Ok.........lahoma

So, I played about 36 measures of moderate tempo bluegrass banjo for my old high school this weekend. They're doing a pretty good production of Oklahoma. It's been fun seeing how everything is pretty much the same, just with different people. Things really don't change that much...

Other than that, it's business as usual. I dropped my transcultural health care class due to being busy as a cracker, but I'll take in next semester. I should still graduate at the end of this academic year if I can test out of a couple of classes (I should be able to!) I've been spending lots of time with the fam. I've been working and going to school as well. On a happy note, we may go to Europe during Winter Break. Brrr..... Oh well, we can't afford to go in the summer!

Sometimes it's depressing to hear what people think of nursing. I try to avoid the subject with those outside the field because people are usually unintentionally insulting or patronizing. I think that much of what people believe about nursing stems from outdated feelings about class and gender. Nursing carries the stigma of not only being a 'technical' rather than academic field (which is only partly true), but also as 'women's work'. It seems that many people carry around this faulty, inherited idea of nurses being simple, but caring as they dutifully scrub bedpans and hand out pills. I'm not trying to say that undergraduate nurses are medical experts (some advanced practice nurses do have very advanced medical knowledge), but it just seems to me that there is a widespread misunderstanding of the profession.

My blog is now linked with facebook, too. Yay?

"You're doin' fine, Oklahoma.... O.K.!"

Sweet stuff...

Check out http://www.denniskunkel.com it's very cool electron microscopy stuff.


Neuroblastoma

How Wilford Brimley got Diabeetus (it's got nothing to do with a so called: " Beetus-bird" )

SLOPPY LIVIN' AND TOO MANY PANCAKES!

Oh, Surgery *and* Patient Care as not just a profession, but a skill set

Remind me never to have surgery. There are just too many cases where: Patient A came in for an elective ______________. They went to OR, but then in recovery he/she went into acute renal/respiratory/heart failure (or had a stroke).

It's not like that's the majority, or even a high proportion of surgeries, but working in a Surgical ICU, that's a lot of what we see.


I'm learning to take advice better, too. When patients' family members/my nursing peers try to tell me how to take care of my patients, I need to realize that I have something to learn from everybody, even people who aren't "nurses". I'm working on reading Nightingale's "Notes on Nursing" and I'm realizing that nursing is a skill set, a knowledge base, not just a profession. Just like a layman may be able to teach a mechaninc or a plumber a trick or tip, they may be able to teach us ways to care for our patients that we haven't thought of. (BTW: Of course, it's imperative that we base our practice on research and not just the advice of strangers.) Many mothers have spent years caring for sick family members and may have valuable experience to share with us. Maybe.

Yeah, It is very much back to school time

So, I'm working full-time and going to school full-time. I tried that last semester and ended up dropping a class.... I think it'll actually work this time!

My classes are pretty low-key for the most part. I think I'll be able to get through them alright.

It's a very community-oriented semester for me. It's interesting to see nursing focused on something other than direct physical needs. The role of the nurse (advocate, etc.) is the same, but instead of focusing on one sick person, the community nurse sets up systems to improve the health of communities.

FYI: Community health nursing is different than public health nursing...

I recently purchased two books by F Nightingale: "Notes on Nursing: What it is and what it is not" and "Florence Nightingale: To her nurses". Very good stuff! It's creepy that I'm starting to enjoy nursing theory....

Oh, Google Image Search

apparently this is from some play about nursing called, "Too Nurse". I don't know whether I would like to see it or not! Kind of strange....

Back to school....

Well, it is that time again....... Back for another wonderful semester of RN-BSN completion. More classes that aren't quite 100% useless, even though they feel like it. I think since I work in an area that is so centered on my clients' medical problems, I lose sight of all that nursing really is. Anything that's not pathophysiology seem pointless to me as an ICU nurse. Sure we deal with psychosocial stuff, but we also have chaplains, case workers, social workers, patient advocates, and loads of other professionals who are better equipped to handle these issues than we are. Betty Neuman said that nurses should be holistic in their care, assessing and intervening not only on a physical level, but also on psychological, spiritual, sociocultural, and various other less tangible levels, but when someone is septic or in respiratory failure or whatever, their sociocultural needs (important as they are) don't seem to concern us as much as their need not to sink deeper into distributive shock. Maybe it's just me! It may really be a nursing problem, but it seems that we barely have the time and staffing to keep some of our patients healthy/alive.

