Its 8am. We are currently on a train headed to Lake Como, Italy. Which is 5 1/2 hrs away, just on the other side of the border of switzerland. We'll be spending our 4 day easter weekend there. Switzerland has public holidays the Friday and Monday of Easter. Therefore all of Switzerland is heading out for a vacation and at every stop the train fills up more and more.
Right now I'm very tired and not in a good mood because Adam's daily alarm went off at 6:30, 45 minutes before we needed to wake up to catch the train. I'm normally not a very nice person to be around when my sleep gets interrupted but after these last 2 weeks I need as much sleep as I can get.
For 2 weeks I've been working every day 7am-4pm. Re-learning all the medical/surgical nursing I've forgotten over the years. Learning about heart surgeries and heart problems that I've never taken care of before. Learning various medications that have completely different names than in the US. Learning the organisation and rythym of the unit. Learning how to chart. Oh and did I mention that I'm doing all of this in another language!
My brain is fried. I'm mentally drained. To make matters worse, for my first week, right after working 9 hours and speaking french 9 hours, I had one last full week of french lessons. Then I'd go take a class at the gym (can't take a break now, wedding is less than a month away, need muscles) On Friday of my first week they let me go home 2 hours early because it was so obvious how utterly exhausted I was, I couldn't even think straight. I was like a zombie. I went home and promptly took a 90 min nap. And napped Saturday as well.
The hardest thing is by far the language. Nurses, remember in nursing school we had to learn medical shorthand and abbreviations. Abbreviations for diseases, shorthand and symbols for the little words you get too lazy to write in your charting or in prescriptions. Now try doing it in another language. I bring a little notebook with me everyday to write in that has pages full of just that. To all my nurse friends who are not native English speakers, I don't know how you did it! Everyone reading this right now needs to go hug a foreign doctor or nurse, there's tons in the US so you have plenty of opportunities. I feel so ignorant for never thinking about how hard it must have been for them. Americans can be like that
My first 2 weeks I mainly observed and learned how to do basic things that I'd forgotten like dressing changes and EKGs, helping patients with their bath (luckily most are pretty independant). Next week I think I'm going to start getting assigned simple patients to take care of.
It's mainly a post-op floor for mostly cardiac surgery patients after they have stabilized in the ICU. There are other surgeries as well, like thyroidectomies, back surgeries and GYN stuff.
Charting is all on paper. Nothing is on the computer. And french/swiss people have weird handwriting that I have a hard time deciphering. They have totally different ways of writing certain letters and numbers. The number 1 is like an A without the line through the middle (because in Arabic, where our numbers came from, it was based on angles, and that shape has 1 angle, and they still write it like that). A 4 sometimes looks like a sloppy 6 to me. A capital M looks like a large lowercase n because they don't make that little downward angle in the middle. And a few other letters aren't like Americans typically write them. And it's a half-cursive, half-normal print mix. I'm always having to ask what is written on the chart. I'm getting used to it though. But reading doctors handwriting... impossible.
As far as nursing duties goes, it's not that different. Some materials are different but most are the same or similar. They use plastic bottles for IV drips instead of plastic bags. And unless it's a dangerous drug like a blood thinner, they don't use IV pumps. There is no medication machine like a pyxis guarding all the drugs. It's just a wall of drawers, alphabetized, unlocked. Except for opoids and such, obviously locked up.
The patients are much more patient than Americans. Which is a huge plus. If you tell them "no" they accept it and don't ask questions.
There's less documentation than in the US. Also huge plus. They worry of being sued for everything you do just doesn't exist here. It's a very American thing. Over charting, over treating, over intervening. Over-CYA (cover your ass). One thing I've realized being out of America is everything there is just over done. It's a culture of excess. I like being away from that.
Some of the values for labs are different because they use different units of measurement. For example a normal blood sugar value here is between 3.3-6. In the US it's 60-100.
The only thing I don't quite like is that the locker room for students and interns is unisex. It's a tiny room without anywhere to hide. So I wear my undershirt to work so I don't have to take off my shirt. And I change my pants as soon as I walk in as fast as I can if there's no guys in there yet, or wait till they leave. It's only 1 or 2 guys, and in europe it's not a huge deal, but as an American it's kind of awkward. Even though, technically, my underwear covers just as much as my bikini does. So I guess it's not a big deal so I'll get used to it.
Oh yeah the other huge adjustment that I still don't like... taking care of men. For a week and a half I successfully avoided having to go near man's private parts but I knew that would eventually have to end. Pre-op cardiac patients have to be 100% shaved on the front side of their body before surgery. I just have to keep in mind that Europeans are more open than Americans about that sort of thing and it's more awkward for me than for them. Which was the other way around when I worked in Labor and Delivery. The patients were all shy about having their hoo-ha's looked at by everyone that walked in the room, while us nurses never thought twice about it.
The staff is incredibly nice and welcoming and supportive and understanding of the learning curve I'm suffering. They help me with all the words and abbreviations and medication names I don't understand. And if they're all joking around and laughing and I'm just sitting there blank faced they say "you didn't get that did you?" and they will then explain the joke to me. Which includes teaching me interesting slang expressions and cuss words. Which there are so many more of in french than english.
They're always making fun of American accents but they mean no harm, it's like how Americans like to randomly break out in a British accent. I like to make them try to pronounce my name in english, and they just don't get it. (I've had to frenchify the pronunciation of my name these last 2 years, here my name is "laurenne" with emphasis on the "renne" and the impossible, back-of-the-throat french R sound)
Almost all of them are from France. The conditions and salary for nurses in france are just terrible so a lot of them come to switzerland where they get paid double. Plus the Swiss just have a hard time recruiting their people to be nurses. Years ago they recruited tons of nurses from Quebec, then from Portugal. Now the Swiss have their panties in a bunch and only want to hire swiss nurses. There was recently a report on the radio about how to make the medical field more appealing to young Swiss people, because there's just so few.
On my first day, as we were sitting down to chart our morning rounds, the nurse I was following stopped mid sentence and said "oh, before we start, I have to show you something very important" she turned around to the wall of drawers of medications and opened the largest one, which is unmarked, inside it was full of chocolate! I said "yeah this is obviously a Swiss hospital"
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