HA!

HAHAHAH.

Just saw these posted on Nurse's Rock   and it really makes me wish I was a nurse in New York! HA! Although part of me still thinks that even though its "the law", those nurses probably still get beat up. But its nice to at least have it be.....the law.

Because in New Jersey, we just have to......well, duck. Dodge. Don't get hit.

Now, luckily, I am small. I'm 5'2" and 145lbs, so I can move pretty quickly usually. I am also very aware of my surroundings at all times, and have a somewhat extra sense of being able to predict people's actions by the way they are radiating emotions. That being said, (knock on wood!) I have not been "assaulted" in the past 6 years.

HOWEVER:

I have:

• Had a tray full of food, silverware and glass plates thrown at me. I ducked. It hit the door behind me. And I still cleaned it up. After I took away all sharp objects near her.
• Had an IV pole thrown at me. I moved. Quickly.
• Been a victim at attempted biting. I moved fast enough to not be bit, yet.
• been scratched, I pretty much bathed my arm in alcohol that day.
• had nails dug into my arms, hands, etc. That's always fun.
• had an entire cup of coffee thrown at me, I ducked. Thank god. Took away alllllll liquids after that.
• been spit at, I ducked. Yay.

I have:

• seen nurses with legit wounds created by patients
• seen nurses sent to the ER, with wounds inflicted by patients
•  seen scratches on other nurses that left scars
• seen bruises on other nurses that lasted longer than a week

So who says nursing isn't dangerous? Anyone that thinks nursing is for sissy little girls can go kick my A$$, thank you very much!




~WNB




WE ARE NINJA NURSES! :D

What is a Nurse?

A (Good) nurse is :

• A nurse
• a friend, to hold your hand
• A psychologist, to help you through your strangest quirks and secrets
• A mom, to tell you "no" and put things back in perspective.
• a politician, so the hospital is a better place.
• an advocate, so we make sure the doctors don't kill you.
• a security guard, for when you start freaking out.
• a mechanic, for fixing everything and anything that breaks on the floor.
• a gymnast, for bending in really small spaces to plug in your IV.
• an artist, you are our canvas.
• a scientist, because what else do we use our critical thinking for?
• A diagnostician, because sometimes we diagnose you before the doctors do.

A nurse is not:

• a waiter, we are not employed to go and get you 4 sandwiches in 3 hours.
• a hotel attendant, we are not going to put a mint on your pillows.
• a punching bag, yeah-just try.
• your drug dealer, because actually- we can't just give you unlimited amounts of narcotics.
• a Marriage/family counselor- solve your own damn problems with your family, outside of the hospital.

C'mon fellow nurses out there- leave some comments with some more you can think of!



~WNB



.

Wow

Found this on Only Underneath the Stars   blog, and as soon as I saw it I was like......yeah. Wow. That kind of sums up how my heart has been feeling for the past 7 years.

Some People Just Don't Get It

I need only to repeat the conversation I had with a patient recently, and you'll see.


All you need to know: Diagnosis- Diverticulitis. Pt is on a clear liquid diet.


patient: Do you think they will advance my diet tomorrow?

Me: Most likely, depending on how your pain is doing, and how you feel. What they will do is move you up to a "Full liquid diet" first, and see how you do with that at breakfast time. If you do well you will most likely get regular food at lunch.

Patient: Whats in a Full liquid diet?

Me: Thicker stuff, more advanced than just clear liquids. Oatmeal, milk, pudding, those kinds of things.

Patient: oh. Thats a problem. I'm lactose intolerant. Like, severely.

Me: Oh, okay no problem. I will write that on your diet orders and they will find things for you to eat that is lactose-free. I am lactose intolerant too, so I'll make sure we find you something to eat.

Patient: Okay, awesome!
Me: How long have you been lactose intolerant?

Patient: Ever since they diagnosed me with diverticulitis, a couple years ago.

Me: I see. Yes the milk products would only aggravate your symptoms more.

