Spring Report from our Florence Nightingale

Here is our semi regular report from a hospital in the Green Zone of Baghdad. Our Forence Nightingale is an Army Nurse, who is halfway through her deployment, but may find out soon that she, in addition to every other soldier serving in Iraq or preparing to deploy will now be serving for 15 months rather than the 12 months they had been told.

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Hello All!
I realize it has been another two months since I last wrote an update. These last two months have practically flown by! It's funny to me as I sit here and think about what has happened in the last two months and to be honest not too much has changed.

About mid month in March I went home on R&R. I don't think it could have come at a better time for me. I was getting to the point of some mild burn out. After you deal day in and day out with broken bodies and spirits it starts to break you down as well. You lose your compassion as you care for the new patients that arrive daily. You compare severity of injuries and wonder why the guy with a broken arm is complaining when the guy next to him is 45% burned, intubated, and is missing a limb. That may be an extreme, but it happens all the time.

They teach you in nursing school and in practice that pain is what the patients tell you it. It doesn't matter if they are sitting there with a blank expressionless face telling you that they are in the most severe pain or if they are writhing in bed. They get treated equally for pain with what the doctor has written for pain. You often question yourself if your patient really understands what you are talking about when you ask them to rate their pain on a scale of one to ten. You also have to consider the language barrier that exists too. Most frequently they tell you a high number which leaves you skeptical as they drift off back to sleep and have to actually be woken up to take their pain medicine. I realize too that certainly they can have pain even though they are asleep. It is often that they get to the state of exhaustion from the pain they are experiencing along with the emotional and physical stress they are under from their wounds. Eventually, something has to give. They get a moment where their body shuts off for a minute to try and recharge to better help them cope.

So, R&R could not have come at a better time for me. I left the night before on a helicopter to arrive to Baghdad International Airport. From there I would fly to Kuwait and then on to Germany and finally Atlanta. It is quite the journey from the CSH. It takes about 3-4 days. I luckily traveled with another female from the CSH that was good company on my trip. You sit around and wait a lot. The ever popular Army slogan of "hurry up and wait" was in full effect. It amazes me how backwards the Army does some things. I don't know if it is done like that on purpose or that no one can change the system for the better.

Anyway along my travels home, I was all curled up in my seat like the 360 other people on the plane with me when I was woken up suddenly. Keep in mind that I had my boots off, glasses off, ACU top off, and I was under my little airline blanket dreaming of nothing. I was in la la land. As I woke up, I am staring at my chalk commander reconfirming that I was a nurse and could I go and check out a soldier that was sick and throwing up. Here I am trying to go home on R&R and I'm still treating patients. Only me! So I pull on my boots and put my top back on along with my glasses and make my way to the front of the plane. The soldier is an older man that is sitting hunched over a bag throwing up. I kneel down next to him and start asking him some questions like how long have you been throwing up? I asked him about his past medical history and allergies. I asked him what had happened preceding his vomiting. I had lots of questions to ask. They are my typical questions I ask someone to help me put the pieces together of why they present in the manner that they do.

The flight attendants on the plane were very nice in assisting me. I asked if they had a first aid kit and they were able to give me the little book that lists everything that comes in it. I luckily was carrying some Phenergan with me which is a medication that helps with nausea and vomiting. It also can make you very sleepy as well. I gave him one and hoped that he would keep it down. He did end up vomiting again, but no evidence of the pill came up. I made the determination that he probably needed some fluids and the only way I was going to get them into him so that he could keep them down was by IV. The funny part was because we were on an airplane I had to talk to a doctor via phone that would allow me to open and use the first aid bag. Apparently there is paperwork to fill out and the airline attendants have to call a doctor to get permission to use the kit and be told what to do. Needless to say I got permission after speaking with the doc on the phone. The other comical part of this was as I was preparing the IV stuff; a Brigade Surgeon (a doctor) came up and asked what was going on with the guy. He said he had just woke up and noticed I was setting up an IV and thought he should see if there was something he could do. I was thinking to myself, “Oh, now you come up!” It was funny to me. Anyway to wrap it up, I started an IV on this guy while in flight gave him some fluids, and monitored him the rest of the way to Germany where we were met by the paramedics. I updated them on what had happened with the soldier and they offered to take him to the hospital, but he refused because he was just as eager as everyone else to get home on leave. I got to take some supplies from the Germans with the signature of the MD, who reported to everyone that I was the one caring for the patient and had everything covered. It was certainly an interesting way to start my leave!

I have postponed taking my CCRN exam until I return home. I actually arrived on the date the test was being given upon returning from leave. I got in at 0400 and the test was at 0900. I though it would be better if I threw away my 300.00 for the exam another day! =) I think it was a better decision on my part to reschedule and give myself a chance to get adequate rest and more study time as well. I still have other courses I need to complete while I am here to keep myself busy with. I have the Captain’s Career Course and the ECCO course which is actually phase one of the ICU course the military offers.

My R&R went well and I did exactly what I wanted, REST. I enjoyed shopping with my Mom, getting tortured by my brother, hanging out with my Dad, visiting my Aunt, Uncle, Cousins, and Grandfather, and chilling with my dogs. I spent much of my time sleeping and trying to figure out what time zone I was in. I spoiled myself with a manicure, a pedicure, and a facial. I also got my hair cut and colored. I actually felt like a girl for the first time in awhile. I ate home cooked meals, sushi, and dined at some of my favorite places. I got my steamers and a couple of cold ones. I got my Panera Asiago bagel and my Dunkin Donuts Iced Coffee.

I also made a trip to Charleston, SC to visit one of my best friends, Laura and Chris. I had a great time. We visited many of the tourist spots and just relaxed. We got some of the best pizza I have had in years and watched movies. We studied for my CCRN exam. We hung out on the beach and ate bagels and took pictures. It was a very nice end to my leave. I hated getting back on that plane to head back here. Traveling back here went much more smoothly though.

The soldier I treated on our way over to the states found me and thanked me. I was also then recognized by several of the other soldiers as the “medic” and was asked for things for headache and nausea before getting on our plane ride home. It was pretty funny and I couldn’t help but chuckle to myself.

So another two months have gone by and again not much has changed. We got the news that we may be extended, but not definite word from our Chain of Command has come out yet. Apparently they have yet to extend any of the medical assets at this point, but there is always a chance. I have begun to mentally prepare myself to stay. I figure if we head home on time it will literally be like Christmas early and if we stay then I am already prepared and won’t be disappointed.

I will try and be better at giving out more updates and sending out some pictures. I have been busy on and off and have not taken that many pictures lately. I will send some along from my R&R when I get to my room tonight. In the meantime, thank you for your continued support, packages, and letters. I will write back soon; I promise. Please know that all of you are in my thoughts and in my prayers at night. I can’t wait to come home and just be ME! Talk to you soon and keep in touch!