MedWorm.com provides a medical RSS filtering service. Over 5000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'I Wanna Be A Male Nurse' source. Sat, 16 Aug 2008 14:42:53 +0100 http://iwannabeamalenurse.blogspot.com/2007/11/when-is-it-ok-to-call-in-sick.html Last week Tuesday, nearing the end of my orientation at my new PCT (Patient Care Technician—basically the same as a CNA) job on the surgical telemetry unit of a local suburban hospital, I called in sick. I struggled with this decision, weighing my symptoms, their effect on my ability to do the job, the possibility of spreading infection, against the unit's need for my presence in the face of a regular shortage of PCTs.What I want to know from you all is how you make this delicate decision. What symptoms tip the scale for you? Assume that the symptoms listed below represent something out of the ordinary (e.g., "headache" would be more debilitating than a headache you might get on a regular basis). Symptoms marked "once" refer to an incident you could reasonably believe would not recur (although you could not be 100% sure). If you have any additional comments (e.g., if you believe taking a particular medication would take care of a symptom sufficiently to allow you to work, OR if you want to mention a symptom that is not included, OR etc.), please use the Comments at the end of the post. Symptoms are arranged in alphabetical order for no particular reason. You should receive a copy of your responses if you enter your e-mail, and I will try to tabulate the results on a more or less timely basis and present them via updates to this post.All fields are voluntary. You may be anonymous if you wish. Name: e-mail: Website: Cough (dry) Cough (productive) Diaphoresis Diarrhea (once) Diarrhea (repeated) Fatigue High Temp. (over 100 deg. F) High Temp. (over 101 deg. F) High Temp. (over 102 deg. F) Nausea Pain (headache) Pain (intestinal) Pain (limbs) Post-nasal Drip Skin Rash Sneezing Vertigo Vomiting (once) Vomiting (repeated) What were your symptoms last time you called in sick to work? Security Code: Please enter the 5 character code you see in the image to the left. Code: BFN Secure Web Mail System (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=1005157 Mon, 05 Nov 2007 05:00:00 +0100 1005157 http://iwannabeamalenurse.blogspot.com/2007/10/family-emergency.html of sorts, a brewing child custody case, is my latest explanation for my absence here.But I got the job as a PCT in the Surgical-Telemetry Unit of the Big Suburban Teaching Hospital, currently shadowing and finishing classroom orientation. And I'm functioning, focusing on the task at hand until there's a lull and moreso until the shift ends, then remembering what's going on in the rest of my life and sinking like a lead weight. A little. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=948432 Sat, 13 Oct 2007 04:00:00 +0100 948432 http://iwannabeamalenurse.blogspot.com/2007/09/politics-and-healthcare-in-cleveland.html Two recent stories from the Cleveland Plain Dealer that I, and hopefully you, find interesting, with a little commentary after each one:Oberlin hospital offers unused drugs to Lorain County's poor+  +  +Oberlin -- Allen Memorial Hospital will be the first hospital in Ohio to make available to low-income patients unused prescription medicine that has been donated by nursing homes.Tanas Wilcox of the Lorain County General Health District said the pilot program allows qualifying patients to buy up to 90 days' worth of prescription medicine through the mail for about $13. The medicine, which normally costs hundreds of dollars, could be for diabetes, heart disease, blood pressure and many other illnesses and conditions.+  +  +A state law passed in 2002 and dubbed "Karon's Law" allows nursing homes and wholesale pharmaceutical companies to redistribute unused medication to the poor rather than pay to have them destroyed.Ohio was the first state in the nation to adopt such a law. But the first program to take advantage of it, in Stark County, didn't begin until 2004. By then, 18 other states had adopted similar laws and put them into practice. In North Carolina, about $6 million worth of recycled drugs are distributed every year.The law came about after Karon Beltz died of complications of breast cancer in 1999 and, her husband, Gary, could not bring himself to destroy $6,700 worth of her unopened cancer medication. He talked to his local representative about it.Ohio Sen. Kirk Schuring, a Massillon Republican, successfully introduced the bill that allowed unused drugs to be redistributed to the poor.+ + + + + + +I never realized before that a law has to be passed to prevent pharmaceuticals from being wasted and to allow people to get the medicine they need when it's available. Obviously, it wouldn't work very well to let just anybody cart off leftover meds, but charity organizations can do a fine job of regulating the process, I think. How much medicine has been destroyed, I wonder, and for how long? How many people have had to go without needlessly over the years? I don't believe in socialized medicine at all, but here is something that could be handled competently by private charities, and the giant oaf of the government stands (or once stood, depending on where you are) in the way.Speaking of my feelings about government ...Strongsville mayor's influence may have led to nurse's firingStrongsville- Mayor Thomas Perciak's political influence may have led to the firing of a nurse who had worked 17 years at Southwest General Health Center. Perciak sent the hospital president a letter in June about nurse Karla Lucas. She was accused of threatening a Strongsville patrolman in her home on May 6 during a child-custody dispute. Three days later, Officer Tom O'Deens wrote a letter to Police Chief C.W. Goss about the incident. The chief forwarded the letter to Perciak. Lucas and her husband, Tony, were taking care of their niece when the girl's mother called police to have the child returned home, according to the letter. The couple complained to the officers about the girl's mother and became agitated. As the officers were leaving with the child, Karla Lucas told them that the child was being put in a dangerous situation, the letter said. O'Deens then said Lucas threatened him by saying: "I am a nurse . . . and I hope to see you in my emergency room in one of my beds." He asked Lucas to explain the comment, but she declined and called him a ". . . pig," O'Deens said in the letter. He found the situation disturbing and wanted it addressed by Strongsville's leaders, his letter said. No charges were filed against Lucas. Perciak, who is the chairman of the hospital's fund-raising board, called Lucas' actions offensive and degrading and forwarded the letter on June 8 to hospital President Gary Rowe. The hospital fired Lucas June 13 for improper conduct and threatening to withhold care in her role as a nurse. The hospital cited the incident with O'Deens, according to her termination letter. + + + + + + +This is bad news for those of us who distrust cops, dislike politicians, and are moving to the Cleveland area. After 17 years, to be fired over some words that may or may not have been said in a heated, emotional moment ... I don't know how to express my feelings about that. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=888546 Thu, 20 Sep 2007 04:00:00 +0100 888546 http://iwannabeamalenurse.blogspot.com/2007/09/short-update.html Constant updates are boring, for me to write, whether or not they are for you to read. I have posts in the works that I think are more interesting, but I have no time yet to finish them. So, for now ...I got the CNA job in the surgical telemetry unit, and I begin on October 8. Anxious but glad. I'll do fine.I received my revised admission letter today from Case! Only need to finish the statistics class I'm taking now (in which I'm doing pretty well) and take a biochemistry course in the Spring. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=885344 Wed, 19 Sep 2007 04:00:00 +0100 885344 http://iwannabeamalenurse.blogspot.com/2007/09/having-it-out-with-melancholy.html Pharmaceutical wonders are at work but I believe only in this moment of well-being. Unholy ghost, you are certain to come again.Coarse, mean, you'll put your feet on the coffee table, lean back, and turn me into someone who can't take the trouble to speak; someone who can't sleep, or who does nothing but sleep; can't read, or call for an appointment for help.There is nothing I can do against your coming. When I awake, I am still with thee.          ~from "Having it Out with Melancholy," Jane KenyonDepression, and other psychiatric disorders for that matter, is still treated differently than any established physical disease, someone reminded me. Hospitals, insurance companies, physicians, relatives, sufferers, all treat it to some degree as though it's not completely real, partly made up, imagined, just snap out of it. At least it seems that way, sometimes more than others.But it is a different creature than a broken arm or a ruptured spleen or a cancer, isn't it? Psychiatric medicine can't nail it down half as well as other branches of medicine seem to cure or hold at bay their conditions. Fear of being diagnosed with cancer might keep someone from calling the doctor, but cancer would never tell you that you deserve it, that it's all you're ever going to get. I don't know for sure, but I would make a small wager that the relapse rate is higher for depression than for cancer.I don't know the answer. The question is like a weight on my chest. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=868191 Wed, 12 Sep 2007 04:00:00 +0100 868191 http://iwannabeamalenurse.blogspot.com/2007/09/job-hunting.html Yesterday was my first job interview since I quit the skilled nursing facility for the developmentally disabled. The interview was for a Patient Care Technician (virtually the same as CNA in this instance) in a Surgical Telemetry Unit at a nearby hospital. I was told that it's a very busy unit and that each CNA and each nurse takes six patients, who are in—and have—a variety of conditions. But few are fully dependent, so at least the level of work I would do would (probably) (hopefully) be something I can handle.I didn't mention my last CNA job, nor did I include it on my resumé ... all the same, part of me is afraid to be found out for a fraud if I begin the job and find, once again, that its requirements are beyond me. The Nurse Managers do place a strong emphasis on "customer satisfaction," so my strength (rapport with patients) will be useful.The worst thing about job hunting is the insecurity that inevitably comes with it. If you get the job, you must begin again in new territory with old fears that you carry from the last job, at which you failed. (OK, not everyone, but me.) If you don't get the job, your income is inadequate, you still lack experience, and you still have to look for a job.And maybe you'll get a call from no one except the nursing home down the street where everything inside is dark and smells like piss. And, if no one else called, and if the nursing home offered you the job, you would take it, because you need the money and the experience. And you would act pleasant while you were there. But you wouldn't really like it. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=845699 Wed, 05 Sep 2007 04:00:00 +0100 845699 http://iwannabeamalenurse.blogspot.com/2007/08/viruses-to-fight-bacteria.html Staph infections and MRSA almost a thing of the past. This would make things a little easier, no?Fire With Fire: Virus Could Combat Deadly Human Bacteria (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=830918 Wed, 29 Aug 2007 04:00:00 +0100 830918 http://iwannabeamalenurse.blogspot.com/2007/08/nurse-daddy.html One good thing about being between CNA jobs is that, when my 14-year-old daughter visited this weekend, I didn't have to spend large chunks of the weekend working and other large chunks emotionally and physically exhausted from having worked.We had several things in mind for her weekend in Chicago, as she loves the city and hasn't been here in a full year. (More and more grown up, she stays in Michigan more and more of the time hanging out with her high school friends, taking care of her (half) sisters, going to her (way-too-expensive-bordering-on-if-not-over-the-border-scam) modeling and acting school one weekend a month. She used to stay 2-3 months with me in Chicago over the summer. I miss her.)Anyway, there was a flu bug of some sort that had hit both her mother and her stepdad just before she left Michigan, and apparently it was incubating in her at the same time. Most of the plans had to be scrapped, and she spent much of the weekend on the couch with ginger ale, water, saltines, Tylenol, Pepto, ice pack, and the first season of Buffy the Vampire Slayer."Of all the weekends to get sick," she said."Well, it's not often I get to take care of you when you're sick. That's kind of nice," I said.She looked a little suspicious, with something between an affectionate smile and a sarcastic smirk on her face. But I meant it. (Not in a Munchausen-by-proxy kind of way, of course. In a sane way.)Taking care of one's sick child is like disciplining and drawing boundaries for a wayward child, like having one of "those talks" about embarrassing and touchy issues. These aren't the most pleasant tasks of parenthood, but they do define a large part of it. After feeling like "weekend dad" (or even less) for months now, it was fulfilling to do some real parental work.And I know it's vastly different in many ways, but my experience taking care of my daughter over the past 14 years is one of the reasons I want to become a nurse. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=811057 Mon, 20 Aug 2007 04:00:00 +0100 811057 http://iwannabeamalenurse.blogspot.com/2007/07/quitter-cleveland-update.html I quit my CNA job this morning, rather than going against probably impossible odds and facing the same emotional roller coaster with a more definite and unhappy ending. I feel awful about it, on so many levels, and I need to grieve and process and then move on.In much happier news, I have received (somewhat unofficial) confirmation that my request for deferred admission to Case Western Reserve University's graduate-entry program in nursing on the Pediatric NP track has been granted! Cleveland here we come, with plenty of time to wrap things up here in Chicago! (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=768919 Tue, 31 Jul 2007 04:00:00 +0100 768919 http://iwannabeamalenurse.blogspot.com/2007/07/firing-range.html Sometimes I try to do things and it just doesn't work out the way I wanted toI get real frustrated and I try hard to do it and I take my time and it doesn't work out the way I wanted toIt's like I concentrate real hard and it doesn't work outEverything I do and everything I try never turns outIt's like I need time to figure these things out          "Institutionalized," Suicidal Tendencies (1983)I've had several "come to my office" talks with my supervisors and the codirectors of the pediatric/developmentally disabled long-term care facility where I work as a CNA. One of these involved two written warnings for poor decision making under the influence of mental exhaustion or ignorance. (Both incidents ended just fine, nothing close to damage or real danger, but they easily could have been serious, so I appreciate the validity of the warnings.) Most of these little meetings have plumbed the depth of mystery Why are you so slow? The last few have begun with "We're pleased with your thoroughness and especially the way you interact with the residents, but ..." (Being thorough and interacting with children or those with the minds of children are two things I'm very very good at. Being fast is not. And I cannot emphasize that enough. I don't mean not fast the way most people use it—I mean really f***ing slow.)Today, a weekday, when the schedule means so much more, I continued trying my hardest to pick up my speed, to keep everyone on schedule, and not to require the help of other (very busy) CNAs or the supervisor and codirector on duty. My residents had to go at 10, and I had them all bathed, dressed, shaved, combed, and cared for orally (is there a better way to say that?) by 9:30 or so, which compared to my performance a few weeks ago is a phenomenal change. By the time my last resident was up and ready, however, I still had three of my guys to feed (the last one is a tube feeder) and I hadn't made any of the beds. So the frantic supervisor and codirector both pitched in, as they have pretty much since I started 4-5 weeks ago, or whatever it was.So today's meeting was "this is not working out the way we hoped it would," and they decided they want me to come in tomorrow to inservice (train) on the only team (group) of residents I've never worked with, on the theory that this is an easier team, and maybe this will be the team I can handle, maybe this will be the solution to the problem.And they have to find a solution to this problem by this weekend, or else it's not going to work out.And I went down to the locker room to collect my stuff and leave for the day, late enough and early enough so that nobody else was there, and I sat down and cried a quiet hiccupping sob for about 25 minutes.And I'm not sure if I should go in tomorrow morning for this last chance Texaco, or if I should call in tonight and tell them I honestly think there's no chance I can improve to the level at which they need me to perform, regardless of how "easy" the team is.I really wanted to be good at this job. I really wanted to face the challenge and overcome my tendency to get mired down in thoroughness and personal one-on-one interaction and be able to balance those with speed and efficiency. I really worked very, very hard, and I really did make progress. But in the end, I have not made the progress they need me to make fast enough.And that breaks my heart. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=767539 Mon, 30 Jul 2007 04:00:00 +0100 767539 http://iwannabeamalenurse.blogspot.com/2007/07/what-is-cna.html Because someone asked, and because I need more feedback encouraging, comiserating, correcting, advising me on how to survive during these first (weeks? months?) as a CNA ... I'll start with a standard textbook/recruiting poster definition from Wikipedia, and follow with something more personal ...In the United States, Certified Nursing Assistants, Certified Nurse Assistants (CNAs), or Nursing Assistants-Registered (NA/Rs), assist residents or patients with activities of daily living (ADLs) and provide bedside care—including basic nursing procedures—all under the supervision of a Registered Nurse (RN) or Licensed Practical Nurse (LPN) (Meyer).In today's hospitals and extended care facilities a nurse assistant is an important part of a healthcare team that includes many personnel outside of nurses. Nurse assistants are needed to provide routine care so that nurses can provide care that only he/she can perform, as outlined by each state's Nurse Practice Acts, such asformulating care plans, nursing assessments, administering medication, and assisting in surgery room preparation. The nurse assistant must not only be very skilled in the actual procedures being performed but must also be able to observe a patient's condition and report that information back to the nurse. Due to other responsibilities, the nurse cannot spend large amounts of time in the room with the patient so the nurse assistant is often referred to as the nurse's "eyes and ears".          WikipediaMaybe it's just my recent experience, having a difficult time my first weeks on the job, but that entry just sounds so Gee Whiz! Just to be thorough, here are some alternate definitions:1. CNA—"The janitor of the nursing profession." (attributed to Mari W., my friend and classmate in CNA school)2. CNA—The blue collar bedrock supporting the nursing profession. CNA duties: all of the heavy liftingthe bathing and shaving of largely resistant patients/residents (and try bathing or shaving someone who doesn't want it)the dressing and feedingall on a compressed schedule in order to get multiple residents/patients out the door to their daily activities and/or appointments on time, every day. Paid about the same as non-union factory workers, and almost as easily replaced (as certification training only takes several weeks), CNAs can also take the blame for some problems that evolve out of management decisions.And some anthropological observations:Peculiarities of CNA behavior: 1. New CNAs can be found on the verge of tears if not actually crying at least once per workday. 2. Older CNAs normally display a lack of curiosity as to the medical conditions of their charges. 3. The more experience CNAs also show a jaded dislike and distrust of management very similar to the attitude seen in factory workers. 4. Most CNAs in long-term care facilities seem to form special bonds with a select few of their residents. 5. Finally, many CNAs—regardless of how long they have worked at their current location—regularly think of pursuing a different job.Is it all worthwhile? Ask me when my body stops aching and I wade through the miasma of self-doubt and exhaustion back into something that feels human. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=761464 Thu, 26 Jul 2007 04:00:00 +0100 761464 http://iwannabeamalenurse.blogspot.com/2007/07/thought-about-quitting.html yesterday was my second day as a CNA on my own taking care of a team of four residents (not the best phrasing, but i have a severely limited time to write this). i was consistently behind (by 2 hours at some points), i was frustrated, angry thoughts toward the residents flashed into my head (like "just straighten the f**k out so i can roll you without banging your knee" and "why can't you just have a f**king normal body for a minute" or "just stop f**king crying, you baby, i'm doing the best i can"), doubt followed, guilt followed, no time for either. on the first day, i started checking care plans before i clocked in, i finished charting after i checked out, i took my lunch break nearly 2 hours late. my legs hurt, my arms hurt, my left wrist hurts (not on the carpal tunnel side), everything is tired, fatigued, exhausted. i have thought more than once that perhaps i'll quit, and perhaps i'm not suited to nursing after all. i feel horrible especially about getting angry at my residents. i feel horrible also about doing the best i can and still performing so poorly. and i'm so tired. and tonight i have a microbiology test that i haven't studied nearly enough for after missing two classes last week due to sickness. and i'm so tired.and today, i do it all again, hopefully with a lighter team (the team i've had for the past two days was one of the heaviest in the "neighborhood"), hopefully better. we'll see. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=736271 Mon, 16 Jul 2007 04:00:00 +0100 736271 http://iwannabeamalenurse.blogspot.com/2007/06/schedule-changes.html According to Sitemeter, no one read this blog last week. So I'm not necessarily expecting an audience. I do regret having to be nearly absent from blogging these days, though, so I'll take this opportunity to mourn and explain and celebrate the recent changes, for myself and whomever else happens to stop by.Got a job as a CNA at a pediatric nursing facility working with severely developmentally disabled, non-ambulatory, mainly non-speaking kids and adults who have been there since they were kids. Three 6am to 2pm shifts per week. When the regular schedules fall into place next week, that and the 18.5 weekly hours with my current research/writing-for-healthcare-consultants job will make 42.5 hours of regular work in a normal week, on every day but Tuesday, getting up at 3:30am three of those days.The compressed summer semester began. I have Human Growth and Development (adolescence to old age) in the AM T's and Th's and Microbiology M through Th 6 to 9PM. I take my books everywhere and do as much homework as I can on public transportation. I get home to the wife around 9:30 or so, and get to bed between 10:30 and 11.Two freelance projects still need to get done, and I'm going to try to use two rare free hours every other T to babysit, more for the baby contact than the money. I think I can work this all out, timewise.I had an interview for a graduate-entry nursing program in Cleveland last week, and according to an e-mail I received today I have another coming up for a second degree accelerated BSN in Columbus. I have not yet finished the next application on my list, due July 1, and I have not yet heard from two professors whom I asked to write letters of recommendation for me. And there are more applications to get out. When will I find time for all of this? I don't know, but I will.The point is, I'm doing a lot of stuff toward my goal of becoming a nurse/NP. The point is, this might all be way too much in so many ways if I had a few minutes to really think about it. The point is this is all good. The point is, I am so tired. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=675137 Thu, 14 Jun 2007 04:00:00 +0100 675137 http://iwannabeamalenurse.blogspot.com/2007/06/today-is-first-day.html of training for my new CNA job. I'm nervous. I'm working 3 hours at my regular job and then going to the new thing for 5-6-7-8 hours, and going home. My bag weighs 50 pounds, containing everything I need, including my scrubs and nursing shoes, which I will exchange for my business casual stuff ... at some point. I want to have one last cigarette after I leave here, but I don't want to smoke in my scrubs, so maybe I'll change at the Home? I observed (shadowed, really) a veteran CNA Saturday morning and watched him work carefully but aggressively, efficiently, and watched he and the other CNAs and LPNs and RNs there work seamlessly together. How can I fit into that tightly knit group? How can I work up to the expectations that they fulfill?So part of me feels paralyzed and wants to go back home and shut down (I did sleep for 15 hours Saturday/Sunday after my observation). Part of me is afraid I won't fit in, that I won't be up to the job. Part of me doesn't know how I'll be able to balance this with my other (much higher-paying and therefore indispensable) job plus my two classes during this compressed summer semester. And the ghosts of things undone bleed in, unfinished freelance projects, uncompleted nursing school applications, unresolved family issues. It all tumbles together, adding mass and gravity to to the ring of accretion circling the black hole of my psychic situation.Or it may as well by like wet clothes clinging together in the laundry. All I have to do is let them dry, pull them apart, fold them neatly, put them away, pull them out and put them on when it's time.This metaphor is probably closer to reality, and in any case is much more workable. So, breathe, take it one step at a time, and do what needs to be done. And breathe. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=658771 Mon, 04 Jun 2007 04:00:00 +0100 658771 http://iwannabeamalenurse.blogspot.com/2007/06/good-news.html I now have my first CNA job, part-time at a large long-term care facility with an excellent reputation. I'm going in at 6:30AM tomorrow for an "observation" and next week from 1-9PM M-F for the training class. Excited. Nervous. Have to get up at 4:30.With the help of friends and family, I got my UIC transcripts out of hock. I paid my bill just in time to move the surprisingly slow process along and manage to overnight the transcripts to Case Western Reserve University by June 1. (oh, that's today!)Once I order the UIC transcripts for Mount Carmel College of Nursing, my application will be complete for their Second Degree Accelerated BSN program. Then, I finish the app for Rush University. Then, on and on and on and on until ... (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=650794 Fri, 01 Jun 2007 04:00:00 +0100 650794 http://iwannabeamalenurse.blogspot.com/2007/05/postexam-thoughts.html Right now (or "right several minutes ago"), of the top 20 hits for "nursing assistant" and variations on Google News sorted by date, in 11 (55%) the term is a strong positive element: essential in its professional capacity; an indicator of character in top students and in the backgrounds of historical heroines and community leaders; Three of the top 20 hits (15%) are about nursing assistants behaving badly: suspicion of rape, stealing drugs and drinking on the job, their certifications in jeopardy for a variety of offenses.This is what I'm thinking about this evening, a few hours after I took the Illinois Nurse Aide Training Competency Evaluation written exam (the last hurdle). It was fairly easy, mostly. There was a sizeable chunk of questions on subjects I don't remember learning, and some the were poorly or confusingly worded (or cleverly worded trick questions, depending on how smart one thinks the test writers were). For the most part, it was more about practical applications of general knowledge of nursing assistant's role and place in the hierarchy. I'll be really surprised if I don't pass. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=623398 Fri, 18 May 2007 04:00:00 +0100 623398 http://iwannabeamalenurse.blogspot.com/2007/05/its-that-last-stage-4-decubitis-ulcer.html This is long past due, and I can't really say it's the first opportunity I've had to finish writing this account of my last CNA clinical. But it's important enough that I need to get it out there. Aside from being an important experience in my clinical education, this was the only time I came away from the nursing home with something other than utter demoralization.I spent most of the time with a largely aphasic, bedridden, elderly Russian man (we'll call him Mr. B) with contracted arms and legs, restraint mitts on both hands, an IV, a Foley catheter, and a stage 4 bedsore on his tailbone. He spoke little English (the only word he spoke that I could understand was Finish, indicating that he was done with his lunch), and unlike the last time I was with him, two weeks prior, he spoke almost not at all, even in Russian.I didn't know (or if I had heard about it some previous week, I didn't remember) about the bedsore until I was changing his adult diaper and saw that the ulcer's dressing was nearly off. Maybe there's no good time to see a stage 4 pressure ulcer, but while wiping bacteria-laden feces in close proximity to the ulcer has to be one of the worst possible times. In addition to this, I now for the first time saw that Mr. B knew how to take off his restraint mitts (placed on his hands after he had pulled out his G tube and nearly pulled out his Foley catheter) using his teeth. So now, feces, open wound, possible pulling out of tubes. Not good.After a short period of figuring whether I could handle the situation myself, I decided to seek help. Before I left the room I spoke to Mr. B (who could not understand me, but I spoke to him nevertheless) and made sure his position, tubes, bed, room, were all generally safe. I found a CNA who brought me to the LPN—a Russian man about my age—who was making the rounds for dressing changes, etc.The LPN was not pleased that I had begun changing the diaper before he had tended to the wound, but he remained calm and didn't seem to feel any extra urgency. When he arrived in Mr. B's room, he talked to me about my education, my career plans, and Mr. B's condition as he methodically went about cleaning the area and redressing the ulcer—it looked like a gaping red mouth with areas of white, necrotized tissue. All the way down into the muscle and the bone. I didn't see the bone, hiding as it was behind the flesh, but the LPN invited me to put a gloved hand inside to feel it. (There is no pain, he said with his Russian accent, There are no nerves left.) Underneath the relatively soft cheeks or tongue of the mouth, a tooth, a broken bone. Mr. B didn't flinch.Changed sheets and diaper twice, at least; always just as we were halfway done, Mr. B began another bowel movement. We just kept up with it. After the LPN left to finish his rounds, I stayed with Mr. B for a few minutes to make sure he was safe and comfortable. I talked and gestured to Mr. B about the importance of not taking the mitts off, but he didn't care. Aside from removing medical apparati that he didn't enjoy, Mr. B (like many elderly residents I've seen) ran his fingers over everything, as though it were a compulsion. It looked like he was reading the world around him, rubbing the edges of the sheets and feel the CNA's hand. That was two weeks ago, but now this form of communication and exploration was denied him.It was going to be a short day; after the residents' lunch, we were done with our final clinical. The LPN had put tape on Mr. B's restraints to prevent him taking them off, and I had informed the CNA that the tape wasn't holding. There was no more I could do. I had learned a little more about the realities of feeding, positioning, and keeping clean residents who can do little for themselves; about the lethargy and silence that can come with debilitation and despair; about gaping red mouths with teeth on old men's tailbones. I had talked to Mr. B, asked him questions, tried to joked with him, knowing that he couldn't understand; I had touched his arm and looked into his pale blue eyes.As I got ready to leave the room, I placed the call light on the corner of his bed and pointed it out to him. I said that if he needed anything, he could press the button with his mouth, the same way he gets his mitts off. And he smiled, for the first time that day. I'm not sure why, since he couldn't understand what I said, and couldn't be laughing at my little joke. But anyway, I felt something as we shared that smile, like I had done my best and made some good decisions and made a real connection with an old man who needed a real connection, even more than I did. And I almost wanted to stay. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=611824 Fri, 11 May 2007 04:00:00 +0100 611824 http://iwannabeamalenurse.blogspot.com/2007/05/need-nurse-here-update.html With the rejection from UIC and the graduation from the CNA course at Truman, I find myself in one of those transition periods planning formally to apply to various nursing schools, following up with the single application I've sent so far (Case Western Reserve University's graduate-entry program), informally planning to apply for a part-time job as a CNA, trying to get unstuck financially ($1400 owed to UIC to get my transcripts out of hock, $625 for summer classes at Truman [minimum $250 to finalize registration before someone else grabs the classes, payment only online and with any credit card except Visa—which (A) doesn't make any sense at all, as everyone takes Visa, and (B) rules out the only viable credit card I have right now, which means that I need to go to the bank today and hope they'll do a cash transfer, then I can try again, only spending 2-3 hours extra of my valuable time, but I'm not complaining, just frustrated ... well, OK, I'm complaining a little], trying to keep up with regular part-time healthcare-consultant researcher/writer work, catch up on freelance political researcher/writer work, sell CDs for cash to spend on my wife and my first anniversary this weekend, study for the CNA competency exam that I'll take a week from Friday, speed up the process of looking for a CNA job, deal with the fact that I may have to move to a different city for nursing school as early as this August but then again I might not get accepted into any of these schools, but at any rate I have to do whatever I'm going to do while balancing several jobs and a daughter who's grown up to the point where she wants to spend more of her summer in Michigan with her friends and less of her summer with her father in Chicago and remaining sane and sober ...What was I saying? Anyway, stepping through and believing the ground won't open up and swallow me, it's "A Matter Of Confidence," yes ... Where are you when I need you, Betsy Crane?It has been a long time since I've posted here, and I apologize. I will do better. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=599743 Tue, 08 May 2007 04:00:00 +0100 599743 http://iwannabeamalenurse.blogspot.com/2007/04/letters-and-mnemonics-and-final-exams.html My final exam for the CNA course is tomorrow morning, and my final clinical and skills test is Sunday. I've been going over the skills and practicing some of them on my wife. For the academic stuff, there are many many lists to know, and I'm using mnemonic (memory) devices. Some are pretty common, like the acronym for recognizing signs of cancer:CChange in bowel or bladder habitsAA sore that does not healUUnusual bleeding or dischargeTThickening or lump in the breast, testicles, or any other body partIIndigestion or difficulty swallowing (dysphagia)OObvious change in wart, mole, or other skin conditionNNagging cough or hoarsenessBut my favorite are sentences in which each word begins with the first letter of each item on the list. Like this one:Questions about PainFFrequencyFFrequentlyAAlleviate or Aggravate, things thatAAskedQQualityQQuestion:DDurationDDidLLocationLLincoln'sRRadiationRRashIIntensityIImproveVVariation of patternsVVascularCCharacterCCirculationOOnsetOOr ... ?These tables are a serious pain in the ass to put together right now. I'm not going to write anymore tables, but I will tell you my mnemonic sentences for two more big CNA lists. If you're really bored, you can even try to decode what these sentences are supposed to help me remember.(for what we call "Beginning Procedure Actions")HelpElvisKickIVPainkillers!ElvisAims toRemainVeryDocile.(for what we call "Procedure Completion Actions")"PeanutButterSoundsSuper!" theColonelProclaimed toElvis.HeReplied,"VeryDelicious!"Wish me luck on the test! (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=542585 Fri, 13 Apr 2007 04:00:00 +0100 542585 http://iwannabeamalenurse.blogspot.com/2007/03/disappointing-news.html Monday, I learned that I will not be moving to the next level in the admissions process for UIC's GEP. They declined to have me in for an interview. So no waiting list this year, and no nothing better. I'm sad, let down, grieving about this.The plan: to take some time off of scrambling to push into the nursing/NP thing, concentrate on finishing up CNA, work, figure out what I want to do next and when. There are several paths to the final destination. The only one that's barred for now is the fast track.Maybe like my wife says, I'm not a "fast track" kind of guy. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=508222 Wed, 28 Mar 2007 04:00:00 +0100 508222 http://iwannabeamalenurse.blogspot.com/2007/03/dnr.html In the nursing home, on the utmost skilled care floor of the whole facility, the worst part is when it's time for break. When I'm working, I barely hold on. When it stops, I never want to go back. I feel demoralized. I feel like hiding. I feel nothing. I will almost definitely commit suicide before I let myself get that old.But other than that, clinicals have gone fine. The bathing; the feeding in between howls in Russian or Yiddish or something; the showering the mean little Russian man who yells at me and complains about me in words that are hidden from me, as I try to calm him in words that are hidden from him; the changing the C. diff diaper on the very nice old lady; the learning not to get jerked around by the partially able who wants to be disabled, and then not to feel guilty about not letting myself get jerked around; these are all fine things.I really need to learn some Russian, with audio and everything, for free, and only the words and phrases I want to know. I really need to find a way to climb back out of hell. I really need to never work in a nursing home as long as I live.They're good people, most of them; even the mean little Russian and the howler can't be understood as the superficial glimpses we get of them now. That is, they can be understood as more then what we know right now. Yes? Even the wheedler who tries to get everyone to do his shit for him, he's not a bad guy. But none of them are getting out of there. This is the last stop before death. Some of them may as well be dead already. Some of them don't even know where they are. Wouldn't it be more humane to ... Wait. Swallow that. Let it go.I may quit before the next two weeks is up. I won't, but as long as I hold it open as a possibility (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=500374 Sun, 25 Mar 2007 04:00:00 +0100 500374 http://iwannabeamalenurse.blogspot.com/2007/03/dread.html Do CNA/nursing students and new CNAs/nurses often feela surge of dreador at least fearor maybe loss of confidenceright beforegoing to work/clinicalswalking into the hospital/nursing homewalking into a patient's room?This condition would present with symptoms includingsudden but predictable onsetsensation of falling, felt as a rising of or "butterflies" in the stomachstiffness and/or weakness of the lower limbspalmar hyperhidrosiscognitive impairmentusually short-term duration—symptoms lift as action is taken, e.g., entering the hospital or the patient's room, and often return when stimulus is encountered againWhen I experience this, I imagine that no other students, CNAs, or nurses feel like this, and I doubt my fitness for this career track. And then I judge that I'm being a little melodramatic. And then I imagine that all other students, CNAs, and nurses feel or have felt this dread before. And then I think maybe that's just a comforting rationalization.So, having to do a makeup clinical at the nursing home tomorrow, and my regular clinical on Sunday, and beginning to feel the Dread a little early, intermittently, when I think about it, I really want to knowDo other people have this condition?Does it ever stop?When does it stop?If it doesn't stop, what do you do? (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=492466 Thu, 22 Mar 2007 04:00:00 +0100 492466 http://iwannabeamalenurse.blogspot.com/2007/03/notes-on-vernal-equinox.html It is my 36th birthday today, on the Vernal Equinox, the "new year" mark of the Zodiac, the meeting point between the sad, dreamy fish and the heedless, feisty ram.I just had my scrubs bottoms shortened so I wouldn't step on them when they slide down from my waist (because they're too big, see--but i got a discount if i bought them from this guy who had made a deal with the school, and his merchandise and customer service skills are both maybe a little shaky, so maybe i didn't get the best scrubs).Now, about clinicals on the third week. I was scared, nervous, late, almost decided to turn back around and go home. But I made it there. My patient had had a severe stroke, and was a little heavy. He spoke only Greek. I turned him and bathed him and changed his bed, with help from a classmate. His son and wife were there most of the time, and I stopped in to see if there was anything they wanted or needed a few times, talked to them and listened to them. I conferred with my patient's CNA and emptied Foley bags with her. I helped a PT transfer a woman with dementia from bed to chair. I answered about 5 call lights.