My last blog!

Ey up, ducks!
Guess who's back in the metropolis that is Nottingham!?
So, one thing I definitely predicted correctly is that my last blog would be written from my couch nest back in my flat in New Basford and here I am😁
I had actually meant to do this blog last week but the jet-lag hit hard when I got home and when I wasn't snoozing randomly around the place I was struggling to string a sentence together!
I made the journey back a week ago - to Gatwick and then crashed out completely on the train home, thank God Nottingham was the last stop! I spent a couple of days getting back to normal and hanging out with Gareth, a few friends & my sister Sara, which was lovely.
I started back to work on Monday - I will have a secondment period to write up a report for my trip but I thought it'd be better to get back to work first and into the swing of things. Felt like I'd never left after the first 5 minutes to be honest😂
One thing that I've found is that people are asking me (naturally enough) how my trip was, what I've taken away from it and how I feel about it all and I'm not really able to answer the question! At the moment it all feels more like it was a dream than anything! I think that's one of the reasons I wanted to get back to work first before starting to reflect and write up anything, give it all a bit of time to settle as at the moment it all feels a bit surreal.
I'm looking forward to meeting all the people who helped me during the application process for the scholarship and in the run up to my trip and also the committee of the League of Friends charity who funded the scholarship. I went to one of their events before I left to share my ideas and plans so it will be great to meet them again to chat about how it all went.
At this point all that's left to do is thank everyone! I know this is the boring bit that no one wants to read but I could never have achieved any of this without so much help.
Jennie Walker & Sam Torgersen who helped me with my application and were brutally honest with me (it was what I needed!).
Joanne Cooper, Louise Bramley & Alix Brookes who had faith in me and my project and awarded me the scholarship.
Bertie Pinchera & the committee of the League of Friends without whom none of this would be possible as the charity funded the scholarship.
My boss, Emlyn, who looked like he wanted to kill me when I told him I'd be gone for over 4 months but never actually said it😁
Hayley Morales & Laura Siddall from Healthperm who set me up with amazing contacts for my visits in Dubai and the Philippines, 2 amazing women!!
Regis Manyana and Florence Mwando who sent me off to Africa as prepared as it is possible to be!
Every family who took me in, fed me, looked after me. Every nurse or doctor who let me tag along, explained things to me, welcomed me.
Prof O'Donoghue, who hooked me up with some amazing people across the States which really ended it all on such a high.
I have been completely overwhelmed by the kindness of strangers on this trip. No one could do enough for me. Fr. Trust in Zimbabwe who drove me 2 hours to the border with Botswana when I was going on safari because he said he wouldn't sleep unless he knew I had gotten there safely.
The Sisters in the convent in Hwange who welcomed me as one of their family for the 2 weeks I stayed.
Rodeo & Janice in Manila and Cebu who stayed with me from morning til night to make sure I had the best trip possible. Not to mention all the hand holding crossing roads as they were both afraid I'd be killed!😂
Nurses clearing their whole schedule in Houston, New York, Boston, San Francisco to give me their time for the day. Heads of every department knowing who I am and why I'm there and ready and waiting for a phone call to come collect me if I so much as mention I've an interest in their area.
It's actually mind-blowing when I think about it all from beginning to end.
If this trip has thought me anything it's that regardless of differences in culture, origin, religion or race, people in general (and nurses in particular!) are naturally predisposed to be welcoming, kind, helpful and supportive. The everyday stresses of life can sometimes get in the way of that and we can be tired and grumpy and forget how good we have it but I've definitely seen the best of human nature on this journey and it has had a huge impact on me and my outlook on my own life and how lucky I am.
Speaking of which my last thank you has to go to Gareth. Lots of people have asked how he coped while I was away (he was grand!!) and how he felt about the whole thing and to be honest I could never have done it without him. Not only has he backed me from day one but he pushed me to stretch what I thought were my limits, do more, see more, go further. I mean maybe he just liked the idea of having the flat to himself for a bit😁 but either way I would never have had the courage to believe I could do this without him.
I've also really enjoyed writing this blog! It's something I've never done and was definitely another new challenge but it was fun and a great way to document the trip, I'll definitely be glad to have it to look back on years from now.

