Sorry, folks, late arrival from panel presentation with Peter. Only arrived late for 2nd presentation (obviously missed first one). 3rd presentation is “Educating a Health Terminologist” by J. Warren. She demonstrates terminology tools educators can use; basic session to inform participants and update them so ‘they’ may have a basic understanding of the role of health terminologist, responsibilities and then help educate others about this role. Some very nice graphic slides to help understanding available in her presentation.
4th presenter – T. Indergaard (Finland) “Counseling of problem-based learning (PBL) groups through videoconferencing”. Discusses project and advice for those pursuing videoconferencing solutions.
Final presenter is J. Brixey “Creating experiential learning activities using Web 2.0 tools and technologies: a case study.” Stressing the social need of connecting with others (see Siemen’s principles of connectivism). Making such connections possible with Web 2.0 tools / platform; ‘at/ap/ac’ if-you-will (anytime/anyplace/anywhere) – aka ‘cloud computing’. Describes project at Kansas University of using 2.0 tools / technologies for facilitation of learning experiences (such as conference attending and so forth). Nice list of social software toolkit application inclusion criteria on her slide (easy to dl/install to easy navigation to user interaction encouragement; about 10 items in all). Use of MSN Live Messenger dictated by desire for concurrent communication between students and faculty. Wide range of 2.0 tools used including SL. Activities within SL range from ppt evaluations to interactive socializations. Nicely done! Off to lunch then perhaps one of the 3 final sessions (start at 1315 through 1415). Final ceremony is from 1415 – 1600. I will not be blogging the closing ceremony because one of the closing speakers requires the use of my Mac computer for her presentation. Later!
Evelyn Hovenga titled “Milestones of the IMIA-NI History and Future”. As this is closing day, as well as the session moved up 1/2 hour, the number of attendees is a bit sparse. Evelyn’s presenting style is to expound on the slide content. Opening setting reviewed is ‘having a vision’ begun in 1987 in Stockholm – nursing competencies. Key activities cited include reference term model, with ICN, begun in ‘99 among others. Key facets of ‘09 vision of IMIA-NI include EHR (using & informing nursing knowledge), clinical data standards dev’t, decision support & ebc options among others. Reviewed what IMIA-NI promotes (I’m guessing what she showed is from the website (http://www.imiani.org/). She discusses a national e-health record using a graphic (spoke-wheel design) with phr as the hub. Next up is discussion of integrated ehr (see ISO TR 20514:2002 Health Informatics – EHR Scope, Definition and Practice). EHR needs to be perceived as foundation of sustainable health system infrastructure, therefore requiring adoption of a set of HI standards along with comprehensive governance infrastructure. A description of ehr architecture is drawn from the open ehr foundation’s content. The bottom line is discrepancy between model (nicely structured) and proprietary systems with different reference models. Graphic of ehr structure is available at open ehr website (http://www.openehr.org/home.html). Clinical knowledge manager is next up and again seems to be also a component of the open ehr website (see ckm (clinical knowledge maanger) at site in previously mentioned link). Clinical content models, and the need for such, outlined at this point and the need for said models to relate to the structure (then dictates how data is used). Clarity is necessary for functionality – key point stressed by Evelyn.
Clinical knowledge repositories discussed with national examples cited (Singapore & Sweden with federated approach); need for repository hierarchy versus ‘flat set’ (need for interoperable for sharing via silo without sharing). Terminology needs to be in context and should have national governance. Future directions of IMIA-NI includes leadership for dev’t of standards of nursing clinical content knowledge. Collaboration with ICN needed to move forward with mindmaps of content, documentation of nursing processes, clinical templates (see Derek Hoy’s work in Scotland) and global nursing knowledge governance infrastructure. Other items needed to move forward range from national mtgs, recruitment of expert nurses and sharing / participating via technology and in-person. That’s all for now.
He later disappeared from our floor for 9 hours. With a PICC line. In that time we went ahead and filed elopement and police were notified. He returned late that afternoon, upset to find that his room had been given away. His explanation for his absence? He was in the parking garage. Meditating. Right. The PICC line was removed and he was informed that he would have to return through the ER.
The next day he was back in the hospital, though on a neighboring unit. Still pulling the same shit. Told again and again that he would certainly die if he didn’t comply with treatment.
