security officer was saying a SP woman hit a motorcycle driver who pulled out in front of her. The Haitians started slashing the tires, and it was a situation in which she had to escape. He said it's next to impossible to get a driver's license here. The government is corrupt. There is kidnapping for randsoms. A simple situation such as a boy playing with a ball can turn into an escalated situation. But no worries, they take measures for top security. There's informants out in the community with the organization that report back where anything wrong is happening, so they can alert the volunteers to get out if something dangerous is going on nearby. There are also Haitian guards with rifles at the entrance of the compound and stand outside our tent at night.

The alarm bell will be going off at 5:30am, and I am super tired, so now is the time to get my body on that schedule and go to bed now.

A Night in San Juan, Puerto Rico

Puerto Rico

I arrived at DFW yesterday, and waited in no lines. I did the self check, and there was no one waiting in the x-ray line. It was straight to the front each time! Very nice! I've learned how to pack light; therefore, I don't have to mess with checking a bag. I arrived in PR last night after a 4 hour flight from DFW, which covered Louisiana, Mississippi, Alabama, Florida, the Bahama, Caicos and Turk Islands. I was very happy that I could still get my cellphone coverage here. My phone never changed times for time zones, so I thought there wasn't going to be a satellite connection. I arrived at my hotel, Coral By The Sea, a mile from the airport. For $80/night my hotel was pretty primitive, but I know that God is gradually weaning me from the American lifestyle so there's not so much of a culture shock in Haiti. I was hoping for one last hot shower, but that was cold too! After being awake for 28 hours, and not eating all day I was hungry and tired. I showed up in the formal restaurant in my sweats and ate a tasty chicken breasts with creole sauce and seasoned rice. Then this morning an omlette with french fries. So far so good on my gluten free diet! Sometimes the options are slim pickings, but the slim pickings were delicious this time.

Everyone at the airport, the taxi driver, hotel attendant, and the waitresses all spoke English. I guess I look American so they all started off by speaking English with me. I took 4 years of French in high school. The Spanish that I do know is from my 6 week exploratory class in the 8th grade and the majority of my foreign speaking patients. I was a little worried about the communication, then today my taxi driver knew very little English. He was asking me questions in Spanish and I knew what he was saying! I try to get by with what little Spanish I do know with my Spanish speaking patients who know little English. When they don't know what I'm saying in English I sometimes use the french word, and sometimes they understand what I am saying. So when the taxi cab driver was speaking this morning I recognized some of his words because they were similar to french. Now when I stop to think about it, I should have never worried to begin with. I have plenty of experience with Spanish speakers and I always get by, and achieve what needs to be done.

The night shift messes with my body for a day or two after coming off of it, and reorienting it into a regular schedule gets tricky. Last night I didn't have my air conditioner programmed the right way so my room was getting humid and the smoke alarm was beeping like the battery was going low. After 3 or 4 hours of sleep I woke up and had a tough time falling back to sleep, despite being awake for over a day before. My body is very rebellious that way, and no matter how tired I am I usually pop a Benadryl to keep me asleep for a good 8 hours. I thought I could get by not doing it last night. I was wrong! It takes about 12 hours for the Benadryl to wear off, so I usually wake up with a Benadryl hangover, but this week I bought the pills instead of capsules and split it in half. I slept through the day, and woke up without a hangover.

So I set my alarm clock to wake me up 3 hours before leaving for my flight. My layover by the way was 15 hours in Puerto Rico. I had a choice between Miami, Alanta, or Puerto Rico as my layovers. The decision was tough. So this morning I got up and walked to the sea, which was 2 blocks from my hotel. I stopped to get my usual Starbucks iced coffee, which usually comes to $1.83 in Dallas or $2.17 in the highly taxed Chicago. Today the same coffee was $3.91!!!!!! $3.91?!?! I know they were thinking “(in my foreign voice)Stupid Americans! They want their coffee! We'll overcharge them!” They're right! I'll do anything to have my coffee! Substance abuse at it's best!

