I'm only making that my post title because I'm listening to my mp3 player. Some of us got to go home early today for a break, so I'm just hanging at the warehouse typing on the blog.
First off, definitely feeling the beat down today. Limited resources, very needy people, tired body and mind, lots of sad stories. I actually had to take a sanity time-out. . .three people were already occupying the three actual eval rooms in critical care, and the doctors, then you've got people with lost paperwork wanting to see the same doctor they saw yesterday, city employees waiting to get their vital signs so they can go on to dental/vision, someone needs their glucose checked right now, and then - where I saw the meltdown in the distance, when the two WAY hypertensive (when I say WAY I mean 220/120) patients approach being escorted by two nurses from triage because they are Vietnamese and speak no english. Oh yeah, there is no Vietnamese interpreter and no space in critical care to help. I have to admit, I was on overload. There were three of us total to sort all 35-40 people out. I triaged what I could and had to walk away for about 15 minutes. Working with such limited resources can be so frustrating when you're used to being a the "World Famous Mayo Clinic" where you just yell and get everything you need. It forces you to be creative in ways you never thought and it can be very uncomfortable and very exciting also. Such a different environment.
We had several "critical" incidents today, but the one I've been waiting for I missed because I actually got a break to eat lunch and left the medical tent. A gentlemen was getting his glucose checked in the tent and it was 610, the nurse got up to tell the nearest physician and the gentlemen started seizing and fell off his chair, going pulseless. I'm so proud of this nurse because she managed the room and got a code going. And where was her critical care nursing help? Eating lunch. Ugh.
Last night I was talking with some other volunteers about overwhelmed I've been with how well we're all working together. I realize it's only a week that we'll be here, but to not know anyone your going with, then be thrown into a chaotic situation with little to no direction and handle the way we have. . .I'm just extremely proud of everyone. People are just shining with their strengths. Just when I think I have someone figured out, they blow me away with something totally amazing and selfless. I mean, there aren't enough words to describe the group dynamic here. It's invaluable to this mission. It's not just nurses, it's the lab people that are working continuously without complaints, it's the pharmacists who have to educate people with very little knowledge of their own chronic illness process on their new medications; the doctors who have patients backed up one after the other - they so much as peak out of their little stall in the tent and we're throwing another patient at them. We have a security guy and a tech guy who have gone above and beyond their scope, doing our laundry, fixing our machines, getting supplies overnighted from Mayo, driving us to Walmart every night, generally putting up with our shit 24/7. I'm speechless.
Tomorrow night one of the "head guys" - I say that because I have no idea what his title is. . .has planned a dinner outing for the entire group, one of the best restaurants in New Orleans - according to one of the locals. I'm excited. I haven't been able to see Aaron down here yet, he got stuck at the clinic he works at, so he won't be able to come over with Cheri until Friday evening. I'm pumped to talk to them about the healthcare down here - to get another perspective.
The high tomorrow is 48 degrees with an 80% chance of rain.
Vote Al Frankin. . .
Wednesday, January 31, 2007
Tuesday, January 30, 2007
Stories
I needed a place to put story anecdotes to be developed later. . .so here are the teasers. . .
Woman raped by a male nurse.
There was a woman I took a medical history on in triage where I nearly lost it in front of her. An unassuming lady in her 50s coming in with only a few complaints but just hadn't seen a doctor in over a year. After running down my list of triage questions I came to HIV and she paused and said, "You know I should probably get screened. I was raped by a male nurse after Katrina and I never did get tested." I was in such shock, I had no words. A nurse - a patient advocate - during one of the worst storms in 20 years, rapes a patient. It was just too much.
CD of pics from EMS, plenty of gruesome pictures of police shooting back at looters, corpses, and plucking people from their roofs.
The man who had a stroke a year ago because his diabetes was completely uncontrolled because he has no insulin because his clinic closed because of Katrina - just needs test strips because he can't afford them at his local pharmacy. We were giving away meters and test strips, but we were currently out, and so I'm going watch this man walk away from me, into the New Orleans abyss knowing that he has no way to check his glucose and treat his diabetes properly.
Thoughts:
Why people stay. Why people go. FEMA trailers. Corruption in the school board and Louisiana state government. The endless complements on our presence and the wonderful hugs I get all day, every day. Confusion and politics in the good samaritan game.
