tag:blogger.com,1999:blog-36436155070704736172024-03-13T12:56:31.145-07:00Downtown DadThanks for visiting. You will note that I never use my family's names. If you are a personal friend, please remember to not include any of our names in your comments. Otherwise, I hope to hear from everyone!Unknownnoreply@blogger.comBlogger448125tag:blogger.com,1999:blog-3643615507070473617.post-4078186874781730722024-03-11T09:42:00.000-07:002024-03-11T09:42:22.542-07:00A Reason for Higher Education in Nursing (and anywhere)<p> This week's nursing topic is, "Is Nursing a Profession?" There are interesting criteria that constitute a definition of "profession," of which there are three: medicine, legal, clergy. </p><p>One of the criteria is extensive education. According to my reading materials, the most common degree held by nurses is a 2-year associates degree (which I hold.) </p><p>One of the concepts being examined this week is whether or not a more extensive education is warranted or merited. That is, versus work and life experience. This has me thinking.</p><p>Here's my hypothesis: while one can learn much from those around them at work and from life experience, those exposures are local to the individual learner. On the other hand, when one receives a more formal education, the exposure is to a more worldly set of ideas and experiences and includes opportunities to practice with frequent feedback to each trial. </p><p>Does exposure to more worldly materials and ideas make a better nurse? </p><p>It reminds me a little of how Wife and I talk to our kids about the importance of good grade in reference to their effect on choice of college: getting good grades does not mean you are required to go to colleges that have higher academic standards of entry; it means that more doors are open to you. </p><p>In that way, the exposure to concepts developed and published from a wide sample of geography and time does not mean that they are definitively of greater value than the experiences from life and exposure to work; it is that the individual has more resources to pull from when confronted by the situations typical and atypical to the occupation. </p><p>And that is with the lean toward the skill aspect of nursing (hands-on activity.) We also have to consider the intellectual sides of nursing, which include interdisciplinary communication and patient education. I can tell you with great anecdotal certainty that neither of those are skills inherent to the average individual - to communicate clearly and to teach others. There are always outliers, but most people need honing of those skills with practice in both speaking and writing. </p><p>Here's an example: the formation of a formal argument. It is one thing to be able to discuss a topic with another person. It is quite another to have learned to express the opinion or position in a format that is logical and difficult to refute because it includes logical rationale and supportive evidence. And how does that fit into nursing? If I have a patient who is resistant to a treatment, I am going to use the analytical skills developed from my BA in English to tell the patient the rationale and then express the evidence behind the rationale. This is all while advocating for patient autonomy: that the decision is in said patient's hands, and that they should make any refusal - or acceptance of treatment - based on being properly informed. AND, they need to be informed in a way that is understandable to that individual! </p><p>If you're going to get most of that skill and ability from life and work experience, your life and work must include a lot of practice and trial-and-error that includes harsh analysis (akin to grades.) You need to know if your method works.</p><p>One can certainly "get by" and get better over time, but the formal education is dedicated to the specific outcome and provides feedback that is less consequential than that of the feedback of a life experience when you were wrong. An F is better than a death. </p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-8650485602272288412024-01-12T08:21:00.000-08:002024-01-12T08:21:08.617-08:00G-tube patient education (for use in any education that is part of a skill the patient will need to perform)I recently was educating a patient about caring for their g-tube, which is a feeding tube surgically placed through the abdomen to the stomach in order to bypass the mouth and esophagus. <div><br /></div><div><div><div>Recently, I was told by a doctor that the tube had to be in place for a minimum of 6 weeks.</div><div><div><br /></div></div><div>However, some patients regain their swallowing ability and, in turn, lose the need for the tube before the time when it is medically safe to remove. The tube still needs to be maintained to prevent pathogens from forming inside the tube as well as from the opening in the abdomen.</div><div><br /></div></div></div><div>Something that I did well: showed the patient the materials, then explained the procedure.</div><div><br /></div><div>Materials:</div><div><ul style="text-align: left;"><li>foam non-stick pad to place between the plastic circle that keeps the tube from retracting into the abdomen</li><li>wet and dry washcloths</li><li>basin with soap and water</li><li>2 washcloths (one for wet, one to dry)</li><li>scissors</li><li>marker</li><li>graduated cylinder filled with at least 50 mL tap water</li><li>piston syringe</li></ul>Processes:</div><div><ul style="text-align: left;"><li>date the foam barrier and cut out a hole for the tube and a slit to slide it into place</li><li>how to clean and dry around the hole in the abdomen</li><li>how much water to suck into the piston</li><li>How to kink the tube to prevent backflow</li><li>Insert the piston syringe and flush the tube.</li><li>Put everything back in place</li></ul></div><div>The patient was uncomfortable with looking at the hole where the tube is.</div><div>Didn't want to touch or clean it.</div><div>Didn't want to flush the tube.</div><div><br /></div><div>What I should have done:</div><div>Give the patient duplicate supplies to handle as I'm handling each</div><div>Ask after each step if they wanted to perform the task on themself. No judgment if declined.</div><div><br /></div><div>One of the challenges is that the patient does not know what it will feel like to push water out of the piston, or if the hole cut in the foam barrier is the right size and they don't want to mess up on themself (just like we, as nurses, don't want to make a mistake on a patient.)