Tuesday, June 17, 2014

IGTBH - Flaky Edition

OK - so I flaked for the last 8 days.  I know I can't really make that up, as the point is to pause to do this every day.  HOWEVER, I can try.  I did think about it on those days, but failed to actually follow through most of the time.  (I did write a few down in my notebook.)   To be fair, I've had less than ideal internet access, as well as marital drama (no worries, it's working out) during this time.

So, to make up for 8 days of not doing it, here are 40 things from the last 8 days that I'm thankful for, in no particular order:

1.  Thank you, Herbal tea, for being so calming and wonderful.
2.  Thank you, yin side of me, for showing up for awhile.
3.  Thank you, Several new friends on RAoa, including but not limited to DoodlesandSuch, adalab, and LeftMySoulAtHome, for making me feel loved.
4.  Thank you, dad for being my dad.  I know it's not always been easy.
5. Thank you John M. Gottman, PhD, for writing a book that might be saving my family.
6.  Thank you, husband, for working through this with me.
7.  Thank you, Jessie, for recrowning me as queen of awkward
8.  Thank you, self, for quitting that job you hate.
9.  Thank you, simplicity, just for being and encouraging me to just be.
10. Thank you, breath, for your lifegiving and centering effects.
11.  Thank you, lack of technology, for helping me re-see life more beautifully.
12.  Thank you, current era, for all the information available these days.
13.  Thank you, ideas, for being ever present in my brain.
14.  Thank you, Jason for doing our family portraits
15.  Thank you, weather, for being great for portraits
16.  Thank you, dad, for dinner after portraits
17.  Thank you, Baklava, for being
18.  Thank you, husband, for Our new deck.  It's stunning.
19.  Thank you, family, for our new walking tradition.
20.  Thank you, Nico, for spending time with your mommy who loves you so much.
21.  Thank you, Maggie, for spending time with your mommy who loves you so much
22.  Thank you, Santi, for spending time with your wife who loves you so much
23.  Thank you, open window, for allowing the cool breeze through.
24.  Thank you, flip flops, for the pleasant flip sound you make as I walk, and for the freedom you provide my tootsies.
25.  Thank you, self, for Finishing my required course on breastfeeding in preparation for the doula workshop next weekend
26.  Thank you, Start from Seed, for hosting THE DOULA WORKSHOP NEXT WEEKEND!!!!!!!
27.  Thank you, life, that I will be a freaking awesome doula
28.  Thank you, future person who will help me with this, for helping me to give a few tired single moms a much-needed break
29.  Thank you, books, for exposing how important family and community are
30.  Thank you, new tires, for working so well.
31.  Thank you, person selling your car, for selling just what we wanted for the price we wanted when we needed a car.
32.  Thank you, tuna salad and triscuits, for nourishing me and making me happy.
33.  Thank you, mom, for my mini greenhouse.  I CAN'T WAIT TO GROW ALL THE HERBS, FLOWERS, AND VEGGIES!
34.  Thank you, inlaws, for what positive things you have done while you are here.
35.  Thank you, Spanx, for making me look ok in a bathing suit.
36.  Thank you, RCCL, that Fabio's new job is going well.
37.  Thank you, 3 liters of water per day along with reasonable eating and exercise habits, for helping me lose 3 lbs.
38.  Thank you, family, for leaving leftovers from sunday lunch!
39.  Thank you, woman standing at the end of my interstate ramp with a sign that says "free gifts.  Jesus included."  for showing the good in people
40.  Thank you, sleep, for coming soon.

Monday, June 9, 2014

IGTBH Day 21 - June 9

1.  Thank you, workday, for having a definite end time.
2.  Thank you, husband, for taking a walk with me tonight.
3.  Thank you, father in law, for making a cold quinoa salad for dinner.
4.  Thank you, kids, for going to sleep rather quickly tonight.
5.  Thank you, bed, for existing so I can go sleep on you right now.

Sunday, June 8, 2014

IGTBH Day 20 - June 8

1.  Thank you, Veronica, for letting me sit next to you in church.

2.  Thank you, Grandma and Grandpa, for letting Maggie and I stop by and visit.

3.  Thank you, sunshine, for being out.

4.  Thank you, Spanx, for making bathing suits!

5.  Thank you, Nurturing the Soul of Your Family, for being a good book.

and an extra because today was harder than usual,

6.  Thank you spinach pie and tzatziki sauce for being so damn good.

Saturday, June 7, 2014

IGTBH Day 19 - June 7

Thank you, Jason, for taking our family pictures today!

Thank you, Botanical Gardens, for being so dang gorgeous!

Thank you, Dad, for dinner.

Thank you, bedtime, for borrowing our cranky kids. 

Thank you, Santi, for the backrub!

Friday, June 6, 2014

IGTBH Day 18 - June 6

Thank you, Angela, for your encouragement, strength, and support.

Thank you, workplace, for providing ice cream sundaes!

Thank you, adenovirus, for getting the hell away!

Thank you, brain, for recognizing something I need to do, even if you haven't found the right way to do it yet.

Thank you, RAoA, for a new friend!

Thursday, June 5, 2014

IGTBH Day 17 - June 5

Thank you, Fabio, for updating me on how you're doing.

Thank you, kids, for needing me so much, even if it's because you are sick.

Thank you, once again, Bacon Egg and Cheese Biscuit, for being so delicious and easy.

Thank you, ibuprofen, for keeping the kids' fevers down.

Thank you, life, for making it clear what's important.

Wednesday, June 4, 2014

IGTBH Day 16 - June 4

1.  Thank you, Bacon Egg and Cheese Biscuit, for being so delicious.  You complete me.

2.  Thank you, work, for being so boring that you're easy to leave.

3.  Thank you, new back deck, for being the perfect reading spot.

4.  Thank you, scales, for reporting that I've lost 5 lbs.  I don't believe you, but thank you nonetheless.

5.  Thank you, Rusted Root, for the video to Send Me On My Way.   It's weird but I love it.

Tuesday, June 3, 2014

IGTBH Day 15 - June 3

Thank you, Hilarious Giant Ducky Float, for existing and giving me something to laugh at at 4:40pm today.
Thank you, kids, for being in amazing moods tonight and making me feel so grateful (see next item).
Thank you, God and the stars, for giving me these two amazing kids and this beautiful family.
Thank you, life, for being so imperfectly perfect.
Thank you, ideas, for your amazingness, especially as I start building my business.