Quotes:
"I'm tired, I'm cold, I'm wet, and my ass is dragging."
"Kicking tires and lighting fires."
"Patient check-in, STOP sending patients to the medical tent."
"Anybody want a sandwich?"
Woman raped by a male nurse.
There was a woman I took a medical history on in triage where I nearly lost it in front of her. An unassuming lady in her 50s coming in with only a few complaints but just hadn't seen a doctor in over a year. After running down my list of triage questions I came to HIV and she paused and said, "You know I should probably get screened. I was raped by a male nurse after Katrina and I never did get tested." I was in such shock, I had no words. A nurse - a patient advocate - during one of the worst storms in 20 years, rapes a patient. It was just too much.
CD of pics from EMS, plenty of gruesome pictures of police shooting back at looters, corpses, and plucking people from their roofs.
The man who had a stroke a year ago because his diabetes was completely uncontrolled because he has no insulin because his clinic closed because of Katrina - just needs test strips because he can't afford them at his local pharmacy. We were giving away meters and test strips, but we were currently out, and so I'm going watch this man walk away from me, into the New Orleans abyss knowing that he has no way to check his glucose and treat his diabetes properly.
Thoughts:
Why people stay. Why people go. FEMA trailers. Corruption in the school board and Louisiana state government. The endless complements on our presence and the wonderful hugs I get all day, every day. Confusion and politics in the good samaritan game.
Quotes:
"I'm tired, I'm cold, I'm wet, and my ass is dragging."
"Kicking tires and lighting fires."
"Patient check-in, STOP sending patients to the medical tent."
"Anybody want a sandwich?"
C-C-Cold - Day Five
I didn't post yesterday because I had no energy to lift my fingers to type. Talking with some other Mayo peeps today, we all agree that this is the best type of exhaustion we've ever had. We have fun all day with everyone at the clinic, but seeing 400 patients in a day is overwhelming.
Yesterday a RN from New Orleans gave us a tour of New Orleans East, the lower and upper 9th ward and the French Quarter. There are parts of the 9th ward that are simply frozen in time. It's just astonishing. One house that we saw had a dresser on the roof with clothes hanging out of the drawers. There are still piles of waste that are all over the neighborhoods waiting for a FEMA pick-up. Then you got out to the French Quarter, and it was business as usual. The two places are within a couple miles of each other and there couldn't be more of a contrast. I learned from our guide that in the state of Louisiana, they are on the "charity bed" system, which means hospitals are allowed to refuse care, but are also required to offer a certain number of "charity beds". So if the charity beds are full, they can refuse care. Now for the kicker, right now with only three hospitals being open in New Orleans proper, there are 13 charity beds available. We have it so good in MN. This state is going to have to take an honest look at their healthcare system and their school system. It's just sad.
Tomorrow's forecast, 10% chance of rain, high of 48 degrees.
Yesterday a RN from New Orleans gave us a tour of New Orleans East, the lower and upper 9th ward and the French Quarter. There are parts of the 9th ward that are simply frozen in time. It's just astonishing. One house that we saw had a dresser on the roof with clothes hanging out of the drawers. There are still piles of waste that are all over the neighborhoods waiting for a FEMA pick-up. Then you got out to the French Quarter, and it was business as usual. The two places are within a couple miles of each other and there couldn't be more of a contrast. I learned from our guide that in the state of Louisiana, they are on the "charity bed" system, which means hospitals are allowed to refuse care, but are also required to offer a certain number of "charity beds". So if the charity beds are full, they can refuse care. Now for the kicker, right now with only three hospitals being open in New Orleans proper, there are 13 charity beds available. We have it so good in MN. This state is going to have to take an honest look at their healthcare system and their school system. It's just sad.
Tomorrow's forecast, 10% chance of rain, high of 48 degrees.
Sunday, January 28, 2007
Sunny Sunday - Day Three
What a wonderful day! We had a total of 1007 patient interactions today, which meant over 400 medical visits. I ended up working in the medical tent where all of the doctors were seeing patients. There were three of us that ended up having to organize the flow of patients for the day, basically making it up as we went along. It was extremely challenging as none of us had any experience doing anything of the like, but we made it work. I can honestly say at the end of the day we truly felt like we had made an impact. We had face-to-face time with every single patient that came through that medical tent, every single one completely grateful for our time and service. We were just happy to be down here, helping out however we could. I am EXHAUSTED. We're back at it tomorrow morning at 0500, with bells on.