Anyway, here's a rundown of my classes....

COMMUNITY/PUBLIC HEALTH NURSING (5 cr.)

I think that I'll either be working with a school nurse or in a community free clinic. I'm hoping this experience will broaden my view of nursing. As a future NP, I hope this will also show me some possible career tracks. This is my first clinical course since Spring of 2007, so I'm really looking forward to doing my first clinical as an RN.

HISTORY OF ROCK MUSIC (3 cr.)

Oh yeah... let's hear it for area IV general education! It was either this or Victorian Novels or something like that. I honestly wanted to take History of Jazz, but it wasn't available... It's a music class, so it focuses on the musical development of rock. How much sweeter does it get?

TRANSCULTURAL HEALTHCARE (3 cr.)

Lesson One: Don't stereotype people
Lessons Two through Twenty: Various accepted stereotypes about the peoples of the world

DISASTER NURSING (1 cr.)

The title of my autobiography? No, silly, it's the title of the one credit hour weekend course I'm taking in September. I hear it's more of a pain than it ought to be.

That's right suckah, 12 credit hours. Did I mention I'm also working 36 hours per week in a challanging setting that require 4-12 hours on call per month with madatory upstaffing? Or that my wife is also taking 12 credit hours? Or that I have a four month old? Yeah, it's going to be busy. No, I will not get to eat a meal at home during the week. Fortunately we've hired my lovely 20 (soon to be 21) year old sister to watch our child. Unfortunately, I've had to drop my guitar lessons.... That made me sad, but there was really no other way. On a happy note, the federal government is paying me almost $600 to go to school this semester. That number will probably go up after my wife gets her Financial Aid package through. If I can do 12 credit hours this semester and 11 credit hours next semester, then I will get my bachelor's degree in the spring.... THEN ON TO NP SCHOOL! Yes, it's true, I'm pretty excited about that.

Life in the hood?

Yeah, it's the po-lice. They're across the parking lot from my apartment and I know not why. Good times!

Theologica and epistemology

I was thinking today how the New Testament reveals Jesus as Logos in some parts. One problem I've been dealing with for a while is how I can reconcile Faith with reason. Reasoning requires doubt. You can't search for answers if you're not allowed to ask the questions. Faith prohibits the asking of certain questions (at least in any meaningful way). God reveals himself to us as Logos, the word, logic. I think we need a balance of faith and reason. It seems that we need to have faith to even accept anything outside our self even exists in any real way.

That's enough of my amateur theology, if you want any real answers, you should look on www.unencyclopedia.org they have all the real answers. Consider looking up "huffing the universe" for hints on how to become God.

Politics!!! Why not?

Have you ever felt like ol' Federalism just isn't what it's cracked up to be? Yeah, I'm a states' rights guy, but when it comes down to election time, the two-party system just gets me down...

What about proportional representation? Besides the fact that it's completely unconstitutional, what's the big deal? Let's just try it out for a while.... Could you imagine congress? California and New England would have their own red army in there, but they would be balanced out by Texas's and the midwest's congressmen with actual firearms. I guess a congress with actual ideological conflict would be better than a bunch of fat cats who sit around and play politics so they can line their pockets with gold.

What ever happened to America? Doesn't our constitution say a few things about liberty or freedom or something like that? The Dems will stick you in a Prius and make you suffer through state-run healthcare (and restaurants, and churches, and schools, etc.), while the Republicans will tell you who to marry (and what to smoke, and who to kill, etc.). Sometimes I think we haven't done much right since ol' Georgie boy left office (Washington, that is). Okay Abe Lincoln was pretty awesome, but didn't he suspend habeus corpus? (shhh... I've heard that's a pretty unpopular thing to do these days).

It's too the point where I actually decided to support BOB BARR..... uggg. The guy supposedly paid for his wife to have an abortion. SUPPOSEDLY. He's for making abortion a states' issue though, so I suppose that's what matters (he rationalizes to himself). I can't see myself supporting John McCain, closet liberal. I definately can't support HIS ALMIGHTY LORDSHIP DESCENDED UPON US FROM ON HIGH, SHAH barack hussein obama, MAY HIS NAME BE PRAISED FROM SEA TO SHINING SEA, AND FROM THE RISING TO THE SETTING OF THE SUN FOREVERMORE, AMEN. Although he does believe/hope in changing the future for the good of all of the people who also hope to believe in the goodness of the future without naughty McDonalds or the shame of Wal-Mart. You know, the bastions of industry that supply the stupid, ignorant, inarticulate, writhing masses of gun-hoarding, God-fearing hayseeds of America with employment and artery-clogging McNugget goodness. Which brings me to my next point....