To sign off I'm going to share some of my favourite photos and trip highlights, this could take a while!

Leaving Notts on June 26th!

In UTH Lusaka

At Victoria Falls

Road-tripping to Kariyangwe with Fr Trust!

Fr Trust in his Forest shirt!

On safari with Polina & Alex, delighted after we saw a leopard!

Gawping at the Burj Khalifa in Dubai

Had an amazing time at Arellano University in Manila

When Gareth came to visit for my birthday😊

Sunrise with G on Bantayan Island

Was in LA for all of 5 minutes but got a snap of the Hollywood sign - success!

Travelling through the desert in Arizona & New Mexico💕

Was very nervous beforehand & very glad to have it over with!

Anastasia on Broadway in New York💜

From Victoria Falls to Niagara Falls

With some of the NUH team at the Magnet Conference in Denver

Throwing away my £15, Primark bought, held together with tape but managed to survive it all bag last Thursday!

And that's it! The fun bit is over and the hard work begins of actually writing the whole thing up but I don't think anyone wants regular updates on that one! Thanks to everyone who travelled along with me via the blog, it's been an absolute blast!

Slán libh!

Kate 😊

The Final Countdown

Hello from Denver!
I've been here almost a week now after arriving last Tuesday evening for the Magnet Conference. It happens yearly in a different location in America. This year there were almost 12,000 nurses here so it was busy to say the least!
It's a really amazing 3 days of talks, sessions, exhibitions and ceremonies with Magnet nurse of the year awards being one of the highlights for me.
The opening ceremony was the most American thing I've ever witnessed, I would say it was like a mash-up of the Oscars and Eurovision. Pomp? Check. Cermony? Check. Extremely unnecessary but nonetheless enjoyable stage 'banter' and musical performances? Check!
That was, of course, until the Awards Ceremony where we witnessed ballet dancers, cheerleaders, aerial artists, street dancers and ice-skaters on a slab of ice in the middle of the auditorium brought in especially for the occasion. Murica is crazy y'all.
In saying all that, it was great fun and something you will never see the likes of anywhere else in the world so the best thing to do is just give in to it and squeal at it all with the rest of the audience!
I went to several of the talks, my favourite given by Prof Sheila Tlou who was presented with the Princess Muna Al Hussein Award due to her work in women's health and HIV/AIDS in her native Botswana and now across Eastern and Southern Africa. She was also Minister of Health in Botswana for 4 years, she had annoyed so many people with her refusal to sit down and be quiet that they pretty much told her to put her money where her mouth was and fix the problem. She didn't need asking twice! The number of people contracting HIV and babies born with it have been hugely reduced and the number of people on antiretroviral therapy surged.
Prof Tlou also had to deal with being a woman throughout all this with people asking her husband why he was allowing her to speak about sex in public! I also love how she tackled homophobic people who challenged her helping gay people - 'don't they realise that life is a sexually transmitted disease!?'. And when asked how she could support that way of life as a Catholic she responded that she believed in 'Evidence-based Catholicism'. The woman is an absolute hero!
It was a privilege to hear her speak and to get to meet her briefly after her talk and a wonderful way to come full circle after visiting Southern Africa at the start of my trip.

It was also great to catch up with the team from New York Presbyterian-Weill Cornell in Denver, such a great bunch of nurses and lovely to keep bumping into them over the 3 days!

Before arriving in Denver I was also lucky enough to get to visit Niagara Falls. I would highly recommend an October visit for anyone wanting to go, gorgeous cold, crisp weather but a fraction of the people! I have to say though I thought Victoria Falls was more impressive (I love being in a position to be able to say that!) but I still loved visiting Niagara, also known as the place where I bought the most expensive postcards in the world.

I also got to stop in Chicago to visit the Carey's. Kevin is a friend from home who's mam and dad live there and I had a brilliant few days with them. They had a choice of 3 concertinas for me and we had Barry's tea and played tunes every day - it was hard to leave!

