Caring for those who don't care

Matthew 5:7 "Blessed are the merciful, for they shall be shown mercy"

This week of nursing school has opened my eyes to an aspect of this profession that I had never considered... and I still don't know how I feel about.

As many of you know, I started clinicals this week, and my first community placement was at AIDS Vancouver Island. Leaving that evening after an afternoon spent with people who are suffering and dying, there was so much on my mind.

First a excerpt from my personal journal about my experience (edited a little so you can better understand):

I realized I had a view of those with HIV/AIDS that was both ignorant and biased. I've always seen this virus as the 'disease of homosexuals', and thinking back on it now... I'm really not sure how I got that impression. How wrong I was!

AIDS is contracted through the exchange of body fluids, such as semen, cervical or vaginal secretions, and blood. At AIDS Vancouver Island (AVI), the majority of patients have been diagnosed with AIDS due to intravenous drug use, presumably having used a needle previously used by someone HIV positive (blood to blood).

However, AIDS is also commonly contracted through any sex act where there is an exchange of bodily fluids, as well as through the placenta of a HIV positive mother to her child.

If the world was perfect, then AIDS would not exist. It is the direct result of an immoral and fallen world... a world where sexual sin and having multiple partners is not only common but even applauded. A world where husbands cheat and then infect not only their wives (who are innocent), but their future children as well. There are stories out of Africa and Asia about clinics that are so short on supplies and funding that they have to reuse needles in order to be able to immunize children and families, not realizing they are infecting hundreds of people with the disease that will kill them by extension.

So, despite the fact that HIV/AIDS is spread to a large extent by sinful acts, aren't we all sinners here? I've heard brothers and sisters in Christ say we shouldn't support research for a cure, or assist the sufferers - that AIDS is a punishment from God on these people who live so immorally. Can they really say that? Surely we are all equally as fallen, and we aren't saved by any righteousness or worthiness that we ourselves possess, but solely by the grace of God. Right? Does having contracted a disease because of an ungodly lifestyle make someone unworthy of treatment? Aren't we called to show mercy and the love of Christ to those who don't know Him? I don't know what to think. I do know that the people I met today were lovely human beings, making the most out of a horrible situation. And I know that I want to help them. I want to heal their bodies, but more than that, I want to heal their souls... or more accurately, I want my Savior to heal their souls. To fix their brokenness, to give them peace instead of evil, to give them a future and a hope (Jeremiah 29:11).

I wrote that on Tuesday. Then today I had a nursing practice class and we had the chance to talk about our different experiences in clinical this week, since we all have various placements around the city. During my turn, I spoke about my realization that as nurses we won't always be working on patients that want to get better... my example was of the addicts at AVI who come each week for their antiretroviral meds , but go right on shooting up and getting high the rest of the time. Bringing up this point led to a discussion that lasted over an hour. This same idea applies to smokers who come in for cancer treatment, go into remission, then grab a pack of smokes from the hospital gift shop on their way out the door... or an obese patient admitted for a heart attack, who then drives to the nearest McDonald's as soon as they are released.

Do these people deserve to get expensive treatments if they aren't even willing to take care of themselves? Shouldn't people who try to stay healthy take priority over those who repeatedly poison their bodies? Canadian Health Care seems to say yes.

Our teacher told a story about a friend of hers who lived up island and was a chain smoker. As a result, he required coronary bypass surgery, but the surgeon refused. He asked the patient if he would be willing to quit smoking after the surgery and when the patient said no, the doctor told him it would be a waste of time to perform an operation on someone who would just reverse it all in a matter of months. He never got the surgery. Now he's dead. This is allowed in Canada.

And it happens much more often than you would think. Alcoholics are repeatedly bumped to the bottom of waiting lists for liver transplants, because preference is given to those without a history of alcohol abuse, for example.

I don't know how to feel about this issue. On one hand, I do struggle to see the point of striving to save someone's life when they'll just be in the following week with the same issues. I've heard stories about alcoholics who come in weekly for kidney dialysis. It seems as though it's only fair that they be working to make changes to their lifestyle as well expecting hospital treatment (again and again).

On the other hand, I am outraged that someone, anyone, would be refused treatment and essentially left to die. It just doesn't sit right with me... and as much as I don't like that they aren't putting in an effort to change their lifestyle, I dread having to look into the face of one of these people and tell them we won't give them life-saving surgery because of the way they live their life.

The way I see it, giving them even a few more days on this earth is giving them a few more days to come to a saving faith in Christ and spend eternity praising His name.

It's definitely an tricky issue, and one that requires a lot of thought and prayer for me. However, regardless of my personal beliefs, if I work in Canada I am bound by their regulations. The nursing knowledge base teaches that everyone is worthy of care and no one should be turned away. What do you think?

Certified to SAVE LIVES

THE TALE OF MY STANDARD FIRST AID/CPR CERTIFICATION:

Before I'm able to start clinical practice next semester, I need to be certified in First Aid. Makes sense, right? So me and 2 of my girlfriends signed up to get certified this past weekend, after months of putting it off.

