Thursday, April 26, 2012

Reading Journal #4

If Air Travel Worked Like Health Care

What a nightmare!  The article relates what a conversation would be like if air travel worked like health care and one were trying to fly from point A to point B.  It highlights how none of the multiple systems and databases in health care operate on the same wavelength.  No one across health care platforms communicates, nearly identical forms must be filled out with a multitude of providers.  Health insurance is selective as to who and what it covers.  Multiple phone calls must be made to accomplish anything.

"This system is insane. It is fragmented to the point of incoherence. Record-keeping is stuck in the 1960s. Communication is stuck in the 1980s. None of the systems talks to the others. Everyone reinvents the wheel at every stage of the process. There is no pricing transparency."
How true.  Just the other day I was on the phone with my health insurance company who is billing me for an outrageous amount.  Didn't I already pay the co-pay?  Isn't that what the co-pay is for?  Why are there so many hidden fees, fine lines, and clauses?  Why can't health care work like air travel?!

Tuesday, April 17, 2012

Nap time? Yes, Please!

Well, who can deny the appeal of a nice refreshing nap?  Sure, it's inconvenient to the modern, non-stop world.  But are there health benefits?  Should time be allotted for napping during a work day?  Should napping be encouraged by doctors?  Is it really worth taking time out of our already busy, rushed days?  How do we take time, spare our precious, precious time to do something as frivolous as nap?

To nap or not to nap?
Napping
Napping:  Do's and Don'ts for Healthy Adults
Sleep Tips:  7 Steps to Sleep Better
The Sweet Science of Dozing
Nap Time!
Pros and Cons of Napping for Adults
Do You Take Naps?
The Role of Daytime Naps in Healthy Adults

For the photoessay, I would like to review the history and evolution of napping, as well as napping in different cultures.

Tuesday, April 10, 2012

Monday, April 2, 2012

Gertrude


            Her name is Gertrude, but we like to call her Gertie.  She is a 94 year-old, 142-pound woman who resides in a long-term care facility, a nursing home.  She has all the character traits that come to mind when you picture your typical nursing home resident.  She has short white-gray hair that she has permed and hairsprayed religiously on a weekly basis.  Her rolling walker has basket attached, which she keeps stocked with tissues and hard candies, the later of which she will never hesitate to give to you.  She will always try to take care of others before she does anything for herself.  She has been knitting the same rainbow scarf since I started working with her over a year ago.  She loves to tell stories of her youth.  Oh, and she will call you every name in the book before she finally comes to the right one.

            Gertie hasn’t always been the elderly woman I have grown to know and love.  She regales me with stories of her youth.  Gertie grew up the youngest child, with 4 older sisters.  In fact, this is how she remembers my name.  When she forgets, she starts naming all her sisters.

            “Evelyn?  Fay?  Doris?  Laura?”  She stops, knowing she has named the corresponding sister with whom I share a name.  This, of course, leads into a story about her older sister Laura.  Laura was the oldest of the 5 girls, and favored her youngest sister very much.  In their youth, Gertie would beg Laura to let her help with the chores.  Laura would teach her how to do housework, protect her, be her confidant.  She always smiles when she thinks of Laura.

            At the age of 19 she married her love, Henry.  They had 5 beautiful children, only 4 of which made it to adulthood.  Gertie is very proud of her large family, often indulging any ear willing to listen about how her daughters and some of her granddaughters are nursing.  She brags about how some of them care for children with cancer; how they are such warm souls to see such heartbreak day in and day out.  She talks about her great-grand babies in California.  Her walls, her bureau, her nightstand are all littered with pictures of a beautiful smiling family.

            I don’t think she sees very much of her family now that she is in a nursing home, but it doesn’t seem to bother her.  As her dementia progresses she talks to the pictures of her family as if they can actually hear and converse with her.  Even though she is developing these little quirks, she is still one of the lucky ones.  She is able to walk, just with a walker, not with someone trailing her around to make sure she doesn’t fall or try to walk out the door.  She is able to wash, dress, toilet, and feed herself, unlike many of her companions. 

            However, those same attributes that make her lucky, also, in a sense, make her unlucky.  She is more aware of her surroundings.  She is aware that the people around her do have to be fed, changed when they inevitably soil themselves, and have very free will.  She sees all this, yet there is nothing she can do about it.  This is where Gertie’s nerves get the best of her. 

            “I’m just a bundle of nerves,” she confesses.  “That’s what the doctors used to tell my mother.”  And its true.  She struggles with the frustration of being forgetful, but not forgetful enough to forget she is forgetting.  She gets anxious when its getting close to bedtime and she hasn’t been given a shower yet.  She gets all worked up when she has a confrontation with other residents about the amount of bingo cards they are allotted.  She gets agitated when she needs something and she can’t find an aid to instantaneously cater to her every whim.  It drives her absolutely up a wall when she sees a fellow resident at the nursing home getting made fun of.

