Navigating HealthCare

 

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I am going to give you some basic tips for getting through your next hospital visit.

1.    Carry your insurance card as well as some form of identification with you.
2.    Have a list of your medications and maybe even several copies. Have the list up to date.
3.    Write down past medical history on that list.
4.    Write down your allergies and tell them to everyone that you see.
5.    Show up early for your appointments. Registration takes time.
6.    Have a list of your vaccinations. Know what you have had and when.
7.    Ask, ask, ask questions. Don’t be a bystander in your healthcare, be an active participant.
8.    When someone gives you a drug, ask what it is for.
9.     If someone orders a test, ask why.
10.    Ask for your test results.
11.    Ask for explanations. It is your right.
12.    If you feel uncomfortable, tell someone.
13.    Carry a notebook and pen with you during a hospitalization to write down any questions that you have.
14.    If you have a healthcare proxy form or any advanced directive form, bring that with you.

This is just a small list, but by asking questions, having the appropriate documentation and lists with you- you can make your journey through the healthcare system much more manageable.

~SarahLee, RN

So You Want to Be a Nurse?

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Are you thinking of changing careers? Are you thinking of finding a career? Have you thought about being a nurse?

Being a nurse can be great work, but it can be hard. A nurse often works 8-12 hour shifts, sometimes without breaks. A nurse sees people at their worst and at their most vulnerable, when they are sick. Being a nurse can be very rewarding, but to become a nurse should not be taken lightly.

I thought that I would offer a little bit of advice to you about what to consider if you are considering nursing.

First, why are you thinking about being a nurse? Do you care about people? How are you when someone is hurt? Are you sympathetic? These are all good qualities to have if you want to be a nurse. If you don’t have the foundation of caring for others, you may burn out very quickly.

Do you know what a nurse does? A nurse does much more than hand out band-aids and water. A nurse assesses patients, formulates a nursing diagnosis, implements a plan of care and then evaluates that plan of care. Each of those steps involve more than you might think. Have you ever followed around a nurse for a day? If you haven’t I suggest that you find someone to follow to get your feet wet and see if this is something that you want to do.

What kind of nurse do you want to be? There are (in the United States) LPNs, or Licensed Practical Nurses. There are RNs, or Registered Nurses. Each of these nurses have different job descriptions and responsibilities. A person can become a LPN generally by completing a 1-2 year course. A person can become a RN by several different routes. To be a RN you have to have an Associates degree or a Bachelor’s Degree. The interesting thing to keep in mind is that whether you have a 2 or 4 year degree, everyone has to take the same board test for nursing, the NCLEX. Many nurses obtain their 2 year degree, pass the NCLEX and then move towards their 4 year degree while working as a nurse. Other nurses go and get the 4 year degree and then take the NCLEX. Of course, following the ADN or the BSN, a Master’s Degree can be obtained in several areas including nurse education and nurse practitioner.

The great thing about being a nurse is that there are so many different areas to be a nurse! You could work in a hospital, in a home care setting, in a Dr.’s office, on ships, on planes and in other countries. Generally after a nurse graduates he or she works on a general Medical-Surgical floor for at least a year to gain experience. Many nurses then specialize in certain areas such as pediatrics, intensive care, emergency care and operating rooms.

There are many great resources out there for those who are learning about this profession. One great resource is the Johnson and Johnson Discover Nursing Campaign. This site provides information regarding the different areas of the nursing career path. The site also provides information about scholarships and schools for aspiring nurses.

This little article has only scratched the surface of what it involves to become a nurse. I encourage anyone who is seriously considering this amazing and at times stressful career to carefully do research.  Make sure that you would be a good fit for the profession, and that the profession would be a good fit for you.

I wish you well!

~SarahLee RN

The Hound of Heaven

This is a very well known poem by Francis Thompson. I read it for the first time today! I am posting this because I think it is worth reading. And reading again, and then again.

