SkyWatch Friday

Last weekend I was hiking on the Wild Pacific Trail. This is an amazing trail with some beautiful scenery. People from all over the world come here just to take in the sights. Renowned Actors and musicians have homes in this area and I can see why.

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When have policies gone to far?

For most of us, our work environment is controlled by polices, procedures, and standards. In most cases these are good safe guards ensuring safe practise is followed. Certainly you want to make sure that the person who is starting your IV or drawing your blood knows what they are doing and that their practise is guided by standards, policies and procedures. There is a certain comfort knowing that your pharmacist is dispensing your medication in a safe and accurate fashion, again based on practise, policies and standards.

There are many safe guards in place to ensure that these individuals meet certain standards and are following policies and procedures.

However, there does come a time when policies that are written and established leave you just shaking your head. Case in point, the other day I was having a casual conversation with one of my colleagues when some how the conversation got turned and twisted to us discussing undergarments. Don't ask me how we got there....we just did. We were casually chatting when another colleague walked by and my co-worker calls out "I hope you are wearing your panties under those scrubs". I giggled, I thought what the heck are your talking about. I truly thought she was making a silly comment, but truth been known there was more to this than I knew. My co-worker has an interesting sense of humour so I wasn't sure if she was joking or not so I called her on it. True enough she goes on to tell me that our employer is currently in the process of having a policy written on the wearing of undergarments!

Yes, you read that right. My employer in it's wisdom feels it necessary to have a policy in place with regards to staff wearing undergarments. Of course I was stunned by this, so I did a little investigation of my own. I contacted our nurse educator who indeed confirmed what my co- worker had told me. "Are your for real" was my response. WOW!!! So, now I am left with a couple of questions. First who is going to patrol/monitor this? How are they going to monitor this? Am I going to have to drop my scrubs to prove I am indeed wearing underwear? Is my employer now going to tell me what kind of underwear I can wear?

My employer keeps telling us they don't have money for certain projects, or extra help, or they need to cut back on supplies etc., but somehow they seem to have the funds available to waste on establishing such a policy. Am I the only one out there that thinks this is just crazy and a waste of valuable resources, time and money?

Unfortunately there are always individuals who push the dress code issue. But I question does undergarments come under a dress code policy? Personally, I don't look that closely at my colleagues to check to see if they wearing undergarments and I really don't care and or think it is any of my business. Again, how are they going to enforce this policy?

What about you, do you work in an environment where your employer has policies in place that just leave you shaking your head?

Hello again.....

Life can throw you a curve ball when you least expect it.

In June I went for my scheduled mammogram. I have gone for regular mammograms since I was 40 at my doctor's suggestion. When my sister was diagnoses with breast cancer 3 years ago I became more diligent with making sure I went for my mammogram and performed self breast examinations, something I have always felt a little goofy about doing but the alternative of not doing it is far worse.

About 10 days after my mammogram I got a call from the hospital telling me that they had booked another mammogram for me along with an ultrasound. Needless to say my antenna's went up. The following week I was in for my follow up mammogram. My little heart was pounding what seemed like a thousand beats a minute. I arrive at the hospital(the hospital I work at) and speak with the technician who will being doing the mammogram, she told me there were some abnormalities that had shown up on the other mammogram and that they wanted to get a better look. She took numerous pictures, she went out and spoke with the radiologist and came back and said I was all done and that they would be in touch.

The following week I had my ultrasound. Again I was nervous as all get out. The sonographer was very professional and explained what she was doing, the ultrasound took maybe 25mins. and then I was on my way home to wait patiently for some word as to what was going on.

My doctor called and I went in for the results. Turns out I had 4 cm. area about the size of a walnut that I had what they called "micro calcification in clusters" the radiologist comments where that they were suspicious of "lobular carcinoma". It was suggested that I have what they call aSterostatic biopsy. Needless to say my antenna's went up even further, and I am sure my doctor could see it in the expression on my face. She said she would arrange to have the test done. I wait patiently. I get another call from my doctor's office to tell me that it has to be a surgeon who makes the referral for the test so now I have to wait to get in to see the surgeon. Another week passes. I saw the surgeon on the Friday. He said he was going to have the request for biopsy faxed to the hospital that day. He was going away for 3 weeks. Urgh!!!

Remember I said I work at the hospital. Well I was going to work that afternoon after seeing him, so being curious I went to see if they received the requisition from his office. They hadn't. I'd have to wait until Monday to find out. Monday comes around and still they haven't received the fax. Well his office is now closed for 3 weeks where could it be. I checked again on Tuesday the clerks in the booking department were great and they put me right through to the person who arranges these biopsies. I spoke to her, she was very apologetic and stated that she still hadn't received anything. She put me on hold a few times...then she came back to me and said...you know I don't have it, but I will book you in anyhow....I couldn't thank her enough, 10 days later I was in having the procedure done, and what a procedure.