I'll admit I went in with a pretty bad attitude. I remember doing this course 3 years ago (expires after 3 yrs - hence me taking it again) and it being incredibly grueling... the hours dragging past. So I expected the same thing again. Instead, I ended up learning SO much and actually having a lot of fun.

Three Factors Made It Bearable -->

1)Our instructor, Justin, had an amazing sense of humor. I can't stress how much a difference that makes

2)I was with friends, so we talked and joked and went to Logan's Pub for dinners afterwards because another friend from our program works there.

3)We had TONS of practice. For every hour that our instructor talked, we spent an hour practicing the skill... so out of the 16 hours of the course, 8 of those hours were spent doing the skills. This is how it worked: After a morning of Justin teaching, we had lunch then came back and broke into partners. One of the people in the pair would leave the room, and the other would stay and Justin would set them up with some kind of elaborate injury or medical emergency. He had a whole box of fake blood, skin with bones coming out of it, harmful objects, etc, etc, etc. So when the other half of the class came back into the room, the room was filled with people all suffering from various horrifying injuries, and they had to find their partner, find out what was wrong with them, and then act appropriately. It was actually kind of stressful at times, but more than anything I had a lot of fun with it.

So, this weekend I: had hypothermia, an allergic reaction to a bug bite, slit my wrists, got knocked unconscious by a piece of cement, and got second degree burns on my hands. I also saved the life of someone: having a diabetic seizure, hit my a car with their intestines hanging out, with heat stroke, with a broken leg including deadly bleeding, and suffering from a stroke.

It was like dressing up for Halloween! He painted our faces, supplied us with fancy wounds and extravagant costumes, along with imaginative, long stories about how we ended up the way we did. It was admittedly a little over-the-top... but it made it so much more enjoyable and realistic.

Afterwards, I actually feel confident in my abilities to help someone in an emergency... or for something more minor. Turned out well I think.

There was something that bothered me though. Something Justin said again and again is, "... until a health professional takes over." Now, in most 911 emergencies, it's going to be a paramedic that's first on the scene... but after the ambulance gets them to the hospital, or after the first aider drives the individual to the hospital, the care of that person will be in my hands. Unlike everyone else in the class, I can't take comfort in knowing the help is on the way and afterwards I won't have to deal with it anymore. It takes the ambulance 4-8 minutes to get there in most urban areas. Instead, I'm the one the injured person is being handed over to. That was kind of shocking to realize... but the longer I let the thought sit in my mind, the more I like the idea of it. I like that I will be trained to handle things like that, I love that I will be saving people's lives for a living. What could be better?!

Back to my old romping grounds

Today, after I dissected an eyeball in Biology, my nursing class held a health fair at a local school. Now, it was up to the students to find a place to hold the fair, and to figure out the time, etc. We called around to schools, rec centers, and other hot spots in the community... and it turned out that Lambrick Park Secondary was our best option. My old high school!

Our class of 30 broke into four teams, each with a different health focus. My group did body image, and the other groups did sexual health, drugs/alcohol, and hand washing. We spent the whole afternoon at the school, and had six grade 9 classes come to walk through our stations. It was a lot of fun, and I saw many kids I've known since they were just toddlers. It was surreal seeing them so grown up and 'cool'. I was also able to talk so some of my old teachers and share with them what I've been up to for the last couple years since I graduated.

When I first walked into the school I felt anxious and unhappy about having to be in a place I had loathed for 4 years... but upon leaving 3 hours later, I felt quite content and at peace. I'm glad we ended up at Lambrick, it was the best place for me to be. It made me remember that not everything about that place was awful... I have some good memories too :)

VIHA fails... yet again.

My nursing class is all abuzz due to a certain news article released yesterday by the Times Colonist. Read it here, then the rest of this post will make sense :).

There were a few years when I volunteered for a homeless outreach downtown called CARTS every Friday night. It was a major part of my life for such a long time and one of the best things I've ever done for myself... but also one of the most terrifying. For the most part, the people I worked with were kind and thankful and lovely, but for the few hours we spent near the needle exchange, I was always nervous of the stumbling, muttering, often violent clientele. It was during my time working there that I realized the benefit of the program on the community. The needle exchange in Victoria was closed a couple years ago, with promises of opening a better one in the near future. Now granted, the old location had turned into a pretty nasty place... but this was because of almost zero funding and lack of knowledge on how to run such a facility. The safe injection site in Vancouver's Eastside, InSite, is truly amazing! The programs they run, and advances they've made, have had an incredible impact on the Downtown Eastside, a pretty famous neighborhood for the injection drug use and prostitution in the area.

I don't know how you feel about these facilities, and I'm not even 100% sure myself. I do feel that the pros outweigh the cons... but there are still many cons.