(A) This was all good. So much better than the Sunday before.(B) This was so nothing like the classroom. 250-pound stroke patients who can't communicate in English are nothing like healthy 20-, 30-, 40something CNA students pretending to be patients in a CNA lab. PTs don't necessarily know how to use a gait belt correctly or effectively.(C) But empathizing, and doing what one can, and listening to stories. And learning to be OK with not being perfect, and to learn, and to pick up and go on. These are good things.This past Sunday's clinicals were cancelled, so I'm making up on Friday with a different group, my first time at the nursing home. So, clinicals Friday, class and lab Saturday, clinicals again Sunday. To me, a heavy schedule, but to you nursing students (not to mention the nurses), a break, I think.So, on the Vernal Equinox, on my birthday, things are fairly even. And this is a good thing, too. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=485141 Tue, 20 Mar 2007 04:00:00 +0100 485141 http://iwannabeamalenurse.blogspot.com/2007/03/thanks-note-to-self.html I will blog about my better experience at this Sunday's clinicals as soon as I have a chance.In the meantime, I wanted to thank Mediblogopathy for this old post. (Not that I think it was posted especially for me, but that it happened to be exactly what I needed to read at that moment, when I discovered it earlier this week.)My next project on the Get-To-It-When-I-Can pile is "How do you keep from burning out?" which I know people have blogged about in the past, which I know I'll need to know soon. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=475014 Wed, 14 Mar 2007 04:00:00 +0100 475014 http://iwannabeamalenurse.blogspot.com/2007/03/clinical-depression.html I have been beating myself up all week about my second CNA clinical, and I'm dreading doing it again this weekend.The deal was, we were each assigned a patient and we were to perform as many procedures as needed (bath, mouth care, transfer, etc.) for that patient. Staff CNAs assigned to each patient could give as much or as little (or none at all) supervision and assistance as they saw fit.Patients represented a wide range of ability, from nearly independent to utterly dependent. My patient was nearly independent: could stand without help; go to the bathroom, walk, bathe with minimal assistance; he didn't sleep in his bed (hadn't slept in a bed in 20 years), so not even the bed really needed to be made (but I made it anyway). I gave him company and conversation. Not too bad at that, anyway.I don't know if it was poor organization, miscommunication, or something else, but I had pretty much no CNA and very little guidance from anyone else, including my instructor. For all practical purposes, the only one who told me what was up with my patient was my patient. And he was sketchy on some of the details of his schedule.Had I been a little more more proactive, however ... I may have found someone who could tell me at what time I was to assist the patient to the sink to wash up, etc. Found out much later that that was part of morning care ... I could have helped the guy was his back and simple things like that, even without supervision or assistance, if I had only known when these things were normally done ... Or are those details so obvious that I should've known?Meanwhile, my classmates were being led through a dozen procedures by more active CNAs, were bathing and changing beds for much more challenging patients, assisting with the postmortem care of a patient who died while they were in the room.I felt useless. I wanted to do something. So after lunch I went to see what my classmates in the other hall were up to. They were performing mouth care for a patient with a severe stroke, and preparing to feed him. This man could not move his body, could barely move his arms or his face, could not speak, had trouble swallowing.After trying unsuccessfully to convince the man to take a second bite of soft food (the first bite having stayed in his mouth, what with the dysphagia and all), one of my classmates asked me if I'd like to try. So I stepped up to the plate eager to finally do something! and proceeded to negotiate with the old man a dozen different ways, even at one point early on asking him to open up and let me see if he'd swallowed the earlier spoonful, offering to assist by putting a hand on his lower jaw and "encouraging" him with some gentle pressure.Later, this is one of the images that would replay over and over in my head. Didn't I realize how humiliating that must have been for him? Didn't I remember that the patient's decision to eat or not to eat is to be respected?This last was brought back to me as the patient's CNA and the head of my CNA program called to me from outside in the hallway, told me to stop.Meanwhile, my application for the Mental Health NP track in UIC's Graduate Entry Program for 2008 is in and has been received. And the application process has begun for another 2-year RN program. But there are so many things here, some more than others, that are so much less than what I thought I was bringing into nursing. Maybe I'm not cut out for it. I mean, if I can't handle a simple day like that ... (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465018 Fri, 09 Mar 2007 05:00:00 +0100 465018 http://iwannabeamalenurse.blogspot.com/2007/02/first-cna-clinical.html So, yesterday was the first clinical. We're doing 4 Sundays at a hospital and another 3 at a nursing home, each for about 8 hours per shift. We're on the extended care wing (not sure if that's the official name) of the hospital, mainly elderly patients, but some younger. Today was an easy day, orientation, very little patient contact, but still a little emotionally exhausting for me.The day started a little late, out the door at 6:05am instead of 6am, because I was on the porch smoking in my pajamas, not wanting to smoke in my scrubs and not wanting to take my tobacco with me. Wet snow had fallen all night and mixed with the city grime and salt.Although I wore my boots and carried my shoes (white K-Swiss sneakers my wife found on sale at Marshalls), I could not find my sweats, so the dirty slush spattered my white scrub bottoms. I misplaced my bus, having never taken it before, but took the option of the southbound L Train to connect with another bus. Unfortunately, I mistook west for east, or vice versa, and waited an extra 12 minutes for a bus going the wrong direction (but only for a few blocks, until the end of the route, and then it turned around). The bus dropped me off on the corner a few minutes after my clinical instructor was to take us from the lobby to our assigned wing, and I still had half a mile to trudge through more slush. It all worked out fairly well when I arrived at the hospital, but the journey had been less than ideal.We chose partners (but didn't do any real partner-type stuff) and were assigned patients. Most of us were nervous. I think maybe I'm more of a natural at bedside manner than other aspects of the job, and a big part of me loves one-on-one interaction, so I really enjoyed the focus on communicating with the patient. Next Sunday, we bathe patients and make beds and many other things. I'm very slow at bedmaking, and I've never bathed an adult before, so I'm nervous. But I'll just take a deep breath, go do the job, and ask for help when I need it.Biggest mistake of the day: While feeding one of the nonagenerians, who was seated in a chair by her bed, I sat on the bed. I wanted to be on her level, and probably more importantly, it was uncomfortable bending to talk to her and put the spoon in her mouth. I didn't think about contamination and making more wrinkles in the linen, not really, not until my clinical instructor gestured wildly to me from the hallway. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465019 Mon, 26 Feb 2007 05:00:00 +0100 465019 http://iwannabeamalenurse.blogspot.com/2007/02/two-more-childhood-psych-disorders-join.html ... and what does this mean, and what do nurses do with this information?Childhood Neuropsychiatric Disorders on the Rise© 2004-7 MedPage Today, LLCAARHUS, Denmark, Feb. 5 -- Four common neuropsychiatric disorders of childhood appear on the rise, with Tourette's syndrome, and hyperkinetic disorder joining autism and autism spectrum disorder, researchers here reported. ...As a wannabe/future pediatric psych RN/NP, this news strikes me on several different levels. First, I want to research all of these disorders, the etiologies, the signs and symptoms, the progressions, the complications, the treatments, the prognoses. (Of course I do. It would be stupid not to.)Second, what does this increase (or is it "increase") mean? Have the diagnostic criteria or the subjective diagnoses of these disorders broadened to encompass more degrees of associated behaviors? Or do more kids really develop these disorders? Are all of these "disorders" really disorders? "Hyperkinetic disorder" seems to me (on skimming through a few titles and first paragraphs—not exactly thorough research) more of a parenting deficit than an actual neuropsych disorder. One web page I quickly skimmed claims that 0.1% of children in the UK have been diagnosed with hyperkinetic disorder, compared to 5% of American kids. It lists such shocking signs and symptoms as restlessness, poor concentration, impulsiveness, possibly disobedience in more advanced stages. Apparently, more than a few of the kids I hung around with in high school had hyperkinetic disorder. Or maybe it was that our home life sucked and our public school was more of a holding pen than a bastion of education and development. (OK, that's a little flip. I do think the child's environment and upbringing plays a big role in that disorder, though.)Finally, I'm very interested in learning exactly what the nurse's role is in treating children and adolescents with these disorders. I have no preconceived ideas (nothing I've invested in or am holding on to, anyway). I have no knowledge. But this is the field in which I want to work, whenever and however I get there. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465020 Sun, 18 Feb 2007 05:00:00 +0100 465020 http://iwannabeamalenurse.blogspot.com/2007/02/walt-whitman-male-nurse.html The pictures combined on the right come from the American Treasures Exhibition, Library of Congress: Wound Dresser web page. The picture below that is from the American Treasures Exhibition, Library of Congress: Wound Dresser, which at times is frustrating—loading some material slow, not loading at all from some links, just cycling endlessly. Anyway ...I really don't care too much about the "male" part of "male nurse." I am interested in where the term came from and the gendered ways it's been used and how often men performing nursing tasks in, say, the 19th century were referred to as nurses versus something like "medical assistants." I don't know these things, so I can't tell you the answers.I do know, however, that my personal Patron Saint of Openness Walt Whitman was a volunteer nurse for the Union army during the War Between the States, and that he referred to himself specifically as a nurse. Whitman also had a series of male nurses take care of him as he grew older, and he called them nurses, and they called themselves nurses.The verb "to nurse" has obvious connections to the feminine (which is not necessarily tethered to the female, no matter what anyone says). In psychological terms, it's about a sort of nongendered mothering—caretaking that requires compassion and contact with all physical parts and processes, as well as courage and detachment and endurance. That's what Whitman's poem "The Dresser" (later renamed "The Wound-Dresser")—written about his experiences as a nurse—calls up for me. That's why I want to keep it around, and to share it. Let me know what you think.from "The Dresser"* * * * * * * *3Bearing the bandages, water and sponge, Straight and swift to my wounded I go, Where they lie on the ground, after the battle brought in; Where their priceless blood reddens the grass, the ground;Or to the rows of the hospital tent, or under the roof'd hospital; To the long rows of cots, up and down, each side, I return; To each and all, one after another, I draw near—not one do I miss; An attendant follows, holding a tray—he carries a refuse pail, Soon to be fill'd with clotted rags and blood, emptied and fill'd again. I onward go, I stop, With hinged knees and steady hand, to dress wounds; I am firm with each—the pangs are sharp, yet unavoidable; One turns to me his appealing eyes—(poor boy! I never knew you, Yet I think I could not refuse this moment to die for you, if that would save you.) 4On, on I go!