Mammograms at the best of times can be uncomfortable especially for those of us who are shall we say are well endowed. The procedure requires that you lay on a table on your side while they try and place your breast on the screen so they can take pictures to find the best place to obtain the biopsy. As most of you know 18 months ago I had open heart and well my chest is still tender thus making it difficult to lay on my side for any length of time. But I persevered, I wanted them to get the best pictures possible. After about 1hour they were happy with the pictures. The radiologist came in and explained what he was going to do and proceeded to freeze my breast and then insert what sounded and felt like a drill in my breast. He wasn't happy with the first 2 samples so he asked if he could do it again. Of course! Would there be any doubt that I wouldn't want you to get the best samples possible. Go for it doc!! The next biopsy he tells me he got good samples....why thanks doc. They patch me up and put the cutesiest little self sticking ice pack on my boob....ahhhhh.

So now the really hurry up and wait game begins. It took 10 days for me to get the results....and it turns out that it was benign. Whew!!!!!!!! Almost 2 months had passed for me to get that news. I actually got the good news on my deceased mother's birthday August 9th. I swear she was looking out for me.

Now more than ever I will be diligent with my self breast examinations and regular mammograms. So ladies, please please do yourself a favour and get checked regularly.

Crossroads...........

She sits there, lights are flashing, the bells are ringing...she looks left...then right...then left again.....she decides to make a dash for it......

I feel like that is my life right now. The lights are flashing....bells are ringing. Something is pulling me in a direction that is forgein to me I'm scared and yet I want to explore this feeling that keeps tugging at me.

I love nursing, not doubt about it. There are so many things that I enjoy about nursing. Teaching and working with patients and their families rates at the top of my list for reasons I love nursing. I have always felt so privileged to be able to enter into their lives if only for a brief moment.

One of the wonderful things about nursing and what it provides, is that not only does it

allow you those opportunities that I mentioned, it affords you flexibly which allows you to explore other avenues.

I am at a crossroad in my life. I have nursed in a variety of environments from Medical/Surgical to Palliative care to ICU and ER and now currently I am working in the Recovery room.
My crossroads is that I feel I could be doing more. I know that one of my better qualities is that I love to teach. I love to work with patients and their families in promoting health. Where I live now I am surrounded by rural communities where their only access to health care comes from the solo nurse in the community. I'm not sure that I am ready to go it solo...but I am most certainly ready and eager to explore the role of a rural nurse in a health centre.

Nursing provides opportunities for autonomy and in my opinion there is no place other than rural nursing where you truly get to experience the true meaning of autonomy.

Working in the hospital environment and being an employee of the Health Authority provides me with a certain sense of security with regards to benefits, but the politics in the environment at times weights heavily and can become a distraction in providing the care that you want to provide for your patients.

I enjoy rural communities and what it provides me. I love the serenity and peacefulness it brings me. I love the concept of not having to rush hither and yon and being able to do things at a more leisurely pace. Yes I think rural life style would suit me just fine.

I have an opportunity to explore this and can do it on a contract basis...it seems like a win situation to me so I am not sure where the hesitation is coming from. Oh the things I need to ponder what to do what to do?

SkyWatch Friday

Ucluelet British Columbia. Heading out to sea to go fishing.....What an exhilarating experience!

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The Graduate

Seventeen years ago....I remember it like it was yesterday. Joe Carter of the Toronto Blue Jays hit a home run down the third base line and won the World Series. The 1992 World Series was the first Series ever with games played outside the USA. It pitted Toronto Blue Jays against Atlanta Braves. Pretty impressive right. Well don't get me wrong but the only reason I remember that Series was because I was in labour with my third child. That was one of the longest days of my life.

Now 17 years later that little baby has graduated from High School. Oh how time flies. School never came easy for my Roisin. She worked extremely hard. Roisin has Dyslexia.With her being my third child I knew something was wrong right from the get go. Roisin didn't know her ABC's before she started school, she wasn't able to spell her name and the letters she managed to print were often mixed up or backwards. Having educators in my family I used them as a resource. Part of the problem with Dyslexia is that the individual does not have an understanding of Phonemic awareness. It was such a struggle to get the school on side and have her tested. After many discussions with the school and frustrating homework nights Roisin was finally diagnosed with Dyslexia. At first she was getting a fair amount of resources from the school district but then that dwindled and we picked up the slack by getting her a tutor 4 days a week. That poor child would do about 10 hours of school work a day and progress was minimal. Her self esteem was dwindling and she was getting so frustrated. Her father and I finally took her out of the public school system and sent her to a school that was specialized in working with children who had Dyslexia. Roisin blossomed, it was an amazing transformation. By the time she graduated from elementary school she was able to stand up and give a speech that she wrote herself and recite it in front of a packed gymnasium of over 200 people. Needless to say her father and I couldn't have been prouder.