Recently I had to write a paper on safe injection sites for my Composition class, and I was assigned the Pro point of view. I've posted it below because I think it's a fairly good argument, however I was trying to win a debate and I don't feel as strongly about the topic as the paper makes it seem. So don't hate me! haha! But PLEASE let me know what you think, and what you're stance is on this issue.

North America’s first safe injection facility, InSite, was opened in Vancouver in 2003, and was greeted by a storm of controversy. Those opposed to such sites argue forcefully that providing addicts with a place to use drugs is encouraging their behavior, and lessens the likelihood of recovery. Increasingly common diseases and infections, such as HIV/AIDS is another worry for those against these facilities. They assert that if intravenous drugs are a main cause of these health problems, then the government should not be providing users with the means to spread them. Still others fear the effect safe injection sites will have on the neighborhoods in which they are established, claiming there will be an increase in violence and crime in the area. Addicts driven by addiction will often go to extreme lengths to feed their habit. These are certainly valid concerns, however, safe injections sites have been proven to do far more good than harm. When considering the pros and cons of safe injections sites, the positive effects these facilities have on the community safety, disease risk, and recovery rate must be considered.

While those against safe injection spots hold that they are a risk to the community, these programs, in fact, do quite the opposite. In a survey of 1,082 injection drug users, 71% reported that because of safe injection sites, they were not shooting up outside, and 56% said they were no longer disposing of dirty needles unsafely (Winnipeg Free Press, 2006). We must look at the big picture. While it is true that the existence of such sites do attract users to one particular location, the negative effects on the community of an open drug scene are very much reduced. By providing a place for drug addicts to go, the rest of the area is made much safer. Addicts no longer hang out outside of local businesses, or leave their used needles in children’s playgrounds, a danger I am sure we would all like to see diminished. Also, with these junkies more localized in just one place, they are more easily monitored by health professionals who can provide help in emergencies, and by the police who are able prevent acts of violence. The provision of kits containing needles, etc, decreases the amount of crime in a given area, as users are not as likely to be forced to go to extreme lengths to get money for materials. Clearly, the result of having safe places to use drugs is having a positive effect on communities.

Along with worrying about the danger to the community, those opposed to government funded injection sites fear the spread of disease, however the reverse is true. Often lacking in money and driven by desperation, junkies will re-use needles or perform sex acts for drug money, but a safe environment providing clean equipment helps to prevent these blood borne diseases from spreading. HIV/AIDS and Hepatitis C, the diseases of most notable concern, are both transmitted through body fluids. Therefore using a needle previously used by an infected person can be deadly, as his or her blood is coming in contact with the blood of someone who is uninfected. The job of safe injection programs is to provide new needles to drug users in an attempt to prevent the spread of these sicknesses is such a manner. They also educate their clients about how diseases, such as AIDS, are spread and what they can do to prevent contracting them. Pamphlets and educational videos are available, teaching how vaginal, oral, and anal sex are all possible mediums for infection, and condoms are available for those who need them. Dr. Evan Wood, one of the chief people involved in the study mentioned above, said, “HIV rates have also come down in the drug-riddled Downtown Eastside [of Vancouver] since InSite opened. That means health-care costs have been reduced because it costs taxpayers $250,000 to treat each person infected with the virus” (Winnipeg Free Press, 2006). Drug addicts who are educated and properly equipped are much less likely to contract an infectious disease than their peers who are without such a refuge.

There are those who think providing a safe place to for addicts to use drugs is like giving them permission to continue their addiction; however the availability of health care and support in these facilities increases the probability for recovery. The study conducted by Dr. Evan Wood found that out of the 1,082 addicts surveyed, 75% claimed the safe injection facility had positively changed their injecting behavior (Winnipeg Free Press, 2006). Instead of being out on the street alone and without resources, intravenous drug users find help and support in government safe injection programs. To some, it is a beacon of hope in a desperate time. Centers for safe drug injections do not merely hand out needles, but also provide services such as free health care, counseling, and group therapy for those looking for a way out of their addiction. There is also residential treatment available, where those in recovery find safe and protected living arrangements that are substance-free. This treatment is intensive (about 28-50 days long) and is aimed at reintegrating former addicts into society. While it may be true that drug addicts find using drugs easier with a safe injection site, it is impossible for them to go there and no be offered support and help to get better. When they decided it’s time to step away from their addiction, instead of feeling hopeless and trapped, they know where to go and are provided with the means to achieve their goals. These programs will even help to find recovered addicts homes and jobs when they are ready. The encouragement and provision of these safe injection centers empowers an otherwise hopeless group of people, looked down upon by the rest of society, and gives them the ability to defeat their demons.

