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