She carried this attitude on into high school. She worked hard, and because of her designation of learning disabled she was provided resources in High School. She fully participated in the school activities, like cheer leading, running clubs, gymnastics, and student advisor/mentor. She made the honour roll many times. She has been a very determined child and times when she wanted to give up she some how found the strength to push forward.

Roisin graduated from High School this past May and is enrolled in a Fine Arts Program at College come the fall. I couldn't be more proud of my baby girl. Through her struggles she has been my teacher and hero. We can learn so much through our children if we just take the time and to watch and listen and to be their advocate when we can.

SkyWatch Friday

This photo is was taken while we were walking the Wild Coast Trail in Ucluelet

We had been in Tofino, and hubby decided that we should go up in a plane to view some whales from an aerial perspective....well we didn't see any whales that day, but we got some wonderful photos...but seeing as this is a "Skywatch" post here a couple of photos we have of sky rather than the rugged coast line.

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A different take on Prom.....

The school year is coming to a close and with that, anyone who has a child in Grade 12, by now is exhausted from all the graduation festivities.

I was reading in our local paper yesterday about a "special prom", or should I say "Gay Proms". According to this article, gay, lesbian, bisexual and transgender(GLBT) students were feeling discriminated against as they felt they couldn't go to their own proms. Some they say fear harassment. Others say they were told by their schools that they could not attend with a same sex date. According to the article there is legislation stating that GLBT have a legal right to bring a same sex date to prom or other school events. However many school districts ignore this legislation and won't allow same sex couples to prom. So what to do? Apparently now there are organizations and youth groups that support a separate GLBT prom.

The article titled these proms as Rainbow Prom. The participants of these proms say they really enjoy them and it provides them with an arena where they can be themselves. The author of the article interviewed a young student of 15 who will be attending his second prom this year.

I like to think of myself as open minded,liberal and that everyone has a right to freedom of speech and personal expression(as long as it doesn't hurt someone else I might add). With that being said this "Rainbow prom" just pushes the envelope for me.

High School is never easy. Students can be cruel I don't accept that, but unfortunately it does happen. Teenagers seem to fear people or things that are out of the norm for them, it pushes their personal comfort zone, and challenges them to think socially and responsibly. Some students excel in this others don't, and hence I gather the need for separate proms.

I can't help but wonder though that while the GLBT group want to be inclusive they also want to be separate. They don't want to be singled out and want the same rights as others and yet they feel it necessary to have their own prom. If they just want to be accepted and included why is it that they find the need to hold separate proms? And what about the 15 year old student who is attending the "Rainbow prom" for the SECOND time? What's up with that? As far as I know high school graduation happens once..not twice...and most certainly not when you are 15. So I ask you, is it truly a prom that these youths' are looking for or is it just an arena where they can hang out with similar minded people and genders? I don't know. It makes me wonder if they don't discriminate against themselves and the so called "straight group".

Most school districts have youth support groups and are far more open and accepting to GLBT individuals. I know that one of my daughters best friends during high school was gay and they had a great time and she never questioned his sexuality, she just loved his flamboyant bubbly personality.

High school can be a hard and cruel environment, a school of hard knocks, but I can't help but wonder if GLBT don't set themselves up by signally themselves out having their own prom.

This certainly gives me food for thought....what do you think?

Happy Father's Day!

Wow where has time gone. Here we are 3rd week of June last day of Spring and it is Father's Day.

Sadly to say my father passed away 22 years ago, I was only 28 when he passed. I felt like I was just getting to know him when he was taken from me.

He never had the opportunity to meet two of my children, he never knew me as a registered nurse. He never saw his grand-daughters graduate or his daughter overcome some of her fears. What he did see was a young lady bound and determined to make her mark in life. He had the opportunity to teach her how to tie a proper slip knot and a passion for the water. He instilled in her social responsibilities, and demonstrate along the way how to be charitable and give from the heart. He taught and demonstrated the love and passion for tradition and family. He set boundaries and curfews and was quick to punish when boundaries and curfews were crossed but just as quick to give a warm and welcoming hug.

He was a man of strong convictions and stubborn at times to his own detriment. He showed me how to raise above adversity and to be proud.

I often wonder what he would think of me now......thank you dad


Happy Father's Day to all you dad's out there!

SkyWatch Friday

These pictures were taken one evening last summer when we were just coming in from picking up our prawn traps.

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The cost of security.....

The Olympics are long over....the cost of security for that event originally was estimated at $400 million dollars. It went a tad over budget.... $1 billion dollars!!!! And who foots the bill.....taxpayers. Now having family members who were involved in the security and knowing what they did....I don't know who got the money cause they didn't. Well most of them didn't.

