does money make sense
in any tangible way
outside of torture

The Last Week of School

One final down, one to go, and then the graduation ceremony is on Thursday.

What a semester this has been! I have had the opportunity to explore nursing in the community, as well as complete my preceptorship in an ICU. I really enjoyed both experiences--particularly the preceptorship--because I felt like it gave me the opportunity to complete my transition from student to novice nurse.

Here are some of the highlights:

The Magic of Learning

My preceptor met me with a smile the first day. She oriented me to the unit, assessed my general knowledge, supervised my opening notes, etc. But as the day wore on, I noticed she was sneaking candy from her pockets.

"What'cha eating?" I asked.

She looked at me askance. "You're totally into Harry Potter, right?" I put a question mark there, but in reality she spoke the words more like a statement of undeniable fact. Luckily, I was, in fact, a Harry Potter fan. I know for a fact my lot would have been different and dire if I had answered her in the negative.

"Of course..." I said. Whereupon she produced several packages of Bertie Bott's Every Flavor Beans, Bloodpops, Chocolate Frogs, and other Potter candies from her pockets. For the rest of the summer, Potter became a constant default discussion topic in the lulls between my educational experiences. She showed me a book she was reading that speculated on the symbolism behind the Potter series. She showed me the costume she had made for her child for the midnight release party. She held her hands over her ears and yelled "lalalalala" as soon as I mentioned that the book had leaked over the Internet. A true fan. (Or addict?)

I wouldn't say that Harry Potter conversations were the most memorable thing about my preceptorship. I learned so much about the day-to-day routine, policies, procedures, computer charting, teamwork... the experience was invaluable. However, I found it refreshing to be paired with someone who was young and at least as nerdy as I am.

I lamented the fact that she took vacation around the book release date, so I could not see her in the last days of clinicals. My classmate and I brought food for the rest of the staff, but I couldn't let this woman's semester of efforts go unrewarded. I agonized over what kind of Potter trinket would be appropriate for a thank-you gift. I felt certain she'd already have anything that could be bought in a store... so I finally decided on something home-made.

The nearest thing to nurses Harry Potter's world are the lime-cloaked Healers of St. Mungo's Hospital. (And trust me, I wouldn't have known this if she'd not told me about the costume she was sewing). As a gift, I painted a small wooden plaque green with the symbol of the hospital, and emblazoned the words "St. Mungo's Award for Distinguished Healer Mentor" on the front. I left it in her locker for discovery. I hope she likes it.

