im sick

pt: um, i saw someone that looked mexican and i kinda feel feverish. earlier i vomicked into my mouth a bit. its gettin worser now. i think i gots the swine flu
me: ............

basic nursing 101

im running around taking care of my patient load and my neighbor nurse's patient load because we have crap going on all over and nurses and doctors are running all over the place. one fun day.

well i take note of a nurse across the way from me change an iv bag. ok routine stuff, nursing 101, right? wrong.

the nurse takes the new bag and spikes it with the old line and lets it continue running. sounds ok, but when you look, and i just got new glasses, the line was full of air.

fully disturbed i had to interject pulling the nurse aside and quietly schooling them. i remember seeing this a few times and i just don't get why it isn't known and understood: air embolisms = bad and maybe death

change your tubing or change and flush it right!!

nursing school was hard

and for many out there it was even harder to get into a nursing program. for me, not so hard. when i actually put my mind into something and do my due diligence...i actually get what i had wanted. well, in most cases. a great book (one of the few) that very much influenced me in my adult life was one by a young steven k scott entitled 'the richest man who ever lived'. lots of bilical references which i like, and it really opened my eyes and my mind.

there's lots of disappointment in life and we get upset. we get upset over what went wrong or why something didn't go our way. the book highlights those reasons, and the main one goes to the effect that you...me or we, didn't do our due diligence. meaning that we didn't cover all of our bases before we went forward in expecting the positive and correct (for us) outcome.

i've been pretty successful in implementing this into my life. still some holes, but im working on it. and i do see a difference in my personal outlook on life, not only with the way i see things, but also the way they effect me. all in a positive way.


ok ok, a little rant but there's some reference to the main topic there. the story is that i wasn't a good student. i slept in class, right in front of the teacher. i was late, i didn't do all my work. i sucked at school. which is a strong reason i originally dropped out during my first semester in college. i went the, what i thought was, the easy way out and enrolled in something i liked....automotive school. my first day on the job i knew that i couldn't do this all of my life.

i met a very nice man...knocking on 50's, living at home with mom and dad, no girlfriend, wearing suspenders, talking to himself and driving what he called a 'chick magnet'. ok super run on sentence there but if you've read any of my entries from previous you know im about thought, not the process :p anyway, it was to get the point through without interruption....i just couldn't do it. i didn't want to end up like this. don't get me wrong, he was the nicest guy, he'd help you out and stick up for you. he lent me any tool that i needed especially the most important one, his mind. super smart guy, he was, a great technician and probably the best i've known in my 6 professional years of automotive.

anyway, i went right back to college when i saw this guy and boy was i motivated. motivation or not i didn't have the best starting grounds. my gpa...wow did it suck. it was just above a 2.0 and barely at that. way before i rear Scott's book i had done a little due diligence of my own. "how could i get my gpa up?"...and not only get it up, but enough to get the schools to want me, and do it quickly, easily, and CHEAP! after all i had funded all this on my own. well...at any local community college there are classes for the 'community'. and not everyone in this 'community' is an academically minded person. but the schools want to make money and gear courses to the masses. these courses still look and work like regular classes and i saw that and i ran with it.

check this quick ehow i wrote up

listed there are the courses i took: TENNIS, ART 1 & 2, and ARCHERY, yes archery. my gpa went from the bitter low it was to a 3.3 and it kept climbing. of course i had other courses to do mind you, but i did my work in those as well. i did an over all 180 and took the highway to a high gpa. that kinda rhymes.

as soon as i completed the required courses and my FUN courses i had a 3.6 gpa and i applied. dont you know i got accepted preliminarily right away while thousands, yes thousands were turned away as fast as i was accepted. the program i entered took 100 students total from an applicant pool of well over 3500. the school was renowned for its ability to take its student body and create an extremely high percentage of passing board certified RN's. its rank easily outdid that of the local and not so local 4 year programs and even ivy league facilities. so as you can see they were in high demand, and would of course only take the best applicants.

doing as i just told you, i slipped into that community of 'best'.

now of course while in the program i would go up and down. as is my nature. i was still not the best student as i am lazy by nature when it comes to studies. i still slept in class, i was still late by the maximum allowed days, and i lived by the creed 'C equals RN'.

i know my teachers saw that i was not a book smart student, but i also know that i shined on the hands on part. and that does count a lot with nursing. you can be a very book smart person, but if you cannot apply it you will be very limited in the office work available.

well, i skimmed by and along came finals. people passed and a very limited number of one failed, doomed to repeat the next year. no that wasn't me, but i was close. i didn't find out my final 'decision' rather than grade until 2 hours after the others did. apparently a meeting was held on my behalf, i was put on hold to wait for that decision. 2 hours is a long time when you're waiting for something like this. TWO HOURS. i am not a drinker, but a handful of classmates took me across the street and easily did i take down the majority of 2 pitchers.