</div><div><br /></div><div>The other challenge is disturbed body image. By exposing the patient to the change slowly and non-judgmentally several times, the patient has time to get used to the change and gain comfort and confidence. Then, adding repeated exposure to the materials for maintenance, the patient will eventually be capable - if not enthusiastic - about performing the task on their own.</div><div><br /></div><div>We can apply the same principles to any number of skills that a patient may require; injections and wound care are two other skills that come to mind.</div><div><br /></div><div>The goal, after all, is to promote the patient's independence and autonomy.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-59118494348917135172023-09-27T04:26:00.001-07:002023-09-27T04:26:44.261-07:00So, I became a nurseIn August 2020, I made a rash decision - I signed up for into to biology and intro to chemistry as prerequisites for the Nursing School at Malcolm X College in Chicago.<div><br></div><div>3 years later, 1 month later, I am in my second week "on the floor" at one of Chicago's top hospitals. </div><div><br></div><div>And, I love it. </div><div><br></div><div>I love interacting with the patients. </div><div><br></div><div>I don't mind the fluids. </div><div>I don't mind the charting. </div><div>I don't mind the regulations. </div><div>I don't mind the hours. </div><div><br></div><div>Now, I'm aware that "The new broom always sweeps clean." However, it's not exactly my first time working with patients nor being in a hospital. </div><div><br></div><div>For the last year and a half, my last job was working in the office of a private psychiatric practice. There, part of my job was to ask my patients about their symptoms, which included patients with major depression, anxiety, personality disorders, and schizophrenia.</div><div><br></div><div>"Are you having thoughts of suicidal ideation or self-harm," was a common question.</div><div><br></div><div>I loved being there. </div><div><br></div><div>On the floor of the hospitals that were part of my clinical rotations while in nursing school, I always felt eager to do the job. </div><div><br></div><div>And now, I'm a professional. </div><div><br></div><div>Not to confuse that with a pro! </div><div>What I mean is, am experienced nurse. </div><div><br></div><div>Perhaps that's what I'll write about,going forward. </div><div><br></div><div>We'll see! </div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-75813101604974776722023-09-19T19:57:00.001-07:002023-09-19T19:57:01.140-07:00Bedtime flipAlmost every night, I am second to bed. Actually - third. Wife on the far side, dog against my pillow.<div><br></div><div>Dog waits for me to pick up the blanket from the side of the bed and gently continue lifting until the blanket lifts and rolls her over to the middle of the bed. </div><div><br></div><div>I fall asleep petting her soft, black, wavy coat. </div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-3643615507070473617.post-15215004297238236422023-06-23T14:47:00.000-07:002023-06-23T14:47:34.379-07:00Evaluating a person<p>While listening to the <a href="https://hubermanlab.com/tim-ferriss-how-to-learn-better-and-create-your-best-future/" target="_blank">Hubermann Lab podcast with guest Tim Ferriss</a>, the following quote was mentioned:</p><p>"Judge a man by his questions rather than his answers."</p><p>-Voltaire</p><p>Please edit "man/his" to "person/their."</p><p>Or don't.</p><p>***</p><p>Funny thing: I looked up the quote. It turns out that, according to my brief research, that quote is wrongly attributed to Voltaire and isn't quite correctly stated:</p><p>"It is easier to judge the mind of a man by his questions rather than his answers."</p><p>-<a href="https://en.wikipedia.org/wiki/Pierre_Marc_Gaston_de_L%C3%A9vis,_Duke_of_L%C3%A9vis" target="_blank">Pierre-Marc-Gaston de Levis</a> (Wikipedia page)</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-59778239423587398522023-06-20T14:46:00.000-07:002023-06-20T14:46:01.848-07:00the amateur vs The Pro<p> At work, I was talking with a person with depression and anxiety who has an artistic gift, but they have not practiced it in a long time. They referenced wanting to use it to make a lot of money. </p><p>When talking with them, I asked if they love doing it for themself and maybe trying out a small gig.</p><p>My supervisor came in at the end of the session. He talked about using their artistic gift in a way to improve structure in their day to alleviate their symptoms. </p><p>That is a pro - knowing how to use tools toward achieving an effective outcome.</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-54594078418724907822023-04-29T10:18:00.002-07:002023-04-29T10:18:31.832-07:00Strategies for Medication Adherence<p> One of the challenges for the healthcare industry is getting patients to adhere to their medication regiment. among the most common examples is that of antibiotics. Something that we learn in nursing school is that patients often will stop taking their antibiotic when they are feeling better, rather than taking the full course of the medication. Another example is getting patients to do prescribed exercises the improve body and system function, such as weight-bearing for bone and muscle strength or aerobic exercises for respiratory function.</p><p>The challenge, of course, is hat once the client has left the healthcare facility, it is up to them to comply on an ongoing basis by incorporating the new regiment into their old routine. I think we can all find examples in our lives where doing so, despite knowing the benefits, is challenging and results in failure.</p><p>What if healthcare organizations had a department for follow-up with clients on an ongoing basis to remind and ensure compliance? </p><p>Think about a position for case workers, nurses, and therapists (PT, OT, RT, SLP, etc.) They can follow-up with the client via phone or video to ensure compliance. </p><p>One challenge: who pays for it? Let's establish the chain of commerce: the client has health insurance and seeks care from the provider. The provider cares for the client and bills the insurance company. The insurance company takes premiums from the client pool and pays the provider. The provider gets a combination of payment from the client and the insurance company.