Memorable Quote of the Semester

"One time a student was working in the ER. And she told us that a woman came in with gonorrhea. She was a prostitute, and she had an ostomy. In fact, she was prostituting the ostomy... and I know none of you are going to forget the concept of 'portal of entry' after that story."

~~~

Alright, that's all I have time for at the moment. One more final to study for. Expect an update after graduation.

E-Journal Club #9

Rogers, Ann E., Wei-Ting Hwang, Linda D. Scott, Linda H. Aiken, and David F. Dinges, “The Working Hours of Hospital Staff Nurses and Patient Safety”, Health Affairs Vol. 23/4, July/August 2004: pp202-212.

ABSTRACT:
“The use of extended work shifts and overtime has escalated as hospitals cope with a shortage of registered nurses (RNs). Little is known, however, about the prevalence of these extended work periods and their effects on patient safety. Logbooks completed by 393 hospital staff nurses revealed that participants usually worked longer than scheduled and that approximately 40 percent of the 5,317 work shifts they logged exceeded twelve hours. The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week.”

This is the Research Council’s journal club article for August and very timely. I have been in nursing long enough to recall a time when we all changed to twelve hour shifts. I should say “back” to twelve hour shifts, because twelve hour shifts appeared early on in the history of nursing. I wonder why they changed to eight hour shifts?
In the past few years, I’ve also noticed a trend toward some of the staff working more extra shifts. Some of the staff actually works enough extra shifts to qualify as working a “second job”. I have been amazed at their stamina, because I work part time and find that exhausting. I also know these are the staff that management favors for their flexibility and are therefore building up bonus points when in fact management should be worried about the rate of errors this article alludes to.

EVERYONE IS WELCOME! Please join us at the next Nursing Research Journal Club on Wednesday, August 8, 12:00 pm-1:00 pm, Sr. Frances Dunn Building, Classroom I.

flashing headlights wipe
face, paramedics, crushed weight
life slips from moments

once a week she plucks
slim the lines above her eyes
to feel in control

the bird flies with wings
the dog has four legs, there's no
original thought

my first and best friend
manages a shop called what
art, butts, boobs and death

Slow summer

Well, it's been a slow summer. Haven't done much. Studying the driver's handbook still and doing online practice questions.It's going well, not that hard.

Was waiting for the Harry Potter movie to come out, saw it and LOVED it, though I wish they hadn't cut so many details out...

Was also waiting for the Harry Potter book to come out and have read it through and LOVED it too. Kind of sad that that's the end of them, thoygh saw an interview where J.K. Rowling has said she will write an encyclopedia type book to fill in the story and backgrounds on the characters. That'll be neat!!!

Am going to get Botox again, for my left leg, this time the calf and the hamstrings.. yay, maybe now I'll get some sleep at night with less spasms!

Getting a CT Scan August 20 for my right hip, we'll see what that does/gives.

Going for a sleep study September 17th, again, we'll see what that gives.

If all goes as planned, I will graduate with my RN in May 2008 and be working as of June/July as a GPL (Grad Pending Licence) and so this means that this is my LAST summer off!

his eyes reflect gold
he keeps open and large
as the Round Tower

he stands beside her
smells her shampoo and talcum
and hopes she agrees

in the city bugs
coated antiseptic
give venomless bites

the rails are hot lines
two dragons spitting angry
as trains grip over

he wants to marry
but I want none of that shit
spectacle of sin

he lives in the tree
he says, caloo, look at me
from here the world spins

I worry about
how much you drink alone and
your recovery

it must be a theme
if you are to make an art
or no one will buy

Can't sleep, browsing the web...

I found an interesting nurse blog (I love nurse blogs!) and am reading away..

http://thinkingnurse.blogspot.com/

Travel nursing jobs aren't always fun...

Today was a rough day. A really rough day. I'll try to write about it when I wake up.

some people say that
depression controls you
like a parasite

the tree with dark curves
is the one you sit under
shade like cocoa bean

E-Journal Club #8

Lokk, Johan, PhD; Arnetz, Bengt, MD, PhD, “Work Site Change and Psychosocial Well-being among Health Care Personnel in Geriatric Wards – Effects of an Intervention Program”, Journal of Nursing Quality Assurance, July, 2002 Vol16(4) pp.30-38

Abstract
"The study evaluated the effect of a change of work site and organization on work environment and psychosocial parameters; the change involved health care personnel at a geriatric hospital. Another aim of this study was to evaluate the effects of a structured psycho-educational intervention program. The study found few changes in the indices of interest on the experimental and control wards. There were, however, significant improvements in social climate, goal quality, and independence of work on the control ward. The investigators postulated that too much external support hampers a group's ability to actively cope with change and might actually lower a group's ability and self-esteem. In order to achieve successful organizational change, psychosocial intervention programs for personnel must be performed by a well-informed, well-chosen, and experienced counselor who is well tailored to the local organization."

I was looking for an article that would focus on the apprehension some of the staff in the hospital have regarding the move in October of this year to a new “wing”. Many of our staff members are new graduates, just trying to cope with learning all the details that your first year brings.
I remember the opening of the third critical care unit here at this hospital not too long ago, and the chaos (stress) that ensued until the small details of where everything is was brought under control. And this “wing” is completely new in design and physical orientation. The visitor waiting room is directly across from the nursing station. How will that work out?

what would you ask him
if you were interviewing
the Dalai Lama

phosphorescent corpse
skin lifting with the sea tide
hair puckered by fish

you're so public school
your ready-to-wear clothing
and shaggy hairdo

near fine dust jacket
crinkly cellophane wrap
and dog-eared pages

he is unimpressed
your son and the internet
are inseperable

your buzzer went off
and now you can fold laundry
like your intentions

there once was a song
that answered all the questions
it is forgotten

this weather gets me
sun, sun, sun always beating
no break from the heat

what worries you more
climate change or starvation --
carbon or carbon?

behind the deadline
you realize you don't care
you have divine right

her feet hang over
she turns a page then listens
to the train whistle

face lit by sparkles
beer bottle tipped to her lips
she is a hot night

bookmarked in Brazil
I wonder about your face
and motivation

sleeping on his side
bright light left on overhead
his neck pulses slow

the pressure is on
to make a poem worth reading
creates writer's block

E-Journal Club #7

Lindgren, Vicki A. MSN, RN,CCRN “Caring for Patients on Mechanical Ventilation”, American Journal of Nursing, May 2005, Vol 105/5; pp 50-59.

Summary: “This article addresses several integral areas of care, including weaning from mechanical ventilation, preventing ventilator-associated pneumonia, providing nutritional support, managing anxiety, timing tracheostomy, preventing aspiration and promoting sleep.”

Here is another example of why I like the AJN. This article, although it does not present new research, displays the current abundant research on the subject of mechanical ventilation in critical care. At the end of each section, she highlights “Best nursing practice”, and includes the references to important guidelines and their web addresses.

When Victoria Randazzo first began to develop her sedation protocol ideas here at St. Joseph's, she gathered many of the great articles published on this subject, including many listed at the end of this article. They began the foundation of what she wanted to accomplish and why.

As we continue to use research and evidence based practice, we begin to ask questions of our nursing practice. It is comforting to know that much of what we do is based on current research and a multidisciplinary approach to the answer.

cross legged on vinyl
you worry you'll miss the stop
a premature death

Happy Canada Day!