The past week I was assigned to a patient that was 20 years old who was diagnosed with stage four ovarian cancer. It has metastasized throughout her body and into her bones. Her kidneys are shutting down and fluid is accumulating in her system. She needs maximum assistance to get out of bed and pivot into a wheelchair to go the bathroom or anywhere else.
My heart broke into a million pieces taking care of her.
Beautiful young women. SO sweet. I asked myself over and over, why? She is so young. Her entire life is ahead of her. She was going to culinary school. She said she loved italian food and loved making pastas from scratch. She has worked in the family business growing up which was a restaurant that inspired her to become a chef one day. She is engaged. A normal 20 year old young lady. Now...
She is so afraid. She has had more procedures done on her in a matter of 3 days than a 60 year old has had in their lifetime. I wish I could fix it! I wish I could make her better!
Despite her fear, she is a fighter. My goal was to be a motivator for her. Being positive. Reinforcing everything she did with positive feed back. Encouraging her to use as much of her muscle strength as she could when transferring. Then telling her she how amazing she did when she was done! Telling her to keep fighting and not let people do things for her if she can do it herself. I told her I want her to try. It didn't matter if she didn't complete whatever it was she was doing as long as she tried! Encouraged her to eat despite a low appetite. I told her I don't care if we have to try a 100 different foods to find one you can tolerate, I'll do it. Everyone needs hope. Even if it's a smallest bit of hope. If it's there it will be enough to push one to fight and want to get better regardless of how bleak the outcome maybe. Everyone deserves that in any situation.
She was so grateful....I gave her a high five and told her she was awesome after she transferred and did a lot of the work by herself one of the times and she flashed me this big smile and thanked me. She hadn't smiled all day...
It made me so happy.
She was extremely polite. She would only address me as "Miss Norah". I told her not to but to call me Norah and she refused. She would also call me "ma'am"...
It's people like her... I do this job because of them. They inspire me. They are amazing. They give me a chance to make a difference. The chance to make an impact. That chance to make a lasting impression.
Toward the end of my shift I went in to check on her and she was chit chatting with her fiancé on the phone. I was getting ready to walk out to let her chat when she called me back into the room. I went back and she told she had a mango for me because mango's are her favorite fruit and she wanted to share that with me. It was so sweet. So innocent. So sincere. It broke my heart. It was bittersweet. I can't put into words how she made me feel at that moment. I wish I had the power to make her better.
I was just so happy to see her in such a good mood before I left that night. She is actually quite the comedian. She made me laugh several times that evening.
She has a beautiful soul. She is a beautiful person. Patients like her remind me of why life is worth living.
Enjoy every moment. Tell the people you love that you love them. Swallow your pride. Be kind to people. Don't intentionally hurt others. Help people when you can. Life is not about the material things. It's not about how much money you make or the title you have. You can't and you won't have all that tangible stuff when you die. That is the only known fact of life. Death.
Make your life memorable not just to yourself but so that others too remember you in a positive light. Don't let the worries and stresses of life let you become jaded. Be the best you everyday.
There is no reward better than knowing you can/have made a difference.
Until next time.
-Norah
Sunday, October 27, 2013
Friday, October 25, 2013
Pull The Trigger!
Pulling the trigger. I briefly talked about it in my "LA night life" blog about how when at a club or bar all the good looking guys and good looking girls are not talking to each other. Mainly because everyones egos are too big and that makes their ego more fragile when it comes to rejection.
This is not unique to just LA. This is everywhere! What's going on in all night clubs and bars or any type of gathering for a matter of fact is a whole lot of not talking!
The hottest guy in club is definitely not the one talking to all the pretty women. Usually he is standing, observing, sipping on his drink because he is scared to pull the trigger for fear of rejection.
This is not unique to men only! Women are exactly the same way. You could be the hottest girl in the club and have spotted a guy you think is good looking and may have even made eye contact with him but never talked to him because "he never made a move."
Well, let me tell you something. If you wait around to be chosen you are going to be doing A LOT of waiting. Also, you are limiting your possibilities to ONLY the ones that "make a move". That does not make any sense. Because most of the time the ones that are making "a move" are not the ones you want to be talking to.
I know the majority of all of us women have this thing about "making the first move". That we have lost some amount of value if we make the first move. I am not telling you to leave your booth and walk across the dance floor to talk to this guy. I am just saying let him know you are interested from a far (eye contact is not enough) so that he has some confirmation that his ego won't be crushed if he approaches you. That's how you pull the trigger as a woman.
Boom! You have instantly doubled the chances of that guy you actually want to have a conversation with to initiate contact. More than likely he will.
More often than not the ball is in our court as the woman. Men go off of our queues. Especially when it comes to initiating contact. Be approachable. Look approachable. Even if your not interested don't be rude. Try to let their ego down gently (preferably with a smile) instead of being a total winch.
Make the most of your outings. You are in control of your destiny. Stop WAITING for things to happen. Things don't just happen! You didn't just happen to get your degree. You didn't just happen to get your job. You didn't just happen to get that promotion. You did something to achieve those things! It's no different when it comes to dating and relationships. Also, sitting at home doing nothing is also going to get you nowhere either. So get out! Do things! Meet people! Most importantly talk to people!
Live in the moment. Don't get ahead of yourself. You can't control the future. You can only control what is happening now. You will never get this moment back. Make the most of it and enjoy it while it lasts.
That is all.
Until next time.
-Norah
This is not unique to just LA. This is everywhere! What's going on in all night clubs and bars or any type of gathering for a matter of fact is a whole lot of not talking!
The hottest guy in club is definitely not the one talking to all the pretty women. Usually he is standing, observing, sipping on his drink because he is scared to pull the trigger for fear of rejection.