</p><p>Let's think about this. The client is NOT going to want to pay every time that they get a phone call from the provider. That would almost certainly cause reduced compliance due to avoidance. It would be like a bill collector. </p><p>Who in the chain has the most to gain, financially? The insurance company. Improved adherence should lead to a better health outcome fore the patient, which should result in lower ongoing costs, and then to reduced need for reimbursement from the insurance company. </p><p>The insurance company has an incentive to give financial incentives to the healthcare organization for following up with the client to ensure adherence. If the client takes their pills everyday, exercises, etc. then there should be some specific, measurable long term goals that would be met. </p><p>By achieving those metrics, the healthcare organization can finance the employees whose job is to follow up with clients and see how they're doing, including what friction or barriers they have to sticking with the program.</p><p>This provides a remote work position for teams or for people who are unable to work in person. This is an established position: I have a friend who works in oncology. She works 3 days per week, one of which is remote and responds to incoming messages through the client portal. Either in addition to that or as a separate position, people can use that position proactively to reach out to clients to see how they're doing by text, phone, or video. Examples of employees who may like this position include the rotation that my friend participates in, and someone who is on disability leave but could still do work, just not in person.</p><p>Finally, the healthcare organization could give the client financial incentives by showing adherence to the regiment. That could come in the form of direct payment (cash or gift card) or reduced billing. </p><p>There may be some who feel that the hands-off, self-determination approach is best: if you want to get better, it's up to you. </p><p>Others may think that the financial incentives lacks the altruism of helping people: people should be helped without needing financial incentives. </p><p>However, the pragmatist knows that neither of those approaches is realistic. Companies expect to make money, workers expect to be paid, and clients expect service. By catering to improved outcomes from both the individual health as well as the financial perspectives, the interests of all parties are served. </p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-37987664443563379932023-02-17T09:14:00.001-08:002023-02-17T09:14:23.635-08:00Quality Improvement in Healthcare: Typing Skills<p> Documentation is one of the most important aspects of the healthcare system, yet many of the people in the system do not have adequate typing skills.</p><p>In any industry where documentation via keyboard is essential and expected, the company would be wise to implement keyboarding skills into their continuing education. (Including grammar and spelling wouldn't hurt, either.)</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-18267386018468909592022-11-19T07:22:00.000-08:002022-11-19T07:22:02.717-08:00Am I an ex-homemaker already?<p> As I get further into nursing school, one thing is for certain: the workload of school is increasing. While there may have been the same number of hours in classes in the first semester, the academic demands of the third semester (out of four total) are three to four times greater. No longer can I do an hour here, and hour there, and then a few hours on one day to keep up. It's two to four hours per day, every day. </p><p>Which means that is two to four hours per day that I cannot take care of things around the house.</p><p>This thought popped when thinking about Thanksgiving. We have 8 people coming over, so having dinner for 12. I'm going to make turkey, stuffing (okay - dressing,) mashed potatoes, and mac 'n' cheese. I was also going to make pumpkin pie and gravy. All from scratch. Okay, I wouldn't make the the bread for the stuffing from scratch. But, I would chop everything, use gizzards for the gravy, and make chicken stock from chicken bones and mirepoix, make the pie crust from scratch, and make the filling from scratch (like, roast the pumpkin and sweet potatoes) and so on. </p><p>However, in the next three weeks of school, I have a major project, several smaller projects, and a couple hundred pages to read (and comprehend and be able to make healthcare decisions based on.)</p><p>So now I get to make a choice: do homemade, or semi-homemade.</p><p>I think that the choice is simple, but it rips my heart out. </p><p>I think we all have a craft that can be replaced by today's automation and prefabrication. I don't want to say that it's a shame, exactly - it enables people to use their time for the pursuits of their fancy. </p><p>Of course, a whole discussion could be made about the choices that people make. For example, better to learn to cook, sew, or build, or to binge watch Netflix and scroll through social media?</p><p>So, as I make my list, I think I'm going to have to choose which thing I make from scratch. I'm pretty sure that I'll stick to turkey, that unforgiving protein that is so easily ruined (and so often,) mac 'n' cheese (which is primarily made by my younger child,) and mashed potatoes (because that's really easy and forgiving.) Stuffing: you're coming out of a box. Stock: box. Whipped cream: can. Gravy: can. </p><p>I recently heard someone say (I wish I could cite the source right now) that you don't know when it is that you'll do something for the last time. It could be getting picked up and held by your parent, picking up and holding your child, or seeing a friend. For a homemaker, there will be a last time that I walk a child to school. A last time that I yell at a child for failing to do a chore or for talking back. There will be a last time that I clean up a child's mess. A last time that the child walks through the door after school, home safe and with something new to tell me. There is a last time. </p><p>Perhaps last year was the last time that I will have made everything from scratch. Will I miss it? I just don't know. </p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-85994226982626830072022-10-31T08:37:00.001-07:002022-10-31T08:37:06.934-07:00Open letter to grocery stores<p> Dear Grocery stores,</p><p>I have a suggestion for a change or addition you can make to help people shop and make good decisions.