—(open doors of time! open hospital doors!) The crush'd head I dress, (poor crazed hand, tear not the bandage away;) The neck of the cavalry-man, with the bullet through and through, I examine; Hard the breathing rattles, quite glazed already the eye, yet life struggles hard; (Come, sweet death! be persuaded, O beautiful death!In mercy come quickly.) From the stump of the arm, the amputated hand, I undo the clotted lint, remove the slough, wash off the matter and blood; Back on his pillow the soldier bends, with curv'd neck, and side-falling head; His eyes are closed, his face is pale, (he dares not look on the bloody stump,And has not yet look'd on it.) I dress a wound in the side, deep, deep; But a day or two more—for see, the frame all wasted already, and sinking, And the yellow-blue countenance see. I dress the perforated shoulder, the foot with the bullet wound,Cleanse the one with a gnawing and putrid gangrene, so sickening, so offensive, While the attendant stands behind aside me, holding the tray and pail. I am faithful, I do not give out; The fractur'd thigh, the knee, the wound in the abdomen, These and more I dress with impassive hand—(yet deep in my breast a fire, a burning flame.) 5Thus in silence, in dreams' projections, Returning, resuming, I thread my way through the hospitals; The hurt and wounded I pacify with soothing hand, I sit by the restless all the dark night ... (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465021 Fri, 09 Feb 2007 05:00:00 +0100 465021 http://iwannabeamalenurse.blogspot.com/2007/02/smoke-em-if-ya-got-em-and-then-what.html I've heard that significant number of nurses (although not a majority) smoke cigarettes. Anecdotal and vague. After searching on the Internet for half an hour, the only relatively recent and relatively relevant figures I could find wereSurvey results revealed that 13.5 percent of nursing students smoked cigarettes, as compared to 3.3 percent of medical students. In addition, 17.4 percent of nursing students and 9.8 percent of medical students considered themselves former smokers.Smoking more common among nursing than medical students, 14 Oct 2003Why do I want to know about this? Well, I'm a smoker, and clinicals for my CNA course start in a little more than 2 weeks. What I really wanted to find was some advice on how not to smell like smoke (potentially upsetting or irritating my patients) after a quick, surreptitious smoke break while on the clock. Nothing. Mostly nothing. Nothing useful. Almost everything that comes up wants to help you quit smoking.See, I know smoking is bad for me. Breathing in any kind of smoke is bad for anyone. Duh. And the particular chemicals in cigarette smoke can be pathogenic. I know that. But I only smoke like 5 cigarettes a day, and I smoke for the same reason I started smoking at 17—to manage mental and emotional stress. I don't really want to give it up yet. The mental and emotional stress is still there, and I've already had to give up other coping mechanisms.Now, I'm trying to cut down to an average of 2 or 3 per day, with the focus on not smoking at all during nurse-type work. In the meantime, if anyone has any advice other than "Quit smoking," I'd love to hear from you. Thanks! (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465022 Wed, 07 Feb 2007 05:00:00 +0100 465022 http://iwannabeamalenurse.blogspot.com/2007/01/cna-begins.html I have now begun my Certified Nursing Assistant course on the weekends. Although I'm a little (or more) disappointed that I didn't make it into the Graduate Entry Program at UIC, this is probably what I need to do right now. My aptitude for practical, hands-on tasks is pretty weak; at the very least the CNA labs and clinicals will give me some practice and challenge me to let my fears and insecurities hang while I approach each patient with confidence, compassion, and attention. Great training for the next steps toward my career.At this point, I ...have the top and bottom of my uniform, a stethoscope, and a sphygmomanometerdo not have my shoes (thinking of getting a pair of Jasco nursing shoes ... are they any good?)am certified to perform CPR (but if I actually have to do it in a real emergency at this point, I'm not sure it would turn out well)have completed my physical (no TB, shots up to date, 23 pounds overweight with high triglycerides, but generally OK)can wash my hands correctly, but suck at making bedsam behind in my homework and have a test on Saturday (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465023 Thu, 25 Jan 2007 05:00:00 +0100 465023 http://iwannabeamalenurse.blogspot.com/2007/01/what-i-did-on-my-holiday-vacation-or.html I know, it's been over a month since I last posted, and I'm sure some of the folks who used to check for new posts here have given up. My educational future is still up in the air, so it's more difficult to focus on the wanna-be nursing blog.Here's the scoop:I spoke to the admissions director of the Graduate Entry Program at UIC and clarified my situation for this semester and for the program next year. Basically, if a Peds NP student does not drop out by Jan. 11, I'm not going to be in the program this year. In that case, I'm going to do two things:I will reapply for next year, improving my application package, declaring Mental Health NP (generally less competitive than Peds and just as conducive to my goal of being a Peds Psych NP).If possible, I'm taking the semester-long CNA course at the city college. At least I can start working after the semester's over, get some clinical experience and exposure to the terminology and tools of nursing, and open myself to a few opportunities. I know of one accelerated BSN program that requires a CNA and one BSN program that gives CNAs a full ride in exchange for working in the university's hospitals.Oh! I've also begun to collect comic books about nurses! I've won four on eBay already, all from the 1960s: 2 issues of Gold Key's "The Nurses," one of Charlton's "Sue and Sally Smith, Flying Nurses," and two of Charlton's "Nurse Betsy Crane." More on all that later.Happy 2007, everyone! (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465024 Sat, 06 Jan 2007 05:00:00 +0100 465024 http://iwannabeamalenurse.blogspot.com/2006/12/overdue-update.html It's been more than a month since I posted, so I need to do that.This weekend, I'm studying for finals in Chemistry (a prereq for several BSN programs) and Research Methods in Psychology (the last prereq for UIC's Graduate Entry Program in Nursing). I have a good chance at A's in both courses.I am still on the waitlist (#1) for the PNP GEP. Classes start in that program on Jan. 8, I think, and a spot could open anytime until the end of that day. So, I have spoken with UIC's financial aid counselor for the College of Nursing, and student loan packages are in place that cover everything, and assuming all the paperwork on my end is ready to go, it would take only a few days from the day I was accepted until the tuition was covered and the remainder of the loan was deposited in my account. I also had a conversation with my boss yesterday, and if I leave for this program with no notice, we still part on good terms; if I don't get in to the program, I still have a part-time job there. This is all good.My biggest worry if I do get in is paying my outstanding balance for this semester at UIC (for the one class I'm taking at UIC). I have not been able to afford to pay it down, and technically the class doesn't count until it's paid for. So, technically I won't have fulfilled the prereqs until I pay for this class.But there is time, and I've done a fair amount of troubleshooting already. Everything will be all right. Anyway, if I don't get in, my plan is to apply again, get a CNA in the meantime, get some clinical experience and maybe a full-time job.I will try to post more often and catch up with some of my favorite blogs in the coming weeks. Who knows how busy I'll be next semester. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465025 Fri, 08 Dec 2006 05:00:00 +0100 465025 http://iwannabeamalenurse.blogspot.com/2006/10/some-thoughts-on-childhood.html The following childhood schizophrenia symptom scale is from the 1988 book Childhood Schizophrenia by Sheila Cantor, MD. Since I'm considering going into Pediatric Psych Nursing, I wanted to find out more about some of the patients for whom I might be caring.One thing that strikes me about this book (very thorough – examines physical characteristics, perinatal difficulties, etc., etc., in addition to the accepted symptoms) is how much everything lies on a continuum. In every mental disorder, there is a range of severity, from high-functioning to low- (or even non-)functioning. Schizophrenia as a class of mental disorder seems to be related substantively to autism. Conduct disorders in childhood and adolescence seem to precede adult schizophrenia. Some physical characteristics common among childhood schizophrenics show up in non-schizophrenics with and without other behavioral or developmental disorders. It makes me wonder about the biological root of the disorder – which dysfunctional or absent protein leads to what symptoms, or what combinations, and what determines the severity of symptoms.Something particularly interesting in my reaction to the book is that I began to see different degrees of different symptoms in myself and my daughter, and to imagine "getting in the head" of a childhood schizophrenic patient. It seems to me that empathy and communication are prerequisite to helping the patients learn to cope with mental disorders. And perhaps I have some facility for communicating with mentally ill children. Which – and I don't know if this will sound totally weird, or if anyone gets it – I think is really kind of cool.Childhood schizophrenia symptom scale[X]Weighted score (circle if present)Flat or severely constricted affect (excluding anxiety)*_____5Perseveration*_____5Good eye contact when communicating needs_____5Inappropriate affect (episodic giggling or crying)*_____4High anxiety (intermittent)_____4Fragmentation of thought*_____4Hypersensitivity_____4Monotonous speech or bradylalia_____3Loose association (derailment)*_____3Neologisms_____2Echolalia or delayed echolalia_____2Illogicality*_____2Mannerisms (usually noise)_____2Grimace*_____2Perplexity_____2Autism (preoccupation with inner stimuli)_____2Clang associations_____1Incoherence_____1Raw score_____Weighted score_____Associated symptoms   Poverty of speech _____Paranoia _____   Poverty of content of speech _____Delusions _____   Ambivalence _____Hallucinations _____Note: Asterisks (*) indicate core symptoms. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465026 Tue, 24 Oct 2006 04:00:00 +0100 465026 http://iwannabeamalenurse.blogspot.com/2006/10/news.html I've been absent from this blog (and pretty much all of my blogs) for a while (more than 2 months), and I miss them, and I miss interacting with the other blog nurses and nursing students out there. Thanks to those who have left comments enquiring and encouraging. I only have a few minutes to post something here, but I wanted to sayI am now #1 on the waiting list for the U of Illinois at Chicago Graduate Entry Program for Pediatric Nurse PractitionerI'm not sure if I want a "." or a "!" there at the end. Chances are still somewhat slim, and I may not know until December, at which point I'd really have to scramble to secure funding. I'm preparing to look for funding in the meantime. Due to the nature of the first part of the program (everyone already has a bachelors degree in something, we spend 15 months getting caught up and prepping for the NCLEX, we will earn no degree in those 15 months), most of the normal funding sources aren't available. And then, it'll throw a lot of my current life logistics out the window. Change always does that.Anyway, right now, I'm taking my last prereq for this program (Research Methods in Psychology) and a prereq for other nursing programs that I'm considering (General Chemistry) and doing well in both of them. I'm still working, being a long-distance father to my daughter (who will be 14 on Friday), being happily married, and obsessing over the time I don't have for a million little personal projects.Hope you're all doing well too. Hopefully, I'll get some time to read your blogs soon. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465029 Tue, 10 Oct 2006 04:00:00 +0100 465029 http://iwannabeamalenurse.blogspot.com/2006/08/lost-in-translation.html Cuddled my hydrocephalic boy again today, and I saw a sign in his room that saidDo you primarily speak Spanish and you need a Spanish interpreter?and then it went on to explain that the hospital is committed to cultural diversity, and to inform the patient's parent how to access the hospital's interpreting services.This was all in English.It wouldn't be a problem for my hydrocephalic boy's parents. Their first language is Arabic – not Spanish.I guess the hospital figures if the parent reads the note slowly and loudly enough, they'll understand it. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465030 Tue, 01 Aug 2006 04:00:00 +0100 465030 http://iwannabeamalenurse.blogspot.com/2006/07/last-weeks-babies.html My blogging has really slipped. At the least, I'm going to try to post weekly notes about the babies I cuddle at Comer Children's Hospital. These two are from last week:The first was nearly three months old, but tiny. Her larger and healthier twin brother had already gone home, and she was being prepared for a four-month treatment for her disorder, to the details of which I was not privy. All I know is that she was fragile and fussy – less fussy when cuddled. She needed the attention and the warmth. Periodically, she would freeze up, stop sucking on her pacifier, unable to do anything but shiver, as though there was a frayed connection in her nervous system. I hope the treatment works.My second was a boy with congenital hydrocephalus. I was a little hesitant to cuddle him until I found his nurse and asked if there were any special instructions or needs. She advised me just to give extra support to his neck, but later on he became agitated when I had held him in the same horizontal position for too long. The pressure on his brain builds up, the nurse said, and he needs his position to be changed, to be carefully brought near-upright. Next time, then, I'll do a little better.The hydrocephalic condition is interesting, though, so I've done a little research on it. Apparently, the cerebrospinal fluid (CSF) doesn't circulate and drain properly from the ventricles of the brain, and so builds up in the ventricles (see illustration at right), putting tremendous pressure on the brain. If the bones of the skull have not yet fused, the bones can be pushed out at different rates, making the head abnormally large and malformed, as well as vulnerable. That was the case with the baby in the picture above, and it was the case with the baby I cuddled last Tuesday. To treat this condition, a pediatric neurosurgeon must place a shunt in the brain to drain the CSF into another body cavity, usually the abdominal cavity. The usual risks of infection following surgery apply, along with risks that vary with the cause of a particular case of hydrocephalus. I believe I read, though, that the prognosis for a long and healthy life is about 50%. I hope my baby is in the better half of that statistic.More InformationHydrocephalus Foundation, Inc. (HyFI): "Facts"Hydrocephalus AssociationColumbia University Medical College: "Pediatric Neurosurgery – Hydrocephalus"CNN.com Health Library: "Hydrocephalus"OSF Healthcare: "Brain/Mental Health/Nervous System" (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465031 Tue, 25 Jul 2006 04:00:00 +0100 465031 http://iwannabeamalenurse.blogspot.com/2006/07/practicing-principles-of-nursing.html I need to "move into the role" of nurse, a trusted person has told me, whether or not the role moves toward me in the way I thought it would. Although I'm not giving up hope on UIC, it's sort of painful to limit myself to (A) following up on UIC and (B) making various Plans B that won't come to fruition for months. I need something more immediate. How do I begin to "move into this role" now, and feel like I'm doing something?One obvious step is to save up money and explore options for loans so I can afford to pay for tuition and books and things. Again, however, the goal of raising $1,000-plus so that I can take my last pre-req – just in case I get into the UIC program – seems too large, and for a purpose that seems too contingent.So, I've tried to come up with a list (with a little help from the Qualities of Nursing list from the Rochester Community and Technical College in Rochester, Minnesota) of personal qualities that I have, that I need to practice and develop, that I think are essential to nursing. The definitions are mine, although in many cases they represent the adoption, adaptation, or synthesis of existing definitions. The links lead to documents or websites with suggestions on developing these qualities in the course of daily life, resources to explore the concept further, or information to help better understand the concept in the context of nursing.CompassionRegardless of what brings them to the hospital or clinic, regardless of appearance, origin, religion, beliefs, gender, orientation, etc., healthcare providers are ethically bound to treat all patients. Developing a greater capacity for compassion in all cases is essential to my future in nursing. On a daily basis, I work on this by not hating everyone I see on my morning walk to work, trying to stop myself from being automatically judgmental by imagining the difficulties others might have had to face. It's not about excusing bad behavior or choices, but being mentally and emotionally prepared to give everyone an equal right to exist, and eventually an equal opportunity for my healthcare services. (See 9 Ways to Develop Compassion from Nancy Watters & Associates in Vancouver Island, Canada.)Mindfulness and ResponsivenessThese two concepts seem necessary to each other, so I'm lumping them together.Mindfulness is a Buddhist concept that basically means being fully aware of and engaged with one's present moment and immediate surroundings. Responsiveness is a way of engaging by answering the needs of people or situations with one's positive attributes. It is assertion instead of aggression, confidence instead of fear-based attack, proactive instead of reactive. The opposite of responsiveness is reaction, a protective lashing out that answers another's flaws with one's own. (See 10 simple ways you can practice mindfulness each day from the Mind Body Medical Institute in Massachusetts.)ResilienceResilience is the ability to pick oneself up and keep going through changes and traumatic events. There are plenty of these (change and trauma) in healthcare settings, and no time to recover from one before moving on to another. To simply "turn oneself off" and become completely detached would compromise the compassion that I believe is necessary to nursing work. Resilience is the key to maintaining the balance between compassion and detachment without burning out. (See the Resilience Resource Packet from the Claremont Employee Assistance Program, a California-based national EAP company.)Knowledge and Critical ThinkingWhat kind of knowledge does a nurse need? What kind of knowledge can a wanna-be nurse get without being in a class or program? Phlebotomy is out for now, but there are plenty of other things I could do on my own to expand my knowledge. I could look up How to Bandage a Wound and then practice on my daughter and my wife. I could read all of the information in sites like Cool Nurse and NursingWiki. I could review my Anatomy & Physiology textbook. I could design and execute research projects on various topics under nursing, pediatric nursing, psychiatric nursing, pediatric psychiatry, pediatric medicine. Anything else?Critical thinking is somewhat different in nursing from what it is in, say, literary criticism. According to Beth-El College of Nursing & Health Sciences at the University of Colorado at Colorado Springs, critical thinking is "a cognitive process based on reflective thought and a tolerance for ambiguity which [is] disciplined and self directed; oriented toward inquiry, analysis and critique; [and uses] multidimensional and multilogical problem-solving ..." Consciously practicing critical thinking in almost any situation looks something like this:Assess: What do I know about the situation? About the people, materials, forces involved?Utilize: What solutions might work for the situation? Why do I believe these solutions will work? What are the likely consequences of these solution?Evaluate: Did that solution accomplish the goal? How well? Is there anything I need to do differently next time?The trick, of course, is to stay responsive and avoid overthinking, so that all of that "critical thinking" doesn't devolve into mental masturbation or fence-sitting.ProfessionalismThis is a basic concept that works for any job as well as nursing. It involves being physically, mentally, and emotionally prepared for the basic demands of the job (which includes being humble enough to change bedpans, bathe patients, and do whatever needs to be done); working well with other people (patients, physicians, and other allied health professionals); communicating effectively (oral and written, on both the giving and receiving ends); flexibility on working days and hours; respect for confidentiality.Basically, what I can do now, aside from being conscious of HIPAA regulations and confidentiality in my work at the consulting firm and my volunteer work with the babies at the children's hospital, is (1) show up for work on time, (2) keep my mind on work while I'm there, and (3) be willing to do whatever needs to be done at work, and not just what I would rather do. This will be a tough one. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465028 Tue, 18 Jul 2006 04:00:00 +0100 465028 http://iwannabeamalenurse.blogspot.com/2006/07/tough-guys-can-be-nurses-too.html Saw this this morning, and wanted to share it.from CBS Sunday Morning: Behind The Mask Of Lucha LibreBrothers, Kayam and Enigma, are known as Los Chivos, The Goats. "Our father, the late Chivo Garcia, was a big legend in Mexico in the 50s and early 60s and we're following his footsteps. We have the blood running in our veins and we love it," Enigma says. They're based in California, because as the Mexican immigrant population has grown in the United States so has the popularity of Lucha Libre. Unlike Mexico, where it's staged in huge arenas, here it's been mostly fought in small, sweaty rings in immigrant communities+ + + + + + +Wrestler Kayam D'Oro, a fourth-grade school teacher, prefers anonymity. "A lot of my colleagues do not know I'm in this profession," he says. And Kayam's beefy brother, Enigma, is a nurse. "My nursing is like a balance for me with the wrestling, you see, because the wrestling is a lot of violence and pushing and nursing is a lot of caring and I care for people, I love caring for people," Enigma says. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465032 Sun, 02 Jul 2006 04:00:00 +0100 465032 http://iwannabeamalenurse.blogspot.com/2006/06/do-not-disturb.html Frankly, I'm depressed about this waitlist thing. I really just want to know one way or the other, not to sit on my hands, bringing them up only to call and feign confidence and smile through the phone as I say not desperately, "I would be very excited to be part of your program! Am I still No. 5?"(I'll tell you a secret: I've skipped baby cuddling a couple of times recently just to sulk and hide.)(I'll tell you another secret: Even when I cuddle the babies, sometimes I feel like I'm just going through the motions. That's awful, isn't it?)I do realize that it's necessary to be tenacious and resilient, and I really appreciate everyone's advice & encouragement.I do plan to call UIC back every other week or so (does that sound right?) to check my place on the waitlist and remind them that I still exist and am still interested.In the meantime, there are Plans B – the Research Methods class in the Fall, if I can scrape together the money; a course in phlebotomy at the City Colleges; CNA certification at the City Colleges; biology and chemistry classes that would qualify as prereqs for other programs.In the meantime, I'm thinking about becoming a Psychiatric Peds Nurse ... or a Pediatric Psych Nurse ... or however that goes ... reading stories like this:17 Pct. at 2 Schools Practice Self-AbuseBy LINDSEY TANNERfrom the Associated PressCHICAGO (AP) -- Nearly 1 in 5 students at two Ivy League schools say they have purposely injured themselves by cutting, burning or other methods, a disturbing phenomenon that psychologists say they are hearing about more often.For some young people, self-abuse is an extreme coping mechanism that seems to help relieve stress; for others it's a way to make deep emotional wounds more visible.The results of the survey at Cornell and Princeton are similar to other estimates on this frightening behavior. Counselors say it's happening at colleges, high schools and middle schools across the country.*****The Web sites, recent books and media coverage are pulling back the curtain on the secretive practice and helping researchers better understand why some as young as grade-schoolers do it."You're trying to get people to know that you're hurting, and at the same time, it pushes them away" because the behavior is so distressing, said [cutter and University of Illinois student Sarah] Rodey, who has been diagnosed with bipolar disorder.