Monday, June 2, 2014

IGTBH Day 14 - June 2

Thank you, mom, for taking the kids.
Thank you, Jessie, for making me feel good about myself.
Thank you, Jessie, for getting us out of the office for some yummy greek food!
Thank you, husband, for giving me the last piece of chocolate cake, soaked in rum........
Thank you, both kids, for snuggling with us, but then for kicking me out of bed, so I get to sleep by myself, which is equally beautiful.

Sunday, June 1, 2014

IGTBH Day 13 - June 1

Thank you, people who came to see if it would work out for me to provide childcare to your son, for showing me that it's ok if not everything works out according to plan.

Thank you, scary change in circumstances, for showing me that I can cope with scary changes in circumstances.

Thank you, day, for being so gorgeous!

Thank you, neighbors, for being so freaking awesome that I want to freaking hug your necks.

Thank you, new friends, for being super awesome and making me excited to get to know you!

Saturday, May 31, 2014

IGTBH Day 12 - May 31

Thank you, Claritin, for finally wearing off... around 11pmish
Thank you, Jessie, for hosting a kick ass cookout.
Thank you, strawberry rhubarb pie, for being.
Thank you, genius mind, for remembering how to get to Jessie's house.
Thank you, new friends, for being awesome.

Friday, May 30, 2014

IGTBH Day 11 - May 30

Thank you, Claritin, for letting me know that I cannot take you.  I'll know in the future.

Thank you, waffle fries, for being so crunchy and salty on the outside and soft on the inside.

Thank you, cousin, for giving me free lunch.

Thank you, Jessie, for driving me around when I was so loopy from taking Claritin.

Thank you, end of the workday, for always being there when I most need you.

Thursday, May 29, 2014

IGTBH Day 10 - May 29

Thank you, clarity, for helping me feel so much love.

Thank you, fluorescent lights for draining my energy so I know how much I love the sunlight.

Thank you, yoga pants, for your yoga pantsy comfortable goodness.

Thank you, children, for celebrating simple things.

Thank you, chocolate cake, for just being you.

Wednesday, May 28, 2014

IGTBH Day 9 - May 28

Thank you, Farriors, for scheduling an early dinner so I have to leave work early.

Thank you, matriarchs of my past, for being strong and beautiful and useful.

Thank you, Goodwill, for having good stuff.

Thank you, Paramore, for getting your song stuck in my head. I rather like it.

Thank you, mind, for being open and not boxing me in.

Tuesday, May 27, 2014

IGTBH Day 8 - May 27

Thank you, three day weekend, for making me think today is Monday and that I still have four more work days this week when I only have three.

Thank you, those who served, for your service.

Thank you, "Mothering the New Mother" for inspiring me so awesomely

Thank you, kids, for being so amazing.

Thank you, weather, for being perfect.

Monday, May 26, 2014

IGTBH Day 7 - May 26

Thank you, life, that bad days are not completely 100% bad.
Thank you, rum, for soaking into leftover birthday cake so nicely.
Thank you, leftover sangria, for existing.
Thank you, Fabio, for being my soulmate.
Thank you, doula training, for being a ray of hope.

Sunday, May 25, 2014

IGTBH Day 6 - May 25 - My birthday!

Thank you, God and Universe, for my life, and each day, which is a gift, pure gift.
Thank you, Mom, for baking my cake and for all you did to make today special.
Thank you to my family, for celebrating with me!
Thank you, Fabio, for the messages that made me feel so loved today.  Making you proud of me is so special to me.
Thank you, my church, for having a BP clinic, so that I can take blood pressure, sharpen those skills, and talk with an RN for an hour every other Sunday morning.

It's my birthday, so I have extra.

Thank you, /u/micha111, for my RAOA birthday gift!  I love that song.
Thank you, Sangria, for lasting all day :)
Thank you, audacity, that you allowed me to take a big step to change my life.
Thank you, Annie, for being my mommy buddy
Thank you, weather, for holding out.

Saturday, May 24, 2014

IGTBH Day 5 - May 24

Thank you, Santi, for finishing the deck so we can have a party!
Thank you, Lilian and Hillary, for the fantabulous flowers.  I love them so much.
Thank you, Jessie, for helping me get ready for the party.
Thank you, in-laws, for all you did to help.
Thank you, everyone, for celebrating my life with me!

Friday, May 23, 2014

IGBTH Day 4 - May 23

Thank you, Mom, for taking the kids several nights a week.
Thank you, brain, for being such a dreamer.
Thank you, unnamed person, for being so attractive.
Thank you, same unnamed person, for being cocky enough to be somewhat unattractive if I think about it enough. This makes life easier.
Thank you, adrenaline, for flowing today and satisfying my jonesing for you.

Thursday, May 22, 2014

IGTBH Day 3 - May 22

Thank you, McFly and Neighbor Frank, for having birthdays so I can make my body produce so much insulin today.

Thank you, Nico, for saying that you'd rather mommy stay home with you than for you to go to a new school.

Thank you, those who created the currently-used calendar, that tomorrow is Friday.

Thank you, fly, for crawling on the doll to make it even more creepy looking, thereby making me laugh harder.

thank you, giggidywarlock, for the aeropress because life will never be the same.

Wednesday, May 21, 2014

IGTBH Day 3 - May 21

Thank you, Lilian, for making our girls' night a priority.
Thank you, Boudreaux's Butt Cream, for helping my little girl's butt feel better.
Thank you, wine, for that amazing numbness.
Thank you, sunshine, for making me feel happy.
Thank you, baby doll, for being so freaky looking and somehow making me laugh.

Tuesday, May 20, 2014

IGTBH Day 2 - May 20

Thank you, Luis, for cooking a yummy lasagna for dinner.
Thank you, radio, for playing my favorite song on the way home.
Thank you, Fabio, for being my best friend and walking beside me from far away.
Thank you, blogger Gala, for this list that inspires me.
Thank you, powers that be, for helping me keep the bigger picture in mind and refocusing me on my real priorities.

Monday, May 19, 2014

IGTBH Day 1 - May 19

Thank you, Santi, for your hard work on building our new deck, and for having it ready in time for my birthday party!

