Tuesday, March 2, 2010

Working at the library

Is espescially tough when one neglects to take their antihystamine in the morning. Sorry about the mucus filled sniffling and such Quiet Study Floor!

Terrible design




"Thats how god made it, that's how god made birth work". --my OB professor talking about the movement of the fetus through the vagina.

No designer but a malicious and sadistic one would create a process so rife with pain and risk for complications and death. It's a very good thing that no such creator exists and so we don't have to worry about what terrible plans it has for us. Evolution is a beautiful process but it is a blind process. The comfort of the mother is not going to exert a significant selection pressure and so with the evolution of bipedal ambulation, humans get a more painful birthing process.

If only there was a team of engineers, biologists and doctors to redesign the birthing process. C-section counts I suppose.

Anecdotes

I go to university to learn from experts in their field in order to prepare me to practice as a nurse and more importantly to gain knowledge for it's own sake. Personal anecdotes are not evidence and offer very little in the way of instruction. With that in mind, it frustrates me that my colleagues so often raise their hands in order to relate a story rather than inquire for more information. This occured ten times in my nursing of families class this morning. That class lasts 1:30h. At approximately a minute and a half per story itnoring any ensuing discussion, these noneducational stories take up fifteen minutes of class. I'd much prefer to get out early than have my time wasted.

In that same vein and class we were shown a memorial video for a stillborn child. The professor stated that it was to show the benefits of GRACE, an organization that assists with greif. This is all well and good but an eight minute video with dramatic video and music does not strike me as increasing my knowledge of how to care for a family. Every couple and family will grieve differently and will have unique needs. Watching what amounted to an anecdote was a dissapointing use of my time and money. I would have felt better sleeping in.

Monday, March 1, 2010

Coffee

THE SPICE MUST FLOW!

Thats totally it!

In Suffering and Death this morning we had a guest speaker. A woman who cares for the dying and their families. For the most part her talk was mildly informative. She was a bit far out of nursing school to remember how much we have been educated up to this point and so her bit on opiate tolerance and its effects was redundant and unnecessary. Other portions of the speech did lend some insight into how to assist the bereaved and the dying.

A few things bothered me.

When requested by the family not to discuss hospice or death with the dying client she said she adhered to the families wishes. I understand following family wishes, but when there is a live patient they have the right to be fully informed about their options no matter how far in denial they may be. Not informing them seems like a lie of omission and something I hope I do not do when I practice.

The speaker stated that she would sometimes hear clients tell her that there were seeing and/or interacting with people who had died previously in their lives. She said she "Chalked it up to the sacred" and would let them live with their delusions. Yes, the sacred, of course thats it. It certainly is a better explanation than a stressed and dying brain misfiring with an intense experience. The exception, she noted after being questioned, was that if the hallucination was agitating the client they would be medicated. So hallucinations that are uncomfortable for them should be medicated, but pleasant ones should be allowed to proceed? That idea taken ad absurdium would lead to all sorts of odd situations such as medicating every believer in an eternal hell that has atheist friends should it make them uncomfortable. Upon questioning she relented that indeed, they could be hallucinations but that she (paraphrasing) "liked to think that they're experiencing something sacred, seeing into the next world"

She was a compassionate and kind person from all that she said, but it does irk me that she seems to have a double standard when it comes to disorientation to reality and her private fantasy of another world.