Thursday, December 13, 2007
Wednesday, December 12, 2007
NURSING IS MORE BROAD THAN I ORIGINALLY THOUGHT
This may very well be the most important week of my life: for my career, for my education, and for my family; which is all well and good, but the fact of the matter is I still don't have a Christmas tree.
Wednesday, December 5, 2007
We were doing nursing theory presentations in our Professional Seminar class today, and all of the sudden, it dawned on me.
For the last probably 6 months, from the end of the Associate's Program until now, I have struggled with the definition and role of nursing. Are we the doctors' servants? If so, then why do we work just as closely with social workers and therapists?
The answer is NURSING THEORY! Nurses do not just deal with medical conditions, we help our patients achieve integration with their environments. That means helping them through family disputes, money problems, and explaining their medications. Roy, Neuman, and many other theorists have worked very hard to give us this vision of nursing.
I was brought up on Neuman. I did not see its significance at first. By studying Roy, it's like learning a second language. When you're a child, you don't understand the complexity of English, but when you learn French, you see all of the aspects of the language you took for granted. I have seen that nursing theory is there to tell us who we are, and establish our true identity as the ultimate patient care profession.
Tuesday, December 4, 2007
Saturday, December 1, 2007
Apparently, orthopaedics is extremely lucrative. Old rich old lady wants a handcrafted hip? Bring her in! Some homeless guy has a bum knee? He can forget about it unless he has some infection ravaging his body, and then he is probably a medical patient with an ortho consult. Orthopaedics is like a surgical get-a-way for old people and golden young athletes; whoever has the time and money to get elective surgery. (In fairness, they also take some trauma patients and some medical overflow like the rest of us.)
Combine these two units, and who gets what they want from the brass?
Wednesday, November 21, 2007
I've been up for 22 hours now. I'm pretty sleepy. Yeah, I'm sure lots of people have stayed up for obscenely longer, but I don't care. I picked up 11-7 last night and I have a group meeting from 9-11. I think I'm going to make 24 hours! Anyway, I'm glad I like my job. I remember dreading going to work as a CNA. I'm glad that's behind me. Oh, I'm going to shadow a nurse practitioner here pretty soon. It should be enlightening. I think I want to go on for my Doctoral degree so that I can teach. I'm not sure yet...
TIRED FACE IS MY HEAD!!!
Monday, October 29, 2007
I held an auction in the fall. There were four people and a sheriff in attendance. The whole house with a crapload of old posessions and portraits of my ancestors went for like a hundred thousand bucks. My neighbors were there. I hated my neighbors. They were all very old. They mowed their lawns in jogging suits and hearing aids. They loved each other, too. I think they were all jealous of my house.
It rained on my neighbors, my old house, and all of those freaks who wanted it. It rained on me too, but I think it got the dust off of me.
So, I went out in the dead of winter to a hill in the woods. I'm not sure who owned the property, but they probably lived far away. I looked around at the huge trees and moss and animals. It was nice since they were all dead or cold. It would be easier that way.
I took the hundred thousand dollars and bought a saw, some nails, and a hammer. It was really hard to cut the trees since their insides were frozen, but if I waited until about six in the evening, they would be soft enough to make some progress.
The very first thing I did was to clear every old thing off of my hill. I cut down every tree and pulled up the stumps with my bare fingers. I used the claw end of my hammer to scrape up ever piece of grass and every stretch of moss. I killed all of the bugs and animals that came through.
One time in kids' school, they told me that the stars we see are actually very old. I almost threw up. I know that teacher was a liar. She was young, but I still think she lived with her great-grandma or something.
I think I almost died that winter. I coughed blood from December until February. One time, I slipped on a patch of ice and fell off my roof. I don't know how long I was knocked out because no one keeps track of me. My hands bled every day and I still have no feeling in the soles of my feet. It was all worth it. In the first week of March, I decided that I could go into my house. I had built the outside of my house first, so that the inside would be as new as possible.