Now Canada is hosting the G8 and G20 Summit in June. The original estimate for this 4 day event ..... "The costs were original estimated at 179 million Canadian dollars, but an additional 654 million Canadian dollars was requested Tuesday, for a total of 833 million Canadian dollars (780 million US)." I am not sure how they can justify a $654 million dollar increase? Isn't there something wrong with that? Who does their budgeting? That person or persons should lose their jobs instantly! I realize that it is not the 4 day event itself where the costs are incurred, it's the whole preparation for such an event. However, come on a $654 million over budget give me a break!

I ask you, if you were to run your household budget like that you wouldn't have a home now would you. The banks and collectors would take everything you had and then some. Your credit rating would plummet. So why is it ok for our government to so poorly plan and estimate expenditures and then expect by just a stroke of a pen they will get the funds they need or want?

It's just not right. I think someone should lose their job over this one! Yes national security is important. That is not my issue here. My issue is some high paying bureaucrat has so poorly budgeted and mismanaged the security funding for this event, and we as the tax payer have to foot the bill.

This brings other points to mind. Why does there always seem to be funds available for events such as this, but we have to close schools, hospitals, and shut down public services. Our provincial government is imposing yet another tax July 1 it's called the Harmonized Sales Tax or HST for short. I wonder who came up with that name. I mean really "Harmonized" what that heck is that? There is nothing "Harmonious" about another tax. This tax was suppose to replace a provincial tax....well guess what....I just got a bill yesterday and they charged me the PST, GST and the HST(which as I said doesn't come into effect until July 1st). So I am paying more taxes while my government is cutting services all over the place.

Back to the over budget security costs for the G8 and G20 Summit in Toronto. Who is being held accountable, why is this allowed to happen? If I saw one positive thing come out of these summits I would support them 100%. But nothing ever does. It's just a bunch of highly overpaid suits rubbing elbows smiling and shaking hands, and enjoying high end meals and sipping on fancy wines and libations.

Yup it just all seems so odd to me. I pay my taxes, I work hard and and I get penalized by being effiecient with my funds while the government can go over budget and no one ever holds them accountable.....Things that make you go Hmmmmmm.

Last Weekend....

Last weekend I had the wonderful opportunity to visit my family on the mainland. It was a busy weekend full of family gatherings and a very special appointment.

The family gatherings first. My sister's daughter became engaged last fall to a wonderful man. Since the engagement there have been engagement parties and wedding showers. Last Saturday my sister had a Bon voyage party for daughter, my dear sweet niece Samantha. You see the man my niece is to marry lives in Australia and that is where they shall wed and reside. My sister although extremely happy for her daughter is saddened that her only child is moving so far away. As many of us as possible will travel down under for the celebration which is to take place in February 2011, but it just won't be the same around here without our dear sweet Samantha.

Samantha will be the first of my siblings off spring to fly the coupe so to speak. We have always been a very close knit family. I have often been amazed that with a family the size of ours that no one has moved away. Well that is not exactly true, I have a brother who lived 4000km away for about 20 years, but even he has now moved back to BC with his family. My camera wasn't cooperating with me that evening, so this picture I got from my sister's Facebook.


It was a lovely party and I wish my niece the happy bride to be a wonderful and joyful life with her fiancee.

Sunday as you know was Mother's Day. I started my day out with a 10km run with my eldest daughter. Yahoo! She is a fit young lady, but not a runner. She was amazed at herself for being able to just put on a pair of runners and go. After our run we met up with my middle daughter who was working and we sat and had a nice lunch. It was off then to the mall. I have been on the look out for a dress. That in itself has been a very daunting task. I wouldn't consider myself a big person, but I am not petite either. So why then is it so difficult to find a dress that fits me? I find shopping one of the most depressing experiences. When I was younger I would be able to pick my size off the rack and it would fit. Not anymore, I must have tried on at least 30 dresses if not more. I finally found one. It's ok but it's not a "Wow" factor by any means. Anyhow, I digress. We found a dress. From there we had to head back to middle daughters house. The initial plan was that they girls were going to cook for me. Well middle daughter was exhausted from work and she also had to go pick up youngest daughter. So I opted to cook the dinner, they did the clean up. We had a nice time and they spoilt me with some lovely gifts.