With Mag & Ger Carey

I'm still in Denver, I was lucky enough not to have to leave straight after the conference and got to stay to hear Aron Ralston give the keynote speech at the closing ceremony. If you don't recognise the name he's the guy from the movie 127 Hours and book Between a Rock and a Hard Place who had to amputate his own arm after it got stuck between a boulder and a canyon wall. Honestly, I have a pretty strong stomach and it turned a couple of times while he was telling us his story. His main message was that we all deal with boulders in our every day lives. There's nothing we can do about that. It's how we deal with the boulder and and how we can try to see the blessing in even the worst situations that make us who we are. Also, his measure for bad days is any day he doesn't have to drink his own urine isn't really a bad day and I think I can take that one on board!
I have one more day here and then it's home I go! To be honest I can't wait. I've been running on adrenaline and 'making the most of it!' for a few weeks now but now I'm just empty. Couple that with the lack of oxygen this high up (Denver is known as Mile High City, probably due to cannabis being legal as well as the altitude in fairness) and I'm slowly losing the ability to function as a normal human being as well as my limited reserves of sanity! I even decided to cut all my hair off yesterday - now I did get someone to do it for me, I'm not that crazy!

I think a little bit of madness can be good sometimes, you do the things you might not normally do without over-thinking it so much. But I also think it's time to go home!
Next and last blog will be from my nest on the couch in Notts. Gareth has Das Boot ready to go with a side of Monster Munch (pickled onion, obvs) and Barry's.

Slán libh!

Kate

Boston Irish

Another week has passed and another week closer to home time! I've loved being on this crazy adventure but I have to admit to looking forward to getting back home soon. Living out of a bag for 4 months is not fun, especially when lovely people keep giving me gifts which is so nice but I'm literally having to wear everything I own at this stage just so I can fit everything else in the bag! And speaking of wearing things, the sooner I never have to look at any of the clothes I've brought on this trip the better! Blind hatred is all I feel for them now😂
I spent this past week in Boston where I visited Massachusetts Eye & Ear, 12 floors of dedicated EENT and it was amazing! It was my last hospital visit of this trip and the perfect place to finish that side of things.
Firstly, I was barely in the door when I was being jabbed with a needle as I wasn't allowed in without my flu shot if I was going to be there for more than 8 hours and as we had a few days planned out that was the case. They know how to welcome you in Boston!😂 This was actually the only hospital on my entire journey that needed my proof of inoculations etc. I was actually glad after so many months of carrying them around that someone finally wanted to see them! Ironically, I've actually refused my flu shot at home for the past 2 years, little did they know that all it would take was a bit of bribery involving visiting a fancy hospital in Boston and I would become very compliant all of a sudden!
I spent my first day observing and shadowing nurses in the adult inpatient floors and emergency department.  I was honestly so envious looking around at an entire emergency department just for EENT patients! Obviously, it has it's limits. Mass Eye & Ear is attached to Mass General Hospital by a bridge and if there are any non ENT related emergencies the patients are transferred there and vice versa. But to have all these triage cubicles and clinical areas set up and ready to go with all the equipment relevant to that speciality was just the most beautiful thing (I'm easily pleased, I know)!😃

Getting my flu shot in Occ Health!

I also spent a day in theatres where everything is electronic, from pre-assessment onwards. Marilee, one of the nurses took me through the entire process with a patient who was due for a biopsy that morning. All patients have pre-assessment and consent done on the day which is a bit different to us (for non-urgent surgery, paperwork can be done several months in advance) and both have their advantages and drawbacks but it was interesting seeing absolutely everything being done electronically. Marilee did say that although the technology is great and helps to eliminate mistakes and confusion and help improve communication she has to be careful not to end up glued to a screen and forget about actually having some human contact with the patient who is right beside her!
It's something that is an issue in the States, the technology in all of the hospitals I've visited has been insane - they are light years ahead of us in that respect and it is amazing the things that can be accomplished with that. But something that is becoming a focus for nursing staff is not to to forget about the patient in the midst of it all and watching the nurses in Boston, I don't think they have too much to worry about. There was a great atmosphere around the building. I was lucky to spend time with the nursing chiefs of Adult, Paeds, ED and theatres (Theresa, Kathy & Jo-Ann) who were all just bossing it but also seemed to have a great relationship with their teams.
In theatre I also met Dr. Randolph who helped set up my visit (through his connection with Prof O' Donoghue), I stayed for one of his procedures in theatre and it was great to meet and have a chat before I finished up for the day.