I think that this was the best time of my life. I hung every wall with ingenuity and precision. The corners stuck in my mind and the edges were confrontational. I cherished every nail and could feel each blow of the hammer. The sound of the pounding was the sound of my heart and I think I cried more than I spoke during that time. I held each piece of board close to me and laid up against it when it was pressed to the studs. From March to the middle of April, I was in love. For the first time in my life, I realized that this new home was the place I was built to inhabit.
The second half of Spring found me making forays into the nearby town. I opened a small practice and was seeing patients for the first time in years. I could stand looking at their rashes and old faces because I knew my happiness was waiting in the blackness of the forest. I even made some friends.
I met you on June first. You were kind and could speak more than anyone I had ever met. I listened and you spoke. Your face was the only one that God ever made by hand. I knew it because it was the only new one I had ever seen.
The day after I met you was the day that I hung the las wall of my new house. I was in such a good mood that I decided to play a little joke that I had read on a comic. I put construction clothes on a new skeleton and lay it to rest behind my wall. I smiled when I nailed the wall to the studs.
When I went to bed I wondered whose skeleton I bought. I had dreams about it too. I dreamt you were old and stained and living inside my walls. I hated you. Why had you aged? You were the only good one ever made. Didn't God care about the good things? But, you were in my house. My house could not age. Neither God nor weather could touch the inviolate youth of my dwelling. It stood bulwark strong against disease, time, Einstein, Nietzsche, Darwin, and St. John. They would surely break upon it like wind on it's facade. I woke with the surety of my own ceiling above me.
I saw you the next day and asked you to come to my house. You said okay.
We got there and quickly ate dinner. We spoke.
"I like your house."
"The walls look new. I wish I could live in a place like this."
"You can stay here if you like it."
"I would like that. I would like most of all to grow old with you."
Little white explosions dotted my field of vision. I thought I might fall over. I probably vomited. I wish my mind could throw up things that made it sick. I'm not sure what happened after that, but I know you left in a hurry and I slept in the attic that night.
I woke up the next two days, but I could not move. I tried, but each time my brain sent a signal to my arms, my arms sent a message back in a language that my brain could not understand. My conscious mind tried to mediate for me, but I mostly just cried. I cried and called it a liar. I didn't want to ever hear my conscious mind again, which is sort of a funny thing to think. If we are one unit, how can we tell ourselves things. When I realized that I realized that part of me was old. I saw that my conscious mind was the part of me that I had got from old people who decided things about our sound pictures and thought rules and I was furious that it had snuck by me for so long.
I did what I had to do. I called my mind out. My id, ego, and superego. They appeared before me in stark contrast. My psychology professors were all liars. My id was not some idiot baby. It was a man with a beard and tangled hair with broken glasses and a dirty coat. My Superego was not some sunday school teacher or judge, she was holding the id's hand and stroking his shoulder, she wore a kind dress and had nice hair. My ego was the true horror. It was a gross caricature and amalgam of my parents, my school, and my country. It drooled and bled and smelled like death. I raised up off of my floor. I raised my hammer and began to beat the beast. I drove nails into the thing and pulled the decaying flesh off of it with the claw of my hammer. The distrubed result of a child's attempt to reconcile conflicting desires, my ego was the one pinning me to the floor. Rationalizing and ignoring, pleading and hiding it strangled me. I tore and tore at the animal until I had torn every piece of flesh from its body. Inside was the prank I had hidden between the walls.
"Joke's on you," it muttered and smiled.
"Uncle Leon?" I embraced the empty frame, cracking a few ribs.
"You little freak. Don't you know you're acting retarded?"
"Uncle, I told you. We don't talk like that anymore."
"Sorry, bud. Hey, what's with all this new stuff?"
"I built it because I hated you."
"Ha! Well, you're certainly a poor carpenter."
"Well screw you, Leon."
So, basically Leon and I moved to Greenwich Village. He's a poet and I opened a free clinic. I guess I still think about you once and a while. I throw up a little sometimes. We go to protests and stuff, but he's really into anime, so we're always watching some weird cartoon with subtitles. He says the dubbed stuff is gay. I tell him he's a freaking plastic skeleton. Then, he turns to me. Opens his bony jaws, and in a raspy voice with dog's breath says:
"Happy Halloween, you butt-munch."