</p><p>First, let's talk about why people go to the grocery store: to buy food to prepare to eat.</p><p>Where do they get their ideas? Usually at home, but sometimes people go to the store and do the same thing they've done: wander around until they get inspiration (or resignation.)</p><p>On the other hand, we've seen an emergence of services like Hello Fresh, Blue Apron, etc who create meals and portion out ingredients that are delivered to your door.</p><p>However, many people like the social experience of going to the store. Here's how you, the grocery store, can profit by having a big brick-and-mortar store.</p><p>First, have meal ideas ready-to-go! You should have both print and QR options. You should have two different ways people can take advantage.</p><p>1) You have the meals prepped and ready for a person to pick up. It should also have a list of optional / essentials that people may / may not have in their kitchen (oils, salt/pepper, etc.) Have the aisle AND shelf location to find these things. How to make more money? Get sauce companies to sponsor their product, such as Tobasco, etc AND include the aisle and shelf! </p><p>2) Help people put a meal together. An example: Salad! Seems simple, right? But many don't know how to use radiccio, chard, and other lettuces and just go for romaine / iceberg (which are fine.) So: educate them! </p><p>Here's how it might look like:</p><p>Start with your produce: greens (lettuces), fruits (tomatoes, mangoes, avocado), chiles, peppers/cucumbers, roots. Have a sample of what a person might buy (1 head romaine, 1 cuke, etc.)</p><p>Then protein. Give them the choice of fresh, frozen, or pre-cooked.</p><p>And keep going. Tell the person where they can find the stuff EXACTLY and then what they may want to add to their order (dessert, chips, etc.) </p><p>You also have prepared foods. Sell the thing you're advertising! In this way, your back-of-house prep team can make these meals to take away ready-to-eat OR ready-to-cook. Saves time and money.</p><p>Use what's cheap and in season! Increase your margin by creating menus that feature items that are both profitable and affordable. Everybody wins! Have date night options, family options, holiday options. Keep thinking! </p><p>However, the current system of a big store is old thinking. Future-proof yourself by helping your customers get what they don't know they want. </p><p>Thanks!</p><p>-DowntownDad</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-77617927170021176892022-04-27T17:23:00.000-07:002022-04-27T17:23:38.332-07:00Patient teaching: understanding how to communicate with the nursing staff<p> I was thinking about some other things I can do when I become a nurse. One of the things I can do when I come on for my shift change is orient the patient to the communication tools. </p><p>While some patients can certainly become overbearing, I also wonder if fear and anxiety can be relieved if the patients know how to get in touch with me and how to use the communication tools to get what they need? </p><p>For example, we give them a call light and the nurses sometimes wear a phone that looks like a walkie talkie. </p><p>The question I have is this: do they know how and when to use them? </p><p>I don't think it would take more than 10 or 15 seconds to say go ahead and push the call light. Then, I can quickly hit the cancel button and say, "See, that was easy." </p><p>Then I can show them how to get in touch with me on my phone.</p><p> I can explain how each is answered. For example, in general, it is expected that the nurse assistants will respond to call lights before the nurses will. On the other hand, the phone number is directly to the nurse. So, if the patient just needs something like water or a simple comfort measure with their linens, that would be something for the nurse assistant and the call light is a good tool for that. </p><p>On the other hand, if it's something more urgent and the patient is able to, calling the nurse is a better solution so that the nurse can respond more quickly and possibly put in orders or get in touch with a provider from the nurses station without having to first come to the room.</p><p>So far, one of the things I've noticed is that the nurses don't do a great job introducing themselves. This could be a great part of that process. I think I would immediately have more confidence in my care. </p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-19932778676122034872022-04-25T07:53:00.001-07:002022-04-25T07:53:28.902-07:00Hemorrhoids and Capitalism<p>As I think I've said before, I'm a big fan of capitalism. Who was it who said something like, <i>it's a terrible system, but it's the best system</i>? Actually, they said it of democracy, but you can say it about capitalism, too. Innovation and self-determination drive improvement, among many other fine qualities. There is the long list of bad things, such as marketing, that contribute to capitalism's woes. I digress.</p><p>You know what's funny about capitalism? Preparation H. Instead of promoting a healthy diet to eliminate hemorrhoids and constipation, we market a med to relieve symptoms. </p><p>The only capitalistic incentive to cure and prevent is money. For diseases keep getting passed, the cure will forever be needed; prevention is needed by new people and needs to be updated. But making a disease come to an end and never resurface is not in the best interest of medicine. Or rather, is not in the best interest of the bottom line.</p><p>I'll counter my Preparation H argument: isn't it great that someone came up with something for the inevitable number of people who, for whatever reason, suffer from hemorrhoids? And, how will those people find the product if not for marketing? From those who suffer from it to those who stock their shelves with such products, knowledge is the first step.</p><p>However, there's also no marketing for the relief of the causes, such as poor diet. Wouldn't it be nice to see information that we should get 2,000-3,000 mL of non-caffeinated water per day (both from liquid and solid sources)? That we should get at least 20g of fiber per day? That lack of physical activity is a contributing factor? That many meds and dietary supplements contribute?