i didn't get a grade so i don't know if i actually failed, or if i just barely passed, i dont know, although by the story one might discern one versus the other. what i do positively know is that i was told after 2 hours of waiting that i would need to return during the summer....to walk for graduation!

i should hope that i need not extend the feelings flowing through my body at that point in time. indescribable. yet imaginable.

i'd like to let it be known that i AM a good nurse, i AM a compassionate nurse (where it is due), and i am ever grateful to the faculty's time spent during those 2 hours on the topic of my passing. and not to boast, only so you know i didn't let you down, i was given the award of nurse of the year by all the residents in my department...a level 1 trauma center, one of the busiest in the united states. thank you

so what is it that YOU do?

nursing is a pretty sweet field in that there are so many different possibilities and venues to work in. during school hours i was encouraged to do med/surg for a year and then branch off to where i wanted to go. in thinking about it i didn't see myself as a bedside nurse with the same patients for hours and maybe even days. i didn't exactly see myself in emergency nursing either but i did enjoy the chaos. that was my draw. everyone says that there are different fields...and of course there are! but what are the unconventional fields out there? my wife will be attending a legal nurse consultant conference in the near future. i hope to expand to a bsn and ultimately a nurse anesthetist program.

so...what is it that YOU do?

tourettes enlightenment

so i've just come back from a little vacation. my grandmother just turned 90 this past weekend, amazing. don't really think i'd make it to that, and the thought of doing so isn't so appealing. always imagined kicking it while still able to hold my bladder, but then again i have problems with that in the field of work im in.

anywho, so the flight into LAX was pretty much uneventful. it was a short time away, so the 6 hour flight gives much to be desired in the sleep category. i get there, have problems adjusting, and by the time i do adjust its time to get home. well the day after i arrive at home i start a couple days of long shifts, so i need to prepare. im all set to get a little shut eye on the long flight home. i walk the airport, scouring over what i can package in my bag. i stock on ice in my nalgene for a cold refreshment during the flight should i wake. and i pick up some other snacks as i would most assuredly miss the on flight beverages and not pay the obscene prices of their food. i even picked up a paper to peruse over as reading helps me sleep.

all set, GREAT! im good, im planned, im collected...just need to get to my seat and close my eyes. sweet right? not so much.

now im in the middle seat and to my left is a nice lady who is quite and seems conducive to sleeping on flights. to my right is a mid 40s man who to no fault of his own cannot keep still, keep quite, or fall asleep. for 6 everlasting hours do the surrounding passengers hear his intermittent moans and grunts.

during the movie, marley and me (a very sad movie by the way) he would laugh and make comments out loud...the type of comments you and i would definitely keep to ourselves.

prior to the video he had a newspaper in hand, continually pointing and grunting, then folding to a different section. at the pace with which he did this it was almost a positive that he wasn't even reading the paper. he'd eventually crumple the paper, stick it in his side which was also my side and hide it there to only select it again for use.

in between papers he did stop to have a light snack. a muffin, apple, and a juice. all of which ended up everywhere. the muffin fell to the floor which i attempted to help on the 1st and 2nd times. the apple made touch down before we did approximately 4 times, and the juice lay nicely on his shirt, lap, and a bit on my right arm.
countless times did he unbuckle, regardless of the seatbelt sign, to retrieve his lost items. even the stewardesses gave up on correcting this action due to the lighted signs.

bless his soul, the gentleman directly in front of this guy had his seat back pushed, shoved, kicked, kneed, pulled, and manipulated so that you could visually see his hair move from the swift actions by my next door neighbor. he truely took it like a champ, and i believe he had it worse than i did.

now the entire time i was in attempts to help when he dropped or needed something and skillfully ignored the constant vocal exclamations. no i wasn't mad, or disgusted. i felt sorry for the man. i felt sorry that he had no control over this. im sure that there were a number of things going through his head that even he probably had no idea of. as mentioned he was of maybe an average 40's, and wasn't dirty or unkempt. he looked clean, proper...he looked like the social norm. his actions are what set him apart from the rest. he obviously has mind enough to keep himself this way, and not into the deep caverns of the mind that many end into. realizing this, i not only felt sad, but also impressed.

what an accomplishment of his own to maintain composure over whatever was making him this way, and keeping himself in tuned with the world of today...mobile and social. it would be easy to believe others would have turned into the house trolls with overwhelming agoraphobia. very impressive.