            Gertie lives for the activities they have at her home.  Boy, do they have a lot of activities.  Daily, from right after breakfast to right before dinner, her days are jam-packed.  Activities can range from arts and crafts to exercise to trivia to tai chi. She gets to play bingo weekly, getting a quarter for every game won.  She makes little decorations they lay among the photos of her family, different ones for different holidays or seasons.  What Gertie enjoys is when they have people come in who sing and play instruments, sometimes they even have dancers.

            Although Gertie can claim many friends at her home, she only has one close friend, her roommate.  Her roommate’s name is Maria; she is a 89 year old who has Parkinson’s Disease.  Maria is one of the residents at the home that is unable to groom, feed, or toilet herself.  She relies solely on the people employed by the home, and Gertie makes it her job to ensure Maria is being well taken care of.  They spend evenings in their room chatting before they go to bed.  As Maria gets tired, Gertie goes off to find someone capable of helping her into bed.  They are always looking out for each other.

            Despite her medications, Gertie’s dementia is progressing.  She is becoming more and more forgetful.  She is loosing her filter that allows her to distinguish between right and wrong.  More often she can be seen with her shirt on backwards, or holding her pictures up to watch TV.  Despite those ever increasing moment where her mind is elsewhere, I will always remember Gertie as she asks me to tuck her in at night.

Tuesday, March 6, 2012

Reading Journal #2/3

The Other Labor Day

No word of a lie, after reading the first paragraph I could not read other sentence until I had ice cream in front of me.  So I trekked across the street in the freezing temperatures to obtain some ice cream from my neighboring Tedeschi store.  As I stood there debating between Ben & Jerry's Phish Food and S'mores I told myself that I will not be part of that 62% that have an increased risk of ovulation-related fertility problems because I didn't treat myself to two servings of ice cream a week.  I no longer have to consider ice cream a treat, but now a prophylactic treatment.

Now that I am situated inside my house eating my s'mores ice cream right out of the carton I can continue my reading.

The article Baby Lust describes the lengths some women, including the author will go to to conceive.  But some of the facts she stated, including the one regarding ice cream consumption are shocking.  I almost want to throw out all the yogurt in my fridge knowing that it may some day make it twice as hard for me to have a baby.

In the article Artificial Wombs, the scientist Liu is working with her team to create a viable artificial womb  that can aid women who cannot carry their own fetus.  She has started with artificial rodent wombs, though she has had limited success thus far.  None of her rodents have survived life outside the womb for more than a few days.  She has hope that she will have a successful rodent womb within the next few years, and a human womb closely after that.  In this day in age, I cannot say this technology is very surprising, and once accomplished it will hopefully will be a great tool for those couples who cannot have have a child traditionally, but still want one of their own flesh and blood.  However it could be a dangerous tool in the hands of those who are capable but do not wish to carry their own baby.

Monday, March 5, 2012

Reading Journal #1

House of Memories

A very emotional tour of this woman's house, this article almost brought me to tears.  I cannot imagine what she must be going through just walking around her house.  She questions whether a house is just a structure that houses us, or one that also houses our memories.  She tells us about her struggle with the sickness and eventual death of her husband just as they are starting their new life together.  She questions the effect moving out of the house would have on her memories of her time there.  As she guides the reader around the house she shows memories of events that have happened in specific locations.  She questions the effect moving out of the house would have on the memories made there.

I love how she uses vivid details to make the reader feel like they are reliving the memory too.  I can picture the rooms and the memories, the pain of dealing with the loss of her young husband.

Thursday, February 23, 2012

Ethnography brainstorm

I may have more readily available resources at my fingertips since I am a nurse, and my mom is a nurse.  But here are some ideas:

ER waiting room
Nursing home
Dementia unit
Rehab facility
Hospital
School nurse's office
Dr's office
Support groups
Military medical group

Here are some people that could be profiled:
Doctor
Nurse
CNA
Patient
Therapist
Military medical staff
People with certain illnesses/ailments
Support staff at medical facilities

Here are some sample ethnographies:
http://soc.sagepub.com/content/27/4/591.abstract

