Sunday, July 29, 2012

On working in the UAE as a nurse.

I wasn't going to Blog again so soon, but after the response I got from my first one I decided to post this one a little earlier. I hope it holds up to expectations.

After working in a hospital in the UAE for 18 months I've had my moments where I've wondered if I want to be a nurse anymore. To explain what I mean by this I have to go right back to my training to help you understand what kind of nurse I am.

 When I started my nurse training back in 1997 My first placement was in a nursing home, and in the first week I nearly left the course, I hated it. More because I hated the way that the home treated the elderly people,  they spoke to them and treated them like children and there was no stimulation for these poor old folk, who would just sit in a chair staring at a T.V. for hours a day.

My next few placements were in various different wards. I didn't much enjoy these either, and recall having a stand up row with the matron of one of these wards when she insisted I should have man handled a poor old lady in certain way, not the way we'd been taught by the school of nursing that's for sure. For the first  18 months of my nursing training I pretty much just went with the flow and got through it. The scariest of my placements was in a mental institution, wow some of the stories I could tell from those 4 weeks!

However the second 18 months of my training we're much more interesting, finally getting to go to some specialist areas. So again to explain what kind of nurse I am......I hated ward nursing and decided that a ward would be a last resort for me, I didn't really enjoy my time in A and E, more because I felt that as a nurse there you we're just carrying out the doctors orders, and had no autonomy, this has probably changed a little in the last few years as nursing triage is first line in most A and  E's now. 

I got the opportunity to go to a hospice which was one of the most amazing experiences of my life, unfortunately the hospice I went to has closed now, due to not enough funding, which is a real shame as it was in the most beautiful settings, if not a bit spooky  at night! It was here that I thought this is for me, however I felt to really be able to empathise  with the people that are ending their lives in these places I needed to be older and have more life experience, but palliative care nursing was and still is somewhere I'd like to work when I'm older!

 I really enjoyed working in theatres, maybe it's cause the patients are asleep! No, to be fair I enjoyed all aspects of theatre nursing from helping in the anaesthetic room, to being scrub nurse, to being in recovery, and I remember at the time again thinking this is for me. 

However as a student nurse I was very lucky to get a placement on an Intensive Care Unit (ICU) it was here that I realised that one of the things missing from theatres that you got in ICU was more patient and family interaction, from my 6 week placement I knew this is where I wanted to work, but at the time not many ICU's took on newly qualified nurses. So I prepared myself for having to work on a ward for at least 6 months. However just as I qualified, the ICU I'd been on as a student advertised some jobs, so I thought why not give it a go, you don't get if you don't try, right?

And it's an understatement to say I was over the moon when I got the job! That was in 2000, and I've worked in intensive care nursing ever since, I spent 10 years working on the same unit, well sort of, it did go through some major changes during my years there, as my fellow past colleagues will remember well. I miss that unit a lot, even though I did have my days where I didn't want to go to work....as I'm sure we all do.....I had some challenging experiences there and worked with some amazing people. It was during my time there that I did my Degree in Critical  Care Nursing and became a senior nurse. 

The one thing that ICU nursing and Palliative care nursing have in common, is that you are given the opportunity to have more or less one to one with your patients, which gives you the opportunity to give these patients the full care they deserve. Which I think is why I feel passionate about these particular areas. Don't get me wrong I think that nurses who work on wards deserve a medal for the hard work they do, but it just wasn't for me, as I'm sure some of them would and do say the same about working on an ICU. Which is a good job really it wouldn't do if we all liked to do the same thing! 

So that's some of the background. In 2010 I made the decision to leave the comfort of the ICU I'd worked on for 10 years, and not only move countries but give nursing in a different country a go. I was very lucky to get a job on an ICU in Dubai, at least it wasn't all going to be new to me....and most of the equipment we use here is the same as back home, so the basics of the job are pretty much the same. But that's where it ends. I'm now working as a nurse under sharia law! And boy are there some differences to our practices here, that I have trouble accepting.To the point where I've considered leaving nursing all together, however when I did have a moment of weakness a few months ago, my boss begged me to stay....which I hope means I' m good at my job! 


So to the differences, we have a controlled and a narcotics drug cupboard, and basically any drug that can have mind altering effects or could be addictive is locked away. This will make more sense to those with medical backgrounds who are reading this, but I had to get my head around the fact that drugs like Stemitil  ( used to control nausea) are locked away, yet a drug like potassium, which if given too much of, will kill you, and is a controlled drug in the UK,  is freely available in an unlocked cupboard! 

Also the process to give patients pain killing drugs like morphine or pethidine is painful, not only do we have to fill in the drug register, we have to fill in a separate prescription which then goes to the UAE ministry of health, of which we have to fill in a separate one for each vial we use, again as my medically trained readers will know, in ICU, we use several vials of a drug to make up an infusion.....man it takes me 3 times as long to fill in the paperwork as it does to make up the infusion! Oh yeh and we have to save the empty vials to be sent back to the ministry of health to prove they were used, and whatever you do, don't break one.....that means getting the police involved.....so as you can imagine....we all love looking after patients who require any of these drugs! 

But my main problem with working here is that there is no such thing as DNAR ( do not attempt resuscitation ) sharia law states that human life should be maintained at whatever cost! In some cases I agree, but when we get 80+ year old patients that have degenerative or terminal illnesses, who are already home nursed because they are unable to do anything themselves, get admitted to ICU, get put on ventilators, then get given CPR, it breaks me.....it totally goes against anything that I've been taught or believe in. So as you can imagine palliative care doesn't really exist, and people die in pain. 