Patient: Yeah usually the next day for me. But I really do just miss a nice cold glass of milk.  What do you miss the most?

Me: Oh, I miss pizza.

Patient: Oh, I eat pizza all the time.


Me: .......righteo then.



So much for "severely lactose intolerant". Granted, some lactose intolerants can tolerate small amounts of cheese, but those people should not qualify themselves as "severely lactose intolerant". Jeesh Mcgeesh.


~WNB

The Artist

Alright. So who else has seen recently Oscar-ified "The Artist" ??

Alrighty, lets back track.

I saw the preview for it initially, a couple of months ago. I squirmed my face at it, like I so often do, judgementally, when I don't like something.

I thought...."Oh!  A movie about an artist! Like me! Yayayayay! Artists everywhere yay! Oh wait...its a silent movie? A Silent movie? In 2012? A black and white movie???? In 2012? It legit looks like it was made in the 1920s. For real. I don't get it. Was it actually filmed in 2012 or is it like, a re-release? Are they going to re-release all the old films, just like they're doing with disney morphing through the 3D phase? Oh, god."

Despite me liking movies, a lot, I take shame in the fact that I was just never able to really get in to the "Classics" of our grandparents time. Believe me, I tried. I took a literature & film class, and saw I'd say the top 10 classics, and suffered through each one. Even Casablanca (hate me now, i'm sorry!) I just don't like the classicy feel of the film. I love color.

So then I went about my life, moved on.

Then the Oscars came. And I kept hearing this movie name. The Artist. And I thought to myself, is that the one that I shunned off the planet when I saw the preview?  Um, Yeah. It was.

So it came to my local independant theater. I saw it listed there for weeks. But I kept tossing the idea around.

I should go see it. I'll probably like it. After all, it wouldn't be all over the Oscars if the majority of its audience didn't like it, right? It has to be good. Or at least a little good. But its silent....and I have major ADHD....can I trust myself to sit through a 2 hr silent film and not fall asleep? Probably not. I like sound. I like sound a lot. You know what else I like a lot? Color. I like color. Can I get over not having color for two hours? I don't know. But its about an artist, right? I'll probably like it. And it has tap dancing, I know that. I like tap dancing. And John Goodman. He's cool. And 2012-ish. GO see it. Just do it. If you hate it, then oh well. Do it.



So, I went to go see it. Anddddddd, the only thing I'm mad about, is...WHY DIDN'T I GO SEE THIS SOONER?


It.was. ADORABLE.


Yes. I do have ADHD. I love sound and I love color, and yet I was perfectly entrapped for the whole two hours in this silent, black and white film that looked like it was filmed in 1930.


Being that lately I've strangely coincidentally been around a lot of people that majored in film and are going into the film industry, (and that I've taken one film class myself), I've picked up a couple things about artistic direction in film. That being so, I can confidently say that the artistic direction, symbolism and picture in "The Artist" is pure genius. Things are very carefully placed, the settings chosen perfectly. Being that it is silent, the actors have to work that much harder to convey emotion, and they did it well. Props must be used ever so carefully to help the audience show whats going on.

As for the music, It was used and not used in all the right spots. It was almost like the music was doing the talking. It was like,  "hey, in case you don't GET the fact that this scene is supposed to be really intense, let me make the music really super intense."

Plot, Incredible. I followed every minute of it and was at the edge of my scene in some parts. There were literally moments where I was surprised the movie took a certain direction, and parts where I was seriously wondering what was going to happen next. Thats saying a lot for a silent movie, I think. It kind of had a "42nd Street" feel to it, where you are watching how (in this case-a movie) is put together, so you see the characters playing multiple roles at different times, off screen and on so to speak.

Characters.....ah, the best part. Leads played by Jean Dujardin and Berenice Bejo, you fall in love instantly with the two of them, like you're supposed to. Berenice Bejo pulls you in the very second you meet her and you can't help but not stop looking at her the whole rest of the movie. Well casted, well casted. She is the center of the movie and it may not have lifted off as well without her enthusiasm, her obvious love for the movie, her smile, and her emotion. Amazing actress and I hope we continue to see more of her.

