Justice

Last night, having decided to stay in my apartment and out of the cold, I plopped down on the couch and turned on the boob tube.  The first thing I saw was an intro for the stories that would be featured on 20/20.  One of the stories was the plight of Amanda Knox, an American college student who - along with her boyfriend Raffaele Sollecito - was convicted of murdering her British roommate, Meredith Kercher, in Perugia, Italy.  Between the stress from work and from the holiday season, I have been avoiding watching the news. Actually, I flip it on to listen for the traffic and weather during the week, but after that I tune out or turn it off.  This time I left it on and what I heard was unbelievable.

Now I know better than to buy into everything I watch on television, but I also realize that there are elements of truth in those news stories.  After the feature was over, I googled "Amanda Knox" and was bombarded with the different links.

Hmmmm...  Where do I begin?

After spending an hour or two on the world wide web, I wasn't sure what to think.  It's hard to decipher truth from spin.  I attempted to channel the spirits of my former political science and communications professors at DePaul who taught me to be more suspicious of the media.  Examining the coverage and looking for the truth was like trying to trim the fat out of a pork roast before you cook it --- time consuming and there will always be some left after all your efforts.

Sigh.

So what did I learn?

• Many Europeans have negative stereotypes of Americans; many Americans have negative stereotypes of Europeans.
• The European and American media continue to feed the ideas we have of each other.  Thanks a lot.
• The justice system standards in Italy are different than what we have here in the U.S.  Jury selection, preventing jury from being exposed to news coverage, evidence requirements, etc.
• It is everyone's desire to punish the person(s) responsible for the horrific slaying of Meredith Kercher.
• It is possible that two innocent people will spend 26 years in an Italian prison.

I realize that this is an oversimplification of the situation, but it is an attempt to make sense out of the dizzying details.  Take a look at the stories online, watch it on TV,  consider the spin, and see what you conclude.  I don't know if it would be any different.

As an observer so far removed from the situation, I don't think justice has been served.  Maybe I've been watching too much CSI or Bones or reading too many Patricia Cornwell books, but I think the prosecutor needs more evidence to convict Amanda and Raffaele.  It should be more than just having a questionable reputation created by the media.

At one time or another, we have all been victims of gossip.  Out of jealousy or fear, people make a judgment about you and then they do a horrible thing --- they sell the idea to anyone who will listen.  They don't stop to explore the root of their issues with you.  They form an opinion and start talking.  The worst part is that people DO listen.  They proliferate these negative ideas about you by passing it on, perhaps adding their own two cents.  And people listen and pass it on. And so on and so on...

Then there you are --- YOU HAVE A BAD REPUTATION.

This has happened to me a few times.  I'm friendly, easygoing, and outgoing.  I've been told I'm "cute" (although most days I don't feel that way).  Being short in stature, people tend to feel comfortable around me, sometimes enough to give me an affectionate hug or noogie on occasion.  I try to be friends with everyone.  "You attract more flies with honey," so goes the cliche.  Well, it's true.  I have enjoyed popularity in the workplace - not out of being a politician - but because I'm nice.  That's it.

When you get attention, there are some people that get jealous.  They desire the same attention.  They don't realize that they can have it too if they are just nicer and maybe smile every now and then.  Seriously, it's that easy.  Instead of putting their efforts into something positive like that or working on overcoming their insecurities, they figure that it's easier to make people turn on you by spreading rumours of your supposed ulterior motives and illicit affairs.  At one point, there were rumours of me sleeping with four different men.

Seriously???  Uh, like that could ever happen.  Who has the time?  Ha ha.  Just kidding.

So the point is that, in my opinion, the people in Italy have made the easy choice of believing Amanda is truly the monster that the European media has made her out to be.  They want to find a killer.  They have negative stereotypes of Americans.  The media has put two and two together and it all makes sense to them.  I'm pretty sure this made an impact on the jurors.

On the flip side, the American media has done a great job of touting her innocence.  It might be true; maybe not.  Who can be completely sure?  We've all seen Snapped.  Can they be accused of taking sides as well?  Sure they can.  The American people want to believe that she is innocent, after all she's one of us.

