Note to an International Language Placement Advisor; Crisis...

The host family father gave Emily 10 minutes to get out of his house, called her an insect and a worm, called her other names, said to go to the street where she belonged and he hoped she died trying to find help. DID YOU KNOW THIS?

What in the world is wrong with this program that you would place my daughter with an insane man who threatened her and turned her out onto the streets of San Jose, Costa Rica, telling her he hoped she died there? I want assurances that no student is ever placed there again. They were like captors; isolating her, berating her, refusing to get her medical help or support in orienting to the circumstances, then forcing her to leave within 10 minutes, before she could be safely seen into the care of the University of Costa Rica driver. She had to hide on a neighbors' porch, for God's sake!

I have called the OSU President's office, spoken with support personnel, and intend to make sure this never happens to another American student. I do not blame her for needing to be home, and immediately. She has been traumatized enough. She is not in a state of mind to concentrate on studies, and needs to get out of there. The other tragedy in this is that it is her first bad experience in a foreign country, and she has travelled extensively. Not to mention that her entire minor degree credits were able to be gained in this convenient time. We are all devastated, and very worried.

Please, please give Emily the support she needs until she is safely on her way home.

Birthday Wish for a Brother-in-law

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Dave,

Hi, SORRY we missed your birthday. We were doing something important, I can't remember what, not that it was more important than wishing you a big happy 65th , but then George said you might not want to be reminded, and then we thought, well, if we don't, he might feel bad, so we had a beer and thought some more and then we toasted you and then we toasted you again, and then we forgot what we were toasting, so we tried that word association game to help us remember, the way the over 55 memory class taught us, and we started with 'a', so that reminded us of alcohol, so we had a beer, and the 'b', and that reminded us of beer, so we had one, the 'c' came up, and I noticed my cup was empty, so we had a drink, which got us to 'd', and that made us realize we had finished our drinks, which got us to 'e', empty cups, so... I don't remember much else, but I think 'f' was really fun and then when we woke up it was Monday and time to go to work, so I am just now getting around to wishing you a happy 65th, and thanks for the party!

Love you!

Bottled Water: Petri Dish for Germs: ALERT!!

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Please be aware that bottled water has no preservatives in it. That means that once you open it, and once you put your lips to the bottle, the water has become contaminated with everything in your saliva. This includes Streptococcus mutans (S. mutans) , Staphylococcus epidermidis, Streptococcus salivarius, volatile sulphur compounds, lactobacilli, Porphyromonas gingivalis, and, recently indentified, Prevotella histicola. In other words, lots of nasty stuff.

So, you drink. And, you don't feel like drinking the entire bottle, so you put it in your car's cup holder, your work out bag, or on your desk for later. Well, if it is not refrigerated, it is now a perfect medium for growing all that stuff so you can swill down concentrated mouth bacteria the next time you take a sip.

You would be better off using tap water; most of it is chlorinated and will resist bacterial growth. Or, open a fresh bottle every time.

Oral bacteria is linked to everything from heart disease to oral cancer to strep throat, to spinal meningitis.

Don't drink bacteria smoothies; drink fresh water, every time. Finish the bottle soon after opening, or toss it.

Desirable Patient

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'You have a patient coming.' says the charge nurse.

'Okay', I say, take the history form from her, which reveals nearly nothing about the patient except dentition, allergies, and what surgery they are having.

I look up the patient on the hospital web for history. Oh, goody.

Meth user (probably will require a ton of meds to deal with even minimal pain), terrible dentition (meaning great breath and streppy saliva, too), gonorrhea recently cleared up (that's good), has anxiety (suddenly so do I right now...), two pack a day smoker (get out the suction), impulsive (meaning all lines and tubes are in danger of being manually and forcefully pulled out; get out soft restraints), Hepatitis C (gloves!), and poor hygiene (get out odor neutralizer and warm wet washcloths), obese (what a surprise).

Okay, I'm ready. Wait, there's another entry by the doctor: 'a rather angry person'. Even better. Get some help so I don't get hurt.

Another day in the PACU, another all-too-common patient. Lest I repeat myself: Goody.

Quote

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We have lived through the era when happiness was a warm puppy,

and the era when happiness was a dry martini,

and now we have come to the era when happiness is

'Knowing what you uterus looks like'.

---Nora Ephron

I had a hysterectomy at 36. I asked to see the parts after removal. My doctor said 'Okay'. I was in the hospital six days. As I was preparing to leave, I asked again to see my parts. The nurse warned me that my uterus, Fallopian tubes and ovaries would be thin-sliced, having been tested for pathology. I said 'Fine. Bring them'.

So, the lab tech brought the parts in a vacuum sealed bag, thin-sliced and tinier than I expected...

The nurse, and the other nurses, hovering nearby, wanted to know, 'Why do you want to see this?'. I know that I want to see the source of my femaleness, the center of my monthly cycles since twelve years of age, and the nest of my children during their genesis. But, being me, I snapped back:

'Because I want to slap the bitch'...