This is not unique to men only! Women are exactly the same way. You could be the hottest girl in the club and have spotted a guy you think is good looking and may have even made eye contact with him but never talked to him because "he never made a move."
Well, let me tell you something. If you wait around to be chosen you are going to be doing A LOT of waiting. Also, you are limiting your possibilities to ONLY the ones that "make a move". That does not make any sense. Because most of the time the ones that are making "a move" are not the ones you want to be talking to.
I know the majority of all of us women have this thing about "making the first move". That we have lost some amount of value if we make the first move. I am not telling you to leave your booth and walk across the dance floor to talk to this guy. I am just saying let him know you are interested from a far (eye contact is not enough) so that he has some confirmation that his ego won't be crushed if he approaches you. That's how you pull the trigger as a woman.
Boom! You have instantly doubled the chances of that guy you actually want to have a conversation with to initiate contact. More than likely he will.
More often than not the ball is in our court as the woman. Men go off of our queues. Especially when it comes to initiating contact. Be approachable. Look approachable. Even if your not interested don't be rude. Try to let their ego down gently (preferably with a smile) instead of being a total winch.
Make the most of your outings. You are in control of your destiny. Stop WAITING for things to happen. Things don't just happen! You didn't just happen to get your degree. You didn't just happen to get your job. You didn't just happen to get that promotion. You did something to achieve those things! It's no different when it comes to dating and relationships. Also, sitting at home doing nothing is also going to get you nowhere either. So get out! Do things! Meet people! Most importantly talk to people!
Live in the moment. Don't get ahead of yourself. You can't control the future. You can only control what is happening now. You will never get this moment back. Make the most of it and enjoy it while it lasts.
That is all.
Until next time.
-Norah
Thursday, October 24, 2013
It's A Thing Called Communication
Communication is the key to success in anything in life. Learning how to communicate effectively is an extremely valuable skill.
"Effectively" is the key word here.
Communication does not seem to exist in the hospital.
Think of nurses as project managers. They basically coordinate everything for the patient and he/she is the expert resource to everyone in the healthcare team if there is any questions/comments/concerns about the "project" or patient in this case.
Let me just say, I NEVER want to be a project manager. If I were, I am sure I would be a very strict one because I don't enjoy wasting my time chasing after people to do their job. Time is money. I expect them to know their role and have it done when it should be done. No excuses.
Day shift is very busy because the day starts off with the MDs making their rounds. Right after they make their rounds they sit in front of the computer and start to put in new orders depending on what happened over night with their patients. As the nurse, on top of the normal AM routine that needs to be completed you also are starting your day with new orders that need to be done. Examples of new orders that are usually placed in the AM are: take down PCAs, start patients are oral pain meds, draw stat labs if needed, hang electrolyte replacements, assist MDs with dressing changes ect. Specifically, what makes day shift so busy is the tracking down of people to do things that should have already been done. Especially when it comes to discharging patients and patients that are "NPO" or nothing by mouth. Let me explain.
Patients that have been "NPO" since midnight the FIRST question they ask me as the day shift nurse is, "when can I eat?" They have been fasting for 8 hours by the time I see them. Often doctors place patients on NPO status for a POSSIBILITY of a procedure. The doctors will know by 10 am or by noon that the patient WILL NOT be going for the procedure but don't think about the fact that this patient has not had anything to eat or drink in almost 12 hours waiting for this "procedure". That is when I have to take the time to track down the MD and ask why the patient is still NPO. Are they still going to for the procedure or not? More often than not, the reply is: "oh no we decided not to do the procedure. I forgot to change the orders ill do it right now"or "we are waiting on cardiology (or some other team that is consulting on the patient) to get back to us on the procedure". That bothers me. The reasons are 3 fold. First, if you are waiting on another team to decide, pick up the phone and find out right now and call me back with a response so I can inform my patient what is going on with their care. Second, my patient was left starving because of carelessness because you forgot to discontinue the NPO order. Third, I had to waste my time I could have been doing something else because the MD doesn't know how to effectively communicate and do his/her job.
Busy is not an excuse. We are all busy. It's part of the job.
I hate, I mean I absolutely despise having to waste so much of my 12 hour day chasing people down to put in orders or just simply do their job. Calling pharmacy to track down where medications are or why the pyxis has not been restocked. Having to go to the pharmacy myself to pick up medications that should have been delivered. Finding out why I don't have paper work that should have already been completed by the time the patient is discharging. Calling multiple MDs to clarify an order or put an order in. Calling MDs to come up and consent patients for procedures that THEY put orders in to be completed. Releasing orders MDs wrote hours prior to the patient coming to the floor and making sure they apply to the patient's current status just to name a few. It's very frustrating. The reason for it all is COMMUNICATION. No one communicates in the hospital. Everyone works as their own entity. It makes absolutely no sense. All the different aspects of the healthcare team is working for the patient. Everyone SHOULD be communicating. God forbid I am discharging patients...
Patients that are being discharged need a lot of things to be coordinated. Where are they discharging to? Is family picking them up or are they leaving by ambulance to a nursing home? If by ambulance, is all the paper work completed? Who do I need to call to give report to? Are their prescriptions filled? Did the MD even write the scripts? Does their insurance cover their prescriptions? If it doesn't, what is going to be done about it? Do they need assistive equipment such as a wheelchair or walker? Have they received it? If not, I need to find out why and when it will be delivered? Is there discharge orders? If not, I need to contact the MD. You get the picture? Now times that by 2 or 3 patients being discharged. It's absolute chaos.