So what do I think?  After taking in the coverage from American and European news sources, then reading this inteview with novelist Doug Preston, who has personal experience with the procescutor Judge Giuliano Mignini, I think Amanda and Raffaele are innocent and that the real killer is already in jail.

Amanda's family plans on appealing the decision.  It will be interesting to see how this story unfolds. For the sake of all involved, my hope is that the truth is revealed and justice is served.

* * * * *

On a side note, here's a way to show your support for Amanda:
Amanda Knox Defense Fund

Best Quote of the Weekend

"I'm on the five-year plan to sainthood..."
-T* (said as we walked down North Avenue discussing his efforts at being a nicer person)

Taking Risks

I like to think of myself as a risk taker.

In my 20’s, I used to ride my bike to work, to run errands, to grocery shop, to my football and volleyball games, and even to the bars. I played all kinds of sports – whether or not I was good at it – touch/flag football, beach volleyball, 16” softball, floor hockey, roller hockey, and indoor/outdoor soccer. I would completely throw myself and my body into it. "Tankgirl" they called me.  My risks also included traveling to Mexico alone, moving to Dallas alone, not knowing anyone, and building a life for myself down there. Even giving up the corporate world and going back to school was a huge risk.


In recent months, however, I feel less like my old self. Where am I taking risks now? To me, risk-taking was always part of the game. What is life if I am not pushing my limits?

At this point in my life, I am hesitant to take any physical risks. If there is any possibility that I will physically hurt myself in the process, I avoid it. I’m actually kind of scared of sustaining any injury. If I can’t walk, stand for long periods of time, or lift something, I can’t work. Period. End of story. Have you ever seen an operating room nurse working while using crutches or in a cast? Nope. I suspect you never will. So guess what – I try to decrease the chances of injury.

But where does that leave me?  Feeling like a wimp...

When my boyfriend wants us to hop on our bikes and head downtown near Michigan Avenue, I feel my heart rate go up.  Pound, pound, pound...  Faster and faster...

I protest.

Do we really have to take our bikes?  Can't we just walk or take the El?  There are sooooo many tourists and SURBURBANITES down there on a Saturday!  Helloooo...  Are you nuts???  They don't know how to drive in the city let alone around people on their bikes!

My mind flashes to the weeks that have passed when I have been either the scrub nurse or circulating nurse taking care of patients that were hit either by a car or a truck as they were just trying to cross the street.  It's classified as a "Pedestrian versus Motor Vehicle."  There's no question who wins in that scenario.  And it's usually not pretty.

I hesitate to spout the gory details because I don't know if most people can handle it.  I'm not most people because I chose this profession; however, it still manages to make an impact on me.  To what extreme, I'm still learning.  I wonder if ER and OR nurses suffer from mild PTSD...

As for non-physical risks, there are still plenty that make my list.  It's probably time for me to pick one and run with it.  Should I write a book?  Start my own business?  Go back to school for my masters degree?  Go for my RNFA?
 
I'm not sure what I'm going to do, but it's time for me to do SOMETHING.  I have a feeling 2010 is going to be yet another exciting year for this City Girl.

Change of Shift --- Thanksgiving Edition

Change of Shift is up at Emergiblog, one of my favorite nurse bloggers.  If you haven't heard of Change of Shift, it's a collection of links to posts written by nurses and other healthcare professionals all over the blogosphere.  Many of you who read this blog, might not realize that there is a whole network of nurse bloggers, physician bloggers, etc. out there who keep up with each other's posts and occasionally collaborate.  It's truly amazing and a wonderful resource for the true behind-the-scenes look at healthcare.

For more healthcare blog reading, check out my sidebar where I have links to my favorites.

Enjoy!!!

Thanksgiving....Now Christmas!

Happy Belated Thanksgiving to all!  Hope you're enjoying the holiday weekend...  Thursday was such a crazy day that I never got around to posting anything.  All I could think of was getting on the road, arriving at my aunt's house safely, and enjoying the company of my family.

Now that's over, everyone else in America seems to be on either a shopping frenzy or a decorating frenzy.  Somehow I have not joined in either one.  No, I'm not a Scrooge.  I'm just trying to be sincere in everything I do for Christmas and frankly, right now I'm not feeling it.  Sigh.  What's a girl to do?  I'm not sure.

