Term of the day: Nectar thick liquids

Patients who have trouble swallowing and an impaired coughing mechanism (dysphagia) are at risk for food and liquids getting into their lungs, which can result in pneumonia. Because of this, patients with dysphagia are often prescribed special diets. Pureed food is pretty obvious, but how about thick water? Thickening agents are often added to fluids to reduce the chance of it getting into the lungs.

NECTAR THICK LIQUIDS - the consistency of fruit syrup or V8

There's also honey thick and pudding thick. My instructor brought some Thick N Easy for my class to try. Suffice to say, thick water is weird and thick Diet Coke is vile.

A walk with pictures

I went for a walk yesteray and took some pictures. Click a picture for more.

Term of the Day: Nursing

You would think I'd have been able to rattle off a good definition of this months before now. I never had a handle on it til now though.

NURSING - the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of illness and suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities and populations.

That's the official policy statement of the American Nursing Association. It really comes down to this, medicine focuses on diagnosis and treatment of a health problem. Nursing focuses on diagnosis and treatment of the response to that health problem.

Cool.

A shock to the chest

I was flipping through my CPR manual today when I came across a wince-inducing, yet funny-in-a-Steve-Carell-kind-of-way notation in the Automated External Defibrillation chapter. AEDs are widely available now so that non-professionals can shock people in ventricular fibrillation (ER fans will recognize this as "V fib") back to a normal heart rhythm.

Sometimes the user can run into a problem though, I mean besides the dying person lying the ground. To whit:

Foundation Facts: The Hairy Chest Problem

If the victim has a hairy chest, the adhesive electrode pads may stick to the hair of the chest, preventing solid contact with the skin. This will lead to a "check electrodes" or "check electrode pads" message from the AED. If you receive such a message, try the following:

• Press down firmly on each pad. This may produce sufficient adhesion between the pad and the skin to solve the problem.


• If unsuccessful, briskly pull off the electrode pads. This will remove much of the chest hair.


• Wipe the area and if a lot of hair remains, shave the area for electrode pad placement with a few strokes of the prep razor in the AED carrying case. Open and apply a new set of electrode pads.

That whole "briskly pull off the electrode pads" is the ugly part. Though to be fair, the victim is unlikely to care too much what with the severe internal chest pain.

Still, sucks to be Alec Baldwin.

Term of the day: Xiphoid Process

Sounds like a band doesn't it?

XIPHOID PROCESS (Say it a couple times out loud. Fun huh?)

It's actually a pointy thing at the bottom of your sternum where the last ribs meet. While it is made of cartilage, the xiphoid process ossifies (becomes bony) in adults. When performing CPR, it is used to help locate proper hand placement for chest compressions. Care should be taken to avoid pressing on the xiphoid process itself during compressions as that can cause the pointy end to pierce the diaphragm. Which is super bad.

Oh wait, it is the name of a band.

"Money (That's What I Want)"

Originally a Motown song (co-written by label founder Berry Gordon), it was later elevated to new heights by the scorching Beatles version. Confident, sexy, and trashy-sounding, it's fantastic. To my ears though, the best version is by The Flying Lizards. Their take exhibits the same characteristics, but in a completely different way. The instrumentation is primitive, robotic, and groovy in that Kraftwerkian German way. And then there's the vocals. Backed by muffled, strained invocations of "That's, what I want," singer Deborah Lizard exudes contempt and self-assurance when she declares, "I want money." She will totally step on your face with her stilleto heel and you will pay her to do it. I mean, if you're into that sort of thing.

I was just pointed to a live performance The Flying Lizards did for the BBC back in the '80s. Like many other "live" BBC performances, they're just miming the song, but the totally fake way they go about it made me laugh. Watch especially for the guy on the left who ends up reading the repetitive "that's what I want" lyric off successive sheets of paper.

(for those reading this through an RSS feed aggregator, there's a video to click on here, just go to my actual blog site and you'll see it)

Also? YouTube is really, really cool.


This post dedicated to Carole, the only person I know who loves this song as much as me.

Pain, see Requirements for Graduation

Yesterday in Skills lab we practiced checking blood glucose on each other. It's a standard procedure for patients, especially for those with diabetes. If you've ever donated blood, you know how it goes: alcohol wipe, lancet to pierce the side of your finger tip, drop of blood on the strip, beep beep, blood glucose.

One of my fellow students noted, "This must be the only major where you sign agreements that it's okay for another student to purposely hurt you."

Gorgeous models (for medical procedures)

BoingBoing really came through for me yesterday. Two posts there directed me to medical simulation model supply websites. What a treasure trove of delights.

Maybe you'd like to practice diagnosing facial lesions? Limbs & Things has the perfect item.



Perhaps you need to improve your cut-down skills on something that will actually bleed, but won't sue?



My personal favorite, just for the sheer morbid humor of it, is the adorably-named Lumps & Bumps set "to be used in conjunction with the 'Strap-on' Breasts when performing breast examination." Cause breast lumps are so cute and totally fun.

