Dont' burn your bridges

I don't want to burn bridges with people I've worked with. It's a small world. You may never know you may cross the same path again.

I went to Mary Chiles last Friday morning to get my personal stuff in my locker and to say thank you to the HN, CN, and the medical director. Kahit na maganda or pangit ang naging experience ko dun, may naitulong pa rin naman sa akin ang pag-serve ko as a volunteer nurse dun in 3 weeks. I paid 1k for 2 months of volunteer pero hindi ko na tinapos ang 2 months. Naisip ko kase na mas mapapabuti ang career ko if I'm gonna serve at Marikina Valley. I didn't submit a letter of withdrawal but I think I should para professional ang approach. Next time na lang siguro pag mapadpad ulit ako sa Lepanto or sa PRC.

Now, my focus is on MVMC because I have bigger chance to get hired there. Wala namang masama kung mag-aspire ako dun. Yun naman talaga ang plan ng bawat isa na VN dun eh. If given the chance, I want to work in the ICU (intensive care unit) dahil andun daw ang learning and you'll get to practice your critical thinking and decision-making skills.

Slacker

I used to be a slacker in my mid-20's. But now that I'm in my 30's, slacking off endangers my survival. I don't want to depend on my parent's wealth because hindi naman kami rich. I don't want to sit and wait for something to happen in my life. Good opportunities don't always land on your lap. I have to go out of my way, wake up early in the morning, stand in long queues sweaty and hungry just to get a license or a certificate or a slot in a training program. I have to give up my whims and caprices to give way to more relevant stuff. Nakakapagod talaga. Pero I have no choice but to work my a$-- off. May reward naman palagi sa bandang huli. "Patience lang, Irene" a friend would tell me. Bakit ba ko nag-e-emote ngayon? Wala lang. Just wanted to look inside myself para ma-encourage ang aking sarili na huwag susuko at papetiks-petiks sa buhay.

Missing Steph

Steph is my closest friend in nursing school. I can entrust my life to her. She's so smart and nice that's why a lot of good things happen to her. Imagine, she passed CGFNS and NCLEX at first take . After passing the NCLEX, her mom gave her an HP laptop as a gift! Her dad survived the big C after a series of treatment the lung center. He's now back in Iloilo.

Steph was my classmate for a couple of semesters. She's a heartthrob, actually. An ilongga who looks like Hilda Koronel (naks!). Our friendship started with a casual conversation while I was waiting for my sundo. Nag-click na kami agad sa moment na yon. And then kami na lagi ang seatmates sa class. Tapos nagkakayayaan ng kumain sa Napoli's timog. Gustung-gusto namin yung garlic chicken pasta. Nauubos naming dalawa yung isang bandehado. Matakaw kami eh. Sikreto ng aming kagandahan. Jowk! Madalas n arin akong tumambay sa dorm nya kapag sad ako or masaya or kapag magre-review kami for an exam. Minsan dun nya ko pinapatulog kapag sya naman ang sad. Favorite topic namin ang aming mga classmates. Haha! Mga tsismosa din kase kami. Kilometric words per minute kung mag-usap kami. Syempre para sulit ang kwentuhan. Walang boring na moment pag magkasama kami. Para kaming highschool kung maghagikgikan. We can read each other's minds. Isang tingin pa lang, gets na namin ang message na gusto naming i-convey sa isa't isa. Sayang nga lang at hindi kami magka-grupo sa mga duty. Mas masaya at mas mataas sana grades namin. Haha. Sa Sunday magkikita ulit kami ni Steph. Madami na naman kaming pag-uusapan. Mga achievements, faliures, aches, and joy, among other things. Sa Trinoma kami magkikita after lunch. Naka-dark blue ako na blouse. Jowk! Hehe. Dapat sya manlibre sa kin kase ang dami na nyang naipasang exams na malulupit - CGFNS at NCLEX. Never pa kami nag-inuman together. Sana one day sa beach or out of town para kumpleto ambience.

My reviewer: Philippine Patient's Bill of Rights

1. Right to appropriate medical care and humane treatment.
2. Right to informed consent.
3. Right to privacy and confidentiality.
4. Right to information.
5. Right to choose health care provider and facility.
6. Right to self-determination.
7. Right to religious belief.
8. Right to medical records.
9. Right to leave.
10. Right to refuse participation in medical research.
11. Right to correspondence and to receive visitors.
12. Right to express grievances.
13. Right to be informed of his rights and obligations as a patient.

Hataw na

Tomorrow's gonna be a big day for me. Biruin mo, dalawang hospitals ang pupuntahan ko from westside to eastside. At 9am, aptitude exam ko sa Delos Santos. Then at 1pm, final interview ko sa Marikina Valley Medical Center. Love ko yung 2 hospitals na yon. Yung Delos Santos, dun ako nag-nursing. Yung Marikina Valley, maganda lahat at malapit lang sa house ko. Gusto ko na rin umalis sa current na pinagvo-volunteeran ko eh. Kase wala ko natututunan. Puro taga-abot lang ng mga hinahanap ng mga surgeon at staff. Di kase nami-meet expectations ko in a training hospital. It's like a survivor's island. It's a jungle out there. Tsaka parang bad shot na ko sa HN dun. Baka kase hindi pantay kulay ng scrub suit ko na pants and blouse. Dark blue yung pants, light blue naman yung blouse. Mami-miss ko dun yung food sa canteen tsaka yung cute na nurse sa 2nd floor na kamukha ni Mark Fernandez. Nakikita ko lang sya pag inuutusan ako pumunta sa pharmacy. In fairness, napawi pagod ko tuwing makikita ko si pogi nung utusan ako ng HN ng pitong beses na akyat-manaog sa pharmacy from second to ground floor. That's it. Nothing else.

Sana nga matanggap na ko sa Marikina. February daw ang start ng Batch 6. At sana matanggap na ko sa Delos Santos as a staff nurse para may sweldo na ko ulit. Ang hirap ng walang income. Ni pambili ng napkin wala ako. Ayoko naman bawasan ang kakarampot kong savings. Mag-loan kaya ako sa SSS or sa Cooperative? Hmm. . . Nahihiya din kase akong humingi na kay Daddy. Dapat ako na ang nag-aabot sa kanya ng pera. It's pay back time na dapat. Sana nga magka-work nako sa hospital. Makapag-review na nga for tomorrow. Memorize ko pa pala yung Patient's Bill of Rights, Sites of Pulse, Rights of Administering Drugs, and Flow Rate Computation.

Mac

Kay tagal ko syang pinangarap. Pinag-isipan, pinag-ipunan, hinanap. Dahil sa facebook, doon ko sya natagpuan. Pinakilala ng isang malapit kong kaibigan. Ngayon, lagi na kaming magkasama, lalo na kapag wala akong pasok. Pinasasaya nya ang aking mga araw. Nagsisilbing inspirasyon sa aking kalinangan. Pinapawi ang pagkauhaw ng aking puso at isip. Nahikayat akong mag-blog ng dahil sa kanya. Ang galing-galing nya. Napakabilis sa pagtugon ng aking bawat utos. Isang pindot lang, bigay agad. Napkasarap hawakan at pagmasdan. Parang isang apparition. I love my first ever mac.

Dilemma

Tama ba ang spelling? Tama. Good riddance I was able to juggle one exam and one final interview. Napakiusapan na i-move yung exam ko sa Thursday to give way to my final interview tomorrow. I hope this time it's gonna be for real. Nakakapagod din ang mag-exam at magpa-interview. How I want to kick off my stillettos and toss out my blazer after every interview. Suffocating. Answering the "strengths" and "weaknesses" and what-have-yous. I gave up my not-so-stable job just to pursue my dream of being a nurse. Now I'm practically penniless. Ano kaya pwedeng sideline na job? online English tutor could be possible. Or a reliever maybe.

So, absent ako for 2 days sa OR. Ok lang. Sabi naman ni CN we are entitled to our personal and professional development. Sana maintindihan din ito ng HN namin. If she would take it against me (like what she did the first time) then I won't give a damn. Basta I would follow my heart, kung saan ako mas sasaya.

Avatar

I yawned at first. The movie was either too dark or too neon. But I liked the message of the movie. Reminded me of how the Native Indians were conquered by the Americans--the teachers were sent first to learn the culture, language, societal structure before they colonize the land. I found the love scene of the avatars awkward because there were kids watching the movie. The kids were enthusiastic and happily clapping their hands during the fight scene between the humans and the Na'vi's. Overall, the movie, to me, is so-so. Maybe because I'm not a fan of sci-fi. Alienating for me.

My reviewer: Glasgow Coma Scale

Glasgow Coma Scale

Overview:
The Glasgow coma scale is used to assess patients in coma. The initial score correlates with the severity of brain injury and prognosis.
Glasgow coma scale =
= (score for eye opening) + (score for best verbal response) + (score for best motor response)

Eye Opening Score
spontaneously 4
to verbal stimuli 3
to pain 2
never 1


Best Verbal Response Score
oriented and converses 5
disoriented and converses 4
inappropriate words 3
incomprehensible sounds 2
no response 1


Best Motor Response Score
obeys commands 6
localises pain 5
flexion withdrawal 4
abnormal flexion (decorticate rigidity) 3
extension (decerebrate rigidity) 2
no response 1


Interpretation:
• maximum score is 15 which has the best prognosis
• minimum score is 3 which has the worst prognosis
• scores of 8 or above have a good chance for recovery

• scores of 3-5 are potentially fatal, especially if accompanied by fixed pupils or absent oculovestibular responses

• young children may be nonverbal, requiring a modification of the coma scale for evaluation.

Rambling

When we're not so busy in the OR, favorite topic most of the time is my age and why I don't have a baby yet. Same reactions when someone learns I'm 31 is "you look like twenty-one, two, three, and so on. Flattering at first. But as the questions go further, annoying na. Bakit ganito, bakit ganyan. EWAN sagot ko. Destiny, perhaps. Maybe it's not the right time. Maybe the stars and moon are not yet conspiring with what I have now. When it does, I know everything will just run smoothly, fits me just right. Now, you have a clue why I look young. I always think positive. Beauty inside exudes beauty outside. Feeling maganda. Hehe.

Love is free, free is love

I am listening to Jonh Lennon's song "Love" while reading S Meyer's "New Moon." Sentimental. I closed the novel and decided to just listen and feel the song. Relaxing. Psychedelic. Para bang addict? Haha. Song trip lang. I get high with music. I get inspired with it as well. Music helped me survive thesis days in college because it kept me awake and creative. In nursing school, I can't memorize the drugs and their mode of actions without it. Like a drug, music is also addictive. Helped me fall asleep--walkman, discman, ipods. Music sets moods. It can make me smile, fall in love, cry over memories, dance and be giddy. Right now, all I can think of is John Lennon and Yoko Ono. They are so into each other. Parang cult. Maybe it was music that brought them together.

Baptism by fire

Today is Saturday, my sixth day in the OR. They said weekends are not toxic primarily because the boss is not there. Well, not for us VN's (volunteer nurses). The lower-level staff are the ones bossing us around. So true. Feels like a neophyte undergoing hazing. Had no choice but to follow them para hindi mapag-initan (para maabsorb? not an exciting idea).

After 2 years of not doing it, I was tasked to be the second scrub. Ok lang sana kase it was "just" a cesarean-section (CS) case. CS is the most basic operation. Konti lang instruments. Sisiw. Or so I thought.

Before the procedure, I was preoccupied by the OB's reputation. Terror daw. Super bilis daw mag-opera kaya dapat daw listo ka din. Nagtatanong tungkol sa case during the operation. Etc. Kaya ayon, I screwed up in gloving her. Haha. Actually, I served all the doctors with the gowns and gloves. Gowning was okay, kahit na minsan nalilito ako which is the front and back. Gloving was all disaster, from doctor 1 to doctor 3. Buti na lang all out support ang mentor ko na si Kuya M and hindi nya ko pinahiya. Sabi ni Kuya M, okay lang daw magkamali basta hindi madalas. The operation was done in just 20 minutes. May sewing machine ata sa kamay yung OB sa bilis mag-suture layer by layer (from the uterus to peritoneum up to the skin!)

I'll just take it as a learning experience. In another operation (total abdominal hysterectomy bilateral salpingo-oophorectomy or TAHBSO) I had the chance to do skin test. Imagine, I was able to do it in just one shot and without shivering hands (the drug was Tramadol). Not bad. Na-overcome ko na fear ko sa mga tusok-tusok na yan. Siguro kase naubos na ang nerbyos ko sa previous operation with the terror (but religious) OB.

PGH

I was absent from my editing job for two days now. Talk about priorities, of course nursing career first before editing career (kase wala namang bright future sa latter). I went to PGH yesterday after the orientation at MCGH (killing two birds in one stone!) to submit the requirements for the APCN (Advancement Program in Clinical Nursing). I and my boyfriend, Ron got there before the closing time dahil inasikaso pa ni Ron yung authentication ng Board Rating certificate sa PRC (which is just about 300 meters away from MCGH. Buti na lang umabot kami sa PGH ng alas tres. Yun pala, pwede naman kahit original copy lang ng Board Rating certificate. Napagod lang kami at gumastos sa taxi para lang umabot sa scheduled time. The qualifying exams will be on February 8. Sana makapasa kami ni Ron. Ron so wanted to work and build his nursing career at the PGH. Astig daw kase kung experience and exposure din lang ang pag-uusapan, PGH na ang pinakamagandang mag-undergo ng training. I don't aspire to work there anymore dahil bukod sa manpower pooling lang sila for so a long time now, sari-saring sakit ang exposure mo. However, I am willing to b trained there para wala nang mahirap or nakaktakot pagsabak ko sa ibang institution. Pending pa 'tong PGH, meaning hindi pa sure na makapasok ako dun as a trainee. For the meantime, I'll go for MCGH para hindi sayang ang time ko now that I am officially resigned form my editing job.

I have a super runny nose while typing this. Type then sniff then sneeze. Sniff-sniff, arf-arf!

OR assignment

Among the 20+ volunteers in MCGH, there are only 3 of us assigned at the operating room. Siguro kase hindi kami mukhang maingay at behaved kaming tatlo. I want the OR slot kase malinis at kakaiba ang mga makikita mong mga bagay at eksena sa loob ng OR. We three were lucky to get the OR slot because this is a special area and MCGH (Mary Chiles General Hospital) is offering low training fees compared to other training hospitals. MCGH advocates harmony among their employees and health care professionals. What they're looking for in a potential applicant is a good attitude and good performance. They are not so much impressed with bookish or smart-alecking trainees. Almost all the staff in the OR emphasized to us that "don't assume; always ask first before trying to do anything, or else you're screwed; magpaka-bibo ka lang maaabsorb ka dito." So nice to hear those tips and advices. The chief nurse said that they will extend your stay into 4 months if they like your performance, otherwise, you're only given 2 months of training and then they will let you go. Hindi sila nagpapaasa or namemera lang.

Day 2 at the OR

My legs are sore. Standing for almost 8 hours at the OR is like a "Survivor" challenge. The only time I was able to sit comfortably was during lunch break. It was a heavenly lunch. Aside from abling my legs to rest, the tinolang manok at the hospital canteen was so good (medyo nabitin ako sa serving).

First case was CS (cesarean section). My colleagues, Ruby and Rainier, were standing at the unsterile periphery of the OR observing like grade schoolers at the CS procedure. From time to time, we were asked to hand out sponges and water to the scrub nurse. The next case was cauterization. Don't ask which part of the body will be cauterized. The next case was TURP (transurethral resection of the prostate).

As what I've expected, the nurses and doctors are all nice and accommodating. Kahit na volunteers lng kami, we were given nice treatment and warm welcome from them. There's harmony among them, even among the surgeons. I think tatagal ako sa institution na ito. Aside from masarap ang tinola at mga food sa canteen, okay makisama ang mga tao dahil tao ang trato nila sa mga tao.

St. Luke's, have mercy on me

Actually, nakapasa na ko sa St. Luke's Global City. Medical exam na lang kulang. Kaso, 2nd prio lang. Why? Gues what, it's because of pharma again! My final interview went like, "Ms. Estabillo, you have a patient with seizure disorder. Could you name some drugs that would be given to her?" My mind went "tic-toc-tic-toc.." as I, my 2 other co-applicants, and the 2 interviewers stared at each other as I groped around the nooks and crannies of by brain for the right answer. Attempting to squeeze out just one of the hundred possible answers, I uttered not one but two stupid answers. Don't ask about my answer. I was so ashamed of myself. After that, I reached the verdict. I already knew my fate. There's none in that hospital. After counting a couple of days, HR lady texted me saying I should call her. So I did call her and knew that I was 2nd priority because I need to brush up on pharma and etc. At least, it's not about losing weight or fixing acne problem (like all those stories I've read in some forums). Gusto kase nilang i-hire mga Stepford-wives perfect na mga nilalang na nurses tapos papa-swelduhin lang ng minimum wage (na ang take home pay ay halos katumbas na lang ng 7pcs na white therapeutic-type stockings!). Sour graping here and just being realistic, ganyan talaga ang financial condition ng salary ng nurses sa kanila.

Adding insult to injury, I was also called for an exam at St. Luke's QC main a couple of months ago. Mas mahirap ang exam nila dahil 2nd round pa lang I got eliminated na. The initial exam was all about IQ. Time pressure ang hihigop sa applicant pababa. I got through the IQ test. Sisiw lang ang vocabulary, synonyms, with a sprinkle of some math series (poor me here!). So Exam #2, we have 70 items to answer in 15 minutes. Matching type it is, pero there are no letters. We have to write the medical terms, some are as short as an acronym like PRN, but a lot of it were as kilometric-long as PERCUTANEOUS ENDOSCOPIC GASTROSTOMY, FOUR-POINT GAIT WALK, and ACTIVE ROM EXCERCISE, to name a few. Gadddd! Weakness ko kaya ang mabilisang pagsulat. Surprisingly, may naka-perfect, not one but two, and they're seatmates pa. Doubt filled the air as we looked at those two "perfect" earthlings. The HR Manager said, "I hope you did not copy from each other." Aamin ba naman sila??? So, the usual eksena na if your name is called, that means you failed the exam and you say ba-bye to your newly found co-app friends and pack up and go to the restroom and change footwear--from pumps to flip-flops--then text your loved ones to seek comfort and sympathy. It was a sad realization for me na hindi para sa 'kin ang San Lucas. Only Bro knows the reason behind my failures. Maybe He's leading me to something better, a hospital with a high-moral employees probably. I think I'm on my way to that hospital on Monday :)

Exam in Marikina Valley Medical Center

I had an exam at Marikina Valley on Wednesday January 6. My mind went haywire over the last part of the exam--pharmacology questions. Aside from problem-solving (concentration and flow rate computation sans calculator), it was fill in the blanks, like, identifying the generic name and mode of action of the given brand name of those effing 15 drugs. I did try my best to write something on my answer sheet. I almost cringed at what I've written there. Almost everything is just a wild guess. Pathetic. I know all the 15 drugs. Daily, I've given them to my patients in nursing home (Villa Cristo Rey). I didn't know what went wrong with my memory. I just couldn't recall any generic names. Ironic that I got a high grade in Pharma in college and I worked hard for that grade (boosting my self-esteem here). Maybe I should take Vit. B complex from now on.

Until now, there are no calls from the HR. I guess i failed again. I said "again" because I took the very same exam last year. That's why I was so disappointed of myself. I blew my chance. But I'm not losing hope. There are other opportunities waiting for me. I just have to go out and find them with a little help from Bro. and prayers from my loved ones.

I'm now looking forward to my volunteer work at MCGH. I was lucky to get a slot in the operating room. I like OR because this is a special area. I can be an OR nurse, be a member of the ORNAP, dream dream dream! I keep on dreaming!

Urgent

yesterday morning, i got a text message from my friend, steph, asking me how to convert 80 and 8 mg to mL. I said "what's this for? mg is totally different from mL." Steph's neighbor asked her to give her shots of ampicillin and gentamycin (antibiotics). She's asking for the formula for the right dosage of medication. With only a doctor's prescription and 2 vials of ampi and genta in her hand, she has to compute for the right dosage for her neighbor/patient. I was jolted by the moment realizing that I MUST and SHOULD know the formula by heart because it is the most common dosage calculation. I then reach for my pharmacology book and browse the index for ampicillin and gentamycin just to be absolutely sure of the right formula. Steph's messages kept on coming as she reiterates to me if her calculation was accurate. We both arrived at the same answers: 0.4 mL of ampicillin and 1.2 mL of gentamycin are to be administered to the neighbor. Whew! I thought nursing doesn't have Math. I'm poor at Math.

Grief

the last quarter of 2009 is not that good. two of my relatives died--uncle lyndon died of stroke (that was his third attack, after 15 years) and lola angeling died of cardiac arrest. she's been bed-ridden for so many years. a neighbor died of diabetic ketoacidosis (DKA) on jan. 1. her blood sugar went down to 20 mg/dL. gosh. a spoonful of melted sugar or candy or juice could have saved her life.

may they rest in peace.

Bagong taon, bagong career

Happy talaga ang New Year ko dahil sa marami akong nakain nung bisperas ng bagong taon. Nakikain lang ako sa bahay ng aking minamahal na Ron-ron at one-to-sawa na internet sa kanilang bahay. Any new year's resolution for me? Eto na lang, I must avoid procrastinating plans and to-do's para umandar na ang aking napiling bagong career--nursing. Dahil dyan, nag-resign ako sa aking trabaho at sa darating na lunes ay orientation ko na sa MCGH (google nyo na lang ano 'to at san 'to). Ang choice ko na area ay ang OR (operating room). Bakit OR, kase sa OR laging malinis at usually the patient is under the magic spell of anesthesia. Pabor na pabor sa akin dahil maiiwasan kong mahawa sa mga contagious diseases. Ang tanging puproblemahin ko na lang ay ang mga tyrant na scrub nurses at demanding na mga surgeons (na minsan daw ay nambabato ng mga instrumento--wag naman po!). Kailangan ko na ulit buklatin ang inaagiw at maalikabok na mga nursing books para hindi ako mapahiya sa loob ng hospital. Anyway, I should be confident now because I have the licenses (PRC and IVT) and training certificates to empower me in facing nursing responsibilities.