How do YOU get into the Christmas spirit?

Random Musing #2

When I bake my LargeMarj Cookies (oatmeal, chocolate chip, butterscotch chip), can people actually taste the Love in them?  They say they can, but I just don't know...  :)

Random Musing #1

Is it wrong that on the way home from picking up eggs at the local convenience store and a slice of New York style sausage pizza from 5 Boroughs, I thought to myself, "gee, I think I need to sign up for self-defense classes"???

Just wondering...

Experiments in Poetry: Charge Nurse

In a previous post, I wrote about being inspired after poetry slams at the Green Mill.  In an attempt to grow creatively, as well as find another release for the craziness of life, I have decided to experiment with writing my own poetry.

To be honest with you, I don't really know what I'm doing.  I'm used to the type of poetry that you learn to read, appreciate, and write in grade school and high school --- the kind with rules.  The stuff that has been performed at the Green Mill doesn't follow any of those parameters.  Or does it?  I can't tell.  It definitely appears that there are all kinds of rules that have been broken.  Sort of freeing, don't you think?

I suppose it doesn't matter because there are no rules to creating...  Right?

Here goes nothing...



CHARGE NURSE by Marjorie

The ER calls
We've got a multiple GSW to the abdomen
That's a GunShot Wound
In case you didn't know
Most likely we'll be coming up...
We'll be ready, I tell them
In a calm voice
Trying to hide my inexperience
My panic...
But there's no time for that.
This is only my second time
being in charge
I'm in charge?
Oh yeah...
Get it together, Girl!

My heart pounds
The trauma surgeon is already up in the OR pacing
My heart is
Pacing
With sweaty palms I dial
I call an anesthesiologist
He's gotta pump the white stuff
The right stuff
Into the 17 year old gangbanger
Who messed with the wrong person
Wrong place
Wrong time
This is all wrong
Me --- being in charge
I just got out of nursing school a year ago
Now I'm here
Alone
Doesn't management care?
Does anyone care?
I care!

Time...
How much time do we have?
Not much the ER tells me
Give me ten minutes
Ten minutes feel like three seconds...
The team is ready
The patient comes up
My heart rate goes up
No time to wait
No time for fear
They rush into the OR suite
Ready to save a life
And I...

I wait for the next call.

Think Pink

I love this video!  For you healthcare people out there, maybe it's time for your facility to join in and create your own Pink Glove production...

Weighty Issue

My job is physical.  I don't think most people realize exactly how much lifting, pushing, and pulling I do in the course of a day.  Let me explain...

When imagining the job of an operating room nurse, most people think of the scrub nurse who sets up the sterile instruments and passes it to the surgeon.  They even picture the typical TV drama scene where a nurse wipes the sweat off of a surgeon's forehead during an operation.  That happens on rare occasion (especially in a pediatric case), however, there's so much more to it than that.  There is the role of the non-sterile nurse, a.k.a. the "circulating nurse" or the "circulator."

What does a Circulating Nurse do?

Here's a typical beginning of the day routine for the circulating nurse:

1. Check the schedule and see what's on tap for the day.
2. Go to my assigned operating suite.
3. Make sure that I have the proper equipment necessary for the first case (right bed, positioning equipment, prep tray (to clean the surgical site), padding (if necessary), suction tubing for the anesthesiologist, etc.).
4. Make sure that I have the necessary medications (local anesthetic, 0.9% saline for irrigation, etc.) and blood products (if necessary).
5. Help my scrub nurse/surgical tech open sterile trays and supplies.
6. Go to holding area/day surgical area to pick up my patient.
7. Conduct pre-operative interview/assessment with patient and answer questions for patient and family.
8. Bring patient to operating room.
9. Help patient move to operating table.
10. Provide warm blankets to patient and apply safety strap.
11. Help anesthesiologist apply blood pressure cuff and monitors.
12. If patient will have spinal anesthesia, circulating nurse supports front of patient while they are sitting up while anesthesiologist works on their back.
13. Help surgeon, resident, physician assistant, and anesthesiologist safely position patient for surgery.
14. Prep surgical site using betadine soap/scrub, duraprep, choloprep, or hibiclens depending on allergies and type of surgery.
15. Once prepped, help surgical team get up to the field and hook up all cords (suction, cautery, etc.)
16. During the case, get additional trays/supplies, answer pagers, do computer charting, etc.
17. At end of the case, assist in transferring patient to cart to bring to Post Anesthesia Recovery Unit.
18. Clean up the room (all bloody items in biohazard, linen gets separated, etc.).