It seems clear that safe injection sites are affecting drug users and the communities in which they live for the better. The facilities attract addicts from the surrounding area and keep them in a more centralized location where monitoring their behavior is easier. Here they are also less likely to put others in dangerous situations by leaving their used needles in public areas or lashing out violently at passerbys when under the influence. The assistance these sites provide reduces the spread of disease by teaching practices that reduce risk of infection, as well as medical support in the event of an overdose or other emergency. In addition, the services available to addicts looking to recover are free, easily accessible, and proven to work. Due to a constant lack of funding, such centers are at risk of shutting down. In such an event, “there will be a backlash in Vancouver when we go back to the same patterns of needles in store fronts and people injecting in public in the tourist areas of Gastown that British Columbia will probably not tolerate it for that long” (Winnipeg Free Press, 2006). This is because safe injection sites have become such a necessary part of public health, providing an essential service to intravenous drug addicts, who are otherwise in a hopeless situation.

Sleep deprivation - one of the many joys of college

Due to the ridiculous amount of homework I had due today, I worked from the time I work up yesterday morning, until the time I went to bed... at 5:00 am this morning. Then I got up again at 7:00. I'm not kidding, and I'm exhausted. Except tomorrow I have to do a 30 minute presentation that I'm only half done, and the next day I have a term paper worth 50% of my final mark that's due, and I have only written 4 of the 8 pages I need. This is not to mention my Biology quiz today, Wednesday, and Friday.

Oh, the joys of a college education. This was NOT in the brochure!

I'm so burnt out, I'm ready for Christmas break :(

You know you're a great teacher when...

Two days ago, on Friday, my whole Biology class took our teacher out for lunch.

There was about 20 of us and after our lab was over at 11:30, we all hopped in each other's cars and drove down to 5th Street Bar and Grill where we spent most of the afternoon, talking and laughing. It was really lovely.

The occasion for all this? Our Biology teacher, Bill, announced last week that his cancer has returned and that he would be going into chemotherapy next week, and thus would no longer be teaching our class. When I heard this news, I was absolutely shattered, as were my classmates.

Bill has been incredible to us this semester, he is one of the most amazing teacher's I've ever had:

First of all, he us utterly brilliant.... he has a PhD in molecular biology and has written several books, he was also part of the team that discovered how a sperm propels itself. He has taught at various prestigious universities, but soon made more money than he could possibly want and retired. He and his wife moved to Victoria, and she got a job as the Head of the Nursing Department at Camosun. It wasn't long before Camosun was short staffed and asked Bill to teach a Biology class. He was growing bored at this point and accepted.

Second, building off the first point, he loves his job. He's not there out of necessity or with research as his main goal. He's there because he loves to teach and he loves the subject. When we met him on the first day of class, we all thought he was a bit crazy because of how passionate he became while talking about the internal structure of a cell (organelles, etc). But over time we grew increasingly fond of this quirky, lovable old man. His teaching style is unique and very effective, I've learnt an incredible amount from him. He's also not an evolutionist, but reminds us often that evolution is only a theory and there are other options to consider. Finally, he teaches us more than the subject matter... he'll usually spend the first half hour of class showing us new research on this or that natural remedy and what it will do. He believes in holistic and natural health, and prevention as opposed to treatment. All this I really appreciate about him.

With heavy hearts all week, knowing Bill was sick and was leaving us, we planned a farewell lunch at 5th Street, and passed around a giant card in which everyone wrote words of encouragement and love and appreciation.

Knowing all this, it's understandable that the news Bill would be with us until the end of the semester because he couldn't get into treatment was met with mixed feelings of joy and concern. He told us Friday. Joy because now we could continue to see him and learn from him daily... concern because we want him in chemo as soon as possible so he can beat this thing!

Regardless, we took him out to lunch anyways and gave him the card and a small gift. He hugged us all and talked excitedly about the material we'd be covering in the next few weeks. He seemed happy to be staying.

Afterwards, back at home, I thought about how it would feel to be a teacher in his position, and have your class take you out to say goodbye. You'd know you were doing something right... and he certainly is.

The beauty (?) of pregnancy

Part of my final mark for Nursing 132 is a 30 minute presentation on a certain age group and their health. My age group is adolescents (I picked them b/c I have a lot of experience with youth that age) but the girl's that did their presentations this morning did it on pregnancy and post-partum health.

In one of the girl's slideshows, the image above came up and every girl in the class cringed and uttered a gasp of horror. The lady is HUGE!

After the presentation was over, we all sat in a circle and had a discussion about the topics covered. Our teacher, Andrea (sweetest little thing you'll ever see) brought up the picture again and asked us a question (with her adorable Brazilian accent, in broken English, of course): "Why is this a negative thing to you? Pregnancy is a beautiful process and a miracle. It is a good thing." Afterwards, we had a big conversation about it and I think I've come to a conclusion about why that picture makes me feel slightly sick.

Partly, I think it's because I haven't been exposed to women who are late in their pregnancies often in my life, and when I have they've been covered up and 'hiding' their big bellies. Our culture as a whole isn't too interested in showing off pregnant tummies because of the emphasis on thinness. My unexposure to this sort of thing makes me view the image and see something that isn't normal. It looks... well, wrong. It shouldn't be the case, because what could be more natural and healthy than pregnancy? But still, it's how I feel.