Well once again my lines were very short at the airport this morning. I got here a couple hours early, and was checked and x-rayed in 20 minutes. A guy had 2 cats and I carried one through for him. I told him I hated cats from growing up on the farm, and the infestation we experienced! Lol! Our last cat that I had any emotional attachment to, died about 3 years ago. Never again though! So now I'm waiting for my flight to Port Au Prince, and am going to monkey around with my new camcorder to figure out how to upload my videos for all to see! Until next time, God Bless!

http://www.youtube.com/watch?v=NA6cnNzRUk0 San Juan Beach
http://www.youtube.com/watch?v=OMu7ljLXLfQ The Hotel

All my ExCoworkers Live in Texas!

My going away tribute to all of my fellow coworkers at Baylor Garland.

http://www.youtube.com/watch?v=sseWDlqg4Gk

Travel Nurse Tips

If you need to renew your CPR card the local agencies such as the Red Cross charge $90, instead check with the hospital your current assignment is at for renewal classes. It only cost me $25 to renew.

Illinois has no nursing board only a professional regulation building. If you need to get them to verify your license to another state then send them the verification in the mail by certified mail which requires a signature. With the verification send another envelope inwhich they must send it to the next place by certified mail. Also call them, get a name, and threaten to stalk them until it gets sent out! Illinois told me that once they receive the verification it takes10-14 days to just enter it into the computer. Normally the entire process can take 4-6 weeks. They sent my verification out 2 days after receiving it in the mail. Talk about pronto!

California also has a reputation for losing stuff. My plan is to send it certified, and all stapled together so nothing can be lost. I'll let you know how it works out. They are notorious for losing checks and applications! I have also been told that they will send fingerprints back if they are smudged. Make sure the fingerprint card you send back is not smudged or bent!!!! If you work for Cross Country Trav Corp, then some of the recruiters can send you the California fingerprinting cards, because it can take forever if you ask Cali to send you one.

Finally there is a website called Highway Hypodermics that shows a comparison of all the travel nursing companies and which benefits they offer. It allows you to see which companies offer the most benefits to the least. Here's the link to the page: http://www.highwayhypodermics.com/travel_nursing_companies.htm

Haiti Update

So finally Samaritan's Purse got back to me a week ago Friday, and they are only willing to let me go for 2 weeks. They said that the 2 week trips have been very difficult on the nurses due to the living conditions and the heat. They told me that if I wanted to go back in the future for longer then they would reevaluate at that time.

So far everything is going well with the planning. I found a super cheap plane ticket on a website called CheapOAir.com. The catch was a 15 hour overlay. I chose where I wanted my overlay to be, Miami or Puerto Rico? Tough decision, I chose Puerto Rico, and will spend the night in a hotel there a mile from the airport and sight see in my extra time.

My car prayer was answered. I will be keeping my car in the garage of one of my coworkers with all of my belongings. My final detail to work out is how I will be getting to the airport. I could take the shuttle, but it'll be something like $80 roundtrip. I don't think that is cost effective or good steward of my money if there is a better way. I have yet to check the train system from my friend's house, but from my apartment it would take 2 1/2 hours.

Finally if you are a traveler overseas and want to save money, you can take the antibiotic Doxycycline for malaria. It's cheaper, you'll have to take it everyday of the trip and a month afterwards, but a 60 count can be purchased for around $10 with insurance versus the $50 for Larium. I used to take Doxy for acne and it made me nauseous on an empty stomach so take it on a full stomach regardless of what the indications say on the bottle. I puked up my food when I took it before my meal. My doctor wanted to give me a different drug than Larium, because he said that no one uses Larium anymore, but the other drug is even more expensive. I also had to get the Typhoid vaccine again. That vaccine is good for up to 5 years, which it's been 6 years since I last had it. Things to keep in mind if you need overseas vaccinations. With it being rainy hurricane season, the Typhoid vacc was a must!

