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Entries about business travel

Nursing at LRMC

Things are changing. The patient load is becoming a little more of what I guess I thought it would be like to work at LRMC. For a time, about all we were getting were local patients. Lots of diverticulitis, lap-chole's, and the like. Now...well, things are changing.

Over the past two weeks our caseload has went from a mixture of locals and a few soldiers from down-range with either minor injuries or medical conditions to an entire new game. I was feeling like it was any other hospital throughout the US with the only difference being that the average age of patients was about 26. We are seeing lots of wounded soldiers now. Amputations, burns, multi-trauma. And they are so young....I have a Canadian patient who is 20 that is breaking my heart!

It's difficult because from a professional level, I am enjoying the learning and the experience. But on a personal and emotional level, it's really difficult to see and deal with.

I hope every night that I can say the right thing and be supportive enough. The wounds that we see are only the beginning. Although most of these boys are dealing well, there are always a few that seem to be having trouble. Recognizing this and being able to support them is important to me. I haven't been there....won't be going there (down-range) and cant even begin to understand what it's like there. I'm not certain that I can offer the proper support that's needed. But, I try...

That's all for today...just needed to vent a little.

So, when you see a soldier returning from the war...remember to say 'Thank you', or give them a smile as you pass them on the street. I still don't believe in what we are doing over there but I support our soldiers!!

Thanks too to all of the NATO troops. You guys ROCK! Thank you for standing beside the US, fighting the same fight and trying to make a difference.

Posted by Khandilee 07:51 Archived in Germany Tagged business_travel Comments (1)

Lots of Living and working and not enough PLAYING

I was reading an article on www.bootsnall.com the other day and I just can't stop thinking about it. I'll find it and link it here later...it was about 'travelers' vs 'expats'. I can say now that I have experienced both of these. As a traveler, I have enjoyed the US, Vietnam and Italy. Now I am experiencing living as an expat in Germany. These are two very different worlds....

I have decided (possibly prematurely) that I do not enjoy being an expat. I much prefer the life of a traveler. I really have no interest in continuing to live here in Germany. I have a decent job, a nice apartment (that I really don't want) and have made a few friends since I've arrived. I really liked the feeling of being able to move every 3 months if I wanted too. I'm probably a little jaded on my opinion right now but that's how I feel.

Being a traveler....I love the feeling of not knowing what the next week is going to hold, or where I will be staying in two nights from now. THe excitement of reaching a new city and finding my way around holds something for me. Where I'm going to get my dinner or what the 'free' breakfast includes and if it will be enough to hold me over until lunch. The push to explore, knowing that I've only a few short days and I'll be gone....it's like a drug, I want more.

Right now, I'm feeling stagnant. Like I am somewhere that I don't fit. It's ok not to 'fit' if I'm traveling but now I am living here and not to 'fit' is not a good feeling. After finally putting my finances together in the states so that I could afford to travel and enjoy my life...I am feeling the crunch of living on a restricted budget. Between making less money and having to set up an entire house and now having BILLS.....well, I am feeling strapped. I'm sure it's just a fleeting thing.....hopefully. Besides the fact of all of the above, yes: I'm in Europe. I should feel blessed but there are a few hurdles standing in my way in order to enjoy being in Europe. I'm trying to work these out and hopefully it will happen soon....

Only 285 days left until I can freely leave Germany and not owe the US Gov't anything.....maybe my opinions will change by then?

Going to go play with Aco now!

Oh...http://www.bootsnall.com/articles/10-02/expats-vs-backpackers-why-all-the-hate.html here is the link to the article. My bad, it was backpackers not 'travelers'.

Posted by Khandilee 12:47 Archived in Germany Tagged business_travel Comments (5)

"Severe Winter In Germany"


"Elsewhere in the world, a strong winter storm is pounding Germany.Heavy snow and high winds reportedly caused more than three hundred car accidents in just *one* day.At least one person was killed... And over forty others were injured in the northern part of the country.The severe weather has also shut down major highways and public transit systems in parts of the region.The storm dumped about 12 inches of snow in some areas."