Secondly, I think it's because I know it will happen to me. It's the realization that it really could be my stomach in that picture. And, frankly, that's terrifying. I'd like to think that when it happens my instincts will kick in, and I'll somehow summon the courage out of nowhere and find the whole process lovely......but really, right now it makes me absolutely petrified. I can't imagine having something that big inflating and moving inside of me! Granted, the woman in to above photo is most likely pregnant with triplets, or at least more than one baby (so says my teacher). That's a bit comforting. When I see the size of the bellies carrying just one child, it's seems much more manageable :P.

It feels like instead of being shocked by that image, I should be in awe of what my body is capable of doing... like, if someone's stomach got that big for any other reason, they're pretty much as good as dead. Yet... we don't die. In fact, we not only live, but we thrive. We carry an infant around inside us, and then we push it out of us.... and we survive. And we like it so much that we do it again!

I looked up some other images of pregnancy to make me feel better, and they definitely did. I'll share them. The more I think about what it is to be pregnant, the more I'm in stunned by the incredible process it is... especially studying in my Biology class what exactly happens the the woman's body pre and post-partum, and fetal development. It's more than just a baby growing, it's wonderfully complex. (Sorry if this post is a bit hard to read, I've gotten only 4 hours of sleep the last 3 nights and I have a midterm exam in an hour. The stress and exhaustion levels are high)

Midterms hit me like a brick to the head

Since I started school in September, I've been dreading these next few weeks. My first midterm is this Thursday, an anatomy and physiology test on Chapters 1-11 (including microbiology and histology which just kills me, I say if you can't see it with you're naked eye, then it doesn't exist! haha). I also have an assignment due Thursday. Then next Tuesday I have a midterm on all the skills I've learned thus far, like blood pressure, pulse, hygiene, determinants of health for every age group, etc. Following that I have a in-class essay that Wednesday, and a lab exam on the Friday (which I'm told is the hardest exam I'll ever take in my life. Great.) And every week following that one, I have at least 2 papers due a week until December 14. Gasp!

All I do is eat and sleep and study and study and study. It's incredibly grueling and I dream of a day off but don't know when I'll get it.

So, that's why you haven't heard from me lately, and that's why you probably won't again for a few days. I'll let you knowhow everything goes though, as I suffer through it.

I can NOT wait for Christmas!

an apology and an update

First off, I find that I really need to apologize for the change in format every time you look at the site. I'm really indecisive when it comes to the look of this blog, so please bear with me! Opinions welcomed. I'm liking the simpleness of this new one, the others were feeling a little cluttered.

Secondly, my class this morning! It was a couple weeks ago now that we were first introduced to blood pressure cuffs and and stethoscopes. We went over where all the major arteries lay and how to get a pulse in each of them. Then we had to practice on each other, and that wasn't so successful. The first week we found out at the very end of class that everyone had been doing it completely wrong, and the second week I knew what I was doing a little better but was still unable to ace the technique. That, along with my failure to feel an apical pulse on even myself, was getting a little frustrating. Today, in contrast, was a day of successes!

The class is 3 hours long, and we spend the first hour practicing skills. I was paired with a classmate named Vanessa and we each took a turn taking each other's blood pressure with a cuff and our fingers. Today was the first time I actually did it! It was so exciting, even though in the grand scheme of things this really wasn't that great a feat. Her blood pressure was quite low, about 115.

Then, I finally felt my apical pulse, another victory. The apical pulse is the most important pulse in the body because it is directly on the heart and thus tells us the most about how the heart is doing. It's where your doctor typically listens to your heart with that uncomfortably cold stethoscope. You know what I mean? Haha. Well, I've tried and tried in past weeks to feel it on myself. There is a really specific place to find on the chest and the directions to get there are really complicated: Find the midclavicular notch, from there slide your fingers down into the 2nd intercostal space, and over to the sternum. Then slide over again to the 3rd intercostal space and feel your way down to the 5th space. Then follow that 5th intercostal space over a bit and YOU'VE DONE IT. It's easier said that done though, especially on women because their breasts make it incredibly hard to find the spaces between the ribs (intercostal spaces). I don't even have a very large chest size, and it's still difficult... our textbook reads, "If the patient has large breasts, carefully move the left breast to one side." I guess you can't be shy in Nursing! Anyways, today I finally felt it for the first time and I was so proud of myself. We were all joking about what someone would think if they accidentally walked into our class and saw all of us with our hands down our shirts! I love this program.

To top off my day, I finally got back my paper on what health means to me that I wrote a couple weeks ago, and got 90%! I was really nervous about what my mark would be since the teacher is tough, but other than a few minor criticisms, he seemed to approve.

Other than all that... I think I'm doing pretty good. This weekend I was bitterly complaining about how much homework I had and my dad said, "Are you unhappy?" That got me thinking, and I've decided that I am most definitely happy. I LOVE this program, I LOVE my classes, I LOVE the people I get to spend my days with, I LOVE what I'm learning, I LOVE what I'm becoming... I'm just incredibly stressed out ALL the time. To me, stressed is different that unhappy.