Thanks for all of the prayers, and I hope to be able to update this regularly on my trip. I bought a small little compact video cam for the trip yesterday, so I hope to get lots of footage.

Vista Del Lago

It's been awhile since I've updated my nursing blog, but back on June 7th I was moved into my new apartment. My first travel apartment has been equipped with a tennis, basketball, raquetball, and sand volleyball courts along with a pool and fitness center. The apartment is complete with a garage, walk in closet, food pantry, washer/dryer room, fireplace, and balcony. Someday I'll post the video of my place. It's right on White Rock Lake and in a gated community. Ammenities goes as far as to provide the carwash vacuum cleaner in the parking lot and grills on the patio. The courtyard is very beautiful, but the downfalls include newborn pidgeons and pidgeon poop covering my balcony and my garage door quit working for the 4th time this week. When I originally moved in there was a business center complete with computers, and a fax/copy/scanner machine that worked. Now it's burdensome to have the staff always faxing my paperwork, because that machine no longer works.

Here's Vista Del Lago's website:
http://vistadellagoapthomes.com

How to sleep during the day.

I have tried everything to help me sleep on the night shift......melatonin, eye mask, dark room, wearing sunglasses when getting off work, and the latest being L-Tryptophan from the health food store. In the end what works the best for me is Benadryl. Without the Benadryl I wake up after 4-5 hours and can't fall back to sleep although I'm still tired. My bedroom at this apartment is a room with white shades, which means that the room is well lit during the day. The only dark rooms in my apartment is the bathroom and the food pantry/laundry room. So I went to Wally World, bought myself an air matress, and put it in my food pantry then shut the door. The room is pitch black and with the help of Benadryl I get good quality sleep. This past week I've been able to sleep in my bedroom with the Benadryl alone, which is a plus since it's a nice comfortable bed. I tell everyone I sleep in a closet. Here's the picture of my sleeping quarters before the door is shut.

Riverboat Tour on the Riverwalk

A sample of the tours in San Antonio

Amy's IceCream

Here is some footage of the ice cream shop that makes your ice cream right in front of you.

Missions in Haiti

I have a lot of updating on my travel nurse excursion, but I am going to update on my current status as far as Haiti goes.

The earthquake in Haiti happened on January 12th. The fact that it happened on that exact date had great significance in my own life. Originally I didn't think of considering going. My heart has always been for Africa and I have felt God calling me that direction. I went into nursing to one day be a missionary nurse there, and to more specifically use the knowledge of the french language that I learned during my 4 years in high school. I don't want that education and valuable knowledge to go to waste. I went to Burkina Faso 6 years ago. Infact I think I left on this very day, July 14th. Since then I have been involved with an African fellowship, had an African roommate for 6 1/2 years, and have several close African friends. I have learned so much about that culture. So going to Haiti is not something I gave thought to when it originally happened, because it's not Africa.

Then 2 weeks after the earthquake I felt God nudging me, "You are a nurse. You want to be a missionary nurse. They speak french, you know some french. You have experience with the African culture, and that's where the Haitian ancestors are from. These 3 things alone are skills that the majority of people don't have, including the majority of nurses!" My former boyfriend is also Haitian, and I've always been curious and wanted to understand which parts of his personality were cultural.

So the search to go to Haiti began with disaster relief. Every website I found for disaster relief required previous experience or completion of a training program with the Red Cross. I then realized that because Haiti was currently on the television screen day and night everyone wanted to go, but in a few months when it was less in the media people would forget. There would be much more of a need and shortage. By delaying my trip it would give me time to review the french language, and be much more prepared and useful.