Tomorrow's forecast, partly sunny high of 50.
I would love to elaborate on the details of the day, but I'm truly so tired, I may fall out of my chair. I'm going to try and jot down tidbits in my journal so I don't forget it all.
Have a great week!
Tomorrow's forecast, partly sunny high of 50.
I would love to elaborate on the details of the day, but I'm truly so tired, I may fall out of my chair. I'm going to try and jot down tidbits in my journal so I don't forget it all.
Have a great week!
Saturday, January 27, 2007
Ode to Wet Feet - Day Two
90% chance of rain, INDEED. It poured all day today. We were running around unloading pallets, setting up stations, and getting completely soaked in the process. With the wind we froze our little butts off! The camp was almost complete when we left, which is a complete success in my eyes. Considering the only thing erected when we got there were the tents. There are now about 15 dental stations, 10 vision stations, 15 medical exam rooms, 4 women's health exam rooms, 1 trauma exam room and two misc. exam rooms. I think everyone held up extremely well considering the conditions.
Everyone continues to be extremely grateful to have "the Mayo people" here, which is a good feeling. I hope that we can add the value that they are looking for.
A couple of statements stood out at our volunteer meeting this afternoon. The population in New Orleans proper was ~400,000 pre-Katrina and is now ~140,000. Even with less than half of the population returning, the death rate has doubled since Katrina. They say that "people are still dying from Katrina" because there are not enough medical professionals to manage patients. Even patients who can afford to pay for their prescriptions can't find a provider to accept them. Those people with unmanaged chronic illness contribute to that death rate as does prolonged stress and an increased suicide rate. It is such a complex problem to solve. As I work in through in my head, I realize that if it were up to me, I would have NO IDEA where to start. There is a whole lot of politics and litigation involved which I'm having a very hard time comprehending. Each person I ask has a different spin on it, which is very interest, but reiterates the issue's complexity.
Tomorrow all of the Mayo nurses are to begin the triage process for the first day of the Recovery Week. The bus departs at 0500 and our finishing time remains TBD. They really have no idea how many people will turn out. There continues to be a lot of press coverage down here, and it will probably be on the national news. The Jim Lehrer News Hour will be down here tomorrow and there will be a press conference from the site on Monday, so keep your eyes and ears open!
Tomorrow's weather partly sunny, windy with a high of 50.
Sends us all of your good vibes tomorrow!
Everyone continues to be extremely grateful to have "the Mayo people" here, which is a good feeling. I hope that we can add the value that they are looking for.
A couple of statements stood out at our volunteer meeting this afternoon. The population in New Orleans proper was ~400,000 pre-Katrina and is now ~140,000. Even with less than half of the population returning, the death rate has doubled since Katrina. They say that "people are still dying from Katrina" because there are not enough medical professionals to manage patients. Even patients who can afford to pay for their prescriptions can't find a provider to accept them. Those people with unmanaged chronic illness contribute to that death rate as does prolonged stress and an increased suicide rate. It is such a complex problem to solve. As I work in through in my head, I realize that if it were up to me, I would have NO IDEA where to start. There is a whole lot of politics and litigation involved which I'm having a very hard time comprehending. Each person I ask has a different spin on it, which is very interest, but reiterates the issue's complexity.
Tomorrow all of the Mayo nurses are to begin the triage process for the first day of the Recovery Week. The bus departs at 0500 and our finishing time remains TBD. They really have no idea how many people will turn out. There continues to be a lot of press coverage down here, and it will probably be on the national news. The Jim Lehrer News Hour will be down here tomorrow and there will be a press conference from the site on Monday, so keep your eyes and ears open!
Tomorrow's weather partly sunny, windy with a high of 50.
Sends us all of your good vibes tomorrow!
