St. Arnold's Brewery, an afternoon of beer

Yesterday I went to the St. Arnold's Brewery here in Houston with some friends. The brewery conducts a tour and tasting every Saturday afternoon. It was packed so the "tour" consisted of an employee with a mic explaining a few things about the brewery, which maybe 25% of the audience cared about. Then he explained the way the tasting worked, which I guess about 75% of the audience cared about (the other 25% were clearly veterans who knew quite well how it worked).

$5 gets you the speech, a souvenir St. Arnold's half-pint glass, and four tokens you redeem for drinks. Even the kids or teetotaling friends can join in as St. Arnold's has a root beer. If your kids are bugging the hell out of you I guess you could go half root and half real beer so they'll become sedated, or possibly belligerent. I kid of course, alcohol for children is a no-no.

I had two Lawnmowers and an Amber. By the time the final call came, I was too full from lunch and beer to use my last token. Next time I'll be more diligent. Click the above pic to go to Flickr for more photos, if you're into that sort of thing.

The South Park me

South Park Studios, where you can watch any episode from the series, recently launched. Following the lead of other animated program websites, they have an avatar generator.
This being South Park (with all that implies), you can chose from the basic body types of Female, Male, Canadian, 4th Grader, and Kindergartner. Skin tones offered are Hispanic, Caucasian, African, and Gay Tan. Yeah. I went with Male and Caucasian. The outfit is the closest I could get to scrubs, though the color is exactly right. Wish I had the Photoshop skills (and the actual program) to take out the "T" and add in a stethoscope and a pocket with pen, scissors, and hemostats. Still, fun!

UPDATE: Mybloody made my wishes come true. Picture now updated with stethoscope, pen, and hemostat. Thanks Mybloody!

My nursing assessment Part I

As I've written about before, patient assessment is a major part of being a nurse. Here's Part I of what I do within 30 minutes of getting a patient either when I'm coming on shift or they roll out from surgery. I was going to type up the whole thing in one post and then I realized how long it takes to write it all out versus just doing it. It's organized by body system and yes, we have a form to remind the nurse of all the things to check.

Neurological

Shine a flashlight in their eyes and watch for pupil constriction. Grade the size of the pupil (esitmated in centimeters) and the speed of constriction (brisk or sluggish). Grade their level of consciousness (alert, lethargic, obtunded, stuporous, or comatose). Grade their behavior (sedated, inappropriate, confused, agitated, or combative). Ask them their name, the day/date, where they are, and why they are there to judge how oriented they are. People who only know they're name are Ox1, if they know they're in a hospital and why and at least can get the month then they're Ox4. While they're speaking, grade their speech (clear, slurred, incomprehensible, or they have a breathing tube in and cannot speak). If they are aphasic, note whther they are having difficulty speaking (expressive aphasia), understanding what I'm saying (receptive aphasia), or both (global aphasia). Put two fingers in their hands and ask them to squeeze and release. Have them push against my hands with their feet and pull back their feet toward their knees. Grade their strength in these movements. Note if they have a drain or pressure monitor to their cerebral spinal fluid and if so the condition of the dressing over it, the level it's at, and the type of drainage (clear, serosanguinous, sanguinous).

Cardiovascular

Listen for heart sounds, note presence of S1 & S2 (the lub-dub sound) and any extra sounds. Check capillary refill at fingers and toes, grade brisk or sluggish (<>3 seconds). Note nailbed color (pink, pale, dusky, cyanotic). Grade the temporal, brachial, radial, dorsalis pedial, and posterior tibialis pulses (palpable, heard with Doppler, absent). Note chest tubes, their placement (pleural, mediastinal), suction applied if any, and what they're draining (clear, serosanguinous, sanguinous). Note pacemaker and/or internal cardiac debrillator and whether it is on. Note whether unused transcutaneous pacemaker wires are wrapped. Print a EKG strip and analyze it for the heart rhythm. Note or adjust the alarm settings for heart rate, blood pressure, and ST segment elevation or depression.

Note all IVs, their size and placement, when they were inserted, how the insertion sites look, and if the dressings over them are intact or due to be changed. If A-line (arterial line used for continuous blood pressure monitoring) and/or CVP (central venous pressure line used for monitoring that pressure as a measurement of right-side heart function and fluid status) present, calibrate the transducers and note how the monitor waveform looks and that the dressings over them are intact and up-to-date.

That's enough for now. I'll get to pulmonary, renal, etc. later. Is this boring? Should I spice it up with stories of things gone wrong?

How explicit before most turn away? Or A Ridiculous Joke

Those that know me well know that I love the band The Magnetic Fields. I interviewed band leader Stephin Merritt a couple time while writing for the UT Austin newspaper. There was a time when I had the money and vacation time to justify flying across the country to Boston or New York mostly to see MF. And despite dropping out of all the other music-related listservs, I've kept up with the Stephinsongs listserv for 11 years. Yah, supa-devoted fan.