LIBERALS: condescending, guilt-ridden, gullible, arrogant, afraid, appeasing, lazy, did I say condescending?

NEO-CONS: bullies, arrogant, ignorant, artless, nosy, self-righteous, fascist

MODERATES: three from the liberal category + one from the neo-con category

LIBERTARIANS: three from the neo-con category and one from the liberal

ME: a smattering of all of them

----------------------------------------------

THE BOTTOM LINE: IN A TWO-PARTY SYSTEM, NO ONE IS TRULY REPRESENTED

P.S.- THE GOVERNMENT BIG ENOUGH TO GIVE YOU EVERYTHING YOU WANT, IS BIG ENOUGH TO TAKE EVERYTHING YOU HAVE (Barry Goldwater)

TNCC

For all you folks that don't know, TNCC stands for Trauma Nursing Core Course. It's mandatory for all of the nurses in my unit. It's not that hard, but it is kind of a cool reminder of what kind of stuff to focus our assessments on with fresh traumas. I guess it doesn't hurt to have a TNCC mindset with old traumas either. I can proudly say that because of a trauma nursing course I took a couple of years ago, I set my assessments up according to the primary assessment as laid out in TNCC. Here is the basic outline of TNCC:

Get report from the medics, maintain C-Spine immobilization, and then:

PRIMARY ASSESSMENT (VERY IMPORTANT, ASSESS & FIX):

Airway- consider adjuncts such as oral/endotracheal tubes if needed
Breathing- check rate, pattern, bilateral chest rise, skin color, acessory muscles, etc.
Circulation- pulses, bleeding, IVs, cap refill, JVD, etc.
Disability (Neuro)- Level of consciousness, pupils
Expose/Environment- Remove clothing and check for problems, make a safe environment

Secondary Assessment:

Full Vital Signs/Five Interventions (pulse ox, EKG, foley, NG, labs)/ Family
Give comfort
History/ Head to Toe assessment
Inspect Posterior / Injuries

Provide/suggest follow-up diagnostics and interventions such as consults, imaging, or labs

Prepare for OR, Admission, or Transfer

It's good stuff. A, B, C, D, E, F, G, H, I




IN OTHER NEWS:

I like MySpace a lot. I don't know why, but it seems like it's much more libertarian than Facebook's rigid layout. Facebook is creepy.

I'm not sure if I want to be a nurse practitioner. I'd make (a little) more money and have more authority and better hours, but my work wouldn't be nearly as cool (Surgical/Trauma ICU vs. Family Practice Office). I guess it's a career, not a hobby; it's not about what's cool or fun... It's actually a really complex issue since NP's have a really weird niche with lots of possiblilities (good and bad).

I'm sleepy.

I'm watching the little sib's this weekend. Good times.

ST elevation

Hey, not all ST elevation is indicative of acute MI. Who knew? Well, I guess I knew it could also be pericarditis, but still... If the ST segment is in the shape of a frown, then your patient should be sad because they are probably having an MI. If it is in the shape of a smile, then be happy! It could be either pericarditis or benign repolarization. Trust me. I am a very trusty source.

I worked 16 hours today and I feel more entitled to complain than ever. I will make it short: I am tired and my feet hurt.

I was in Neuro ICU again today! Woot. Good times for all! I was managing ICP though, which is usually a busy process. Fortunately no Mannitol today (way too many labs with that one), but I was pushing sedation hourly. Oh the tedium. Not really, I like managing ICP, it is a good chance for a nurse to use discretion and make a real difference.

A few random goals for my work days:
-Patient has better sounding lungs when I leave than when I came
-Bond with the family
-Finish report before 1530
-Leave the patient and the room cleaner than I found them
-Lots of other groovy things


Fact: When I see commercials on TV encouraging people to pursue careers in healthcare, I shout at them, "Noooo". I actually think healthcare is very swell. Swell like edema. I wonder how swell ever came to be an adjective that means "great". I am sleepy. Hypnotoxins!