Four or Five hours easily lost coordinating all of this on top of doing my daily job responsibilities as a nurse. I love being a nurse and caring for patients. I do not like chasing people down to do their job so that I can do mine effectively.
Nurses are what make a hospital function. There are really good nurses and their are bad ones. Not every nurse will be proactive and find out why the patient is still NPO or go pick up medications from the pharmacy to administer it on time. It's not an easy job. Not everyone is cut out for it.
I am so passionate about it because I really care about my patients. It frustrates me when people are careless in their care of patients. When people are hospitalized it is a traumatic experience. They are already stressed about a million different things. They should not have to stress because a doctor forgot to put in an order or is waiting for another team to come up with a decision. Be proactive! Get answers! It's not fair to leave patients waiting.
What happens when we have that one patient that is proactive in his/her care and demands the MDs come in and explain why they want to do a CT scan, why they want to place a foley catheter, or why they want to start the patient on a new medication. That patient is labeled as "difficult". That is sad. Because most of the time in the hospital we OVER utilize resources. Patients just trust the doctors know what they are doing. As the patient, it is YOUR body, YOUR health, YOUR care. Be involved! It is our job as the health care team to communicate and explain. If someone has a problem with that, they need to re evaluate their profession.
Communication is a difficult issue to solve in any setting. Most importantly I start with myself. If I effectively communicate it makes my job that much easier. Then collaborate on committees to try to establish a system that facilitates better communication. Problem solving is key and with change comes resistance.
Be adaptable.
Remember that change starts with you first.
Leaders create more leaders.
Until next time.
-Norah
Sunday, October 20, 2013
LA Night Life
Los Angeles. LA. La La Land. Whatever you like to call it.
I am a nor cal girl that recently moved to so cal. I enjoy being a part of the "night life" scene when I can. No matter where you are the club scene is essentially the same. It never changes. It will always be there. If you can't make it out one weekend or a few weekends you are not missing out on anything life changing.
However, I do find LA night life to be interesting because LA much like New York is a place where people are chasing their dreams. Almost everyone I've met is not originally from LA or Cali in general. Many people have their "day job" and then their night job is the job that is going to help them hopefully one day achieve their dream. Whether that be a singer, dancer, actor, producer ect.
Hollywood nightlife is a whole other beast on its own. Hollywood night life is where you will find the posh clubs that feel like Vegas but you are not in Vegas. Women get in no problem, men it can be a hassle if you don't have pretty ladies with you or you don't know someone that will get you in or your not dropping money on a table. When you walk in it's dark, the music is loud, beautiful lighting, nice architecture, classy go go dancers, a raised DJ booth at the front of the dance floor, the bar is packed as usual, booths everywhere, and everyone is dressed to impress.
Here you will find that people will rack up their credit cards every weekend for no special occasion buying tables located in the far back corner of the club because the ones near the dance floor are just ridiculously priced so a table in the back is better than no table at all.
All this does is attract the people that are after fame and fortune. Kevin Hart said it best in one of his stand up comedies, "stay in your lane". If you go to one of these posh Hollywood nightclubs and are acting "hollywood" when in reality you know you are not what you are presenting yourself to be then you are setting yourself up for trouble, especially the men.
Many women in LA I have noticed will buy a dream at a drop of a dime. I can't tell you how many times guys have tried to hit on me by starting the convo asking if I am a singer, model or actress. No, I'm not, but let me guess, you are a producer? haha. Ladies, don't get caught up. No shame is chasing your dream but don't let some dude sell you one in the club.
If you're out in the club spend a night just observing the dynamics that take place in the club. Often you find that the good looking girls and good looking guys never end up talking or approaching the other because both of their egos are too big. When your ego is too big it becomes fragile. A good looking guy who views himself as being a 9 or 10 a lot of times will not approach the hottest girl in the club. Why? Because he already sees all the other guys hitting on her and she has politely rejected them so he doesn't want to attempt for fear of bruising his ego. The same goes for good looking women. But, you also have to consider the fact the many women generally don't make the first move to begin with.
If you find yourself in this situation you can always gauge your bets by just trying to make eye contact with the girl you have your eyes on or just go talk to her and have a NORMAL conversation instead of hitting on her right from the start. Say something she will remember. Be different. Don't start deep conversations in the club. Keep it light and playful. I promise you will have better luck. At the very least having a convo with her.
Everyone puts up a facade to some extent especially in the beginning. Just make sure it's something you can actually keep up with. A basic example of this is if a guy takes a girl out on a date the first 2 times to Morton's then Ruth's Chris and has rented a luxury car both times and makes sure to make a point to show his gucci belt and Loui wallet on the dates and he starts to pick up that the girl is impressed by these material things. He's starts to second guess everything because she likes him for the facade he has put up but he knows he can't keep this up forever so what ends up happening? He just cuts it off. He did it to himself.
Especially in LA where everyone acts like they are balling you have to be careful. You don't want a guy or a lady wanting to spend time with you or date you because of the superficial things you own or the connections you may have. All these superficial things don't mean anything in reality. In LA it's hard for many to get passed that because it is everywhere and there is a big emphasis placed on it.
If you are in LA and go out to hit the town at night. Dress up. Talk to people. Observe. Dance. Don't take yourself too seriously. You'll have a good time.
Welcome to La la land :)
Until next time.
-Norah
I am a nor cal girl that recently moved to so cal. I enjoy being a part of the "night life" scene when I can. No matter where you are the club scene is essentially the same. It never changes. It will always be there. If you can't make it out one weekend or a few weekends you are not missing out on anything life changing.
However, I do find LA night life to be interesting because LA much like New York is a place where people are chasing their dreams. Almost everyone I've met is not originally from LA or Cali in general. Many people have their "day job" and then their night job is the job that is going to help them hopefully one day achieve their dream. Whether that be a singer, dancer, actor, producer ect.