Any actress that is visibly able to portray what they are saying with only using their gestures and body language and lip reading, is a genius. I think so, at least.


I'm going to leave you this time with not a trailer- as I so often do. This is because when I saw the trailer, I squirmed my face, both times. It didn't make me want to go run and see the movie. I went because I wanted to see what all the hype was about. So instead I'm leaving you with my favorite (ADORABLE!!!) clip from the movie. Enjoy!

PS- Take it from me. I'm squirmy. I have horrible, horrible ADHD and hardly can't sit through anything. I don't normally like B&W or silents, ever. But this, this was awesome. Go.See.It. I promise you'll like it.



~WNB


.

Oh, I Didn't Check the Blood Calendar...

Miller Keystone Blood Bank calls me. (This is a first).


me: hello?

MKBB: Hello! We are in an extreme shortage of your  blood type. Would you be able to come in soon to donate?

Me: Um.....yeah, how about tomorrow?

MKBB: Great!! Is whole blood okay?

Me: Yeah...I can also donate platelets too, if you need. Whichever you need more, I don't mind either.

MKBB: *pause* Well, we don't need platelets tomorrow. We're going to have a shortage of platelets on....Wednesday.

Me: Wednesday?

MKBB: Wednesday.

Me: But not tomorrow?

MKBB: Nope. We have enough platelets for tomorrow. Can you come in Wednesday?

Me: No. I'm busy.

MKBB: Okay, so whole blood it is, tomorrow.


Me: Okay then......



Does *anyone* else see that as weird, or am I just going crazy??




~WNB

Sheer Brilliance

So I have this 86 year old patient. When I first got her a couple days ago, I thought she was a little..."slow", because she never talked, didn't listen to us, did whatever she wanted to do, was confused, and kind of had a constant "dazed and confused" look to her. But after spending a couple of nights with her, I realize she's actually remarkably sharp.


We put her as a fall risk because my hospital flips out if anyone falls and we do everything we can to prevent falls. So basically even if you're 20 and in for the night, we'll find a way to peg you as a "fall risk". But regardless- This little lady was the epitome of what a fall risk should be. Confused, elderly, likes to pull her IVs out, unsteady on her feet, gets up on her own without calling, etc. Complete, high fall risk. So our hospital standard protocol is to put these little alarms on these patients that ring pretty loudly if it releases from the patient (i.e. the patient got up from the bed). The alarm is done by a string (old school) and is connected from patient to bed.

The alarm definitely worked for a couple days. It went off so many times that I was beginning to hear that tune in my sleep off-shift. But she was so active that there were times when we found her flying free around the room without the alarm having gone off because it wasn't put on. So even though we could see she was definitely getting her strength back and she was walking OK around the room by herself, we still wanted her to be a high risk because well......see above. We like everyone on fall precautions.



Well, last night I had to hand it to her. When I first got on shift, (literally- first five minutes), she was found sitting naked on the side of her bed, pulled IV out, took her heart monitor off. And she's smiling. Cool.

We asked her if she had to go to the bathroom. She shook her head no, said she just went. Also, cool. So we got her alllll situated back in bed, tucked in, comfortable and Definitely put that bed alarm back on. Securely. For sure.

Despite  the fact that she was forgetful and I was pretty much talking to Dori, I felt like it was worth trying. I sat down with her and slowly explained to her the importance of calling for help before she goes to the bathroom and we will come help her get up, etc. We shook on it and made a deal.


Well, go flippin figure, next time I come to check in on her, where do I find her?

In the bathroom. 

Why didn't the *trusty* bed alarm go off?

Because she unvelcroed it from the bed, and was holding the entire thing in her hand, so that the alarm wouldn't go off. Sitting on the toilet.