The only other bummer right now is how tired I am. Like, I'm completely exhausted. Too much homework, too little time. This morning my alarm went off and I got up, turned it off, and... fell back asleep in bed without being conscious of it. I got woken up at 7:30 and had to run around in a panic to be ready in time. Don't worry, I made it.

Hope Thanksgiving treated you all well,

Until next time!

H1N1

The other night my dad was asking my about H1N1 and what they've said in school about the virus. Our teachers have been anticipating that we as nursing students will be getting these kinds of questions, so they actually have been briefing us with updates, which has come in useful.

During the conversation with my dad, he asked why the media is saying that H1N1 will most effect the younger population. That was one answer I didn't know... I actually hadn't even heard about that. It would make much more sense for the virus to hit people with weak immune systems the hardest, and that would be, for the most part, the elderly or older adults.

Finally, 2 days ago I learned the answer! I was so excited that I raced home right away to tell my dad after class. It was explained to me by a biochemist, so I'll do my best to make as much sense as he did. So, here is why people in their 30's and younger are more at risk of catching the H1N1 flu than those that are their senior:

H1N1 (or Human Swine Flu) is a strain of influenza that is so named because it affects pigs. It can also (obviously) affect humans however, and is a respiratory illness causing symptoms much like what you would expect with the regular flu. It has been declared a pandemic influenza virus by the World Health Organization, and we're anticipating it to hit hard this winter in Canada.

Influenza has been around for hundred of years, and during that whole time it has undergone many different genetic mutations, resulting in certain strains of the flu. This is why you can't just get a flu shot once and be covered for life! Because the next year there will be a different strain of the same virus, and you're vaccination for the year before will be ineffective, because it was designed to be effective on the specific strain of the year before.

But, like a breed of dog, influenza is a particular 'breed' of virus. And just as you can only change so much in a Black Lab before it's no longer a Black Lab, the influenza virus can only mutate in so many way before it loses it's identity. Making sense so far? Over the hundreds of years it's been around, influenza has pretty much run through the full spectrum of mutations that are possible for it to go through and still remain itself, so it's now common for strains to reappear that have been seen before. Human Swine Flu is one such strain! Interesting isn't it? Despite all the hype and fear around H1N1, it's already occurred; first in the 1950's and again in the 1970's.

So why are older adults more likely than younger people to be affected? Because it's quite likely that they were already vaccinated for this particular strain of influenza when they were just children, or teenagers, and still carry the antibodies. Cool, right?? Please note: I beg you not to read this and then think you have nothing to worry about! It's possible that you missed your flu shot the particular year it was for the H1N1 strain. Even if you didn't, a flu shot still cannot guarantee 100% success, especially after so many years have passed.

It's therefore still very important that you take precautions to keep yourself from being infected. Here are some tips to avoid contracting H1N1 or spreading it to others -->

- Wash your hands regularly with warm water and regular soap, especially after you cough or sneeze. When you can't wash your hands, use hand sanitizer.

- Cover your nose and mouth with a tissue when you cough or sneeze, throw the tissue in the trash right after you use it, and wash or sanitize your hands right away. If you dont have a tissue, cough and sneeze into your upper arm or sleeve.

- Avoid touching your eyes, nose or mouth as germs can spread that way

- If you become sick, stay home and limit contact with others.

This flu virus is mainly spread person-to-person through coughing or sneezing by people infected. People may also become infected by touching something with the H1N1 flu virus on it, such as counters or doorknobs, and then touching their eyes, nose, or mouth.

Stay healthy you guys! Thanks for reading :)

Until next time,

Brit

Strategies for improving self-esteem

Today in class we discussed self-esteem: the importance of self-esteem as a professional and encouraging it in patients.

SELF TALK- If you're having a bad hair day, tell yourself that you have beautiful eyes and lots of friends who like you anyways.

VISUALIZE- If you feel nervous before a meeting, visualize everyone in the room congratulating you on your great idea.

AVOID COMPARISONS- Focus on what you can do to enhance your own talents and abilities.

REFRAME- If you experience one failure, keep the larger picture in mind rather than focusing on that isolated incident.

DEVELOP HONEST RELATIONSHIPS- Cultivate friends in whom you can confide and who will give you honest feedback for improving your skills and abilities.

LET GO OF THE PAST- Talk yourself out of your "old tapes"; focus on ways to enhance your abilities in the future.

SEEK SUPPORT- Talk with professional counsellors who can help you identify your gifts and talents.

Watch this

Watch this is you really want to freak yourself out. We watched it in class a few weeks ago.

Upstream Thinking

It wasn't long after I started my classes that I was introduced to the term 'upstream thinking'. We were told that as nurses, we must be 'upstream thinkers' and we all nodded our heads, pretending that we knew what the instructors were talking about. Finally, my Health and Healing teacher explained the term last week, and I can now totally understand why this term is used so much. It's important!