Hollywood nightlife is a whole other beast on its own. Hollywood night life is where you will find the posh clubs that feel like Vegas but you are not in Vegas. Women get in no problem, men it can be a hassle if you don't have pretty ladies with you or you don't know someone that will get you in or your not dropping money on a table. When you walk in it's dark, the music is loud, beautiful lighting, nice architecture, classy go go dancers, a raised DJ booth at the front of the dance floor, the bar is packed as usual, booths everywhere, and everyone is dressed to impress.
Here you will find that people will rack up their credit cards every weekend for no special occasion buying tables located in the far back corner of the club because the ones near the dance floor are just ridiculously priced so a table in the back is better than no table at all.
All this does is attract the people that are after fame and fortune. Kevin Hart said it best in one of his stand up comedies, "stay in your lane". If you go to one of these posh Hollywood nightclubs and are acting "hollywood" when in reality you know you are not what you are presenting yourself to be then you are setting yourself up for trouble, especially the men.
Many women in LA I have noticed will buy a dream at a drop of a dime. I can't tell you how many times guys have tried to hit on me by starting the convo asking if I am a singer, model or actress. No, I'm not, but let me guess, you are a producer? haha. Ladies, don't get caught up. No shame is chasing your dream but don't let some dude sell you one in the club.
If you're out in the club spend a night just observing the dynamics that take place in the club. Often you find that the good looking girls and good looking guys never end up talking or approaching the other because both of their egos are too big. When your ego is too big it becomes fragile. A good looking guy who views himself as being a 9 or 10 a lot of times will not approach the hottest girl in the club. Why? Because he already sees all the other guys hitting on her and she has politely rejected them so he doesn't want to attempt for fear of bruising his ego. The same goes for good looking women. But, you also have to consider the fact the many women generally don't make the first move to begin with.
If you find yourself in this situation you can always gauge your bets by just trying to make eye contact with the girl you have your eyes on or just go talk to her and have a NORMAL conversation instead of hitting on her right from the start. Say something she will remember. Be different. Don't start deep conversations in the club. Keep it light and playful. I promise you will have better luck. At the very least having a convo with her.
Everyone puts up a facade to some extent especially in the beginning. Just make sure it's something you can actually keep up with. A basic example of this is if a guy takes a girl out on a date the first 2 times to Morton's then Ruth's Chris and has rented a luxury car both times and makes sure to make a point to show his gucci belt and Loui wallet on the dates and he starts to pick up that the girl is impressed by these material things. He's starts to second guess everything because she likes him for the facade he has put up but he knows he can't keep this up forever so what ends up happening? He just cuts it off. He did it to himself.
Especially in LA where everyone acts like they are balling you have to be careful. You don't want a guy or a lady wanting to spend time with you or date you because of the superficial things you own or the connections you may have. All these superficial things don't mean anything in reality. In LA it's hard for many to get passed that because it is everywhere and there is a big emphasis placed on it.
If you are in LA and go out to hit the town at night. Dress up. Talk to people. Observe. Dance. Don't take yourself too seriously. You'll have a good time.
Welcome to La la land :)
Until next time.
-Norah
Friday, October 18, 2013
Strategic Altruism
Altruism is a great quality to have in a person. Doing things altruistically is amazing.
However, sometimes one must be strategically altruistic. What I mean by this is a person still is doing something for the better of others at no cost or pay out to him/her simply by participating in whatever it is also benefits him/her too in some way.
An example of this is being on a review board. One may not want to be on the review board but by volunteering his/her time to be a part of it not only is he/she being involved and helping others but also strategically this is a perfect way to build a network. Maybe the other people on the board could possibly help one get a job he/she wants, help with a business venture, or help edit a grant proposal.
It's not money in your pocket but its buying and building equity in yourself. Plus, volunteering is favorable because there is more flexibility. If it were a paid position there is more responsibility and rigidity to the schedule.
There is nothing wrong with being strategically altruistic. Helping others while helping oneself further one's goals.
Networking is under estimated. Network, network, network!!! That is how you can make BIG things happen for yourself.
Introduce yourself! Talk to people. Go out to lunch or coffee. Ask questions! You can learn A LOT more from talking to an experienced venture captialist over a one hour lunch than you ever will in a 2 year MBA program.
People that go into debt or fork out the money to go to big name colleges like Harvard for an MBA are not paying those big bucks for the classes they are taking. The money they are putting down is for the network they are creating by simply being in the program. They are investing in themselves and building self equity.
It is on you to make what you want out of your life experiences. Anywhere you go you never know who you may meet and what they can potentially help you achieve in life by simply having them as a reference. Don't be so reserved or stuck up that you don't learn how to interact with people or look down on people YOU think are not good enough for you.
You never know what the person who you think is not good enough for you could actually do for you. Sometimes doing tedious things needs to be done to achieve what YOU want to achieve.
Learn how to sell yourself. Be confident! Learn to always look put together when leaving your home. You never know who you will meet. First impressions are everything. Remember...
Strategic altruism.
Until next time.
-Norah
However, sometimes one must be strategically altruistic. What I mean by this is a person still is doing something for the better of others at no cost or pay out to him/her simply by participating in whatever it is also benefits him/her too in some way.
An example of this is being on a review board. One may not want to be on the review board but by volunteering his/her time to be a part of it not only is he/she being involved and helping others but also strategically this is a perfect way to build a network. Maybe the other people on the board could possibly help one get a job he/she wants, help with a business venture, or help edit a grant proposal.
