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Showing posts from 2019

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…

Guest Post: How to Rock Your Nursing Resume by Karen Walcott

So you’re about to graduate Nursing School? Congratulations!!! Now you have to think about landing your first nursing job. Writing a resume can be daunting so let me offer you a few tips.

1.Don’t use a Microsoft Word Resume Template: Recruiters and Hiring Managers are very familiar with Word Templates. They are basic, generic, and unoriginal. You want your resume to stand out so don’t use the templates. They are plenty of other options out there. a.Canva: Creating a free account on this website will give you access to customizable resume templates with modern layouts. b.Etsy: There are a number of shops where you can purchase beautiful resume templates. There are even a few templates designed especially for nurses. Check out shops like Templates Design Company, Resume Template Studio, and Caps Look. Their nursing resume templates range in prices from $5-$15.
2.If you’re just graduating from nursing school and do not have any formal nursing experience than your resume should contain the …

4.12. How to Make a Book Trailer (For Free!)

1. Get a trailer, preferably secondhand. 2. Fill it with books.
Okay, just kidding. It's actually even easier than that (and free!) to make your own book trailer. Here's how.
1. Find some images (including your book's cover image) that you like, and pick a bit of text to go with each image. The text could be exerpts from the book, praise, brief author bio, or general "tease"s or hooks to intrigue potential readers/buyers.
2. If you use Windows, the former Windows Movie Maker has been replaced by Photos, which is also free. If you use Apple, iMovie will do.
3. Create a new movie project in either platform. In Microsoft, add images to your project library and drag and drop them to your storyboard, where you can set duration (e.g. 5 seconds) and add text. In Apple, import images/videos, drag and drop into the film reel, and add captions.
4. In my case, I liked the captions in Microsoft Photos but hated the special effect, so I had to go to someone's house that …

4.11. DNR...

Dear Grandpa 親愛的爺爺,

Our response to the no-doubt difficult DNR decision before you is nothing but love, and great respect. You have been a role model to all of us, stern yet loving, wise but playful. You and grandma gave us the best Chinese New Year memories year after year, even now, when we return to Pingtung with children in tow, and you continue to create for us happy memories to cherish for a lifetime. We will always have the pebble-stoned beaches, the aboriginal culture museum, grandma's rice balls and pigfeet soup, all the good times--that love is forever part of us.

您一直是我們的楷模,剛毅兼關懷,智慧中帶幽默.您與阿嬤給了我們最溫馨的童年回憶,從小到大每年都如此. 如今我們帶著小朋友一起會去過年,他們也一樣有許多他們將珍惜一輩子的快樂回憶. 我們永遠都記得,在海邊玩水,原住民博物館,阿嬤美味飯糰與豬腳麵線--一切愛的片段烙在我們腦海裡.

One thing not many people in our family know: when my mother coded in the ICU and the doctor wanted us to sign the DNR papers, a "family friend" who was not family and we barely knew, who had become a recipient of confidential information after helping translate wh…

4.10. PAWS = Pet-Assisted Visitation Volunteer Services

Meet Frida, the most cosmopolitan, well-read dog ever. Pets provide more than entertainment, companionship or improvement in literacy (when kids read to dogs--at home or at library events). Pet therapy is an actual thing, though not in a Frida = Freudian psychoanalyst type of way. Rogerian psychiatrist, maybe:
Human: "I'm having a bad day."
Pup, speaking with soulful eyes: "Tell me more about your bad day."

The therapeutic value of pets has been extensively studied, and evidence shows that animals can directly influence a person’s mental and physical well-being. Having a pet, or spending time with a trained "therapy pet" in a hospital, treatment center or long-term facility can decrease anxiety and enhance mood in many patients.  

Penzi, devoted therapy dachscund!
Pet therapy has proven especially effective in people receiving cancer treatment and those with anxiety, cardiovascular diseases, PTSD, dementia, or residing in long-term care facilities.  The sim…

4.9. SATC = Sex & Taipei City

Interviewed here by her favorite librarian, Mimi, Yu-Han Chao is the author of a new short story collection, Sex & Taipei City (available now with Red Hen Press).
Mimi: That’s a really cute book cover. Did you draw it?
Yu-Han: Why, thank you, and yes, I did.