We love Him, because He first loved us. 1 John 4:19

Nicholson & Lee, eds.  The Oxford Book of English Mystical Verse. 1917.
239. The Hound of Heaven
By Francis Thompson  (1859–1907)
I FLED Him, down the nights and down the days;
  I fled Him, down the arches of the years;
I fled Him, down the labyrinthine ways
    Of my own mind; and in the mist of tears
I hid from Him, and under running laughter.         5
      Up vistaed hopes I sped;
      And shot, precipitated,
Adown Titanic glooms of chasmèd fears,
  From those strong Feet that followed, followed after.
      But with unhurrying chase,        10
      And unperturbèd pace,
Deliberate speed, majestic instancy,
      They beat—and a Voice beat
      More instant than the Feet—
‘All things betray thee, who betrayest Me.’        15
          I pleaded, outlaw-wise,
By many a hearted casement, curtained red,
  Trellised with intertwining charities;
(For, though I knew His love Who followèd,
        Yet was I sore adread        20
Lest, having Him, I must have naught beside).
But, if one little casement parted wide,
  The gust of His approach would clash it to.
  Fear wist not to evade, as Love wist to pursue.
Across the margent of the world I fled,        25
  And troubled the gold gateways of the stars,
  Smiting for shelter on their clangèd bars;
        Fretted to dulcet jars
And silvern chatter the pale ports o’ the moon.
I said to Dawn: Be sudden—to Eve: Be soon;        30
  With thy young skiey blossoms heap me over
        From this tremendous Lover—
Float thy vague veil about me, lest He see!
  I tempted all His servitors, but to find
My own betrayal in their constancy,        35
In faith to Him their fickleness to me,
  Their traitorous trueness, and their loyal deceit.
To all swift things for swiftness did I sue;
  Clung to the whistling mane of every wind.
      But whether they swept, smoothly fleet,        40
    The long savannahs of the blue;
        Or whether, Thunder-driven,
    They clanged his chariot ’thwart a heaven,
Plashy with flying lightnings round the spurn o’ their feet:—
  Fear wist not to evade as Love wist to pursue.        45
      Still with unhurrying chase,
      And unperturbèd pace,
    Deliberate speed, majestic instancy,
      Came on the following Feet,
      And a Voice above their beat—        50
    ‘Naught shelters thee, who wilt not shelter Me.’
I sought no more that after which I strayed
  In face of man or maid;
But still within the little children’s eyes
  Seems something, something that replies,        55
They at least are for me, surely for me!
I turned me to them very wistfully;
But just as their young eyes grew sudden fair
  With dawning answers there,
Their angel plucked them from me by the hair.        60
‘Come then, ye other children, Nature’s—share
With me’ (said I) ‘your delicate fellowship;
  Let me greet you lip to lip,
  Let me twine with you caresses,
    Wantoning        65
  With our Lady-Mother’s vagrant tresses,
    Banqueting
  With her in her wind-walled palace,
  Underneath her azured daïs,
  Quaffing, as your taintless way is,        70
    From a chalice
Lucent-weeping out of the dayspring.’
    So it was done:
I in their delicate fellowship was one—
Drew the bolt of Nature’s secrecies.        75
  I knew all the swift importings
  On the wilful face of skies;
  I knew how the clouds arise
  Spumèd of the wild sea-snortings;
    All that’s born or dies        80
  Rose and drooped with; made them shapers
Of mine own moods, or wailful or divine;
  With them joyed and was bereaven.
  I was heavy with the even,
  When she lit her glimmering tapers        85
  Round the day’s dead sanctities.
  I laughed in the morning’s eyes.
I triumphed and I saddened with all weather,
  Heaven and I wept together,
And its sweet tears were salt with mortal mine;        90
Against the red throb of its sunset-heart
    I laid my own to beat,
    And share commingling heat;
But not by that, by that, was eased my human smart.
In vain my tears were wet on Heaven’s grey cheek.        95
For ah! we know not what each other says,
  These things and I; in sound I speak—
Their sound is but their stir, they speak by silences.
Nature, poor stepdame, cannot slake my drouth;
  Let her, if she would owe me,       100
Drop yon blue bosom-veil of sky, and show me
  The breasts o’ her tenderness:
Never did any milk of hers once bless
    My thirsting mouth.
    Nigh and nigh draws the chase,       105
    With unperturbèd pace,
  Deliberate speed, majestic instancy;
    And past those noisèd Feet
    A voice comes yet more fleet—
  ‘Lo! naught contents thee, who content’st not Me!’       110
Naked I wait Thy love’s uplifted stroke!
My harness piece by piece Thou hast hewn from me,
    And smitten me to my knee;
  I am defenceless utterly.
  I slept, methinks, and woke,       115
And, slowly gazing, find me stripped in sleep.
In the rash lustihead of my young powers,
  I shook the pillaring hours
And pulled my life upon me; grimed with smears,
I stand amid the dust o’ the mounded years—       120
My mangled youth lies dead beneath the heap.
My days have crackled and gone up in smoke,
Have puffed and burst as sun-starts on a stream.
  Yea, faileth now even dream
The dreamer, and the lute the lutanist;       125
Even the linked fantasies, in whose blossomy twist
I swung the earth a trinket at my wrist,
Are yielding; cords of all too weak account
For earth with heavy griefs so overplussed.
  Ah! is Thy love indeed       130
A weed, albeit an amaranthine weed,
Suffering no flowers except its own to mount?
  Ah! must—
  Designer infinite!—
Ah! must Thou char the wood ere Thou canst limn with it?       135
My freshness spent its wavering shower i’ the dust;
And now my heart is as a broken fount,
Wherein tear-drippings stagnate, spilt down ever
  From the dank thoughts that shiver
Upon the sighful branches of my mind.       140
  Such is; what is to be?
The pulp so bitter, how shall taste the rind?
I dimly guess what Time in mists confounds;
Yet ever and anon a trumpet sounds
From the hid battlements of Eternity;       145
Those shaken mists a space unsettle, then
Round the half-glimpsèd turrets slowly wash again.
  But not ere him who summoneth
  I first have seen, enwound
With glooming robes purpureal, cypress-crowned;       150
His name I know, and what his trumpet saith.
Whether man’s heart or life it be which yields
  Thee harvest, must Thy harvest-fields
  Be dunged with rotten death?
      Now of that long pursuit       155
    Comes on at hand the bruit;
  That Voice is round me like a bursting sea:
    ‘And is thy earth so marred,
    Shattered in shard on shard?
  Lo, all things fly thee, for thou fliest Me!       160
  Strange, piteous, futile thing!
Wherefore should any set thee love apart?
Seeing none but I makes much of naught’ (He said),
‘And human love needs human meriting:
  How hast thou merited—       165
Of all man’s clotted clay the dingiest clot?
  Alack, thou knowest not
How little worthy of any love thou art!
Whom wilt thou find to love ignoble thee,
  Save Me, save only Me?       170
All which I took from thee I did but take,
  Not for thy harms,
But just that thou might’st seek it in My arms.
  All which thy child’s mistake
Fancies as lost, I have stored for thee at home:       175
  Rise, clasp My hand, and come!’
  Halts by me that footfall:
  Is my gloom, after all,
Shade of His hand, outstretched caressingly?
  ‘Ah, fondest, blindest, weakest,       180
  I am He Whom thou seekest!
Thou dravest love from thee, who dravest Me.’