Thank you, Nico, for trying so hard when it is awfully hard to be 3 years old and additionally hard when your mommy is so strict with you!

Thank you, Maggie, for being my cuddle bug.  Mommy needs a cuddle bug.

Thank you, Anthony, for letting my kids love you so much.

Thank you, Frank, for helping Santi with the deck.

Friday, May 9, 2014

Polio Eradication, or lack therof


Reading this story is somewhat perplexing.  I understand the spread of Polio in places that the virus exists, and how the social and political climate affects the level of protected individuals.  When they bring up Ukraine, however, I am a bit confused.  Has Polio been reported there, in the drinking water? 

A quick google search turns up this helpful article: http://www.reuters.com/article/2013/11/15/us-ukraine-polio-idUSBRE9AE0LJ20131115

In this article, it is spelled out more clearly: low vaccination rates in the middle east contribute to the rising rates.  With lower levels of trust in the government, Ukraine's citizens are vaccinated on a lower level, and so are vulnerable to travelers from the mideast. 


Thursday, May 8, 2014

Nursing Shortage

Granted, it is a USAToday article.  Okay, but I will read more later when I can.


What I am paying attention to here is the nursing shortage abroad.  Don't get me wrong - I want to also serve in the USA - probably the majority of my career.  But I want to live abroad as well and am wondering if there are places in Sub-Saharan Africa and/or India that could work while raising a family.

What can I learn here today?

A big shocker: I hate my job.

I work with awesome people.  These people are good at what they do and they love it.  They have personality, and are funny, and I get the sense that they are just good people.  My work environment is safe, and I am fully aware that there are many people who would love to sit at a desk all day.  I even have grown accustomed to that part and can't say that it's the worst thing anymore.

The problem is that I am absolutely passionate about everything to do with nursing and medicine and surgery and public health and disaster relief, and feel almost exactly the opposite about business cases and risk assessments and board reports. 

A fun little fact: some nurses have to make business cases and board reports.  Assessing a patient is a type of risk assessment.  (I must point out that it's actually not the process of risk assessment that I hate - it's the fact that I am assessing risk on things that are not living beings.  I understand the importance on a mental level, but it does not resonate with me.)

So, I have chosen to be miserable until such a time that I can go to nursing school.  But today I am reversing that decision.  I am going to choose to be as much a learner here as I am when I dig into chemistry videos or articles about nursing as a career.  Every day, I will ask myself: What can I learn here today?  It may be something that only helps me until I leave.  Then again, it might be something that helps me in communicating with doctors, in organizing my thoughts, prioritizing, focusing.  And it could very well be that one day I will need to present to a hospital board of directors. 

Can I give some credit where credit is due?  A dear friend points this out.  Where life is unfair (and this is hardly unfair; I am being paid), there is always a reason -- there is always something we are meant to learn. 

Why am I here today?  What is it I'm supposed to be learning from this?  How can I better live today?

Tuesday, May 6, 2014

Happy Nurses' Week!!

I have to admit that I did not know that it was nurses week but I'm glad to know now!  I loved this piece in TIME: http://life.time.com/culture/national-nurses-week-time-to-say-thank-you/#1.

What should I do? 
* As I failed to get the name of the extraordinary nurse who cared for me after the birth of Maggie, maybe I should send the nurses of the mother/baby unit something - a fruit basket? Candy? What else do you give as such gifts?  Definitely with a note saying how wonderful they were. Maybe it would be better to send a note now and treats later, as I hope they are covered up in treats this week. 
* Also something for Bev, who has encouraged me to shadow where she is director of nursing.  I still have not followed up with her and need to do so. 

Monday, May 5, 2014

Daydream Exploration: Travel Nursing

Well, my research into this daydream -- working as a nurse in Spain -- is quite disappointing.  Spain has an overabundance of nurses and there are not enough jobs.  They are not in need and not giving out work permits or visas.  Sheesh.

There are quite a few places I would like to live in Spain.  I speak South American Spanish but do understand (and am understood by) Spanish speakers from Spain.
Mallorca is one, and there is an english-language agency there that provides in-home care.  This is not really my area of interest, but one possibility.

Midwifery is another area in which there is a need.  Again, not what I hope to specialize in, but ...

Sunday, May 4, 2014

Antibiotic Resistance


Dire straits, y'all.

Friday, May 2, 2014

To read


MERS and Contagion?

This makes me think of Contagion, althuogh it is only one of an unfathomable number of diseases that are dangerously spreading from animals, and then slowly around the world, due to increased crowding and travel. 


The following paragraph was interesting to me:
While experts do not yet know exactly how this virus is spread, CDC advises Americans to help protect themselves from respiratory illnesses by washing hands often, avoiding close contact with people who are sick, avoid touching their eyes, nose and/or mouth with unwashed hands, and disinfecting frequently touched surfaces.

Aren't all respiratory illnesses basically spread through the virus making its way to your hands through coughing or sneezing, or someone else coughing or sneezing, on a surface?  And we touch our faces and eventually infect ourselves by touching a mucus membrane?  How would this vary?

Friday, April 25, 2014

Vital Signs

AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000372049.58200.da
In a short article in the American Journal of Nursing, Louise Rose, PhD, RN reminds us of the importance of monitoring vital signs.  "Abundant research," she says,  "indicates that vital signs aren't consistently assessed, recorded, or interpreted."  This is despite the fact that they are the best indicators of many complications or conditions, and offer clues to the reasons for deterioration of patients.  
Rose offers suggestions as to why vital signs may be pushed off as a menial task.  It is, after all, repetitive and time consuming.  In some cases, machines perform the task automatically; perhaps a nurse is not reviewing these reports.  On the other hand, less experienced medical professionals may deliver inaccurate results.  And, likely as any explanation (probably moreso) is that the nurse workload prevents them from taking and/or recording accurate vital signs.

So, how can and should this be addressed?  Isn't this fundamental?

I won't pretend to have the answer to this problem, but I do think it helps to be aware of the situation.  This is probably very indicative of the environment I will be entering.  If something this fundamental is being overlooked, what does that say about nurse morale and workload?  Or is it something else?

Thursday, April 24, 2014

Medical Spanish - Entry 5

ligadura de trompas - tubal ligation

"tenia usted ligadura de trompas?" - Did you have a tubal ligation?