I also became a bit obsessed with the hyperbaric chambers that they have here - 3 in total and mostly used back in the day to help injured firefighters (due to smoke inhalation) and divers (injuries due to incorrect decompression when coming back up) as there is a large navy presence on this part of the East coast. Due to better equipment and stricter safety regulations there are now less of those accidents to deal with and the chambers are now mostly used to enhance wound care for complex patients e.g. if someone has had a flap and it isn't taking for some reason they will have 2 sessions a day in one of the chambers as the increase in oxygen can help improve healing. Again, so jealous of the technology available here!

I also had the added bonus of being surrounded by an almost entirely Irish community! Everyone I met was either first or second generation, visited Ireland pretty frequently and were still very connected to their roots. There were Kennedy's, O' Donovans and Mcs everywhere I turned. Not to mention a bizarre amount of Claddagh rings! It was the same in the city, people were just chatting about visiting Ireland or Irish relatives as they walked down the street. There's a beautiful famine memorial in the city centre (37,000 Irish landed in Boston around the time of the famine which started it all) and I even found some Barry's tea on sale!
Although the best had to be when I was having lunch with one of the hospital staff, Kevin, who presented me with a Barry's teabag at lunchtime as she brings them everyday, she didn't even know I was coming!

Delighted sure!

At the weekend I visited Salem as I've always wanted to go and it's not far from the city. My friend Gary, who I know through playing Irish music, drove me there and we visited one of the many museums. It's the only house left with a connection to the witch trials as one of the judges used to live there. October isn't an ideal month to go to Salem as it's so close to Halloween so very busy but unfortunately I didn't have any other options!

The Witch House. Bit creepeh.

After the museum and some food we went for a few tunes in The Druid pub which was great! I haven't played in months so was definitely rusty but got into the swing of things after a bit and had great craic with a Chicago flute player, French guitarist, Alaskan bodhrán player and Connemara/Boston flute player! Maybe I should do my next study on the diversity of people who play Irish music!
I've had a couple of free days this week as things are starting to wind down coming to the end of my trip. Again, part of it was due to a previously planned visit in Toronto that didn't work out but at this stage I'm not going to panic about stuff like that as I've seen and learned more than I ever thought I would so anything else at this stage is just a bonus!

The beautiful scenery on my way from Boston to Canada through New Hampshire & Vermont

 I'm still going to Toronto as I already had my train and accommodation booked so I'll just have to go to Niagara Falls instead! I did stop in Ottawa for 2 days on my way to see Heather, an old friend from my college days back in Galway. It was lovely to catch up and she and her boyfriend Steve made sure I had a thoroughly Canadian experience as we went to the ice hockey (Ottawa beat Dallas 4-1. Woo!), toured the parliament building (no sign of Justin😢) and went for a hike to see the beautiful maple leaves in all their autumn glory! They also made sure I tried poutine (chips, cheese curd and gravy, it's as weird as it sounds but nice!) and beaver tail (a flat bread shaped like a beavers tail, of course!) to round it off. I mean at this stage I'm practically entitled to citizenship, right!?

I'm in there somewhere!

So, next on the list is the Magnet Conference in Denver. I'm really looking forward to meeting some of the NUH team there but also some of the Magnet teams from hospitals I've visited around the States have invited me to their functions so it will be lovely to see them again.
I've got a couple of days to get on top of paperwork and admin which is good and then it's onto the home stretch!
The visit to Boston being my last hospital and specifically ENT really did feel so apt as I thought back to my very first visit in Lusaka, Zambia. 3 ENT surgeons, 10 ENT beds and 1 scope for the entire country. Talk about coming full circle to finish in a 12 floor, dedicated EENT hospital with it's own theatres, emergency department, entire floors dedicated to research and developing their own drugs, their own MRI, CT and PET scanners. All just for 1 speciality and 1 city! The world is a crazy place.
To think that their is such discrepancy in hospitals around the world and the way patients can be treated is hard to believe. Seeing it with my own eyes in the one trip actually makes it harder to take in for some reason!
Nurses seem to be the common denominator though. Technology and equipment aside, the role of nursing across the world when stripped back to basics is about caring and advocating for our patients and that is something that has been the same from Africa to Asia to North America.
To finish the whole shebang at a conference with 20,000 (ish!) of these lovely people definitely sounds good to me!