The phone number for Limbs & Things? 866-GOLIMBS. Of course I've ordered the catalog.

Kyoto Kagaku has a amazing selection of models as well.

Love the creepy Whole Body Phantom.



Though, if you really want to scare the kids at Halloween, I recommend the Digital Rectal Examination simulator.



As expensive as these items are, I just know there's some perv out there who's tired of his Real Doll and is willing to drop a three thousand bucks for a Clinical Female Pelvic Trainer w/ Interchangeable Uteri.

Term of the day: Sleep

This may seem obvious, and it is. I just love the definition given in one of my textbooks.

SLEEP - sustained natural, periodic suspension of relative consciousness

Wow.

Seeing as I'm getting a sore throat, it’s time for me to get a lot of it starting about 20 minutes from now. Though, slugging generic Nyquil and sacking out for 12 hours isn't all that natural.

I heart soap

Thanks BoingBoing. I totally want anatomically correct heart-shaped soap.

New series: Term/Phrase of the day

I'm learning new things at such volume and speed that I thought I'd start doing a daily post about my favorite new term or phrase of the day.

The term for today is:

PROTEINACEOUS

Doesn't it sound sort of sexy? It's not. I learned it in reference to proper handwashing procedures. We don't want bodily secretions that contain proteins remaining on the hands. "Dang, that mucus is highly proteinaceous."

My new life as a nursing student

Today marks the end of the week-long introduction to my new life as a nursing student. It’s going to be a lot different from now on. It’s more than just the end of MWF or TTH classes in favor of once-a-week, three-hour lectures or that procrastination is verboten less I fail miserably.

It’s a couple hundred pages of reading a week, 8 AM or earlier classes almost every weekday, and constant studying for that dosage calculation test or health assessment or skills demonstration. And I am not complaining. This is what it takes to be a better-than-competent nurse. Here’s my books for the semester (minus a couple I don't have yet):



My classmates and I are already in the swing of things though. Last week, an instructor asked, “Have y’all heard about critical thinking?” The whole class laughed. We'd heard that constantly for a couple days. Just following doctors' orders is for losers.

Dork-out for SCOTUS

Tomorrow the US Senate votes on the confirmation of Supreme Court nominee Judge Samuel Alito. Unless he busts into the Senate chamber smoking a formaldehyde-soaked joint which he then uses to set fire to an American flag while his heretofore secret gay lover gets an NEA grant to ban handguns, he's a shoo-in.

I'm no fan of Alito, but I dearly loved the exhaustive coverage by NPR of his and John Roberts' confirmations. Daily wrap-up podcasts? Yes please! And of course with NPR coverage of matters judicial comes the Voice, NPR legal affairs correspondent Nina Totenberg.

Oh Nina, how I thrill to the sound of your arch, mannered tones. How I exalt at your veiled sarcasm. How interesting to discover that not only did you break the (non-)story of Douglas Ginsburg's pot-smoking during his Supreme Court nomination, but that your stories about Anita Hill's accusations led to the re-opening of hearings on Clarence Thomas. How I hang on your every word when you re-enact Supreme Court proceedings.

Seriously, I love the way she reads them. I imagine her in front of the microphone with little Supreme Court Justice finger puppets, waggling them in turn as she performs as Justice Kennedy, Souter, et al. You just know that she puts much more incredulosity in there when she relates one of O'Connor's pointed questions to the lawyers. Nina is so awesome, she has a permanent seat in the Supreme Court press box right next to the sketch artist. She was on The Colbert Report last week and I got waaaay too excited when she played the saucy minx to Colbert's uptight blowhard. Hee!

My level of dorkitude over the Supreme Court is such that I was shocked, shocked I say, when I read that 57% of Americans couldn't name even one Justice at a time when there were two seats to fill on the bench and the Bush administration had to pull Harriet Miers' nomination. I've known for a long time now that I'm far from the average American, this is even more statistical proof. From the survey cited above, "The percentage of Americans who can name all nine current Supreme Court justices, statistically speaking, is zero. The percentage of Americans who can name eight or more of the nine current Supreme Court justices also statistically rounds to zero." Great, I (and others like me) round to zero. Sigh.

During my trip to Washington DC several years ago, the coolest thing by far was the tour of the Supreme Court building. Since the Court wasn't in session, we got to sit in the chamber. Friggin' sweet.

Among the interesting things I learned:

- There is a seating section for the general public and a separate one for lawyers who'd been admitted to the Supreme Court Bar.

- William Howard Taft is (and will likely remain) the only President to go on to serve on the Supreme Court

- When Justices pose a question to the lawyers arguing in front of them, it's usually a roundabout way to send a message to the other Justices.

- Ruth Bader Ginsburg argued in front of the Court several times years before ascending to the bench.

- During their weekly private meetings, the newest member of the court has to get up and open the door if someone knocks. Breyer's been doing it for 11 years. Now it will be Alito's turn.

- There really is a basketball court in the building. It's the highest court in the land. Ba-dum bum, crash!