</p><p>What is the market for health promotion? I don't mean going to the gym - I mean going for a walk. There are no coupons for raw foods, only prepared foods. Just some of the challenges that our system faces. </p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-66598090115036193062022-04-11T08:22:00.001-07:002022-04-11T08:22:40.967-07:00Looking ahead: Combating immobility<p> I'm thinking about my future nursing practice. We're currently talking about mobility / impaired mobility. Could I carry a ball with me that I play a little catch with patients who are able? Everyone loves to play catch!</p><p>Could I have every patient who is able get up and walk a lap in their room every time I come in? For example, when I bring their meds, get up - even if just to stand up. Maybe walk 10 feet then back to bed. Just something to get them out and it <i>may </i> not take a lot of time. </p><p>What if they can't get up? Can I get them to roll side to side? Could they just dangle? Do some ROM and / or incentive spirometry as I prep their meds? I bet I could get some sort of board and / or bar to get them to do some leg presses or a sort of bench press while in bed. </p><p>How about having an ongoing game like checkers, chess, or cards that I come and play for 5 minutes here and there? </p><p>Can my patients text me instead of / in addition to call light? Teach them to send a text that begins with their initials and room#, then their need. Obviously, this only works if I have a work-issued communication device.</p><p>I'm just thinking a lot about what I'm seeing and experiencing as a nurse. I want to connect with my patients for the purposes of healing, not just get them in, get them out. </p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-89438861954708845272022-01-24T09:06:00.007-08:002022-01-24T09:06:48.314-08:00Best Practices: change is hard for those who "Do"<p> I'm in nursing school. I also think a lot about "best practices." </p><p>Best Practices is the idea that there are ways of doing tasks or skills that are "better" than others. It doesn't usually mean that there is ONE best way, but that ways we thought were best may be superseded by a way we had never learned nor considered.</p><p>Let's take a daily task like brushing one's teeth for example. At what point did we learn that, 1) brushing for 2 minutes is best and 2) that brushing the gums is essential? '</p><p>Filing your nails? Best practices says to file in only one direction, rather than back-and-forth that we often see (even in salons.) </p><p>So when I'm in nursing school and at clinicals, I hear a common refrain: that there is book nursing, then there is the real world. And I'm highly skeptical.</p><p>Skeptical with this caveat: part of our initial education told us that, as a novice nurse, we will want to do things "by the book," but that when we become a seasoned veteran, we will know that there may be methods, procedures, or processes that we have customized through trial-and-error. </p><p>My skepticism is this: there is an accumulation of knowledge from all of these seasoned nurses who learn things by this trial-and-error that work better than the way they were taught in school. Some of these nurses take that knowledge, do studies, publish those, which are then put into books that teach the new wave of nurses. </p><p>In other words, shouldn't these seasoned vet nurses consider that there may be thousands of other seasoned vets who have figured out a hack to various daily nursing challenges that can be incorporated for the benefit of the patient, the nurse, and the facility? I have to think so. </p><p>However, when in class, I brought up something that I'd learned in my book that wasn't introduced in our lab. The professor said that she only used that method for a specific instance that didn't come up very often. However, the book cited a nursing research paper that said that their studies (reports from nurses) showed significant reduction in pain for patients when using a certain injection method every time this process was done. Now, I'm not a nurse, but why isn't this thing (that's in the book that they're using to teach us) something that they know about?</p><p>Furthermore, when I've been in the clinical setting, I'm not seeing it done. It's something that we should be seeing (or feeling) when we get our COVID vaccinations. Yet, the pharmacists who have given me the shots are not doing this. </p><p>We learn that brushing our teeth for 2 minutes has significant benefits. Washing our hands for 20 seconds has significant benefits. </p><p>Being me, I also think about the number of things that we do during the day for which there are updated "best practices" and there's no way to keep up with all of them. Sigh.</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-66397735587942266832021-12-13T16:30:00.001-08:002021-12-13T16:30:42.241-08:00Emergency Priorities<p> I was thinking about the ABCs (Airway - Breathing - Circulation.) The other day, our professor said that they were essentially listed as priority: 1st = airway, 2nd = breathing, 3rd = circulation.</p><p>I was just thinking about that and started with a disagreement: in CPR, circulation is priority (the body needs blood circulated more than it needs the breaths bc there is usually a couple of minutes worth of oxygen stored.) </p><p>Then I thought about the idea that, if we identify a person who may need CPR, then we'd first check on their airway to see if there is an obstruction, which could solve the problem. If the airway isn't obstructed then I would check to see if the person is breathing. If not, then I would check for a pulse (circulation.) If none is identified, then I would start the CPR process (call for help, body position, etc.)</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-87742866742245054552021-11-13T05:47:00.005-08:002021-11-13T05:51:04.663-08:00Food Failure<p> I realized the other day that there is not one meal that I can think of that I can cook the exact same for all four people in our house that we all would eat. </p><p>Actually, that's not true. I think that if I served plain hamburgers with French fries and glasses of water, we would all eat that. </p><p>It makes me sad and reflective on how this came to be and I can only look in the mirror. </p><p>There are lots of other successes that I can point to and say that I influenced that positive outcome. This is not one of them.