I'll explain to you what upstream thinking is the same way our teacher taught us last week:

Imagine a flourishing little village of happy indians that live on the side of great big river. Their lives are very simple and easy. The land they live on is lush and bountiful, they hunt and gather for their food and there is never a shortage. Everyone is happy.

Then one day, as the villagers were each going about their daily activities, they heard frantic cries from the water, and they all ran to the bank of the river just in time to see a small drowning child being swept along by the current! The entire village mounted a big rescue party. Running down stream, the men were able to grab the child before he went over the edge of the water fall. Whew!

Well, after this incident, it wasn't long until the very same thing happened again a week later. All the villagers were drawn to the river bank by the frantic screaming of a little girl, unable to escape the fast water. Again, the village went after the child and were able to snatch her out of the water just in time.

Again and again each week this same event occurred. The peaceful, worry-free lives of the villagers was disturbed by desperate attempts to save children that were drowning in the river. Some of the time they were successful in their mission, but other times they heard the cries too late and the little boys and girls went tumbling over the waterfall to their deaths.

This went on for so many years that nobody in the village could remember a time when their lives were peaceful and they didn't have to worry about saving children from the river. But they never gave up, and always went after the kids in need.

Finally, one day after a failed attempt to save a small boy, one young man that was very troubled by the event sat down to think about the village's woes. Then he asked a question that no one had ever asked before:

"Where are these children coming from?"

That question caused quite a stir. No one had ever thought to try and find the source of the children! So the village formed a search party, and the group of strong men went off up river in search of the place the children came from. After many days of hiking through the rugged forest, they came to a village much like theirs and saw there that the villagers let their children play much to close to the slippery bank of the river, and that the same boys and girls were slipping and falling into the water. The men quickly sought out the chief of the village and explained the situation to him. He was shocked! For many years the children in their village had been going mysteriously missing and no one could discover where they went. The chief fixed the problem immediately and built a wall beside the slippery river side so that the children would no longer fall in.

The men returned home and delivered the good news. Everyone was happy again and the village could return to their simple, carefree lives again.

This is a long story to explain a simple truth. Nurses must be like the young man that thought to ask, "Where are the children coming from?" Instead of just treating the problems again and again and again, we have to ask, "Why is this problem occurring?" because maybe if we do, we can stop the problem before it happens. That's upstream thinking.

AN EXAMPLE:

Bobby has an infected arm.

-Why?

Because he got a cut on his arm and it got infected

-How did he get the cut?

He was playing in the junk yard and he fell on a piece of jagged scrap metal.

-Why was he playing in the junk yard?

Because it's close to his house and he and his friends go there often to play together, unattended.

-Why is there a junk yard to close to his house? Why is there no one to watch Bobby and his friends?

Bobby lives in a low income neighborhood of mostly single, working parents that are jut getting by. His mother works 2 jobs and can barely make ends meet, like the other parents in the neighborhood.

By going to the source of the problem, nurses can be advocates for change in their communities. They can see problems and raise their voices for the people that don't have a voice.

Interesting, isn't it? Does the concept make sense to you?

To know yourself

On the first day of classes, all us first year nursing students (192 of us) were gathered on the field listening to the head of the department talk about the next four years of our lives. Among other things, she said something along the lines of, "In this first year it's going to seem like all you're doing is talking about your feelings, but there's a reason for this! For the first year you have to learn how to take care of yourself, then you can learn how to take care of other people." Hearing her say that made me feel really excited. I love talking about my feelings! And I could definitely see the truth in what she said.... couldn't wait.

My first class, on my first day, was a class called Nursing Practice. I walked in a tiny bit late (with an excuse that's too long to explain here) and instead of the expected rows of desks and chairs found myself in a brightly painted burgundy room with a circle of chairs in the middle, mostly already filled by my classmates. That class was 3 hours long and how did we spend that time? That's right - talking about our feelings. There was 16 of us, and we went around in a circle and we shared about ourselves: our interests, likes/dislikes, hobbies, reasons for going into nursing. And then we talked about what we were worried or nervous about, what we were excited for, our dreams and hopes. 3 hours. Talking. It was glorious.

Then, later that same week, I went for the first time to my RP class - Relational Practice. This is an entire class devoted to the sole purpose of teaching us how to have good relationships. Our course outline says that the goal of the course is to learn to know ourselves, and ourselves in relation to others, and that our objective in the class is to become more caring people. Better people. It seems like a dream come true... and the instructor is amazing.

And so this theme has carried on through the last 2 weeks that I've been back at school. In every class we take the first 20 minutes and go around in a circle to share about how we are each feeling and what our stress level is, etc. In my RP class she asked us to tell the group what kind of weather we were that day (I said sunny with a chance of showers in the afternoon). There really is a big emphasis on being mindful of yourself and testing what you believe and digging deep down into yourself for feelings and then talking about them with the class. It's cool, and I've enjoyed it... uuuuntil..... Wednesday. Wednesday I had my Professional Practice class, which was lovely and informative, and at the end of which we were given a journalling assignment (Did I mention that we have to keep a journal? Oh yes, it's so that we can write about our feelings and express ourselves :D ). The questions we had to write about was this: Why is it important to know yourself in order to be a good nurse?

