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Hx = History

One can have a history of codependent behaviors, a history with a substance (under our breaths, "hx of EtOh," to avoid embarrassing anyone), or a history with a particular person. History is, as the word suggests, subjective. There's the good kind of history as well--for example, the story of Florence Nightingale, and the history of nursing graduation rituals.
This already sailor-looking cap made a lot more sense once my dear friend Meg gifted me her mother's WWII nursing cap pin (complete with lovely anchor design), which made me wonder whether the history of nursing caps had something to do with the military.  The short answer is, no. Apparently, the nurse's cap was modeled after a nun's habit, paying homage to nuns being the earliest nurses. Florence Nightingale continued the tradition of the cap by making it part of a nurse's uniform that keeps hair neatly in place. We nursing students know that Nightingale was all about keeping the environment clean …
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4.18. Gratitude, Remembering the Dead, & Pokemon

Our last nursing school exam, many of us lingered in our usual seats with our 100-question, filled-out scantrons far longer than necessary, because for how long these past two years were, at this final moment, we suddenly weren't quite ready for it all to end.
Pretty sure this is what our pinning ceremony will look like.
We have so many people to thank--one another, those who have been there with us, taught us, who helped us survive in some way, who watched our children, who are our children, those who gave us life or in some cases, saved our lives, literally or metaphorically, because first, there's living, and then, there's living life.

Becoming a nurse reminds us every day that life is short, unpredictable, and we should make every moment count.
And we remember and honor our dead, too. They say that every person you lose, they take a little bit of you with them, and you, in turn, keep a little bit of them. Not sure what it says about me that all my dead seem to come ba…

4.17. Giving Birth Dream

It's that time in the semester for Really Weird dreams. This happens to be a Giving Birth dream, which I'm sure has something to do with my regretting not studying my OB book for a particular, recent, exam.

In my dream I am pregnant, and am just considering Hey, Google-ing or using Naegele's rule to figure out when my due date is (although of course I don't remember the first day of my last menstrual perod), I feel a bit of pressure Down There, something slippery come out, and I reach down.

I have given birth to an intact bag of waters, baby suspended inside. The bag, incidentally, is a 1000ml IV bag of 0.9% normal saline, so I know it's sterile.
Instead of calling an instructor, or doctor, or 911, I try calling one of my classmates who precepted in OB. The call goes to voicemail.

My daughter comes up, concerned, and I calmly ask her to get some towels.

I wonder if there are still sterile gloves lying around somewhere from when we took them home from lab to practic…

4.16. To wean = gradually eliminate

There's weaning off a ventilator (breathing machine) in the ICU, and there's weaning a baby. Both are difficult, but as a mother who breastfed (reluctantly) for more than two years, I personally never want to go through the latter again.

1. One can wean off a ventilator using "Synchronous Intermittent Mandatory Ventilation": the ventilator provides a minimum of, say, 12 breaths a minute, and the patient supplies additional breaths. If all goes well, the machine delivers fewer breaths, and the patient breathes more and more on his or her own.
Similarly, the mother desperate for her body back may offer the breast for a reduced number of times or only fixed times a day. For example, 10pm, 4am, 7am, 5pm. Try telling that to the pacifier-rejecting baby who uses you as a human pacifier. All night long.
2. One can also use a T-piece (what it sounds like--T-shaped tubing), which replaces the ventilator and delivers humidified oxygen. The longer time the patient can tolerate w…

4.15. Pareto Principle = 80/20 rule

Italian economist Vilfredo Pareto first developed the 80/20 rule (aka the law of the vital few, or the principle of factor sparsity) from observing that approximately 80% of land in Italy was owned by 20% of the population.

The business world has long said that 80% of business comes from 20% of customers, and statisticians have noted that historically, 80% of events come from 20% of causes. 80% of traffic occupies 20% of roads, and perhaps nobody cares about this, but 80% of peas also come from 20% of pods, Mendel or no Mendel.
The Pareto Principle applies to healthcare in many ways. 80% of healthcare costs come from 20% of patients (same goes for readmissions), and along the same vein, 80% of clinical problems that arise throughout a shift come from 20% of patients. On the other hand, if we flip the rule, we also see that 20% of our efforts may produce 80% of effects. As nurses and medical professionals, we may prioritize the most critical and urgent 20% of tasks to produce 80% of re…

4.14. Mercy Medical Center = Dignity Health

Dignity Health’s slogan is “Hello Humankindness” and Mercy, the hospital next door (across the street, technically), our benefactor, our teacher, has been beyond kind to us Merced College nursing students.
Let us count the ways.

The ED taught us how assessment and nursing judgment is everything.

OB showed us the most amazing thing in life—the beginning of life itself.

The ICU reminds us what really matters: airway, breathing, circulation, disability, exposure, and family.

Telemetry highlights the science and wonder of the human heart.

5th floor (home of my awesome preceptor!) covers everything from anemia to Zollinger-Ellison syndrome, and cancer, too.

6th floor has procedures & drains & dressings galore, and all the assessments, too.

7th floor was where we as first semester Smurfs in royal blue, trembling in our hideous white shoes, first got our feet wet (sometimes literally).

We thank Dignity Health, Mercy Medical Center, for helping us grow from baby nurses to novice nurse…

4.13. Photo Essay: R = Resilient

Dear Mom,
It's been almost four years since you fell sick and passed. So much has changed since then, including me.
Sometimes I look in the mirror and startle because I think I see you. Something in the eyes, the lips that aren't quite certain but curl into a polite smile anyway, because it's what we've been taught. 
When you were my age you already had three children. I have just one, but she is everything (and more than enough). She gives me a reason to make responsible and strong decisions as a role model, because now it's about setting an example for what she should accept or not in her life one day.
Fist bump over hand shake.
Saying "no" and walking away and standing up, even when it feels uncomfortable or seems unthinkable, impossible.
 A belt is a belt is a belt. Sometimes a gait belt, sometimes punishment.
There have been a few.
We've lost a few matches in life, as well as a friend or two.
Leukemia, S. pneumoniae, HIV, all of them…