It's not money in your pocket but its buying and building equity in yourself. Plus, volunteering is favorable because there is more flexibility. If it were a paid position there is more responsibility and rigidity to the schedule.
There is nothing wrong with being strategically altruistic. Helping others while helping oneself further one's goals.
Networking is under estimated. Network, network, network!!! That is how you can make BIG things happen for yourself.
Introduce yourself! Talk to people. Go out to lunch or coffee. Ask questions! You can learn A LOT more from talking to an experienced venture captialist over a one hour lunch than you ever will in a 2 year MBA program.
People that go into debt or fork out the money to go to big name colleges like Harvard for an MBA are not paying those big bucks for the classes they are taking. The money they are putting down is for the network they are creating by simply being in the program. They are investing in themselves and building self equity.
It is on you to make what you want out of your life experiences. Anywhere you go you never know who you may meet and what they can potentially help you achieve in life by simply having them as a reference. Don't be so reserved or stuck up that you don't learn how to interact with people or look down on people YOU think are not good enough for you.
You never know what the person who you think is not good enough for you could actually do for you. Sometimes doing tedious things needs to be done to achieve what YOU want to achieve.
Learn how to sell yourself. Be confident! Learn to always look put together when leaving your home. You never know who you will meet. First impressions are everything. Remember...
Strategic altruism.
Until next time.
-Norah
Monday, October 14, 2013
You inspire me continued...
Today the patient I mentioned on my previous post that was diagnosed with ovarian cancer passed away. I took care of her just this passed Friday. She was still "alert and oriented" as we like to say in the hospital. She was still talking and knew what was going on and able to request medications ect.
Taking care of her on Friday was really emotional for me because she had just been readmitted to the hospital a few days prior because her situation was declining. Again, it was the same experience as the last time I took care of her.
Her room was packed with all of her loved ones. She is such a selfless person it is SO amazing. Truly. I cannot put into words. This lady was actively dying and she was worried about everyone else and not herself. She was in unfathomable pain on a hydromorphone drip, she was nauseated and throwing up and her nephew was getting ready to take a shower and in the middle of all of this she stops and tells her sister, "does he have a towel, make sure he has a towel".
I had to walk out of the room because my eyes were filling with tears because this woman was so amazing. Selfless. She pulled on all my heart strings. She was apologizing to me that she kept asking me for pain medication and nausea medication. It just blew my mind. I told her to not apologize! That I didn't want her to be in pain and if I had to be in there all day to make sure she was comfortable I would. Always saying thank you. She's always grateful. Just purely amazing.
It was sad for me to know she passed away today. I was thankful I was not caring for her because it would be very difficult for me emotionally to be in the middle of all of it because I have such a strong connection with her and the family. However, I did give my condolences to the family. I tried so hard not to cry. My eyes kept tearing up as the family was thanking me for everything.
Bittersweet.
She impacted me in such an amazing way. I'll never forget her because she inspired me so much. It's extremely rare to meet people these days that are selfless. She was the epitome of selfless.
I would be happy if I could inspire even one person the way she has inspired me. I'm so grateful I had the opportunity to meet this woman and had the chance to tell her how amazing she was and how she had inspired me in just the few days I had the privilege of caring for her.
We live in a world that is extremely selfish. Everyone is so focused on achieving their goals and making money that no one really cares about the person next to them. People hardly even care about their own family let alone people that are not even blood related. I am determined to be different. There is nothing wrong with setting goals for oneself and achieving greatness in life. But what is the purpose of achieving greatness and keeping it all to yourself?
True greatness to me is not about how much money you have in your bank account, the car you drive, the house you own, the name brand of your purse/wallet, how many people follow you on twitter or instagram, or that you have a private jet. Greatness to me is how many people can say you have changed their life for the better by just being the person you are. Greatness is when a person does things for others with no expectation or intentions of wanting anything in return. Greatness is inspiring people to be better by just being in your presence. Greatness is selflessness. Greatness is when you are gone people remember you for your actions/deeds not for your fame and fortunes...
Until next time.
-Norah
Taking care of her on Friday was really emotional for me because she had just been readmitted to the hospital a few days prior because her situation was declining. Again, it was the same experience as the last time I took care of her.
Her room was packed with all of her loved ones. She is such a selfless person it is SO amazing. Truly. I cannot put into words. This lady was actively dying and she was worried about everyone else and not herself. She was in unfathomable pain on a hydromorphone drip, she was nauseated and throwing up and her nephew was getting ready to take a shower and in the middle of all of this she stops and tells her sister, "does he have a towel, make sure he has a towel".
I had to walk out of the room because my eyes were filling with tears because this woman was so amazing. Selfless. She pulled on all my heart strings. She was apologizing to me that she kept asking me for pain medication and nausea medication. It just blew my mind. I told her to not apologize! That I didn't want her to be in pain and if I had to be in there all day to make sure she was comfortable I would. Always saying thank you. She's always grateful. Just purely amazing.
It was sad for me to know she passed away today. I was thankful I was not caring for her because it would be very difficult for me emotionally to be in the middle of all of it because I have such a strong connection with her and the family. However, I did give my condolences to the family. I tried so hard not to cry. My eyes kept tearing up as the family was thanking me for everything.
Bittersweet.
She impacted me in such an amazing way. I'll never forget her because she inspired me so much. It's extremely rare to meet people these days that are selfless. She was the epitome of selfless.
I would be happy if I could inspire even one person the way she has inspired me. I'm so grateful I had the opportunity to meet this woman and had the chance to tell her how amazing she was and how she had inspired me in just the few days I had the privilege of caring for her.