Wednesday, April 23, 2014

Medical Spanish - Entry 4

parpadear - to blink
pestañar- to blink (this is what is used in Argentina.)

pestaña, por favor.
blink, please.

Tuesday, April 22, 2014

Feelin' Flighty

I have some research to do.  I have some studying to do.  I could learn some more medical Spanish. I could find a journal article or current even to read and reflect upon. But, my mind is so restless tonight, so, I'm gonna go with it.  What's bugging me?

Costa Rica is bugging me.
Last time this happened, it was some nonspecific European country. 

While I think it is absolutely important to serve my community here, and while I feel a calling to help in poorer areas, both domestically and abroad, I also think a year or two abroad in an interesting place would not only be fun, would not only be great for the children, but would also expose me to other ways of thinking that can help me think outside the box here. 

So, I'm starting to think about it.  My destination would necessarily be English- or Spanish-speaking.  And, I would need to be able to take my family.  How would Santi come along?  How would we find a place that worked for both of us? 

I read this, about teachers who "life swapped," and this about the feasibility and logistics of travel nursing with a family. 

Daydreaming: Costa Rica

I've started daydreaming about at least a visit to Costa Rica.  I've always wanted to go, and posts from an old friend living there keep it popping back into conscious thought. So, I'm going to dedicate time to researching this possibility.

I think, first and foremost, a visit is in order.  I may message the friend above in a few days.  The problem is always money, but by January, we should have saved enough to go.

I think it should be a family trip.  Said friend has a child.  I know that will make the trip a little more stressful, but I also think that we can enjoy this with the kids.
Then again, it makes me think we should wait until they are just a bit older.

About.com says to visit sometime between November and April.  We can't use vacation time this year, so it's perfect to wait until after the beginning of the year to do so.
Flights look to cost about $670/person, so about $2800.
I would think we would stay in hostels.  This one is owned by Argentines, http://www.lonelyplanet.com/costa-rica/peninsula-de-nicoya/mal-pais-and-santa-teresa/hotels/funky-monkey-lodge.

Wow.  I get a little bit into this and I already know that I cannot sacrifice going on the DR mission trip to do this.  So, maybe this is still on the roster, but not for 2015.

It's funny how many other things this brings up, though.  One sentence in a very touristy article resonated with me:
If you’re traveling with a good deal of luggage and not visiting any remote areas, it may be worth it to rent a car. 

When I said that I couldn't really put my finger on what goal I wanted to reach for this week, this sort of touches on it.  I want to not travel with a good deal of luggage, and I mean that literally and metaphorically.  I don't want my kids to be burdens; I want to be in a place that makes me ready to connect with them.  I don't want to be connected to my iphone; I want to be free of the burden of that.  I don't want to constantly worry.  I just want to enjoy. I don't want to have a garage full of stuff that needs to be gotten rid of.  I don't want to have a closet that looks like it threw up.  I don't want to worry about what people think.  I just want to be.

I think that's what Costa Rica symbolizes to me: freedom.


I'm not saying a visit is not in order.  I will still research about working there as a nurse.  But I think this daydream plan has shifted focus to how I can get ready to go to the DR next year.

Monday, April 21, 2014

What I'm Reading Today

How Public Health Advocates are Trying to reach Non-Vaccinators

The approaches described in the article are interesting, because the situation was actually the opposite for me.  While pregnant with my first son, I was unsure whether to vaccinate.  One of the factors in arranging a meeting with his pediatrician was whether the practice would allow us to skip vaccinations or modify the schedule.  This practice allows that, and is the only one in our area that I found that did.  When I went to meet with the pediatrician, I asked him about vaccinations.  He calmly explained with facts, and offered articles as support, why vaccinations are safe and why the risk from not vaccinating is much greater than from vaccinating.  His approach made sense to us, and we choose to vaccinate our children.  When we go to our check-up appointments, the vaccinations are a part of the appointment.  That is, if we were non-vaccinators, we would have to actively deny the vaccination. 

With more understanding, I know why it is so important that my children, and all children who are able to be vaccinated, are.  I still agree with the practice's approach of allowing non-vaccinated children, because those children, whose parents are making a bad decision, should also have a right to health care.  I wish our provider didn't have to be the one to provide it, because I did worry before my children were vaccinated, but I felt the quality of care we receive there was excellent, so I did not change providers.

Sunday, April 20, 2014

Saturday, April 19, 2014

TEAS Study Notes

Questions I am still finding answers to for studying TEAS - ongoing list compiled from various sources.  I delete them as I feel comfortable with them, and am adding more based on practice tests.  The original compilation is from a post on allnurses.com.  Just google that site plus "how I studied for the TEAS V"

Reading - the first section

•Know which primary sources make sense for a given type of story

•Summarizing sentences...be able to choose which is the best fit for a given story. [I can do this but want more practice]

•Understand what you can logically conclude from a story [I can do this but want more practice]

•Inference and what can be concluded from a given example [I can do this but want more practice]

•Decipher the meaning of a word based on its context in the sentence (mine were not as easy as the examples, so really think about this style of question.) [I can do this but want more practice]

•Choosing an appropriate title for a given paragraph (again, sounds easy, but I had to really think about this one because the answers are similar)

Math - the second section

(1) calculating percent increase/decrease
 (2) Work rate problem formula.

•Be able to list four numbers in the order requested. These numbers may include whole numbers, fractions, and decimals in any combination. Be VERY careful to order them as requested. (ex: greatest to least, least to greatest) [In the practice tests I keep doing it in opposite order!]

•Roman numerals.

•Familiarize yourself with interpreting information based on charts. (seems easy, but be sure you read headings and info on the charts, as there may be very important information)

•Know when you would use a bar chart/circle graph/histogram/scatter plot/line plot. Ex: if you want to show a change in something over time, you would use a line plot.

•Know the FOIL method

•Be very, very, very familiar with absolute value and how to solve equations that include absolute value.

Science - the third section

•Scientific reasoning

•The scientific method (know the steps, in order, and know examples of each step)

•Understand why an experiment is repeated

•Know the fundamentals of electronegativity

•Understand the various physical states of matter (gas, liquid, solid) and how a change in state might change pressure/volume/etc.

•Get a feel for the chemical properties of water, along with the specific values for it (such as specific heat/temp at which it freezes/boils/etc.)

