Why clinicians are not on social media

This is so true.

Dr Eric Levi

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This is a recurring question I get asked by patients, communication officers and other doctors. Why are clinicians not on social media? What are the barriers to getting clinicians on to Social media?

Many of the reasons and excuses can be summed up to these 3 F’s:

1. False understanding of the purpose of Social Media

Many clinicians think that it’s a frivolous waste of time with selfies and food photos. Others think that it’s about marketing and self-promotion. Some others think that it’s a place where patients slam you and rate you.

Those things are not the primary use of social media in health care. Social Media is my medium of education, my personal network of learning. As a surgeon, I engage with other surgeons, and clinicians who are not within my specialty. I learn lots from anaesthetists, Family Practitioners, paramedics, nurses, Speech Pathologists and other craft groups. We…

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I like wearing scrubs but…

I like wearing scrubs but not when it’s freezing outside! I have to wear sweatpants from my apartment to the garage just to make sure my legs don’t turn fire ice and break off. So icy cold.

Blizzard of 2015: Sleeping overnight at the hospital

Fortunately so far I was usually home when a storm hits. But not this time. On Sunday, the news started to spread that there was going to be 20-30 inches of snow across NYC and Long Island from Monday until Tuesday midnight. And I was scheduled for both Monday and Tuesday.

So I got myself ready… Just in case I was going to stay over. Another pair of scrubs, toothbrush, toothpaste, other toiletries, and pajamas.

I went to work Monday. Watching the news, I saw the weather get worse. I probably would make it home but my small car probably wouldn’t be able to make it back to work. My nurse manager asked if I was going to stay. I said yes– I just need a sleeping area. She said she would arrange one, don’t worry.

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After work, I went to the cafeteria. They were nice enough to give out sandwiches, cookies and water for those staying over. Many of my coworkers came in early the night before. Dedication!

I went back to my car to drop off my lunch supplies and pick up my bags. I was considering sleeping in the car but by the time I got to my car, I thought it was way too cold. I headed back inside.

When I was working the night shift, we put sleeping mats in the shower because we didn’t have anywhere else to store them. I thought that the shower was pretty useless and nobody was ever going to use it. Funny how I ended up using it that night. I just wish I brought my sandals!

I slept on a mat in the conference room. It wasn’t too bad, except that the ground was hard so I had to reposition myself every few minutes haha. I put my phone on airplane mode to conserve battery.

It was actually kinda nice not to have to travel to and from work. Extra sleep time 😃 It was nice to wake up and find out that four other nurses also stayed overnight. One patient care assistant (PCA) worked the 3-11, slept, then 7am-3pm. Another PCA did 11pm and ended at noon. Another one did 3pm-7am. Thank goodness for them!! 😀

They offered a $2.50 credit for breakfast. So that was nice.

But we started with 7 nurses when we usually work with 10 so it was a rough start to the morning. Most of us started with a triple! As the morning came, two more nurses came in so it felt a lot better.

Anyways I am glad that there was a mandate for no cars on the roads overnight so the trucks could plow most of the snow away. And I am glad that I didn’t have to drive through bad weather by staying inside.

We don’t have mandatory overnight stays so we don’t get paid to sleepover. I believe that at some other hospitals that in a state of emergency that they do this to keep enough staff on duty. Do you think that nurses should get paid to sleep overnight or during the day or that it’s a waste of money to do so? Or does short staffing cause unsafe patient situations? What is more important?

I submitted my grad school application– yes!

I finally finished my essay after several drafts so I submitted my grad school application online. It really makes you think about why you want to go into a career and forces you to be certain about what you’re going to do in the next few years.

I did share my blog in the personal statement essay. In this 21st century, I hoped that was ok. After looking at Twitter, I found that the school also had a WordPress blog. Perhaps they will see what blogging can do for someone… And help many people!

It’s been somewhat of a relief to finally be done with applying for grad school. I went to two information sessions, studied and took the GRE, took the PALS classes, studied and passed the CCRN, made sure recommendation letters are completed and in (and thanked those who’ve helped me), got my Michigan license… It’s been quite a few things to coordinate. Having a timeline helped but it’s mostly been studying, studying, studying. While I welcome the break, I know that I’m going to be itching to do something again.

My (I mean, my boyfriend’s) First Computer Built From Scratch

So building this computer from scratch was super exciting for me because I had never seen the inside of a computer. Ok, maybe I did see it once but none of it really made sense to me. In fact I thought it was terrifying because I was afraid I was going to break something.