Monday came and I was off to a very important appointment with my youngest daughter. This appointment I was hoping would be her last one. At a young age of 8 my youngest daughter had been diagnosed with cancer. For the first few years post treatment we were at Children's Hospital first every month, then every 3, 6 months and then finally every year. I always dreaded May as I knew it was appointment time. Subconsciously, I know I worried about it and I would stress about it. This year was no different. We knew the routine, we would report in, get the requisition to go get xrays and then return and wait to see the specialist. You know this whole time we have always had the same specialist. He is an amazing man. Anyhow, it was our turn to see him. He came in, we chatted, and as always he asked my daughter what she had planned for her life, we told her she graduates this year and of course he asked her if she was going to follow in her mom's footsteps....and as always her response was the shrug of the shoulders and a huge smile. He then examined her, looked at the xrays and said, "how long have you been seeing me?" Our response was "10 long years" He said "well I've got some good news" this is it he said, we don't have to ever come see him again! Yup that was it, she had been cleared and given a clean bill of health and no more Dr. Brown visits. That was the best news ever. That was the best Mother's Day gift ever! I cried, I hugged Dr. Brown and even as I type this I find I am becoming a little emotional. It has been such a roller coaster ride. But finally that ride is over. Thank you!!!!!

So, we left his office holding hands hugging each other and with grins from ear to ear. My baby graduates this month and truly now has been given the go ahead to live life to it's fullest. What an awesome way to start this phase of her life!

The Importance of Good Pain Management

Ever since my days as a Palliative care nurse I have been interested in Pain Management. I was always amazed at the high doses of narcotics the palliative patients were on, and yet they were still functioning. During my time as a palliative nurse I learnt about various ways of managing pain in conjunction with narcotics.

When I went into Critical Care nursing many of my colleagues worried about administering to much narcotic for fear of putting their patient into respiratory arrest. Through my years of nursing I have seen pain management approached in many ways. Statistically they say that most patients are under medicated, and that patients don't report pain as often as they should. This under reporting and under medicating can have long term effects.

Over my nursing career I had attended many pain management seminars and it was only the last one I attended back in February that they actually talked about alternative treatments. At this particular seminar the guest speaker was talking about treatments and measurement tools that I was using over 15 years ago in Palliative care! I have been told that palliative care was and still is years ahead of other fields when it comes to pain management.

The other day I received a patient from the O.R. who just underwent a hip replacement. This woman was only 47 years old. Very young for a hip replacement. The anaesthetist was giving me report on the patient and told me that this young woman was on extremely high doses of narcotics and other medications. When she told me the amount of narcotics this young woman used my eyes widened and my chin dropped.

Many questions entered my head. Firstly, how is it that this young woman could be on such high doses of narcotics? What was her doctor thinking? Had she tried alternative ways of dealing with her pain? What strategies were in place for this woman once she got through her surgery to help her get off these high doses?

At this point you are most probably wondering what I consider high dosage....This patient starts her day with 200mg of Oxycontin and 1200mg of Gabapentin (this was originally used to treat seizure disorders but it has been found to help on neurolgic pain as well)....then around noon she has another 100mg of Oxycontin and another 1200mg of Gabapentin.....at bedtimes she has 200mg of Oxycontin and 1200mg of Gabapentin. So in a 24 hour period she is having 500mg of Oxycontin and 3600mg of Gabapentin. In additions to this she has Oxycodone for breakthrough pain!

Now I don't know about you, but I have nursed many many patients who have had hip replacement and have not required this amount of narcotic preoperative.

Having a sister who has dealt with chronic pain issues and who has also had a hip replacement I can most certainly sympathize with this individuals pain issues. The question for me is what was the doctor thinking prescribing such high doses? More times than not nowadays doctor's are recommending to their patients that they seek out physiotherapy, water therapy, message, yoga and meditation to name a few. Why wasn't the doctor suggesting that this patient be connected with a Pain Management clinic? To just continue to increase this patients dosages seems irresponsible to me.

At this point this patient is now addicted to these pain medications. This in itself presents a very difficult position for myself as a nurse as these patient tend to be very challenging when it comes to dealing with postoperative pain. Case in point. When this surgery was performed, it was performed under a spinal with a nerve block. When the patient arrived in the recovery room she was alert and in no apparent pain. After a neurovascular check it was evident that this patient had a good spinal in place. The anaesthetist had written orders for this patient to have what we call a "Patient Controlled Analgesia". PCA is a way for patient's to control their own pain medication. The theory behind PCA's is that it is believed that it provides the patients with a feeling control over their pain management and that they actively participate in their healing process. These patient often tend to do better and are discharged home sooner. The PCA is a machine which is programed with a narcotic set to deliver a certain amount of medication at certain intervals. There is a safe guard in the machine that will only deliver the drug within the given time...so the patient can push the button as much as they want...but the machine will only give the medication when programmed to do so. Most patients find this very satisfying and in fact statistically speaking patients tend to under medicate themselves when using this device.

Back to this patient. Upon her arrival it was determined that I would give the patient her afternoon dose of Oxycontin and the Gabapentin, so it would be on board when the spinal started to wear off. I also got the PCA going early and showed her how to use it. I worked with this patient for over an hour before I was finished my shift. She was using the pump relatively frequently but did not express signs of pain. Her vital signs were all stable. The next day I asked my colleague how the patient made out. Well as it turned out the patient went into a pain crisis. The anaesthetist had to come back in and provide more spinal medications and other narcotics. Unfortunately, the narcotics all caught up with her and she stopped breathing at one point. As a result she ended up in a step down surgical unit where she could be closely monitored.