•Understand what happens during serial dilution and what values result from it (these are very easy)

•Know the general concepts of natural selection and adaptation. Make sure you are able to distinguish between the two given an example.

•Know all of the factors that influence birth/fertility rates. Be able to decipher if the population will increase or decrease given an example.

•understand population growth/decline based on rates of emigration immigration/birth/death.

•Know your biological classifications from general to specific: Domain, Kingdom, Phylum...etc. Watch these questions, paying attention to whether they are asking for more specific or more general in the order.

•Know as much as you can possibly learn about Nucleic Acids/DNA/RNA. Know their make up, how they bond, the nitrogenous bases and how they pair, which are unique to DNA or RNA, and which are shared by both DNA/RNA, know which are purines and which are pyrimidines.

•Know what it happening in all of different stages of translation and transcription. Know where it happens.

•Know the parts of a cells in both eukaryotes and prokaryotes, and what those parts do. Know if they produce anything or if they are involved in an immune response...etc.

•Understand the makeup of the cell wall in both plant and animal cells.

•Always, always, always equate protein with amino acids (the building block of proteins)

•Understand what chloroplasts do and how they do it.

•Chromosomes, genes, and alleles...know what they are, how they relate to each other, and how they affect organisms.

•Cell differentiation - know what the meso/endo/ectoderm become.

•Mitosis/Meiosis - understand all phases (ex: G1, S, G2...)of each and what is happening in each. (I found videos useful in this...especially those from Khan Academy) Know what types of cells these happen to.

•Be sure you understand what a heterotroph and autotroph is and how they relate to each other in the life cycle.

•Review photosynthesis - review it again - then review it again. (the entire process) Know what it produces and how that product is used.

•Be very familiar with cellular respiration, why it happens and what is happening.

•Be able to read a codon chart and decipher the outcome from a given example (this question was more difficult than the basic charts I studies. make sure you study both basic and more advanced examples)

•Mutation vs. adaption

•Phenotype/Genotype - what are they and how are they related?

•Punnet squares and calculating probability given an example. You will need to make sure you can set these up properly, which includes knowing the difference between heterozygous/homozygous/recessive/dominant and how they fit into the equation)

•Kinetic and potential energy. Make sure you can recognize an example of each. I suggest googling several examples so you can solidify the difference in your mind. My question was more difficult than the basic, but easy to understand because I had the concept down pat.

•The dreaded earth science question - is there one? Yes. And as covered in the manual, mine was about the sun. It was a concept not covered in the manual, but was easy nonetheless. There were no other earth science questions on my test. No rocks, clouds, water cycle...etc.

•Understand the purpose of a catalyst

•Know everything there is to know about the periodic table and the information you can get from it. Atomic number, atomic mass, how many protons/electrons/neutrons are in a given element. Know how the numbers relate to each other and how to decipher how many of each is in an element if given a specific number. (again, Khan Academy was a great resource on this). Also know the physical and chemical patters withing the table (what the rows mean, what the columns mean, which elements are more likely to have ionic/covalent bonds). Lastly, make sure you understand electron configuration.

•Be very familiar with valence electrons and why they are important

•Enzymes and vitamins - what do they do, where do they come from, why are they important.

•Understand pH balance/acid/base. Know what a given pH means (acidic or basic?) and understand what adding something to it may to to the pH (think about things that may raise or lower the pH of blood, for example)

•Understand bonds - ionic/covalent

•Understand hydrocarbons - saturated/unsaturated

•Make sure you remember how to balance a basic chemical equation (Khan Academy has an excellent video on this.

•Anatomy/Physiology as follows:

•Know the path of blood through the heart, including valves and whether the blood is oxygenated)

•Know the make up of the lungs and where oxygen exchange occurs

•Know the sections of the brain and what each is responsible for

•Tissue types, where you would find them, and what they do. Know several examples of each type of tissue.

•Digestive: follow bollus through the digestive system in its entirety. Know about peristalsis. Know about the digestive enzymes. Know where protein/carbs/fats are broken down. Know where the bulk of nutrients are absorbed. Know which division of the nervous system controls it.

•Know the functions of the liver, spleen and pancreas. Know which systems they belong to (and they may belong to more than one....hint)

•Know what the lymph system does and how it accomplishes it. Be mindful, also, of what it doesn't do. Just a suggestion.

•Be very familiar with the nervous system and its divisions. Know what each controls and the branches that make them up.

•Make sure you understand the structure/function of the kidney...well.

•Anatomical directions (super/inferior, proximal/distal...etc.) apply to an example.

•Know how the thyroid and parathyroid work together and what they do separately.

•Immune system - natural vs. artificial/active vs. passive. Recognize examples of each type. Also know the different cells involved and what they do.

English - the fourth and final section

•Recognize common possessive nouns.

•Pronoun/Antecedent agreement.

•Dialogue - correct punctuation and usage

•First/second/third person voice and recognizing which from a sentence or short story.

•Grammar usage for style/clarity

•Using sentence context to decipher the meaning of a word.

•Recognizing a simple vs. complex sentence

•Be able to identify a top and supporting sentence. Know the difference.

•Know the meaning of common prefixes/suffixes/roots (ex: uni, ous, endo...etc.)

•Rules of capitalization.

•Correct usage of commas, ellipses, semicolons, colons, hyphens, and parentheses.

•Correct usage of quotation marks and apostrophes.

•Go over a list of commonly misspelled words. You will have one on your test. if you get confused, look away from the word and write it down. If that doesn't help, write it in a sentence.

Thursday, April 17, 2014

TEAS Study Notes: Electronegativity, Covalent Bonds, Ionic Bonds

Electronegativity - the measure of attraction of an atom for the electrons in a chemical bond.

Note - electronegativity/ionization energy increases as we move up and to the right on the table.

Medical Spanish - entry 2

I had to go looking for new vocab today because the word of the day site didn't have anything new for this entire week.  Today I have two ways to say jaundice:


piel amarillenta

I will ask my in-laws about these terms tonight.  My thoughts are:

ictercia - probably pronounced ick-ter-CI-uh

piel amarillenta - piel means skin, and amarillo means yellow, so I'm wondering if amarillenta is yellowed. 

Monday, April 14, 2014


Oh, man, am I under the weather.  It's just a cold or something similar but it's rough.  I just want to crawl under something.  Preferably, a soft, warm blankie. 