As mad as I was that she figured all of that out, I had to hand it to her. Never in all my six years of being in the healthcare field have I *ever* seen someone dismantle a bed alarm, nonetheless a confused elderly 86 year old. I have seen many many people take the clip off of themselves and keep the bed alarm at the bed so it wouldn't go off,which is smart, yes, but easy to figure out. But to take the whole thing off the bed is really thinking outside of the box.  I was truly impressed. I didn't even know she knew where the bed alarm even came from. But I still tried to act semi-responsible and mad. Kind of like a parent that is shocked his kid did something totally kick-ass awesome even though its totally not a good idea.


Thats all today. That was definitely the highlight of the night. In case you're curious, she actually behaved after that incident and actually sang multiple songs for us from her bed, all night. Not sure if she sleeps, ever. At all.





With love,

~WNB


.

Have it Your Way

This is how it all went down last night at work:

patient is young female (younger than me young). Came in with ovarian cyst. Possible OR today, so no food after midnight. I go in to see her at shift start. She's nauseous and vomiting.

me: Hi, looks like you're not feeling good. You're feeling nauseous?

Patient: Yeah. I threw up.

Me: I see that. Are you still nauseated?

Patient: uh, yeah. It's because I just drank orange juice.

Me: okay. Well OJ can be very acidic and hard on the stomach, so how about we stick to gingerale or water until midnight?

Patient: Well they said I couldn't drink or eat anything after midnight.

Me: yes.  that's correct, just in case you have to go to the OR.

Patient: So I wanted to eat my dinner really late tonight. My boyfriend brought me McDonalds. Can I still eat that?

Me: As long as its before midnight, yeah, and you're feeling okay.

Patient: Okay.


Patient calls me back again, 10pm.

Patient: I threw up again.

me: Okay. You're nauseous again?

Patient: yeah, its because I had the Mcdonalds.

Me: Yeah.......how about no more food or drinks for the rest of the night?

Patient: Yeah, that sounds like a good idea.



Patient calls back again, 11:59 pm

Patient: I threw up again.

Me: Okay, you're nauseous again?

PAtient: yeah. I had some crackers and juice.

Me: Oh, okay. I thought we agreed you might feel better if we lie low on the foods and drinks for now?

Patient:  I know but If I can't eat until after my test tomorrow I was afraid I'm going to starve. I don't want to starve so I just had one more thing before midnight.


Me: Okay.
 *At this point I start removing all food and drink from the bedside table, being that it is 12:03 am.*

Patient: No! I want to finish my coffee, then I promise no more.






*Slam face into wall now.*

Some people just don't get it. I thought it was ingrained into human nature that when you're nauseous and especially vomiting- you naturally don't want to eat or drink???? Aye AYe AYE!



~WNB


.

It's a Southern Thang

I have spent the last five days in Kentucky, on the border of Ohio (we literally took a walk to Ohio). In my mind, we were travelling horizontal from New Jersey, and it wasn’t until we arrived and the valet park attendant said “Ya’ll have a nice day now” that I realized we were indeed, “South”. How the heck did we do that?



I have had a great time, though! The very first thing I realized about Cincinnati, Ohio was that it was so Clean. Like, seriously clean. I knew Chicago was cleaner than NYC, but is all of Ohio so clean? The entire city looks as if it has been plucked out of one of those freaky Inception dreams where everything is surreal. The buildings so new, the sidewalks so fresh, no construction, the windows so polished….seriously.



But the real funny difference in culture when travelling hours away is the people.




Lets take the following scene, for example.