For someone who mostly consumes technology rather than produces it, I thought it was a great learning opportunity. Plus it was a Build-It-Yourself Computer birthday gift for Dan, my boyfriend. 🙂

If you have a Microcenter close to where you live, I highly recommend going there if you’re interested in making a computer. The tech support was really helpful in making decisions and they price match with all major retailers (such as Amazon and NewEgg). One opened up in Queens, NY, driving distance from my residence.

img_0471_FotorAs you see in this photo above, there are several boxes with labels. In the green text, you will see:

These are the things that you see outside of a computer. I remember when I was younger I thought that was the computer. But alas I was wrong.

The computer is really the stuff marked in blue text.

  • CPU or the Computer Processing Unit. This is the ‘brains’ of the computer. In this case, it is the Intel i5. While it includes a fan to cool, we also bought a separate CPU Cooler.
  • Motherboard. This is literally the body of the computer and where everything attaches to make things work. It’s the MSI Z97 Gaming 5 here.
  • Graphics card or the Graphics Processing Unit (GPU). This determines how pretty and how fast the pictures are on the screen. It’s the EVGA Geforce GTX 970.
  • Power Supply. You need something to power up the computer! It’s the Corsair RM 750 here.
  • CD and DVD drive. Because a desktop computer should have at least one. It’s $15.

Now onto memory (because what’s a computer without a storage area like the human brain?):

  • RAM or Memory. We initially forgot to buy it so it is not pictured here. This is the ‘short term’ memory for the computer to run everything once the computer is turned on.
  • Solid State Drive (SSD). This is a fast access ‘long term’ memory. With no moving parts, the storage is written directly on the SSD and will less likely fail, also generating less heat and using less electricity. Many small portable laptops such as the MacBook Air uses a SSD. It’s recommended to put the Operating System (OS) such as Windows on here for faster boot up time. Here we’re using the PNY SSD 240 GB.
  • Hard Disk Drive (HDD). This is a slower than SSD access ‘long term’ memory. It involves a spinning disk where information is magnetically written on and read by an arm in the drive. It takes time to spin up the drive and access the information. This is perfect for storing movies and pictures! And we got 1TB to spare (that’s 1024 GB!!).

One of the great things about building your own computer is that it is very easy to add more memory (SSD and HDD). So let’s say in a year I run out of 1 TB. Then it’ll only cost $80 for a 2TB HDD. That’s much cheaper than having to buy another computer all together.
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In the above picture you will also see the computer case: the Fractal Define 5. It’s the latest case and it has sound dampening in the case. It is super important to keep the computer cool so some fans in the computer is recommended. This case will keep the computer running whisper quiet. Also I’m a fan of Finding Nemo so he’s on top. The panda is from San Diego Zoo and the Despicable Me Minion was a winning prize from the Las Vegas Circus Circus Hotel.

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First things first. Prevent static shock otherwise you’ll fry the motherboard. We took off our socks and shoes and touched the metal inside of the case to ground ourselves before touching any parts. And grab a bowl to place the screws. And a screwdriver.

Notice the white slots on the side. That’s for the memory (SSD and HDD).

Take out the case and the motherboard.

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Take out the CPU and put it inside the hole.

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Attach the included CPU cooler or the optional one bought separately.

Also attach the RAM memory (usually 2 places).

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Now it’s time to place it (as in the motherboard, CPU, cooler and RAM stick combo) inside of the case.

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Screw it in (8 to 9 little screws).

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Place the power supply inside (the Corsair RM 750 shown here).

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Attach the power supply cords to the motherboard. This particular one is called ‘modular’ meaning that you can pick and choose which cords you need. In some more simple power supply have a ‘non-modular’ cord, which means you’ll have additional cords that you probably won’t need. Having extra wires in a computer is not good for circulation since you want to have as much airflow through the computer as possible to keep it cool.

Screw on the SSD and HDD each separately onto a white slot.  Connect it to the motherboard and power supply.

Connect the Graphics card inside.

Majority of the wires are threaded into the back. Tie up all the wires so it’s not a mess.

Close up the computer. Connect it to the monitor, keyboard, mouse and power. Turn it on for the first time. Congratulations!!

I have to thank Linus Tech Tips on YouTube. We watched his video during our installation process and it made it easy. So thanks!

 

 

What It’s Really Like to Care for a Dying Parent

It’s really tough to decide the best course of action for someone who is dying, especially in our society where life, any sign of life, is prized, and not necessarily the quality of life. It’s truly difficult to make a decision for someone’s life especially if you love them.

But the better question is, would you want to live in that fashion?

Talk about death decisions with your loved ones so they know what to do in case something happens. This will save time and grief among the family and friends. The health care proxy doesn’t have to be guilted into making that hard decision that no one is willing to make.

As for organ donation, if someone willingly signed up to be an organ donor, I would assume any organ is ok as long as it’s usable and that I don’t look completely mutilated after the process. I mean, in the end an organ is an organ. If it can help save another life and I’m already dead, why not help out someone else?