This brings me back to my original question, why wasn't this woman on some form of pain management regime prior to her surgery? Why was she allowed to be on such high doses of narcotic?

It is so important to identify patients early on who might be at risk for narcotic abuse or that might require treatment for pain management. There are many things that can be done before increasing a persons pain medications, and there are many tools available to health care practitioner to asses their patient for possible narcotic abuse.

Pain management is so important and "good" pain management benefits everyone in the long run.

Changes

They say change is inevitable. I would agree. I look back over what I would still consider my short life and I can't believe all the changes that have taken place. Technology being on the top.

When I was in High School, we didn't even have computers. I learnt to type on an old manual typewriter which looked very similar to this one here......

I got up to 45 words per minute on that thing. Unfortunately, I didn't concentrate enough on the numbers row and to this day I have to look at the keyboard for the numbers.

I remember after I graduated I was going to go to college and become a Legal Assistant. Well that all fell by the wayside as I got employment with the Federal Government doing a clerical position. I got that job primarily because of my typing skills and well I think the female manager who hired me liked my story about my brother who has Down's Syndrome. I digress.

I worked for the Government for 10 years. During that time I saw amazing changes. Facsimiles machines had this rolled paper that you had to fit into the machine when a call was coming through...we all know what they look like now...compact and you just dial and send that's it. Back to the typewriters.....during my years in the office I saw the typewriter change dramatically, to the electronic....then the ones that had the mini screens and memory banks...and then yes the computer.

My colleagues at work marvel at how quickly I can type....most of them went straight to nursing school and didn't have to have typing skills. But now days you have to be able to have some command of typing or you won't survive.

Change is inevitable that is for certain. The manual typewriter to the computer. What about computer games. Now I never was one that was very big on computer games, but do you remember Pong? That was that game where the ball went from one side of the line to the other. You could adjust the speed with a dial. I can remember one Christmas when my parents bought that for the family. We had family Pong tournaments. It seems so funny now when I think back on those days.

Look at what I call our implements of torture. Our housecleaning products. The vacuum for instance.....
Here's an old Hoover.....and look at what you can get today...


this nice robotic vacuum. My goodness how things change. I could go on but I won't. I just wanted to demonstrate how significantly things have changed in our life time.

Just as technology changes, so does the workforce and how we perform our work in that environment. For the past ten years as nurses we have been told that we will be going to electronic charting. I know it has happened in many areas, but not in the province that I practise. It's interesting and mind boggling how things can be so different from even fromone health authority to another all in the same province. Case in point....when I left the mainland we were already inputting lab work and tests etc electronically. The only time we used a requisition was if the computers went down. Six years later working in my small town, we still do paper requisitions. The results however, are provided via the computer. So not only do you have to have typing skills to acess the information but you need a basic understanding of computers in order to retrieve the information you are looking for. I personally don't have an issue with that....but I know nurses who are just 5 years older than me have difficulties with the computers. Most of their nursing career was performed in a completely different work environment. These nurse who are now only a few years away from retirement are having to learn all this new technology. They have no choice. In order for them to maintain their practice they are forced to change their ways and learn a different way of doing things.

This doesn't seem to be such a challenge for the younger nurses. They grew up on computers and electronic mail and such. But nurses in their late 50's early 60's not so much. That in itself presents some major obstacles for some nurses. Our senior nurses bring so much to the nursing environment it seems a shame to lose them because they can't keep up with the techonology. Of course when it comes to direct patient care you need to stay current. But learning data entry and things like that seem a little over the top for me.

I embrace change. What I don't embrace is when the technology it being crammed down my throat. I believe that is what some of the more senior nurses are feeling. They were still able to care for a critically ill patient without all the gadgets. Sometimes I think we do ourselves a disservice and put to much faith in technology. We need to remember the basics...look at the patient...how are they responding to the treatment....do the numbers reflect what I see and if not then why not.

Yes change is inevitable. What I find to be very important when change is about to occur is to include your staff. Let your staff become change agents. If employers are set on change they can be proactive and make it a positive thing for everyone.

What changes do you find you are faced with? Do you wish you had some consultation before the change occurred?

Food for thought....don't you think?

SkyWatch Friday

I love sunrises....this is another series of the sunrise, the view is from my back yard....I was in awe of what looked like some kind of sphere in the sky.....

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Let's talk hormones.....