Wednesday, February 22, 2012

My Memior

            We all have some kind of connection to health and medicine.  We have all been sick, we have all been to the doctors at some point in our lives.  Some of us may have been in the hospital at one point, and most of us have visited a hospital to see a loved one.  We can all tell a tale of at least one vivid memory regarding health and medicine.  I can tell you stories till the cows come home about my medical experiences, but this tale is unlike many others.
            I was sitting patiently, picking through my Army issued MRE (meal ready to eat) for something actually edible and awaiting my turn.  I was nervous.  I was mentally going over everything I had learned in medic school in the last 14 weeks. This was my last obstacle, trauma lanes.   All my hard work had lead up to this.  I had done astonishingly well, and if I didn’t pass this, I wouldn’t be able to claim my place as an honor graduate.  I had to do well.  I had my aid bag; I knew where everything was in it.  I had to.  I had my ever-present M16 rifle by my side.  I was decked out in full battle gear, waiting for my name to be called.
            I had heard stories from those who had gone before me, by nothing could have prepared me for what was about to happen.  The moment I crossed the threshold of those double doors my senses were bombarded.  My ears were filled with booming rock music and instructors yelling.  My eyes darting from student to instructor to mock battle casualty, all set up in 8 little mock battlefield areas.  My mouth instantly dried and I started to sweat.  My heart was pumping; adrenaline was racing through my body.  But that was the point, to stress us out and push us to our limits to try to simulate a real combat situation. 
            At this point my mind was racing.  I see my casualty; I am already mentally evaluating him.  I have two battle buddies with me, and we make our way over to where he’s lying.  I do my quick “care under fire” assessment, my ABC’s. Does he have a working airway?  Yes. Is he breathing?  Yes.  Is his circulation visually compromised?  Yes.  He has no left foot.  This is definitely something that needed to be taken care of before he can be moved.  I grab the tourniquet out of his aid pouch, remembering that one should never use their own tourniquet when avoidable, you never know if you will need it yourself.  I tighten the tourniquet around his leg, two inches about the wound, just like I have practiced countless times.  I mark his forehead with a “T” and the time the tourniquet was placed.  It is now safe to move my casualty, his recovered foot, and all of his gear to cover where I can perform a more detailed assessment.
            Once we are situated in the safe area I begin to assess the casualty further.  I go back through my ABC’s making sure I haven’t missed anything.  At this point I needed to start an IV.  I know it is important to have venous access incase fluids need to be started to replace the blood he’s lost.  I start the IV in one of my battle buddies, because it is important to practice all the skills I’ve learned and manikins aren’t that receptive to needles. 
            Now it was time to do a head-to-toe assessment.  I start at the head, looking and feeling for anything abnormal.  I am looking for bruises, cuts, deformities, blood, burns, swelling.  I am feeling for tenderness, instability, crepitus.  I move down the body, checking the neck for any vein distention or tracheal deviation.  I make my way down the torso, not finding any abnormalities.  I check the arms, I find that the right forearm is unstable, and as I palpate I hear crepitus, the grinding, cracking noise of bone bits rubbing against each other.  I secure his arm with a splint from my aid bag and move on.             
            As I move around his unconscious body I am sure to take my weapon and my aid bag with me.  I know that if they are out of arms reach they are no use to me and my instructor will not hesitate to snatch them from me.  Similarly, he does not hesitate to shout and spray me and my uniform with fake blood as I work quickly to assess my patient. 
            I finally reach the tourniqueted leg and can bandage the exposed stump.  I quickly do so, and know it is time to assess my casualty’s back.  I set up my litter so I only have to turn him once, and my battle buddies leg roll him onto his side.  I quickly check his back for abnormalities and place the litter against him.  We collectively roll him and the litter back to the ground and work to fastened him it.  The litter straps get fastened at his noggin, nipples, navel, and knees.  His gear gets placed on the litter with him, and we ready to carry him out to where he will be evacuated to a hospital. 
            The three of us carry him out to a clearing and set him down.  My last task is to call for evacuation using the 9-line medevac procedure we had been taught.  I give them the pertinent information regarding the casualty and his wounds, and all that’s left to do is wait for the imaginary helicopter to come get my make-believe casualty.  A half hour after I began, some fake blood, real sweat and tears later, I am done.  I have succeeded at my task, and hope that someday when I reach the real battlefield I can be equally successful in saving lives.

Tuesday, February 7, 2012

My Ad - A Rhetorical Analysis




Well, lets LOOK at the ad.  This is an image of a billboard in Wyoming, most likely right off the side of the highway.  The target audience is probably commuters, but in general drivers and their passengers.  The bright green color really grabs the attention of the viewer and the texts stands out in contract with bold black font.  While the main message that the advertisers are trying to get across is smaller and at the bottom of the ad, it is implied by the witty slogan that appears in big, bold, and smack-dab in the middle of the billboard.  This witty slogan gets the point across, but is also large and simple, so it can be read interpreted quickly and easily, even by those paying attention to the road.  In the bottom right corner of the ad, the advertisers pose a challenging question, a “what are you going to do about it?” kind of question.  In the opposite bottom corner, is the sponsor’s logo.