This is how it goes down in Kentucky:


You approach a Starbucks. But magically, someone has the door open for you already because everyone is just that nice. You walk in. At least five different people (strangers) say hi to you, on your way in or their way out. If you dare whip your phone out and text someone while you’re on line, at least three different people (this actually happened) will find a way to make conversation with you, somehow. The conversation will be a legit conversation that requires effort and adequate responding on your part. Just when you think your conversation is over, someone behind you in line pops in with, “Hey ya’ll I didn’t mean to eavesdrop but I just thought your conversation was so intriguing and I must join in with my own input.” So then you, the original conversationee and another person are still talking about the weather. And none of you have ordered your coffee. The cashier looks at ya’ll standing side by side (makes conversation easier) and doesn’t know who is next. And I kid you not, everyone in line will encourage everyone else to go first and I heard “I’m in no rush, please you go ahead” said at least five times. And everyone smiles, all the time. At 7:30 in the morning. Its like Disney world. When I did make it up to the cashier and ordered, it turned out they were out of my favorite brand of tea. I said it was okay if I got a different one, but she insisted on going to their back room and finding the restock of my tea. And no one in line complained. And their tip jar for the cashiers was FULL. It took four times as long to stand in line and wait for my order, but I made three new friends (two other wedding photographers and 1 other a sound/filmmaker. )





Now Lets take the same typical scene in New Jersey/ New York:


You approach the starbucks. You open your own damn door. You stand in a long line, but it usually moves pretty fast because everyone goes fast. Absolutely no one talks to each other in line and everyone is either 1) talking on a cell phone 2)texting on a cell phone 3) doing anything else on a cell phone 4)playing with a tablet/ipad 5)reading the newspaper in their hand 6) reading the newspaper on their phone 7)watching the TV screen for the latest news. In fact, everyone else has their phone out so you pretty much feel compelled to do SOMETHING on your phone, even if you just checked your facebook,email and all your recent text messages right before you approached the starbucks. Its okay, do it again there could be something new. Besides the business man yelling into his cell phone (usually at the same time he’s trying to order), the only other chatter you’ll hear is the occasional set of friends chit-chatting in line and it will be about business, or about the coffee they ordered. It is RARE for strangers to talk to each other and if they do its usually because one feels like they did something to the other that warrants a half-felt “sorry” (i.e. bumped into one another ever so slightly [northern people never like to touch]). On occasion you’ll have the out-of-stater that asks how that brand of coffee is because he’s trying to make conversation, and he’ll get a “Its good.” (with a smile-maybe) in return. On the good side, you move through the line quickly, you get your order quickly and you get out quickly. On the bad side, you make no new friends. Also, if your favorite tea brand is out- sorry for you. You BETTER have a back up order ready to go in your mind or else you’re gonna get some audibly grumpy people in line behind you. Also, I have never seen a tip jar at a starbucks, ever around here.


It’s not even like I just noticed this. Its not just Ohio and its not just New York City/ NY/ NJ. In all my travels I have seriously generally noticed this sharp difference in American sub-cultures. Its astounding.




I wonder why this is, though? Why the “South” is known for generally being slow (physically- not cognitively), but for being very nice. The “North” I think is known for being fast-paced, grumpy, all attitude and ready to push you out of the way. Also, when I told one of my new found Starbucks friends that I was from New Jersey, she immediately thought “Jersey Shore” and asked if Jersey was all interstates and factories like that. *Slam face against wall now*.



But I guess what I’m trying to say here is that even though the North has that reputation in public, it doesn’t mean we’re automatically bad people, it just means we have grown up where things move fast, you get things on demand, you move fast, you get things fast, you do things fast, you constantly have at least one piece of technology on your body or in purse, and you have checked at least one form of social media (twitter, facebook, email, text) within the last ten minutes. It’s all on how we’re raised, how life is grained into us from the beginning. What’s taught to us about what’s acceptable and what’s not.



On that theory, I would love to meet someone who grew up constantly on the move around the world and United States. I wonder what culture they adapt to. That would be an interesting sociology project.


Even though I brand the North here with a horrible reputation and I give the South a nice reputation (I think I did, at least), I don’t think I could live in the South. Is that so wrong? Is it wrong to love the Northern culture, where everyone is opinionated, grumpy and quick? No. Because I think we’re also intelligent, effective, cultured, and undeniably witty.