I can't sleep because of the tickle in my throat.  The tickle, which subsides.  The tickle, which returns.  Returns at the godawfulest moments.  Like when I am 89.5% asleep.

I still want to write things.  I interviewed three nurses.  I have more to go.  I have a lot more to do.  But right now, I am barely functioning. 

So, I'm here.  Just not here.

Saturday, March 22, 2014

Medical Spanish - Entry 1

Medical Spanish's word of the day is "el conocimiento," meaning consciousness.  To ask, "did you lose consciousness," one would ask, "Perdio usted el conocimiento?" [sic] (I left out the accents.)

I've never heard that used.  It's the first time I've come across a phrase on medical Spanish's page that I did not previously know and will have use for. 

It makes sense.  I think of conocimiento as meaning knowing - not knowledge, really - but being familiar with.  So if I think of it in terms of if you've lost the ability to know - that makes sense.

Thursday, March 20, 2014

someone i love has

inoperable laryngeal cancer.  he is also not a candidate for chemo.

radiation, i know you're not our star player.  but come out for us, kid.  

Public Health Concern: Conspiracy Theories

A survey getting some press today indicated that half of all Americans believe in health-related consipiracy theories.  This survey was conducted by political science professor Eric Oliver at the University of Chicago, and published in JAMA

Some of the conspiracy theories include:
  • Vaccines cause autism
  • Cell phones cause cancer
  • The FDA is deliberately preventing access to natural cancer cures
  • The use of GMOs in food is a program designed to shrink the world population
This, to me, represents a very difficult challenge in public health. I believe that, in buying into these myths, people believe they are being responsible and thinking critically.  It is hard, though, to refute the "evidence" that people have access to: they saw it on the internet, and therefore it must be true.  This is tough to refute not because it is true, but because what people believe is true often has little to do with what actually is. 

To give examples of concrete issues with these views, if a patient believes that there is a natural food out there that will cure him of cancer, and meanwhile refuses to accept chemotherapy, there will be a real consequence to that person and his family. Unfortunately, that consequence could come too late for it to be useful as a learning experience to that patient.  I have not heard of a situation in which this is happening en masse, however.  The anti-vaccine mamas, however, are, as a group, taking a path that not only puts their own babies at risk, but those children and adults who are not able to be vaccinated.
In a more abstract sense, would trying to change these views by any means lead your patient to distrust you, and do more damage to the situation than good?  I feel this is extremely likely, and this secondary danger may be even more dangerous than the first situation.  It certainly depends on the patient. 

Wednesday, March 19, 2014

Nursing Jobs for New Grads

Kurtz, Annalyn.  "For Nursing Jobs, New Grads Need Not Apply." CNNMoney.  January 23, 2013.  http://money.cnn.com/2013/01/14/news/economy/nursing-jobs-new-grads/

Another article with some age.  But, it's not as if this is changing quickly, as noted in the article itself.

See also: http://www.georgiahealthnews.com/2013/05/nurses-jobs-sign-times/, http://www.healthecareers.com/article/top-reasons-why-new-nurses-cant-find-jobs/172234, and

It's a truth that I do not want to accept. Despite it being shouted from the mountaintops that there is a dire shortage of nurses, nurses, and new grads in particular, are having a hard time finding work. 

I do have a few things working for me.  When I finally finish this degree (ha! start!), I will be getting a BSN.  So, I do feel more likely to find employment than ADNs, especially with the push for BSNs over ADNs that I've heard about happening at more and more hospitals.  My first choice program has a 100% employment rate 6 months after graduation, as well.

I don't even pretend that means I will get my choice of jobs. I am pretty sure that I do want to work in the hospital setting, but a nurse I spoke to yesterday (one whom will actually be helping me to find some shadowing opportunities) reminded me that there are scores of other options for working as an RN.  Allow me to go off on a reflection tangent.

While most of my excitement regarding nursing comes from fantasies of working as a scrub nurse, nurse anesthetist, or ER nurse, public health is another interest of mine.  Before our vacation, I did some research into the public health situations of the countries we would be visiting.  My most basic motivation behind becoming a nurse was a desire to help people.  Perhaps working at the health department is not as exciting as I wish it to be, but working with HIV/AIDS patients is of interest to me.  Helping low-income pregnant mothers-to-be take care of themselves and their babies is very important.  I do fantasize about later being able to take part in my church's medical mission trips, and the assessment skills I would sharpen in those environments would be so helpful there.

On the other hand, I do not know anyone who has not been affected by cancer in some way.  Research is second nature to me.  I may not love it in and of itself, but I could love it for its outcomes. 

Accepting that the hospital is not the only place of employment for new grads is part of the battle.  Because I have had to wait for the right time for nursing school, I have also made experiences for myself.  I can do more, though.  It is very hard to do so, especially for nurses who have other things going on.  It's not just children, but many second-career nurses also have aging parents to care for.  Sometimes, working one job is all we can do. There are many obstacles that can keep us from taking extra time to gain experience outside the job, but when the market is so competitive, it is really incumbent upon us to prove our interests and skills in as concrete a fashion as possible.

While it is not an option I am currently considering, if I do not find a job in any of my top choice area, geriatrics is a good area to look into.  The population is aging, and we helpers are needed to take care of a population that has taken care of us.  

I have some time before I am on the job market.  I have hope that the job market will improve in that time, but I do not expect it to do so quickly.  I think it is important to remember that experience in any area of nursing can inform other specialties.  Elderly people also have surgery; mental health patients have babies; children visit ERs; HIV patients sometimes require addiction recovery services; diabetic patients may require surgery.  There are so many crossovers, that skills built in one area cannot but serve as experience for another, down the road.  It is important, then, to stay alert to these transferable skills, just as someone attempting over years to transition into nursing might do.

Tuesday, March 18, 2014

Response to Manton's Emergency Nursing piece in the Imprint (forever ago)

Manton, Ann, PhD, RN, FAAN.  “Emergency Nursing.”  Imprint: The National Student Nurses Association Journal.  January 2004.  23 – 25.