The message the ad is trying to get across is a simple and well-known one, second hand smoke is a killer.  What people might not know is that it kills an average of 50,000 people annually, and this fact is displayed across the bottom of the billboard.  But since we are all aware of the dangers of smoking, they use a witty slogan to try and get the message across.  “’Til secondhand smoke do us part.”  By using this witty remark, they are trying to get smokers, and those subjected to second hand smoke to look at the issue in a new light.  Maybe this is an angle they have never looked at before, their happily-ever-after could be cut short by those little sticks of cancer that some people just can’t seem to get enough of.  

“Where do you draw the line?”  This challenging question proposed in the bottom right of the billboard makes the audience think.  “Where DO I draw the line?”  It makes one sit and ponder a bit.  Do we stand up to our spouses smoking in the car, in the house, or right beside us, subjecting us to their nasty habit?  Do we stand up to coworkers whose cigarette smoking is blowing into our faces?  Do we have the nerve to say something to our friends about how their life decisions impact those around them?  It’s hard to approach someone and ask them to not smoke around you, but when are we going to stand up for our own health?

The same sponsor for this ad did a series of similar ads concerning second hand smoke that you can find here.  Some of the other interesting and surprising facts and statistics on these ads include; waitresses are 50% more likely o die from cancer caused by second hand smoke, and second hand smoke contains the same chemicals used in prison executions.  

Where do you draw the line?

Tuesday, January 31, 2012

The Choosing of the Theme

Ideally, I would love to write about Health and Medicine.  Being an LPN, trying to get my RN, the theme appeals to me the most.  I want to expand my knowledge on the subject and share my real-life experiences.  For the memoir I would love to write about getting my LPN in the Army, maybe on "trauma lanes" as a medic, and the adrenaline rush of saving my mock war casualty amidst the "battle scene."  For the observation I would like to do a day in the life of a nursing home resident, or maybe as a school nurse.  I am thinking that my argument could be the pros and cons of holistic medicine in the current world.  I don't know much about holistic medicine right now, but it is a subject that greatly interests me.  And for the photo essay?  Well, I'm not too sure right now, I am debating doing something on medicine 50 years ago, compared to modern medicine.  More specifically, I want to do treatments for mental illnesses, and how far we have come.

My back up plan:

Food:  A chance to release my "inner fat kid"  Here are some ideas for the essays:
 - My vegetarian diet
 - Wine in the making  (talk to a vineyard owner, perhaps?)
 - The effect of eating dinner as a family (vs in front of the tv, etc...)
 - Foods from around the world

Arts:  Well, before I was a nurse, I was a photography major.  So naturally, art appeals to me.
 - My experiences in the dark room
 - Behind the scenes, a day on the set (work with a production studio?)
 - Digital vs film
 - Photo capturing life

Family:  My family has had 10 exchange students, so that has made a very unique impact on my life.
 - My exchange student (language barriers and the hilarity that ensues)
 - Through a mother's eyes.  (Whats really going on in that head?!)
 - The effect of eating dinner as a family (again...)
 - Vacations as a family.

What do you think?  What would you like to read about?

Monday, January 30, 2012

All about me

Well, hmm.  I can't say I have a chance to, or need to, write very often anymore.  I never found great joy in writing.  The most I write nowadays is when I have to do my nurse's notes at work, and even then its not that much.  I do love to make lists, lists for everything.  I do happen to have a favorite pen, a nice little fountain pen that writes oh-so smoothly.  Favorite paper?  Something with lines, otherwise I write crookedly.

Since I am not a huge writer, this semester I would like to learn to find joy in writing.  I think I lost it in nursing school.  I wrote all the time when I was in basic training, but maybe that was because I was cut off socially from the world except by way of written word.  During that time I also had a little journal that I used to write my random thoughts in.

I think one of my greatest weaknesses would be my flow of words.  Sometimes I just don't know how to flow smoothly between my statements.  But I'm going to work on it, I promise!  Strengths?  Well I'd say I'm fairly creative.  But I'll let you be the judge of that over the semester.

While I may not be a huge fan of writing, I absolutely adore reading.  I am working on building myself a library.  (You know, like the massive one in Beauty and the Beast.)  I just finished reading Miss Pelegrine's Home for Peculiar Children.  Read it in half a day!  Now I am working on Alice I have Been and Faery Tales.  Some of my favorite authors include Dan Brown, Jodi Picoult, Nicholas Sparks, J.K. Rowling, and James Redfield.  My rule of thumb generally is the book has to capture me in the first 50 pages, 75 if I think it may have potential!

Tuesday, January 24, 2012

Welcome!

And so begins my journey into blogging.  I hope you enjoy the background pictures in my blog.  I plan on changing them periodically, they are all my own.  :)

Here is the link back to the Eng101 site.