The hospital I was currently working at was sending doctors and nurses; however, as a Christian there is a much higher purpose for me doing this. I wanted to go with a Christian organization and not as a humanitarian effort. I didn't know where to begin. For some reason Samaritan's Purse popped in my head. The organization of Franklin Graham (son of Billie) and of which my church in Iowa City had gone to New Orleans with after Hurricaine Katrina. I decided to visit my old church's website and there I saw it again, them fundraising money for Samaritan's Purse. I then did a google search for missionary nurses to Haiti, and my very first return was Samaritan's Purse, so I filled out one of their applications and prayed.

Over the next several months the course of my life changed to put me in a better position to spend more time in Haiti. I became a travel nurse, which allows me to take weeks or months off to do missionary nursing without having to put in for vacation time.

In June my prayer began to be answered. I received an email from SP requesting me to fill out an application again. I emailed them, and received more information. They need nurses in their clinic in Cite du Soleil (City of Sun) through the summer and fall. Morgann said that if I emailed her my application personally that she would process it as quickly as possible. My computer crashed in the spring and I lost my application, so I had to start from scratch. I finally submitted my application yesterday after traveling and working for the past 3 weeks.

Last night more sure tail signs from God came about. I was talking to my neighbors, 2 brothers, in our pool. They were telling me how the very first missionary to die in Haiti was standing a year ago in the pool right where we standing. They told me that if I went to Haiti I could go for them in her memory and that they had been friends with the Grahams for years. Wow! If that's not God speaking than I don't know what is.

I extended my contract 8 weeks which will allow me to pay off my car, and have no bills. My plan is to go at the end of this contract, Sept 25th anywhere from 2 weeks to 2 months. I'm praying that the Lord will reveal the amount of time he wants me to be there through the organization's response. I am all for eating beans and rice. As of this summer I have discovered that I have a gluten intolerance. Since cutting gluten from my diet I have had huge burst of energy. Rice is gluten free, but often is enriched by adding coating to it that has gluten. I am praying that this won't be the case, and my diet won't become an issue in visiting. Gluten now gives me huge headaches and makes me very lethargic when I go back to eating it.

I also at this point am unsure of how my finances will be at the end of September after paying off the car and buying the plane ticket. The plane ticket is the only cost I am responsible for on this trip. My room and food will be covered there. I want the car paid off, so there are no monthly bills to worry about while gone. The only two definate bills I will have left is my monthly storage bill for my furniture and phone bill. I plan on freezing my car insurance and storing it. My two prayers is for a place to store my car with all of my belongings if I don't get a chance to drive back to Iowa after finishing my assignment. My other prayer is my phone. I didn't buy a Blackberry that can be used internationally, and to have a job ready for when I return is very important. I need my local American phone number so future travel employers can call and interview me while overseas.

There are few details for God to work out yet, but I know that with God all things are possible.

Assessing Fall Risks Accurately

The last hospital I worked at had this huge emphasis on preventing falls, with a "NO Falls" tolerance. We had a safety officer walking up and down the hall at all times making sure call lights were within reach, bed wheels were locked, patients were toileted, etc. It still didn't prevent falls from happening. The tool we used to evaluate people didn't make sense. People that weren't fall risks could be a high fall risk according to the assessment. Now I'm at a hospital with a more exhaustive and accurate tool called the John Hopkin's Fall Risk Assessment. Here it is:

Complete the following and calculate fall risk score. If no box is checked, score for category is 0.

Points

Age (single-select)
o 60 – 69 years (1 point)
o 70 – 79 years (2 points)
o ³ 80 years (3 points)

Fall History (single-select)
o One fall within 6 months before admission (5 points)

Elimination, bowel and urine (single-select)
o Incontinence (2 points)
o Urgency or frequency (2 points)
o Urgency/frequency and incontinence (4 points)

Medications: includes pca/opiates, anti-convulsants, anti-hypertensives, diuretics, hypnotics, laxatives, sedatives, and psychotropics (single-select)
o On 1 high fall risk drug (3 point)
o On 2 or more high fall risk drugs (5 points)
o Sedated procedure within past 24 hours (7 points)