Italian Spiderman

MAKE ME A MACCHIATO, PUSSYCAT!

watch Italian Spiderman on Youtube or MyspaceTV; it's pretty funny

House

Yeah, I like that show a lot. My wonderful wife rented Season 3 today and I'm just starting the second disc.

The Standard Nurse Complaints:

1. They don't give nurses any credit...
- Yeah, it's true they give firefighters more medical competence than they do nurses, but that's standard procedure for TV. There are a ton of important team members in the hospital; it would be impossible to make characters for all of them.

2. The doctors do things they'd never do...
- I can just see a big shot doc running a patient through the CT scanner (or performing phlebotomy, etc.). Most of them don't even know how to use our IV pumps, but again it's probably a matter of getting as much time as possible with the main characters of the show.


Yeah, I'm a crybaby. Oh well. Nursing still has a long way to go. So does televison.

Anyway, I love this show and I will watch it in spite of my complaints!

addendum

I had my first patient die the other day. It was strange. Where a person was, a body lay. I had empathy and compassion for something that occupied that body, something which was striving and had purpose and soul. Then, with the flattening of a line and the quieting of a beat, that something was gone and the body became flesh. Since there was no clergy or physician available at the time, it was left to me to tell the patient's dearest loved ones that this had occured. With compassion, but without pretense, I informed the family that the soul they had cherished was now beyond their reach. Maybe someday, when their living bodies still and become flesh, they will be reunited, but I left that for them to work out. All I knew was that the person I had cared for was now gone and it was up to me to get the flesh off of the bed so the housekeeper could wipe it down and we could put a new body onto it.

When the housekeeper was nearly finished in the room, I noticed a scrap of paper pressed up against the side of a clear trash bag (clear trash bags in a hospital, what a swell idea). In the final hours of life, my patient had scrawled some barely legible message on this sheet. Seeing that handwriting was eerie. There was a bit of my patient's spirit stuck to that page. The symbols on that page weren't just a note, they were the last remnants of that individual's consciousness left in that room. It made me think a lot about the frailty of life and the nature of what we leave behind. In the hospital we have lots of plaques on the walls dedicated to old-timey physicians who were probably big shots back in the day, but to me now they are no different than any other dead person. Life is too short to be prideful, arrogant, and hateful.

Someday your lungs will fill with fluid as your heart loses the capacity to push the blood through your body; your cells will starve and you will die. In the same way, the field laborer, the imbecile, the artist, and the trauma surgeon will all finish their lives. Many will do so with a young nurse standing by, ready to file their paperwork and clear their bed.

Isn't it weird sometimes how the more you experience, the less you know?

"People are just people; people are just people like you", "and everyone must breathe until their dying breath". (Yeah, I'm kind of a Regina Spektor nut lately.)

yeah, i pretty much forgot about this thing...

Okay, I haven't written here in a reeeaaallly long time. Basically, I've had a very busy summer.

May

6th- Anika was born! Off work for a couple weeks.
9th- Finished the semester w/ A's and B's after some rescheduled finals
20th- back to work...

June

First two weeks- BLC Camp Nurse! Good times. Scrapes, sprains, and a suprising amount of Otitis Media. Also earned my Pediatric Advanced Life Support certification.

14th- 1 year anniversary of my RN licensure

20th- officially off of orientation @ work! I became an independent ICU nurse (oxymoron... no ICU nurse is independent; it is a team effort. that sounds retarded, but it's true!).


July

10th- went with Angie to Indy for the weekend; left Anika with mom and dad. I gained seven pounds in four days! proud to say, it's all off (it was all water and *ahem* 'bowel' weight, i guess).

14th- back to guitar lessons after missing approximately one whole month of them!


so I'm back. i hope i remember to write more. i'll give you a brief run down of where I am with my life right now.

WORK

yeah, it's nice not to have to work with a preceptor any more. i get my own assignments now. i've been almost exclusively assigned to the neuro section of the STICU, which is fine with me because I love neurology and because it's intentionally quiet back there for our SAH (subarachnoid hemorrhage) patients. i'm not really antisocial, but perhaps a little schizoid/paranoid in some social situations (namely school and work; in four years at IPFW, I haven't made a single close friend!). I do fine with patients and their families, but with my co-workers I just am really shy. anyway, the nursing in 'the unit' is cool and complex; i have learned a ton! I'm working on my Advanced Cardiovascular Life Support Certification now. Good times. I'll then take my Trauma Nursing Core Class next week. Good times x 2. I had to save my patient's life from some family practice residents the other day. They were literally writing the order to withdraw all care from this individual until I dragged his family in there and explained to them exactly what was going on. They had been completely misinformed. It was a disaster. Anyway, work is quite good.