In a not-so-surprising turn of events, he was found face down in his bathroom. Blue and purple. Lying nearby were syringes (not hospital issue) and his own personal stash of Dilaudid pills.
It’s sad to see someone have so little regard for his own life. What’s sadder is to see it over and over again.
I experienced deja-vu when I was assigned another patient with 8mg Dilaudid po scheduled 5xday. With an additional 2mg Dilaudid IV q2h. Who tried to tell me that she was supposed to get the pill and IV at the same time. Who told me that her pressure was low when she was in pain, and that it would rise after she got the medicine. Who tried to tell me the druggy behavior I was observing was from anything but the 40 mg of Dilaudid she took everyday. Who complained how she was tired and sluggish all the time and that the damn doctors couldn’t figure out what was causing that. Who told me there were some good veins here on her legs if I could find any good ones on her arms.
So, I told her about a patient I once had. Who also took an enormous amount of Dilaudid every day. Also for chronic back pain. Who was told that he was going to kill himself if he didn’t stop. Who’s now fighting to live. No. Scratch that. Who we’re now fighting to save. And I asked her. Should we be trying so hard to save someone who was trying so hard to kill himself every single day?
I realize that wasn’t really appropriate, but I knew she’d heard it all before. And even as I spoke, I could see that she was thinking of nothing but her next dose.
I generally avoid patronizing bloated national corporations that devour small businesses and cripple local economies, but Panera makes a decent Everything bagel and the hot tea is tolerable. I could get out of there for under $5, which complimented the pittance I earned as a Graduate Teaching Assistant at the University of Tennessee.
One morning at the Panera on the Strip in Knoxville, I ran into Becky, a nursing student whom I’d met through Reformed University Fellowship (RUF) at UT. We chatted and joked while she organized some notes on her computer and I congratulated myself on getting up early, which, I have discovered, is my Achilles’s heel and the key to getting anything done.
Becky and I have similar senses of humor, and we’d spent enough time together for her to know my character. For a woman to know your values, lifestyle, and the substance of your relationships is important if you plan on making sexist, politically incorrect, irreverent, suggestive, or awkward jokes. You have to establish a rapport before trying out some of your edgier material. Otherwise, she’ll tell all her friends that you’re a misogynist, bigot, God-hater, pervert, or social bumpkin. Seizing that golden “That’s what she said,” opportunity in mixed company isn’t worth the fleeting pleasure of a few chuckles from the guys and stink eyes from the women. One unsavory comment can cement your reputation as an all-around creep.
Believe me.
Another nursing student named Jane came up to the table where Becky and I were sitting. Silky blond hair, blue eyes, delicate features, dazzling white smile—Jane possessed the classic kind of beauty that causes men double take over their shoulders and have car accidents.
I was definitely headed for a wreck.
Jane asked Becky how she thought she’d fared on a test they’d taken that morning. Neither was confident in her answer to one particular question: what did the letters of the nursing association, N.H.P., represent? They tossed ideas back and forth.
“National Healthcare Professionals?” Jane asked.
“No,” Becky said, “I don’t think that was it. Maybe Nursing & Healthcare…something?”
While they were trying to unravel this mystery, I was strategizing—1) how to enter the conversation; 2) how to impress Jane with my intelligence and charm her with my wit; and 3) how to make her fall in love with me without falling in love myself. I needed to do all this in sixty seconds or less. After all, the future of our children depended on it.
One of girls was suggesting another option:
“Nurses for Healthy… .”
I had my door. Time to walk through it.
“Pornography?” I said.
Becky chuckled. She gets my sense of humor, and knows I’m not a pervert.
Jane, on the other hand, stared down at me, a mixture of shock and disgust on her face. She looked at me like I’d just confessed to cheating on her best friend or like she’d just caught a noseful of hot trash. I represented everything that she hated about men.
Well, that didn’t go well, I thought.
One type of humor involves predicting what people expect you to say then defying those expectations. For example, if someone asked, “Hey Austin, what’d you do today?” I might reply, “I spent all day cremating bodies and drinking lemonade.” Of course, that couldn’t be farther from the truth, no matter what I actually did that day. That’s what makes it funny. Perhaps I have a warped sense of humor, but this type of absurd response to a common question gets a laugh most of the time.