Well, this got me thinking. Sure, I've been enjoying all this me, me, me stuff but I haven't had to think about why we're doing it yet! And as I sat down tonight, with a crisp new journal page before me, I couldn't think of anything to write. And let me be clear, this is not usually a problem for me. It took me a while before I could start writing, but once I did the words just kept coming. What a relief.

Why is it important to know yourself in order to be a good nurse? For me it became easier to answer when I made this questions a bit broader. Why is it important to know yourself in order to be in any relationship? It goes back to what the head of our department said on that first day - in order to be able to take care of other people, we must first know how to take care of ourselves. I think that can apply to more than just the physical, but the emotional, social, and spiritual as well. It's hard to be in any intimate relationship when you are unstable in some way.

In the profession I'm going into, I'll be seeing a lot of, well, troublesome things.

It could be something like cardiac arrest, in which case I will have to be strong both physically (performing life-saving procedures) and emotionally (staying cool and calm in high stress and pressure situations).

Or it could be something like a terminal cancer patient making the decision to leave treatment and live their last few months in their garden at home. I may feel that they are giving up and should stay and fight with the chance the radiation therapy will work, or grieved that this person is going to die. If I am not healthy emotionally in all this, I could burn out and grow depressed, etc.

In a job where I will always (potentially) be surrounded with death and sickness and horrible things happening to good people, a spiritual health is important as well. Leaning on God as my support and trusting in His divine plan will be an invaluable comfort to be in distressing times.

How do we become 'strong' in all these ways? I think it's by getting to know ourselves by questioning our assumptions, testing our beliefs, going where things feel uncomfortable. It's after we've done all these things that we really know what it is that's important to us. When we really know who we are and we're secure in that.

Hopefully that makes sense. Don't worry, my journal entry is much more clear and concise.

My Schedule (just so you all can sympathize)

MONDAY:
Anatomy & Physiology - 8:30-10:00
English Composition - 10:00-11:30
Nursing Health and Healing - 12:30-3:30

TUESDAY:
Nursing Resource Center - 8:30-11:30
Nursing Practice - 12:30-2:30
Praxis - 2:30-4:20

WEDNESDAY:
Nursing Professional Practice - 8:30-11:30
Anatomy and Physiology - 1:00-2:30
English Composition - 4:00-5:30

THURSDAY:
Nursing Relational Practice - 8:30-11:30

FRIDAY:
Anatomy and Physiology - 8:30-11:30


Brutal, hey? And where exactly do fun and relaxation fit in? How about time for exercise or enjoyable activities? Guess not... oh well, maybe in 4 years.

A little bit of panic

So here I am, midway through the second week, and I already feel like I've been doing this forever. I'm tired, and drained emotionally... and mostly I'm just really stressed. The first week's homework just kept building over the week and climaxed with my 3 hour Biology lecture on Friday where the prof dumped 3 quizzes, a pre-lab, and a worksheet on us for the following week. My weekend was spent cooking dinner for my over-worked boyfriend and plugging away at hours of reading. Sunday night I was up until 1:00 am finishing up the Bio homework for the next morning... and that was just week #1!! It can only build from here, right? Sick.
Well, Sunday and Monday (and the beginning of Tuesday) were spent thinking my life had ended and there was simply no way anyone could keep up with the work load of 7 full-time courses. Whenever I tell fellow classmates or friends about the number of courses I'm taking they gasp in shock and shake their heads in horrified sympathy. I was grumpy and depressed and distracted. Well, I still am. But in the last day and a half I think I've managed to shift into a slightly better frame of mind. Sure, the sheer magnitude of the amount of homework I have is overwhelmingly impossible to complete... but I can only do my best, right? There's no point in obsessing over the things I can't get done as long as I'm working to the best of my ability all the time and giving it my everything (which is all I have to give, so it had better be enough). Know what I mean?
My last class today was Biology (which is by FAR my more difficult - anatomy and physiology, dont cha know)and everytime I've come out of that class previously I've felt burdened and panicked... today was different. At the beginning of class we had a vocabulary quiz for which I had studied tremendously hard and I got PERFECT! This put me in a much better mood... and then at the end of class the instructor was handing back our worksheets and he held up mine for everyone to see, praising it's detailed diagrams and excellent coverage of the topic. He did this anonymously, of course, but I knew that it was mine and that's all that mattered. I left feeling great :)

So, all this to say, that it looks like I'm going to make it. I've realized that when everyone said that Nursing school is deadly difficult, they weren't joking and I'm no exception. It's tough... really tough. But the material is so interesting, and I love the people in my program and my teachers and the whole concept of nursing. There's no doubt that nursing is for me... now it's just the work load I need to figure out.

Until next time,
Brittany