*****Seventeen percent said they had purposely injured themselves; among those, 70 percent had done so multiple times. The estimate is comparable to previous reports on U.S. adolescents and young adults, but slightly higher than studies of high school students in Australia and the United Kingdom.The study appears in this month's issue of Pediatrics, released Monday. Cornell psychologist Janis Whitlock, the study's main author, also led the Web site research, published in April in Developmental Psychology.Among the Ivy League students who harmed themselves, about half said they'd experienced sexual, emotional or physical abuse that researchers think can trigger self-abuse.Repeat self-abusers were more likely than non-injurers to be female and to have had eating disorders or suicidal tendencies, although self-injuring is usually not considered a suicide attempt.Greg Eels, director of counseling and psychological services at Cornell, said the study's findings are not surprising. "We see it frequently and it seems to be an increasing phenomenon."While Eels said the competitive, stressful college environment may be particularly intense at Ivy League schools, he thinks the results reflect a national problem.Dr. Daniel Silverman, a study co-author and Princeton's director of health services, said the study has raised consciousness among his staff, who are now encouraged to routinely ask about self-abuse when faced with students "in acute distress.""Unless we start talking about it and making it more acceptable for people to come forward, it will remain hidden," Silverman said.Some self-injurers have no diagnosable illness but have not learned effective ways to cope with life stresses, said Victoria White Kress, an associate professor at Youngstown State University in Ohio. She consults with high schools and says demand for her services has risen in recent years.Psychologists who work with middle and high schools "are overwhelmed with referrals for these kids," said psychologist Richard Lieberman, who coordinates a suicide prevention program for Los Angeles public schools.He said one school recently reported several fourth-graders with burns on their arms, and another seeking help for "15 hysterical seventh-grade girls in the office and they all have cuts on their arms."In those situations, Lieberman said there's usually one instigator whose behavior is copied by sympathetic but probably less troubled friends.Rodey, a college sophomore, said cutting became part of her daily high school routine."It was part of waking up, getting dressed, the last look in the mirror and then the cut on the wrist. It got to be where I couldn't have a perfect day without it," Rodey said."If I was apprehensive about going to school, or I wasn't feeling great, I did that and I'd get a little rush," she said.Whitlock is among researchers who believe that "rush" is feel-good hormones called endorphins produced in response to pain. But it is often followed by deep shame and the injuries sometimes require medical treatment.Vicki Duffy, 37, runs a Morris County, N.J., support group and said when she was in her 20s, she had skin graft surgery on her arms after burning herself with cigarettes and a fire-starter. After psychological and drug treatment, she stopped the behavior 10 years ago.Author of the 2004 book "No More Pain: Breaking the Silence of Self-Injury," Duffy recalled being stopped on the street by a 70-year-old woman who saw her scarred arms and said, "'I used to do that.'"Rodey said she stopped several months ago with the help of S.A.F.E. (Self-Abuse Finally Ends) Alternatives treatment program at a suburban Chicago hospital. Treatment includes behavior therapy and keeping a written log to track what triggers the behavior.Rodey said she feels "healed" but not cured "because it's something I will struggle with the rest of my life. Whenever I get really stressed out, that's the first thing I think about."And more, more articles and web pages that I have not yet finished reading, but want to:Baby BluesRise in childhood depression prompts greater attention on kids' mental healthOctober 4, 2004NurseWeekNational Children's Depression Awareness DayMay 10, 2006Medical News TodayDepression in Children: What Causes It and How We Can HelpDecember 2003personalityresearch.orgAnd the 2006 Pediatric Nursing Conference I'd like to attend, with some workshops and seminars on nursing and childhood depression and other pediatric mental health issues. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465033 Sun, 18 Jun 2006 04:00:00 +0100 465033 http://iwannabeamalenurse.blogspot.com/2006/05/waitlist.html I returned from my honeymoon (just got married Friday May 12) to find out I've been waitlisted for UIC's Graduate Entry Peds NP program.It could be late October by the time I know whether I'm accepted or not.Although I'm sure there were better applicants (on paper, at the least), I'm still a little depressed and anxious with this news.But I need to press on anyway, continue working & cuddling, finish registering for the Research Methods class in the Fall, look into alternate plans, breathe ...... wait ... (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465034 Wed, 17 May 2006 04:00:00 +0100 465034 http://iwannabeamalenurse.blogspot.com/2006/05/reflections-on-cuddling-baby-a-letter.html Dear M,Yesterday I cuddled a baby for hours who reminded me so much of you. He is a plump little thing named A_______. I remember him from last week, only he's been moved into his own room now. They were preparing him to go home to his family, but he's caught a cold, which, unfortunately, is exacerbated by a split in his larynx (a cricoid fracture, or split in the cartilage that forms part of his upper respiratory tract) that happened during an intubation.What connects him to you in my mind was the look in his eyes. He's so afraid, M, so anxious and tenuous about the world and his place in it. He can't seem to get comfortable, and even when he is able to sleep, it's a guarded sleep, a cat nap, and the slightest thing will wake him up. Breathing the wrong way can cause him pain, and he startles and gulps and gasps for air, and the more desperately he breathes, the less efficiently he breathes. It's a vicious circle. One of many. Just like yours.His trauma was major abdominal surgery in his first couple weeks of life. Yours was a broken home and a mentally ill mother. He has breathing problems that reinforce his anxiety. You have the muscle and joint pain that come from years of holding your anxiety in.I took care of A_____ as best I could, reading his cues to find what worked best, at least for the moment, to calm him down and allow his body to function. I got to feed him, too, after watching Nurse P for a while to learn how to encourage him and when to give him a break. I supported his cheek and chin as I had seen the therapists from Otolaryngology do in past weeks. I held him against my chest and patted and rubbed his back (as I rub your back on nights when you can't sleep).When it was time for me to go, I shifted him and he woke up, startled, beginning to cry, and I spoke soothingly to him, rocked and bounced and swayed him, put him in the crib on his belly and patted his back. Nothing worked perfectly, permanently, but nothing really ever does, in maybe all cases. But his nurse was there, ready to take over, and it was time for me to go.With grownups like you and me, M, the problems are more complex. But the solutions are much the same, I think. The main thing when we are caring for another is to just be present, to pay attention to the inarticulable pains, to seek to comfort (for comfort is necessary to health) for the moment (for each moment is different and requires something different than the last) while holding in our field of vision the big picture. So many situations, we cannot bring to a resolution; for so many problems, there is no ready answer. Only presence, and attention, and touch. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465035 Wed, 10 May 2006 04:00:00 +0100 465035 http://iwannabeamalenurse.blogspot.com/2006/05/intro-to-preemies-ii-respiratory.html from the Mayo Clinic:If your baby is premature, how well he or she will thrive depends largely on the baby's gestational age at birth. Risks are greatest for the babies born most prematurely – those born between 23 and 26 weeks gestation.Some of the major developmental events the baby still has to go through in week 23 and after in the respiratory system:Week 23 to 26: "The respiratory system, while immature, has developed to the point where gas exchange is possible." 1Week 23: "Blood vessels in his lungs are developing to prepare him for breathing."Week 24: "Her lungs are developing 'branches' of the respiratory 'tree' and cells that produce surfactant, a substance that helps the air sacs inflate easily." 2["Nurse" Jeffrey's Note: Surfactant also keeps the lungs from collapsing in on themselves. Babies born before they are able to make their own surfactant will need treatment with steroids or synthetic surfactant. According to Princeton's Dr. Brigitte Mihalyfi (in 1998), synthetic surfactant was "standard care for babies who are less than 32 weeks and 1,500 grams (slightly over three pounds) and who have respiratory distress" by 1998. A recent abstract from The Cochrane Collaboration (2006) says that a natural surfactant extract may be more effective.)]Week 26: "Her lungs are developing now, too, as she continues to take small breaths of amniotic fluid – good practice for when she's born and takes that first breath of air."Week 27 to 31: "Rhythmic breathing movements occur, but lungs are not fully mature." 1Week 27: "He may suck his fingers, and although his lungs are still immature, they would be capable of functioning – with assistance – if he were to be born prematurely. Chalk up any rhythmic movement you may be feeling to a case of baby hiccups, which may be common from now on. Each episode usually lasts only a few moments, and isn't bothersome to him, so enjoy the tickle."Week 34: "... her lungs are well developed by now. If you've been nervous about going into preterm labor, you'll be happy to know that 99 percent of babies this age can survive outside the womb – and most have no major long-term problems related to prematurity."Week 38: "Her organs are fully developed and in place, but her lungs and brain – though developed enough for her to function now – will continue to mature right through childhood."Week 40: "This marks the end of the normal gestational period. The child is now ready to live in outside of his mother's womb." 2However, "The lungs also continue to grow for about 8+ years postnatally." 31. "Fetal Development: Fetal Period," 20 April 2006, Wikipedia, 29 April 2006, <http://en.wikipedia.org/wiki/Fetal_development#Fetal_Period>.2. "'Your Pregnancy' timeline," Baby Center, 29 April 2006, <http://www.babycenter.com/pregnancy>.3. M Hill, "UNSW Embryology – Respiratory Development," 2006, University of New South Wales – Embryology, 30 April 2006, <http://embryology.med.unsw.edu.au/Notes/respire.htm>. There's a great condensed version of all of the complication and treatment information at StudentBMJ.com from the British Medical Journal. I'm linking it here as a resource for myself, and as a shorthand to round out this post, so I don't have to struggle to research and write while simultaneously getting on with other parts of my life. A quick summary:Respiratory Distress Syndrome, treated with assisted ventilation and corticosteroids.Chronic Lung Disease, treated with assisted ventilation, corticosteroids, and diuretics.You can see some of the equipment used for assisted ventilation and airway support in the pictures above. I get to see them every Tuesday. Which reminds me, I must get going. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465036 Tue, 02 May 2006 04:00:00 +0100 465036 http://iwannabeamalenurse.blogspot.com/2006/04/charge-syndrome.html A few Tuesdays back, I cuddled a baby girl in the TCU (Transitional Care Unit) who was having a very hard time. She rattled when she breathed, and she cried and screamed in a predictable intermittent pattern, as if the pain came in waves. The nurses needed someone to stay with her while they attended to their many other tasks, so I went upstairs from the NICU, where I normally spend my volunteer time.Aside from her discomfort and her problems breathing, she was "different" than other babies in a couple of obvious ways. Her eyes seemed to be different shapes, one wide open, the other nearly shut (see the photo of Kennedy, another child with the same condition, to the left). Her ears were square, with no lobes. I held her and talked to her in as soothing a voice as I have, and gently pressed a finger against her free hand so that she could grab and squeeze, and stroked her forehead (until it became apparent that she didn't really like that). Her pacifier was back in the crib, and I adjusted her a little so I could stand up and grab it. It helped her calm down, but with her respiratory problems (tons of mucus) and blockage or constriction of her nasal airways, she had to alternate between sucking the pacifier and breathing through her mouth. Like many premies, she also hadn't perfected her suck, so I had to balance helping her keep the pacifier in with knowing when to leave it out. We did fine, though, and after 30 or 40 minutes, she was comfortably asleep.When her nurse and I had a chance to talk about the baby's condition, the nurse told me that the doctors thought the baby had CHARGE Syndrome, and she offered me some information she had printed out from the Special Child: Disorder Zone website.CHARGE stands for C = colobomaH = heart defectsA = atresia of the choanaeR = retardation of growth and developmentG = genital and urinary abnormalitiesE = ear abnormalities and/or hearing lossColoboma is a defect of the eye that normally results in some loss of vision.The heart defects can be many different things, but commonly include Tetralogy of Fallot (1) narrow pulmonary trunk and stenosed pulmonary valve [increased resistance and pressure making it difficult for deoxygenated blood to get to the lungs]; (2) hypertrophied right ventricle/wall of right ventricle [from overwork due to (1), makes its function less efficient, increases the chance of heart failure]; (3) ventricular septal defect [an opening in between the right and left ventricles, so that oxygenated and deoxygenated blood mix before pumping into the lungs or the rest of the body]; (4) aorta opens from both ventricles [so that oxygenated and deoxygenated blood both pump through the body's main artery into the body].Atresia is the closure of an orifice, and the choanae are the openings into the nasopharynx. This is a big reason the baby had trouble breathing – her internal nares were blocked off.The developmental retardation is thought to follow from vision and hearing problems, which is good news, as educational and developmental techniques and tools for vision and hearing loss are more advanced than those for structural problems in the brain or similar causes of retardation.Common genital and urinary abnormalities include undescended testes and a small penis in boys and small labia in girls; hormone problems causing an absence of puberty; and abnormalities in the kidneys or urinary tract.The ear abnormalities are generally "short, wide ears with little or no earlobe" that "may be soft due to floppy cartilage. The outer portion of the ear may appear as though it has been snipped-off." Mild to profound hearing loss affects about 80-85% CHARGE children.And that's only the beginning. CHARGE Syndrome Foundation has more in-depth and complex information about the current diagnosis of CHARGE. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465037 Tue, 18 Apr 2006 04:00:00 +0100 465037 http://iwannabeamalenurse.blogspot.com/2006/04/update.html Where the heck have you gone? I need an update :)          ~ "leosrain"Sorry, I've been elsewhere, concentrating on other things, sleeping heavily when my body gave me no other choice. I had my admissions interview for the Graduate Entry Program at the University of Illinois at Chicago College of Nursing on a Thursday morning a couple of weeks ago. It went well, not perfectly, but I'm pleased enough with my performance. Thanks to Sean of The Semi-Boring Life of an Almost Nurse and Kim of Emergiblog for their advice in the Comments of this post. Thanks to my girlfriend Meg for encouraging me, helping me come up with questions and answers, and coaching me on presentation. Thanks to Google, allnurses.com, and Monster.com's healthcare resume and interview archives for additional help in preparing.I had no idea what the format of the interview would be, but even preparing for something closer to a job interview proved helpful. The only thing I wish I had done differently is to spend more time reviewing my application materials, assessing and anticipating possible problems, potential signs of a "bad fit" between my needs and what the program has to offer, and formulating honest answers to address those concerns.Here's how it went (although I can't guarantee the 100% accuracy of this information):The interviewers included a Peds faculty member from the GEP (15-month intensive "undergrad" component) and another from the PNP program (graduate component). They began, after introductions, by taking me through the program's courses and schedule, to make sure I understood the basics and the demanding nature of the program.They invited me to ask questions (something I had prepared for by doing a little research and identifying a couple of things I was genuinely curious about).How do you ensure that students who become RNs after 15 months of an intensive program are as competent as new RNs who are BSN grads?The intensive program actually contains a somewhat heavier nursing courseload than a BSN program, just compressed. Other schools (Yale, Rush, I think were two) have had this sort of program in place for years without any problems in the quality of the graduating nurses.How much opportunity is there for a student to pursue a specific area of interest?There are some classes (like three different palliative care courses) that are open to all interested NP students, although the required courses are packed so tightly it can be problematic logistically to take an elective course. The thesis project also provides a limited opportunity to concentrate on a specific area of interest.Then, they asked me questions regarding some of their specific concerns stemming from my application packet.You had indicated an interest in working in a NICU in your Goals Statement, and we wanted to make sure that an NNP (Neonatal Nurse Practitioner) and a PNP (Pediatric NP) are two different things, and that we don't offer an NNP concentration.I did actually realize that as I began to do some research for this interview, after I had submitted my application. Honestly, at this point, so many different areas of pediatric nursing interest me that I don't think it will be a problem. I would be excited to work with any age group or (I think I said "pathology" and that might have been a mistake) from adolescents with addiction issues and mental illness to younger children with terminal illnesses, or anything else.You were very frank about your grades in graduate school (we both smile), so I have to ask ...Sure. A lot of things are different since ...I would think the answer is "maturity"? And the grades from your prereqs are very good.Yes, I've matured since then, learned from my mistakes. But I'm also in a different place in other ways. I feel a purpose in nursing that I haven't felt in anything else. When I was in graduate school studying literature, I wasn't sure what the purpose was, what I was going to do with it, why it was important. So I believe the maturity I've gained over the years plus the sense of purpose I have around nursing will keep me on track.(She pulls out the notes I prepared for my boss' presentation on HCV patient care from my application packet) I was wondering, how was this actually used? Who was the audience? We aren't even sure what consultants do.That particular piece was used by my boss in an audio conference, over the telephone. It was a CME seminar, with several doctors talking about clinical subjects related to HCV (Hepatitis C Virus), and my boss talking about the business end of HCV patient care, the importance of follow-up, overcoming barriers to patients following their care plan. (I didn't actually elaborate that much, but since y'all can't see the HCV notes, I thought I'd throw that in there.)Most of what we do is to advise clients on how to increase their revenue by improving billing and reimbursement, coding, hiring, marketing, all of the business aspects of the practice. We approach every specialty differently. I mean, the needs of practices that serve HCV patients is different from ... they aren't cosmetic plastic surgeons. But the philosophy behind it all is that taking care of the business end of a practice improves the patient care. If your staff isn't getting along, if you're worried about losing your lease, if your front desk staff might be embezzling, if your coding mistakes put you at risk for an audit, these problems are going to impact the quality of health care you can provide to your patients. (OK, I only used one or two of those examples, but I can't remember which, and they're alltrue.)They couldn't tell me how many other people were up for the same PNP slot. So, while I think I did OK in the interview, I have no idea at all how good my chances are for admission. All I can do is wait, till sometime in May ... (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465038 Mon, 17 Apr 2006 04:00:00 +0100 465038 http://iwannabeamalenurse.blogspot.com/2006/04/elective-c-sections-and-premature.html Read an interesting article about an NIH panel formed to decide what to do regarding the still-rising spike in purely elective C-section deliveries over the past 10 years.The panel's chief recommendations:-That risk to future pregnancies means that women planning more than one or two children should not have a purely elective Caesarean. Topping the concern is that a prior Caesarean significantly increases the risk of a life-threatening placenta problem in a later pregnancy.-Newborns are more likely to have respiratory problems if they're born by Caesarean, regardless of the reason for the surgery. So doctors should perform elective C-sections only if they're sure the woman has reached at least 39 weeks of gestation, when fetal lungs are fully mature.Full-term pregnancies are typically defined as lasting 40 weeks from the start of the last menstrual period, but gestational age can be difficult to measure correctly. The March of Dimes last week reported that most births now take place at 39 weeks, a change the nonprofit group attributed in part to pre-planned C-sections, which it fears also may drive inadvertent delivery of slightly premature babies.-Doctors should never bring up the option of a purely elective C-section. But if a mother-to-be requests one, the health provider should determine her reason for the request and help weigh the risks and benefits.-If the woman's reason is a fear of pain during labor and delivery, doctors should help her choose from among the multiple safe options to avoid that; pain-numbing epidurals are the most effective. Caesarean recovery can be painful, too.Most interesting to me is the (possible) relationship between elective C-sections and premature birth. I knew that determining the date of conception and gestational age is far from an exact science, but I hadn't thought of what an impact that could have down the road. A couple of weeks can mean the difference between a healthy full-term baby and a pre-term baby with some serious difficulties. Not so much of a risk that it's a national emergency, as far as I can tell, but definitely a factor on which to keep one's eye.Here's the full 115-page NIH panel report in PDF if you want it. And I'm interested to know what you all think of this issue. (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465039 Thu, 13 Apr 2006 04:00:00 +0100 465039 http://iwannabeamalenurse.blogspot.com/2006/03/uic-wants-to-interview-me-for-graduate.html So, now what? How do I prepare? Are there standard questions for which I should think of answers? Does anyone know? (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465040 Tue, 28 Mar 2006 05:00:00 +0100 465040 http://iwannabeamalenurse.blogspot.com/2006/03/delivery-controversial-question.html I've been thinking about the problems some nurses have had being allowed to work L&D (did I say that right? I mean labor & delivery, obstetrics, childbirth). You may know that I don't put too much stock in the politics of "Male Nursing." The L&D issue I find particularly interesting, though. I'd like to explore it and, if you don't mind, get some feedback from you all about this issue. Here's how I'll start:In September 2003, at Abington Memorial Hospital in Philadelphia, PA, a white L&D patient's white husband requested "that no Black employee [be] involved in delivery of his child." Hospital supervisors agreed to the request, and all black doctors, nurses, techs, and other staff were prevented from entering the patient's hospital room. African-American staff, predictably, objected and filed a lawsuit, and the hospital apologized and pledged to enforce its extant policy that "employees will be assigned to patient services without regard to race, creed, color, national origin or religion of either the patient or employee."A similar scenario (albeit not in L&D) occurred in 1998 when a 90-year-old white man, senile, confused, agitated, was brought into a Detroit Medical Center hospital. According to his family, he had been attacked by a black man years ago, and had been afraid of blacks ever since, and in his present condition was not able to cope with contact with African-Americans. Hospital staff initially agreed to post a sign explaining the patient's situation and requesting that all black staff stay out of the room. Later, but not before word reached outraged members of the staff and the community, the sign was taken down and no request to ban black staff was honored.In both these cases, it was perceived by the patients' family member/s that the patient's comfort and peace of mind was most important. Can you imagine trying to give birth to a child if someone you detest or fear is in the room with you? Can you imagine being bedridden and helpless when you're alone in a room with someone you feel might violate you?Of course, the patients' perceptions were erroneous. They wrongly saw threats, criminals, inferiors where there were in fact highly skilled, trained, educated hospital staff. (There are hospital staff who are threats to patients, but they are few and far between and they can be of any race, creed, etc.) And of course the right thing was done in the end in both of these cases. The white patients' mistrust, fear, and/or hatred of black people was utterly irrational and should not have been given priority over the hospital's need to provide the best possible healthcare, free from the burden of shifting staff around as well as from creating an environment of hostility for its staff.Then let's look at the following:That a significant number of hospitals in the U.S. (an assumption on my part) have as an official or unofficial policy either that male nurses shall not be allowed in the delivery room, or that male nurses shall only be allowed in the delivery room with the consent of the patient.That male OB/GYNs have no such restrictions or conditions.That there is no difference between male and female nurses as far as training and education.That a healthcare professional while providing healthcare can generally be trusted to act in a professional manner, regardless of gender.That any generalized judgments as to the male's lack of emotional or temperamental capacity for performing a nurse's duties during childbirth are without scientific basis, and a function of irrational and antiquated thinking.Am I missing something? Is there a profound difference between gender and race when it comes to this issue? How do we determine when the patient's comfort level is more important than the undisrupted flow of healthcare services and the dignity of healthcare workers? What do you think? (Source: I Wanna Be A Male Nurse) I Wanna Be A Male Nurse blogs http://www.medworm.com/rss/comments.php?id=465041 Fri, 24 Mar 2006 05:00:00 +0100 465041 http://iwannabeamalenurse.blogspot.com/2006/03/volunteer-week-interview.html Last week, I had the oppor