You also have to consider the questioner’s lifestyle and sensibility. For example, when my grandmother asks me how I’ve been spending my time, I like to tell her that I’ve been doing speed and carousing with beautiful women. Does she get offended? No, she giggles, and tells me that I remind her of her husband, my grandfather. She has never used illegal drugs or engaged in promiscuity, and she knows I haven’t either. Telling my Grandma about it even if I had would be ludicrous. That’s why it’s funny.
The more outlandish, illegal, or immoral the activity I proffer, the more delighted the other person typically is. I say “typically” because on occasion I do misread my audience.
N.H.P. could not possibly be “Nurses for Healthy Pornography,” but it still wasn’t a hit with Jane. You win some, you lose some.
Rather than risk being turned to stone by Jane’s gaze, I got back to work on my laptop.
****
Fast forward about two years.
I went to see my friends, the , play at . After the show I found a camera on the stage. Looking at some of the pictures gave me a pretty good idea that it belonged to one of Jane’s friends because Jane was in a lot of the pictures. A guy named Casey I’d met a few times knew Mary Catherine, the owner, and promised to return it to her. I met Mary Catherine later at a Sundown in the City and told her about my encounter with Jane.
Mary Catherine shed some light on her friend’s reaction to “Nurses for Healthy Pornography.” The time I offended her in Panera coincided with Jane’s discovery of her boyfriend’s second computer which he used to look at pornography. He kept his other computer clean because he knew that she checked the cache on a regular basis.
In using that word “pornography,” I had churned up for Jane three years’ worth of deceit, anger, frustration, disappointment, and disgust.
Oops. How do you apologize for that?
Here’s the apology I would have given:
“I’m sorry that many men settle for false intimacy, and rather than address their own fears and insecurities, they make a hiding place in lust and perpetuate an industry that objectifies women and adulterates the good gift of sex. I’m also sorry that I have a twisted sense of humor and made light of something that has been a source of pain for so many.”
Mary Catherine assured me that Jane is a kind, gracious, and forgiving person and that if I had chosen any other word, my first interaction with her would have been much different. Why couldn’t I have just said “puppies” or “pepperoni” or “prancing”?
My sense of humor is always getting into trouble. It needs a good spanking.
Moral: N.H.P. stands for “Never Horse around about Porn.”
For whatever reason, you may be considering pumping your breast milk for your baby. This is a particularly useful compromise for mothers who either have to go back to work or have some issue where it is not physically (and often times financially) feasible to be near your baby 24/7. Your baby can reap all the benefits of breast milk even if they must be bottle-fed.
Here’s a bit of advice about picking a breast pump from the :
The checklist
To decide which type of breast pump is best for you, ask yourself these questions.
How often will you use the breast pump? If you’ll be away from the baby only occasionally, a simple hand pump may be all you need. These pumps are small and inexpensive. You simply squeeze the handle to express the milk. If you’re returning to work full time or you’re planning to be away from your baby for more than a few hours a day, you may want to invest in an electric pump. Electric pumps stimulate the breasts more effectively than do hand pumps. This helps empty your breasts and protect your milk supply.
Will you need to pump as quickly as possible? A typical pumping session lasts about 10 to 15 minutes per breast. If you’ll be pumping at work or in other time-crunched situations, you may want to invest in an electric breast pump that allows you to pump both breasts at once. Double breast pumps help stimulate milk production while cutting pumping time in half.
How much can you afford to spend on the pump? You can buy breast pumps from medical supply stores and most drug and baby stores. Manual models cost less than $50. Electric pumps that include a carrying case and insulated section for storing milk may cost more than $200. Some hospitals rent hospital-grade breast pumps, although the equipment that attaches your breast to the pump must be purchased. Some health insurance plans cover the cost of buying or renting a breast pump. Because there’s a small risk of contamination, borrowing a breast pump or buying a used pump isn’t recommended.
Is the pump easy to assemble? If the breast pump is difficult to assemble, take apart or clean, it’s bound to be frustrating — which may reduce your enthusiasm for pumping. Make sure you can remove any parts of the pump that come in contact with your skin or milk for cleaning after use.
Is the suction adjustable? What’s comfortable for one woman may be uncomfortable for another. Choose a pump that allows you to control the degree of suction. Some manual models allow you to adjust the position of the pump handle.
Is the pump heavy? If you’ll be toting the pump to work every day or traveling with the pump, look for a lightweight model. Some breast pumps come in a carrying case with an insulated section for storing expressed milk.