SCHOOL

starts in August.......

MUSIC

I finished my first book of classical guitar technique (shearer's book). I'm now on a book of novice/intermediate arrangements of classic guitar pieces (royal conservatory of music's guitar series 2). It's first/second position stuff in the keys of C, G, and D for the most part. I love it!


ETC.

sis is still in Yellowstone! hurry up and get back here...

I love being a dad. It rules my world.

Anika Marie Cupp

She was born May 6, 2008, weighing 7 pounds, and measuring 20 inches long. She is happy and healthy and resting comfortably! Go to my MySpace page to check out pictures and video of da baby! The link is on the right side of this page.

Atrial Flutter

Anyway, I can't sleep. I took a two hour nap at about eight o' clock and now I'm up for a while.

I've been on a digital camera binge lately. I've taken like a hundred pictures in the last few days. I put most of the good ones on my MySpace page http://www.myspace.com/cuppwk01 they're okay pictures, mostly of my fam. I don't post much on my facebook page, sort of because I can't really stand facebook. I started a flickr account until I realized that I really had too many various accounts already.

We had our second baby shower today. It was pretty cool; we got a ton of baby stuff. We also went to church at Bear Lake today for the first time in a long time. It was pretty cool. I love Bear Lake very much. Every time I drive out there I just think how lucky I was to grow up somewhere so cool and so grounded.

May Day

I think that May Day might be a communist holiday, but I'm not sure.

Work was cool today. I was very busy and I think my preceptor was getting kind of impatient with me being a little behind the 8 ball, but I was keeping up alright. I'm excited about getting off of orientation in about a month. That will be good times. I was in the Neuro ICU today (possibly my favorite wing of our unit). One patient had a hemorrhagic stroke yesterday and the other has a massive cerebral infarction over night.
There are always ethical dillemas in neuro. The only one that really gets me is witholding nutrition. Not feeding someone who is capable of taking enteral nutrition goes against every nursing instinct I have. I can understand taking people off of ventilators or medications, but witholding feedings just gets me.

My guitar lesson was subpar. I felt like I had a decent grasp on the music, but each week we add new layers of complexity to what I'm supposed to be doing, so I'm always just falling short of our goals, but improving none the less. For one thing, I can't get my nails right. This impedes my tone a great deal. I need to just let them grow and quit messing with them. My guitar lessons should go much smoother from now on, since I am finishing school next week (although I'm taking IV Therapy in the summer, it shouldn't be much of a challange).

I've got my eye on the finish line....

Yeah, a great song by Pedro the Lion, but also true about me right now. School is practically over, I'm almost off orientation at work, and the baby is due in three weeks. The funny thing is, when those things happen, they just create new things for me to do. So, basically there are no finish lines.

I went for a jog today! It was pretty short (just to the video store), but it's a start. I was so out of breath when I got home, I auscultated my chest to make sure I wasn't having some kind of critical cardiopulmonary event. My lungs were well ventilated without adventitia and I didn't have any S3 or S4 heart sounds, so I figured I just ran up a healthy O2 deficit. Ten minutes later I was fine.

Last Monday I had a pathophysiology test that I didn't even know was on the syllabus (my organization has been atrocious this semester). It was on my weakest subjects, nephrology and gastroenterology. Give me hearts and brains any day, but kidneys and guts just have too many small parts to keep track of. I WANTED TO HANG MYSELF ON THE LOOP OF HENLE! stupid nephrons...

I'm probably getting a new old car sometimes soon. It'll most likely be a tiny import. Take that, global warming!

Also, my time at Blackhawk is now complete. We taught our last weekend of Sunday School this week. We've been teaching these kids for about a year now, so I'm sure gonna miss them, but now we're going back to good ol' BLC! Good times for all.

Overhaul

Yeah, I've changed everything because I don't feel like talking about work on here, most of the time; although, I really like to talk about work in general.

So, yeah.