I’m sure if I moved to somewhere South and lived there for awhile, I would get used to it. Then, when visiting or returning back North I would probably hate how the people are. Like I said, its all what you are used to at the current time. I think 87% of Humans don’t like change. I just made that up.


In order to survive in the North, you have to make it your own. People will not openly talk to you like they will in the South. If you want to meet people, you have to target them and make your own conversation. You have to be bold. Say what’s on your mind. If you want to be shy here, that’s okay- but you won’t get noticed and that’s just that. I kept to my shy self in Ohio and still 3 people wanted to talk to me in Starbucks.


The reason why I’ve been in Ohio is for another convention (another blog post coming up). At the end of the convention the announcer said, “Well, all that have come from far and near, I hope you all leave with a new friend you didn’t have before”. Me and my dad looked at each other and laughed. “Nope!” We both thought. Oh well. I’ll try harder next time….


 
See Ya'll later,
 
WNB
 
 
 
PS- if any of my readers are from Kentucky, Ohio or anywhere thats branded as being "South", then I hope I didn't offend you. You're lovely, thats the point. You're all so lovely its nauseatingly lovely. I'm just astounded how different people are based on where they live, and thats my point. Have a nice day! :)
 
 
 
.

Gingerale is a Soda, Too

Hey everyone!

So I wanted to do a little piece on patient education, something that has been irking me a little lately while on the job.

When I was in school, patient education used to scare me. I used to think, how can I teach a patient about their health condition when I barely know anything about it myself? Sure, I can research it and tell them what I learn, but what if they ask me questions? What if they find out I know absolutely nothing and am therefore incapable of being responsible for their lives during my shift??!

Okay, maybe thats an exaggeration . But regardless, I still got scared about the thought of effective patient education one day. I never dreamed that one day it would actually come naturally and I would find myself automatically in a "patient teaching" moment that I didn't even have to prepare for. Which has happened many times already, so awesome!

I always used to think I would enjoy teaching patients about something I knew a lot about, because obviously its easier to teach. Well, I was wrong. About it being easier to teach.

Every single time, it baffles me to no end how much the general public does not know about health and medicine. Granted, I don't expect you to know a single thing about a condition we just diagnosed you with. But a chronic condition you've had for years....Is it so wrong that I expect you, as the patient, to know a little bit about your disease/condition? At least a little?

For example, very recently I have had a patient of mine for about 11 days, in with migraines. Elderly lady. Used to suffer migraines years ago, they went away, but all the sudden they returned with a vengeance, which-naturally-worried her, being in her elder years. Brain tumor? Stroke? Brain bleed? Heart attack?

So she comes in and we run all these tests, basically to rule out a stroke. All negative. Not finding anything. So now we are left with the epic neverending pain management for migraines.

So we try morphine. Doesn't work. Try imitrex. Worked, but they came back. Tried DHE, a special migraine treatment. Didn't work. Tried dilaudid, which works but the headaches come back. We tried IV Thorazine, a powerful anti-psychotic also known to treat headaches. Nothing. The headaches would go away and then come back with a startling vengeance.

So, on her eleventh day in the hospital, she was having this return pain problem and wasn't getting any sleep for me. I knew her well at this point (that tends to happen when you have her for eleven days), so I pulled up a chair and had a serious talk with her about migraines, at 4:30 am. Now, this was about a week ago so I'm going to paraphrase a wee bit, but this is a little bit how our conversation went:

Me: miss migraine, I was thinking. You've been getting these headaches and were giving you some pretty powerful pain medications. Then they go away, but they come back. So that leads me to believe that there has got to be some sort of trigger every time that causes them to keep coming back. So we have to find this trigger and delete it.

Miss migraine: okay.

Me: okay. Problem is, migraines are very tricky. There could be many triggers. First of all, let's start at the beginning. When these headaches came back again after all these years, had you just started any new medications?

MM: no.