Mimi: Judging from the cover, these are cute stories about sex?
Yu-Han: Yes and no. The opening story is more explicit than the others, the lingering result of edits requested by a Zyzzyva editor when the story appeared in the journal. There are betel nut beauties and a grandfather obsessed with Japanese porn in the collection, but most characters are ordinary people, and the “sex” here has more to do with repression, gender concerns, failures of intimacy, and social (in)justice.

Mimi: Can you cite any direct influences or inspirations?
Yu-Han: Growing up in Taipei city in the 90s. Pai Hsien-yung (白先勇)’s Taipei People (台北人).

Mimi: So a sort of updated Taipei People?
Yu-Han: Not as up to date as it was when I first wrote it, be…

4.8. Sharp Objects: 3 Personality Disorders

Sharp Objects, a novel by Gillian Flynn (and also made into an HBO series), centers on reporter Camille Preaker who returns to her tiny hometown to cover the murders of two preteen girls. All three female main characters in the book exemplify Cluster B personality disorders, which exhibit dramatic, emotional or erratic behaviors. *Spoilers below.

To discuss the familial pattern of personality disorders, we may begin with Camille’s mother, Adora, who always has an alcoholic drink in hand and is a candidate for Histrionic Personality Disorder. People with this disorder fail to develop richness of inner feelings and lack the ability to provide people (their daughters, for example) with genuinely sustained affection. Adora also has Munchausen By Proxy (MBP), or Factitious Disorder by Proxy. It’s implied in the book that Adora’s mother had dosed her and sickened her just as Adora does her three daughters (one of them she poisoned to death; the remaining two have issues discussed below.)

Ce …

4.7. Code Red = Fire

To say one's life (or the state of the nation) is a dumpster fire is too vague. What, exactly, is burning? We have to find the cause/flammable material and deal with it as is appropriate.
Class A fire: ordinary trash fire, dumpster fire. Flammable materials include bills, marked-up novel manuscripts, bureaucratic paperwork, annoying ordinary things gone wrong. Extinguish with water, monoammonium phosphate, class A extinguisher. Don't take things personally, pay the bills, sign the papers, put it behind you.

Class B fire: flammable liquids and gas fires. Drama, fighting, tantrums. Do not give histrionic people more fuel or water, which will only increase their surface area. Cover with a blanket. Class B extinguisher. Walk away and do not engage.

Class C fire: electrical fire. Sometimes the (internet, human) connection is like an addiction, and rumors, gossip and obsessions do more harm than good. Facebook Insta Snap Tweet Tinder. Unplug; cut off power source. Do not use water.

4.6. Ship of Fools

In the Middle Ages, people with mental illness were sent off into the open sea in a sailing boat to search for their lost rationality. 
The ship of fools is a Bosch painting, the title of several songs, and the name of a few modern films. In The Republic, Plato describes a gang of foolish sailors who take possession of a ship, chain up the captain and throw people they don't like overboard. More interesting, perhaps, is Foucault's discussion of Narrenschiff, ship of fools, in Madness and Civilization, as the symbol of the (changing) status of madness.

Madness was fascinating because it was unknown, and the "madman" seemed to possess some kind of forbidden knowledge that related to the end of the world. Madness, like death, was a mystery, and in a religious era, that also became linked to the theme of apocalypse.

That's what Bird Box was about, right? That maybe "mad" people aren't actually mad, but are the only ones who saw the truth this entire ti…

4.5. EKG = electrocardiogram

Because studying all the abnormal heart rhythms is giving us paroxysmal supraventricular tachycardia, here're some EKG poems instead.


The dangerous valentine’s fib
what she saw-
           toothed           electrical chaos
hogging oxygen
 no output
rapidly fatal to relationship in
           3-5 minutes

faint pulseless apneic
no blood pressure
           absent heart

fixed, dilated pupils
cold, mottled skin

           won't work if heartless tho

Ventricular Asystole

           no impulses left
no depolarization QRS contraction
only P
           sometimes not even that
electrical           silence

inadequate cerebral perfusion oxygenation
after cardiac arrest comes respiratory arrest

CAB it but
   don’t shock
           don’t shoot
implantable converter
           no magnet
vest that if conscious
           press button to prevent shock
otherwise a donkey’s kick to chest

4.4. BLS Algorithm = Make Your Own Adventure

The theme song to this post is Stayin' Alive, at about 100 beats per minute, the recommended rhythm for high quality chest compressions.

