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What is it about Quentin Tarrantino that I’m just not getting?

I saw Pulp Fiction and was confused.

I forced myself though Kill Bill and the sequel because I was told they were really one long movie. Watching both didn’t make it any better.

I just turned off Death Proof after the first 10 minutes or so because I find it hard to believe someone had such bad scripting, acting, and editing on purpose. This is supposed to pay homage to a genre?

On the other hand, I never liked Picasso either. But, then again, not everyone does.

I’ve been working as an RN at Super Hospital for seven weeks now.

I’ve attempted a couple IVs, I’ve removed foleys, I’ve removed central lines
I’ve dealt with chest tubes, I’ve drawn blood
I’ve made my first minor but scary error in patient identification
I’ve had a patient try to climb me like a tree because he thought he was going to die
I’ve held the hands of frightened people dealing with illnesses they can’t pronounce

My preceptor has been exceptional
She asks for my opinion, she gives her advice
She makes herself available, she doesn’t loom over my shoulder
She looks things up when she doesn’t know the answer
She commiserates when the craziness of administration interferes with patient care
She puts up with my constant barrage of “why”
She laughs at my poop jokes

I really like what I’m doing, and I’m glad I struggles through all the garbage of nursing school and emerged an RN.

Dr and Doll

I love Norman Rockwell imagery. There’s something about it that not only speaks of a different time, but a different relationship between the healthcare provider and the patient. He understandably focused on the Dr and not the nurse. In fact, I Googled and found no images of a nurse caring for a patient. That’s not to say he didn’t do any, just that I didn’t find any with that search.

Dr and Doll 2

Regardless of his possible omission, the role of the nurse is very different than it was in the 40’s and 50’s when he was painting these popular images. As I’ve stated in the past, nurses are not doctors, and shouldn’t be.

Doctor and boy looking at thermometer

Something else has been sticking in my craw recently, and that’s the “rights” of patients to dictate their care. As a new RN I’m still navigating the waters in this area. I’m a firm believer that patients should be involved in their healthcare. They have every right to decide the course of their treatment. But managing that on a practical level can be challenging. People continue to eat too much, too often, and the bad stuff. They smoke. They don’t exercise. And I’m just talking about the nurses I know at this point.

Kidding!

Seriously, if a patient continues to behave in an unhealthy manner despite all evidence and advice to the contrary, when is it okay to stop treating? People with psychological conditions are forcibly treated, making it lawful to step in because the patient cannot distinguish reality, or is unable to care for themselves. The current popularity of blaming everyone else for our own condition is valid in a court of law (“They made the hot coffee too hot and I was burned”, “I can’t stop eating McFood, they must put something in it”, “I never would be this fat if they didn’t make Twinkies”….). Isn’t this a similar type of crazy living in a fantasy world?

Shouldn’t the healthcare providers be able to say “no” to the people unwilling to care for themselves in any meaningful way? Part of me thinks hell yeah! this is a possibility, and the other thinks that first part is sick. As nurses we’re here’s to help. But where is the line? Isn’t enabling exactly what we’re doing at some point?

And how about the professional patients? “No, I can’t tolerate dilauded, I need morphine.” “I’m more comfortable on 5 liters of oxygen, not 2.” “At home, I always crush that pill.”

These are the ones that are typically “frequent flyers” in the ED, the ICU, the substance abuse clinics. I spoke with one patient waiting for another set of lungs because her last pair were giving out. She was going through nicotine withdrawals because we couldn’t let her smoke inside. When do we cut them off? If they know so much about how to manage their health, then why do they keep showing up at the hospital?

Now, I’m not talking about the people who despite their best efforts simply cannot control the course of their condition/disease (cancer, AIDS, etc), but those who choose consciously or not to let go of that control until they get into a hospital. I don’t know the answers, but I’m very curious to hear other opinions.

I’m not making fun. As it says in the song itself, I wish the people trying to die could be allowed to do so with some grace and dignity.

Stop by Respiratory Therapy 101 for a great blog as well as this song.

People are stupid are amazing have too damn much time on their hands.

Check out the new Ginsus.

Morgue

I just worked two days in a row as a Nursing Assistant. These happen to be the last days I’ll work as an NA, because I start as an RN in a week.

Yesterday’s shift was different because I “floated” to a new unit, and had to deal with all the nonsense that entails. Overall it went well, however.

Today I had my first body-prep for a patient that had passed away a couple of hours before I arrived. I thought it oddly symbolic that it would happen on my last day, having never done it before. The nurse who helped me with it was very kind, letting me do some of the things and explaining procedures as they’d be done on a “normal” patient versus the current one. It went smoothly and I was glad the patient’s body was treated with dignity the whole time.