We live in a world that is extremely selfish. Everyone is so focused on achieving their goals and making money that no one really cares about the person next to them. People hardly even care about their own family let alone people that are not even blood related. I am determined to be different. There is nothing wrong with setting goals for oneself and achieving greatness in life. But what is the purpose of achieving greatness and keeping it all to yourself?
True greatness to me is not about how much money you have in your bank account, the car you drive, the house you own, the name brand of your purse/wallet, how many people follow you on twitter or instagram, or that you have a private jet. Greatness to me is how many people can say you have changed their life for the better by just being the person you are. Greatness is when a person does things for others with no expectation or intentions of wanting anything in return. Greatness is inspiring people to be better by just being in your presence. Greatness is selflessness. Greatness is when you are gone people remember you for your actions/deeds not for your fame and fortunes...
Until next time.
-Norah
Tuesday, October 8, 2013
Primary Nursing vs Team Nursing: RN, LVN, CNA
Many people view “primary nursing” as a negative thing.
Primary nursing for those that don’t know is when a hospital functions with
registered nurses (RNs) only. Meaning, no licensed vocational nurses (LVNs) or
certified nursing assistants (CNAs). The patient ratio is the same (at least
for California). The nurse can have up to 5 patients on a med surg floor and up
to 2 in ICU. The work to be completed for all the patients is the RN’s SOLE
responsibility. The RN is held accountable for everything.
The majority of hospitals function under a “team nursing”
model. Where the RN is the lead and is paired with a CNA and an LVN. The
patient care for 4 to 5 patients is split between the RN, LVN, and CNA. An
example of this type of nursing would look something like this:
Suppose the RN is assigned 4 patients. The CNA in total is
assigned 8/9 patients and is split between two RN assignments. The CNA is in
charge of bed baths, bathroom needs, changing linen, refilling water, emptying
drains, recording drain outputs, and helping patients with meals ect. The LVN
is assigned to 2 of the 4 patients of each RN totally 4 patients for his/her
own. The LVN can do everything the RN can do with the exception of passing IV
medications, verifying drips such as insulin and amiodarone, transfusing blood,
and verifying new orders. That leaves the RN with doing patient assessments,
contacting the MD for orders, passing medications to the other 2 patients not
cared for by the LVN and only passing IV meds for the 2 patients the LVN is taking
care of IF there is any IV
medications to give and most patients don’t have drips or blood transfusions
regularly on the floor. Essentially the RN’s main job is to basically
coordinate the care for the 4 patients throughout the day.
Before I go into my opinion on the two models of delivering
nursing care, research has proven that patient mortality and morbidity was
significantly improved in hospitals practicing with the primary nursing model.
I have had the privilege of working in institutions that
have practiced both models. I favor the primary nursing model. I favor this
model because I as the nurse am held accountable for everything that needs to
be done for the patient. I know exactly what is going on because I did it. I
know what that drain out put looked like. I know how much that drain put out
because I was the one emptying it. I know whether the patient brushed his/her
teeth because I offered it to them. I know how much water they drank because I
refilled it ect. ect.
Take an extreme situation for example such as a code. I have
an MD asking me how much fluid did this patient take in today? How much did
that drain put out the last hour? When was the last time the patient had
narcotics? I have answers right away or at the very least a really good
“guestamation” of what the answer might be. This is a very real situation. Many
MDs will be asking you these types of questions as you are cracking ribs doing
chest compressions on your pulseless non breathing patient. The MD and the code
team are going to want the RN to
paint a picture of the events leading up to the arrest.
Now, lets consider this situation in a “team nursing” model.
The patient codes and the RN is running the code but has not had the chance to
speak with the CNA or look in the computer to see if any drain outputs or urine
out put as been recorded. The RN does not know how much fluid the patient
consumed because the CNA refilled the water and fed the patient. The RN does
not know that last time this patient received narcotics because the LVN is in
charge of passing all oral medications including the norco the is ordered PRN
(as needed). Now here comes the MD as you, the RN, is doing chest compressions
and the MD starts shooting questions as you: when was the last dose of norco?
What has this patient’s urine output been so far? How much has that drain put
out? As the RN you are a deer in headlights at this moment. You don’t have any
of these answers right away because “it wasn’t your job” to do those things.
Your CNA and LVN I guarantee are not in the room either. It’s just not good.
I’ll play devils advocate because I know there will be some
people reading this and thinking: “well that’s your job as the RN is to make
sure you have all that data and you are checking to see what the CNA and LVN
are doing”. That is a very nice textbook thought but, anyone that is an RN
knows how busy it is in the real world hospital and you don’t get to sit in the
front of the computer all day tracking down what your CNA and LVN are
doing. Also, as the RN you don’t want to
micromanage your CNA and LVN constantly asking them what they are doing and
when they are going to do their next task. That is all I am going to say about
that.
This is an extreme situation but I believe it paints a very
clear picture. The RN is just not in tune with everything going on with the
patient. I find myself at the institution I am currently working at with the
team-nursing model asking myself a lot of questions about my patients because
the care is split between too many people. I then find myself chasing after the
CNA and the LVN to do their job when my phone is being blown up because they
aren’t doing their job. It creates animosity between coworkers because in a
team-nursing model it is very easy to start blaming things on others as the
reason why things did not get done. Ultimately, as the RN you are responsible
for everything that needs to be done for the patient. Blaming it on others will
not work.
I came from a primary nursing institution and I find myself
doing what is considered the CNAs job and the LVNs job all the time. Simply
because its easier for me to do it and most importantly it is in my patients
best interest to do it rather than leave my patient’s room leaving them hanging
until the CNA or the LVN can come to their aide. Believe it or not this happens
ALL the time at my current institution. Because of this thought that, “that’s
not my job, that is the CNAs job” or the LVNs job. Therefore, the RN even if
he/she has the time and is already in the patients room when tell the patient,
“ill get the CNA to come help you” and will leave and have the patient wait
another God knows how long until the CNA finally can come assist the patient
while the RN goes back to pinning posts on pinterest. It makes me crazy!