I think I just spent an hour writing that. I feel better. At first, I just thought it would be funny to write a tell-tale heart story about a guy who builds a skeleton into his walls. Then I think I just started to throw in some half metaphors. It might be about my first two years of college, but I wouldn't look for too much meaning in it. It wasn't meant to mean anything. Then, It was getting really old, so I made it into a halloween thing. I might be retarded.
Wednesday, October 24, 2007
Wednesday, October 17, 2007
I CAN'T separate my religion from my politics. That's okay because my religion says for me not to make laws that force you to feign righteousness. Laws don't reign inside my religion, so why would I manufacture laws to force on others? In America, laws are just rules we all agree on to make it possible to live in the same place.
I'll try to separate my feelings about myself and my life from my feelings about you and yours. I promise that I'll try to think. I think that'll help us live closer together.
I just spouted emotional rubbish. That's not very constructive is it? It might be. To make up for that, here is something completely opposite:
I chose to analyze the descriptive statistics of a study done in
The authors of this study effectively used descriptive statistics to clarify and point out patterns in their data. They frequently used arithmetic mean +/- the standard deviant and grouped frequency distributions. They used these methods to quickly show relationships between data that were rather obvious without further analysis (i.e. average patient age, percentage of patient with nasogastric tubes, etc.). The writers also employed multivariate logistic regression analysis to find correlations between their dependant variable and their various independent variables (i.e. nasogastric tubes, aggressive procedures, etc.). The report also included a few simple tables which were effective in highlighting relationships without becoming distracting.
Overall, the authors effectively used descriptive statistics to clarify the raw data, and point out relationships between variables. Their statistical analysis was thoroughly explained in the text, and all of the analyses were relevant. I would also point out that these researchers employed SPSS software in their analyses.
Suljagic, V., Cobeljic, M., Jankovic, S., Mirovic, V., Markovic-Denic, L., Romic, P., Dragan, M.
(2005). Nosocomial Bloodstream Infections in ICU and non-ICU Patients American
Journal of Infection Control, 33(6) 333-340.
Take that! You don't to find the Pearson Correlation Coefficient of me and awesome to know that we have a steep slope indeed. = humility
Monday, October 15, 2007
Artist in your militant jacket, your convictions lined in metal discs on your sleeve. You carry a guitar and paints. You confront, you explore, and you examine. You write and expound about the mysteries that surround you. You see the sheep in polo shirts, wal-mart slacks, and white shoes and think that perhaps they don't see the same world that you do. You subject practical concerns to metaphysical ones. Your long hair, strange face, and fringe politics make you an uncomfortable figure for many. You prefer it that way. You live to confront expectations. You also age. The war that you lived to end in college, will come to an end. The president you despise will grow old and die. Your music will either fade out completely or be re engineered into a popular blasphemy of its former self. You may continue on with your convictions into old age, or the wearing of gravity and necessity may mold you into a more convenient form. I have seen it go either way. I have seen your adolescence in with intractable headaches, seizures, or some other young brain problem. You make a Michael Jackson glove out of the mesh we use to cover your IV site by cutting a thumb hole, we do that all the time, but I compliment your ingenuity anyway. I have seen you old and disabled. Your paintings hang on your wall. Every night you tell me that you were a great artist and a teacher. You tell me about Paris. I have actually seen your painting in someone's home. I have seen you come in to us with no intentions of leaving. You do not wish to be resuscitated. You want peace, quiet, and solitude. You didn't cry when you had your shots as a child, either. I will bring your morphine on schedule and try not to wake you.