Anne Manton is an associate professor at Fairfield University, as well as past president of the Emergency Nurses Association.  Here, she writes about the job of an emergency nurse, and the pros and cons of this specialty.  I would like to reflect on the five factors she presents for preparation for a career in emergency care:

First, Dr. Manton emphasizes that quick thinking, the ability to prioritize quickly, and flexibly restructure ones day are vital to being an ER nurse.  To an extent, I believe these qualities are important to all nurses, but very much enhanced in the fast-paced environment.  In my own life, I have experience with this in caring for a family including two babies, while thinking in two languages.  Additionally, when I served as network administrator, information security officer, and operations coordinator, I learned quickly how to wear various hats in any given situation.  Obviously, this is not the critical environment of nursing, but I do know that I am able to multitask and prioritize on the go.  I also believe that having a very firm knowledge of the subject matter enables one to prioritize and multitask efficiently.

Secondly, Dr. Manton says that assessment skills, as well as the ability to apply those assessments, are key.  Again, I feel that a thorough knowledge, gained through study and experience, are what enable a nurse to assess correctly and to understand the significance of the information gained.

Thirdly, “[e]mergency nurses need a strong knowledge base in every area of nursing.”  This is especially attractive to me.  Along with my desire to work in a fast-paced environment, I am interested in a complete picture of knowledge in nursing.  And, like in number one, I do think that this knowledge is helpful no matter what area of nursing one is in.  However, it is absolutely vital for an emergency nurse.

Next, Manton stresses the importance of critical thinking and notes that, as opposed to other specialties, many ER patients do not yet have a diagnosis.  This, again, is especially attractive to me.  Of course, it could be very stressful to deal with situations in which there are big unknowns.  However, I have always enjoyed putting pieces of information together, as well as working with a team.  It also seems like a test of knowledge, but under higher stakes than usual.

Finally, “good communication skills are imperative,” says Manton.  I think I excel in this area, and in two languages, at that.


I think often about my desire to be an emergency surgery nurse, and whether that is a dream that I can make into a reality.  I also think about where I want to work before working in the emergency department.  Manton suggests gaining experience in medical/surgical nursing, which suits me just fine as I am dying to get into an OR.  I also wonder if my path does still involve nurse anesthesiology.  This would guarantee OR work – but would be quite a bit different (as all nursing is) in the ER, as well. 

I’m not sure I’ve drawn any conclusions here.

Thursday, February 13, 2014

Laugh a Little

I am starting this post with no clear idea of where I am going with it. I feel like this may be a bad idea, but I am going on vacation tomorrow, so I will likely forget I posted anyway. 

I've done a lot of thinking about why Facebook has become so annoying to me lately, and I think there are two main reasons. 

The first reason is that everyone is trying to sell something. I have friends who do direct sales who do not fill my newsfeed with advertising disguised as status updates. I am hiding all those that do. 

Secondly, all the posts about how moms have it so hard these days. Oh, I am with you. Mommyhood is hard. I never, ever expected it to be this hard.  And it is good to occasionally read something about how you're not alone in the struggle. If you are a new mom, please read no further. You do need to hear those messages. 
Ok, but, really? The rest of us? First of all, if you're sitting here reading about how hard it all is for the 50th time, does that tell you anything? Let me rephrase.  You are taking time to read about how hard your life is.  Not talking to a friend about it, not reaching out for help, not arranging for time away, and certainly not actually focusing on the tasks at hand. Nope. You're listening to someone who doesn't know you tell you it's ok if you have dirty dishes.

They are absolutely right by the way.  You are one person and it absolutely is impossible to do it all sometimes. So, when you are deciding what must get done for the day, it's possible that dishes come before Facebook surfing and momblog reading. It's possible that you might model better ways of taking a break than gazing emptily at your mobile device. Reporting an article per week about how it's ok not to be perfect. 

We know that. No one is asking for perfection. There is a difference between asking for perfection and asking you to be all in.  If you can't handle being actively engaged most of the time, why are you doing it?

But this is not all doom and gloom. The thing is, I feel like these blogs were spurred by something. I'm guessing the something was distraught moms, shocked at how hard motherhood is. That, I get. I have been there, have the spit-up covered t-shirt.  Here's the thing.  Not having to be perfect, but staying engaged while you are charged with the care of your child, can lead to a lot of silliness, a lot of laughter, a lot of priceless moments. You will find yourself laughing more with your children than you laugh at the stupid meme 400 of your friends will post. 

Monday, February 10, 2014

20140210 Current Events: Freaking Crazy Technology edition



I am only beginning to learn about 3D printing and its applications.  It still feels like something of the space age, to be honest. The technology will allow many people to survive who once died waiting on organ transplant lists, or from their body having rejected an organ.
This article presents an advance in this technology. Mini-robots are now able to move individual hydrogels. This is important in that tissue structure is complex.

Friday, February 7, 2014

20140207 Current Events

http://www.medscape.com/viewarticle/820234?src=rss#3 Mandatory Flu Vaccinations for Nurses

This article on medscape tells about a pregnant nurse who was fired for refusing the flu vaccine.  I find this situation to be very interesting.  I really want to side with the nurse.  I want to be able to say that I believe that should have been her option.  I want to say this because, in other cases, I myself would like the right to refuse a vaccination if I feel that it is not safe.

However, this is the flu vaccine.  I myself have never received it, but I do get it for my children every year, and when I begin nursing school, I will begin taking the shot.  I simply do not take it because I have never had the flu and I do not currently work with an at-risk population.  Since my children's immune systems are immature, I feel incumbent to vaccinate them.  Because the flu is so contagious, I do believe that anyone working in a hospital, long term care facility, or, really, anywhere where there is a concentration of people (such as a school) should receive the vaccination if they do not have a solid reason not to.

This nurse was pregnant, and she feared that the vaccination could put her baby at risk.  Her anxiety over this was so great that she was able to get a physician's note saying that the stress from worrying about this was putting her baby at risk.  However, this just is not fact-based.  While no group of pregnant women is assembled as part of a study of effects on pregnancies before the vaccine is released, data from after the vaccine is released shows that receiving the vaccine may actually lead to lower incidence of pre-term birth.

In an age of evidence-based practice, do we want a nurse who won't use the evidence?