Patient care equipment: Any equipment that tethers patient, e.g., IV infusion, chest tube, indwelling catheters, SCDs, etc) (single-select)
o One present (1 point)
o Two present (2 points)
o 3 or more present (3 points)

Mobility (multi-select, choose all that apply and add points together)
o Requires assistance or supervision for mobility, transfer, or ambulation (2 points)
o Unsteady gait (2 points)
o Visual or auditory impairment affecting mobility (2 points)

Cognition (multi-select, choose all that apply and add points together)
o Altered awareness of immediate physical environment (1 point)
o Impulsive (2 points)
o Lack of understanding of one’s physical and cognitive limitations (4 points)



*Moderate risk = 6-13 Total Points, High risk > 13 Total Points Total Points

Plum A IV Pump by Abbott

I have found information on the cassette style IV pumps that I have been using at Baylor. Here are the step by step instructions to priming the lines:

1. Spike the bag

2. Pull out white knob on infusion cassette. This allows the chamber to fill up.

3. Hold the cassette upside down and fill up the chamber.

4. Flip it upright at the first drops of the bubble/circle chamber filling.

Here is a website with a video on how to set up these pumps: http://www.wonderhowto.com/how-to-plum-iv-infusion-pump-nursing-259932/

I have yet to figure out an easy way to clear the pumps, but I did find an instruction manual to these pumps. It can be found here: http://www.ardusmedical.com/manuals/Abbott-Plum-A+-Op-Manual.pdf

I hope if you are a traveler or a RN that ever has to use these pumps and needs more info then this will help.

Equipment and Eclipsys

Most of the frustration of working in this new hospital is learning how to use all of the equipment and apparatus. Everytime I go to do something on my own I have realized I need help, because it's different.

I went to spike my first IV fluids only to realize the plug to pull out of the bag was different. I had to go ask questions. I was afraid that if I pulled out that plug and it was the wrong plug then there would be a liter of fluid all over the floor. Priming the tubing was whole another challenge. The tubing is different and requires fliping a button half way down, flipping a chamber upside down, letting the chamber fill, then flipping the chamber back over. Nothing seems to be common sense.

While the nurse that I was following was busy doing another task I offered to help her in starting new IVs. Then while I was trying to start the IV noticed there wasn't a needle retracter. I blew the patient's vein once, then was able to start it the next time. I attempted to start another IV on another patient and blew the veins twice more in the process. This will take some practice getting used to the needles.

Even the oxygen tops are different than I have ever seen before. I've worked with eons of oxygen cannisters in multiple settings and have never seen them like these.

Above all of these technical issues of equipment was the 2 nights of paper charting I did. There was paper after paper. I have never seen so much charting, checking the charting for the past 24 hours, then checking it for the whole shift, then checking it again with report. This weekend the hospital will finally go to computer charting called Eclipsys. We spent 3 long days in front of computers learning to use this system. I took detailed notes and typed up a cheat sheet for all in my class to use. We'll see how it goes tomorrow night. It'll be frustrating taking the time to figure out everything until I can flip from screen to screen knowing where everything is.

Redlining!

Red lining is a term nurses use to describe checking off orders, but that's not the redlining I am talking about. One thing I have noticed here in Dallas is all of the red lines on the pavement in the parking lots designating fire lanes. Red lines are all over this city. I will include the pictures.

Southern Hospitality

More than just a coined phrase we use in the North. It actually exists!

Last week I was getting ready to cross the street. There were no cars around, until I decided I was going to cross the street. I was waiting on the side until a truck passed by then I was safe to cross. But instead the truck stopped to let me cross first.

The other day I got off at my bus stop and asked the girl sitting at the stop where the other bus stopped at. She took the time, walked me down a path, to show me where the stop was.

I had the rental car place take me home after dropping off the car and the guy got the door for me like they do when you are on a date.

At the end of my first shift the nurse manager on the unit that I am working took me all the way out to the bus stop, because she wanted to make sure I found it and got there in time. Wow!