Yeah...that's the news. It's really not as bad as all that but it has been cold and snowy here. Not much fun for outdoor activities, well...that is unless you like to play in the snow. Which I don't! My off days have been spent inside as much as possible and off the nasty roads. I think that I am starting to get a little stir-crazy here. I'm certainly ready for Spring!!

I did get out of the house a little.....watched Avatar 3D last week, awesome movie! Maybe I need to go see it again? I also ventured to the MALL yesterday. In Neunkirchen, about a 30 min drive from me. Fortunately, it's mostly driven on the Autobahn so the major part of the drive was on good roads. Neunkirchen is an old industrial town and from what I saw, it isn't a very pretty town, you can certainly tell it's industrial history on arrival. I spent the afternoon at the Mall, window shopping. There is also an old water tower that has now been converted to a 4 screen movie theater. I've got to check that one out....soon!

Plans are being laid for a trip to Paris while Mom and Dad are here. I promise to take pictures. It's been a difficult trip to plan. As silly as it sounds, I am not at all interested in going to Paris. I know that my parents will love it though so that will make it worthwhile. Me....? Where do I want to go? Crazy places like Krakow, Poland.....Bucharest, Romania.....Budapest, Hungary....Capacidocia, Turkey. Yep, they are all on the list! I'm actually hoping that I'll be 'pleasantly' surprised and actually like Paris. Not holding my breath on that one though.

I'm still dealing with bullshit paperwork with the DOD. It's annoying. I was screwed this week for payday as the reimbursements that I was supposed to get weren't in my paycheck. Come to find out, the employee that told me I would have it this week, simply didn't submit it. Would have been nice to have known this in advance. Really screwed up my budget. Which sucks double since Mom and Dad are going to be here before it gets straightened out! Enough about that.....

I'm looking forward to seeing Aco. It will be nice to be reunited with her. Maybe things will start to feel like normal once she is here with me.

Work is going good. I'm on nights now and starting to feel like my normal self again. Days was going to kill me! I'm going to be trained for charge RN next week. Seems with all the Navy leaving (we are losing 5 by the 1st of March), I will be the ONLY permanent person on nights. The rest will rotate through, so it's looking like it's going to be up to me to keep it running smoothly. No pressure there.....wish me luck!

Scheduling is a little better on the new schedule. I have one stretch of 4 days off in March and am trying to figure out where I am going to spend it. Need to find a sitter for Aco so I can do some traveling without her. There are just certain places that aren't going to be good for her to go with me.

Working on Trinity's flight for Spring Break. Yes, more government paperwork, but if I can get them to cover her flight then it's worth the paperwork. I cant wait to see her and have been trying to get her room put together so she will feel 'at home' when she gets here.

Guess that's all for now....

Stories and pics of Paris coming soon!

Posted by Khandilee 04:22 Archived in Germany Tagged business_travel Comments (2)

The Nitty Gritty on the Job

Since I've been here almost a month, I thought it was probably time to update you on the work side of things. It's been chaotic to say the least.

My first two weeks were spent with a Sponsor. It's my understanding that the Sponsor is supposed to get you through the in-processing, help you find a car, and a house and just simply help you settle in and get all the paperwork completed.

Unfortunately, my sponsor (god love her...she tried), had NO idea what I needed to do! So, we spent the first two weeks running around in circles. Go here to do this and find out that you can't do it until you have something else done first...get lost trying to find the other thing and finally find it to see that they are at lunch for the next hour. This was the process during the ENTIRE first two weeks....uggghhhh!

There isn't any sort of support or distinct processes for the civilians coming in and I have made this my own pet project to improve. I hope that those coming in after me don't have the frustrations that I have had. I have been fortunate to connect with two other civilians that came in the same time as I did and we have tried our best to support and help each other.