Me: how about any new foods? Start using any new products, any new restaurants?

MM: *she thinks * no.

Me: okay. I'm going to go over some common food allergens that are known to cause migraines. Do you eat a lot of dairy?

MM: no, not really. I have a lot of stomach issues so I don't drink milk or eat cheese. Every once in awhile I eat yogurt.

Me: okay. How about alcohol use? Any red wines?

MM: no, I never drink.

Me: okay. How about chocolate?

MM: yeah, I like chocolate. My friend brought me a bag of M & Ms to eat while I'm here.

Me: okay well chocolate has been known to cause migraines. Maybe we should lay low on the chocolate for right now, and see how you feel.

MM: well actually I haven't eaten any in about a week, and headaches keep returning, so what else?

Me: okay, how about pig products? Pork, bacon? Ham?

MM: every once in awhile, not really. I cook a sunday dinner, sometimes with pork but rarely.
Me: okay, so besides the chocolate, you don't eat a lot of the big triggers.I also want to talk about dehydration. Do you feel like you stay hydrated?

MM: I always feel dehydrated- I can feel it in my skin. I try and drink lots of fluids though but none of it works I guess.

Me: okay. What kinds of fluids?

MM: well I like Sierra mist. So my son brought me a case of it to drink here.

Me: okay. How about water?

MM: yeah I drink water. But I like Sierra mist better, so I drink more of it.

Me: okay well, actually, the carbonation in soda can actually cause severe migraines in some people believe it or not. So I want you to try and stay away from the sodas for a day or two and see how you feel.

MM: oh, really? I had no idea. Okay,  I'll ask for a gingerale next time, I hear ginger is good for you too.

Me: ginger is good for you, but gingerale also has the carbonation and will generate the same bad effects the Sierra mist does. So how about we stick to water for a couple days?

MM: okay, I can do that.

Me: okay. I also want you to think about allergies. Consider seeing an allergist when you go home, they can help you pinpoint something specific that we talked about that you could actually be allergic too, and your manifesting it as a migraine symptom. I also want you , from now on, to look for patterns. Every time you get a headache again, I want you to think about what you were doing for the entire hour before hand. What you ate, drank, did, smelled, etc. it's helpful to write it down, look for repeats.

MM: interesting. No one has ever told me any of this before. I'm interested to try these things.

And thats basically how the conversation went. Yet another baffling case of a patient that suffered from chronic migraines, and yet didn't know the basics of what caused them. I figured out the basics of migraines before I ever stepped foot in nursing school, because it was something that mattered to my own health significantly.  There are many things that could be causing her migraines that I can think of, including :

- Food allergen (dairy, chocolate, pork, soda, etc).
- Environmental allergen (dust, mold, mildew, trees, pollen, etc.)
- dehydration (drinking too much sugar, carbonated beverages, not enough clear fluids (water).
- ineffective caffeine balance (too much caffeine or too little)
- possible gluten intolerance
- something more serious (chiropractic issue, osteopathic issue, brain issue, etc).

So All of this made me realize that I so desperately want two things.

1) I want to readdress my previous desire to go into a career of a Nurse Practitioner, specializing specifically in holistic practice and nutritional therapy.
2) I want to go back to school for a degree specializing in holistic therapy AND/ OR  getting my nutritionist certificate.

Is it so wrong that I think that I can help my patients already, with what little I do know, more so than any of these nonconclusive, expensive tests and ineffective pain management? I just think that if powerful pain medications like Dilaudid are only masking the pain until it returns, then obviously there is a bigger issue to address that maybe the doctor's aren't seeing. And do they think to send in a nutritionist? Dietitian? No.