Whenever I am walking there are countless number of people that stop to ask me if I want a ride. I thought it was strange until one of the bus drivers in his 50s or 60s told me that when he was young they always stopped to ask a lady if she needed a ride. In the Midwest we get suspicious about this, but here it's the norm.

I'm sure there have been and will be many more of these stories to share as I remember and encounter them.

DART bus journey!

Today I took the DART bus for the first time. Not quite like Chicago with buses every 7-10 minutes. They come once an hour in places, so my trip has to be coordinated perfectly with the train. The buses also don't let you know what your next stop is like the buses in Chicago, making it extremely difficult to know where to get off. I let the bus driver know, but it wasn't his usual route. He didn't know where my stop was either. My goal was to go to the Galleria, but because I didn't want to find myself walking and walking forever once I got off the bus I went to the mall instead.

My bus driver happened to be the bus driver that picked me up to take me back to the train station. We talked on both trips. He was probably in his late 50s or 60s from San Antonio. He told me that back in the day he also always asked the girls if they needed rides. So it definately is a Texas thing to ask girls if they want rides.

Hotel Tour

This is the video of the Extended Stay Hotel in Dallas that I am staying in for 5 weeks during my first travel assignment.

Pros: Close to train and bus lines, weekly housekeeping, close to several restaurants, walking distance to Wal-Mart Supercenter.

Cons: Bus system not reliable, hall traffic noisy, no swimming pool, men with fake gold grills inviting you to hang out at their crib.

So this is how they get a date in Texas?

I'm used to all of the black guys in Chicago and Iowa being very extroverted with their approach to women! Pulling up to the curb in their cars... "Hey girl what's your name?" "Can I get your number?" "Hey Angelina Jolie!"

But here the white guys are hootin and hollerin out their windows. One pulled up as I was getting a Red Bull out of the vending machine. At first I thought he was going to ask me for directions, but as I approached him I thought maybe he was my long lost cousin. I couldn't hear him, because of the freeway, but after the 4th time I heard him. "Do you date?" lol! Is that how they ask you out here? No "Can I get your number"or"Will you go on a date with me?"

The variety of comments I have got is funny. "Do you have time to talk?" "Do you need a ride?" At least 5 times in a 15 minute period did I get the latter question. Crazy! All of my exes live in Texas (literally), but my new love resides in Tennessee, or will it be Texas too?

What is Travel Nursing?

Travel nurses work usually 13 week assignments in any of the 50 states, the District of Columbia, Virgin Islands, Puerto Rico, and Canada. However the assignments can be as short as 4 weeks, and vary being 4, 5, 6, or 8 weeks. There are also other travel companies that take nurses outside of the country but usually want a 1 to 2 year committment.

The facilities that use travel nurses sometimes are going through transition periods and only need a temporary nurse. They may be training new nurses and need experienced nurses to fill in until they are trained. They may also use temp staff until they can fill their openings.

Travel companies vary in their benefits. All travel companies provide housing. For assignments that are 8 weeks or longer I will have a furnished apartment. If I chose to find my own apartment then I receive a stipend rated on the cost of living in the area. I chose to have a furnished apartment, so that I don't have to lug my furniture all over the country with me. For less than 8 week assignments they will put me up in an extended stay hotel. Some companies will even pay for the nurse's electricity, internet, fitness passes, etc. Mine covers the costs of food and I am paid for my mileage traveling to my assignment. I also receive health insurance and a 401K when my assignment is 8 weeks or longer. They also cover licensing, immunizations, TB tests, drug screening, training (CPR, ACLS, etc), and offer free continuing education credits.

If the nurse has a permanent address while traveling then they are eligible for the tax advantage program. Less taxes are taken out of your paycheck if you are paying bills somewhere else. Along with all of these above perks I make a full salary. These salaries can be up to $10-$20 more an hour than staff nurses. So this is what travel nursing is! Travel! Make Money! Have Fun!