</p><p>If I have any advice to a young family, it is to reduce the number of snacks in your pantry. Snacking between meals is unnecessary and a symptom of boredom. Make meals that everyone can tolerate and that are balanced. Introduce new foods in small amounts but frequently and prepare them simply. Wait to introduce condiments. </p><p>Finally, there is no such thing as "kid food." Foods high in salt, sugar, and saturated fat are tasty to all humans. We (yes, I include myself) are just preparing our kids to be diabetics. </p><p>That is all. Good luck, because I know it's easier to type in a blog than it is to do in real life.</p>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-3643615507070473617.post-34052300776877215822021-11-01T06:46:00.002-07:002021-11-01T06:46:22.817-07:00Cravings no more<p> I've been on a ketogenic diet (really, carb sensitivity diet) for about 4 months. The reasons for doing so were weight gain and cravings for sugar.</p><p>The latter was the main problem. At 6'5", 218 lbs, I was a bit overweight, but not too bad. Still, it had been creeping up. And I am almost 100% certain why it would have continued to tick up. </p><p>Because of cravings.</p><p>I would get addict-like cravings for sugar, especially at night. When I'm in it, it feels like an uncontrollable, out-of-body experiece. I'm looking at myself from outside of myself, saying that this is stupid and that I shouldn't be eating all of this junk food. But my body would be incontrol and do what it felt it needed to do. </p><p>Now that I've been eating a carb-restircted diet, my cravings are almost zero. I can be around foods that would have made me cave and maintain my discipline. </p><p>In other words, it's not just psychological discipline, but my body has better <i>chemical</i> discipline. It's not demanding this food.</p><p>Case in point: this past weekend was that of Halloween. I love chocolate. Love. I love chocoalte candy. Love. So, I told myself that this weekend I would be able to eat anything I wanted. And I did. Pizza, candy - whatever. </p><p>This morning, there's candy all over the place and I'm not interested.</p><p>Since starting right around July 1st, I have lost 18 lbs. I do wish that I'd done measurements and blood work before starting (adipose fat and blood sugars and other levels,) but I didn't.</p><p>That's all. If you want to learn more, these are the resources that have influenced me:</p><p><a href="https://tim.blog/">Tim Ferris</a></p><p><a href="https://peterattiamd.com/start-here/" target="_blank">Peter Attia</a></p><p><a href="https://philmaffetone.com/2-week-test/" target="_blank">Phil Maffetone</a></p><p>https://www.ketogenic-diet-resource.com/ketogenic-diet-plan.html</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-90765010080095379192021-10-25T16:18:00.003-07:002021-10-25T16:18:40.210-07:00A better way to pay for journalism<p> I really don't know why I share my thoughts, but here's another one.</p><p>I hate macro data collection. I think it's a gross invasion of privacy and completely goes against the 4th Amendment (The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.) </p><p>The fact that said data collection by big tech is not technically done by the government but by said industry with the blessing of our government is tantamount to the same. That's my opinion, anyway.</p><p>Btiching without suggestion is not my style.</p><p>Here's my latest big idea that I'll never fulfill. </p><p>If I were a web developer, I would create a news and non-fiction content search that facilitated easy transactions for reading content. Let me explain.</p><p>Let's say that I want to read the Wall Street Journal article about the gigantic profits of the world's premier widget manufacturer. The Wall Street Journal wants me to be a subscriber, however. They need to pay their staff and all of the overhead that is required to run a company, of course. </p><p>In the olden days, the drivers of revenue were ads in the paper and classifieds in that dedicated section. </p><p>Craig's List, job listing sites like Monster, and Facebook marketplace have destroyed the classifieds stream. (These assertions have been widely reported.)</p><p>That "nobody" reads the print versions of these means that the ads that one would find in the printed pages are no longer as valuable. (This assertion is a logical assumption of mine.)</p><p>Instead, like the rest of the internets, data is collected as we go through sites so that companies can figure out what to market to us (not necessarily a bad thing - I've dealt successfully with targeted marketing) but also how to keep us engaged for longer. </p><p>Can we agree that data collection is a bad thing?</p><p>And, what if there was a better way for the written word to be more valuable to produce?</p><p>What I propose is this: an account that pays for articles that we read. Let's say, for example, that we want to read the reporting on the <a href="https://www.icij.org/investigations/pandora-papers/global-investigation-tax-havens-offshore/" target="_blank">Pandora Papers </a>. The ICIJ does have a donate button, but what if there was an easier process? What if I had a small, dedicated amount of money, in a digital wallet that was for the sole purpose of paying for these articles. Furthermore, if we are "all" paying, then we actually wouldn't have to pay very much per person to make a huge impact. </p><p>How would it work? I have an I-pass. When I drive on the tollway, I can roll right through the tolls because I have an RF transmitter that pulls a fee from an account for which I have pre-loaded money. Why not with articles?</p><p>But I don't want to pay $1.00 per article!?! My response: we shouldn't need to! I think the average price per article would be in the $0.01 to $0.05 per article. Let's say 1,000,000 people read an article: that's $10,000 if it's the penny price and $50k for the nickel. And, if it's a debit transaction as opposed to a credit transaction, then it's a cheaper transaction price. </p><p>I'm sure there is a lot that I don't know about e-commerce that would make this complicated, but I do think it could work.</p><p>That's my idea. If you like it, take it and make it happen!