Saturday, May 15, 2010

Things to Think about When Choosing an Obstetrician

Recently I was doing a Non-Stress Test (NST) on a patient in our antepartum testing center. Her amniotic fluid level was below 5cm, so I was waiting for the physician to call back with orders to send her to labor and delivery. Turns out her physician was not available, and the "on call" MD was a physician that the patient didn't know.
Cindy(not her real name) looked at me and remarked, "I thought MY doctor would always be the one to deliver me."
This was not the first time a patient had this reaction. Which prompted me to write this blog.

Things to think about:

1. If your OB is a single practioner:  Does he/she do all their own deliveries?
    ( Meaning being available 24 hours, 7 days a week.)
    My experience tells that this is RARELY the case.
    Some OB's have very small practices ( less than 10 pts/month)
    so this may be possible.

2. If your OB is a single practioner and does share call with other MD's,
    who are they?
    How does the call schedule work?
    Do they share your doctor's standard of care?
    How does your OB communicate with them ?
    Since the "on call"  MD is not physically affiliated with the
    private practioner, most rely on the "Prenatal Records"
    to provide the information. 
    If you have a birth plan, special requests,etc.,
    ask physician to attach a copy to your prenatal forms.
    This information is then delivered to the hospital L & D Unit
    where you plan to give birth.
   
    A good idea is to ask for your own copy of the "prenatals" @ 36 weeks.
    If you are ever in a situation where you can't get to your
    planned hospital having this information in your purse
    will be valuable.

3. If your physician practices within a "group," you still need to ask
    how the call schedule works.
    Usually your MD will deliver your baby if you give birth
    during the business day.( 8am-6pm )
    Then the "on call" doctor takes over.
    Some OB/GYN groups share call with other OB/GYN groups.
    That means you may know the doctors in your group,
     but may have to spin the roulette wheel on the others.


    The hospital I work at has several group practices
    and single practitioners. Poor MD/Patient communication continues
    to be an issue.

    My recommendation: Never Assume Anything! Always Ask!
    It is your right to know.

Friday, May 14, 2010

Fear, Hope and God's Grace- My "Shawshank Redemption"



As I sit here today, I can't help but feel blessed.
I've been on a journey for what seems like my lifetime.
My parents divorced when I was a 7-8 year old child. My memories of my biological family are few.
Whatever "photographic" evidence my mother had was destroyed. I remember looking at pics where my father's face was torn out.  Eventually those pictures disappeared altogether. I don't blame my mom. It is what she needed to do to move forward. I know she felt she was protecting not only me, but my sisters. To this day, she just says that I have no idea how awful her marriage was.
For me, it left a void in my life. Mom remarried and we were adopted by the man I consider my father. (Though not right away.) My paternal biological family was "those whose name shall not be mentioned."
And for many years that was the case. However, mom would tell my sisters and me that our biological father "never loved" us.
As I grew into adulthood and became a mother myself I sought "therapy." I couldn't fathom a parent not loving their child. I found it difficult to trust my men in my relationships. I thought that one day they would leave me. I felt I was "unlovable" no matter what evidence/reality was right in front of me. My greatest fears were/are abandonment and rejection. In fact, those fears propelled me in many life decisions.

I decided to reach out to my paternal biological family. Thanks to the internet and social websites, I  connected with them. I was fearful that no one would answer my e-mails. I thought I had accepted that possibility. What I couldn't admit was my buried yet palpable fear of rejection. I remained so cool/cavalier on the outside but internally there was a knot in my stomach. I prayed & gave it up to God and  then "Let it Be." All I could do was hope.

Through God's grace, the family responded. It wasn't until this morning that I realized how relieved I feel. The little girl in me feared rejection. That little girl cried this morning because indeed... "Fear CAN hold you prisoner...Hope can set you free!" God is Good!

Thursday, May 6, 2010

National Nurses Week: May 6th-12th 2010

Today is National  Nurse's Day. My hospital will recognize nursing care with a Luncheon/Dinner.

"NURSING YESTERDAY, TODAY AND TOMORROW"
Driving transformation in our community's health care
A Cirque du Soleil Celebration especially for you!


I didn't realize how funny that title was until I wrote it here. Sometimes being a nurse does feel like a "Cirque du Soleil."  I do find myself spinning, bending, juggling and flexing to provide excellent care for patients! Kuddos for the humor! But I digress. This Blog Post is about trying to celebrate Nurses', Mom's, Dads, Love, etc., for 1 day. Don't get me wrong, I do enjoy the yearly recognition, but what about the other 364/365 (leap year) days?

At the yearly party, nurses' are treated to great food, SUPERB desserts buffet 
(cookie, candy, cake with take home boxes) and a raffle. Unfortunately I can barely do this within my 1/2 hour lunch. Sometimes the unit is so busy other nurses bring back food to share. Each nurse used to get a little "gift." The gifts were pretty funny and mostly useless, so the nurses voted to donate the money spent on those gifts to a local charity.( Isn't that just like us?)

While I enjoy all of this fanfare, I would give it up for more consistency year round by the administration. I want to have more communication from management. Communication that treats me like the professional I am. Communication that promotes change. Honest Communication that speaks loudly to my value to the healthcare team. I believe management suffers from inertia. By that I mean that their focus appears to be on the "brick & mortar," & gaining certifications such as "MAGNET,"( I know those are the foundation for the hospital.)
but I believe the administration could do more to promote nursing " well-being " year-round.
However,even as I write this, I realize that the appreciation for nursing & change has to come from within the "rank and file."  Change begins/comes from within each nurse.
 In view of that I'd like to share the following piece by Donna Cardillo RN,MA, in NurseWeek.


