Nolita Madros, Transcript Section 11

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Nolita Madros,
Transcript Section 11

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MARLA: And then the other thing I wanted to ask you is about issues of confidentiality, and how you deal with those in a small village.

NOLITA: I have a good one for that one.

I'm not allowed to disclose medical information. That pretty much, you know, someone comes up to me and ask me how is this person doing in Fairbanks in the hospital, I -- I'm not allowed to disclose medical information, you'll have to contact one of the family members and find out.

And you know, that pretty much -- some of them will understand, a lot of people will understand that I can't give out information, but there are just a very few that -- that will poke at me.

MARLA: Yeah.

NOLITA: In the hopes of, you know, I will release something. But I -- I normally don't. I never do.

MARLA: Okay.

NOLITA: Because it's -- it's too fine of an area. We're just not allowed to do it.

MARLA: Yeah. And you mentioned something to me when we were talking yesterday about when the clinic was in your house and that you were very aware of issues of confidentiality.

NOLITA: Yes.

MARLA: And what -- what was that?

NOLITA: Well, my voice is a little -- I don't mean to talk loud, it just carries a lot better.

So when we were over there, we have the Vanee ducts, and sometimes if the TV wasn't running in the front room, even if I was way back in the building, you could hear my voice because it carries quite easily.

So -- so I have to make sure the TV was on up front so that way, it will cover whatever I'm saying in the back.

And my son, he just moved over here, like about a week ago when I came home. And I didn't bring him up sooner even though they said I could, because -- well, he's a teenager, you know, and I didn't want to put myself and my patients at risk for breaches in confidentiality because you can't -- you know, teenagers, they see and they say stuff without really thinking what they are saying.

MARLA: Right.

NOLITA: So I didn't bring him up until the clinic was moved well away from that area.

And he knows that even though he gets out of school at 3:30, he's not allowed to stop by here and loiter because I just won't -- my job is important and I like it and I won't put myself at risk for it.

MARLA: Right.

NOLITA: And he knows not to come here.

MARLA: And you like to keep your life separate from your job?

NOLITA: Exactly. Yeah. Although sometimes it -- you know, when you're really busy, kind of run together, but you know, I keep it separate. When my son is around, I keep it as separate as possible. Because kids are kids. You know.

MARLA: Yeah. And I think it's something that you're trained that you learn about confidentiality, and a 15 year old might not --

NOLITA: Yeah, they don't understand.

And that's the other thing, I really discourage, working in the clinic, is family members that work in the clinic having their family drop by and socialize.

MARLA: Yeah.

NOLITA: You know, I -- that in itself, if it happens too often, is a confidentiality breach, too, because then they -- they see who comes to the clinic. They don't really know why, but then, you know how in a small village, a little crumb can be a mountain in no time.

MARLA: Right.

NOLITA: And for no reason at all.

MARLA: Right.

NOLITA: Just because they were loitering or visiting. And so I really discourage family members from dropping by and stuff.

MARLA: And hanging out?

NOLITA: Yeah.

MARLA: Yeah. I think that's probably a good policy. Then I also was wondering how you deal with emergency situations when you're, you know, in a village.

NOLITA: What do you mean?

MARLA: If you're in an emergency situation and it's someone you know or, you know, obviously, you know everyone now, you've been here for a year or so, but I just wonder how you deal with those situations?

NOLITA: You just kind of have to separate it. You have to put your personal life and your personal feelings aside to do your job because the main thing right now, they are coming in by ambulance, they are coming in for an emergency, you need to be focused on what you're doing, not the fact that, oh, that's my aunt or my cousin and my son or my daughter. You know. You need to set all those feelings aside and deal with what's happening right now.

Because -- and I know, it seems like it's kind of cold, but if you're more focused on what you're doing and not emotional stuff, you get the job done a little bit better and you're more, you know, level.

MARLA: Did that take a long time to learn or was that --

NOLITA: To separate that out? Yeah. It has. And there are days I do something and -- or I have a bad emergency, not particularly here, but you know, because I've worked throughout the state.

MARLA: Right.

NOLITA: And it's like maybe a day later I finally sit down and look at what I did and it's like oh, my gosh. And then the emotion part kind of hit and I, you know, cry. And I relieve my stress by sewing, as well.

MARLA: Yeah.

NOLITA: So you have to do something to keep sane. And I -- I sew little projects. I've got about 15 projects right now, but, you know what, if I stay on one project too long, it just takes forever to get it done. So I've got little bits of a whole bunch going. And that just kind of, you know, relieves the tension.

MARLA: Yeah.

NOLITA: So.

MARLA: Yeah. I was wondering how you kind of deal with those.

NOLITA: The only time I really -- I really cried when I was seeing a patient was when my own son was hurt.

And I was -- we were living in Ruby, and Ruby is a very hilly, live on the hillside type thing. And he was five years old, and he just got his bike like a week before for his birthday, and he was five, he got a helmet, pads, he got the works. He was going to be safe going down these little hills with his little two-wheel bike without the trainers.

And one afternoon I got home from, work four o'clock, and 4:30 he's, mom, I'm going down to William. William is his friend that lives at the bottom of the hill.

And I said, okay, you can go to William's. Are you taking your bike? He said, yeah, I'm taking my bike.

He put on his little helmet, put on his little elbow pads and knee pads and he took off down the back side of the road to the -- to the other road and down the back side of the yard.

And I didn't really pay attention because, you know, he had all his gear on and he's on his bike and he's going downhill.

Well, guess what. He gets to the other end of the yard and out of sight, he takes off the helmet, the pads and everything, and he goes down the hill and he hits a big rock.

And 10 minutes later I've got a 5-year-old male, bike accident, possible head injury coming in.

So I go to the clinic, and it's like he came in and it's like, oh, my gosh, he had like road rash on his arms, on his legs, and on his face, and so I don't know. And he had a cut on his cheek that went all the way through.

So when I talked to the doctor, he said, you have to sew either the inside, which is hard to sew, or you have to sew the outside so that -- he said the inside will heal, you know, from the skin in.

So it's like he's only five and first time I'm ever going to sew him. And he's in his little papoose all wrapped up so he don't move, and I'm irrigating, cleaning out gravel, and I end up sewing his cheek like six or seven stitches.

And that was the only time I cried while I was working. Because he was kind of thrashing and I was by myself, and a couple of people came in and helped me, but it was pretty emotional when I was working on my own son.

MARLA: Yeah.

NOLITA: And so I -- all the whole time I was crying.

MARLA: And was he crying, too?

NOLITA: Well, yeah, he was crying, but -- but I think he was more -- I was -- well, I was torn. I was upset because he left the house with all his safety gear on, and not 10, 20 minutes later I get him by ambulance because he had crashed, and if he had -- if he had have worn all that stuff, he would not have been as bad.

Because the road rash is very hard to get out, especially the fine gravel. You have to scrub it out. There's no way to get it out. You have to take a brush and scrub. And that in itself is traumatic for anybody.

MARLA: Yeah.

NOLITA: So.

MARLA: And then extra hard to have to do it to your own child.

NOLITA: Yeah.

MARLA: Wow. Yeah. I could see that being a --

NOLITA: That's probably the only time I cried while I was doing something.

MARLA: Yeah.

NOLITA: Otherwise, I pretty much set my emotions aside and just get the job done.

MARLA: Yeah. Well, that's, I think, probably a common -- a common way of coping with it, you know, you have to kind of separate --

NOLITA: Uh-hum.

MARLA: -- those, and especially emergency situations.

NOLITA: Yeah. So.