The other night at work, I was taking care of an elderly man in his 80s. Like it so often happens, I often end up having heartfelt conversations with patients around 3-4 AM. Some people may think that just because I work nightshift, I never see my patients, because they sleep the whole time. Not true. They sleep 25% of the time, lol. In reality, I spend a lot of time with them before they go to bed, from when I come on at 7pm to 11pm (about). I get to put them to bed, which can be quite a personal thing- I am involved in their routine on a nightly basis. Then, once they go to bed, I see the average patient even 3-4 times after that. Either they need pain medication, need...anything, they need their vitals attended to because they are out of whack, or they need assistance to the bathroom.
So this patient was having a lot of gastrointestinal problems, so I was in with him a lot helping him to the bathroom. After one of his trips, he was feeling sentimental and we got to talking. He got to telling me his life profession, about his wife whom he's still happily married to, his friends, what he does per daily basis in his retirement. He was telling me how upset he was that he's never been sick his entire life, and then now in his retirement- the time he's always envisioned being able to enjoy- he's sick now. But then he got to telling me something, something that he probably didn't even realize made me think so much.
I've heard this a lot from patients, especially my elderly crew. They are worried more about their home life, more so than the fact that they are sick at the moment and in the hospital. They are usually worried about their dog, cat, etc., or worried about their spouse, or the mail, etc. But for some reason, this guys stressor made me so sad.
He was so worried about his vegetables. He was telling me he has been working on a full garden at home for years now, and how his wife was now alone at home. He said she wouldn't be able to drive his truck down to the garden and pick his vegetables, and they would go to waste- Even though she told him she would try. He didn't even want her to try, because he didn't want her to hurt herself.
Now you may think, why is this such a big deal? But the look on his face, the sorrow....he was so incredibly upset, to the point of almost tears, as he said "those tomatoes were just about grown too, they were going to be perfect....and now I'm in here. You know, I try to feed all my friends? Some of my neighbors and friends, I give them my vegetables because I have so many, and they are so poor that they rely on my garden. And now I'm here and can't be in my garden."
These kinds of things are hard for me to hear because as a nurse, I can't help them on these problems, whats making them so sad. I can treat pain, I can treat upset stomachs, I can treat mental conditions, I can treat infections, I can treat electrolyte imbalances, I can treat chemotherapy side effects, etc. But I can't go to my patients home and pick their vegetables or feed their pet, or make sure their spouse is OK. It breaks my heart. I am the type of personality where I want to fix everything, not just in nursing. When I'm in a relationship, I want to make that person completely happy. I can't stand for my boyfriend to ever be upset- I do everything possible to turn the frown upside down, if I can't help it. And it kills me if I am ever the cause of someone else's sorrow.
I had a patient tell me a story a couple of weeks ago. There was a time where my patient that I was taking care of at that moment, her husband was in a nursing home while she was still at home, by herself. I guess conditions warranted that either family wasn't close by, didn't care, or family didn't exist, so it was the two of them. Well she went and visited her husband every day in the nursing home. Well one day she didn't come visit. The husband knew something was wrong, he told a nurse. The nurse shrugged it off, figured he was getting confused or the wife was just busy at home that day. The next day, she didn't come again, he told another nurse. She did the same thing. He began telling some of the other residents, and they backed him up- telling the nurses that the wife does exist and she hadn't been there in a couple of days. Eventually, one nurse decided to go above and beyond her call of duty. She remembered seeing the wife at one point. She found the patients home phone number and called the house, there was no answer. She called again later in the day and there was still no answer. She decided to call the police, and asked if they could please go check it out. Turns out they found the wife in the basement on the floor, she had went to get something and tripped. She was alive but had spent 3 days on the basement floor with a broken hip...Obviously the police saved her and sent her to the hospital, but ultimately, that nurse saved her. That nurse went above and beyond her call of duty to help her patient, the husband that she was taking care of. She saw the whole holistic picture, what was making him so upset. She fixed it and I think that's amazing.
So my patient was that wife, a couple years later and she was telling me that story. She told me how she survived by crawling to where she knew she had saved food down there, and fought through the pain, and some other....unpleasant survival techniques- being that humans have body systems that need to be relieved. It was so sad, but inspiring.
Well that's it for today folks. To all my other nurses, just remember- there will be things you can't fix sometimes. But what you can do is be there to listen. Sometimes that's all that your patient needs. So often does the nurse treat the body system that needs attention, and then they leave. Sometimes we have to leave because another patient is critically ill....but other times....not so much. Just always remember the psychosocial aspect of your care plans. See the whole picture. It will make you so much better of a nurse...
- A Writer in a Nurse's Body
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10 + Years in Nursing In Medical Surgical, Women's Health, Telemetry and Informatics.
Showing posts with label Holistic health. Show all posts
Showing posts with label Holistic health. Show all posts
Monday, August 20, 2012
Sunday, July 22, 2012
Another WIN for Therapeutic Modalities
Hello everyone! Sorry I haven't posted in approximately ten years. I have either been out of town, nothing to say/write, or just trying to find seconds to spare just to breathe. But there's no excuse! So look for a lot of upcoming posts. Many weeks of no posts= a lot of pent up thoughts waiting to escape into blog posts! Yay!
So this post stemmed from last night at work. Here's the situation:
My patient had a total abdominal hysterectomy approximately 2 days before she was under my care. Under report I learned that she had not had a bowel movement since surgery (but this is common with recent abdominal surgery), and that she has having a lot of bloating and pent up gas cramps/pain. When I first saw her, she was having some intense nausea. However she had just received a one time dose of morphine, which can very often cause some intense nausea, especially depending on how its given. She also received a PO (by mouth) dose of percocet (she was in a lot of pain). Percocet can also cause nausea. So I decided to give it a little while and told her I would come back.
Well, not ten minutes later is she throwing up, but not much. I still attributed it to the recent doses of narcotics and helped her clean up and decided just to keep an eye on it. However about thirty minutes later she was in intense nausea again, so much so that she couldn't stand up, and was vomiting. My mind started reeling....is there an obstruction? As with any abdominal tampering, its possible to get an unfortunate bowel obstruction. If severe enough, this would then cause anything that's in your intestines above the blockage to come out upwards because it has no where else to go. Keep in mind that she was promoted to a regular diet, just as of the previous day.
So keeping in mind the very real possibility that we were facing an obstruction and may be putting in an NG tube (this would drain out the contents from your intestines above the obstruction), I didn't want to scare her so I didn't even mention it yet. She was already having enough anxiety from her pain and nausea.
Then a thought occurred to me....I always try and put myself in patients shoes. I have had my own very extensive share of gastrointestinal problems and have a lot of experience with different therapeutic techniques, both with western and alternative therapy.
So despite the fact that I've been blessed enough to have never had abdominal surgery, I have had my fair share of "gas issues", especially thanks to my ever so lovely lactose intolerance. So I thought, what do I do for gas cramps/pain?
I went in the room and asked if anyone had taught her the "Left side trick". She looked at me strange because I pretty much made up that phrase on my own, but what else do you really call it in a quick bundle? She obviously said no and I then proceeded to have her lay on her left side and massage her entire abdominal wall in a clockwise motion, slowly and rather firmly (but not enough that it hurts). This follows the natural pathway of your intestines and helps guide the gas out the exit door, so to speak. If you're super lucky, it may even promote the probability of having a bowel movement, in addition to the gas passage increasing the then probability of a bowel movement.
So I had her concentrate on this technique, as I so often do when I'm in gas pain. I also encouraged her to take some deep breaths, and to remain on left side, while also in the fetal position. I find that in the fetal position, the pressure of your knees against your abdomen also helps guide things out the exit door, and....well, it "opens up" the exit door completely, making it that much easier to pass gas.
Now for the epic result?? I checked back in about thirty minutes after that education time, and I honestly didn't have much faith in my alternative non-medication therapies. I came in offering a powerful anti-emetic that she was now eligible to receive, but turns out? She was feeling much better already. Her nausea had receded slightly and the gas cramps were improving. Win!
Even more win, when I went to go to check on her in the middle of the night, I heard some unexpected news that she actually passed gas! Woot! She even managed to pass a very tiny (but one all the same!) bowel movement. Woo hoo! A + for non-medication therapies, for the win!
I couldn't believe it worked. I mean, I thought everyone knew that trick. I thought it was an old age wive's tale, or whatever they call it. I learned the trick in a mother-baby class in college, when we were taught how to alleviate gas in babies. I assumed it would work for adults, and its always worked for me and now for my patients too! :)
So, thanks for reading through a rather gaseous post.....it can be helpful if you also suffer at times! Who the heck doesn't??! Admit it. You probably just farted. Yeah, I just said fart.
Anyway, like I said, I'll try to post more upcoming! Stay tuned....
With Love, WNB
.
So this post stemmed from last night at work. Here's the situation:
My patient had a total abdominal hysterectomy approximately 2 days before she was under my care. Under report I learned that she had not had a bowel movement since surgery (but this is common with recent abdominal surgery), and that she has having a lot of bloating and pent up gas cramps/pain. When I first saw her, she was having some intense nausea. However she had just received a one time dose of morphine, which can very often cause some intense nausea, especially depending on how its given. She also received a PO (by mouth) dose of percocet (she was in a lot of pain). Percocet can also cause nausea. So I decided to give it a little while and told her I would come back.
Well, not ten minutes later is she throwing up, but not much. I still attributed it to the recent doses of narcotics and helped her clean up and decided just to keep an eye on it. However about thirty minutes later she was in intense nausea again, so much so that she couldn't stand up, and was vomiting. My mind started reeling....is there an obstruction? As with any abdominal tampering, its possible to get an unfortunate bowel obstruction. If severe enough, this would then cause anything that's in your intestines above the blockage to come out upwards because it has no where else to go. Keep in mind that she was promoted to a regular diet, just as of the previous day.
So keeping in mind the very real possibility that we were facing an obstruction and may be putting in an NG tube (this would drain out the contents from your intestines above the obstruction), I didn't want to scare her so I didn't even mention it yet. She was already having enough anxiety from her pain and nausea.
Then a thought occurred to me....I always try and put myself in patients shoes. I have had my own very extensive share of gastrointestinal problems and have a lot of experience with different therapeutic techniques, both with western and alternative therapy.
So despite the fact that I've been blessed enough to have never had abdominal surgery, I have had my fair share of "gas issues", especially thanks to my ever so lovely lactose intolerance. So I thought, what do I do for gas cramps/pain?
I went in the room and asked if anyone had taught her the "Left side trick". She looked at me strange because I pretty much made up that phrase on my own, but what else do you really call it in a quick bundle? She obviously said no and I then proceeded to have her lay on her left side and massage her entire abdominal wall in a clockwise motion, slowly and rather firmly (but not enough that it hurts). This follows the natural pathway of your intestines and helps guide the gas out the exit door, so to speak. If you're super lucky, it may even promote the probability of having a bowel movement, in addition to the gas passage increasing the then probability of a bowel movement.
So I had her concentrate on this technique, as I so often do when I'm in gas pain. I also encouraged her to take some deep breaths, and to remain on left side, while also in the fetal position. I find that in the fetal position, the pressure of your knees against your abdomen also helps guide things out the exit door, and....well, it "opens up" the exit door completely, making it that much easier to pass gas.
Now for the epic result?? I checked back in about thirty minutes after that education time, and I honestly didn't have much faith in my alternative non-medication therapies. I came in offering a powerful anti-emetic that she was now eligible to receive, but turns out? She was feeling much better already. Her nausea had receded slightly and the gas cramps were improving. Win!
Even more win, when I went to go to check on her in the middle of the night, I heard some unexpected news that she actually passed gas! Woot! She even managed to pass a very tiny (but one all the same!) bowel movement. Woo hoo! A + for non-medication therapies, for the win!
I couldn't believe it worked. I mean, I thought everyone knew that trick. I thought it was an old age wive's tale, or whatever they call it. I learned the trick in a mother-baby class in college, when we were taught how to alleviate gas in babies. I assumed it would work for adults, and its always worked for me and now for my patients too! :)
So, thanks for reading through a rather gaseous post.....it can be helpful if you also suffer at times! Who the heck doesn't??! Admit it. You probably just farted. Yeah, I just said fart.
Anyway, like I said, I'll try to post more upcoming! Stay tuned....
With Love, WNB
.
Saturday, February 4, 2012
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
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
Saturday, January 21, 2012
A Big Win for the MD Community!
So, I know a lot of you readers know that I am extremely anti-dairy. Not just lactose intolerant but I am a big believer in the theory that dairy products are damaging to anyone's health and that I can come up with a number of ways that dairy can be causing any symptom you might be having right now. However, what you may not know about me is that I am extremely PRO for Probiotics!
To explain a little, probiotics are simply the combat for antibiotics. Both, essentially, are needed, and good things. Antibiotics are given to patients who need to fight off a harmful bacteria that is present in their body somewhere. The antibiotics wipe out all bacteria found in the system. However, the body always has a balance of good and bad bacteria. We get both kinds from food breakdown, water, contact, etc. When we are feeling healthy, we have a better balance of good bacteria, they are essentially "Winning". When we start feeling symptoms of an infection, it means the bad bacteria are essentially "winning", so to speak. So when an antibiotic wipes out all your bacteria, its also depleting your good bacteria. Because of this, when you are on antibiotic therapy, you might start to experience unpleasant symptoms (diarrhea, nausea, etc.). To help combat this its really important to replace your good bacteria. How can you do this, might you ask? The answer is probiotics.
Probiotics can be found in many ways. The easiest way for the common population is yogurt. This is easy to tell patients and anyone that doesn't feel comfortable buying a "box/bottle of bacteria". Yogurt just sounds more....easier to stomach? A lot of people don't understand. They think that by purposefully putting bacteria into their system, even if its good, that is harmful. What they don't GET is that you're doing yourself an extreme favor. You think its gross putting good bacteria into your system? What about putting bad bacteria into your system when you drink bad water, or food poisoning, or accidentally put your fingers in your mouth after touching everything? By taking probiotics, you help the "good guys" win inside your body. You help your body restore its natural balance, so the good guys can win the war and keep you healthy.
Now, yogurt is the simplest form. However its also a very small dosage. Also, for people that also firmly believe in the anti-lactose theory, I cannot get probiotics from yogurt. However there are lots of other ways to attain them. Some of the big brands you may have heard of are, "Align", or "Phillips Colon Health", or, what I take and love, "Culturelle". There are also many many other combinations. Each one has their own unique effect and if you do choose to try one, its important to find one that works well with your body. For example, Align and I didn't get along at all. For some reason that strain of bacteria, even though it was good, didn't sit well with me. However Culturelle, what I take, is what I believe to be the cause of my usual good health nowadays.
So, going back to my title, I get really, really really frustrated when my patients are on antibiotics (strong ones at that) and yet they never, ever get replacement probiotic therapy. And then the patients end up with a new strain of bad-bacteria that happens when your good bacteria is depleted, its called c-difficile. This causes extremely unpleasant diarrhea. When you get this, your doctor will give you yet another antibiotic to treat the new bad bacteria, and yet they NEVER mention probiotics! It drives me nuts. Then I try and educate my patients on everything they need to know about probiotics in a nutshell, and they ask me how come their doctor has never told them to do this, and my face usually says it all without saying anything.
However, recently I had a patient on your typical IV(intravenous) antibiotic. After a couple days in the hospital she started developing the typical diarrhea. Now, her family started freaking out- What is this? What is wrong with her now? Why is she having diarrhea?? Can she have imodium?? Well, the MD (doctor) was called to tell him about this new diarrhea, and the nurse prior to me asked if she could have some imodium. His response, much to my surprise, was: "She can have one dose of Imodium but I'm prescribing some yogurt three times a day. I really want to push some probiotics here."
I was. ASTOUNDED. That was the first time, in my life, I've ever heard a doctor push the probiotics. Not just in my small RN career, but as a patient for 22 years with many, many many stomach issues. I almost literally jumped for joy for that doctor. I wanted to call him back myself and say, GOOD JOB! Finally!
I can't even tell you why doctors don't do this automatically, prophylactic. Is it because they aren't educated about it in school? Maybe. I don't know. Is it because they don't "believe" in anything thats not an actual drug? Probiotic therapy can be considered holistic therapy, is that out of their range of practice entirely? Drives me nuts.
On a sidenote, I had a patient recently that was admitted for severe migraines. The doctors were running every test and scan under the sun and they couldn't find any reason for these severe headaches. When I found out they were chronic migraines, I started thinking. I received her as a patient on her third day already in the hospital. When I went in to go see her, I asked her if she had ever seen any specialist for these migraines. A neurologist? A nutritionist? An Allergist? An Opthamologist? Anything? Her answer was no.
So I sat down with her and did a little tiny nutrition consult with her. I went over the top 5 foods that cause migraines. Turns out, she eats all of them. A lot. I taught her ways to take these foods out of her system and how to replace them. I taught her about the benefits to seeing an allergist, and that they can help you figure out if you're actually allergic or intolerant to a type of food that can actually be causing your migraines. I asked about vision, and she said she used to wear glasses until "she didn't need them anymore". I told her she should see an eye-doctor just in case, because your eyes may be straining to see and you don't even know it. However, nutrition alone, the first thing I went over, is enough to fix 85% of her migraines, I can guarantee it. Her and her family asked why, despite her being in the hospital (which everyone believes to be the big savior to all your problems), no doctor has ever told her anything I just did. Again, my response was...........I wish I knew. I can't bash the doctors in for not educating their patients, that is strictly against my range of job description. And yet how do I tell my patient honestly that the doctors didn't tell you this because they don't know? The doctors are so focused on drugs and tests, before something as simple as talking about nutrition. She eats the top 5 foods that cause migraines! Think about it!
Anyway, vent over.
There are some things I just want to go over about probiotics, while I'm still talking about them (well, I was). This is just in case I may have caught your attention and you want to try taking them. Here are some pointers.
I think thats all I have to say. Whew! Long post. I hope some of you have found this helpful. I know when I started probiotics, I went from being nauseous every single day to hardly-ever. And when I accidentally skip a day or two, I can tell, because my symptoms start coming back.
It is really important to remember here that I am not a doctor. All the information provided above is from my own personal knowledge and own personal experience. It has not been taken from any website or book, but instead is a collection of knowledge from many sources in my past. It is important to know that if you do choose to start probiotic therapy, that it is your own choice and I am not your doctor. I am a firm believer in them, but that doesn't necessarily mean they work for everyone. If you have any questions about probiotics, feel free to leave a comment. I hope it works for some of you and this wasn't a really boring post.
Thank you all for reading! With love,
~WNB
To explain a little, probiotics are simply the combat for antibiotics. Both, essentially, are needed, and good things. Antibiotics are given to patients who need to fight off a harmful bacteria that is present in their body somewhere. The antibiotics wipe out all bacteria found in the system. However, the body always has a balance of good and bad bacteria. We get both kinds from food breakdown, water, contact, etc. When we are feeling healthy, we have a better balance of good bacteria, they are essentially "Winning". When we start feeling symptoms of an infection, it means the bad bacteria are essentially "winning", so to speak. So when an antibiotic wipes out all your bacteria, its also depleting your good bacteria. Because of this, when you are on antibiotic therapy, you might start to experience unpleasant symptoms (diarrhea, nausea, etc.). To help combat this its really important to replace your good bacteria. How can you do this, might you ask? The answer is probiotics.
Probiotics can be found in many ways. The easiest way for the common population is yogurt. This is easy to tell patients and anyone that doesn't feel comfortable buying a "box/bottle of bacteria". Yogurt just sounds more....easier to stomach? A lot of people don't understand. They think that by purposefully putting bacteria into their system, even if its good, that is harmful. What they don't GET is that you're doing yourself an extreme favor. You think its gross putting good bacteria into your system? What about putting bad bacteria into your system when you drink bad water, or food poisoning, or accidentally put your fingers in your mouth after touching everything? By taking probiotics, you help the "good guys" win inside your body. You help your body restore its natural balance, so the good guys can win the war and keep you healthy.
Now, yogurt is the simplest form. However its also a very small dosage. Also, for people that also firmly believe in the anti-lactose theory, I cannot get probiotics from yogurt. However there are lots of other ways to attain them. Some of the big brands you may have heard of are, "Align", or "Phillips Colon Health", or, what I take and love, "Culturelle". There are also many many other combinations. Each one has their own unique effect and if you do choose to try one, its important to find one that works well with your body. For example, Align and I didn't get along at all. For some reason that strain of bacteria, even though it was good, didn't sit well with me. However Culturelle, what I take, is what I believe to be the cause of my usual good health nowadays.
So, going back to my title, I get really, really really frustrated when my patients are on antibiotics (strong ones at that) and yet they never, ever get replacement probiotic therapy. And then the patients end up with a new strain of bad-bacteria that happens when your good bacteria is depleted, its called c-difficile. This causes extremely unpleasant diarrhea. When you get this, your doctor will give you yet another antibiotic to treat the new bad bacteria, and yet they NEVER mention probiotics! It drives me nuts. Then I try and educate my patients on everything they need to know about probiotics in a nutshell, and they ask me how come their doctor has never told them to do this, and my face usually says it all without saying anything.
However, recently I had a patient on your typical IV(intravenous) antibiotic. After a couple days in the hospital she started developing the typical diarrhea. Now, her family started freaking out- What is this? What is wrong with her now? Why is she having diarrhea?? Can she have imodium?? Well, the MD (doctor) was called to tell him about this new diarrhea, and the nurse prior to me asked if she could have some imodium. His response, much to my surprise, was: "She can have one dose of Imodium but I'm prescribing some yogurt three times a day. I really want to push some probiotics here."
I was. ASTOUNDED. That was the first time, in my life, I've ever heard a doctor push the probiotics. Not just in my small RN career, but as a patient for 22 years with many, many many stomach issues. I almost literally jumped for joy for that doctor. I wanted to call him back myself and say, GOOD JOB! Finally!
I can't even tell you why doctors don't do this automatically, prophylactic. Is it because they aren't educated about it in school? Maybe. I don't know. Is it because they don't "believe" in anything thats not an actual drug? Probiotic therapy can be considered holistic therapy, is that out of their range of practice entirely? Drives me nuts.
Its frustrating because as an RN, when I get patients with either stomach issues or headache issues, I know how to help them. I have had both for 22 years and I know a lot of tricks in the book. And yet I can't help them because I can't prescribe anything myself. I can't "refer" them to the type of doctor they really need to be seeing instead. Sometimes I wish I were a doctor just for that reason. But I would be a holistic type of doctor, because I'm a big believer. Because of this, I still might become a Holistic Nurse Practitioner that specializes in gastroenterology....we'll see.
On a sidenote, I had a patient recently that was admitted for severe migraines. The doctors were running every test and scan under the sun and they couldn't find any reason for these severe headaches. When I found out they were chronic migraines, I started thinking. I received her as a patient on her third day already in the hospital. When I went in to go see her, I asked her if she had ever seen any specialist for these migraines. A neurologist? A nutritionist? An Allergist? An Opthamologist? Anything? Her answer was no.
So I sat down with her and did a little tiny nutrition consult with her. I went over the top 5 foods that cause migraines. Turns out, she eats all of them. A lot. I taught her ways to take these foods out of her system and how to replace them. I taught her about the benefits to seeing an allergist, and that they can help you figure out if you're actually allergic or intolerant to a type of food that can actually be causing your migraines. I asked about vision, and she said she used to wear glasses until "she didn't need them anymore". I told her she should see an eye-doctor just in case, because your eyes may be straining to see and you don't even know it. However, nutrition alone, the first thing I went over, is enough to fix 85% of her migraines, I can guarantee it. Her and her family asked why, despite her being in the hospital (which everyone believes to be the big savior to all your problems), no doctor has ever told her anything I just did. Again, my response was...........I wish I knew. I can't bash the doctors in for not educating their patients, that is strictly against my range of job description. And yet how do I tell my patient honestly that the doctors didn't tell you this because they don't know? The doctors are so focused on drugs and tests, before something as simple as talking about nutrition. She eats the top 5 foods that cause migraines! Think about it!
Anyway, vent over.
There are some things I just want to go over about probiotics, while I'm still talking about them (well, I was). This is just in case I may have caught your attention and you want to try taking them. Here are some pointers.
- Remember that it is important to find the one that works for you. If you experience unpleasant symptoms from one for a long period of time (more than a week), its time to try another one. Don't give up on them entirely.
- If you've never taken a probiotic before, you most likely WILL get symptoms from them, no matter what brand you choose. This is simply because your body is greeting the new good bacteria, the war has officially begun inside your body, and basically, war isn't pleasant. The good guys will start to win and resulting, expel all the bad bacteria from your body. This will result in some diarrhea, and maybe nausea, but the side effects should disappear after a couple of days. It is important to continue taking them regularly despite symptom occurrence. If you stop taking them, the bad bacteria will start to win again and you'll just be back to square one. By taking them regularly, its like sending in troops to fight the war. By continuously sending in good, healthy new fresh troops to fight, your chances of winning are a lot better.
- Probiotics can help cure much more than just combating antibiotic therapy. Basically, if you are at an overall health status (by this I mean, no infection present), probiotic therapy CAN be your antibiotic therapy. GOing back to my military analogy, if you have a team of 10,000 good-guy troops maintaining an area, (in this case, your body), then if one or two or three bad guys come in to cause trouble, they are going to die instantly. Your gut (stomach, intestines) is actually one of your biggest immune response fighters. By maintaining a healthy gut, your strengthening your immune response exponentially. This means that probiotics will help fend off colds. They will increase your chances of not getting sick when you drink bad water or bad food. They will increase your chances of not getting sick when travelling abroad. Probiotics in general are known for also regulating the bowels, meaning if you had diarrhea- now you won't, and if you were constipated, now you won't be. Basically, bad bacteria cause irregularity of the bowels. Depending on the strain, it causes diarrhea or constipation. The probiotics help reverse either one. By reversing either symptom, it also will exponentially delete any symptoms of nausea as well. Double win!
- It is important to remember that although probiotic therapy is amazing for the immune response, it cannot fight against a virus. It WILL help keep your OWN immune system STRONG so that if a virus DOES enter your body, YOUR own body might be able to fend it off before you even get symptoms. But if you already have a virus, starting a probiotic regime is not going to solve anything. This is why when a friend of mine has a cold, I don't start them on probiotics immediately. I tell them to ride it out, and then start probiotics to maintain health when you are feeling better.
- It is VERY important to realize that although I'm not a terrific huge fan of antibiotics, they are still life-saving in some cases. They are not to be shunned, and if your doctor does prescribe one to you, it is important to take it. I am in no way saying that you shouldn't. HOWEVER, this is when its especially important to take probiotics. If you don't want to go big on them, all you have to do is try some yogurt. Thats all. However the Biggest most Important thing here, is that you do not take both at the same time. DO NOT take your antibiotic pill and your probiotic at the same time, it will cancel each other out and accomplish nothing. It is important that if you are prescribed an antibiotic twice a day, to maybe take your probiotic in between your antibiotic. Regardless of the timing, be sure to space them both out so they both have a chance for your body to react and do their job.
- Once you start probiotic therapy, it is important to achieve a "maintenance dose". This dose should be fairly small (usually one pill a day). This dose is important to take when nothing is abnormal. No weird symptoms going on, you feel healthy, you're not travelling, you didn't eat anything weird, you haven't been exposed to anything funky recently....BUT, if you HAVE done anything I just said, its important to "boost" your dose a bit. Its important to try and figure out what works for your body and how long you need to do it. If I am exposed to someone else being really sick, I'll take maybe two pills a day for however long I'm going to be exposed. If I'm travelling and eating different foods than what I'm used to, I might take two a day, or even up to 4. If I'm starting to feel sick, I'll boost it up until I feel better. Get it?
I think thats all I have to say. Whew! Long post. I hope some of you have found this helpful. I know when I started probiotics, I went from being nauseous every single day to hardly-ever. And when I accidentally skip a day or two, I can tell, because my symptoms start coming back.
It is really important to remember here that I am not a doctor. All the information provided above is from my own personal knowledge and own personal experience. It has not been taken from any website or book, but instead is a collection of knowledge from many sources in my past. It is important to know that if you do choose to start probiotic therapy, that it is your own choice and I am not your doctor. I am a firm believer in them, but that doesn't necessarily mean they work for everyone. If you have any questions about probiotics, feel free to leave a comment. I hope it works for some of you and this wasn't a really boring post.
Thank you all for reading! With love,
~WNB
Saturday, July 23, 2011
Where I want to Be
I'm having an off night. Can't really explain it....I don't think I could if I even tried. I guess thats the scary part? But its midnight now and I am drawing and listening to some music and this is helping. If "this" is still happening Monday I will *have* to go to the Doctor even though I hate most doctors and how all of my health issues are subjective. For once It'd be nice if a doctor could see what is inside of me, what I am feeling, rather than what they can see. I get it, for them. I know. I know how frustrated doctors are. Its like stabbing in the dark with patients like me. If they can't see the problem, how is it best to treat? Drugs, drugs, drugs? Ugh. Hardly. I want to go back to my holistic NP but can't exactly afford $180/hr right now.
Drawing helps, it gets my mind away from me. It takes me somewhere else.....when you are able to focus on something like that, whether it be drawing, or playing some sort of video game, or....running, or walking, or painting or whatever, when you can be awake and yet let your mind "take a break" from yourself, from your thoughts, its sort of free to do what it wants. Its like accessing the dream state while awake. Although I am in my present self focusing on my drawing, my mind is a thousand miles away. And then I re-focus and my drawing is 75% done! Nice :) So thats what drawing does for me. Thats what reading does. Thats what writing does. Thats what music does.
Right now, in this present moment, I would really just love to be here:
Speaking of Europe, I'd also rather be back here right now:
Drawing helps, it gets my mind away from me. It takes me somewhere else.....when you are able to focus on something like that, whether it be drawing, or playing some sort of video game, or....running, or walking, or painting or whatever, when you can be awake and yet let your mind "take a break" from yourself, from your thoughts, its sort of free to do what it wants. Its like accessing the dream state while awake. Although I am in my present self focusing on my drawing, my mind is a thousand miles away. And then I re-focus and my drawing is 75% done! Nice :) So thats what drawing does for me. Thats what reading does. Thats what writing does. Thats what music does.
Right now, in this present moment, I would really just love to be here:
 |
| Bryant Park, New York City This place, right here.....this place is magical. Everyone who has been there, knows it. Definitely makes my "top five" favorite places...and I've been to Europe. |
This probably marks my favorite place. Luxembourg Gardens, Paris. Which is funny, because I didn't even know this existed in the world, let alone Paris, until I got off the bus and it was right in front of me. But isn't that sort of what makes it surreal? Those special moments when you think you are lost, and you make a turn and you walk into this magical place where all these people are, and you think, how does everyone else know the address to heaven?? And there you are, in the middle of it all. It's perfect, and you are happy. I want to go back.
So, thats that. Tonight is a blast Blue October kind of night. As Justin Furstenfeld puts it, "Just believe in all who shine the light to help you see...'cause if I believe in you, will you believe in me?" from Kangaroo Cry
Goodnight, World. Here's to hopefully a better weekend ahead :)
~WNB
PS- This is my 365th post!!! Ah! Funny since that marks a year, sort of, even though I've had this for two years now. Odd. :-)
Saturday, April 9, 2011
So I'm Not a Basket Case
Appointment with the Holistic Practitioner went very well!
- She's testing an 88 food sensitivity panel to see what my body is reacting too- YAY!
- She is testing my thyroid for suspected hypothyroidism
- She is doing a complete metabolic panel to test my nutrients & hormones and all that cool stuff.
- She is testing (the right way) for Celiac disease because she highly suspects that to be the culprit of the majority of my problems....
..which means I would return to a Gluten-Free diet, pretty soon. Which is hard, but worth it- If it makes me feel better....And this time around it will be easier to do because in just the two years that I have done it last, the Gluten-free nation is rapidly gaining popularity. This means more products, more attention, more restaurants hopping on the bandwagon, Yay!
I respect this practitioner so much because of how she looks at the patient. She sees the whole picture, which is what every doctor should be trained to do, and what a good nurse does anyway, regardless of education. So, putting those two points together, a Holistic Nurse Practitioner makes absolute perfect sense and should take over as the Surgeon General or President of the United States, or something like that....
Doctors these days are losing primary care. Doctors don't want to go into primary care anymore, because its losing money. They aren't being trained anymore to "know everything" because once out of school, they go for the big bucks and they specialize. They specialize in one body system and they are "experts" in this system (most of the time). Well that's GREAT, except for when my Gastroenterologist is only looking at my GI system and not concerned about how whats going on in my gut can be affecting my anemia, headaches, heart, and so forth. It all Connects and this nurse practitioner is the first medical professional that I have seen that realizes this and is testing everything. I am so happy to finally be on the same page as a medical professional.
Its a shame that insurance companies aren't working with holistic practitioners (at least in this area) because if you think about everything I just said, they are stupid not too. Holistic Practitioners (whether they be a doctor or nurse) see the whole picture and are therefore more likely to make the patient well again. Also, holistic practitioners promote overall wellness and are more able to maintain it, which insurance companies should be interested in. Its got to be cheaper to keep a patient healthy with a little work than to treat big problems with a lot of work, right?
I agree that sometimes, specialists are needed. Sometimes a primary doctor or a holistic practitioner gets in over their head and don't feel comfortable treating the case because they don't have enough knowledge about it. They get referred to a specialist for their safety. And those are the patients that should be seen by a specialist. But why should someone with chronic GI (and other) issues be seen by a GI doc when a holistic practitioner can see the whole picture and treat with natural supplements and diet? (Rather than a prescription for the rest of your life?) I hate prescription drugs. My GI doc wants to put me on one for the rest of my life....and well, I am doing everything in my power to avoid that.
So, I'll keep you updated! I won't know more until a couple of weeks, so look forward to it. :-) Thanks for Reading!
I feel like health is on the way =]
~A Writer in a Nurse's Body
- She's testing an 88 food sensitivity panel to see what my body is reacting too- YAY!
- She is testing my thyroid for suspected hypothyroidism
- She is doing a complete metabolic panel to test my nutrients & hormones and all that cool stuff.
- She is testing (the right way) for Celiac disease because she highly suspects that to be the culprit of the majority of my problems....
..which means I would return to a Gluten-Free diet, pretty soon. Which is hard, but worth it- If it makes me feel better....And this time around it will be easier to do because in just the two years that I have done it last, the Gluten-free nation is rapidly gaining popularity. This means more products, more attention, more restaurants hopping on the bandwagon, Yay!
I respect this practitioner so much because of how she looks at the patient. She sees the whole picture, which is what every doctor should be trained to do, and what a good nurse does anyway, regardless of education. So, putting those two points together, a Holistic Nurse Practitioner makes absolute perfect sense and should take over as the Surgeon General or President of the United States, or something like that....
Doctors these days are losing primary care. Doctors don't want to go into primary care anymore, because its losing money. They aren't being trained anymore to "know everything" because once out of school, they go for the big bucks and they specialize. They specialize in one body system and they are "experts" in this system (most of the time). Well that's GREAT, except for when my Gastroenterologist is only looking at my GI system and not concerned about how whats going on in my gut can be affecting my anemia, headaches, heart, and so forth. It all Connects and this nurse practitioner is the first medical professional that I have seen that realizes this and is testing everything. I am so happy to finally be on the same page as a medical professional.
Its a shame that insurance companies aren't working with holistic practitioners (at least in this area) because if you think about everything I just said, they are stupid not too. Holistic Practitioners (whether they be a doctor or nurse) see the whole picture and are therefore more likely to make the patient well again. Also, holistic practitioners promote overall wellness and are more able to maintain it, which insurance companies should be interested in. Its got to be cheaper to keep a patient healthy with a little work than to treat big problems with a lot of work, right?
I agree that sometimes, specialists are needed. Sometimes a primary doctor or a holistic practitioner gets in over their head and don't feel comfortable treating the case because they don't have enough knowledge about it. They get referred to a specialist for their safety. And those are the patients that should be seen by a specialist. But why should someone with chronic GI (and other) issues be seen by a GI doc when a holistic practitioner can see the whole picture and treat with natural supplements and diet? (Rather than a prescription for the rest of your life?) I hate prescription drugs. My GI doc wants to put me on one for the rest of my life....and well, I am doing everything in my power to avoid that.
So, I'll keep you updated! I won't know more until a couple of weeks, so look forward to it. :-) Thanks for Reading!
I feel like health is on the way =]
~A Writer in a Nurse's Body
Wednesday, April 6, 2011
Told You So
I get to see the holistic Nurse Practitioner tomorrow! I am nervous/excited for her help. I hope I agree with what she wants to do and understand it. At this point, though....I should just listen to the professionals and just do it. Clearly I'm not doing a good enough job on my own.
Ironically, Like I said in the Blog Post the other day, I am going to see her tomorrow and I feel fine right now. Of course. But I can't bank on that- I have to show her what I've been feeling the past couple days. Despite feeling fully energized again, no nausea, normal, no headaches.....of course.
It just occurred to me that I have been under a lot of stress and I was really worried about this exam I had this morning. Last night I was practically ready to go to the ER, I was delirious about this exam. Can stress really have that much power? Because now the exam is over, and well.........I feel better.
So I don't know. I'm just really curious to see what she says tomorrow. Hopefully she won't think I'm a total basket case.
~WNB
Ironically, Like I said in the Blog Post the other day, I am going to see her tomorrow and I feel fine right now. Of course. But I can't bank on that- I have to show her what I've been feeling the past couple days. Despite feeling fully energized again, no nausea, normal, no headaches.....of course.
It just occurred to me that I have been under a lot of stress and I was really worried about this exam I had this morning. Last night I was practically ready to go to the ER, I was delirious about this exam. Can stress really have that much power? Because now the exam is over, and well.........I feel better.
So I don't know. I'm just really curious to see what she says tomorrow. Hopefully she won't think I'm a total basket case.
~WNB
Tuesday, April 5, 2011
Quick Post
So today, I hit my total breaking point on approximately.....every aspect of my life. mental breakdown? Idk.
regardless, this includes still feeling like s***. So, based on the fact that I have FELT like crap and DONT want to feel like crap any longer and for Europe, I finally called in the professionals. I really want to see this Holistic NP about 45 min away from me. She has helped close friends and I know she can run the right tests....even if she isn't under my insurance and it will be expensive. But at this point, I will pay for health. I need to feel better. I need answers.
So I called, thinking it would be no problem.
Well, they are "booking appointments two months in advance. FS)(*)$#*. So, I was like....Crap. So She gave me an appt for June, after Europe of course, and put me on an extensive waiting list if there were any cancellations. Boo.
THEN, about fifteen minutes later I got a call asking if this Thursday would work. Its conflicting with a lot of important things, but health takes top priority. So, yay!!! I really hope she can help. I have my fingers crossed so much it will take weeks to uncross them. :-(
Huge exam tomorrow. Not prepared. Freaking out. Probably a significant cause of me not feeling well. Oh well. If thats the case, I wont feel well again until....May? May 14th? Graduation?
regardless, this includes still feeling like s***. So, based on the fact that I have FELT like crap and DONT want to feel like crap any longer and for Europe, I finally called in the professionals. I really want to see this Holistic NP about 45 min away from me. She has helped close friends and I know she can run the right tests....even if she isn't under my insurance and it will be expensive. But at this point, I will pay for health. I need to feel better. I need answers.
So I called, thinking it would be no problem.
Well, they are "booking appointments two months in advance. FS)(*)$#*. So, I was like....Crap. So She gave me an appt for June, after Europe of course, and put me on an extensive waiting list if there were any cancellations. Boo.
THEN, about fifteen minutes later I got a call asking if this Thursday would work. Its conflicting with a lot of important things, but health takes top priority. So, yay!!! I really hope she can help. I have my fingers crossed so much it will take weeks to uncross them. :-(
Huge exam tomorrow. Not prepared. Freaking out. Probably a significant cause of me not feeling well. Oh well. If thats the case, I wont feel well again until....May? May 14th? Graduation?
Friday, February 18, 2011
The Many Me's of Future Me
Right now, It is February.
I graduate in May. Early, May.
I take the NCLEX in June, most likely.
It is really, really, really time to start thinking about real and actual and concrete options for the next step in my life. I firmly choose not to say "the rest of my life" because I honestly don't have the commitment for that, unless I end up really, really, really liking my job... which, would be great.
I am really scared.
There are SO MANY CHOICES. I want to do a lot of different jobs. (In Nursing). But the nursing community *tends* to prefer you to choose a "line" of nursing work, rather than try a bunch of different things. OF course, some nurses disregard that advice and dart from working in a NICU to working in a doctors office...But most nurses follow a chain, or line. For example: Start out as EMT Nurse, go to ER nurse, go to ER chief nurse, go to flight/transport nurse, go to...something crazy. Emergency has a TON of crazy options.
I honestly feel like I am in high school again, and I am changing my mind every single week on what type of nursing I want to do.
There are four "paths" I can see myself following.
1) Labor and Delivery: I say this because I came into this Nursing program with L&D deadset in my goals- I desperately wanted to be an L&D nurse and nothing else. Well, that has changed over the last three years, but recently I have been reconsidering that as a strong possibility. Will I be a midwife, as originally planned? Probably not. Is learning how to deliver a baby an amazing skill to possess, in any situation, for the rest of your life, in and out of the hospital? Yes. Will I like working on an L&D floor? Probably.
2) Floor Nurse. Regardless of this is on Med/Surg, or Oncology, or telemetry, or wherever...I think I would like being a floor nurse. Even if it is "at the bottom of the nurse chain" as far as nurse positions go, I would feel OK there. Once I got in my comfortable "been on the job for awhile" shoes. This reflects two parts of me. The part that wants to just be alone and come to my job, do really good work, and go home. It also reflects the part that desperately wants to make a set of nurse-friends on a floor that I can trust and rely on and laugh with, a lot. I want that. I want both parts. There are two nurses on my current floor that always work together and they always are making each other (and everyone else) laugh, and always have each others backs. I want that. But at the same time I feel that being on the floor promotes independence, if you so desire. I see a lot of nurses on my floor that are plenty sociable with the other nurses, (as I would be), but they stick to themselves and get their own work done. I can see myself being either.
I know, that as a floor nurse, I would be the best that I possibly knew how to ever do. I have a lot of Med/Surg experience. All I need perfection on is the actual "Nursing skills" (i.e. IV's, wounds, foleys, talking to doctors, reading doctors writing, calling doctors, giving meds, etc.). I have the "compassion" down and the Therapeutic communication down. the Caring. I'm working on my critical thinking and physical assessment skills. They will come. As a floor nurse, I would put every thing I have learned over the past 5 1/2 years as an aide and past 3 years as a student nurse and put it into giving every single one of my patients all of my attention and doing everything I can for them. That, I can't wait for. I always try to do that now, on my job, but it is very hard to do when you have 30 patients. I look forward to managing 6-10 patients (even though that is still a lot of work).
Units I would Like:
-pediatrics
-telemetry (maybe)
-adolescent
-burn unit?
3) Emergency.
I never thought I would ever be putting emergency as a third option in my future. And its true...I'm not normally a fan of the emergency room. I never, ever came into this program ever expecting to like emergency nursing. However, it all started when I realized bigger goals that I had required emergency room nurse experience. (flight nurse, NASA, etc). At first I said- Okay, fine. So much for those goals. But after revisiting the idea a couple times, and actually spending a clinical day in the E.R., I wouldn't shoot the idea down completely....
this is why: (another part of me)- hence the blog title-
1) I like to work fast. I like having a TON of things on my mind to do. I like feeling scatterbrained. Not all the time, of course, but I like being busy. It makes me feel important, and needed. Like I am doing really important work. I like the thought of climbing up on a stretcher on my 14th hour of work and doing CPR. I like being so busy that I forget to even eat. Thanks to my ADD, I like having something to do every five seconds.
2) Patients are on a high turnover. This is a disadvantage and advantage- dis because if you like them, you can't connect with them, you can't get to know them. The most you can do is leave a lasting impression on them to help represent your hospital and move on to the next patient. Advantage because if you don't like the patient...well, they are in someone else's hands pretty soon. I would be seeing a lot more than 6-10 a day. But for shorter periods of time. ER nurses need excellent critical thinking skills, and need to be fast. Excellent instincts....Can I do that, though?
4) Holistic Nursing-
Okay. This is funny. A couple of months ago I was in an extreme holistic phase. I wanted to treat myself holistically and the rest of the world. I was obsessed. Have a headache? Take this herb. I wanted to focus on nutrition. This all sounds lovely, but pretty much means I would have to be a nurse practitioner. There are a *couple* other options with holistic nursing...but, I'm just not sure. I don't think I want to land in an NP position. But then again I once said I never wanted to do ER nursing. I still like nutritional healing. But I have lost a *lot * of faith in the whole shebang because all of my personal treatments for my own health failed, and I am back to square one- despite making a lot of dietary changes. And I can't afford to make an appt to actually see the HNP to discuss what else I could do...and then she would prescribe a lot of things, and thats a lot more $$, and I just don't know. Its complicated. So, Holistic nursing is still a possibility. But I'm thinking....less of a possibility than it once was.
Okay. This is a long post. But I got a lot of important thinking done. Tomorrow, or Sunday, look for Part 2: Actual Options, not Pathways. I.e.-Getting Specific. I also will talk about the student nursing convention I just got back from (I learned a LOT!!!) and update you on my new york times mission. But its late and this is long enough for tonight. Thank you for reading..
With immense amounts of love,
~ A Writer in a Nurse's Body
P.S.-
Things I could NEVER see myself working in ( I say this now, to document it!)
- Intensive Care Unit of any kind
- Psychiatric
- Oncology
PSS- THis actually isn't that long of a post. I thought I typed a lot longer. But I did a lot of thinking, so it counts as a long post. :)
I graduate in May. Early, May.
I take the NCLEX in June, most likely.
It is really, really, really time to start thinking about real and actual and concrete options for the next step in my life. I firmly choose not to say "the rest of my life" because I honestly don't have the commitment for that, unless I end up really, really, really liking my job... which, would be great.
I am really scared.
There are SO MANY CHOICES. I want to do a lot of different jobs. (In Nursing). But the nursing community *tends* to prefer you to choose a "line" of nursing work, rather than try a bunch of different things. OF course, some nurses disregard that advice and dart from working in a NICU to working in a doctors office...But most nurses follow a chain, or line. For example: Start out as EMT Nurse, go to ER nurse, go to ER chief nurse, go to flight/transport nurse, go to...something crazy. Emergency has a TON of crazy options.
I honestly feel like I am in high school again, and I am changing my mind every single week on what type of nursing I want to do.
There are four "paths" I can see myself following.
1) Labor and Delivery: I say this because I came into this Nursing program with L&D deadset in my goals- I desperately wanted to be an L&D nurse and nothing else. Well, that has changed over the last three years, but recently I have been reconsidering that as a strong possibility. Will I be a midwife, as originally planned? Probably not. Is learning how to deliver a baby an amazing skill to possess, in any situation, for the rest of your life, in and out of the hospital? Yes. Will I like working on an L&D floor? Probably.
2) Floor Nurse. Regardless of this is on Med/Surg, or Oncology, or telemetry, or wherever...I think I would like being a floor nurse. Even if it is "at the bottom of the nurse chain" as far as nurse positions go, I would feel OK there. Once I got in my comfortable "been on the job for awhile" shoes. This reflects two parts of me. The part that wants to just be alone and come to my job, do really good work, and go home. It also reflects the part that desperately wants to make a set of nurse-friends on a floor that I can trust and rely on and laugh with, a lot. I want that. I want both parts. There are two nurses on my current floor that always work together and they always are making each other (and everyone else) laugh, and always have each others backs. I want that. But at the same time I feel that being on the floor promotes independence, if you so desire. I see a lot of nurses on my floor that are plenty sociable with the other nurses, (as I would be), but they stick to themselves and get their own work done. I can see myself being either.
I know, that as a floor nurse, I would be the best that I possibly knew how to ever do. I have a lot of Med/Surg experience. All I need perfection on is the actual "Nursing skills" (i.e. IV's, wounds, foleys, talking to doctors, reading doctors writing, calling doctors, giving meds, etc.). I have the "compassion" down and the Therapeutic communication down. the Caring. I'm working on my critical thinking and physical assessment skills. They will come. As a floor nurse, I would put every thing I have learned over the past 5 1/2 years as an aide and past 3 years as a student nurse and put it into giving every single one of my patients all of my attention and doing everything I can for them. That, I can't wait for. I always try to do that now, on my job, but it is very hard to do when you have 30 patients. I look forward to managing 6-10 patients (even though that is still a lot of work).
Units I would Like:
-pediatrics
-telemetry (maybe)
-adolescent
-burn unit?
3) Emergency.
I never thought I would ever be putting emergency as a third option in my future. And its true...I'm not normally a fan of the emergency room. I never, ever came into this program ever expecting to like emergency nursing. However, it all started when I realized bigger goals that I had required emergency room nurse experience. (flight nurse, NASA, etc). At first I said- Okay, fine. So much for those goals. But after revisiting the idea a couple times, and actually spending a clinical day in the E.R., I wouldn't shoot the idea down completely....
this is why: (another part of me)- hence the blog title-
1) I like to work fast. I like having a TON of things on my mind to do. I like feeling scatterbrained. Not all the time, of course, but I like being busy. It makes me feel important, and needed. Like I am doing really important work. I like the thought of climbing up on a stretcher on my 14th hour of work and doing CPR. I like being so busy that I forget to even eat. Thanks to my ADD, I like having something to do every five seconds.
2) Patients are on a high turnover. This is a disadvantage and advantage- dis because if you like them, you can't connect with them, you can't get to know them. The most you can do is leave a lasting impression on them to help represent your hospital and move on to the next patient. Advantage because if you don't like the patient...well, they are in someone else's hands pretty soon. I would be seeing a lot more than 6-10 a day. But for shorter periods of time. ER nurses need excellent critical thinking skills, and need to be fast. Excellent instincts....Can I do that, though?
4) Holistic Nursing-
Okay. This is funny. A couple of months ago I was in an extreme holistic phase. I wanted to treat myself holistically and the rest of the world. I was obsessed. Have a headache? Take this herb. I wanted to focus on nutrition. This all sounds lovely, but pretty much means I would have to be a nurse practitioner. There are a *couple* other options with holistic nursing...but, I'm just not sure. I don't think I want to land in an NP position. But then again I once said I never wanted to do ER nursing. I still like nutritional healing. But I have lost a *lot * of faith in the whole shebang because all of my personal treatments for my own health failed, and I am back to square one- despite making a lot of dietary changes. And I can't afford to make an appt to actually see the HNP to discuss what else I could do...and then she would prescribe a lot of things, and thats a lot more $$, and I just don't know. Its complicated. So, Holistic nursing is still a possibility. But I'm thinking....less of a possibility than it once was.
Okay. This is a long post. But I got a lot of important thinking done. Tomorrow, or Sunday, look for Part 2: Actual Options, not Pathways. I.e.-Getting Specific. I also will talk about the student nursing convention I just got back from (I learned a LOT!!!) and update you on my new york times mission. But its late and this is long enough for tonight. Thank you for reading..
With immense amounts of love,
~ A Writer in a Nurse's Body
P.S.-
Things I could NEVER see myself working in ( I say this now, to document it!)
- Intensive Care Unit of any kind
- Psychiatric
- Oncology
PSS- THis actually isn't that long of a post. I thought I typed a lot longer. But I did a lot of thinking, so it counts as a long post. :)
Monday, October 18, 2010
Tomorrow
So tomorrow I got an appointment to go see a Holistic Healthcare provider-but not as a patient. I got in to ask her some questions about her profession and what not. I'm nervous but excited. This is step one of many, many more to come to a full career choice. This could make or break it for me, although I'm pretty sure it would take a lot to "break it" considering I am pretty positive this is what I want to do.
THese are the questions I plan to ask her:
Introduction-
- Introduce myself; where I go to school, I'm a senior; where I do clinical rotations.
- I am very interested in holistic therapy, but have a lot of questions- where to go, how to start my career.
Questions:
- Where did you get your degrees? What were the degrees? Do you have any other recommendations of good schools in area?
- Do you think holistic therapies are catching on in America? Do you think there will be a rise in interest in the next couple decades?
- What kinds of jobs would be available to me? Hospital positions? My own practice?
- Do you primarily diagnose conditions or do you primarily treat existing conditions & symptoms? Do people come looking for a second diagnosis? Only symptom treatment?
- How many patients do you see per day? (average)? How long do you spend with each patient?
So hopefully all goes very smoothly tomorrow and I do not run in to any problems. I am very excited J
I'll keep you updated!
~A Writer in a Nurse's Body
Wednesday, September 1, 2010
Finally, an Answer.. Sort of.
So, I have come to a major life decision. I have finally really (realistically) realized (WOW That is a lot of words with the real- prefix!), that I want to get my Masters in Homeopathic medicine. I might open up my own practice one day even. But I am very interested in staying away from the "western" medicine stuff. I want to treat patients naturally, the way the world is supposed to be without a zillion drugs thrown at each patient. I want to get to know my patients, treat them with natural therapies, herbs, relaxation...natural stuff. Only problem is, our culture here isnt *huge* on schools for this. Our culture here sort of looks down on this type of medicine, because America has Western, modern, advanced medicine that is obviously much better for you. Ugh. So, I may have to go to Europe...I don't know...Or find a school here. I think Im going to try and get my Family Nurse Practicioner first, that way I do have a "westernized" base, just in case and I can fall back on that and also, use that knowledge to still treat my patients. Its still very useful information, I just dont have to throw drugs at my patients just because i have a degree that enables me to do so. Then...my doctorate! Oh boy. Wow, i'm going to be 40 by the time I'm done....whats the point?? Lol. But I Love school, and this is what I want. So good :) Woo! Finally, somewhere, somewhere to head towards...a goal!
Wednesday, January 20, 2010
Stereotyping and “Cultural Awareness”
Classes started today. Well, yesterday really, but today I have seen all my classes (I have two). They seem to be pretty much what I expected. My Psychiatric mental health class Lecture seems to be a lot more interesting than I would have expected, but still hard. She told us she was the "APA Paper grading queen". Needless to say that's not good. But everything she taught today I agreed with wholly so I think I will like her, in terms of nursing and being a good nurse.
"Culturally Competent", "Practice good, cultural awareness", "Know your patients culture, their beliefs and practices".
These are all phrases I've been hearing the past…three courses in my Nursing program. Except today. All this time we have been taught to professionally accept each and every culture, each patient for who they are. Which is all good and well, however, the way we've been taught is to read their chart, see they are of a certain culture/ethnicity (sometimes it doesn't list their culture per say) and we have to reference a book, or a chart of some kind, to plan how we are going to act or what we might say when with our patients. All this time I've done what I was told, whatever, I need to get the grade, right? In my recent experience, my last clinicals (Peds and OB), I had a patient of my own each week. First things first, people naturally look at names and make assumptions. I try not to, I really do, but everyone does. Second, it lists their primary language. I can't help but groan when it says something other than English. But I consider that understandable…it will be hard to communicate with my patient for the entire day. OK so then we have to make a plan for them based on their culture. But sometimes (more than not), I consider their culture to be….American! Is that such a thing? I meet them and they practice nothing out of the ordinary…no specific religious beliefs or practices, no specific foods they eat or health practices specific to them, no anything. Another time I had a patient that was from the Congo and moved here when she was 16, now she is mid-twenties. I thought, while reading her chart that boy, I am going to have an interesting day. But I met her and low and behold, perfect English, was just as "American" as you or me.
The point I'm trying to make here ( I promise there is one) is what my teacher pointed out…Exactly what I've been thinking all this time. That patients cannot be categorized by culture! I can't look at a chart and see "Asian" and plan my whole day based on if they think it's rude or not to make eye contact, be in personal space, eat certain foods, etc. She made the point that yes, keep it in mind, all those lovely things, but never act on them until you get verification from the patient. Meaning, meet your patient, make your assessment, ASK THEM if you haven't already figured it out, what they eat, if they have any specific cultural practices, if they need certain special needs met. Nurses can't be mind readers. Yes, we are naturally good at picking things up in our assessments but we can't automatically know. Thing is, if we see someone is Indian let's say, even if I know everything about the specific Indian culture (which I don't, trust me), I can't be positive that he/she even agrees with his own culture! You have to ask not assume.
I guess I consider myself American, as much as I squirm when I say that. No, I'm not unpatriotic; I love my country, most of the time. However the term "American" in other countries generally brings about a bad name, bad reputation. Yes, I have eaten McDonalds in my life, yes, I have a cell phone, an ipod, a laptop, whatever. I guess it depends who you ask, but Americans are usually portrayed as "Lazy, fat, want things done without having to do them, etc.". If I travelled to another country and needed healthcare, and they saw I was American, how would they treat me? I certainly wouldn't want them to base anything after any stereotype they might have, before they met me and then made their plan of care.
That's another point. I hate Western Medicine. Western is generally deemed what we practice here in America. Doctors are very different here, things are different in general. How we do things, how we come to diagnoses, how we do procedures, how doctors dish out drugs first thing without solving the initial and primary problem ( I really hate that). Eastern medicine (Europe, Asia, etc.) does things very differently and I can only pray America can learn, or so help me I'm moving across seas. They solve problems holistically, they approach things differently. They treat the body as a whole, not systemically. They turn to alternative methods before procedures, unnecessary tests, drugs…And as for the medical portion, I consider them to be far ahead in terms of research.
Well I need to research this topic before I say anything else. It bothers me a lot and is very important to me. I have to go switch my laundry now, but I might go back and edit this and add more later on…Til then, toodaloo!
~A Writer in A Nurse's Body
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