And then, I do see her side.  How do we know what is true?  But anecdotal stories of things going awry are hard to critically examine, since they don't really give us enough information to prove causality.  In some cases, it is less clear. With a disease so easily spread as the flu, I just don't think there is enough evidence against the vaccine. Could her employer have given her some tasks away from patients until after she had the baby, or after flu season? It is possible, but would that be her job? I am all for being flexible, and I think employers should be flexible. But I can also see how they wouldn't want her in the building, and also that there might not be another job suited to her with minimum patient contact. It could truly be a dangerous precedent.

letter to the editor regarding nurse demands in a strike; nurses being overworked; quality of care

This is a letter to a paper editor, spurred by a patient's observations about nurse scheduling and overtime, as well as an impending strike. The patient appreciates the competence demonstrated by her nurses and expresses dismay at the focus on profit rather than patient outcomes. 

Saturday, February 1, 2014

The Trophy is not to Blame

I have seen several articles making participation trophies the scapegoat to basically all that is wrong with our generation, and it irks me every single time.  

Don't get me wrong, the practice of handing out participation trophies should end. It is wasteful, for one thing. I had a lot of softball and basketball trophies. Most of them were participation trophies, but there were a few good ones in there: a couple of second places, a first place, and even a first place all-stars trophy. Guess what? They were all ugly, all useless, and all got in the way of toy storage. I felt obligated to keep them, until one day I didn't. I have no clue whether they are still in my parents' basement. My t-shirts from the team got far more use.  I do still remember end-of-season pizza and swim parties, and those were good times. I don't know a kid who, if asked, would choose a (really ugly) trophy over a party, but I am sure they might be out there, and I am sure they might have more reasons to choose that than that they think they are entitled to a trophy.

So, you say that there are no participation trophies in the real world of adult life. Really? Are you sure you've never, ever received an adult participation trophy? Let's look at this real world.  Did you ever have an off day at work? Did you blow a presentation, make a mistake, or spend time chatting with a coworker while on the clock? Did you still get paid for that day? You probably even aren't at 100% for 100% of the hours you work per week. In that case, you may not have actually worked enough hours to qualify for benefits. Bet you got them anyway.  Maybe you give your best, but maybe you're not the best in the field. You may be passed over for a promotion, but you get paid because you work and you do a pretty good job. Not a great job, but you work hard. 

That doesn't apply to you? I bet you work 60 hour weeks, right? Lots of people do. Has your family ever suffered because you weren't with them?  I bet you still get to claim tax benefits, either from being married, even though you may sometimes not be the best spouse or from having kids, even if you barely see them. Not to mention the true benefits of having them.  You know, love, and stuff. 

I could go on with other examples, but let's just get to the heart of why this tendency to blame the supposed faults of a generation on participation trophies bothers me.  Who decided that our generation would receive participation trophies? Maybe it was inspired by children who threw fits when other children got trophies for winning, and maybe not. In any case, an adult, who would not him or herself receive the trophy, started this practice. 

So, it's not our fault. We were victim to a misguided set of beliefs. Poor us.  But we shall overcome, and we certainly will not inflict this horrendous practice upon our children.  That would teach them that if they are not particularly good at something, they can still expect to be rewarded with cheap pieces of plastic, and that would in turn symbolize to them (not us, mind you; it's children who care about the outcomes of t-ball games) that mediocrity is to be celebrated. 
But we certainly did not learn that ourselves.  No, just our peers with less critical thinking abilities than us, says Matt Walsh. 

It's all about something that we had no control over at the time it was happening and that we can easily discontinue. 
Except that it's not. 

I used to see adult participation trophies on a daily basis. Did you get dressed this morning and do you own a mirror and/or do you ride in a car? Do you have a latte with pretty swirls? Oh, did you cook dinner today, or can you afford to go out for a treat?  Do you have an opinion about something, founded or unfounded? Do you agree with something someone has said that may be controversial? Do you have legs and feet?  Well, you deserve to be on the front page of a newspaper with a circulation including your friends and their friends. A circulation you more or less choose, and can shape to reinforce you for performing everyday acts of mediocrity, beginning with being self-obsessed. And you deserve to know that people like what you're putting out there. You're entitled to that attention, at whatever cost. It's adult interaction. 

I am a parent. I was a stay at home mom to two toddlers for a year, and I wasn't very good at it. (Luckily, they still love me.) You know what I observed about my attachment to my smartphone?  

It did not relieve stress. It did not help me stay connected with grown-ups. The real connections I have know where to find me outside of the Facebook. 
That is just me and if you tell me that your smartphone use does help you de-stress or stay connected, it is possible that you may be using yours better than I used mine.  I still completely and wholly believe that if you are worried about participation trophies and you are actively participating in social media, you might be looking for an easy way out. You may have accepted a scapegoat because it is far easier than examining your need for constant reinforcement. The trophies are already gone and you had no part in it. The boomers did that to us, the buncha dumbasses. 

Is it a problem? That's for you to decide. I think at this point, some of us might agree that participation trophies may not be the issue. It may not be Facebook, either. It could be some need you as a parent feel to break the bank at Christmas. Or something. There are just a lot more likely causes than rewarding kids for trying. 

Let's go back to the fact that our families still love us. This makes me think about the parable of the prodigal son. So, the responsible son worked every day of his life for his father. His brother, on the other hand, took his inheritance and left to enjoy everything he could find to enjoy. So, dude comes back, and now their dad is throwing the irresponsible son a party.  Not the one who works hard every day of his life. Not the one who has stood by his father thick and thin. Nope.  

So forgive the colloquialism, but I just can't see this conversation playing out any other way. The responsible son says, "WTF, dad?"

And does his father say, "you know, son, you're right.  I shouldn't be celebrating this failure of a son, this person who abandoned us?"  

You know, he didn't. 

He said, "come on and enjoy this party. Have a glass of wine. Here's some fatted calf.  You're going to get your reward. But come celebrate your brother's return with us."

Mom-bloggers like to tell me that we all feel like failures as parents sometimes. I guess it may be true. But I still feel like I may be a pretty mediocre mom. I don't craft. I tried to home preschool my son, and failed so miserably that I couldn't even get up and try again. I gave up on being a stay at home mom. I said I wouldn't spank; I do. I said I wouldn't scream; I do. I try my best, but that is so, so often not enough. I break my own heart almost daily. 

Love is not a trophy. But damn if I'm not thankful for the grace that means that I don't have to be the best to be worthwhile. The rewards I get for doing my best, even when it's not the best, inspire me to try harder. If I could use that, how much more could a child?