# 51 - The Long one

#51 - The long one.

My plan, after my fishing disaster was to fortify my line, and have another crack at that monster that got away on Tuesday morning.  But for some reason I slept in and only woke in just enough tome to shower, dress and run down stairs to work.  That sleep was perhaps the best that I have had in ages.  Little did I know that I would need that rest in my reserve tank.   The day was huge.

Locals here are getting to know me, I hear them coming to the window and ask the receptionist "That new white nurse, can I see Em?"  I put up a sign down at the IBIS store advertising Flu shots, and there has been a steady stream of people coming for a shot, and a chat.  It is nice to get to know the folks.  As I am seen more and more out and about after hours, people are gradually opening up, and discussing stuff that they wouldn't have just a week ago.  Being new in any community is not easy.  Making the effort can be tough when the way that you communicate is different by values, customs, culture, and language, to the people with whom you are trying to communicate with.  But slowly I'm getting there.

I was talking with my wife just last night,  about how I am not just home sick this trip, but for the first time I am lonely.  As a social person, I need people around me, that is what energises me.  But here, I am in a unit by myself, ontop of the clinic, away from the village, and when the shift is over, and the sun goes down, and I am sitting in the unit just waiting for the phone to ring, it feels pretty lonely.  That is the hardest bit about this trip, this time.  So I was saying to my bride, that I am looking forward to today (Wednesday), because there is a two day doctor clinic. That meant that I would have another human in the unit next to me, with whom I could share a meal and an evening of conversation.  With a really good night sleep under my belt, and a spring in my step, i had a cracker of a day.  More interesting primary health things to follow up.  It was a day full of STI (sexually transmissible infection) followups, testing and counseling.  Some Flu shots, lots of pharmacy supply and a team meeting with the other Outer Island nurses via telephone conference.  The Dr flew in from nearby Warraber (Sue Island) just after lunch, and after exchanging pleasantries, we retired to the mountains of work that we had 4 hours to wade through.

It is coming close to knockoff time near 5pm and i ask the doctor if she would like to share a meal (left over curry), she accepted, our plans were set.  This would be a night where I had some company  !!
Then a man came in with chest pain...

I went through the routine, thankful that I had spent half an hour fixing my ECG machine.  Assessment, ECG, GTN, Aspirin, Vital signs (NO oxygen!!   you know how I feel about oxygen) 18 g IV cannula, bloods collected & spun, and discussed it with the doc in the next room.  This guy had a medical history that reads like a Harrisons Internal Medicine Textbook, so with his history, and risk factors, we just couldn't ignore the symptoms.  Most clinics have an Istat machine.  This is a small hand held electronic machine that you put a blood sample into, and it will give you a series of blood test readings.

One important blood test is a protein in the blood that is released from damaged heart tissue during a heart attack.  It is called Troponin.  Ideally we would have performed a Troponin level on the patient, but Yam Clinic has not got a machine, so we were required to call the Thursday Island hospital and arrange for transfer.  It is going on to 630pm.  an hour and a half after closing time.  Irene the doctor informs me that the patient will be transferred, and as she is telling me this, I have Retrieval services Queensland on the phone telling me the same thing, only their news is not good.  They cant get here til morning light!!!  I was asked to nurse the patient on the monitor until they arrive.

There go my evening plans - of all the nights on Yam to score an all nighter, it had to be one where I actually had some company.  So right now it is 230 am, by clinic is clean, restocked, and my patient is snoring.  The light flickering of a flouro down the corridor is sending Morse code messages to the island spirits., The immunisation fridge is droning on maintaining my cold chain between 2 and 8 degrees., my patient doesn't need obs till 4 am, and it is time to check my facebook.  My friend Brian is doing his first night as a newly registered nurse, and we have been texting on an off for a couple of hours.  I sit here in the clinic at the computer , slower than dial up internet of the 90s, and reflect that in the face of all adversity, I have company.  A world of online insomniacs, friends and colleagues that are away from their beds tonight also, and a blog to write. 

Best case scenario is that the helicopter will be here around 8am, assuming handover on the air strip is swift, I should be able to knock off and catch some zzz at 9 am (just over 6 hours away).  At that time I would have completed a shift that was 25 hours in duration.  This is a special job, with unique challenges, and the more that I reflect on it the more I realise that (even with out sleeping)
... I am still......Living the dream.