ToTH Speaks.

3:43am: Another view of nursing: people, parts, and tubes.
I was thinking about another way of dividing up the tasks and tendencies of nursing. ( Cut for those who don't care. )

4:59am: On trained impulses, and false positives.
Ever been out with one of your childbearing friends who is taking a baby-free night for dinner and socializing? Ever seen what happens if someone in the restaurant has a crying baby? Ever watched them be almost physically unable to relax until someone quiets the noise?

I'm conditioning myself to be like that for IV beeping. But less than 1/6th of the IVs on the floor are mine, at any given time. Oy. (:

1:26am: If you have chronically cold feet, diabetes, or a family history of strokes...
This event, below, might be a good opportunity to get an assessment of your baseline vascular status. At $50, it's a really good deal.



"Knowledge is the best medicine. That’s why the Oakwood Heart & Vascular Center and Oakwood Annapolis Hospital are offering state-of-the-art vascular screenings from 12:30 to 6 p.m. on July 30 at Summit on the Park in Canton.

Participants can receive a $189 screening package for only $50. The screening package includes carotid artery, abdominal aorta and leg circulation screening, as well as an electrocardiogram (EKG) and full lipid blood cholesterol screening. A 12-hour fasting is required for the cholesterol screening.


Oakwood provides immediate and accurate screening results via painless, state of-the-art ultrasound imaging technology. You can discuss your results in privacy with an Oakwood board-certified cardiovascular and internal medicine physician at the event.


Hors d’ouvres and refreshments will be served. Space is limited, and you must pre-register for your screening appointment by calling 800.541.8110. The event is open to the public, and screenings will take approximately 30 minutes."

2:05pm: Sangria slush, check.
Fiesta party dip, check.
Onion Onion!TM dip, check.

Beer bread, pending.

The lady will be bringing chocolate pound cake, sweet pepper jalapeno spread, and raspberry limon spread, at the very least. Impending tastiness alert. (:

And, of course, in the middle of what should be a cleaning frenzy, I decide it's time to reorganize the kitchen. But the kitchen flows *much* better now. (:

6:10am: On developing professional confidence.
I turned a corner recently, and seem to have decided that, even on days made more frustrating by my not having perfected every single nursing skill known to man, and occasionally missing details that highly experienced nurses wouldn't, that I'm not only acceptably good at nursing, but am on my way, should I continue where I am, to being very, *very* good.

Given some of my insecurities about competence, I always feel better when I know I've overshot the margins of "good enough" by quite a wide margin.

I became aware that I'd turned the corner after two recent incidents. In one of them, I went on shift and found out that the prior nurse had been pleased when she found out I was taking over for her patients, and had told one of them that I was "very good". This might be the sort of thing you tell patients to boost their confidence, but my gut seemed convinced that she meant it, and had good reason to do so.

The second was relentlessly practical. I needed to put in a Foley on a woman. I gathered up my aide the kit, got the lady in position, and with no fuss and no drama, set the materials up, kept sterile technique, and got it on the first try. Given my prior level of Foley anxiety, that's a testimony in its own right.

I was recently trying to figure out how to think about all this, and came up with a few broad categories of things you need to become good at in nursing. The four major ones are Triage; Nursing Skills; Comfort and Communication; and Efficient Process.

Usually, your natural personality and life expeience gives you a leg up in one of these categories, Some people are brilliant with their hands, but get so focused on the hand skills that they lose sight of the person, or the overall processes that need to happen. Some people are great at making sure everything they do is efficient, but may get so lost in perfecting the efficiency that they forget to triage and prioritize. Some are so good at comfort and communication that they lose sight of efficiency, or spend so much time talking to the patients that they're losing sight of the big picture.

My strong suit is comfort and communication. I've *always* done interview style assessments with my alert patients. I may have been a bit rigid, at first, but I always gave them enough time to tell me, in their own words, what was going on with them, and what their priorities were. When a patient has me as a nurse, they know I have heard what they've said, and will do my best to align my priorities with theirs.

I'm now feeling pretty confident about my triage skills. This is one of those things that I think most people have to learn from experience, and now that I have some experience, I'm not so lost in the woods.

The efficiency is getting better, too, but it's coming hard. However, necessity being a mother and all, it is coming.

Nursing skills, well, there are still gaps, for certain. But I keep more or less mastering new ones, and each time I cross paths with a prior one, I learn something new. So, this will come with time, too.