Non-therapeutic nursing communication

Nurse messing with a patient's head, Google image

Psych patient, emerging from anesthesia: 'I feel strange, like another person.'

Nurse: 'That's just the feeling from the medication. You gradually get less floaty as it wears off.'

Patient: 'This may be a strange question, but, what is my name?'

Nurse: 'Julie.'

Patient: 'Julie.' Again: 'Julie.' Patient, raising her hands in front of her face and watching them turn this way and that: 'Julie.' Wistfully, crease on forehead: 'Julie.'

Nurse, glancing down at chart, quickly: 'Oh, sorry, Janey.'

Great Lyrics, the best images highlighted...

Two a.m. and she calls me 'cause I'm still awake,
can you help me unravel my latest mistake,
I don't love him, winter just wasn't my season
Yeah we walk through the doors, so accusing their eyes
Like they have any right at all to critisize,
hypocrites, you're all here for the very same reason

'Cause you can't jump the track,we're like cars on a cable
and life's like an hourglass, glued to the table
No one can find the rewind button girl,
So cradle your head in you hands
And breathe, just breathe,

May he turns 21 on the base at Fort Bliss
Just today he sat down to the flask in his fist,
Ain't been sober, since maybe October of last year.
Here in town you can tell he's been down for a while,
But my God it's so beautiful when the boy smiles,
Wanna hold him, maybe I'll just sing about it.

Cause you can't jump the track, we're like cars on a cable,
And life's like an hourglass, glued to the table.
No one can find the rewind button boys,
So cradle your head in your hands,
And breathe, just breathe,
Woah breathe, just breahte

There's a light at each end of this tunnel, you shout
But you're just as far in as you'll ever be out
These mistakes you've made, you'll just make them again
If you only try turning around.

Two a.m. and I'm still awake, writing a song
If I get it all down on paper, its no longer
inside of me, threatening the life they belong to
And I feel like I'm naked in front of the crowd
Cause these words are my diary, screaming out loud
And I know that you'll use them, however you want to

Cause you can't jump the track, we're like cars on a cable,
And life's like an hourglass, glued to the table
No one can find the rewind button now
Sing it if you understand.
and breathe, just breathe

by Anna Nalick

Waving Flag - K'naan & David Bisbal - Sudafrica 2010 Coca Cola HQ

Quiet Sunday

Today is Sunday, and sunny, for the first time all year. It is quiet here, the sounds coming only from chickens, doves, quail, the wind chimes and the wind in the trees. It is a rare sound, this quiet.

Not even a telephone call has shattered the stillness and calm. One child is in the goal in Canada in a professional soccer game, another is cleaning an apartment on this last day of rent for the school year. Yet another is busy settling into a newly rented house with a yard and place for a garden.

George and I are here at home, doing little chores and recuperating after a long six hours of moving furniture and boxes for the apartment cleaning child. We find ourselves just sitting down sometimes to catch up some energy from yesterday, and enjoy the sun.

I wrote a donation check to one son's alma mater, for a less fortunate student athlete. In the drawer where I filed the receipt, I found an old calendar from one of the kids' grade school and elementary years. The listed activities were a shock to the system.

My God, we were on the move every day, mornings, afternoons, evenings, weekends. Entries for 'soccer practice/E, soccer practice/G, orthodontia/M, school jog-a-thon volunteer/me, dogs/shots' appeared all on one day square. That would be a busy week for me now. But, George and I did it. Over and over and over for over twenty years. We also had birthdays, Christmases, volunteered for the local Search and Rescue program, took care of his aging father who suffered with Alzheimer's, taught kids to dive and drive and hunt and camp. We also gave them food and love and approval and life skills. Every day, every week, every month, for more than two decades.

It is no wonder the quiet sounds so good, the pauses feel so good, the silent phone is such a secret conspirator in our calm. Time out for good behavior.

Nurses Are Understanding And Tolerant

We have to be. We get told the most incredible stuff. We are expected to do the most intimate and icky stuff for people. We are expected to deal with folks at their most vulnerable, grumpy, juicy and unlovable and still treat everyone the same, with dignity and respect. We are yelled at, hit, treated with condescension, and mistaken for maids or waitresses.

But, we keep doing our jobs. Because we know what some of our patients don't. We know that nursing has evolved over the years to a complex, thinking, analytical career that places us where the real eyes and ears of patient care belong, and where the first catches are made that head off impending doom, and that is the bedside. We know that the knowledge in our heads and the assessments we make from the moment we lay eyes on our patient can and do save lives.

I have wondered if education in advance of planned surgery or hospitalization would help change the attitudes and behavior of those that are disrespectful and rude to nurses, something like a patient education note on 'how to interact with your health care professionals'. I think some people just see nurses as 'helpers' to the doctors, not realizing that we have entirely different scopes of practice and areas of expertise. In fact, doctors often ask the nurses for not only their opinion and help, but for any orders the nurse can think of for the patient to complete their care, orders that the nurse will carry out. Meaning WE often tell the doctors what we will need to assure thorough, safe and complete care. Bet most folks didn't know that.