Ok....we have all know or heard about Premenopausal Syndrome(PMS) and it's symptoms. Those of us in our 40's and generally in our 50's have heard of Menopause. I think even our male counter parts have heard of both of these medical terms. However, rather than trying to do their research to understand this syndrome and change in life, they tend to tease the female gender about their symptoms....and comedians make a fortune off of our natural and uncontrolled hormonal changes.

I remember years ago talking with my sisters about male menopause. Yes male menopause, this is not a medical diagnosis but I and my sisters were convinced that our male counter parts experience a form of menopause.

Well I can tell you I was nothing but surprised when I saw an ad on the TV the other night about TRT(Testosterone Therapy Replacement) for men. Then the following evening what should I come upon but an article in the March edition of Reader's Digest about Testosterone and men. Of course the article didn't have a catchy title as it would have had it been directed at women... it was titled "Can Testosterone Restore the Aging Male". Needless to say my curiosity was piqued and I had to read on.

According to research Testosterone levels decline gradually with age, according to this article they say it declines One percent a year after men reach the age of 40. At 70 they say that men have about half of what they had in their 30's. It goes on to say that with less testosterone , sexual function and motivation decrease, muscle mass shrinks, fat deposits grow, bones lose density and are more susceptible to breakage, and the risk of developing Type 2 diabetes rises.




Well fancy that. Doesn't that sound familiar ladies. Surprise Surprise.....men do go through a hormonal change.....wow!!! And they thought it was only women.....or of course our male counterparts wanted us to continue to believe it was only women who went through a change. Well wouldn't you know it...science comes along and poof men now are faced with very similar hormonal issues as us women.

I don't believe this to be earth shattering news. I think us women had our suspicions about this all along...but our male counterparts were to afraid to let this news go public!! . Well the word is out now gentlemen and you are now just as susceptible to humiliating taunting and teasing as us females have had to endure for so many years. Of course, science and the pharmaceutical companies have to capitalize on this and true to form they have come out with a pill(hormones) men can take to replenish the decrease in testosterone....why fancy that...Ladies, now doesn't that sound alot like the female version of HRT??? Hmmmmmmm. Ok, maybe I am being a little cynical about this, but all these years men have teased and taunted us women for our hormonal changes and blamed us and our moods for relationship issues. Well guess what men.....we now have TRT to throw right back at you.

Another thing I found interesting about this subject is that from a pharmaceutical perspective they market their products as a cure for decreased libido...and their focus was to improve the male sexual drive. Again, it makes me wonder who is marketing this drug...and why are they only looking at one component. I think I know why.....do you? I think it's because sex sells. Doesn't matter what it is...if it is sex related it sells, and they even glamourize it by titling a movie by it. With men so focused on their libido and performance, they forget about the other part of them that makes them attractive to their female counterparts....that is their brain.




If you are interested in learning more you can always google the topic Testosterone Replacement Therapy.....or check out the March 2010 issue of Reader's Digest for more on this topic.

Addictions......

I think we all know someone who either has an addictive personality or is addicted to a habit forming substance. Merriam-Webster defines Addiction as:

1 : the quality or state of being addicted
2 : compulsive need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal; broadly : persistent compulsive use of a substance known by the user to be harmful

Addicted: 1 : to devote or surrender (oneself) to something habitually or obsessively ed to gambling>
2 : to cause addiction to a substance in (a person or animal)

There are many kinds of addictions. Jesse James, Tiger Woods and Clinton with their sex addiciton. All addictions are destructive, and disruptive in one way or another.

As a nurse I have seen my share of patients who have abused their bodies with the vast number of habit forming substances. I can't tell you how many patients I have nursed that have come through the ER doors and end up in ICU. These patients are usually on ventilators as a result of drug overdoses or as a result of their bodies being so abused from these substances, that it can no longer fight off the aliments that have bombarded their bodies.

We talk about the impact these substances have on the individual and the health care costs that are expended to treat addicted individuals. What we don't often openly talk about is the impact these addictions have on the people around the addict.

Let's just think about this for a moment. I recognize that addicts come from all walks of life. From the well to do families to the poverty stricken street person.

I use to think that circumstances played a large role in who would become an addict or had the potential to become an addict. But I am not sure of that anymore.

Again let's look at Jesse James and Tiger Woods for example. They have a huge support network. They have caring loving and supportive families, church networks, and even fellow workers. Yet their addiction controls them and almost destroyed them and their careers.

Addicts start to isolate themselves or only associate with people of like mind. The addicts with a stronger constitution somehow manage to maintain their social network, but for how long? They make themselves an outcast. They slowly remove themselves from the social network that is trying to support them. The families become overwhelmed by the addicts behaviours and feel lost, betrayed and even isolated as they feel they are the only families going through this. Some feel embarassed to let others know that they have a family memeber who is an addict. Addiction not only affects the addict but the family around them. Addiction is like a wildfire consuming and destorying everything in it's path.