Well, you can tell by the way I use my walk
I'm a nursing student, no time to talk
Bed alarms loud and bedpans warm
Answering call lights since 6:30 this morn
And now it's all right, it's okay
And you may look the other way
We can try to understand
CPR's effect on man
Whether you're a student or whether you're a patient
You're stayin' alive, stayin' alive
Feel the epi pushin' and people compressin'
And we're stayin' alive, stayin' alive
Ah, ha, ha, ha, stayin' alive, stayin' alive
Ah, ha, ha, ha, stayin' alive
Code Blue somewhere, somebody help me
Somebody help me, yeah
Life goin' nowhere, somebody help me, yeah
I'm stayin' alive

The Basic Life Support & Advanced Cardiac Life Support algorithms are probably some of the darkest flow charts available outside of thos…

4.3. Circles of Trust

Intimate distance is 0-18 inches, personal distance 18-40 inches, social distance 4-12 feet, and public distance more than 12 feet. But that's just physical space.

The tricky kind of space, with invisible walls erected all the way to the clouds, hidden bear traps and quicksand that surprise visitors, and boundaries that crumble when they're most needed--that's all metaphor.

Whose negative words do you let in when you shouldn't? Who should you reach out to more? Whom should you hold close? (This is becoming a terrible who/whom grammar exam.) If Kevin no longer sparks joy, but instead incites murderous rage or brings endless dilute tears, maybe he needs to go out with the other boxes of stuff you Marie Kondo-ed to the Goodwill.

In a world of strangers, room full of acquaintances, lifetime of relationships come and gone, how many people remain in your inner circle of trust? Two? Three? Now that one has died and is forever watching over you, how many remain? 
You are Freud…

4.2. Phobia = fear

Some of us may have started first semester of nursing school with an irrational fear of needles, but by now, we have bigger problems ("Just stick me.") 

Plus we're getting better at IV insertions so there's less DIGGING AROUND IN EACH OTHER'S VEINS, fewer bruises, and more neat little scabs on the dorsal palmar venous arch.

There are plenty more fears to overcome, however.

Acrophobia = fear of heights

Ailurophobia = fear of cats (the "Cat Spring Roll" story in my collection, Sex & Taipei City, is for you, non-lovers of cats.)

Algophobia = fear of pain (as opposed to those of us who apparently enjoy it)

Anthophobia = fear of flowers (and we're not talking about allergies)

Astraphobia = fear of lightening

Belonephobia = fear of needles (and bologna?) Also: Trypanophobia = fear of needles, injections & blood draws.

Brontophobia = fear of thunder (Raindrops on roses and whiskers on kittens...)
Cynophobia = fear of dogs (esp. if a dog tried to e…

4.1. Levels of Anxiety

Not everyone, even someone in the middle of a panic attack, realizes just how much anxiety can change us physically--temporarily. Actual visual fields decrease (tunnel vision is a real thing), and stress can turn into physical symptoms that, if sustained, may become hazardous.
I. Mild Anxiety
Heightened perception, enhanced learning (yay!), restlessness, irritability, increased motivation. Possibly a good thing, all in all.
Public speaking scenario: You have to present to a small group of peers.
Nursing school scenario: You have a skills checkoff (or five) tomorrow.

II. Moderate Anxiety
Reduced vision field, reduced alertness, suboptimal learning. Ego defense mechanisms like denial or regression occur. Some physical symptoms such as faster heart rate, breathing, muscular tension and gastric discomfort occur.
Public speaking scenario: You have to present a speech to an entire class, while your Communications instructor times and grades you from the back of the room and is dinging you for…

Type C = cancer

Are you type A, B, C or D personality?

Not to be confused with cluster A, B, or C personality disorders, the official definitions of type A, B, C, & D personalities are presented below, abbreviated but word-for-word, from Townsend & Morgan's Psychiatric Mental Health Nursing's uncanny glossary. Some of us thought we were type A, but this whole time we were type C (for cancer--sadness.)

Type A: prone to coronary heart disease. Excessive competitive drive, chronic sense of time urgency, easy anger, aggressiveness, excessive ambition, inability to enjoy leisure time.

Type B: not prone to coronary heart disease. ability to perform even under pressure but without competitive drive & constant sense of time urgency experienced by type A. Type Bs enjoy leisure time without feeling guilty, are much less impulsive, and think things through before making decisions.*

Type C: attributed to the cancer-prone individual. Suppression of anger, calm, passive, puts the needs of others b…