Why it's important to put things back where they belong

Last night while working at the university bookstore, I checked a used textbook to see if the media CD that comes with new books was still in the back pocket. There was a disc, but not the media CD. Suffice to say that the person who traded in that textbook is in for a rude shock the next time they open their Bridget Jones's Diary case.

Hirsute hatred

Stephen Colbert has no love for me and others of my ilk. But then he also hates owls.



Imagine the scorn he has for Bearded Owlmen.



Especially the ones with PhDs from Columbia.


Tags: The Colbert Report, beards, owlmen

Awfully cute

This is the most adorably sad thing I think I've ever seen. If I catch the bastard that took Terry's frog...

Lo siento. Yo soy un gringo con educado mal.

The medical staff at the hospital where I worked last summer were a geographically diverse lot. They came from all over the US and even different countries. So while it's understandable that many didn't grow up being exposed to different ethnicities, it still made me chortle when they would mangle the pronunciation Latino names. I'm not talking about saying "AIN-jul" instead of "on-HEL" either. Try and keep a straight face when someone loudly calls out for Mr. PEE-na.

One time a nurse had us all in tears when she recounted her first night of work in Texas. She paged a patient several times before a co-worker explained that the patient's name was probably hey-SOOS mar-TEEN-ez, not GEE-sus MAR-ten-ez. The same nurse later told me about a dream she'd had where she was at work and fluently conversing in Spanish with a patient. Only she didn't understand what she was saying and was concerned that she was giving the patient bad medical information. Aren't work-related anxiety dreams fun?

I took Spanish for my first degree but hadn't used it until I started working at the hospital last May. Even then, I only used a handful of phrases so I could complete the registration process. I doubt I will ever forget the (probably grammatically incorrect) shpiel:

"Hola. Se llamo John. Necessito informacion para registracion, OK? Este es consentimiento para tratamiento. Firma aqui por favor. Bueno. Tiene numero de seguro social? Que es su domicilio?" and so on.

The rapid rise in Spanish-speaking only patients in the state led the Texas Student Nursing Association to pass a resolution years ago calling for nursing schools to require students to take a Spanish for Healthcare Workers class. Most, if not all, accredited programs require it now. I'd planned on taking the immersion course that UT offers during the summer. Students live with a host family in Guadalajara, Mexico while attending Spanish class every day. After several weeks, the students then volunteer in a clinic for further practice.

Unfortunately, I won't have the funds to take that version of the class. I'll have to take the boring regular version on campus this Fall. Como se dice "c'est la vie" en español ?

Grand mal or la petite morte?

An incident from my time at the hospital:

EMS gets a call that an elderly man has had a seizure and is now unconscious. When they get to the scene the man's wife is freaking out. With a little effort, but the paramedic rouses the old guy. He's fine. Turns out he and his wife were having sex for the first time in 15 years - thanks to Viagra or Cialis I assume - then he sat up too quickly and briefly passed out. Even after a decade and a half, it still seems like his wife should be able to tell the difference between a seizure and an orgasm.

Rose Bowl aftermath

Even though I'm getting my second bachelor's degree from UT Austin, I've never been a booster of its sports teams. I'm just not a sports guy, and the non-joiner in me reflexively withdrawals from rabid fandom. Regardless, the Longhorns winning the Rose Bowl was thrilling, with a smattering of dread. Great game, very exciting, and yet because of that win I'll be working my ass off at University Co-op shipping tons of UT-branded merchandise to fans all over the country for the next several weeks.

Before each semester begins I usually work the graveyard shift as a temp, filling textbook orders. This time, I started earlier than usual because of all the pre-Rose Bowl excitement. For the past two weeks, I've boxed up countless Rosebowl Bound T-shirts, sweatshirts, hats, pins, pennants, buttons, keychains, orange wristbands, mugs, shot glasses, koozies, $300 DVD collections of 2005 games, and real roses with UT designs screen-printed on the petals.

This is of course in addition to the regular merchandise the Co-op carries like shower curtains, bed linens, golf bags, poker chips, Santa-in-burnt-orange Christmas ornaments, bottle openers that play "The Eyes of Texas", wheelchair wheel covers, and baby indoctrination DVDs. I swear, they could bottle Bevo farts and they'd sell. It's astounding how much money people will spend on really ugly crap.

Well, at least there will be plenty of overtime available. I start tonight at 11 PM, wish me luck.

New Year's Eve photos

Finally put up my New Year's Eve photos. Click any picture for more.

RIP Starship Pegasus

On my way back from Dallas recently, I came across the most pathetic roadside attraction I've ever seen.


The mixing of science fiction (starship) and fantasy (pegasus) is a bit odd, though Blade Runner had a unicorn in it. Maybe it's a homage.


Mini-golf is totally futuristic. I would have played a round, but it appeared to be closed for good.


At first I was suffused with ironic glee, then it just made me slightly depressed.


Now it's just a Pace Age Fantasy.

My new shirt

My sister gave me this shirt for Christmas. I can only assume that inducing seizures in those around me so that I may care for them is her way of supporting my nursing education. She's a peach.