Sometimes I wish I could get into the mind of an addict. What draws them to their demon. The demon that robs them of living their life to the fullest. The demon that makes relationships challenging. The demon that causes them to have extreme mood swings, and finally the demon who robs them of their physical health.

If genetics play a role then why do some family members become so inflicted when others are not? Science is helping us understand the chemical changes that occur in the brain as a result of substance abuse. Science is also investigating and helping us understand why some people have the addictive behaviours they display.

Unfortunately there is no cure for addiction. Drugs can help control cravings or behaviours, but they won't cure it. The only cure....is abstinence. A complete cessation of the demon that holds the addict hostage. Some folks have found AA to be of great assistance, others go to rehab programs or seek counselling. Some programs attempt to help the addict find the root of their addiction and teach them life skills. Ultimately...it's all about "you" the addict. What do you want? Do you want to beat the demon....can you find the internal fortitude needed to wake up each day and tell yourself "today I am not going to......."

We can point the finger for the causes of addiction. The legally advertised cigarettes with their carcinogenic addictive properties or the alcohol companies with their tantalizing spirits to the drug lords and politicians and their ill intended policies. But ultimately, don't we as individual have to take some responsibility for our own behaviours and choices regardless of our socioeconomic environment?

SkyWatch Friday

These photos were taken last summer. We had just finished going out and picking up our crab and prawn traps. What a glorious evening it was!

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Sky Watch Friday

These photos were taken last month looking East towards the mainland(Vancouver).....a storm was brewing......

If you would like to join in on the fun please check out.....SkyWatch Friday

Tradition

Tradition.....you know the problem with tradition....it's just that...it's a tradition. It's one of those things that conjures up both good, happy fond memories, along with sad memories. Traditions as much as I love them... cause me angst.

I was raised in a family full of traditions. Tea and crumpets on Sunday afternoon, special dinner items only cooked for special occasions like Easter, Thanksgiving or Christmas. Halloween and the bon fire and fireworks with the neighbours. Getting our new Easter and Christmas outfits. Regular visitors we would have for the holiday celebrations.

Then there were the Birthday's. Rule number one....if you were the birthday person you didn't have to do any chores .....Rule number two....you got to sit at the head of the table in Dad's chair for dinner. Rule number three there would always be jello, ice cream and cake for dessert! It was your day!

I grew up on so many traditions I never realized that traditions were in the making until I started repeating them when I was raising my own family, at which point I found myself starting some of my own traditions. For my girls for their 16th birthday I would have a huge family gathering I would rent a hall and decorate it to the nines, music food and dancing. I also made a big deal for the Prom night....I always had their friends over....I'd make appetizers, and have bubbly for the graduates....they would have the limo pick them up at our house....I felt so privileged to be able to share this with my girls and their friends.

My girls call me the queen of festive decorating. From fall to summer I would have the house decorated for the season. When the girls were little I would take them to the park and we would pick up leaves bring them home...I would iron them between wax paper then cut them into shapes and put them on the windows....they soon began to expect the house to be decorated...and if I hadn't started the decorating for an occasion they would tease me.

Another tradition was at Christmas...when my girls were little and two of my older sisters had smaller children as well. My sister Eileen would have all the children over and we would make gingerbread houses. Eileen would have made all of the gingerbread pieces from scratch for the houses...it was the best gingerbread I have ever tasted. I know my girls could hardly wait to go to Aunty Eileen's. At Christmas when my youngest was about three I started a tradition of reading them the book Polar Express. It is now compulsory to them that this story be read every Christmas Eve...my eldest is now 24 and she still expects to hear it.

So where is the problem with all of that? Well sad but true time marches on....people we have loved and who have been such an intricate part of our lives have passed away and with their loss some of those traditions have gone, and are now only memories.

As much as I love spring...it is also a difficult time for me. My father, my sister and my niece all passed away in March and April. Then along comes September and the fall and I think of my mom who passed away. Losing more traditions and thus making more memories.

So my problem with traditions is that they bring fond memories but also sad ones. This past Easter I was spending it with my stepsons and my hubby's family. My girls were with their father and my family. My sister hosted Easter dinner for 28 people. Her husband had sent out a request to all who were attending asking them to make a little presentation. Well apparently it was a great success. My girls grandparents who are 84 and 85 years old performed a song. Grandpa played the harmonic while grandma sang Springtime in the Rockies....I am told there was not a dry eye in the house. It just so happened that I called my sister's place to wish everyone a happy Easter at the same time these festivities were taking place...they put me on the speaker phone and I ended up reciting the St. Francis of Assisi poem I had posted on my blog....but rather than read it...I sang it as I was taught in elementary school. Ah....yes more memories in the making. I just wonder if brother in law is now going to make this an Easter tradition?

Here's to tradition and memories. Although they cause me angst I treasure each and everyone of them!