In a nutshell, that is why I am for primary nursing. What is
your opinion? Feel free to share your experiences, thoughts, or comments.
Until next time.
-Norah
Saturday, October 5, 2013
Comical Southwest Flight
I fly fairly often. Mostly on southwest airlines.
Tonight was by far the most entertaining flight I have been on. The flight
attendants were comical and I absolutely loved it. These ladies must get a lot
of attention from the men on these flights because who doesn’t love a woman
that can make you laugh?! Clearly this was something rehearsed because they all
knew the routine. The one that was on the speaker doing all the talking must
have had aspirations to be a comedian at some point in her life cause she was
extremely comical and animated. Here are some examples of the things that were
said:
“This is a full flight folks look for the best looking
person and please take a seat next to them” (because of course as we all know
everyone takes forever to take a seat! Especially on southwest flights)
“Please send your last texts and update your fb status now
because I know you need to tell everyone what you are doing at this moment then
please turn your phones off”
“Should we lose cabin pressure which we never expect or else
we would not have shown up to work tonight…”
“Oxygen masks will drop out above your head, place the cup
over your mouth and nose and breath like you’ve never breathed before”
“If you are flying with children, why…?!”
“Just kidding, if you are flying with children pick the one
with the most potential and start there and work down the line placing the
masks on their faces”
“Put the vest over your head and wrap it around you tiny
little waist and blow to inflate. And ladies so you don’t mess up your hair
*they all put on cute shower caps over their hair”
“If you don’t know how to swim or forget once you hit the
water its ok. Just kick, kick, paddle, paddle, breath”
“This is a non smoking flight this includes the levorotary.
If you do smoke on this flight you will be charged 25,000 dollars and if you
have that kind of money to spend you should be flying delta”
“We are going to dim the lights now, if you would like light
to read push the button above your head that looks like a hairy light bulb to
turn it on. If you push the flight attendants button it will not turn her on”
These are just some of the quotes I can remember off the top
of my head. Meanwhile performing this the ladies were wearing the glasses that
have a nose attached to them with the bushy eye brows. It may not sound as
funny typed out but, it was hilarious to say the least. Had to share my
experience. These ladies definitely know how to have a good time.
Until next time.
-Norah
Are ALL Americans Deserving of Health Care?
We Americans as a whole do not agree that EVERY American is deserving of healthcare.
Why? Many different reasons. It’s disheartening.
One of the main reasons being, we believe that if you don’t have it you simply are not working “hard enough”.
We are the only country and that works ourselves down to the ground.
It’s not about money. It’s not about budget. It’s simple. We simply do not believe every American should have access to healthcare. End of story.
It’s the same as education opportunity. We SAY that we believe everyone should have access to education. We even have public schools in place but, that doesn’t mean all schools are equal.
We cannot say a child raised in a home whose parents both attended ivy league universities has the same opportunities as a child raised on Martin Luther King blvd somewhere in the "United" States in an indigent community whose parents, grandparents, sisters, brothers, uncles were/are living the fast life dealing drugs and maybe even part of gangs. These are two extremely different situations resulting in entirely different life opportunities.
How does a child in the second situation that may REALLY want to go to an ivy league university and has hopes and dreams of becoming the president of the united states one day ever make that a reality? It’s almost unheard of. Why? First, and most importantly, this child is fighting an uphill battle surrounded by people that simply don’t understand his/her hopes, dreams, and aspirations. No one believes in him or her. Everyone he/she is surrounded by is feeding his/her mind with comments such as: “they don’t care about us”, “they don’t want to help us” ect. He/she is attending schools where the teachers have given up on the kids and don’t see a bright future for these kids so they simply don’t care. It is VERY hard for this child to keep pushing through when all the odds are against them to make it to that ivy league college one day.
It’s not the color of their skin, it’s not that they are indigent, it’s not that he/she is not smart, its not that he/she is not hard working, its simply the opportunity is NOT the same.
The people who are born into wealth and ivy league graduate parents and go on and go to an ivy league college him/herself and then turn around and say to the girl/guy that grew up on Martin Luther King blvd that you aren’t deserving of healthcare because “you just didn’t work hard enough” or “you aren’t working hard enough” therefore you are not deserving is completely absurd.
On that note, have you noticed that anytime there is a street named after Dr. Martin Luther King it just so happens to be “the ghetto” of that city or neighborhood? That is a whole discussion on it’s own. It always gets me. Did the street come first or the neighborhood population?
Very interesting.
I would love to hear your opinions. Please feel free to comment.
Until next time.
Wednesday, October 2, 2013
Love Drunk
You go out, you meet this amazing girl/guy and you have great convo maybe even danced together. You exchange numbers and you go home and you cannot stop thinking about this person. You are infatuated. You want to know more. Is he/she really as amazing as you think they are from the short time you spent together?
So you see each other again and he/she seems perfect to you. Everything you are looking for in a guy or girl for the gentlemen out there. You hang out more often and chat here and there. You just can't seem to find one flaw about this person. This is when you know...you are love drunk. Because, lets be real. Everyone has flaws. He/she CAN'T be perfect. But when you are love drunk, hell ya they are perfect!! You think the most annoying thing is cute about them. This is when you need to stop. Take a few steps back. Slow-it-down.