I'm glad, though, that I've not had to sacrifice my area of strength to gain ground in the other areas. That would make me quite sad.

6:04am: Saturday night, 8:30 p.m.: post-tasting gathering
There will be any leftovers, a couple of quiches, and the makings for fresh pizzas, customized to the taste of those present. If it's a relatively small gathering, which I expect, I suspect we'll have one small pure social cluster, and one board gaming cluster. If only board gamers are present, we population may not need to mitose.

5:58am: Samples for the food tasting going well. (:
Complete so far (not responsible for marketroid bits):

Garlic Garlic!TM dip
Farmers Medley dip
Spinach and Herb dip
Key Lime Cheese ball base

Tasting the three dips, I'm realizing that dips, like quiche, could give me a lot of opportunity to experiment and play with flavor combinations. I'll likely get several packets from these folks, for the times when I don't have time or energy before a gathering to get elaborate or creative. Their stuff is quite tasty, too. But I'm already itching to see what their spinach dip would taste like if I added some fennel.

As for the key lime cheeseball, well, it's only because I'm a good hostess that there will be any left for you folks.

If you think you'd want to attend, but are worried about the salescritter, I wouldn't be too twitchy about it. I'm not going to let her go high pressure.

9:55pm: Saturday: early, selling tasty things; Late: sales-free socialation!
For those of you I didn't send a formal invitation to (most of you, sorry):

You're Invited to a Tastefully Simple Taste-Testing Party!
We'll be tasting all kinds of delicious and easy-to-prepare products. Join us!

Host: Tracy Worcester and Andy Vinton
Date: Saturday, June 28, 2008
Time: 6:30
Location: 5675 Big Pine Dr

If you don't want to try the tastiness or endure the salescritter, arrive after 8:30 for a free-form social event. (:

Oh, if you want in on the food, please RSVP for yourself and whoever you might bring; I've got to let the salescritter know how much foodishness to bring.

3:26pm: Careful about ground beef in Michigan.
Apparently, there have been 10 cases of E. coli linked to ground beef, four of those in Washtenaw county.

http://m.lsj.com/news.jsp?key=79302&rc=lu

3:03pm: Hey! I can lurk *your* lives until I have time to be social again!
One of the stupidest epiphanies ever: I just realized that, if I'm lonely and don't have the energy for real social interaction, I can just read my LJ friends list without actually posting. I get to stay caught up on what's going on with you, without actually having to be interesting or extraverted in my own right.

Given that I've gone probably a good two months without regularly reading LJ, this is a damn useful insight. Rumor has it y'all've doing some pretty eventful things since I was last paying attention. (:

2:22pm: Geek Social Fallacies.
I just stumbled again over the Geek Social Fallacies website, and re-reading it was a good reminder.

I've got a stone tendency towards GSF1 and GSF4, and my self-esteem occasionally suffers because on some level, I want GSF3 to be true, but have learned I just can't live that way. In experienced at least twinges of all five of them, which is a little embarrassing, really. And several of them, I've worked hard to maintain the balance necessary to have and hold onto the non-pathological forms, depsite an understanding of their failure modes.

What about you folks? Any of these strike a chord with you? Which did you have to reject outright, and which have you tried to keep the virtue side without sliding into the vicious extreme?

http://www.plausiblydeniable.com/opinion/gsf.html

12:06pm: A bit better, a bit worse. (:
I just unsubscribed from the list for thyroid cancer survivors, so I suspect my email volume is about to drop dramatically. With luck, this will make the signal to noise ratio high enough that I'll actually start logging in and reading things more reliably.

However, I'm bowing to the inevitable between now the end of the Vision Quest, and am publicly admitting that I should not be absolutely relied upon to show up for anything but work and Andy commitments between now and August 1st. It is, quite frankly, startling to me how much more time I need for sleep and essentially solitary pursuits just now. *shrug* Not a bad thing, really. But I need to be honest about it and stop making social commitments, in the short term.

I went a week without listening to my voicemail, too. Oy. I *do* hope my inner social nexus creator comes back on line after this, though. I not only miss you folks badly, but I miss *her*. Which probably sounds strange, to miss an aspect of yourself which has gone dormant for a while, but is nonetheless true for me, right now.

9:18pm: Possible Still Not Dead celebration.
On July 26, I am making the final payment on my cancer debts. About three weeks after that, they'll admit that my check isn't going to bounce, and send me a piece of paper that says I'm free.