I firmly, firmly, very firmly, believe that all patients need a BALANCE of holistic therapy and modern medicine. I obviously support medicine, being that i'm in the center of it. I participate in it as a patient and as a nurse, I administer modern medicine and practice. However, I believe there is a line to be drawn that hasn't been drawn yet. I believe modern medicine has its place, and is very important in some cases. There are some conditions that can be *helped* by nutritional intervention and herbal remedies, but will never truly be cured without an antibiotic, antiviral, surgery, etc. You can't cure cancer by throwing vitamins at it. I get that. But making a patients life significantly higher quality after surgery/chemotherapy and perhaps extending life with the right nutritional intervention? Yes.

I want to be a holistic practitioner, but more importantly I want to remain on the realistic side of it. I don't want to lose the realism that modern medicine still deserves its place. I feel that many "holistic people" shun modern medicine 100% and it ends up being their downfall. Then, other people blame these people for killing themselves because they stuck with holistic therapy and didn't "go to the doctor". Thats not the right way to do it.

Instead, I feel holistic therapy/ nutritional balance is needed for problem prevention. For maintaining patients at a healthy, happy, normal baseline. To help patients deplete harmful substances, practices and carcinogens before they create the problem that needs modern medicine. Get it? I want to always be smart enough to know when to *give up* so to speak, temporarily, and send my patient immediately to an emergency room. Of course, the nice thing is- once I send my patient to the hospital and they fall into the pool of modern medicine- I don't lose them completely. From what I understand, if I choose to set up a partnership or work for a hospital that tolerates and accepts holistic practitioners, then I can follow my patients into the hospital and still maintain my nutritional and herbal interventions so that I don't have to start at square one, and yet the patient can still have necessary tests run, lab work done, etc. Its a win-win.

I just wish I knew how far down the rabbit-hole was acceptable to go. Lately I have been experimenting with a sugar-free diet and yeast-free diet (thats another blog post completely). But that means I am dairy free, sugar free and yeast free, chocolate free, tomato free, butter free...and the list goes on. But I have strong reasoning behind all my choices, but I get it that other people must think I'm a "crazy health freak".  I wish wish wish I could help my friends and family make the same choices as me, and I often have to restrain myself from taking soda or a glass of milk out of my friends/families hands. I cringe when I see billboards for milk still.

This is all a simple problem mostly dealing with self-restraint, but the true problem arises when I'm at work. Thinking back to my patient described above, how much can I really delve into the world of migraines, when everything I have to say is holistic intervention?  Legally, I canNOT say (but would LIKE to):  " Miss Migraine, we are not doing anything for you here. These tests show nothing, this pain medication is actually hurting you more than it is helping and you need to get out of the hospital. You need to go see an allergist and at least a dietitian."  If I said that, I could and probably would lose my job if that patient then in turn said that exact thing back to the doctor. That wouldn't go over well. So how much is in my official range of practice? How much can I tell patients based solely on my own experience and reading, without backing it up with hospital paperwork that doesn't exist?

What I truly want and need here is a hospital that is solely- holistic based. They treat all patients with nutritionists and dietitians first and foremost. They prescribe herbs and understand them greatly. They prescribe drug medications only when extremely indicated, or holistic interventions not working. I wish I wish I wish....maybe, one day. I just wish doctors believed. The problem is more often than not, modern medicine is at war with holistic therapy. When Patients are curious about turning to holistic therapy, they ask their doctor first. Unfortunately more times than not, thats where it stops. The doctor shoots them down immediately and says that is all "hosh poosh" and never works. Its never backed up by clinical trials. It could kill you.  *slam face against wall now*

What we need is a society where the two realms of practice work together, that is all. A balance, not a war.

My lifestyle practices will never change and will definitely be a part of my future children's lives. I hope to find a husband that either will adopt most of my food choices or at least is willing to work with me and not feed anything to my children that I choose for them not to eat. Is that completely psychotic? I just strongly believe children should never grow up on milk, artificial flavoring, sugar (too much)...I hope that doesn't make me psycho. I hope more people catch on to what I've realized about the American food industry and more people start doing something about it, soon. Because its slowly killing us.



THanks for reading this abnormally long blog post, and bearing with me. Much needed post to get off my chest!

With love,
_WNB