Mr. Merritt does not compose autobiographical lyrics despite the seemingly heart-felt pronouncements in many of his songs. Though a relatively modern element in popular music, the confessional, when-I-say-"I"-I-really-mean-me style of lyrics seems to be the default interpretation of critics and audiences. Nobody really thinks that Bob Marley actually shot the sheriff or that David Byrne was a psycho killer do they?

Recently Merritt was interviewed about the release of the new Magnetic Fields album Distortion and had this to say, “In the lyrics, there’s only so much intimate detail that heterosexual audiences can put up with. So even if I were autobiographically inclined, I don’t think I would go very far into details. Fortunately for me, I’m not at all autobiographically inclined, and when I put autobiography into my songs I’m generally joking.”*

So, if Stephin was autobiographically inclined and if he went into intimate details, then we'd have, what, More Songs About Butt-Fucking? Actually, that sounds like a pretty good idea. I'm officially claiming that title for my new queerpunk band Big Black Dildo. Or Cock. Is Big Black Cock better?**

*Stephin Merritt, Los Angeles Times, Jan. 27.
** I almost can't believe that I went this far for stupid Steve Albini joke. Almost.

My SXSW week

So my schedule last week went like this:

Monday

Work 6:45AM - 7:15PM

Tuesday

4 hours of computer modules at work, gym, watched California Split

Wednesday

Work 6:45 AM - 7:15 PM
Drive to Austin 8:30 PM - 11:00 PM
Stuff badges for SXSW 11:15 PM - 11:50 AM

Thursday

Listen to REM from behind Stubb's 12:00 AM - 1:30 AM
Sleep 2:30 AM - 10:30 AM
See bands, wander 12:00 PM - Friday 1:30 AM

Friday

Drive back to Houston 2:00 AM - 5:00 AM
Sleep 5:00 AM - 7:00 AM
Classroom education at work 8:00 AM - 4:00 PM
Watch TV, eat, sit around 4:45 PM - 6:30 PM
Sleep 6:30 PM - Saturday 08:00 AM

Saturday

Drive to Austin 9:00 AM - 12:00 PM
See bands, wander 12:00 PM - Sunday 2:00 AM
Sleep 2:30 AM - Sunday 7:30 AM

Sunday

Drive back to Houston 8:15 AM - 11:00 AM
Think of about how attached I am to Austin and SXSW 11:30 AM - 11:32 AM
Nap, gym, laundry, grocery shopping, watch the original Funny Games 11:32 AM - 9:45 PM

So that's what I did last week. It wasn't a successful SXSW in that I didn't see too many things that impressed me and wasn't able to see any films. In fact the only band I really enjoyed whole-heartedly was The Raveonettes. A few were interesting, but nothing more than that. I'll chalk it up to my own fatigue and jadedness. The kids are alright, must have been me.

UPDATE:
I forgot to write that Black Moth Super Rainbow were great Saturday night/Sunday morning. I really enjoyed their collaboration with Octopus Project last year at SXSW and they clearly came ready this time. They had confederates in the crowd who, at climatic moments, would throw out candy and confetti, spray fake snowflakes, and float (empty) piñatas through the very engaged audience. Every couple of songs, the guy in the band who was crouched on the floor playing keyboards or vocodering would stand up, look around, and seem amazed at the size and excitement of the crowd. Yay for them.

Hi-ho, the derry-o

So I'm at home, organizing stuff with Wigstock: The Movie playing in the background. I've never seen it before and I do like talented drag queens, but still I'm barely paying attention. Near the end of the movie I look up during Crystal Waters drag king performance and say to myself, "Is that Michael K. Williams, better known as Omar on the best TV show ever The Wire, as a back-up dancer?!" Through the magic of Tivo (and a quick Google to confirm that he was a dancer for Waters), it is confirmed. Michael K. Williams, pre-scar, is in Wigstock: The Movie furiously workin' it.

Couldn't find a online clip of it so I just took pictures off the TV screen.

What a difference a day, or a weekend, makes

Today was much, much better. My preceptor apologized for how crazy it got last week and I admitted that I was somewhat demoralized by the experience. She said I did okay and that run-of-the-mill cases were never like that. I offered that other nurses came up to me while I was finishing up paperwork to see if I was okay and had my preceptor left me and gone home?! It was just paperwork and the oncoming shift had already taken over, but it was nice to see that they cared. We laughed about her now getting a reputation for being a harsh, cruel bitch who tosses her preceptees into the deep end of the pool. And then releases the sharks with lasers on their frickin' heads.

We again took two empty beds, but my preceptor (I've got to think of a decent pseudonym for her so I can quit typing "my preceptor") promised that she'd get me something more entry-level. It was another pump case, what we call it when the patient has been on a heart-lung bypass machine during surgery, but a much more stable one. In addition to getting the workflow down that much better, I learned that shivering unrelieved by warming blankets is likely due to a reaction to anesthesia and that Demerol treats it. Cool. I also learned not to throw away IV tubing from surgery even though you're not presently using it because you might need it later to infuse fluids. Noted.

Much better day. I absolutely can do this. Yay.