Little bit more low key this week, I've only moved city once!
Before I left Vancouver I had one more day with the nursing students at UBC. I had been especially looking forward to attending the pharmacology lecture with them seeing as I just finished my prescribing course before going on this trip. A lot of it was much the same just with A LOT more class participation! Students are keen on this side of the world! I had just been lulled into a state of half listening to familiar material when they started talking about the 7 rights of administering medications. Seven!! As any nursey people will know we learn the 5 Rights; Person, Drug, Dose, Time and Route. In UBC they teach a standard 7 which include our 5 and add Right Documentation and Right Reason which I couldn't argue with! They actually round it up to 10 with Right Technique, Right Education (for the patient) and Right Follow-up but the initial 7 are what they use to teach on the wards. It's all logic we use in the UK and Ireland but I think that from a teaching point of view the 5 Rights sounds a bit snappier and still contains all the vital components! Still, I have to admit to being a bit short-footed and defensive for the first few minutes when I thought that they taught twice as many as us!
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| With a group of term 4 patients in Skills Lab |
There was also a lot of talk about generic drugs vs branded drugs. I didn't really get what the big deal was but I guess as it's almost all generic drugs we use in the NHS it's not an issue we have to deal with. In the US and Canada it is often only the branded drugs that have been through stringent trials and regulation. This is done by pharmaceutical companies who brand and set prices for the drugs etc. Every drug is licensed by their company for a set number of years (currently 20 years) and after that other companies can sell it under it's generic name. The problem is that there is no regulation with what these companies do with the drugs so ingredients and amounts can be different. Even minute differences can make a huge difference and be extremely dangerous as I found out listening to students discussing theirs and their families own experiences taking a medication they thought they knew but caused serious issues due to tiny differences in the make-up of the drug.
Once I had finished for the day I decided to take a walk around the massive campus. You can see the ocean from most parts of it so I figured it was pretty close and seeing as I had basically no free time in Vancouver I thought I'd take advantage of being so close to it and go for a stroll. After walking what was probably a couple of miles I came to the entrance to a national park at the edge of the campus, once you go in a bit their are steps down to the beach so off I went! Little did I know that it was 500 steps and when I got there without paying attention to any of the signs I ended up on a nudist beach with quite a few people availing of the facilities! Considering I'd climbed down half a bloody cliff to get to the beach I was in no hurry to climb back up again but I honestly didn't know where to look!🙈
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| If only I'd read this sign on the way down! |
Don't get me wrong, I've been a nurse for 6 years - I've seen plenty of people without their clothes on but usually I'm expecting it plus they're not usually frolicking on the beach!😂
Also almost nearly died getting back up to the top again but it was a beautiful beach and a very unique(!) experience so it's all good😆
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| St. Paul's Hospital |
On Friday I spent the morning in St Paul's Hospital in the city centre of Vancouver. I spent the morning with Irena, the only registered nurse in the ENT department! She showed me around and I couldn't believe the differences in the nurses role in our 2 departments! In NUH we have 8 RN's (and that's not including management roles) who run nurse-led clinics and the emergency clinic alongside a junior doctor. Trache changes, dressings, nasal fracture reductions, removal of foreign bodies and so on are all nurses roles in Queens. In St. Paul's there is one registered nurse which is crazy! Because of that all of the above tasks are done by reisdents (equivalent to registrars) which puts extra pressure on their clinics. But another huge difference is the amount of invasive procedures they do in Outpatients. Polypectomies, turbinate reduction, myringoplasties, tonsil haemorrhage management are all done in clinic! Those are all done as day cases in theatre on our side! Although even though we have more nursing staff which takes the pressure off, they had noticably more and better equipment in clinic so I guess it depends what you use your budget for. It seems no one can have the top notch equipment AND the staff! Typical.
Oh and I got to have my sense of smell tested which was really cool because it's a test we don't offer on the NHS so it was really interesting to experience it. Mine is above average, just fyi - woo!🎉
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| The Alligator forceps in St. Paul's. We call them Crocodile forceps!😄 |
After a hectic time in Vancouver I had 4 free days before my next visit in San Francisco so I stopped in Seattle where I am now, with the first series of Grey's Anatomy on Netflix as I type! Although I'm more of a Frasier fan myself! I didn't really think about it too much and didn't know what to expect but I'm so glad I came here, it's just the most amazing city. Really laid back and a great place to try to get back on top of my sleeping pattern! I even went to my very first baseball game on my first evening in Seattle to watch the Mariners play the Yankees and it was class!
I've had a great few days here exploring and spending all my money in the tonnes of amazing bookshops dotted around the city.😥
Also, lots of people have asked about the hospital from Grey's Anatomy. The hospital it's based on, Harbour View Medical Centre, is here and I did pop by but it's not the one with the famous entrance that everyone sees on screen. That one is in LA, sorry guys!
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| Seattle Grace is based on Harbour View Medical Centre but the entrance is in LA! |
Tomorrow I head to San Francisco on the Amtrak, this one takes 23 hours and I've had more than one person tell me I'm crazy! But I've stocked up on American snacks (living the Gilmore Girls dream with milk duds, red vines and reeses cups!) and I have tonnes of reading material, surprise surprise! And I honestly can't wait to get a train down the West Coast of the US!
2 cities, 2 hospitals, 1 university, 1 nudist beach, 12 books and a partridge in a pear tree.
Until next time!
Slán😊
Kate