</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-55532322321424990492021-10-14T08:15:00.003-07:002021-10-14T08:15:46.281-07:00Physiology and psychology of Mobility dysfunction<p> That's a fancy way of saying that, when it's hard to move, problems of the body and of the mind can result. </p><p>Here's the thing that my book pointed out that I'd never considered. Are you ready?</p><p>A dysfunction in mobility can make is difficult or impossible to leave an uncomfortable or undesirable situation.</p><p>Can't get up and go? Then you can't get away. You're stuck being in and around environments. </p><p>People who you don't like? You're stuck. </p><p>In a conversation that you don't like? you're stuck.</p><p>Want to go to your happy place? You're stuck. </p><p>Want to go to the place you go when you're sad? Depressed? Angry? Horny? Dreamy? Feeling creative? You're stuck.</p><p>The main factors that contribute to mobility include strength, flexibility, balance, and coordination. You can immediately imagine what a reduction in function in any of those can have on the ability to get from one place to another - even something as simple as getting out of bed and sitting in a chair that's right next to the bed.</p><p>Or go to the bathroom. </p><p>Or go for a walk.</p><p>Or get something to eat or drink.</p><p>Or get dressed.</p><p>Or go to bed.</p><p>And so on.</p><p>To go back to the original thing that blew my mind - the ability (or inability) to get out of a situation that I don't want to be in... What a fundamental function that we take for granted. </p><p>Even if it's just being done being at a place. Let's say, a friend's house. You've been there for a couple of hours. It's been great, but you're ready to go. Nope. Gotta wait till the method of transportation is ready to take you. Done with your meal? Gotta wait. Done with your TV show? Gotta wait. Done with your game of cards? Gotta wait. Done taking a piss or taking a dump? Gotta wait. </p><p>Oh - and lest we forget that being immobile is NOT just for the elderly. Want to masturbate? Ha! Menstruating and need to change your pad or tampon? Ha! </p><p>You want to get out of a situation and you're stuck.</p><p>Take care of your body, people.</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-29516841044329510852021-10-06T12:02:00.002-07:002021-10-06T12:02:30.218-07:00The Work Cascade<p> Maybe it has to be meaningful work? </p><p>I have found that, even when the work is daunting, once I get going, I get into it. Today, for instance, I had been putting off a couple of assignments for my Clinical section of Nursing 101. </p><p>We had a break from clinical rotation. Our professor used it for two things. First, we were able to have a conversation about our experiences, which lasted about an hour. It was a really good exchange about our experiences and any questions or comments. </p><p>For those who know me, I am not afraid to speak aloud about my impressions. The major thing that I mentioned was how nursing in practice is different from how I was observing it over our two clinical sessions. </p><p>One instance was about documentation. According to the book, it is supposed to be done after seeing every patient. This is to ensure the least amount of information loss. In practice, the nurses would do their rounds, then go to the computer and document. </p><p>The second instance happened on our first day. The nurse needed to get a blood glucose measurement using a tool called Accucheck. First, you use a tool to make a small prick in the patient's finger. Then, you use a special strip that's attached to a small handheld gadget to gather a drop of blood which is analyzed in just a few seconds. The patient did not want to have it done to them, so the nurse had one of my classmates hold her so that the nurse could do the procedure. According to our book, there were several problems with that, both moral and legal.</p><p>Part of our discussion dealt with the idea that we sometimes have to do things to ensure the patient's health. In this case, it could possibly have been rationalized that, without the measurement, proper medication and nutrition could not be provided. My main issue, though, was that the nurse didn't use any communication skills with the patient. She didn't ask the patient why she was so opposed to the procedure. Did the patient understand the importance of the procedure? Could we have come back a little later?</p><p>Sorry - waaay off track on what I first brought up! </p><p>After we all talked about our experiences and had our discussion, the professor was going to give us time to work on some projects independently. First, though, he went through the projects and we were able to talk about them one at a time to understand what was needed to complete them.</p><p>Once I got going, I was hooked. I took a couple of short breaks to walk the dog and have lunch, but I kept thinking about my assignments and wanted to get back to it.</p><p>It's like that, too, when I start organizing a room or painting a fence. I'll find any excuse to avoid those things. But, once I get started, I get focused and want to do a really good job. </p><p>That's why I called it a cascade - once I start, I don't want to stop because of the momentum that I've built.</p><p>Do you ever have that experience?</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-614836194375481642021-09-20T17:43:00.003-07:002021-09-20T17:43:40.988-07:00The Teaching Process<p> Imagine you're a young person and want to learn a new skill. Let's say you're going to help your parent put together a table and chairs of the new dining room set. As a child, you're new to using screwdrivers, but are eager to learn. You go with your parent to the place where the assembly will take place. </p><p>However, you're surprised when your parent doesn't hand you a tool. Instead, they open up their laptop and proceed with a history or tools, especially screw-driving tools. </p><p>How exciting. Sigh.</p><p>Or, scenario B: </p><p>You start opening boxes with your parent, who shows you first how to use a box-cutter knife by demonstrating it, then hands it to you or you do it hand-over-hand and then you get to do it by yourself. Then you get the parts sorted and start assembling; again, your parent demonstrates where the screw goes and how to use the screwdriver, then you do hand-over-hand, and eventually you get to turn it yourself a few times until it gets too hard and your parent does the last few turns. </p><p>Which was a better learning experience?