As of August 1, I will be completing the year-long Vision Quest thingie that's been absorbing a surprising amount of my emotional energy.

So, I think it's time for a party. How does the weekend of August 23rd sound for people?

1:51am: Hey, look! Still not dead!
Since the last person who greeted me on IM started out with "Hey, you're not dead!", I thought I would show some signs of life.

However, still not a whole lot to say at the moment.

3:34am: And the crowd goes wild!!!!
Okay, the crowd of one. I now have internet access from work. I'm on my lunch hour, and I can email or LJ, or whatever else I want. I thought I was going to have to do this in a skulking way, but it turns out not. My quality of life has just gone up dramatically.

I've also convinced my boss to allow me to have Tuesday-into-Wednesday night off on a regular basis, which means I get to not only go to Tios, but get in a good social loiter. This, also, is likely to have a solid positive impact on my life.

I never really believed that, after graduating, I was going to have a whole lot in the way of cash crisis. But that is on the primary cloud on my horizons, currently. Two car payments at the same time really sucks. But, this too shall pass.

8:27am: Mixed bag.
On the plus side, my dishes are done and the plants I put in at Andy's are still alive and well. On the down side, money is still tight, and will be until I get the last of the payments made on the Kia.

Andy's out of town with his folks over the holiday, so I'm actually getting a certain amount of down time with myself. While I definitely miss him, it's actually being kind of nice, too.

Both cats are still alive. I won't be moving to Ypsi until either late July or early August. I'm getting in a lot of reading, and that's being *very* good for me.

Hoping to remember to muse in public about the rebalancing I seem to be doing between my inner introvert and extravert. I've temporarily overcompensated to the introverted sign, but there are good signs that I'll soon be settling back into a healthy center position. (:

6:17am: Sublet my 2 bedroom apartment!
$760 / 2br - 2BR sublet, great landlords, great location! (Ann Arbor/Vets Park)

Sublet my lovely 2BR 1 bath half duplex in a beautiful residential neighborhood in west side Ann Arbor. On the AATA busline, walking distance from Kroger and Plum Market, Nicola's Books, the Ann Arbor Public Library, Veterans Park, and many excellent restaurants and coffee houses. Easy access to I94 and M14. Large kitchen, beautiful high ceilings. I'm moving to be nearer to my guy and my workplace. Excellent landlord. Willing to either sublet or finish lease early or work with landlord for you to take over as tenant. Either email me or feel free to phone at (734) 239-4400.

* cats are OK- purrr
* Location: Ann Arbor/Vets Park

6:09am: Still not dead. (:
Neurochemistry went a bit depressive recently, but I seem to have touched bottom and am headed back up.

* I've started planting things out at Andy's, which is both satisfying, and a fairly good sign.

* I've got a plan for keeping myself focused and engaged at sword class, which will be good from both a social and an exercise perspective.

* After talking and thinking about it for about three years, I've found a place which has not-particularly-extraordinary-but-perfectly-acceptable kayaks on sale, and I'll be putting one on layaway on Wednesday. I need to reclaim my love for water, and harnessing it to my desire for exercise seems like a good plan. With luck, I won't drown in Ford Lake. Or anywhere else, even. (:

* Quinn's still among th living, and still pretty happy about that.

* Still looking to find someone to foist my lease onto. Good two bedroom apartment, sane landlords, on Ann Arbor buslines! Actually, I should post my Craiglist posting here, too.

5:27am: Focusing on my actual life.
You know, the part of life that involves doing the dishes and sending the bills out on time. I got knocked off track on this a while back, so it's taking bonus time to get the keel back to being even.

Recent highlights:
* Quinn's down to 4 pounds, eight ounces, but still seems pretty happy about being alive. I'm stressed, but still coping.

* I'm converting my room at Andy's house in a library and reading room, so I can actually get many of my books back out of boxes. It turns out lack of access to the books had been putting a high level of emotional wear-and-tear, as evidenced by the huge rush of energy and happiness I'm having around this task.

* Dishes, meh. Next place I live, I want a dishwasher again.

* If anyone would like to either sublet or assume my lease on a lovely two bedroom apartment in Ann Arbor at $760 a month, I'm looking to relocate closer to work and Andy, and, in my perfect world, would be able to do so before August, when my lease is up.