And I bet most folks coming in for a surgery don't realize that the nurses that care for them after the surgery are considered critical care nurses, some of the best, most skilled and educated in the business. That those nurses are some of only two or three units of nurses in the hospital that can and do administer vasoactive, paralytic and sedating drugs at their discretion. We have a broad standing order base that allows us to give prompt, complex care for unstable patients.

So, I think a 'please' or 'thank you' or smile would be nice once in a while. Remember:

Your nurse is here to save your ass, not kiss it!

More Plys, or Plies, More Better

My favorite brand of toilet tissue has gone from two-ply to three-ply. No notification, no opinion poll, no forewarning. Just one day, BAM! they pull a hygiene Emeril. What could make a nice safe steady two ply brand do something like this? It got me thinking...

America is fat and getting fatter. Do big asses need more plys, or plies, as the case may be? If we are eating more, we are producing an equal amount of, well, waste. So, can that be the reason? Do we think 'Yeah, I've got this big ol' ass and I'm shittin' like an elephant, so I better pick up this three-ply paper so I don't end up wipin' all day long. Yep, good call.'

Or, maybe we are just in such a hurry, we want to speed things up, even if it only by one ply. 'A good wipe used to take X long. If I use this new, improved three-ply invention, I could be back to my keyboard in less time, even after taking time to use the new MRSA killing hand soap. Yep, good call.'

Or, maybe, when we finally get to meet that 'smart, successful, quirky' cyber dreamboat in person, s/he just might notice the special attention we give to our guests at great expense to ourselves, and that one little thing about the toilet tissue will be the thing that turns our online match into the 1 in 5 marriages made through a dating service. 'Yep, good call.'

Or, maybe it's because we figure we are worth it. Damn it, my folks toiled all their lives and only had single ply to show for it. They gave me a good, though humble, single ply start. And now, I have worked hard and can reward myself and my kids with this really great three ply tissue. We have arrived. 'Yep, good call.'

My toilet tissue company probably figured any or all of these things would work. And maybe they're right. They pay professional figure-outers to know this stuff. We are merely puppets in the toilet tissue tug of war between companies in this huge, free trade competitive wonderful country of ours. I just wished they'd warned me. Or asked me.

Universal Language

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My daughter is leaving for Costa Rica soon, to study upper level Spanish at the University there. She is already quite fluent, as are my husband and my two sons. Realizing the importance of having a second language, we put them in an immersion program at first grade. Their skills have surpassed my husband's, who has lived in Mexico for extended periods in his life and who has relatives from Mexico. I have very limited understanding of the language, and even less spoken fluency.

So, in my travels with my family into strange lands with strange language, or when I face a deaf or demented or infant patient, I follow the advice of Allen Klein:

There are no language barriers when you are smiling.

Celebrating Celebrations

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In the past couple weeks, I have coordinated several major family celebrations. A 90th birthday for my mother-in-law. A sixty fifth birthday for my husband. A welcome home for kids who haven't been home for months. The house was full, dinners each night were huge affairs that meant hours of shopping, prep work, and cooking. Then, the entertaining. Then, the clean up.

In between, I worked. And tried to give my patients the best part of what was left of me. I took one moment at a time, one patient at a time, one meal at a time, one dirty kitchen at a time. And, today, the last person left. The Canadian relatives are home, the Mexicans relatives have returned to their distant abodes, and the out of staters drifted away later. The house is quiet. And much in need of a total cleaning; three bathrooms, five bedrooms, two refrigerators stuffed to absurdity, a neglected garden, a kitchen that, while looking clean, has sticky floors, drips on the fronts of cabinets, a stove, microwave and two ovens that are certifiably unsanitary, and one incredibly grubby carpet.

And, not surprisingly, my energy slowly ebbed over the course of the extended frivolity. And, now, I sit in my marginally habitable home, warm memories flooding me, small stains evoking small smiles. And, I am glad I came through once again for my family, and for George's family. It is for them that I do this, the all encompassing 'them', which over the years has come to mean those folks most important to me, and those important to them.

As I think about the role women have played throughout the existence of mankind, I feel a sense of connection with the ones who came before, the hunters, gatherers, the medicine practitioners, the storytellers and keepers of the secrets and traditions. Because that is what I have been doing for my family, and for George's, in the gatherings and celebrations I put together. Relationships, connectedness, tradition, heritage, all are displayed and shared and confirmed. There is reassurance in the sense of belonging that these gatherings engender.

So, exhausted as I am, I draw sustenance from having been a part of a larger milieu, that of our history and heritage. I'm not sure that the participants were aware of anything beyond the good food, great local wines and beer, good company and laughter. But, they were. And are. All part of the greater aspect of being a family, of being human.