Love and Hate-a Nurse’s List

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A list, as inspired by the writing challenge

I love:

Holding your hand as you are afraid and feeling you become calm
Explaining to you what the Doctor said in simpler terms
Listening to your lungs and realizing that your pneumonia is getting better
Giving you a cup of water when you are thirsty
Helping you take a shower when you haven’t taken one in days
Noticing when you are getting worse and ‘pulling’ you back from the brink
Talking to you about your surgery and answering your questions
Having the time to hear about your family
Making your pain more manageable
Making you laugh
Sending you home!

 

I hate:

Cancer
Short staffing and call-ins
Seeing you cry
Watching you in pain
Watching your family cry
Dementia induced paranoia
Hospital acquired psychosis
Having to use Haldol and restraints (as related to the above)
What smoking does to your lungs and how you can’t breath
Staff conflicts
Seeing you come back-when you wish you could just be home.

commentary for “Let Her Go”

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Well you only need the light when it’s burning low
… you always need the light unless you really like the dark…

Only miss the sun when it starts to snow
…or when it isn’t shining at all…

Only know you love her when you let her go
…I hope you knew that before you let her go…

Only know you’ve been high when you’re feeling low
... you need to feel low to know how high feels…

Only hate the road when you’re missin’ home
…then its time to go home…

Only know you love her when you let her go
And you let her go
…then get her back.

