Best Practices: change is hard for those who "Do"

 I'm in nursing school. I also think a lot about "best practices." 

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 It doesn't usually mean that there is ONE best way, but that ways we thought were best may be superseded by a way we had never learned nor considered.

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? '

Filing your nails? Best practices says to file in only one direction, rather than back-and-forth that we often see (even in salons.) 

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.

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. 

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. 

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. 

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?

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. 

We learn that brushing our teeth for 2 minutes has significant benefits. Washing our hands for 20 seconds has significant benefits. 

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.

Emergency Priorities

 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.

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.) 

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.)

Food Failure

 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. 

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. 

It makes me sad and reflective on how this came to be and I can only look in the mirror. 

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.

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. 

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. 

That is all. Good luck, because I know it's easier to type in a blog than it is to do in real life.

Cravings no more

 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.

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. 

Because of cravings.

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. 

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. 

In other words, it's not just psychological discipline, but my body has better chemical discipline. It's not demanding this food.

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. 

This morning, there's candy all over the place and I'm not interested.

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.

That's all. If you want to learn more, these are the resources that have influenced me:

Tim Ferris

Peter Attia

Phil Maffetone

https://www.ketogenic-diet-resource.com/ketogenic-diet-plan.html