Ultrasound Numero Dos

Well, it's week 33 and we just got ultrasound #2. We've been measuring about 2cm small the entire pregnancy, so our CNM wanted to see what was up. Apparently nothing was up. The ultrasound was completely normal, and everything looks good. At the first ultrasound we elected not to know the sex, but this time we couldn't wait. We found out that we're having a girl! It surprised us because we thought the first ultrasound looked boyish. This one seemed even more convincing, though. Plus, at 33 weeks, things are fairly obvious. 21 weeks was a little early. Well, Willard IV will have to wait; Anika Marie Cupp will be first!

hmm.... plans

I oscillate between a few different options for my graduate education. I go back and fort between nursing and seminary. Right now, I'm thinking seminary, but I'm sure I'll have a good day at class and go back to nursing, but who knows?

oblivio accebit

Yeah, I still hate school. I thought I liked pathophysiology and couldn't stand my other classes because of the subject matter, but I think it's because I don't have to do anything for patho. For exampe, I read a little bit of the endocrinoloy section to brush up on the old pituitary hormones, but didn't read any of the cardiovascular or pulmonology chapters and still got a 94% on the multiple choice section. It's not that I'm awesome at those things, it's just that it's an easy class if you're already a nurse. Then, last night, I was doing homework for my research class, which I had previously liked, when I decided that I hate that class with a passion. My school-assocaiated laziness has reached a new level.

Work is still cool though. I got a new preceptor since it's the halfway point in my ICU orientation. His name is Tracy, he's been an ICU nurse for like ten years and he's a pretty cool dude. The bad thing about my orientation is that no one knows how long it should be, nor at what point I am at along that line. When I was hired, I was told that I would have an abbreviated orientation, but it hasn't really worked out that way. I would like it to work out that way since one of the reasons I was hired was that I had been an RN for about 6 months already, so they were thinking I would be sort of ready to go. The truth is that working full time in the STICU on days is pretty much the complete opposite of working part time on the medical neurology floor at nights. I do think that I have a bit of an advantage from my experience though in that I'm used to having responsibility for my own patients, working independently, and some things specific to being an RN in the Parkview system.

The other day, one of my patients was getting a percutaneous tracheostomy. Two pulmonologists, a family practice resident, and the endoscopy nurse came to do it. So, one of the docs was using the bronchoscope via the ET tube and the other was doing the cutting (I'm sort of surprised that a general surgeon didn't do it, but you know.) Anyways, the doc doing the cutting told one of the best lame jokes I've heard in a while. Keep in mind that it was on St. Patrick's day. "What is Irish and gets left out on the porch all night?" .................................."Patty O' Furniture!" Also, after they were all finished, I was helping the endo nurse clean everything up and we found a picture that was left behind which was printed from the bronchoscope. The pulmonologist using the scope had accidentally taken a picture of himself with it. It was strangely amusing. Nothing compromises an airway like aspirating a pulmonologist.

Music and movies

Music- Sufjan Stevens, Seven Swans

Movies- Nines

Yeah, pretty cool stuff.

Post-Spring Break Resolve

Well, after the first week back to school after Spring Break, I have found myself less motivated to do well in school than ever before. Nursing classes are interesting, but not nearly as challanging now that I have a good chunk of Critical Care RN experience under my belt. My classical guitar lessons are pretty much the only (somewhat) academic obligations I look forward to. Other things are good, though.

Work is going alright. I feel like I know the science prett well, it's just the day-to-day application of that science that gets me. Example: My patient in Acute Renal Failure status post AAA rupture is on a Nicardipine drip @ 10mg/hr to maintain SBP below 140 mmHg. I'm concentrating on titrating the drip and monitoring vitals. An experienced RN taking my patient at shift change notices that at the concentration of Cardene we are using, 10mg/hr is 100 ml/hr, quite a bit for someone in kidney failure with practically no urine output. That is the kind of thing I never had to worry about (as much) on the general neurological floor. I guess that's why ICU has such a long orientation. Also, it seems that every time you find a critical change in your patient, the very presence of a physician undoes it. The other day I had a patient who was "rapid responsed" from the medical floor down to the ICU. He was sedated for intubation. A few hours later he was still unresponsive. I was going through all the steps of the neuro assessment, voice, touch, shouting, peripheral pain, etc. and I wasn't getting anything from him. We finally persuaded his nephrologist to give us a neuro consult. The first time the neurologist talks to him, the guy perks right up. Very embarrasing. The dialysis nurse who was with me the whole time was just as surprised as I was. Apparently the sedation was just taking a long time to wear off, frakkin' Versed. Why couldn't it have startd to wear off before we bugged the nephrologist for a neuro consult?