</p><p>This is my criticism of my nursing program education. We're definitely doing some hands-on in our first weeks, but the book starts off with history and national organizations. Sure - we need to understand HIPAA since we are going into healthcare settings to do clinical rotations. Otherwise, we need to focus on what to do when we get there! Then, you can interweave standards of practice, scope of practice, and the like. But starting us off with Florence Nightingale? I mean, I'm a history guy, but SNOOZE.</p><p>I look forward to learning more about her later. In the meantime, teach me how to be a nurse!</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-39533154899242986012021-09-15T12:25:00.003-07:002021-09-15T12:25:23.687-07:00Dealing with rejection - from the rejector's sideIn my Anatomy 2 class, I have found myself having become a class leader. With that, a group project was assigned and we could form our own groups. I found a couple of people with whom I felt that I shared similar level of engagement and we formed our group.<div><br /></div><div>Since then, I have had many requests from other classmates asking to be in my group.</div><div><br /></div><div>First, it's a nice compliment to have people want to work with me. At the same time, it doesn't make sense to make our group so big. </div><div><br /></div><div>I'm trying to recall where I heard the following strategy that I used. It may have been from Tim Ferris (tim.blog).</div><div><br /></div><div>Anyway, I have had to learn how to say no to people. Being a "people pleaser" is something that has both benefitted me as well as create situations where I fail to fulfil responsibilities to their completion. </div><div><br /></div><div>My response has been, "We have enough people in our group. A couple of other people who don't have a group have reached out to me as well. Should I connect you to them?"</div><div><br /></div><div>In this way, I've said no. I want to be helpful, so offering an alternative is still being true to being helpful, an important value to me.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-31404417982947242292021-09-09T09:22:00.003-07:002021-09-09T09:22:29.839-07:00Fun Fact: Blood Vessels<p> If you laid out all of the blood vessels in a human body, they would stretch between 60,000 and 100,000 miles. (Child vs adult.) Yes - miles.</p><p><br /></p><p>https://www.fi.edu/heart/blood-vessels#:~:text=But%20if%20you%20took%20all,arteries%2C%20veins%2C%20and%20capillaries.</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-38838340635729912042021-08-05T08:07:00.001-07:002021-08-05T08:07:28.871-07:00Mask your lungsPainting my front fence and stairs has been something I've been putting off for far too long. <div><br /></div><div>It's the cleanup. </div><div><br /></div><div>I hate it. It's the worst.</div><div><br /></div><div>And, I could just as easily buy throw-away stuff, but that goes against my principles. Which, of course, is why corners of my house are cluttered. Brutal.</div><div><br /></div><div>At any rate, I finally wrap my mind around getting the project done. Calculations of square footage are done, sanding and scraping are done, gathering supplies, and finally buying the paint. </div><div><br /></div><div>While sanding and scraping, I realized - why am I not wearing a mask? </div><div><br /></div><div>One thing that I hope we've all (most of us, anyway) have realized is that small particles get in the air. While we absolutely cannot avoid all particles, regardless of what level of mask we wear, we can reduce the quantity - or load - that we inhale.</div><div><br /></div><div>So, I grabbed my gaiter and went to work. I also put it on while painting because, my logic told me that, while rolling paint on, there would be droplets invisible to the eye that would get in the air that I certainly didn't want to breathe. </div><div><br /></div><div>Am I certain that I'm right? No, as I have no way to test my hypothesis in a practical way. Err on the side of caution? We all measure risk. Protecting my lungs from harm is something that makes sense to me!</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-3643615507070473617.post-88410675383219025052021-03-18T09:01:00.001-07:002021-03-18T09:01:10.704-07:00Study Habit Flow Chart<p> The best study habit that I've developed through suggestion and experience is the ability to read without understanding. </p><p>What???<br /></p><p>I think that's one of the biggest challenges that I've faced in my limited time as a science student. My chemistry professor in the fall '20 semester said to read the chapter without working hard to understand it.</p><p>That is really hard for me.</p><p>What I'm learning, though, is that if I can plow through it and just read it and maybe learn some of the vocabulary before the lecture, that I can then go back and it will start to make sense. </p><p>For example, in studying for a test, I'm going back and filling in my notes from class. The class moves way too fast to make detailed notes during the lecture. I find myself missing important information and discussion if I take too many notes, so I just try and get the highlights and make "bookmarks" of where in the PowerPoint it can be found. </p><p>Now that I've laid that foundation, I am going back and filling in notes and making compare and contrast tables and it's all coming together.</p><p>Again, though, it starts with that first step of reading without understanding, which actually takes a good amount of fortitude because you keep saying, "What???" to yourself and the desire to go back and read and reread until you get it. </p><p>Oh! And make questions about the things you don't understand, even if it's just, <i>I don't get X main topic</i>. Those become bookmarks for your mind and will actually help to reinforce the learning that comes from the lecture.</p><p>So: read without fully understanding -> form questions from the reading to take to lecture for discussion -> take notes on the lecture and ask when your questions aren't answered in the lecture -> reread and make flashcards for vocab with new understanding -> review notes and fill in missing info and detail -> tables to compare and contrast concepts and processes -> flow charts to show the steps and components of a process</p>Unknownnoreply@blogger.com0