I'm sure there's more stuff I could add, but you get the idea --- I'm busy.  If you notice there's a lot of physical stuff involved in my job.  Lifting trays with surgical instruments.  Supporting patients during a spinal.  Prepping a patient's "surgical site" can be physical depending on the type of surgery.  At the end of the case, I'm helping the surgical team move the patient back onto the cart to transport them to the Recovery Unit, plus helping put away all the dirty trays back onto a case cart that gets sent to our sterile processing department to be reprocessed.

For most services, this isn't too bad.  Unfortunately, having Orthopedics as my specialty, almost everything involved is HEAVY.  Since Orthopedics mostly involves fixing bones, you've got trays with mallets, drills, saws, knee implants, hip implants, plates and screws, and other Home Depot type stuff.  The equipment is heavy, but now it seems the patients are getting heavier too!

In the recent past, I had SEVERAL morbidly obese (over 400 lbs) patients who were getting total knee replacements or total hip replacements.  Now, I don't have anything against people who are morbidly obese;  I have friends and family members who struggle with their weight.  Honestly, I feel for them because it's not just the stigma of being "fat", it's the health problems that go with it.  They have heart problems, high blood pressure, sleep apnea, diabetes, etc.  The list goes on.

But anyway...

Take care of these patients is a real challenge.  Most of the time, I am pushing the cart alone down long hallways from the holding area to the operating suite.  I put all 120 lbs of me into the forward motion.  I feel awful because sometimes people stare.  I hope that my patient doesn't see this and I keep chattering on about the weather or something.

During induction (when we're about to put the patient under general anesthesia), I pray that their already taxed hearts can take all this.  After all, surgery is very invasive to the body.

Positioning them is a challenge because we have to make sure that the operating table can handle their weight.  Multiple hands are needed, even if you have a couple of strong people.  You really need to cover every angle for patient and staff safety.  Many times there is, how do I say this, body overflow (?) off the table, so the team has to make sure that the patient is padded adequately in order to protect the integrity of their skin and nerves.

During a knee replacement sometimes a tourniquet can't squeeze hard enough to prevent blood loss.  With hip surgery, there is no tourniquet.  The staff is always on alert to give the patient more blood if necessary.

So how do these patients end up getting this type of surgery?

Because of their weight, morbidly obese patients have put so much pressure on their joints (knees and hips) that they suffer from severe osteoarthritis which causes a lot of pain.  So what's the solution?  They have to get a joint replacement.  But guess what comes after that?  PHYSICAL THERAPY.  So these poor people have to get up and try to walk after surgery?  Yes, sirree, they do...  Physical therapy is painful enough if you're at your appropriate weight for your build, but how about if you've got more than a little extra weight?  From what I've heard from surgeons and people who have gone through it before, it is difficult to motivate some of these patients to get up and move when they have been accustomed to being sedentary prior to surgery.

I'm trying hard to make sense of this.  Why perform surgery on these patients without requiring a certain amount of weight loss?  Why perform surgery when you're not sure they will be motivated during physical therapy?  What's the solution?  How do we make life better for these patients?  Can they somehow lose the weight prior to surgery?  I realize that it's a mental battle, so I'm wondering if orthopedic surgeons could team up with psychologists to get these patients on the right track.  I don't know what the answer is...

There has been a lot of press lately about the issue of obesity in America especially with the heated discussions about healthcare reform.  I'm sure we'll be hearing more about this and perhaps maybe Americans will be more motivated to take more responsbility for their health.

It's Not Easy Being Green....er, Me

Oh, Kermie...  I love you!!!



When it feels like no one understands what you're going through
Or you've got that blue feeling that you can't seem to shake
When you're feeling so alone
Or the world has got you down
Just listen to Kermit's song...

Makes me feel better already!  :)