Is the pump noisy? Some electric models are quieter than others. If it’s important to be discreet, make sure the pump’s noise level is acceptable.
Are the breast shields the correct size? Every pump has a shield to place over your breast. If you’re concerned that the standard breast shield is too small, check with individual manufacturers about other options. If you want to pump both breasts at once, make sure the pump is equipped with two breast shields.
What if the electricity fails? An electric pump needs to be plugged in. If an outlet isn’t accessible or the power fails, you’ll need a rechargeable battery pack. In case of emergency, you may want to keep a manual pump handy.
Here are a few of our picks for breast pumps:
Playtex Nursing Necessities Embrace Deluxe Double Electric Breast Pump System
25 speed and suction combinations that let you customize your own pumping rhythm
Soft Comfort massaging breast cups, which use both massage and suction
Soft air cushion that minimizes tugging and stretching of nipples for pumping comfort
Closed system that protects milk from bacteria and germs, and prevents back-up
Medela Pump in Style Advanced Breast Pump with Backpack
Uses standard outlet with AC adapter or battery pack
Durable motor lets you use the Pump 4 or 5 times daily
Exclusive one touch let-down button
Removable cooler carrier
Double pumping accessory kit
Highly recommended!!
Lansinoh Double Electric Breast Pump – 1 Count
Double Electric Breast Pump
Mom can set and control Vacuum strength & cycle speed
Patened closed system prevents milk back up into tubing and pump motor
Simple to Use – comes pre-assembled, and with few parts
Easy to Clean – No need to clean tubing because closed system does not allow milk to back flow
Jailbait – noun/adjective, describing an individual’s age or referencing an individual under the age of sexual consent. Synonym of babe, youngin’, shorty, chicken-head, nursery schooler, wee tyke, little’un.
(Jale-bate)
"Jailbait:She won't look like this when you're out in 20 years."
1. Jailbait refers to a smoking-hot piece of ass that you just can’t touch. You cannot touch these hotties because doing so would land you in an 8 by 8 cell with Bubba, your new best friend, who’s only inclination is demonstrate his salad tossing skills (definition to come). Unless it’s your goal to spend the remainder of your sexually active years behind bars, my suggestion is look but don’t touch.
"You my new jailbait roomie? I cain't wait to introduce you to the joys of prison livin'!"
2. Jailbait also refers to people under the reasonable dating age. You might think that she’s cute, or that he’s funny, but when you find out they’ll be carded and rejected from your favorite night spot, you should probably reconsider dating them. If you have to nurse your date to sleep, burp them, or clean their little bottoms, you certainly cannot have wild, unbridled sex with them. Also known as “Cradle Robbing.”
Well, the good people of SCOTUS just wrapped up their term and now get a nice long summer vacation. (Or a long rest-of-life vacation, if you’re Justice Souter.) But nurse & lawyer are still hard at work! Of the 83 cases decided by the Supreme Court this term, these lucky 7 addressed health care-type issues. For the next week, Lawyer will review one case each day with a brief summary and an even briefer opinion!
Oooh, remember this one from the ? The question was whether a drug company could be sued for damage caused by the on-label use of an approved drug. (In other words, for insufficient warnings on the label.) The drug company says that being FDA-approved should give them protection. But the patient – who lost an arm, by the way, to a gnarly infection — prevailed! The FDA requirements represent a MINIMUM – and are not sufficient to get the manufacturer off the hook.
Lisa Fogg-Lacroix cradles her baby’s head while baby holds on to her breast at feeding time. The bonding between mother and child at times like this is so important in addition to the nourishment provided by the mother’s milk.
Nurses in Zambia have been on strike for more than three weeks in a dispute over pay and allowances. Unions have urged them to return to work because it is reported that the Government won’t negotiate until they do. They are reportedly demanding at 25% increase in pay.
The public outcry in the region began when a woman gave birth in the car park of the Lusaka Hospital, and moments later the baby died.
So this begs the quesiton – when has it gone too far? Are conditions in Zambia so bad that without this 25% pay increase the nurses are unable to feed themselves or their families? Or is the 15% increase that the Government has offered acceptable in light of the lack of care patients are receiving?
Read a more in-depth article the, leave me a comment with your views.
Lisa Fogg-Lacroix cradles her baby’s head while baby holds on to her breast at feeding time. The bonding between mother and child at times like this is so important in addition to the nourishment provided by the mother’s milk.