Slán go foill
Kate

Autumn in New York

When I last wrote I had just arrived in DC and was having a bit of a catch-up day. It was lovely to stay with my neighbour from home, Mary, who delighted in telling everyone we met that she used to babysit me and my sister Sara back in the day!😂 Her place is really central so on my second, and last, day there I hopped on the subway to Foggy-Bottom (I know, right!?) and walked up to the Lincoln Memorial to wander around the monuments. Luckily, I've been to DC before, on a music trip to the Comhaltas (good luck pronouncing that one, English friends!😁) convention back in 2013 so I didn't feel under any huge pressure to go around sightseeing as we had done a good bit back then.

I did go to the Vietnam Women's Memorial to pay my respects, as I did last time, as it was mostly nurses who served during the war.

Vietnam Women's Memorial

There were a lot of Veterans around so afterwards I sat and had a chat with one of them. His name was Bruce, he had done 2 tours in Vietnam and it was amazing to hear his story of fallen comrades and feeling obliged to come visit the memorial in their memory even so many years later. His stories of seeing fellow soldiers die in front of him and rescue missions were just harrowing. I was looking at the wall of names when I saw him and thought I may as well go over, sit down and actually talk to someone rather than just looking at a wall of names when I, thankfully, don't know any of the people on it and I'm really glad I did. He's writing a book so that his grandkids and great-grandkids can learn about his experience when they're older and he was showing me pictures of the working draft on his iPad! These old timers are better with technology than I am!

The following day I headed for New York. I actually stayed in New Jersey as my sister, Amy, has a friend living just the other side of the Lincoln Tunnel who had a spare bed with my name on it. I hadn't seen Katie in years so it was lovely to stay with her and meet Ned, the completely insane dog!😄 The next day I visited New York - Presbyterian/Weill Cornell Medical Centre and had such an amazing time. I spent the day with Rosanne Raso, Chief Nursing Officer who is also the editor-in-chief of Nursing Management, the journal of excellence in nurse leadership.

Rosanne & myself, hands on hips at the insistence of her secretary, Uvanda!

We attended the Tier 3 Hub which happens daily. So, there are 3 tiers. Tier 1 is a "huddle" between staff and manager in departments. Tier 2 is between the managers and Tier 3 when the directors all meet after the Tier 1 and 2 huddles. It involves things like bed state, flow, equipment and staffing problems. One of the big things they are tackling at the moment in NYP is 'zero workplace harm'. Pretty self explanatory as it involves staff being physically harmed by patients or relatives but also focuses on emotional well being and verbal abuse. The smallest instance of any of the above is brought up at this meeting and investigated. It was great to see individual staff nurses being mentioned at such senior levels in reference to their mental and emotional well being at work.

Interestingly, Cornell are the only hospital in the current top 10 across the country (they are currently no.10) without Magnet status. Considering how lauded Magnet is, it's some achievement to be in the top 10 at all without it but they are going for their first designation this year. I met with Rhoda, their Magnet lead who went through the entire process with me and what it means to be a Magnet hospital.

Rhoda & me

It's been really interesting to learn about it as I had wondered if Magnet is just another one of those things that ends up with you ticking a load of boxes, getting a fancy title but ultimately not making much difference to any of the staff or patients. What I've discovered thought is actually the opposite. Magnet has helped so many of these hospitals to completely transform their nursing culture from the top down and bottom up to meet in the middle with strong leadership and engaged, enthusiastic and driven staff nurses. Everywhere I have visited in the States has been Magnet designated or going for it and one of the common themes is nursing staff leading projects, problem solving, creating positive change on the front line and all of this with strong backing from management. If this is what Magnet means, bring it on!