TIME

xojane

There are two things that movies consistently get wrong: sex and death.

Just like no real-life sex scene has ever involved seamless, body-fluid-free sex (I, for one, seem to consistently get stuck in my skinny jeans while covertly trying to take them off), very few deaths are the simple, dignified situations we see portrayed on screen. Death, real death, is a messy, confusing process for everyone involved.

A few months ago I wrote an article for xoJane about my mother, who was diagnosed with terminal brain cancer. At the time she had plateaued. Roughly three weeks ago, however, that changed.

Determined to walk, she hauled herself out of bed — and promptly fractured her pelvis. At the time, she was still receiving treatment — now she’s in hospice. As terrible as it was before, this is worse. She is completely bedridden and has a catheter. Despite everyone’s best efforts…

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CCRN: How to Pass The First Time

I passed the CCRN last week! Yay!!! The CCRN is a certification exam for critical care nurses. It basically verifies your knowledge about critical care concepts after working 1750 hours in the last two years. The benefit of getting the CCRN means getting a pay raise or a bonus. Or intellectually, it solidifies your basics. But if you’re reading this, you probably already know that. You have the more important question — how do I pass the CCRN?

Before I studied, I also searched the internet for the best way to study for this difficult exam. There were two things that stood out to me.

  1. Listen to Laura Gasparis’ videos.
  2. Do all of the questions from PASS CCRN®.

I got all of the material from a friend, from another friend.

I listened to all of the videos and wrote down notes the first time around so I wouldn’t have to listen to it again. It meant I had to pause the video sometimes to write notes. There were 6 videos about 2 hours long. So roughly 12 hours. I did 2 videos each week while working full time. It took 3 weeks to complete.

Then I did all of the questions from Pass CCRN. Don’t read the book. Doing the questions will inadvertently make you go through the important concepts and details. I gave myself the goal to complete either a complete section (for shorter, easier sections) or a certain number of questions each day. Cardiac (20%), pulmonary (18%), and ethical (20%) are the most heavily weighted sections. For the cardiac and pulmonary sections, it initially took me about 2-3 hours to complete 30 questions because I would read the rationale and write a flashcard for the material. There are over 300 questions on cardiac alone, and there’s a good reason for it.

I felt the most important things about cardiac are:

  • The different medications (pressors, vasodilators, diuretics, beta blockers, calcium channel blockers, ACE inhibitors, ARBs), how it works, side effects, and how it affects afterload, preload, and contractility (which comprises of stroke volume (SV)).
  • How does SV and heart rate (HR) affect cardiac output (CO)?
  • In different disease states, what is lacking, and what do you need to fix the problem?
  • How does the intra-aortic balloon pump (IABP) help? Complications?
  • What does the pulmonary artery measure, what do those values mean, and what do you do when you see a value out of wack? What are physical assessments would you find?
  • What are the different types of murmurs, where do you listen, what typically causes stenosis vs regurgitation?
  • Different types of chest pain, MI.
  • 12 lead EKG — this took some time for me since at work it’s only required to know how to read a lead II EKG. But since I started studying, I’d look at 12 lead EKGs at work and it’s kinda fun.

For pulmonary:

  • ABG interpretation (compensated vs uncompensated; what would breathing too fast or too slow cause? How would you treat different values?)
  • Ventilator settings – which ones affect respiratory rate? What does PEEP do? How does that relate to the V/Q ratio?

As I did the questions, I used a flashcard program called Anki. It’s a fantastic memorization tool using the concept of spaced repetition. And the best part is that it’s free to download on the computer or laptop and to use over the internet. It’s $25 to download on your iPhone or Android but it’s worth it.

Basically, I did the questions on one side of the screen, and had Anki opened on the other side. Anything I didn’t know or wanted to review, I either copy and pasted questions or answers, or paraphrased the concepts. It’s easy to put too many things to memorize on one card and that’s the last thing you want to do. When you’re reviewing the card, you don’t want to think, “oh I got half of the card correct… so do I choose that I got it right or wrong?” You want to be decisive and pick whether or not you got it correct.

I have the flashcards that I created for the CCRN that is easy for you to download, although you should probably create your own or edit mine to make it easier for you. Comment below or email me if you’re interested!

And good luck in your endeavor.

Just 89 out of 150 questions to pass. So you can do it! 25 are for research. Only 125 actually count. You have up to 3 hours to take the exam.

The exam is $225 if you’re a member of AACN. You’ll go to goamp.com to see the test sites and register for the exam. You’ll get 3 months to take the exam. Once you pick, you can change the test date once for free. Majority of the test sites are in the HR Block. How nice of them!

I took mine in Astoria, NY. I was the only one and it was quiet. Good experience.

Anyways, go for it. 😃