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.

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. 

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
http://www.workingnurse.com/articles/why-nursing-school-grads-have-trouble-finding-jobs

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.

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.

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. 

20140210 Current Events: Freaking Crazy Technology edition

http://www.brighamandwomens.org/about_bwh/publicaffairs/news/pressreleases/PressRelease.aspx?sub=0&PageID=1670

http://www.nature.com/ncomms/2014/140128/ncomms4124/full/ncomms4124.html

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.