School = lame. Pathophysiology is interesting, but not difficult because it's a mix of ASN to BSN (Bachelor of Science in Nursing) students and straight BSN students. The unlicensed (straight BSN) students have to take some very difficult classes at the same time as patho, plus they really don't know very much yet anyway, so it keeps the class at a fairly shallow level. Nursing Research is interesting, but kind of redundant. I've already had Nursing Informatics and Nursing Statistics; research is basically the combination of those two. English W233 is laaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaame. Expository Writing. I hate this class. We write pointless papers, she marks them off for arbitrary matters of style, then we redo them. I hate general education courses. Well, I'm kind of lying about that, because in the fall, for my Gen. Ed. area IV, I'm taking: HISTORY OF ROCK AND ROLL, which I am quite excited about. I'll be taking it alongside Community and Public Health Nursin (which has a clinical component) and Transcultural Healthcare (kill me now, please... can you say: fabricated interviews with my Burmese neighbors?). A total of 11 credit hours, I've become weak in my old age. The more I get tangled up in "real life" (work, babies, taxes, and such), the less important school seems, but if I want my real life to include normal hours and comfortable environs, then I had better stay very interested in school.

My musical endeavors are actually fruitful and satisfying. I'm taking classical guitar lessons with IPFW's professor of guitar studies. It's really cool. I've never practiced my guitar in such a focused manner. I'm almost finished with Aaron Shearer's Classical Guitar Technique, Volume I. Soon I shall be truly Bach-ing out.

The baby is doing well. We're at thirty-one weeks and everything is looking good. It kicked me in the head the other day, though. Angie is doing amazingly well. She has gained exactly the right amount of weight, her blood pressure is stable, and she has little to no swelling yet. She feels pretty good most of the time.

We're still deciding on when we want to move. We're going to start going to Church at Bear Lake after the baby is born, but we're not sure we actually want to move this summer. We'll probably wait another year.

Research Symposium and Biology in general

It was pretty cool. I'm not really prepared to deal with a lot of the basic research side of things, but there was some interesting clinical information presented. The first three speakers were Cardiologists. Lame. Not really, the heart is pretty cool for an organ with one lame function. My favorite speaker was Dr. Fen Lei Chang, neurologist with FWN and a dean of the IU Fort Wayne Medical School. He basically spoke about how basic research in neurology, on animals and whatnot, doesn't translate well into clinical trials. He explored some of the neuroprotective studies and their, for the most part, failure. The last presenter was over Hematology-Oncology. It was interesting, but not extremely relevant to my practice at this point. I think being an Oncologist is a losing game. The better they get at treating Cancer, the less Oncologists they're going too need. All hearts and brains will go bad eventually, but Cancer can be prevented and cured.

It's always cool to see people who have pushed the boundaries of human knowledge. What those guys are doing is essentially filling in the blank spaces on a map. They can show with their research what others can only speculate over. It's pretty sweet.

I love looking at molecular biology though. The fact that we are not just one living thing, but actually many, many smaller things is facinating to me. Thinking about the fact that our existence is mediated by atoms trying to get their share of electrons is bizarre. When I'm feeling like my life is mundane or small in the big scheme of things, I like to remember that I am a dazzlingly complex array of Carbon and Calcium and Sodium and Potassium and many other elements bound into molecules that make living cells which cooperate and strive to keep me integrated. You may think that the fact that we are made of dust and water makes us ordinary, but I disagree, I think that it's the opposite. I think it makes us miraculous.

I think that the dichotomy inherent in humanity, animal v. elevated, is facitnating. I think that's why I love the brain so much. It is the embodiment of that conflict. The whole notion of this sort of conflict, rests on a lot of philosophical assumptions, but what meaningful thought doesn't? If we couldn't accept any assumptions, then we couldn't think anything at all because we couldn't trust our senses or our reason. You know, I think that I'm a bit of a rationalist. I have no philosophical education whatsoever, so I'll probably misuse these labels; but, I'm quite sure that I'm not an empiricist. Yes, I believe in the scientific method, but not without some philosophical backing. If I didn't see value in human life then why would I want to help preserve it?

Maybe it's good that I'm in composition class after all. I think I could use some help with paragraph structure, among other things.

Wikimedia

It is a drug... Wikibooks and Wikiversity are almost completely undeveloped. I may just waste my life there trying to build up the nursing information.