Also one of the things I feel really strongly about and had involvement in in the Uk was organ donation, ha, that doesn't exist here either, and even though a patient can be diagnosed as brain stem dead, the family don't get the opportunity to donate the organs, they have to sit and watch the person slowly die on a ventilator, because we can't just switch it off like we legally can in the UK,  we even have to perform CPR when the heart finally does give up, and if we don't, that could mean a jail sentence for anyone involved!

The other thing that I struggle with is having to get insurance approval for everything, before doing it. It's a standing joke out here amongst the UK ex-pats, that are used to the brilliant services of the NHS, that you go to A and E here and the first thing they ask you is how are you paying! Then they'll ask you what's wrong! 

If after all this, if any of you are thinking that coming to the UAE and working as a nurse is a good idea, you won't be doing it for the money! The lifestyle maybe-yes! On average the pay is the Same as the UK, and working hours here are longer, on average 48 hours a week. There aren't really part time jobs here, if your lucky, like me you can get a locum contract, in which you get paid an hourly rate, but that's all, I get none of the extra benefits that having a full time contract out here gives you.....but I'm lucky I get all that through my husbands job anyway. 

So for the moment I will keep up with the nursing, I am very lucky to have a supportive husband and my Dubai family to help me through the tough times, and who knows if things go to plan, I'll get a year off soon anyway! 

Thanks for reading,

Keep well,

Katie x

Friday, July 27, 2012

In the beginning

On living, nursing, kick boxing and pregnancy as an ex-pat!


I have been debating whether or not to start a blog for a while. Myself and Ian ( my husband) have some pretty cool plans for the next few years and I was planning on starting a diary style blog next year.

However after being advised by my wonderful hubby to start jotting down ideas now ready for that future diary, I started to get the bug for writing and one thing led to another and I've decided to start this earlier than originally planned. 

The main reason for starting early is that I want to share some of my experiences on the titled subjects with anyone whose interested in reading about it! And before you all get giddy, NO I'm not pregnant - yet! 

This however is the main reason why I was holding off starting this blog, as I am planning on being pretty open and i don't want people to be asking me every time they see myself or Ian if we are!

So I suppose I should start the story off with why I wanted to start a blog! It all goes right back to 2 years ago when I decided to sell up in the UK and move to Dubai. 

Whilst trying to sell a house, the second car in a year, sort out the contents of a house, what to keep in storage, send to Dubai, throw away, send to charity or try to sell! I went for a routine check up for my contraceptive pill to find my blood pressure was through the roof. So after being monitored for a month, just before getting on a plane to leave the UK for a new life in Dubai. I was advised to change to the mini pill as my blood pressure was still too high for a person of my age.  

After being on the mini pill for a year, my blood pressure was slightly better but as a nurse I still considered it too high. I'd put a load of the weight I'd lost in the last couple of years back on and even though I was incredibly happy with my new life in Dubai,  there was something missing......my libido had almost completely run off into the dessert. Don't get me wrong I love my husband soo much it hurts but I just wasn't that interested in sex, even watching my previous crush, Jason Statham  on TV struggled to get my pulse racing! So after many discussions it was decided that for my health and for our marriage I should come off the pill. 

However the consequences of doing this and accidently getting pregnant In Dubai are a little more serious than back at home. Here there is no morning after pill, or option for abortion, not that if an accident happened I think we would have gone down this route, but myself and Ian were always happy with our decision to not have children.

Our health insurance didn't cover maternity, so it would have been an expensive accident, we' d have had to buy a package for pregnancy here which would cost anywhere between £6000 and £12000, depending on what level of care you want, and of course me being a ICU nurse would want the best....hell  it's my health we're talking about.

The other option would be for me to go back to the Uk to have the baby, I love my parents very much but the thought of being heavily pregnant living away from my home and Ian just filled me with dread!

So just in case an accident happened we took out better health insurance for both of us I now have the dogs bollocks bupa insurance! Once everything was in place I came off the pill, it was like the end of an era, I'd been taking it for over 15 years!  

You have to remember at this point myself and Ian still didn't want children! We just decided to make our own luck and cover our arses.

But OMG,  boy, did my libido come back....poor Ian didn't know what had hit him! The problem is the "switch" as I called it for maternal feelings that I said was obviously off for me also got switched on, for the first time in my life I felt broody....WTF.....how do I tell my hubby this? It was at this point I went home to the UK for a week , and whilst visiting my best friend finally voiced my feelings, she reassured me I was normal and not going insane! 

The only thing is I didn't realise until I got back to Dubai from this trip that Ian had aslo been having the same feelings! Holy crap.....this is the couple who said they never wanted children. So after much discussion, we decided that after our 10 month waiting period for my insurance to cover pregnancy  we would try for a baby.

Boy are those 10 months going slow, as the months go by we are getting more broody, especially as some of our close friends have recently had babies or are about to. We have also gone from thinking it'll be ok if we can't get pregnant to oh shit what if we've left it too late. 

So that's where we are now, I'm not going to let on how far into our 10 month waiting period we are, so that we don't get badgered with the question! Some of our nearest and dearest know and I'd appreciate it if they kept that to themselves!

However in the meantime, until I announce on Facebook that myself and Ian are having a new addition to the family that doesn't have feathers or fur....I hope! I plan to blog about my experiences of living and working as a nurse in Dubai....so far it's been an eye opener.....so until next time.

Keep well

Katie x