I'm on week number 4 now and I think I have most everything done and am ready to start focusing on the work aspect of the job.


In-processing paperwork
Bought a car (been lucky that it's still running)
Obtained Auto Insurance (super easy)
Opened a local Bank Account (cant do much here without a local account)
Got drivers license (this was a process, failed the first time).

Wow! When I write it down, it certainly doesn't sound like I've done much.....

To Do:

Find Housing (need to get this done SOON)
Sign up for benefits (have to hurry on this as it's due by the 30th)

I still have two BIG items to complete and I'll be officially DONE!!

The Job....

I've been very lucky on the floor that I was placed on. The staff are great! They have all been welcoming and helpful. I already feel like part of the team (at least on the day-shift).

Most of the nurses on the floor have less than 2 years experience and I can see already that I will probably be a resource on nursing issues.

I'm slowly learning the 'chain-of-command' and appropriate protocol.

So far I have seen the following types of patients:

- appendectomy
- gunshot wound to hand
- ski accident resulting in broken femur
- septic shoulder wound
- s/p IED blast w/multiple trauma: LBKA, R Disarticulate Hip, trach,
- kidney stones
- s/p IED blast w/pelvic, sacral and RLE trauma
- Pancreatic pseudocyst

The nurse:patient ratios are some of the best that I have ever seen (although this might be because we are slow right now).

We have our two trauma patients on 1:1, and the rest of the nurses have no more than 3 patients at a time. It's a slow speed and will probably take me some time to get used to.

I'll try to update more soon....

Posted by Khandilee 01:42 Archived in Germany Tagged business_travel Comments (5)

Quilts of Valor

If your looking to read something witty or a great adventure....just stop now. Today's writing is much more somber.

My day was filled with emotions. Today, was one of many days that we are sending injured soldiers home to the States. The difference is that today, I was a part of it (if only as an observer for most of it). I've followed nurses on the floor for the past several days and interacted with several of the patients on my floor. Today, two of them got to go home. From a nursing standpoint, there is a lot of work that goes into getting these soldiers home. Everything has to be planned and orchestrated just right in order for a soldier to keep his/her place on the flight. Just one mistake and they can't go....imagine how disappointing that would be.

Just before we wheeled the patients to the holding area, they were presented a Quilt of Valor. It's pretty simple, really. Just a small quilt, just large enough to cover. It's the story behind the quilts and the look on the soldiers face when presented it that is really important. The story that was told to me is that a mother made a quilt and sent it to her son and all his buddies liked it and wanted one. From there, the organization Quilts of Valor was born. The quilts are all made with love and each one has a note to the soldier on the back, including and who it came from.. It all seemed kinda cheeky to me until we presented one and the nurse told the soldier 'it's like a hug from home' . The look of appreciation and homesickness on the soldiers face was indescribable...

After all the paperwork and prep; I followed one of our patients to the holding area where they would board a bus that would take them to the plane. Some of these soldiers will have a very long trip in front of them. They start the day early; having to be in the holding area by 0830. The more critical patients (ICU) are transported at 1100. From the holding are, they are loaded onto buses that will carry them to another holding area at the airport. The flight doesn't actually leave until early afternoon. Then the soldiers are in-flight for 9 hrs with many of them catching another flight in the states to continue the trip home.

It's frustrating how removed we are in the states from what is happening here. These men and women are flying in daily with a myriad of injuries: gunshot wounds, blast wounds, some with minor injuries and some with injuries and amputations that will follow them for the rest of their lives. Some of the wounds are deeper....unseen....emotional, that will haunt them forever. I feel ashamed that over the past several years I haven't given these men and women much thought at all.....

I'll just leave you with one thought: No matter how you feel about what is going on with the War, if you happen to run across a soldier....PLEASE...acknowledge them....thank them...or at least smile to them. Their sacrifices are many.

Posted by Khandilee 01:27 Archived in Germany Tagged business_travel Comments (5)

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