Thursday, July 31, 2008

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.

Sunday, July 27, 2008

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)

Friday, July 25, 2008

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.

Tuesday, July 22, 2008

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!

Saturday, July 19, 2008

Italian Spiderman





MAKE ME A MACCHIATO, PUSSYCAT!




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




Friday, July 18, 2008

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!

Tuesday, July 15, 2008

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.