Super Tuesday?

Yeah it is. Go Paul. Anybody but McCain will be just fine.

My microphone will be here tomorrow! I went to Guitar Center on Saturday to see if I could get one without waiting, and when I asked if they had the Behringer, the guy behind the counter almost interrupted me to say that apparently I didn't want a Behringer. Okay my friend with the weird hair, I know what I want and I don't need you to try and tell me. I guess I'll see if he was right tomorrow! I've had a Behringer audio interface for over a year and I have no complaints.

I'm registered for the Parkview Research Symposium on Saturday. It should be very fun and enlightening.

I had a dream last night. In the dream, there was a song. It was really awesome, but I don't remember it.

New mic for me!

I'm buying a new microphone! It's not exactly top of the line, but it's what I can afford. A Behringer C3 shall be my new singin' hole. I know a lot of people knock Behringer stuff, but I've had my FCA audio interface for about a year now, and I really can't complain (For the price, that is). It should arrive in about 2 weeks, and I'm a bit excited.

composition

Well, maybe it's not such an atrocity, but I still like the way I write my papers more than the way my lame teacher wants me to write them.

The End of January

Work is good. I'm learning a lot about the form and function of the STICU. I feel more comfortable with a ventilator now. I was terrified of them when I first transfered. I've had a few classes over Swanz-Gantz catheters, hemodynamics, and the various and sundry ICU-only drips. It's really facinating. I hate all the paperwork that goes along with an orientation, though. Trying to keep up on all the little check-offs is a real pain.

School's alright, though I've fallen behind a bit already. I enrolled late into an internet Gerontology course. I'm trying to get caught up on the posts and skimming the readings. Healthcare research is a so-so class. I think I'll pick up some details about research methodology that I missed in Stats, but I'm not sure how much attention I'll be able to give it. English is a total waste of my time. I have to write meaningless papers and listen to condescending lectures. The whole idea of a composition class is shady anyway. How can you tell someone how to write? Who is sitting on the throne, dictating to us how the English language is to be used? You cannot formalize language. If I want to use seimi-colons in place of commas, there is no law that says I can't. I know that in actuality we all share an unwritten standard of what is and isn't good writing, but the whole thing is so subjective. My biggest and favorite class is pathophysiology. We are reviewing all of the things we have already been taught, but more in depth. It is a lot of reading, but it is interesting.

I really want to get a lot out of school this semester. In the Associate's Program I did what I had to do to pass, but this time I want to really absorb the knowledge. I want to have a more informed practice now and be ready for graduate school in a couple of years.

Spring 08!

Yeah, so I've started the new semester, the new job, and being a father (expectant). School is cool. Pathophysiology promises to rock me to the core. Basically it's stuff we learned back in Nursing 115/116/224 but more in depth. We started with a quick rehashing of cellular A&P/metabolism blah blah blah. Then we got into Fluid & Electrolytes. I used to hate F&E. Anymore I think it's kind of cool. When I was a student it was just a bunch of pointless numbers to memorize, but now that I'm a practicing nurse it has context. It seems very relevant. People's lives may depend on whether I recognize their hypocalcemia or not. Knowing what the IV fluids are doing to my patient at the cellular level is so important, but the AS program only scratches the surface. You have enough time to memorize the words Hypo/Iso/Hyper- tonic and then it's on to something else. Dr. Kaskel rules. She is intelligent, but makes an honest attempt at teaching us.

My new job is cool. Or will be soon. I've been doing ECCO, Essentials of Critical Care Orientation, computer training. It takes at least a week to get through it all. It goes through each body system, outlines the A&P, diagnostics, and major Patho issues, and quizzes you on them. I guess it's just to dredge up the things you flushed out after boards. I'm also starting my ICU core classes, hemodynamics classes, and dysrhythmia classes for work. My brain may explode. Monro-Kellie hypothesis: explain that. Expanding brain matter? Maybe increased ICP from irritation.

So yeah, I'm the father of a 21week old, gestationally speaking, baby ____. We had our ultrasound, but asked them not to reveal the gender of the child to us, however, after looking at the images I think it is a boy. They're posted on my MySpace/Facebook pages.

SAD NEWS: I have to drop my music minor........ ARG! On the up side: I'm working full time and approaching fatherhood. I still plan on taking classical guitar lessons, though.