Staring at the bottom of your glass
Hoping one day you’ll make a dream last
But dreams come slow and they go so fast

…Dreams are called dreams and not made to last…
Stop staring and dump that glass…!

You see her when you close your eyes
Maybe one day you’ll understand why
Everything you touch surely dies
…don’t worry about understanding…
… change your touch…

Staring at the ceiling in the dark
Same old empty feeling in your heart
‘Cause love comes slow and it goes so fast
…You have an empty feeling in your heart that only God can fill…
…Love can go slower if you let it…

Well you see her when you fall asleep
But never to touch and never to keep
‘Cause you loved her too much
And you dived too deep

…you can never love too much…
… why did you…

…let her go?

Doctors and Nurses

Doctors and Nurses

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Linked are two articles, from which all in healthcare can learn and reflect. The original article is On Breaking One’s Neck: by Dr. Arnold Relman, with a complimentary article :A Patient’s-Eye-View of Nurses by Dr. Lawrence Altman.

There are compliments in both articles for nurses, as well as warnings that should be considered.

. As quoted from the original article :On Breaking One’s Neck:

“What personal care hospitalized patients now get is mostly from nurses. In the MGHICU the nursing care was superb; at Spaulding it was inconsistent. I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.”

The review article in the New York Times, written by Dr. Altman,  brings to light the thought provoking differences between physicians and the nursing staff. Dr. Atman expresses concern at the movement towards technology, citing technology as objects that can “Deflect the doctor’s attention.”

I think that nursing as a profession should also heed this concern-does our bedside report become just a huddle in the hallway? Are we including the patient? Are we prioritizing our time between the computer and the patient?

Hopefully we are not, as nurses, using as our starting point of care the review of notes-or as Dr. Relman so memorably states:

“Lengthy notes in the computerized record, full of repetitious boilerplate language and lab data, but lacking in coherent descriptions of my medical progress, or my complaints and state of mind.”

This is referring to the MD notes-but what about our nurses’ notes? Do they adequately reflect the patient? Do they just present the data, or the whole person? I have a tendency as a nurse to at times subconsciously rely on previous documentation-but our starting point needs to be the patient, not the notes. How are we doing? Do we clarify what we saw in the record with the living person in front of us?

Another nice quote, by Dr. Altman, complimenting nurses is as follows:

“Nurses’ observations and suggestions have saved many doctors from making fatal mistakes in caring for patients. Though most physicians are grateful for such aid, a few dismiss it — out of arrogance and a mistaken belief that a nurse cannot know more than a doctor.”

I think that nurses everywhere should read these two articles and be thankful for the recognition. But we should also realize that what is wise for the doctors is wise for the nurses.

We should never forget, in this healthcare system that is changing faster and becoming more difficult every day, the patient is first-and someday the person in the bed could be me or my family.

I had a nursing instructor once that said:

When you enter a room, and you see lines, and IVs, and ‘stuff’, don’t worry about all of those lines, start at the patient, and work your way out.”

Will our patients, will we, our families, be reduced to hallway huddles and medical note jargon and technical terminology? Or will our care be about the individual, the person, with a cautious inclusion of technology as needed?

These articles provide warning signs about our healthcare and we will do well to heed them, whether doctor or nurse.

A Diverse Ramble

 

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Discussion swirled

Back and forth

About how some things are not

Just scientific but in fact

Unexplainable

And who could deny?

For they say

There are no atheists

In foxholes

Why would there be here?

For this is our foxhole

And truly,

There cannot be an absence

Of a Divine Order of affairs,

For the filling of the void and

The answers to the longing

That causes these questions

Is found in the One

The Logos

Who in the beginning was the Logos,

And was with God

And was God.

And because I know

That all things were created by Him and for Him…

And that by Him all things consist,

I rest

While the questions continue,

They continue sticking their heads up

Looking about

Without any armor

And I in my foxhole,

Protected and safe,

Sleep.

 

Ref: John 1, Colossians 1