* Work's doing quite well. Don't ever go into nursing as a field if you can't cope with the occasionally really hard day, or even week. But, if you're suited to loving the work, and choose your employer and subfield well, the good will balance out the hard.

* Missed sword class on Sunday. I may have to just plan on practicing Wednesdays when I work the weekend, and Sundays when I don't. I do miss our old, two-evenings-a-week class schedule sometimes.

6:03pm: Small yay!
My weight fluctuates from day to day and week to week within about a five pound range. But, as of this morning, the bottom end of that range is now under 200 pounds, for the first time since I dropped swordfighting because of nursing school.

*grin*

7:26pm: Well, crap.
A lot of the recent document is good, and sound. But re-reading and introspection make it clear that a) it was written from a space of having had my buttons pushed, and b) it is not unreasonable that it pushed buttons on other people.

Sigh. I'm not always happy about having my intellect and intentions implemented by the wet sack of neurochemicals which is a human brain.

I've also figured out the two or three real issues that were underlying my reactivity, almost none of which figured directly in the document. I'm going to get a few days of regular sleep and food, think some more, and then make a few phone calls. I'm hoping to chat with several people face to face to figure out what all happened, and start finding ideological middle ground.

8:06pm: Second draft.
I attempted, this weekend, to write a statement of ideals about community-building and my original mission for the convention. I had previously attempted to get dialogue going about some of the issues involved, but was told there was no need for such a conversation. So, since I needed a dialogue to make sure my goals for PenguiCon were still roughly in alignment with those of the attendees, I printed up copies to hand out at random at the convention.

The intended summary? Come have fun. All are welcome. Share. And play nice.

I received a storm of shit, pretty much telling me that writing this and handing it out to attendees was a high-handed power grab, and the content was a vicious personal attack. (Thank you, by the way, to the small but elite cadre of people who served as damping rods during recent events...( Hey, look! Drama! )

You want to know what the funny thing is? I thought the attendees were going to read the document, get a warm and fuzzy feeling, and generally wander off a be a bit nicer and a bit more tolerant to their fellow geeks. I thought I was helping make the community just a bit more cohesive, and just a bit less likely to fragment under stress.

I considered comment locking this, but I still do want to know what people think (about the content of the ideas), so I'll take the gamble and risk of leaving comments open, for now.

Here's the exact text of what I was handing out:

( Read more... )

1:37pm: First Draft: Penguinista's Manifesto
First Draft: Penguinista's Manifesto, words from Pcon's co-founder

* There is no "one true way". People attempting to take over PenguiCon as a whole to be a vessel for their "perfect" vision can and should be publicly mocked. If mockery proves insufficient, and anyone should establish a power base, and continue in their attempts, you have the blessing of the Penguinista to drive them off into the outer darkness. I'll likely help.

* No one "owns" PenguiCon. I don't "own" PenguiCon, despite co-founding it. The chair of any given year doesn't own it. Whoever our current evangelist and grey eminence extraordinaire is, they don't "own" it. Every single geek who brings a bit of whacked creativity, or maintains one and shares it with others, comes as close to ownership as is possible. However, it is possible that someone covet the energy and power and coolness that is PenguiCon. Therefore, I state: To own PenguiCon is to enslave it to one person's vision of what it should be. Do not attempt to enslave my child. If need be, I, or my intellectual heirs, will foment a revolution to free her.

* PenguiCon is not a thing to be possessed. It is an energy and more than moderately chaotic process. It is also a diverse and strong-willed community. It can be directed, but the process is like herding cats. If it becomes easy to direct, then it is probably stagnating, and you should be worried.

* PenguiCon must chronically morph and mutate, or it will stagnate and die. PenguiCon was founded as a breeder reactivity for cutting edge creativity, and a place for cross-pollination for various forms of passionate geekery. On the plus side, odds are good, every year, there will be a new shiny thing to play with, and many, if not most, of the old shiny things will return. On the down side, even your best and favoritist shiny thing may, in time, senesce and die off, if it does not have at least one volunteer to make it happen, and a moderate group of people who love it. If someone kills it off for a year, and its passionate geek base still exists, have faith. Shiny things are like kudzu. You can cut them back, but they grow back.