so 6 hours of this experience, i was definitely tired. and i paid a little price, i was late getting up for work the past 2 days and rushing was my penance. i do believe that i have adjusted more to the daily time and living here on the east. and in reflection i feel thankful for the time i had with him. it brings to light a number of different things. i am grateful for that which i have...my health, my mental health, my family, my life, even my troubles. my troubles for that i know, increasingly so, that it could definitely be worse. i could have similar setbacks, and i may not be as strong as this man was. its a different spin on looking at things. when i first met my wife, then girlfriend, she would constantly say 'it could always be worse'. well that's been a bit of a stable in my daily life. i get killed at work, a horrible day but not the worst...it could be worse. during the winter i almost crashed twice in one commute to work...i didn't, and it could have been worse. a fight with my wife, it didn't escalate...it could be worse. my mother in law lives and works with just under 30% of one lung, im lucky to have 2.....

to take from this is the statement, "it could be worse". whatever it is that you are into, just think of what others are overcoming or attempting to. in the fast paced world we live in, take a moment, set aside a few seconds here and there...
realize that you are so very blessed to have what you have.
realize that not all have that,
and do not for a second take for granted that which you have been given...
given by your own hand, another's, or by no physical hand at all.

scrapper assault

ok so in these hard economic times there are differences in what people are willing to do for money. one such thing is scrap steel and other metals. prices for these are at all time highs, especially for copper. depending on what type of neighborhood you live in you may have a number of trucks rolling by with multiple people in them. they're looking for signs of any metals

and when spotted they jump out and end up scouring through your trash, usually making a mess of things. taking what they want so they can resell and make a profit, all the while leaving your trash scattered.

this, my friends, is actually illegal. the trash is city property and these people are stealing. there is a large profit to be made by this, and these people have figured it out and are using their trucks to hoard and steal and make money.

well, one of my recent patients, a super nice guy, has a little stock pile of scrap steel and wood in his back yard. he did work here and there for himself, and others. being retired he just kept the stuff around which he collected over his many years of construction and other handy work. over some time he had noticed that his stockpile had been slowly decreasing. he sat around watching his stash as he spotted a young man of decent taking his steel and running out to his truck and driving off.

John had a leisurely life so he sat around waiting and watching for that man to return, and sure enough he did. John decided to confront this young guy for stealing his stuff. John stepped out and said a few words walking toward the young man, who in turn grabbed a 2x4 of wood and proceeded to swing at John's head. the 2x4 did connect with John's head on multiple occasions making him stumble, yet John was good enough to get a few swings at this younger and stronger guy, also striking him a few times. the man eventually ran off leaving John to bleed profusely from his wounds.

about 20minutes later John makes it into my emergency room via PFD medics where he is trauma cleared and placed into my room for triage and care. there were over 10 staples needed to close the wounds inflicted by this thief. John was very proud that he wasn't knocked out and even fought back as best he could. during his triage, the police came by with a young ethnic man in tow. tugging and attempting to pull away while cuffed and looking down at the ground he was presented to John. "Yea, thats him" he said "did i get him?" he exclaimed unable to visualize any markings due to the blood dripping in his eyes. "John, you got him good, you did great" i said.

John, who was clearly into his late 60's was so overwhelmed with happiness that he got him back that his staples went in without a flinch. the police, detectives, and myself praised him for his heroic fight back. John felt accopmlished and on top of the world. he was eventually cleared and discharged, police officers gave him a ride to the district to make a report and file charges. it was a hassle, but John didn't care, he was still floating. He was old, but didn't give up, and didn't shut up. he was on clouds.

the jacka** kid had a superficial scratch on his neck.



as happy as i was of the outcome and of making John feel better, i couldn't help being bothered by the story he had to tell me. what is going on in this world...

Cradle to the Grave

Check the new advance nursing magazine write up on the Cradle to the Grave program. this program has been the brain child of the chief trauma surgeon, amy goldberg, at a local hospital and along side her staff and the hard work of a very motivated individual, Scott Charles.

Scott takes high school students through a very graphic and detailed walk through of another young child's life. the story goes from his very early beginnings, to when he was taken away by gun violence here on the streets of philadelphia. they go through lectures, a bit of story telling, and walk through the actual trauma bay of one of the busiest Level I facilities in the US. in the bay, a reenactment of this young child's fight for life and death is presented to the high school kids, all in hopes of leaving an imprint on what the street life has to offer.

philly continues to be in the top 10 cities for gun related deaths. the cradle to the grave program has been up and running for many years, more than the 3 that i've been at this hospital. and hundreds of students walking through that trauma bay...all but one child had kept clear of the trauma bay since.

i personally would like to thank those efforts put forth by all the team of the cradle to the grave program. this needs to be recognized further and implemented in facilities all over the world. please, pass the word.