A White Christmas

As I was working early Christmas morning I peeked out the window of my patients room and noticed it was raining. YAY, maybe the snow will melt enough so that I can get all the way home and to my sister's house for Christmas!!! Boy, was I ever WRONG... I ended up with about 7 or 8 more inches of snow on top of what I already had and I had to park my car at the bottom of the hill (where it is still stuck). As providence would have it, I happened to see a friend in her truck as I was trudging along the road making my way home, she graciously offered me a ride the rest of the way home.
I napped by my fireplace for a few hours and hitched a ride with Becky, Steve, and the their dog to Sean and Lisa's house. The festivities went as planned (mostly) with the highline being watching my mom try to play guitar hero. What a kick in the pants!

Barefoot in the Snow Up Hill Both Ways

I took the bus to work last night half anticipating that I might get stuck there in the morning waiting for day shift to come in with all the snow. I had "prepared" myself for such possibilities by packing an extra set of scrubs, socks and three times the amount of food as the usual.
All night long I found myself peeking out the window, each time expecting to see the promised snow. Finally at about 2am, I noticed some tiny flakes drifting sluggishly to the ground by the light of a lamp post. Next thing I knew it was 0730; the day shift was actually HERE and the snow was accumulating quickly.
I checked the sound transit website "just to make sure" and then headed out to catch my bus. We got rerouted on our way home due to road closures, bus spinnouts and thick layers of ice. By the time the bus finally dropped us off, I found myself in the northern portion of downtown Kirkland. So... It was nice morning walk up to the university campus in a winter wonderland wearing scrubbs and clogs. How invigoratine after having worked all night! Unfortunately the snow was little too deep for my shoes and I ended up with a good amount of snow in my clogs. (Yes, I actually had planned ahead for that too, but I had left my boots in the my car at the park and ride. I hadn't anticipated this bus reroute.)
When I arrived at the university, the campus was open and my nursing students were about to sit down to their final. Poor Dr. C. had left his house long before dawn to fill in and administer the test. I also learned (from the students) that he had left his car in Bellevue and walked over an hour and a half to get to campus. Now that's dedication. Had I beat him there I would have called him so he could get back home before he got too stuck and administered the test myself. We had roughly tied however, so it didn't matter; the exam was taken by all who showed up. Afterward I held a little improv. "Cable Chains 101" session with a student's car.
Fortunately I have the only office on the campus to contain 6 beds. Yep... I watched "the blanket show" in my little lab in the bed right next to my intubated Santa mannequin. When I awoke, it was still snowing!


I checked the internet once more before going back out and found that my busses had been canceled and all the other busses rerouted. Once again I had to walk to downtown only this time, no bus! Down to Lake Wa BLVD I went and finally got a different bus which at least got me across 520.

In a Good Place

It's that time of year again... Well yes, it's the holidays but that's not quite what I meant. What I'm talking about is the end of the semester with all it's finals to take, papers to grade, grades to report, etc.. Add all of those things on to working extra hours and the other sometimes not so pleasant surprises life throws at you and that can make for some overwhelming times for everybody!
Just last week I was lamenting over a situation in which I had zero power/ability to fix. I know, it's a nurse's worst nightmare. No matter how much I thought about it, there was nothing I could do to change the situation (or at least for the better). It wasn't longer however, before I was reminded by a friend that when you find yourself amidst (or even looking on) situations such as these in which you realize you are powerless and it looks like there is no hope that in actuality we are in a very good place. It is during these times we can rest in knowing that God holds all things in His hands, even this. (Whatever the 'this' might be.) We are forced to rely on His faithfulness to His promise. These are often the times where God grows our faith, reveals His truth, and draws us near. So... Before you have some "ineffective individual coping" just remember; if you know God you are in a good place.
Jer 29:11 (NIV) "For I know the plans I have for you," declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future."

The Greater Gifts

Thanksgiving 2006 was the first official holiday hosted by my oldest sister in her then new house. I had invited some close friends to join us, a Russian mother/daughter team. While preparing my contribution to the Thanksgiving meal I received a call from my friends asking if they might bring along a close family friend of theirs "with no other place to go." Of course I said this would be fine as we all know that this is exactly what Thanksgiving is all about.
As I picked up my friend Marina on my way out to the house, I was informed that I was to pick up Oscar (the secondary guest). As she told me the address I immediately recognized it as the Union Gospel Mission downtown. (You can't work 9 years on ambulances in Seattle and not have them all memorized.) As we rolled up to the front door, Oscar was waiting. He walked with a serpentine gait and used a cane; Oscar had cerebral palsy. Oscar also had a PhD in Russian studies and a history of aplastic anemia.
Long story short, we all enjoyed a wonderful meal together. When it came time for the festivities to end, I found myself once again driving Oscar back to the mission. In the car on the way back he thanked us profusely for inviting him and said he had a wonderful time that he will never forget. "How can I pray for you," he asked. Though Oscar had "nothing" he wanted to express his gratitude and prayer was the most valuable thing he could offer. Oh, what a powerful gift it is! We prayed for more of God's love because love is: patient, kind, forgiving, selfless, rejoices in truth, never fails.
I don't know how what prayer does or how it works. All I know is that God tells us to do it and when you talk to God...

EMS Holiday Memories (Part 2)

It was Christmas Eve and I was working a 12 hour overtime night shift with a guy named J. Culvin. We'd worked overtime together before and had always gotten along just fine, but every time we worked on the same rig we ended up running back to back calls. Holding true to our tradition, we did run back to back calls setting our record at 14 calls for our 12 hour shift!
There is however, one of those 14 calls that really stands out. We were in the Northgate area when we got called by the police department to respond to an apartment complex. We were told that the scene has been secured and that we should go in. When we arrived we found the complex swarmed with at least 8 police cars. We grabbed our jump kit and stretcher and headed up the elevator. As the elevator doors opened at our destination we made the startling discovery that scene was indeed NOT clear. We were met by a man running down a hallway with a kitchen knife taped to a wooden dowel. We attempted to use the stretcher as a barrier between us and quickly closed the elevator doors just as he was tackled by police and sufficiently pepper sprayed. We then restrained him to the bed and hauled him off to "Crisis Triage Unit" (aka psych. emergency funny farm).
Our last call of the day involved picking up a flight crew at the airfield and driving in to the trauma center. When we finally finished our shift and made it back to the station our hearts sank as we realized our stretcher was still loaded with all their flight equipment. Back to the airfield we went!!!

EMS Holiday Memories

I've heard much talk of holiday memories floating around, it got me thinking about some of my own... I don't remember the exact year, but it was at least 6 years ago, I was still working working full time on the ambulances. It Thanksgiving Day and the family was gathered at my moms house. To my dismay, I was getting ready to head out for my 12 hour shift of ambulance craziness. My brother was the one carving the turkey that year. He took it upon himself to shave me off a few slices and put them in a ziplock baggy so I could have Thanksgiving dinner at work. We even packed an extra portion for my partner too.
When I got work that night we were almost immediately sent to South King County to cover Federal Way and Kent. It was a slow night and we found ourselves sitting at Federal Way quarters watching Charlie Brown's Thanksgiving while enjoying our turkey in a ziplock. I almost forgot that we were at work until finally a call went out and our pagers went off.

Bujumbura, Burundi or Bust?

A few weeks ago while checking my email I noticed a new message from Frank and Carol Ogden, a missionary couple to Burundi. I had met them a few times before, once when I sent supplies with Frank (he's a surgeon) and another time at a missions event when both of us where scheduled to speak. The message was titled invitation to Burundi! As as I read it I could hardly believe my eyes, they were inviting me to go and work at Kibuye Hospital in Burundi, a sister hospital to Kibogora (where I had taught my trauma curriculum in Rwanda)> They wanted the trauma curriculum and anything else I might be able to teach!
The origonal proposal was to go in February. Of course I told them I was interested but I would have to work things out with my own students here in Seattle. I recieved a call from last night with more information. They asked if I would be willing to teach a few classes at Hope Africa University in the nursing and medical schools there. They assured me that dates could be more flexible. It seems that the school year in Burundi begins in February and ends in December. The students at HAU would be in session while my own students at NU are on break. This could work!!!!

The Raven(s)

As I was reading of the students blog posts, I began to reminisce about nursing school and I starting looking through old pictures and papers. I found several journal entries I had made while I was in Alaska working in the villages there. Here is one them that I seem to have found at quite the opportune time.

We had a meeting at 1pm about the the community health aid program. I ended up not going because Aeromed had a flight for me to go on. Our call was in a village called Tooksook Bay. It located on Nelson Island near Night Mute. On the way to the village I got to sit in the co pilots seat. As we landed I noticed there was an overturned plane lying on the side of the runway. (This was the previous Areomed flight that didn't quite make it.)

After we landed we were picked up by a man on a "snow go" towing a wooden sled. We put all of our equipment on the sled including Tom, the flight medic, and rode along the frozen coastline to the village. Our patient was an infant with probable RSV.
During the flight back to Bethel I was looking out the window and noticing that there was absolutely nothing down there (not even trees) until you reach the village. These people were totally isolated. I was thinking about when God calls people to places like this... As I continued to look out the window I saw a raven flying below us.

I thought about Elijah at the Brook Kereth. The Lord had sent him there to escape the wicked king Ahab who was killing all the prophets of God. Even though God had sent Elijah to a remote and desolate place, He did not leave him "high and dry." God provided for him from the waters of the brook and He used the birds (ravens at that) to minister to him and bring him food.
These ravens did not bring the message of "nevermore" but rather the message of "evermore." Sometimes God leads us to desolate places, places where we think we couldn't possibly have a ministry. We just need to remember that it's all God's ministry, He doesn't need us (fortunately He wants us)to carry out His master plans. God can use even the ravens. In fact, sometimes He leads us to those places to minister to us. If we are faithful to follow God to the ends of the earth, He is faithful to provide for you forevermore.

I Kings 17:4
You will drink from the brook, and I have ordered the ravens to feed you there.

Vulnerability: Naked and Unashamed

Yesterday in post clinical conference I decided to talk to the students about vulnerability. The discussion that followed only confirms that I do indeed have a QUALITY group of students. While I cannot do the conversation justice here in this entry I will try to touch on some of the highlights.
As humans created in the image of God, we have a desire to know and to be known. This takes vulnerability. Vulnerability can be frightening. However, it is in our vulnerability that we grow the most. It is also in vulnerability that the 'self' is overshadowed and the One who sustains us becomes more visible to others. Many times it is in our most vulnerable state that we can bare the most powerful witness.

2 Corinthians 12:9 But he said to me, "My grace is sufficient for you, for my power is made perfect in weakness." Therefore I will boast all the more gladly about my weaknesses, so that Christ's power may rest on me.

Another student discussed how the position of vulnerability should be respected. He also mentioned how we must see it as an honor to be the one who is present with another "when they're on the floor or in the bed."
"When it comes right down to vulnerability is what makes us as followers of Jesus different," replied another. "In other religions, it's all about appeasing an impersonal god. In Christianity, it's about giving yourself over to Him. It doesn't get any more vulnerable than that, it is in this that we have a personal relationship with the Saviour. Jesus even made Himself vulnerable here on earth, He died naked on a cross all for us!"
"When Adam and Eve where in the Garden of Eden the Bible says they were naked and unashamed. But the wanted "knowledge," so they disobeyed God and ate from the Tree of the Knowledge of Good and Evil. Suddenly they realized they were both naked and became ashamed. They hid and sewed together fig leaves to cover themselves. It think that today we have a deep longing to be 'naked and unashamed.' The only way we can do that is through Him."

Adults Say the Darnedest Things...

There is a woman in the secured Alzheimer's unit who is convinced that another male patient is her husband. (Of course this is simply not the case.) At meal times she sits next to him, picks off his plate, and then tries to feed him.
One morning one of the nurses aids was helping the man get out bed and mentioned to him that his "girlfriend" was waiting outside the door. The man leaned over and whispered, "Can you tell me her name? I don't want to offend her!"

Nursing Home Soap Opera

We've survived another week of clinical, but not without some measure of drama. It's comical really... It seems that one of my male students has found a new "girlfriend" in the Alzheimer's unit. A little lady follows him about spouting out comments like "I'll have me a piece of that" and "Isn't he delicious!" This is also the same woman who takes a drink of water and says "There's something wrong with this, it's not spiked." My other male student rescued a dementia patient from out of the bushes where she had lost herself a few hours earlier.
Another one of the student's patients significantly improved after being placed on hospice and taken off of all of his medications. It seems he now talks, walks and eats all of his meals without help. He couldn't do any of these things before he put on hospice care.
One of my young ladies received highest compliments from for the administrator for getting her severely obese patient with anasarca and terrible venous stasis ulcers on her legs into a recliner. This woman had apparently been in her wheelchair almost constantly for several weeks. She even slept in wheelchair refusing to get into bed which of course made it hard to elevate her terribly swollen legs.
It turns out that another students patient had been a medical assistant in a doctor's office. She coached the student through taking her vital signs and testing her blood with great joy and excitement. Ironically it was the sweetest girl you could ever know that was the one who made her patient cry. However, the bout of crying was brought on by a "goodbye" at the end of the day. It's such a privilege to work with the next generation of nurses, the ones who aren't jaded and haven't developed bad habits yet. How refreshing!

Decreased Intracranial Adaptive Capacity

I used the student computer on lab on Friday afternoon to download and print some documents off of another instructors coarse website because my own computer didn't have the program she had used to create the documents. Several of the nursing students where working frantically on a paper they have due next week. The assignment was to perform a health assessment on a classmate and then create a nursing care plan based off of the 4 top priority nursing diagnoses. The longer I sat in that room the more questions they asked me.
Nurses cannot legally make medical diagnoses, however they can make what are called nursing diagnoses. Every year a group called NANDA (North American Nursing Diagnosis Association) has a conference to approve the next list of official nursing diagnoses. When I was in nursing school there were only 144, my has the list grown!
As I went through the lists I couldn't help but wonder what it would have been like at those conferences. Here a few new ones that kind of make me go Hmm...
Decreased Intracranial Adaptive Capacity
Impaired Adjustment
Diversional Activity Deficit
Ineffective denial
Acute Confusion
Ineffective Individual Coping
Knowledge deficit
Do they speak from experience? Sometimes you just gotta wonder...

Long, But Worth the Read

Yesterday as I was walking backing into the health sciences building I held the door for a girl coming in behind me. As I was walking up the stairs to the lab, the girl stopped me and asked where she the nursing offices where. She went on to explain that was alum of the nursing program and she needed to talk to one of the professors about a problem she had. As I walked with her down the hall she said "You work at UW don't you?"
I wasn't quite sure how she knew that but of course I said yes. Then she asked if she could tell me about her situation, I of course said yes to that too. The poor girl just fell apart as she began to tell me her story. She had just started a new job in an oncology (cancer care) ICU. A few weeks ago while she was still on orientation she had her first patient code (cardiac arrest). They where able to resuscitate the patient twice that day but the woman died two days later.
She went on to explain that at first she felt OK about what had happened, her co-workers and her manager had congratulated her on how she had handled the situation.
She didn't fall apart until a few days later... Just before her patient (who is extremely sick) had coded she had drawn a blood gas from and arterial line. After she had drawn the blood she noticed a very small bubble in the in the line. The preceptor told her to flush it anyway. To make a long story short the poor thing became convinced that she had killed her patient by giving her an air embolism. She had been tortured by this awful thought for two weeks while on a family vacation, she was about to go and tell her manager this.
We talked for about an hour. I tried to explain to her that it takes several milliliters of air to cause and air embolism, the amount of air in 2cm length or art line tubing isn't enough to cause anything. The patient was on the way out! The question I asked her was "Where did that thought come from?" No one had told her she had killed her patient or that she was a bad nurse or that she couldn't do it. Those condemning and untrue thoughts were coming from the devil, who else wants us to fail? Who wants to disable us with our own thoughts and keep us from being who we are called to be? We can't let ourselves go down that path. While people can and do make mistakes that they need to be accountable for, they cannot take false responsibility. One cannot also be overridden with guilt to the point where they can't move on and it affects productivity.
2 Corinthians 10:5 says:
We demolish arguments and every pretension that sets itself up against the knowledge of God, and we take captive every thought to make it obedient to Christ.

Isaiah 55:8-12 says:
"For my thoughts are not your thoughts,
neither are your ways my ways,"
declares the LORD.

"As the heavens are higher than the earth,
so are my ways higher than your ways
and my thoughts than your thoughts.

As the rain and the snow
come down from heaven,
and do not return to it
without watering the earth
and making it bud and flourish,
so that it yields seed for the sower and bread for the eater,

so is my word that goes out from my mouth:
It will not return to me empty,
but will accomplish what I desire
and achieve the purpose for which I sent it.

You will go out in joy
and be led forth in peace;
the mountains and hills
will burst into song before you,
and all the trees of the field
will clap their hands.

As we were talking another professor came in and the three of us had the opportunity to pray these promises. I think we all needed to be reminded to take captive every thought and seek a higher understanding grounding ourselves in truth.


I can't take credit for this picture, it was taken my a person I met in Rwanda who worked for World Concern. The picture was actually taken in Pakistan.

Playing Dolls...

Last week our nursing students started what is lovingly known as "Boot Camp." Boot Camp is the concentrated time we spend in the skills lab learning basic patient assessment and other fundamental skills such as bed baths, bed making, hygiene cares,etc... Some of these skills are practiced on one another while others are practiced on mannequins. Last Friday I was helping the students practice bed baths when one of them said, "I feel like I'm a little girl playing dolls." Essentially that's exactly what we were doing. Little girls (and sometimes even boys) have been learning the art of how to physically care for others by "playing dolls" for centuries.
One group of students was practicing basic care on the pediatric mannequin when the they noticed that the arm was not securely attached. Needless to say we ended up with a traumatic amputation. I took little Jill (the name they chose for their "patient") into my office for some orthopaedic surgery. I was able to reattach the arm but unfortunately due to some missing parts Jill will have a slightly more limited range of motion in her right shoulder.
In my attempts to find some material for some upcoming class discussions I have been reading a wonderful book titled Fearfully and Wonderfully Made. It's by Dr. Paul Brand and Philip Yancey. Dr. Brand was a missionary doctor at a leprosy hospital in India. The book is written from his perspective and discusses the ingenious design of the human body and it's implications to what that means in the concept of community.
In one chapter Dr. Brand describes how he was able to learn more about the disease process of leprosy by studying the bones found in a 500 year old leper colony. He recalls a lecture he once attended by a famous anthropologist. In her lecture Dr. Mead claimed that the earliest sign of civilization is not a clay pot or tools. She claims that the earliest signs of civilization are healed bones! Such artifacts, she said, are never found in the remains of savage societies. The artifacts left behind by them are always evident of violence and destruction. A healed femur (such as the example she had when giving this lecture) showed that someone must have cared for the victim and provided for him (at personal sacrifice) during his time of recovery.
How fascinating, the concepts of caring and community truly are what make us "civilized."

On Monday when I came back into my office after making some copies I found Jill sitting at my desk!

One Week Down

So ends the first week of school... I'll say it went well, it really did. Classes are in full swing and the students have already had an "exam." On Thursday I gave a short "schpeal" about blood pressure, what it is, how the body regulates it, what affects it, etc... Friday I tested them on it. They each took turns taking a blood pressure on one another as I listened in with a double stethoscope. Apparently I make the students hypertensive! Their nervousness was never more obvious to me. In spite of this, they all did very well but I'm starting to wonder how things are going to be when we start breaking out the needles!

Let the School Year Begin!

It's that time of year again, school starts in just a few short days. The students have moved into the dorms and the parents have left. Teachers everywhere are making last minute preparations, hanging borders, making word walls, and expanding their classroom libraries.
I had the pleasure of visiting a "teacher store" with some elementary school teachers of mine. I also had the distinct pleasure of writing "Mrs. Baros" inside the covers of all sorts of exciting titles ranging from "Winnie the Pooh" to "Amelia Bedilia" to "The Boxcar Children."
Just last week "Mrs. Baros" helped me go through my classroom library which incidentally had much more boring titles like "Therapeutic Nursing Interventions" and "The Physicians Desk Reference." I must admit that I would rather be reading Encyclopedia Brown than writing my lecture on fluid and electrolytes.
Last Friday morning I had the distinct pleasure of leading the devotion time during the new student orientation. I was reading the passage in Exodus 17 where the Israelites are fighting the Amalekites in the valley while Moses stood on the hill holding his staff. As an illustration I had one of the students hold a box over her head as I read the scripture. After a few verses I would then add one of their text books to the box. Of course it didn't take long for her arms to get tired (as I can be long winded and each of those darn books weighs at least 6 pounds). Her classmates soon figured out that they could help her by holding her arms up. When I finished reading the chapter I asked a few questions about the application of this passage. They seemed to grasp the theme of encouraging one another in the Lord, baring each other's burdens, and standing firm in truth but when I asked them what was above their heads one of them quite seriously said "our assigned readings." Actually I was going for the whole "The Lord is my Banner" thing but...
Later that afternoon I weighed that box and found out that with all it's contents it was 52 pounds! I'll bet our students were wishing they were reading Amelia Bedelia or Encyclopedia Brown too.

Classroom Civility, Manure, and Professor So and So

The last few weeks have been blur as the summer is coming to a close and the school year is almost here. This week has been marked by my sister's wedding, 60 hours of work at the hospital, and of course the faculty retreat and other preparations for the upcoming semester. As I drove onto the campus this morning I was greeted by the maintenance crew preparing the dorms and classrooms for occupation. In just a few short days the students will begin moving in.
I ended up going to faculty retreat in my scrubs as I had missed my bus and therefore didn't have time to change clothes. During the opening of the meeting the Dean passed out gifts to each one of us; chocolates and a bag of manure (fertilizer). He went on to explain how he had gone to a conference at West Point and visited the site where a part of the movie "Hello Dolly" was filmed. Apparently there is a part in the film where she says "Money is like manure, it has to be spread around to make things grow." Dr. C was encouraging us to spread around our encouragement and expertise as instructors to help our students and each other grow.
I'm going to have to get an office plant now just to use my fertilizer.
Dr. C's presentation of the gift of poo was followed by a presentation about civility in the classroom. I must say it was a little interesting to be sitting amongst a group of women twice my age talking about the lack of respect shown by the "me generation" and their "sense of entitlement" and constant need for reassurance. Sadly I agree with this opinion and sadder still I'm more a part of this generation than that of my collegues. How did we ever get this way, so demanding yet so insecure in ourselves?
What's the answer? There is now a school wide policy that students can no longer call faculy by first names. We must now be called by title and surname, so that's Professor Morgenroth to you! Personally I'm not to crazy about the idea. Why can't we just go southern and be Miss April? It's a pentacostal Christian university, heck I could be Sister April (accept that sounds Catholic); or how about just the last name? Some of these students will be older than me and I want to be approachable. What a dilema... It will be interesting to see how this new policy changes the culture of the University, especially with last years students coming back to Professor So and So. Too bad I can't be Professor So and So...
Any opinions for any of you teachers out there?

AWOL

Last weekend was our family's annual reunion at the house on Lake Crescent. Sadly, as people don't get transplants at the most convenient times, I had to work at the hospital so I missed it. Wouldn't you know it, the very day following the reunion was the start of a stretch of days off.
Angela and I took the opportunity to run away, we left right after I got off work on Monday morning. Technically I wasn't actually AWOL, at least not from work... We had quite a nice time with a little bit of hiking, a little bit of swimming, and whole lot of doing nothing and it felt good!

Mexicali 2008

This June marked my 12th year with the Mexicali Mission Team, it's hard to believe that it's been that long! I mentioned a bit about the trip in a previous post but I was unable to share pictures at the time. Somebody finally clued me in to a website where team members had been posting their pictures so thanks to them I can now share a few.

Here are the girls digging a ditch to lay pipes for the new bathroom. The previous "bathroom" was just an outhouse and the sink didn't actually have running water. Did I mention it was 118 degrees while those girls were digging the ditch?


As we broke ground for the plumbing ditch we found layer after layer of clay crusted carpet. The pile in the picture isn't even all of it!


The guys worked for hours to raise the roof, here's part of it.


Appartently I just can't go on an international trip without randomly doing the Macarena with a bunch of students. Here we are dancing on the rooftops.


Also holding fast to tradition was the annual banana suturing event.


The girls were "just trying to cool off..."

Amazed

Friday night I had dinner with a friend from nursing school I hadn't seen in quite a long time. It was great to see to her, chat and catch up. We talked for hours about everything from grad school to Africa to Sri Lanka to being nurses. It was one of those conversations where the other person is saying exactly what you needed to hear and your saying exactly what that person needed to hear. I love it when that happens!
Of course she asked about Rwanda, but it wasn't until I started telling her the story that I realized just how truly amazing the whole thing was. God did some pretty incredible things to pull this off. Here are few:
~The Rwanda project was not actually the project I had originally intended on doing. ~I had to change my project 24 hours before my proposal was due.
~The project was approved for the proposal writing stage at 4am, just 20 hours before the proposal was due.
~The approval came about through a series of 16 emails between three people: Myself at work in Seattle, Julie in Rwanda, and my professor who was in Japan at the time. Hence we were all on the computer at the same time.
~When I got the go ahead to write the proposal the professor said "If you feel like God is calling you to do this then go for it!"
~About 8 weeks before my departure date to Rwanda, my computer was stolen with all my work on it. A brand new computer was gifted to me not more than 24 hours after the incident.
~I got an entire month off to go, a major feat when you're a nurse in the midst of a nursing crisis.
~The program was for the most part successful but I think that I was one who learned the most.
~I graduated on time when it looked like I might not!
That whole experience was such a gift from God and the story a testimony of His faithfulness. It blows me away just to think about it.

Chili Chocolate and other Chocolate Fun

I recently stated in a post that I like chili chocolate. Since making that claim I have been asked several times about it. I know that the combination of chili and chocolate sounds a little "iffy" but I think if you tried it you might be pleasantly surprised. I spent an entire 2 weeks in Mexico in search of the stuff once. I recently found it again at an Eastern European market. It's good stuff Maynard!
In my search for pictures of chili chocolate, I also came across some other chocolate fun. Check this out! I've got to admit that it made my night here at work.

Life After Grad School

Mexico
Hello all, I know it's been awhile but I've only just recently returned from Mexico. No, it wasn't really a vacation, I was with 20 teenagers! We were doing some service projects which included building a roof, painting, and bringing indoor plumbing to a pastor, his family, and his church. We also had two different sites for teaching Vacation Bible School. VBS is not really my gifting however, so a few times I was designated to stay and cook dinner for the rest of the group while they were away. Have you ever tried to make 100 tostadas?
Overall the trip went very well and the students learned a lot and had a great time. They were even glad I made them share testemonies in church. By the end of the week the VBS sites had a total of 90 kids in attendance. The plumbing ditch was dug to specifications in spite of having to dig through endless layers of clay caked carpet (yes, this was outside). No one was seriously ill or injured. We returned last Thursday night and believe or not I actually miss the students! Unfortunately I do not have any pictures of the trip as once I got there I found that I had forgotten to take my camera's memory card out of my laptop! I'm hoping some other kind souls will share their photos with me.
A Social Life?
Naomi, Kate, and Julie would be proud... Just before leaving for Mexico I had a dinner party. Of course this required cleaning the house and cooking, two things I rarely did while in grad school. The menu: lamb, buffalo, and rice stuffed grape leaves (dolma), a lovely salad complete with craisins, and two types of home baked (yes, I made them from scratch) bread. I had to make some for a potluck at work anyway, so why not make a party out of it?
I'm not much of an entertainer however and I don't have a Wii or an X-box or anything to make people play Guitar Hero on or anything. I much prefer actually interacting with my guests anyway. We ended up suturing bananas! Actually, these sutures don't look half bad. I think some of my guests may have missed their callings.
July 4th
The Fourth of July was pretty low key for me. I went to mom's house and sewed with her and my sister. I'm excited to report that after 4 years I have finally completed Operation Rescue Ugly Couch! Stop the insanity, I wonder what's next...

Tagged

I was recently tagged for a little survey thingy... I can't say I've ever really done this before but I found it slightly interesting. It forced me to take a look at who I am after so many years of neglecting certain parts of myself and/or blindly running about like a headless chicken. I've started asking myself other questions too, it's been eye opening. Reflection plays such an important role in learning and growing. So Shiloh, here are my answers:

Five Things to do on my List today:

• Go to the bank
• Go to the Department of Licensing to get a a drivers abstract so I can drive the school van
• Pack for Mexicali
• Do laundry so I have clean scrubs to wear to work tonight
• Figure out what I'm going to do for devotional books for 20 kids

Snacks I Enjoy:

• Frozen grapes
• Almond Joy (this was my food of choice for long curriculathons)
• Chili chocolate (yes, you read that correctly)
• Raspberries

Things I would do if I were a Millionaire:

• Pay off my mortgage
• Start a nursing school in Kibogora Rwanda
• Get a PhD and not work at the same time
• Use my millions of dollars to get Shiloah Health Outreach off and running

Places I have lived: (too bad extended trips don't count)

• Des Moines,Washington
• Federal Way, Washington
• Seattle,Washington
• Milton, Washington
• Kirkland, Washington

Bad habits I have:

• Not taking my trash can out to the curb in time
• I'm terrible at making schedules for myself
• Not backing up my computer files!
• Going through life sleep deprived
• Being "anti-social" at times

Jobs I have held:

• Lifeguard/Swim Instructor
• EMT
• Camp Nurse
• Nursing Clinical Instructor
• ICU Nurse

Masters of the Universe: What's Next

The master's degree is finally a reality! I completed my thesis defense on June 11th and walked at the UW School of Nursing graduation on June 13th. I had just come off of a 12 hour night shift so some parts of the day are blur but overall it was enjoyable. The best part however, wasn't parading across the stage sporting my new hood; it was knowing I had the support of family and friends.
So now that this part of my life is over, many people have been asking me what's next. I'm trying hard not to be too tempted to start back in school right away. I'm really thinking that now is the time to gain a little balance, take some time to regroup. In the immediate future: I am leaving for Mexico with a group of 20 teen-agers THIS Friday! We'll be working with a church and their youth on construction projects and Vacation Bible schools. This is my 12th annual trip with this group. In the not so distant future: I am accepting a position at Buntain School of Nursing at Northwest University teaching a clinical group and helping with management of the skills lab. I will be decreasing my FTE at University of Washington but plan to continue in clinical practice to maintain a current perspective on patient care. I am hoping that this will led to a more normal schedule and a better balance.
Ultimately over the next year I would also like to concentrate more on the development of Shiloah Health Outreach as a non-profit organization. Also on my list: clean the house, fix the back deck, write the Mexicali Bible studies BEFORE the meetings begin, sew more, sleep more, and the list goes on... Of course we'll just have to wait and see if God doesn't have different plans...

I'm Back...

It's been a long week. Saturday and Sunday I found myself "practicing" my public speaking in churches and at missions events. All of those things went well but I couldn't help but feel a little guilty that I wasn't working on my thesis.
Sunday night and Tuesday night were perhaps the last all nighters of my academic career. It wasn't as bad as I thought it might be. I talked myself into thinking that these nights were sacred events. I even went down to the store and bought some special coffee beans, a stack of printer paper, a printer cartridge, a new flash drive, and some fruit snacks. By yesterday morning when I left the house for the university, the only thing I had left was a stack of the printer paper. I had used the rest of my purchases completely!
The presentation went well, thank you to everyone who prayed for and/or showed up at my thesis defense. My project was approved for graduation and all my papers were signed. I had a nice lunch with some great friends afterward and then headed home to sleep. I couldn't have asked for a better way to celebrate.

Defender of the Thesis

Well folks, I finally have a date to defend my thesis! Mark your calenders for June 11th at 9 am and pray hard. Unfortunately I have to work nearly everyday between now and then so I'm a little stressed about having enough time to prepare. Will having my project "critiqued" by a panel of academics somehow desecrate my experience? I hope not! Here goes...

Some Long Awaited Photos

Naomi took this picture, it's one of my favorites.That is the Rwandan flag, the other side of the lake is Congo.This was our house. (Just kidding)

A backboarding lesson.

Missionary Mail

The postal system in Kibogora is unreliable at best. So... Every time someone from the states comes out, they always end up transporting mail to and from Kibogora. The night before we left I was met by several folks who brought mail by in hopes that I could take back with me to mail from the states. I ended up with 74 pieces of mail! Five or six days from Rwanda to any of the 50 states sure beats 6-7 weeks!

Borrowed Students and the Macarena

I know... I've fallen down on the job of posting more Africa pictures. Actually, I've just been saving them up for you and building the suspense. ;)

A few days before we left Kibogora a group of students came from Roberts Wesleyan College in New York to help teach English at two local high schools. The night before we left they were invited to one of the schools for a special performance of some traditional dances. I finished teaching my last class a little early so I decided to go along with RWC group.

Long story short we found ourselves as the guests of honor sitting in front of a huge throng of Rwandan high schoolers watching the performance. It was actually quite the interesting experience. However, by the time the performance ended we found ourselves trapped in the building as there was a torrential downpour outside.

We were stuck there, sitting in front of 500 students who were all staring us expectantly. It was our turn. We were all asked to introduce ourselves. I decided it would be too complicated to try and tell them that I wasn't associated with the Roberts Wesleyan group and it didn't really matter anyway so I borrowed some students. After the introductions and several awkward moments of silence I finally figured out that they wanted us to perform.

I told them "Quick, do the Macarena or something." I didn't think they would actually do it!!!

Update On Our New Friend

Meet Daniel, he is boy who was severely injured after being hit by a bus. I mentioned his story and showed you his x-rays a few entries ago. Here he is and he's doing great! He is off of oxygen and off of his IV. His lungs are sounding fairly decent and best of all he is walking which is SO important to his recovery. He still has a ways to go before he can return home, but he's certainly on the right track!

Out of Africa

Hello everyone, we've finally made it home! We left Kibogora at 8am on Thursday morning and arrived in Seattle at 2pm on Saturday afternoon. It was quite the long trip, especially when you include the 10 hour time difference between Rwanda and Washington.

Thank you to all of you who have been praying about our flights. We were able to fly to Kenya instead of Uganda. We ended up with our longest layover being only 7 hours in Niarobi. I found some good coffee and a great book so it really wasn't that bad at all.

However, true to our experiences, Naomi and I did seem to have some very different plane experiences. She always ends up sitting next to people who are photographers and such and always seems to have made new friends by the time we get off the plane. I however stuck sitting against a wall next to man reading "The World's Most Infamous Murderers." "So... Who's your favorite murderer?" ;)

On the 10 hour flight I was once again stuck with a "window seat" next to two men who slept nearly the entire time and seeminly never had to get up and use the bathroom!

Now that we are home I'm going to try posting more photos so don't tune out yet, the best is yet to come!

Photograph with Caution!

I know that I promised everyone that I would take a lot of pictures… However, I’ve learned that one must exercise caution while he photographs. You must be prepared as the moment you take out your camera you will be surrounded (and perhaps stampeded) by men, women, and children who will want to be in your picture. It is therefore nearly impossible to obtain candid photos and if you don’t like being surrounded then forget it! We experienced this on market day as we walked down the crowded streets of a small village. The kids followed us for miles. Our only saving grace is that sometimes the parents say the “white ghosts” will eat the little children who misbehave. I’m sure you could have guessed that I was designated to be the “crazy scary cat lady” who chased them away; Naomi was our official photographer. She does better in large crowds and has a better camera. Unfortunately I do not have the software to download her beautiful photos so I won’t be able to post them until we get back.

Quick, While the Internet is Working...

The internet is momentarily back up!!! I thought I would try to write a "live" blog post while I still can. Our time at Kibogora is up, we leave tomorrow. Overall the classes have been a hit; so much so that we ended up teaching and extra 4 times through our entire curriculum! At first i was a little disappointed that we didn't have as much time to spend with each group to really get the information to soak in. However this morning I was excited to see some of the nurses teaching thier peers and even the doctors how to secure a patient on a backboard!
Several people have asked how they can pray specifically for Kibogora. Here are some of the most pressing needs we have seen here.
1) The Child Survival Program which provides food to malnutritianed children and education to their mothers is in danger of ceasing as the grant is finished. They are in the process of applying for a new grant.
2) Bushangi Hospital (about 45 minutes from Kibogora) was badly damaged in the Feb. earthquakes. None of the hospitals have been payed the money owed them by the government for the mutual. Bushangi is in danger of closing.
3) Kibogora Hospital is also owed money by the government. Until the money is paid they cannot buy the medicine their patients need.
4) The nursing school nearby has been closed. The government as asked Kibogora if they could be a site for a new university level nursing school. (Of course the funds would not come from the government) They are considering this and praying about funding.
5) The boy who was hit by the bus is recovering!!! Please pray for his continued recovery and that he will have the strength to continue on the diffiicult road to habilitation.
6) The hospital is in despirate need of oxygen concentrators.
7) Pray for continued strength for Julie and Sheila (she's back!) as they continue to work at Kibogora long term.

If I can add a selfish request...
Our flights home have changed, we now have to fly through Uganda, South Africa, and Amsterdam. The layovers between are 12 hours + which is never much fun, espicially with the current situation in South Africa. Pray that we will get home safely. Just maybe our flights will change again for the better! (We hope)
This may be the last entry until we return home, but then again it might not...

Backboards in Africa!

In my preparation of the current Basic Trauma Training curriculum I learned that Kibogora Hospital did not have a backboard. For those of you who do not work in the medical field, a backboard is like a giant body splint. It is used to immobilize patients who may have very serious head, neck, and spinal injuries which could potentially result in paralysis or even death. At home a back board is considered a basic essential. How could I teach proper care of spinal injuries without a backboard? We could have one made!
I drafted some plans for a back board and measured out every detail, or at least I thought I had… Apparently it wasn’t obvious that the thing was supposed to be able to support the weight of an adult. The first attempt was made of paper thin balsa wood! I couldn’t help but laugh, I suppose it was my own fault for drafting the plans in only 2 dimensions. When we explained that the board was supposed to be used to move patients and therefore needed to be sturdy enough bare up to 90 kg. we all laughed.
The next version was proudly presented to us on Julie’s lawn. I made Naomi try it out this time while all the Zamoos (guards) picked her up. It worked well and for the most part it resembles a real backboard. It is the first backboard for all of the Southern Province! We have plans to “break it in” during Mondays classes.

Nakibazo

Hello all, sorry to have kept you waiting so long since the last post. We have had some internet and electricity problems for the past few days. The hospital is on generator right now until tonight at 9pm and then it's lights out! Seems like unstable electricity should be a huge problem when it comes to running a hospital but somehow they manage. The truly Rwandan response to anything unexpected seems to be "nakibazo" which means no problem. I guess it's kind of like "hakuna matatah" on Lion King?

A Few Photos

It's early Saturday morning here and I seem to have caught the internet at it's "fastest!" Here are a few photos I hope you will enjoy.

More Trauma and Drama

Last night just before dinner Sheila came and told us that they were requesting a "muzungu consult" at the hospital for a trauma patient. Apparently it is a cultural thing that doctors will not listen to nurse's regarding clinical decisions so as you can immagine we were all very surprized by this.

Naomi and I went down to the hospital to find an 18 year old boy who had been hit by a bus. He had a very badly fractured left arm with multiple rib fractures on his left side accompanied by deminished lung sounds. I'm not an expert at reading x-rays but I think he also had a small pneumothorax. The physicians wanted to transfer to him to Butari for surgery consult. They were asking us if we thought this would be safe and advisable or if we should keep the patient at Kibogora.

He was too unstable to transfer in the "ambulance" with no oxygen for 3 hours, a potentially expanding pneumothorax, and unstable rib fractures on a "road" that is more like a dry river bed. So... Long story short we prayed hard and admitted him to the ICU. I wrote a "nursing care plan" (ICU orders in reality) and wrote a very thorough note in English. I checked on him again during the night and agian in the morning. He has been stable! I'm not sure how he will do long term as there are a million possible complications but I'm confident that the decision to keep in Kibogora was the right thing to do and the ICU nurse did a fantastic job of caring for him.

ER

While having dinner last night at Julie’s house, Sheila received a call from the head nurse at the hospital. Three emergent surgery cases had come in since afternoon and hospitals only surgeon is unexpectedly out of town. Two of the cases had been successfully transferred to Butari, the next closest hospital with surgery capabilities. The third case was a soldier with a suspected head injury. After her phone conversation Sheila asked if Naomi and I would go down to the hospital and “have a look at the soldier.” We arrived in the ER to find it full with only one poor nurse taking vital signs on the next bed.
We found our soldier unresponsive with a large palpable mass on his back. I suspect he may have been bleeding from a lacerated spleen and traumatic brain injury. He was too unstable to transfer to another hospital and there was no vehicle available to take him anyway. Sadly, there was nothing to be done and the man died 30 minutes later.
In the mean time, something on the next patient seemed to be alarming. When I looked behind the curtain I found an unconscious man lying face down in vomit gasping for breath and a malfunctioning oxygen concentrator.
Everyone helped to reposition the patient and we got the oxygen concentrator momentarily working again (it still required someone “rebooting” it every three minutes) but the patient had already aspirated. There was no suction available. His oxygen levels went from 47% to 88% and we decided to make a break for the ICU.
The whole night was an intense experience for everyone. I am beginning to understand how things work here and the everyday challenges that the staff face while caring for their patients. It is very different here…

Muzungu Moments Part 3

This afternoon I took my laptop down to the hospital to use the internet. In order to get a faster connection I encamped outside directly below the satellite dish. I was just about to finish posting the second edition of Muzungu Moments when out of the corner of my eye I spotted two little girls peaking around a corner at me. Once they knew I had seen them they giggled and waved, I waved back and said “Mediwe.” (Good afternoon in Kinyarwandan). They approached me slowly and cautiously with curious looks on their faces. After a few minutes they sat next to me on the ground watching as I typed. In the past I have been rightly accused of being “nerdy” and/or “teacherly” but I also know watching someone type isn’t one of the most riveting of activities.
Fortunately I had recently downloaded my camera’s memory card onto my hard drive. The girls smiled and giggled when I showed them pictures of snowy college campuses, water skiing, blin cakes, and some of the pictures of Kibogora that I had just taken. I also had some pictures of the fake injuries I had concocted before leaving the states. We skipped over those pictures quickly!
Soon the girls had figured out that they could move the arrow on the screen by using the touch pad. The biggest kick in the pants was when they learned to type their names; another Muzungu Moment.