* PenguiCon is an ecosystem; its parts have a life cycle. The cycle has four major steps. Create. Grow. Stabilize and consolidate. Senesce, and trim or die off. Wash, rinse, repeat. We need, at all times, to have people with the skills to create things, grow things, stabilize things, and prune. The personality types involved often grate on one another. If you must fight, please, may I request a few rules of engagement. Be courteous; make the argument about the issue, not the people. Respect each other; you are all vital to the health of PenguiCon. Be articulate; make sure you actually *need* to have the fight. And choose the most private forum feasible, please, because I hate watching you fight.

* Alienate none, within the bounds of sanity.

* Creativity is the most important thing. Diversity is the most important thing. Fun is the most important thing. Remember this.

8:57am: On Remembering the Blindingly Obvious...
...or, how Tracy got her geek on and began to regain her sanity.

I was feeling pretty burned out. The new job was a challenge, and before that, the accelerated program was hellish with poverty as an accelerant. Oh, and before that I was dealing with having thyroid cancer. So, I suppose what is really surprising is my being ambulatory, not my being stressed. (:
But I am, and I take miracles of this type for granted, and therefore, I was distressed that I was lacking my usual perky demeanor. So, once I regenerated enough energy to whine, I started meeping plaintively about the lack of fun in my life, my undermind thus making an only somewhat covert play to get y'all to Come Entertain Me.

Fortunately, in this case, y'all have busy and interesting lives, and thus no one leapt in to take the lead of diversion duty. After a few days, I regenerated a bit more energy, and associated brain cells, and realized: I'm a geek. I don't *need* other people to entertain me. I have eight seasons of SG-1 to watch, and literally several *boxes* full of books in Andy's basement that I haven't had time to read in the last few years. And that's just the tip of the iceberg. I completely broke myself of going into bookstores when I launched the massage therapy business, since I had no money. While I want to fling most of my spare money at paying down my debt, if I wanted, even one new book per week isn't going to slow that down dramatically.

I just spent my night off finishing Iron Sunrise my Charlie Stross and watching the first two discs of season 3 of Stargate. And I've realized: I'm out of hell. From here on in, poverty, and the resultant separation from a wide variety of fairly cheap things that give me joy, is a thing of the past.

Don't worry, I'm not going to go off the deep end. I'm going to look at my expense figures for the last month or so, see if and where I have slush, and trade an indulgence I don't really value for a Books and Media line item in my budget. I cut that out years ago as nonessential. *And I don't have to any more.*

To those of you who are un- or underemployed, there are more jobs going begging in medicine than nursing jobs, particularly for the geekly minded. I'm only intensely familiar with the nursing pathway, but medical technologists, biomedical engineers, MRI techs...it takes a lot of geeks to make a modern hospital run.

3:21pm: I get to stab my cat every day! Vet visit report.
I had to take Quinn, my profoundly beloved 16 year old cat, in for an emergency vet visit yesterday, since she'd been doing poorly for several days, and I didn't think it was smart to wait for Monday. Ann Arbor Animal Hospital is about three blocks away from me, which gives her less time during the drive to stress herself insensible, and they're very good. But, the whole process *is* very stressful for her, and vet care isn't even close to free. Insanely cheaper than human medicine, mind you. But still.

Some good news; her kidney values, while not good, don't look like end-stage renal disease, which is what I feared. For those who don't know, the words "end stage" in that diagnosis tend to be pretty descriptive. So that was a relief. On the other hand, her kidney numbers didn't explain her overall malaise very well. We couldn't get a urine sample, since she'd stress-peed in the car on the way over. *sigh*

She's down to 5 pounds, 6 ounces, and while she's never been a heavyweight, that's still about 50% of her normal weight. They gave me an appetite stimulant and an antibiotic, told me to give her a room of her own so I can assess what she's eating and what she's putting out, and will send her blood out for thyroid testing.

Also, the vet said she was dehydrated, so I now get to run an IV *on my cat* every day. (:

The only change I've put in place so far was giving her the IV earlier today, and she has not only come out from the bottom of the closet, she's sitting in my lap sleeping. Either she's getting somewhat better (my best guess), or she's doing the thing that sometimes happens with the dying where they bounce back long enough to have one day of normal pleasures before they go. That doesn't feel like the likely explanation, just now, but I need to look that possibility in the eye.

I know, one of these days, I'm going to come away from the vet with the feline version of hospice care. Or she'll go in with a true emergency, and not come back out. Given her weight, that time is probably going to be pretty soon.

But, la! Not today. And, with luck, not tomorrow either. (: