Monday, November 7, 2011

Ethical Dilemma: Forming Biases and Judgments Towards Patients

As I was doing my patient research for one of my patients who had hepatic encephalopathy, I had found my self forming judgment and biases against my patient. I read that EMS had to transport her from her house because her home care aide reported that she had increased confusion. The EMS report stated that they found empty beer cans in her room and she reeked of alcohol. When I read this, I quickly remembered a discussion I had with a classmate about a doctor who told his patient that "She did it to herself". I couldn't help but agree with how the doctor thought. Here is a person who was terribly sick because of years of abusing alcohol, smoking, and doing street drugs. She is in the hospital occupying a bed and using up so much resources, which could have been better allocated to someone whose illness wasn't self-inflicted.

That would have been my thoughts if I wasn't more aware of the determinants of health and other ethical principles such as not judging a person by pure face value. As I have learned from my past clinical experiences, what is said on the chart is not always 100% accurate and there are other vital information that aren't included and can only be known from the patient themselves. It is very easy to fall into the trap of forming hasty generalizations because of a limited information provided to us. I do not know my patient very well but I am sure that there is a reason behind the self-abuse. Although the information was limited, I have noticed that she has bipolar disorder. From the mental health course that I have taken, I have learned that substance abuse is one way for people to self-medicate. Bipolar disorder is a condition in which people go back and forth between periods of a very good or irritable mood and depression. Mental illness is not something that people chose out of their free will and they deserve the help that they need without the negative attitude that some people would have because of the misconception that "they did it to themselves".

Some would argue that they did have a choice to abuse substances, but again as a health professional, our role is to promote health and help a patient to the best of our resources and abilities. Just like a person who smokes, we cannot change them through force, we have to form a partnership and work with them towards mutually set goals when they are willing and more accepting to learn. It is difficult not to form biases, but we have to wear our nursing caps and leave our personal biases out the door.

These are just my thoughts on this subject.

Sunday, November 6, 2011

Thoughts on Dying and Upholding the RN Image

http://www.pbs.org/wgbh/pages/frontline/facing-death/

Watching the Frontline video titled "Facing Death" has brought about questions regarding morality and ethics: How far will you go to sustain the life of someone you love or even your life? Dying is a normal part of the life cycle, but no one wants to die. The program has showcased how modern  medicine can keep a human body functioning for years but the poor quality of life of someone who is on life support sometimes outweighs being alive. Prolonging someone's life could actually be more harm especially if someone is always suffering from excruciating pain or worst, brain dead. But again I always believe that the right to live belongs to everyone, therefore it is also their right to decide what happens to them. This is why I think it is important for everyone to have personal directive, so that one's wishes will be respected during an event that someone loses the ability to choose. The video didn't talk about euthanasia, or assisted death, but this will always be a topic of controversy around end of life care. No one wants to be in excruciating agony, therefore making sure that someone is comfortable during the last hours of their life is important. Again if we look back on the principles of beneficence and non-maleficence, letting people die with dignity and peace seems to be the right thing to do. Also, if treatment will only cause more pain and suffering for a patient with little to no chance of surviving, that treatment plan should be revised or all out discontinued. Morality will always have a grey area and much discussions about this topic should be pursued for improvements in end of life care to occur. I also find it important for a nurse to be aware of the process of grieving (Denial, Anger, Bargaining, Depression, and Acceptance) so that a nurse can find the right timing to talk about options left for the patient.

For the journal that I have read regarding the impressions we leave, I find it important for nurses to always be professional with their interactions with their patients. This is especially true for registered nurses as they now have to prove their contribution to health care as licensed practical nurses are able to do what they do and are paid significantly less. Registered nurses should always let their patients know that they are registered nurses, and by informing their patient's this, nurses should definitely need to leave a good impression. As I have seen in clinical, socializing and chatting at the nursing station should be only done when one has made sure that absolutely everything is done for the patient and that one actually spent time to know the patient so that one will have the necessary information to plan competent and compassionate care. Excellent communication skill is really highlighted as this determines the majority of the patient's first impression for the nurse.

Friday, October 21, 2011

Working as a Male Nurse in a Gender-Biased World

If you’re working as a male nurse, you know the odds are stacked against you. Women, who have been monopolizing this role for decades, may resent you stepping into their employment territory, especially in this economic downturn. The media pokes fun of male nurses, and a lot of older folks don’t trust a male nurse. However, you can shine in your position if you take the following steps:

Show Off Your Strengths
One of your primary strengths is probably exactly that—physical capability. Offer to help other nurses with the physically challenging duties such as moving patients, lifting equipment, and carrying supplies. You may also be one of those men who possess admirable emotional strength, which will come in handy in your position as well. Be ready to step in when tempers flare or drama floods your floor. You can be the source of strength your core group of nurses relies upon.

Overdo Professionalism
You can’t take professionalism too far in this role. It’s too easy for some homophobic old guy to accuse you of inappropriately changing his bedpan or some suspicious woman to accuse you of leaning into her in a sexual way while you moved her from her gurney to her hospital bed. You’ve got to be on your guard at all times to make sure you:
  • Treat others with respect, even if the patients (or visitors) are not respectful of you
  • Use professional medical language
  • Ask permission when appropriate
  • Explain what you are doing and why you are doing it before you perform your nursing duties, especially if those actions could possibly be misconstrued
  • Get another nurse in the room with you if you have to perform any task on a patient who you suspect might not trust you

Develop a Sense of Humor
Sure, there are going to be guys who take pot shots at you and other nurses who might not give you the respect you’re due until you’ve worked with them awhile. Still, it never helps to be defensive or sour-natured. Come up with a few dismissive lines and learn to laugh off anything that smacks of an insult. Remind yourself that in time, you’ll show both your coworkers and your patients who you are: a strong male nurse who can carry them across the room, handle their breakdowns, and drug ‘em up so they feel better again. What’s not to love?





Bio:
Erinn Stam is the Managing Editor for scholarships for nursing students. She attends Wake Technical Community College and is learning about nursing scholarships for men. She lives in Durham, NC with her lovely 4-year-old daughter and exuberant husband.

Friday, August 12, 2011

23 Years Old

The lake shimmered like a silver mirror, as the full moon casted it's rays upon it. Nostalgia hits me as I remember seeing the same scene not long ago. In my head I told myself, "OMG! I'm as big as the moon!". My emo moment ended right there and I was saddened by the thought that I'm actually outside 10 at night jogging. MLIA.

I then forced myself to think of more serious thoughts and remembered that in a few hours I was going to turn 23 years old... Gawd, I'm this close to being an old man and die.

I then reminisced and thought to myself that my life hasn't been a total waste. It was exciting actually. Although the majority of my life was wasted in pursuit of academic excellence, I did have a taste of social life. Like I met friends, enemies, and people who at one time were special to me. I do not regret my decisions in the past as regretting will not not correct my mistakes or alter the consequences. I do on the other hand relive these mistakes in order for me to learn from them and at least become a better person. I am sorry though for the people I've hurt and offended in the past. No excuse or apology will atone for my crudeness and selfishness. Hopefully in the following years we can learn to forgive and forget and start afresh.

I thank the people who have stayed by my side despite my shortcomings and unpredictability. I hope our friendship and camaraderie will stand the test of time and all other obstacles on the way. To the people on Facebook who took a few moments of their time to greet me, I am honored and thankful. I appreciate it a lot and I am glad to hear from all of you again.

I am now 23 years old... I am a young adult. It's scary how time has passed so quickly. I now start a new chapter in my life. I am excited.

***
Photo Credits to Thinaar's Blog

Thursday, June 30, 2011

Muslim Are Our Neighbors

With the recent events such as the September 11 attack, many Muslims have become a centre of fear and hate. Many Muslims become victims of stigma; Stigma is defined as an occurrence of labeling, stereotyping, and discrimination. Stigma is usually caused by lack of education or knowledge about the Muslim culture.

This is why My Fellow American is such a wonderful website. It helps people realize that Muslims shouldn't be outed because their culture and religion is a bit different. My Fellow American showcases many stories from real people whose lives were touched by Muslims. Here is a video of how someone helped a Muslim family helped feel more at home in their neighborhood:




Just like with any other group of people, it is unfair to be making generalizations and assumption about someone based on stereotypes. Sure, relying on stereotypes to help us make sense of someone is easier but it's just wrong. Take this for example, you go to a school with a really bad reputation like having really low grade averages. Just because you come from that school doesn't mean you are stupid, because you might actually have a 4.0 GPA (or A).

I have several Muslim friends, and I can honestly vouch that they are very different from stereotypes.

Monday, May 30, 2011

Rejection Sucks


This is how I feel right now... my heart feels heavy and I'm about to cry right now. I guess I should start getting used to rejections if I want to be dating people. Well let's do a post-conference on my short-lived romance:

Let's name this person K, to protect their privacy. K is a 23 year old Filipino, and we met on an app on the iPhone. What a great way to start a relationship right? Well we were chatting and I started liking K because K had a great sense of humor and K was smart. We then met one day and I was just swept off my feet. K wasn't really attractive but I was into K a lot. We spent the whole day and the conversation was fantastic. Well I thought so anyway, I don't know what K was thinking...

Well I just talked with K and K said that K was more into a friend and K didn't want to  mislead me or anyone else... which was kinda misleading because previously, K said K was in no rush to be in a relationship... but whatever. At least K told me head-on on what to expect.

My heart hurts right now, but I still am thinking of K. K says we could still be friends when I asked, but I have a feeling that this is actually the end of the road for us...well for me at least, since there was no us to begin with.

I'll be ok somehow, I'll be able to move on. I feel horrible and uhm... rejected? Things will be better?  I have no idea... I don't care anymore...

Saturday, May 28, 2011

There are days when I just feel like laying in bed and doing nothing, this is one of those days. Well I feel like this every day but once I get to work everything just falls into place and I get to do my actual job.

I actually love what I'm doing, it's just the act of trying to wake up that sucks. Well I prefer the day shift as compared to the evening shift anytime.

Well I guess I should head to work right now.

- Posted using BlogPress from my iPhone

Monday, May 23, 2011

Night Shifts Make Me Loopy

These past few days has been sort of exciting and new for me. I have been picking up night shifts, something that I would never ever would have done because I value my sleep a little bit too much.

Anyway, something interesting happened. I had a sudden realization that I love what I am doing. I remembered the Lady with the Lamp, Florence Nightingale, the founder of modern nursing. I'm no lady (that's for sure) but like her, I was dressed in white and I walked along the corridors of my hospital checking on my patients. Well it was more off doing a sleep monitoring sheet, but still... I was emulating a nursing characteristic of being observant.

On a personal note, night shifts on my unit could be very boring and repetitive since every one is asleep but I still find it enjoyable. The camaraderie that I have with the nurses and the other psychiatric aide is amazing.  

I just wish they give me more than an hour before they call me to work an 11 PM to 7 AM shift but I guess it can't be helped. Night shifts do make me loopy at times, making it more important that I know my limits since I do not want to work unable to think incoherently. I could pose as a danger to myself and my patients, this is why honesty and integrity is needed in nursing as well.

I am looking forward to more night shifts.

Sunday, April 17, 2011

Finals Blah and Fitness Action

Ok that wasn't the most creative title that I could think of, but it captures my emotions right now. I'm at university on a Sunday trying to study for an exam which I am sure I could pass. But again, overconfidence is a deadly thing. I just have to look on the bright side, just two more years and I'm finally done with nursing school.

I do have a positive topic in this entry: I'm finally doing something to lose weight! Yup I had enough of being overweight. Sure I'm not really big but I'm not slender either, if you catch my drift. I was planning on taking a run outside since it's already spring but I kept having a lot of excuses not to. A great excuse is that we actually had a heavy snow fall so running outside would be considered a suicide attempt. My other excuse was that it's too late to run whenever I get home and I'm lazy (laziness not being a good excuse, of course). I did manage on the other hand to buy a treadmill. Yup you heard me, I decided to invest in an exercise machine because this way I don't have to pay horrendous gym membership fees and this time I could actually go on the treadmill whenever I want... well unless my ex-brother and his hoodlum friends decide to sleep over.

Anyway this morning I think I had an allergic reaction of some sort. I woke up at the crack of dawn because I felt a lump in my neck. It felt like there was a foreign object dislodged in my neck and it just won't go away even with a sip of water. I was going to go to the emergency room when it finally went away. I was thinking that it could have went into my lungs (which would lead to pneumonia or pulmonary obstruction) or into my stomach (which could possibly lead to bowel obstruction) which would be very bad. Later in the day I realized that I might have had an allergic reaction to the water bottle that I drank from. I noticed that paint was chipping of and I only felt the tightness in my esophagus everytime I took a sip from it.

I also read online that it could also be caused by stress as some people seemed to have the same problem as me. There's nothing physically wrong with their throats but stress is causing their throat muscles to spasm. OR... I could go to a doctor and have it looked at... which I'm not really interested to do cause it would take too much time... but again... time or my life... seems like a no brainer, I'll do it after finals if I'm still alive.

Tuesday, April 5, 2011

Casey Heynes: I Support You!



I was very disturbed by this viral video that I saw on YouTube. My heart goes to Casey Heynes who was bullied for most of his life just because he weighed a few pounds. It pains my heart to hear him talk about suicide because he couldn't take the bullying anymore. People say that violence is never an answer but in this case, I support Casey Heynes, the Bully Punisher. I see Casey as a hero, a beacon of light for all of the people who are abused by people like Ritchard Gale.

Ritchard Gale is a little liar! He said that Casey attacked him first but it is clear from the video that Ritchard came along with his group of bullies and attacked Casey. I don't feel sorry for you Ritchard Gale and I hope this event will haunt you for the rest of your life. Casey was defenseless (a gentle giant) and was against the wall when you punched him several times. You deserve everything that you are getting right now. I know I sound horrible but you are a liar. If you just said sorry like you meant it, you might be hated less.


To Casey, you are not alone. The whole world supports you and we are proud of you! I am happy that you have a family that loves you. Casey said that he had 9 friends who deserted him... well you have hundreds of thousands of friends around the world now!

I was bullied as a kid too and I was very young when I first knew how fear felt like. I was so miserable and I felt so lonely because no one was there for me. Like Casey I had a few friends (who were there when they needed something from me) but when I was being teased that I didn't have friends, I told my bully that I did have friends and pointed at my supposed to be friends. It was so painful to be told right in front of your face that they never considered me as a friend. Children could be so cruel especially when they are ruled over by a school bully.

This is Casey's message to all people who are bullied: "Look for the good days, keep your chin up and school ain't going to last forever".

For more information on this historical event, you can visit http://www.caseyheynes.com/.

Wednesday, March 30, 2011

Nursing Uniforms

When I first started working as a psychiatric aide, I gained a great appreciation for scrub suits. It is unfortunate that the traditional nursing uniforms (the all-white uniform) have now been laid to rest and have been replaced with scrubs that not only give you more comfort but it is also more practical. It's also great that you have a choice at different colors and designs--- well if you're female that is. Men on the other hand are stuck with the plain blue scrubs. Well you do have a choice of light blue, dark blue, aqua blue, and black (not really a color).

Although I do wish for more choices for male nurses but I guess we have to make do with what we have now. I’ve recently been out shopping for scrubs and I’ve been surprised at how expensive some scrubs could be.  Even with my 10% student discount, scrubs would still cost me around $40 to $80 for a set. Makes me wonder why they’re so expensive, but it does help to know some cheaper alternatives like buying scrubs online like at http://www.nursinguniforms.net/. They have really affordable scrubs so you could buy a dozen so you won’t be stuck wearing the same scrubs in a monotonous cycle. They have a decent selection of scrubs and I’m pretty sure they’ll be adding more brands soon. With a purchase of $100 or more you will get free shipping so you could spend more on scrubs and less on having it sent to you. I especially like the warm upscrubs, great for chilly mornings or frigid nights.

Another neat feature of http://www.nursinguniforms.net/ is their blog. I really found it interesting how the nursing profession’s history and other nursing concerns are laid out and discussed thoroughly so it is a great site to visit to know more about nursing.

As a special treat to all nurses and everyone else who works in the health care field, Nursing Uniforms will provide a 20% discount when you use this coupon: NU2011. A great way to start spring would be to throw away your dark, gloomy scrubs and buy yourselves bright, new scrubs.

Monday, March 21, 2011

Stigma in Mental Health Care



Boy it's been a while since I last posted something of substance (not to mention nursing related) on my blog.  As always I have been unproductive in my student life, doing things other than studying (like blogging). Anyway, I guess it's better than being out in the streets late at night partying right (defensive mechanism: rationalization; I'm actually just a lazy bum)? 

So on with my post... I've recently applied for a position as a psychiatric aide in a geriatric mental health facility where I formerly worked as a dietary aide. I'm pretty happy to have taken the position as it is pretty hard to get a job in the health care field with out the proper education (I'm still a 2nd year nursing student). 

Many people would ask why I decided to work in a mental health facility in the first place. People think that people with mental illness are dangerous. Well ladies and gentlemen, that is a MYTH. You will find more aggressive people at retail stores than a mental health facility. The problem with mental health is that it is surrounded by stigma. Stigma is defined as an occurrence of labeling, stereotyping, isolation, discrimination, and status loss (Björkman, Angelman, & Jönsson, 2008, p. 170). Mental illness is just like any other disease: it is treatable; yet so many people treat people with mental illness badly and shun them away. It is said that people with mental illness already suffer the disabling symptoms of the mental illness, plus they have to suffer the social isolation from it. Some people with mental illness would rather suffer in silence from voices in their head or depression just because they fear of being labeled as crazy, wacko, nut job, and other derogatory, hate-laden labels.

I have worked with people with mental illness and I could tell you right now that they are the most sweetest people and I enjoy being with them every single day. You have to understand that they're talking to themselves or are not making any sense because there is something wrong with the neurotransmitters in their brain.

Media has portrayed people with schizophrenia as dangerous just like the picture above. In reality, people with schizophrenia are more likely to hurt themselves than anyone else. They are not dangerous and they don't have a multiple personality as the picture erroneously portray.

Understanding what mental illness is and educating people about it is important to reduce stigma. Mental illness is very common and you may not know that your close friend has it, yet he still seems normal. Mental illness is just like having hypertension. We should never treat them differently.

I have written a paper about stigma and I was surprised that some nurses who work in somatic care carry more negative attitudes and beliefs against people with mental health and they believe that people with mental illness are intrinsically bad and that they are causing their own problem. People with mental illness come to the emergency room to seek help but they are just dismissed by nurses since these nurses think that depression is just a matter of "will power". Like other physical disorders, mental illness should be treated and these patients should be referred to the appropriate mental health professionals. 

Did you know that there is great difficulty getting access to mental health services? Your problems are not taken seriously until you prove that you are a danger to yourself or to others? How on earth will you prove that? Well I guess you have to wait until your disease progresses and you do something against your own will.

There are several problems in mental health care right now. First is of course the stigma that comes with mental illness, second is difficult access to services, and thirdly we even lack funding and professionals in mental health because of stigma. 

I hope for a day when stigma will be totally eradicated and that people with mental illness will gain access to the treatment and support (even their own family will disown people with mental illness) that they need. Mental health is interesting, I might be a mental health practitioner someday... who knows.

References

Björkman, T., Angelman, T., & Jönsson, M. (2008). Attitudes towards people with mental illness: A cross-sectional study among nursing staff in psychiatric and somatic care. Scandinavian Journal of Caring Sciences, 22(2), 170-177. doi: 10.1111/j.1471-6712.2007.00509.x

Monday, March 14, 2011

These people make me sick.


Japan has suffered great loss when they had the earthquake + tsunami + radiation exposure crisis, yet these people mock Japan and are even happy for Japan's disaster. I have never seen such sadistic people in my life. These people are not worth calling human beings.