I also visited NYU Langone Health, another Magnet hospital! I spent the day with Dr. Kim Glassman, Chief Nursing Officer and also spent time with the Magnet leads for the site and had lunch with the Magnet Champions of each department who were lovely and shared what they call their 'Magnet Stories' with me, just examples of staff excellence really but they are required in writing for the application process which is actually nice in a way as it means staff are properly acknowledged for their work.

My visit ended with a trip to the Kimmel building, their newest building and the fanciest place on earth! I swear, it was unbelievable. Touchscreen everything! I was afraid to touch anything, I always get a bit clumsy in fancy places (just ask my friend Denise about the pink gin in her brand new kitchen! Still so sorry!🙈🙈) so it's better if I just nod and smile!

It wasn't all work in New York as I was there over the weekend. It was lovely to just go wandering in Central Park and up Broadway and 5th Ave. I managed to get discounted tickets for a show at the last minute too which was amazing and also caught the Columbus Day/Day of Races/Indigenous People's Day (it has many names!) Parade on Monday which was great!

Parade down 5th Ave!

Broadway!

It might sound a bit sad but one of my favourite things was just doing normal work things in New York! Commuting into work past Time Square and the Empire State building rather than gawking at them like a super tourist (my usual posture) was just surreal and did make me a bit giddy! Cue lots of photos to Gareth with #commute underneath!😂

On the way to NYU Langone!

Off the subway and Time Square only up the road!

I honestly just can't get enough of New York. It's just so alive with noise, lights, people, traffic, sirens, steam rising from the manholes. It never stops! Anywhere else in the world this would annoy the hell out of me but here it just fits. It's part of the city and I love all of it! I hated leaving but it's onward and upwards (literally!) to Boston and visiting Massachusetts Eye & Ear Infirmary, a dedicated EENT hospital! And Harvard teaching hospital! I think I'm getting over excited again but when you grow up watching American movies visiting places like this is like going to a movie set! 

Only 3 weeks left to go too, time really does fly when you're having fun😊

Kate

The Not so Hateful Eight

I'm writing today from Washington DC after travelling through 8 states since my last blog (Texas, Louisiana, Mississippi, Alabama, Georgia, South Carolina, North Carolina and Virginia)! It sounds a lot more exciting than it was, most of it was just passing through on the Greyhound or Amtrak but I'm claiming each and every one of them!😂
But before I go off topic, I had a few more jobs to do before I left Houston last week. I had my presentation with some of the nursing students and faculty on Thursday. Dr. Gallagher had asked me months ago if I wouldn't mind sharing my project and where I was up to in my trip with them during the week and I agreed thinking it was months away and I could worry about it later! As it grew closer I did get a bit anxious about it, not about the speaking bit - anyone that knows me knows I've never had a problem with that whether it's 100 people or an empty room😅 I'm just not as great with the whole technology bit though. Usually when I need to do anything like that (such as setting up this blog!) I tell Gareth what I want and he makes it happen! And although he did offer to help I thought maybe I should tackle this one myself and created my very first solo Power Point - woo! It's the little victories sometimes!

Presentation time!

The presentation went really well actually, the students didn't know much about health care systems outside of the US and were really interested in how the NHS works and how on earth I managed to get 4 months off clinical work to travel the world, I had a hard time explaining that one myself!
I also got to sit in on a couple of other classes, one in particular was focused on international health care and nursing so it was the perfect opening for a discussion afterwards. We watched a video and a couple of the scenarios were specifically about discrimination and racism.

That feeling when your teacher told you you'd be watching a video in class😁

When we got to talking about it I found it fascinating as a lot of us shared or had witnessed similar experiences but the difference is the history in this part of the world. As Dr Gallagher said "You're in the South now, Kate". Many African American nurses (and people in general of course) can face huge problems when looking after certain (white) older people who are still deeply entrenched in beliefs which are long since thought to be unacceptable. Many of these people come from families where their parents owned slaves and they are slow to let go of those times and show complete contempt for African American nurses and are not in the habit of hiding it. Race issues are still such a volatile and tense subject across America but more so in the Southern states.

One of the faculty members herself has an Irish mother and black father and when she was born, in the 60's, there were still black and white hospitals in Texas (and other parts of the States I'm sure). Her mother had her in the white hospital thinking that her skin colour would be lighter as a new born and having a white mother and no one would notice. She was tipped off, luckily, by a member of staff that the other staff did know and were not feeding her daughter or doing the same checks etc. on her child because they knew she was black and that she'd better get her out of there ASAP. She did so and soon moved to Mexico City (an incredibly diverse city where they could live a bit more normally) where this woman grew up and it was fascinating to here all this from her perspective. The Civil Rights Movement feels like a life time ago for a lot of us but here I was speaking to a woman who was only in her fifties and segregation was still widespread throughout her childhood.
One last thing that I was fascinated with was how the hospitals here deal with stock going missing and saving money. They have locked trolleys (look a bit like a crash trolley) with all the meds in it so you can't just go grab 2 paracetamol for a patient, or anyone else for that matter. You scan the patients barcode and click on the drug you want. The screen tells you how many there are, how many you are getting and the new balance. They have something similar for equipment. All syringes, needles, tubing etc. are kept in locked cupboards under the same system. Apparently hospitals have noticed huge savings as stock and meds have, obviously, stopped disappearing.

Snazzy drug trolley

I can see how it would work though. I know from experience that when we run out of something on the ward you just run to the ward next door to borrow what you need but also usually take a few extra as you know it'll be a while before you get new stock. Bit of robbing Peter to pay Paul and it usually works both ways and ward staff share what they have pretty readily but it's not ideal.

I finished in Houston on Friday and decided to squeeze in 48 hours in New Orleans on my way East. And man it was worth it! Such an amazing city!

View of Jackson Square & the Cathedral from Washington Artillery Park

I got the overnight greyhound on Friday night and booked a walking tour for the next morning as I knew if I didn't have a plan I'd just lope around like a zombie for the day. It was pay what you like, started in Washington Artillery Park on the banks of the Mississippi River and right through the French Quarter, finishing in NOLA's most famous Cemetery giving a brief history of the city's colonial past from French to Spanish to French again and finally American! We also went to the house where Tennesse Williams lived while he wrote 'A Streetcar Named Desire'😍
It was a great start to the weekend! 

One of the oldest buildings in the city with American, Louisiana and New Orleans flags flying

Juat walking around the city was amazing, bands on every corner playing jazz, singing, dancing. You don't have to book a thing to enjoy New Orleans. I could've sat on the steps of the cathedral for hours just listening to it all.

When you put a couple of dollars in the hat and they pull you in for a selfie!

I also had a visit to my first Irish pub in the States as one of my best friends,Laura, told me that her aunt and uncle own a pub there so of course I popped over to say hello and watch the Saints play the New York Giants (Saints won!). In true Irish style, Carmel and Sean tried to get me to stay in New Orleans for another 2 weeks so they could buy me pints and bring me out to the house for a good minding!😄Carmel is actually a nurse though so it would have been tempting to stay as she has a lot of connections around the city and could've set me up in no time but we've decided that I'll have to go back instead!

Chilling with the gang in Finn McCool's bar, New Orleans

As I had my ticket to DC booked and Mary Liddy, neighbour and friend from home waiting for me, I had to crack on. After another incredible Amtrak journey (the American landscape really is stunning) I arrived in DC this morning. Mary is from my road at home and has lived here for years so I stopped off on the way to my next visit at the end of this week in NYC to see her and also use her washing machine! I've spent today catching up on emails and life admin - I'm always at my happiest when I've done my washing so today is a wonderful day😂

I'm off to New York on Thursday to spend some time at NewYork-Presbyterian/Weill-Cornell and NYU Langone Health, another 2 visits made possible by Prof O'Donoghue at work.

I am going to miss just randomly seeing groups of older men in their Levis, cowboy hats, big moustaches and leather boots just hanging around in places like Calexico, El Paso, Dallas and Houston - I swear I couldn't help but gleefully jump up and down (mostly on the inside!) whenever I saw any of them! But I'm also glad to be heading East, I'll be seeing a few familiar faces in the coming weeks which is very welcome at this stage of the trip I have to say!
Keeping the no-flight tradition going another while longer by catching the Megabus up the way on Thursday morning.

Learning so many new things on every visit so looking forward to seeing what the next week has to bring! 

Slán go foill

Kate 😊