Now I’m winding down and getting ready to get some sleep. NCLEX in a few days, and new job a few after that.

Zombie Food Pyramid

Zombies might have it right.

I’ve been wondering about my normal diet. I’ve been active for most of my life. I’m now 42, and things are not as springy as they used to be. I don’t have the occasion to run on the playground during lunch. I don’t ride my bike to my pal’s house after school. I don’t have water polo practice after dinner.

The last couple of years have added almost 15 pounds to my frame. All that time studying and reading and being in the lab and not getting exercise is catching up with me.

But when I decide I should eat better, I find out that “better” is very much an opinion. Low fat diets are suggested by everyone from the US government to my Nutrition instructor. But you have a look at what Gary Taubes has to say and you start to wonder. What if we got it wrong? Then you hear Michael Pollan on NPR (is that another sign of age or what?) who also has different ideas about what it means to eat well.

Maybe if I just ate their brains, I could figure it out.

Pet Cemetery

Being so close to taking the NCLEX (still no word on the date) I find myself distracted from this important event by our dog, Kailie.

To really understand the situation, some backstory is necessary. Kailie came to us from my ex-girlfriend. Yup, you read that right: ex-girlfriend. Back when I was a young Indian Brave this woman and I, (whom I shall refer to as “S”) were and item. It lasted a while, and we parted friends, staying in infrequent touch ever since.

Now the weird part.

The Queen and I have known each other for our entire adult lives. We literally met our Freshman year of High School. We never dated during school, but had an attraction that both shared. It so happens that S didn’t treat my then-friend and future-wife very well during the period we were together. Oh yeah, it gets better. You can’t make up this type of stuff.

Fast forward a couple of decades, and now S is dying of cancer. I take a couple of days to spend with her since she has no real family, and end up promising to take care of her kids (how she referred to her dogs, since she never had any). The inevitable happens, and after we arrange for one dog to be placed with a friend, we take the other into our family.

Kailie is a great dog. Potty trained, loves people, doesn’t chew on stuff, likes travelling in cars, loves being wherever her people are (inside or out). Her one difficulty is she was never socialized with other dogs. S rescued her and her sibling from the pound, and then kept them away from other dogs for the entire time she had them. They spent 90% of their time inside, and even more in the last months of her life.

After over three years of loving Kailie, we reached a point where she couldn’t do anything right in the eyes of the Queen. She shed. She walked on flowers. Her food was expensive. She pooped. She was left outside for longer and longer periods. There was no active animosity, but the woman I love had taken a dog in under odd circumstances, having never had more than a guppy in the past. It reached the point where we actively searched for another family to take Kailie. We almost had her placed a couple of times, but her inability to be around other animals was a problem. We posted online in a couple of different places. We worked our friends and acquaintances. We put up flyers.

It finally came down to bringing her in to the pound. I was the bad guy, and I left her there with strangers. It broke my heart walking out of that place. I called periodically over the next week and half, checking on progress to see if she was doing OK or maybe even getting adopted. They had no info for over a week, just that her evaluation was pending. My next phone call I found she had been “put down” because of behavior problems and difficulty adjusting to the environment. She stopped eating, was vomiting, and had diarrhea.

Intellectually, I know that we didn’t really have a choice with the way things were going at the castle. We tried every avenue we could. But I just keep thinking how sad and lonely she must have been, and how I was the one that left her there.

The End

Okay, I like “nigh” better than “near”. So shoot me.

Less than two months to go in school.

I start my final rotation in two weeks. This is the equivalent of a BSN “capstone” their final year. Since our program is only 18 months, our final bit is called the “internship”, and lasts seven weeks.

By mid-December I’ll be done with everything for my RN. I’ll have the option to complete additional hours and sit for an additional certification (which I plan on doing), and then I’m released to take the NCLEX.

In the meantime, I’m finishing papers, taking quizzes, completing projects, giving presentations, attending classes, going to clinicals in Psych/Community, and taking finals. None of these things should be too difficult, but if I forget or mess up to any appreciable degree I can mess up my chances of getting out free and clear.

So often in nursing school there seems to be this huge boulder over our heads, ready to smack us down if we do the little-est misstep. I know NNR has been feeling similarly. (I feel you!)

On a happier note, stop by Kim’s place for the latest Change of Shift! I’ve been too distracted to even read more than a couple posts in the last two offerings, but get thyself over before the wrath of Dog descends upon you.

New Change of Shift logo

While taking a break from reading and studying I checked out woot.com, which someone had told me about. Interesting place.

They posted this letter about a price reduction they recently had. I thought it was pretty ballsy brave interesting how they chose to write it. Lots of ‘tude.