Christian, in plain clothes, happy with your family, but working hard. You seem poor and somewhat ineloquent. You put all of your eggs in one basket. Sometimes you carry the knowledge of your faith like the sky hold is blueness. Sometimes you carry your faith like a heavy, splintery, cross. Sometimes you try to hide your faith in the bushes while you engage in some indiscretion. You go to your Church to meet your friends, you go to your knees to meet your God. You have many facets. You are supposed to support guns, wars, and the free market, but you're not sure why. You are pulled toward pluralism, but you hold on to the Scriptures as your anchor. You call the businessman greedy and the artist immoral, although you know that you are both of these. Others see your dim exterior, but cannot guess what lies inside you. I have seen you also. You lie in bed quietly. Your Bible is on your bedside table. I don't think I've actually seen you reading it, but it is there. You take your meds and trust your doctors. Sometimes you blame things on God that are not his fault. Your locus of control fluctuates from internal to external and back again. If you are in a coma, your family invariably leaves Christian pop music on 24/7, which I suspect may annoy you, but they think that 88.3 heals. Your family cries much harder than you do. They want treatment options, home health care, and second opinions. You don't mind. Your faith grows stronger as you breathing becomes more difficult. Sometimes you have visions of celestial beings.
I have seen myself in all of these. I live in pretense and die in pain. I cling to the present, long for the past, and am anxious about the future. Sometimes it seems like riding a bike down a dangerously steep hill, you know you will wreck soon, but some of us just make it longer than others. The important questions are, what's at the bottom of the hill, and how can we enjoy the ride?
I had to work sunday night. It was an easy night. Four patients, two strokes, one cancer, one meningitis. Easy stuff.
Tuesday, October 9, 2007
I love the internet, I HATE INTERNET CLASSES! It's like, I like bikes, but if I had to ride one for too long (like the amount of time I have to spend checking on these idiot classes) , I would vomit blood.
Angie and I are going to Indianapolis on Friday and staying two nights! We're going to either a dinner theater or symphony orchestra on Friday night, seeing Indy on Saturday, and going to a Pacers game on Saturday night. Plus, we're 21! We can go anywhere! It will rule.
Wednesday, October 3, 2007
From the E-Medicine, Gilbert's Syndrome article:
History: At least 30% of patients are asymptomatic, although nonspecific symptoms such as abdominal cramps, fatigue, and malaise are common. Abdominal symptoms in these patients are a poorly defined entity and may be secondary to underlying anxiety. However, not all patients with Gilbert syndrome and abdominal symptoms are anxious; nevertheless, they appear to have organic-type discomfort that is hard to characterize and frequently eludes diagnosis. No relationship exists between these abdominal symptoms and plasma bilirubin levels. Abdominal symptoms apparently may be multifactorial, with underlying anxiety probably playing an important role.
Abstract Random! Surprised?
Actually, I scored AR=30, AS=27, CR=27, CS=16. 27-40 = dominant style, 16-26 = intermediate. I am primarily a feeler, but also an idea person and researcher. I am not a nose to the grindstone, focused, lame-o.
Tuesday, October 2, 2007
Work has been nice. I got to hang blood for the first time. I also got some good experience suctioning trach's. Good times.
I'm trying to get a piano moved from Albion to Fort Wayne on Saturday. I'm mustering recruits. It should be thrilling.
Tuesday, September 25, 2007
I'm working on some cover songs again. I'd like to start playing in the coffeehouse, but I think I need some practice first.
Monday, September 24, 2007
Willard K. Cupp 21 M 0001298321
Chief Complaint: Generalized Headache, Anxiety, Restlessness
History of Present Illness: Patient arose at around noon today after working until 3 AM. Upon waking, the patient immediately was assailed with the triple threat: headache, anxiety, and restlessness. He planned on taking some Ibuprofen and eating something delicious to relieve his symptoms per his usual routine. Upon finding that he had no snacks in the house and forgetting to take his meds, he was forced to carry on without relief. He proceeded to put away laundry and pack up the laptop under the crushing weight of his ailments. The patient managed to complete these tasks and drive himself to the firefly for treatment without incident, except for forgetting his cell phone. Upon arrival, the patient self medicated with a ham and cheese sandwich and a Jone's soda, in an attempt to avoid his usual "unhealthy" choice of a brownie and coffee. This mistake cost him $4 more than he usually pays, with no relief from any of his symptoms.