Friday, February 25, 2011

Nurses Need to Know More About Hockey

Tried to initiate a conversation with a patient but he was talking about hockey, so I then changed the topic to his delusions of him being the authority of cats and dogs. I realized that I needed to be more knowledgeable of hockey in order to initiate therapeutic communication.

Tuesday, February 15, 2011

Twitter-like Function on Blogger

Blogger should have a Twitter-like function so that I could frequently update my status. Yes, I am one of those annoying people who updates their status on Facebook about every single thing that goes on in their heads or whatever they do.

Tweet!

Monday, February 14, 2011

Valentine's Day Update

Hello world and to all the people who actually follow my blog and rants. As you would have guessed from the post title, today is Valentine's Day... yipee dee... Yes I am this ecstatic about it... not. Anyway, I still wanted to greet the lovely couples out there, Happy Valentines Day. I would also like to extend this greeting to all the loveless people as you have shown to the world how strong you are even when you are alone or as other lovey doveys would call you as a "half waiting for your other half...".

Well I started my day 1 in the morning as I was cramming for an exam which didn't really need cramming for since it was retarded. I am so negative, let's turn up the mood a bit.

Today I recalled an event in my childhood. I was staying at my grandmother's house when my cousins came home with a nest filled with hatchlings. These birds were so cute. Innocent as I was cute, I got our cat and showed him the nest of birds. I thought that he was staring at amazement and shared the same feelings of awe as I was when he was taking a moment and stared at the birds... he then took a bite and began chewing on the poor little bird. I was frantic! I wanted to stop him but I also didn't want to break his neck! What a traumatic childhood indeed. My first encounter with life and death...

How's that for changing the mood? ^_^

***
Photo credits from thevillagepizza.ca

Sunday, January 30, 2011

Drug Calculation Quiz Retake

In my pharmacology class, we had to take a drug calculations quiz. We either get a hundred percent or we fail. Guess what? I failed...

I am angry and bewildered as why I would fail such a simple math exam. I double checked each and every one of my answers but I still ended making a mistake. I hate making mistakes and I hate being a failure. I am not a failure and this event has taken a toll on my self-esteem... specifically my pride.

Sure, this is a humbling event and it reminded me that to err is human and that I shouldn't think badly of others who fail because they too might be just like me... had a case of bad, dumb old luck. Life is a gamble and it's how you deal with what ever life gives you is the most important part.

I was grieving when I found out I had to do a retake. I was in denial (I couldn't make a mistake), I was angry (that stupid teacher checked my paper wrong), bargaining (I didn't really bargain...), I was depressed (I wanted to die), and finally I accepted my failure.

I just lost 2% of my total grade and it really doesn't look that bad. I will make this failure as a sign to work extra hard and be more diligent in my studies.

It does help to think positively.

Friday, January 7, 2011

NEVER BUY A BROTHER PRINTER

I'm too angry to write an entry right now but I just wanted to say that Brother printers are a complete waste of money. If you want to throw your money away, buy a brother printer!

Tuesday, January 4, 2011

My Conscience

Let me first express how I feel so bad about being a jerk to my mail lady. I didn't say thank you to her or even acknowledged her when she said "thank you" to me and I feel really bad... I am such a jerk at times.

I could honestly say that I could never do any bad will to anyone who doesn't deserve it because my conscience will eat me for days. I don't know if having a strong conscience is a strength or a weakness, but one thing's for sure: I have a conscience.

Wikipedia defines conscience as "an aptitude, faculty, intuition, or judgment of the intellect that distinguishes right from wrong" and is "described as leading to feelings of remorse when a human does things that go against his/her moral values, and to feelings of rectitude or integrity when actions conform to such norms."

I find having a good conscience as a strength because it helps me in making the right decisions and it protects me from the severe consequences of wrong decisions. Having a conscience is only a weakness when every one else doesn't have one. You'll end up being eaten, chewed, and spitted out by immoral people. Nevertheless, I try having a good balance with my conscience. I will follow the golden rule, "One should treat others as one would like others to treat oneself". Although the platinum rule ("people should treat others as those others would like to be treated") is better, my moral fibre isn't strong enough. I still prefer the "eye for an eye" logic.

***
Photo credits to David Tanguay
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