Research suggests this love drunk phase can last up to 18-24 months. That is two years!! So what happens if you decided to marry this person at 6 months or 1 year? What happens after 2 years? All of a sudden all those things you thought were so cute are probably annoying now. Everything starts to become more clear. This is usually when relationships that haven't become marriages fall apart or start to hit some shaky ground. Couples start to argue more, expect more, want more. "The passion is just not there anymore". How many times have you guys heard that between your friends? Here's the thing.
Even when YOU DO find "mr. right" or "ms. right". The love drunk phase dies too. However, you still like/love the person that is left when your love drunk goggles finally come off. The annoying things about them you can deal with. You realize they aren't perfect and neither are you but their imperfections are perfect for you. Because the looks fade. We all know you can have the hottest guy and after being with him for a while he's not so dreamy anymore because of who he is. Same with women. Men, you can find the hottest, sexiest lady out there but you all know and have probably dated that girl and realize looks only get you so far. At the end of the day, when a person grows up and matures and is ready for a committed relationship he/she is looking for that person that is of course good looking (as beauty is in the eye of the beholder) but can also be his/her best friend. This is men AND women!
Someone that he/she can be romantic with and at the same time be silly and laugh with. Someone that enjoys your same hobbies. Because at 60,70,80. That is what you will be left with. Not the hot muscle man or the hot toned lady in 5 inch heels with perfect legs. It's the person on the inside. I don't want to be cheesy but, it's the truth. Are they a good hearted person? Will this person take care of you when your 75 and you fall in the bathroom and break your hip? Will they still adore you in that hospital bed, wearing a hospital gown, with your saggy butt hanging out and crack jokes with you to make you laugh just so you'll feel better even if its just for a moment? I think that is ultimately what everyone is looking for at the end of the day when all the fun/partying days are over.
The best thing you can probably do is when you are in the love drunk phase and you just can't get enough of that person. You want to see him/her all the time and spend all your free time with him/her. You need to check yourself. Take a step back. Let the passion die down a little. More often than not you will realize that he/she is not AS great as you had made them up to be in your mind. They may be a great person. Just not freaking amazing! haha.
If you really like someone I think the best way to go about it is just be their friend. Get to know them as a friend (maybe a friend with benefits for some). But that way, it's no pressure on either one of you. Just be yourself. That way you can get to know him/her in his/her natural state instead of a state of trying to impress you which often is the case when it's an official dating experience. Maybe you will learn that he/she isn't so great after all or maybe, they really are amazing and you want to take it to the next level. It just leaves your options open. Because once your lovers it's hard to just be friends but, friends can always be lovers one day or...just remain friends.
Choose wisely ;)
Until next time
-Norah
So you see each other again and he/she seems perfect to you. Everything you are looking for in a guy or girl for the gentlemen out there. You hang out more often and chat here and there. You just can't seem to find one flaw about this person. This is when you know...you are love drunk. Because, lets be real. Everyone has flaws. He/she CAN'T be perfect. But when you are love drunk, hell ya they are perfect!! You think the most annoying thing is cute about them. This is when you need to stop. Take a few steps back. Slow-it-down.
Research suggests this love drunk phase can last up to 18-24 months. That is two years!! So what happens if you decided to marry this person at 6 months or 1 year? What happens after 2 years? All of a sudden all those things you thought were so cute are probably annoying now. Everything starts to become more clear. This is usually when relationships that haven't become marriages fall apart or start to hit some shaky ground. Couples start to argue more, expect more, want more. "The passion is just not there anymore". How many times have you guys heard that between your friends? Here's the thing.
Even when YOU DO find "mr. right" or "ms. right". The love drunk phase dies too. However, you still like/love the person that is left when your love drunk goggles finally come off. The annoying things about them you can deal with. You realize they aren't perfect and neither are you but their imperfections are perfect for you. Because the looks fade. We all know you can have the hottest guy and after being with him for a while he's not so dreamy anymore because of who he is. Same with women. Men, you can find the hottest, sexiest lady out there but you all know and have probably dated that girl and realize looks only get you so far. At the end of the day, when a person grows up and matures and is ready for a committed relationship he/she is looking for that person that is of course good looking (as beauty is in the eye of the beholder) but can also be his/her best friend. This is men AND women!
Someone that he/she can be romantic with and at the same time be silly and laugh with. Someone that enjoys your same hobbies. Because at 60,70,80. That is what you will be left with. Not the hot muscle man or the hot toned lady in 5 inch heels with perfect legs. It's the person on the inside. I don't want to be cheesy but, it's the truth. Are they a good hearted person? Will this person take care of you when your 75 and you fall in the bathroom and break your hip? Will they still adore you in that hospital bed, wearing a hospital gown, with your saggy butt hanging out and crack jokes with you to make you laugh just so you'll feel better even if its just for a moment? I think that is ultimately what everyone is looking for at the end of the day when all the fun/partying days are over.
The best thing you can probably do is when you are in the love drunk phase and you just can't get enough of that person. You want to see him/her all the time and spend all your free time with him/her. You need to check yourself. Take a step back. Let the passion die down a little. More often than not you will realize that he/she is not AS great as you had made them up to be in your mind. They may be a great person. Just not freaking amazing! haha.
If you really like someone I think the best way to go about it is just be their friend. Get to know them as a friend (maybe a friend with benefits for some). But that way, it's no pressure on either one of you. Just be yourself. That way you can get to know him/her in his/her natural state instead of a state of trying to impress you which often is the case when it's an official dating experience. Maybe you will learn that he/she isn't so great after all or maybe, they really are amazing and you want to take it to the next level. It just leaves your options open. Because once your lovers it's hard to just be friends but, friends can always be lovers one day or...just remain friends.
Choose wisely ;)
Until next time
-Norah
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