Family History: Significant for being awesome, but maybe a bit neurotic.
Personal/Social History: See HPI. RN at Parkview hospital, AKA he works like a dog. Also, everything on his unit is being changed as they merge with another unit. He is also a full time college student. Married: his wife will probably kill him if he spends another five bucks at this place.
Review of systems: Negative. As in: I don't feel like writing all this stuff out.
1. HEADACHE DUE TO CAFFEINE DEPRIVATION
2. ANXIETY DUE TO VARIOUS SOCIAL/PERSONAL SITUATIONS
We will attempt to proceed with internet, time wasting treatment. If this does not lead to resolution, then we will proceed with coffee therapy. If anxiety continues we will look into brownie options. As he needs to get started on his homework soon, time is of the essence and we may need to initiate treatment very soon.
Thank you for allowing me to participate in the care of this patient.
Your Mom, MD
Wednesday, September 19, 2007
Babelgum.com, it's a pretty cool site. You can download the client and watch indie films. I haven't had time to really check it out, but so far it's pretty cool.
I am so bored. I'm on the internet way too much. I've noticed I have an inordinate number of posts on my friends' various profiles.
Tuesday, September 18, 2007
I'll try to talk about my life as a male nurse and make that the focus of this blog. I'll probably avoid talking about specific, significant others in my life. I may also rant about politics, philosophy, music, or religion. I will probably sound pretentious and ignorant at some point. That's okay because everyone is ignorant at some point or another and we all have a duty to present our views to foster dialectic discussions. If I am obstinate or obtuse, then it' becomes a problem.
Work: I worked from 3 PM until 3 AM last night. Not bad- that's my usual. I didn't get downstaffed, so I can't complain. I did get floated from 3P-7P. I went to ortho. It was my first time floating, so it was somewhat horrifying, however, everyone was exceedingly gracious and my patients were mostly medical anyways. I'd better get used to it, because neuro (my unit) is combining with ortho and trauma in November. The old-timey, cap-wearers are pretty ticked about it, but I've only been on Neuro for 6 months, so I'm barely a 'neuro nurse' anyway. I'm keeping my job, so really I'm sort of excited about getting some trauma experience. We had a joint staff meeting with ortho at 8 AM today to talk about this wonderful merger. That meant I only got like 3 hours of sleep last night. I can't complain though, I spoke with a family practice resident who said she worked over 100 hours last week! I always thought she was a bit short with us, I guess I can't blame her.
School: I'm officially sliding into the middle semester slump. I'm taking my classes for granted and just doing what I have to do. I'm putting forth an effort starting now to regain lost ground. It's hard to feel motivated about Stats, Professional Seminar, and Informatics. I love Health Assessment even though it's just basically rehashing basic techniques, at least it is clinically focused. My music class rules. I get to play my guitar. What else needs said. Music Minor: prognosis is guarded. Changes to my work schedule may make my dreams of a minor nearly impossible. We'll see!
Life: Good! Teaching sunday school with Ang. It's tough to get up early, but I'm really enjoying it. If I'm too crusty to work with kids at this age, then I've really got issues. I'm going to the CN football game on Friday. Good times for sure! I still need to make it out to a CN soccer game. I'm sure I will, it's just a matter of scheduling.
Music: Practicing the tuba daily. My tone is gross, but not as bad as it was. My sightreading is improving. Still focusing on longtones, buzzing, and scales. No banjo/mando practice as of late. I've been playing my guitar for class, so that is very cool. I actually HAVE to compose melodies. It's the best class ever.
Politics: Who to support for president? Nobody! I think I'll write in Jesus for president this year. Plus, what to do about healthcare? How can we maintain competition while making care affordable? It's a toughie. I guess people should just do what they have to do to get themselves insured, but I guess that's pretty naive. Also, gay marriage... should it be illegal? Should the government even be involved in something that is so religiously/philosophically based (marriage)? I'm not sure yet!
I hope I can blog as dedicatedly and as well as my sister, who's Xanga posts I look forward to in my inbox.