Friday, January 26, 2007
Arrival in Slidell, LA - Day One
We had a very uneventful flight down here today. Everyone made it one piece and were greeted with sunny skies and 60 degree weather. Awesome welcome. We took a bus drive through New Orleans to Slidell and every turn we took was more devastation. There are middle/upper-class neighborhoods where every sixth house is experiencing renovation, but the in-betweens are completely vacant. There is still spray paint on the outside of the houses from when they were searched and what they found - "dead dog", "dead cat" - not quite sure what code they used for people. You also see the FEMA trailers sprinkled throughout neighborhoods in the front yard or side yard. During the bus ride the driver told us "right here, we'd be under 6 feet of water" and "this bridge we're driving on was disconnected in several sections" (the 11 mile bridge that crosses Lake Pontchartrain -- the other bridge is 24 miles and is the longest in the world).
We arrived at the old furniture store, now the Operation Blessing Command Center, around 5:30-6, got a brief tour, dinner, our badges and a very military-like mission briefing, which included the "Rules of Engagement". Everyone is in good spirits, excited about the known and unknown and being very flexible. The Operation Blessing people were very excited to have our help, which felt great. There are 400 medical professionals that will be serving at the New Orleans Recovery Week, and they are expecting at least 10,000 people to show up. Although the focus is chronic illness, we have been told that this tent city medical center is the closest acute care available in a 10 mile radius, so they have also seen gun shot wounds and acute MI, which is unfortunate, but great that they can get help somewhere with only 3 of 11 hospitals up and running. They said the site of Recovery Week is actually across the street from one of the once major hospitals in New Orleans that is completely empty now.
Tomorrow we help set up the site, move equipment and get the flow of traffic down. It looks like we'll have some early days for the next week. 90% chance of rain tomorrow with a high of 60. Still better than 19 degrees. . .
They have some laptops available here, hooked up to a satellite. So I will update when I can!
We arrived at the old furniture store, now the Operation Blessing Command Center, around 5:30-6, got a brief tour, dinner, our badges and a very military-like mission briefing, which included the "Rules of Engagement". Everyone is in good spirits, excited about the known and unknown and being very flexible. The Operation Blessing people were very excited to have our help, which felt great. There are 400 medical professionals that will be serving at the New Orleans Recovery Week, and they are expecting at least 10,000 people to show up. Although the focus is chronic illness, we have been told that this tent city medical center is the closest acute care available in a 10 mile radius, so they have also seen gun shot wounds and acute MI, which is unfortunate, but great that they can get help somewhere with only 3 of 11 hospitals up and running. They said the site of Recovery Week is actually across the street from one of the once major hospitals in New Orleans that is completely empty now.
Tomorrow we help set up the site, move equipment and get the flow of traffic down. It looks like we'll have some early days for the next week. 90% chance of rain tomorrow with a high of 60. Still better than 19 degrees. . .
They have some laptops available here, hooked up to a satellite. So I will update when I can!
Sunday, January 21, 2007
Operation Blessing
there was an email sent last week to all nurses asking for volunteers for "new orleans recovery week". this is in conjunction with "operation blessing" - an international aid organization. all those interested had to apply right away and then would be notified by last friday if you were "invited". i was amazed to recieve the email friday afternoon that i was invited to go. i thought for sure i'd be overlooked since i've only been a nurse for two years. they were looking for cardiac and endocrine specialties - i think my float experience to the cardiac and medical icus may have just helped!
as of today, i have no idea what we'll be doing exactly. there is a schedule of a "typical day" which seems to go from 6:30am-6:30pm, with a mre for lunch. the "mennonite ladies" make breakfast and dinner. i know we'll be sleeping in cots at the operation blessing command center, and i know what flights i'm on, but that's about it. we have a meeting on wednesday for all who are going where we get fit-tested for tb masks, and they said we'd be provided more info at that time. i'm excited to see who else is going and if i'll know anyone else.
the only thing i can count on at this point is that it will prove to be an amazing experience. i plan to give updates whenever i can.
as of today, i have no idea what we'll be doing exactly. there is a schedule of a "typical day" which seems to go from 6:30am-6:30pm, with a mre for lunch. the "mennonite ladies" make breakfast and dinner. i know we'll be sleeping in cots at the operation blessing command center, and i know what flights i'm on, but that's about it. we have a meeting on wednesday for all who are going where we get fit-tested for tb masks, and they said we'd be provided more info at that time. i'm excited to see who else is going and if i'll know anyone else.
the only thing i can count on at this point is that it will prove to be an amazing experience. i plan to give updates whenever i can.
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