The word “Zen” is often bandied about. Although many definitions of Zen exist, it’s simply the art of being present in everything you do, giving full attention to each action, each interaction, each task. Unfortunately, we often are mentally on to the next thing before we have finished what we’re currently doing, thus shortchanging the task at hand. How can you adopt a Zen philosophy in nursing? Here are seven suggestions:




Set your intention each day. Before going to work, decide what you wish to accomplish, not in terms of tasks or projects, but in terms of an overall philosophical goal. For example, your intention might be to be patient with everyone you encounter — staff, family members and clients — and consider that they all are carrying a heavy load. Your intention can be the same each day or take a different focus.



Ground yourself. Take at least five minutes before your workday (and during the shift as necessary) for meditation, prayer and contemplation to center yourself. Spending even a few minutes with your eyes closed or cast downward, focusing on your breathing, connecting with your spirit will help you stay in touch with your inner voice and wisdom. Grounding brings you into the present moment rather than projecting into the future or obsessing about the past. A racing mind that reacts sensitively to little things has lost its spiritual power. Meditation restores that.



Create good karma. The word “karma” is derived from the Sanskrit word kri, which means “action.” It is the universal law of cause and effect that says every thought, word and act carries energy into the world. Therefore, do not judge or criticize others. Absolve not to partake in gossip or negativity of any type. Look only to help, support and encourage. Your thoughts and actions directly impact your environment.

Affirm your path. Remind yourself daily of the sacredness of your work — your chosen life path. It is truly a privilege to walk the path of the healer. Although the road may be rocky and steep, the destination is worth the journey. You save lives. You help bring new life into the world. You are there to ease the transition when life departs the body, and are there for every other aspect of the life cycle. Your work has value and meaning.



Aspire to new heights. Each day, consider how you can become a better person and a better nurse. Always be moving forward in your career and life, looking for ways to improve, to bring new positive energy into your world. This might involve learning a new skill, taking a class, getting more organized, being more generous and so on.

Be mindful in everything you do. When you are with a patient, focus only on that patient for that time and be more aware of every aspect of him or her. To be mindful is to be truly alive and present with those around you and with what you are doing. Even routine tasks can become a meditation of sorts.



Tap into abundant energy. The universal life force, also known as chi, is present in every living thing. It flows freely in us when we eat healthy food, get proper exercise, breathe clean air, live and work in an uncluttered environment, and avoid negativity. Taking care of yourself, including using modalities such as Reiki and massage therapy in your self-care routine, will help to keep you energized and doing your work at the highest level.



http://news.nurse.com/article/20100503/DD01/105030020


Thursday, April 15, 2010

Reflections: A Love Letter to My Husband Dennis

All of my 7 readers (old Rick Dees joke) know by now that I find my life's inspirations in many ways. Music is one. Today's inspiration comes from BeBe and CeCe Winans album "Still."  I love the whole CD.  Each time I listen to it, I connect to a different song. I suppose it depends what I'm feeling that particular day. The song of the day is "I Found You." This was a perfect fit because I've been reflecting on what a blessing my husband is in my life.
We met through business in 1990. I remember I enjoyed talking to him. And even though I thought he was cute for a "yuppie," what I was most impressed by was his good heart. However, most people we worked with thought of him differently. ( I will not comment about those folks.)
As I spent more time with Dennis, I came to enjoy his sense of humor & laughter, as well as his hard headed opinions & anger. (For the benefit of my kids...yes he did bring me over to the "Republican" side.) When it came to intimacy, he generously cared about my pleasure. (still does)
Twenty years ago I found it hard to accept that someone could genuinely love me. I questioned if I deserved love. I was so ashamed about choices I'd made as a young women. I thought I should be punished for the rest of my life. It was then and continues to be Dennis who reflects all of my goodness back to me. My husband who is not committed to any " religion," found a way to help me see how God sees me. He (Dennis) did this through his constant acceptance of me, quirks, past baggage and all.
It's Unconditional Love.  I believe in God. I believe God introduced Dennis to me. The first year of our relationship,I struggled with this concept.
Dennis proposed to me on Valentine's Day 1991. We married in 1993.
Our love has grown through happy and challenging times. He is my best friend who continues to reflect my goodness back to me.



I Found You (Cindy's Song)
BeBe and CeCe Winans


When I found you...I found somebody who cares
When i found you...Found my most intimate prayer
When i found you...I found what every heart dreams of
When i found you...I found love


When I found you I found the rest of my life
When I found you I told all others good-bye
When I found you I saw my fears fly away like a dove
When I found you I found love

I Know True love sounds crazy
But worth waiting for
You are the one...My only
Forever More

When I found you i found my fate in your arms
When i found you i found no cause for alarm
When I found you i knew this love was a gift from above
When i found love...

Face of the tea party is female - Kenneth P. Vogel - POLITICO.com

Very intering piece. Needless to say, I agree!
Face of the tea party is female - Kenneth P. Vogel - POLITICO.com

Great Blog post

I've been ready to throw a "pity party" for weeks now! Dealing with the changes in my body,the changes in my back pain, and my all over defeated attitude, I'm overwhelmed. This particular blog entry helped me! Please read it! Maybe it'll help you too!


Live in the Moment : The Art of Now!

Wednesday, January 27, 2010

My Letter to Obama after Virginia & New Jersey

I sent this letter to the President afer the Virgina and New Jersey elections.
And yes, I do write to the White House. I know it's probably a waste of time, but I humored myself into thinking my voice counted.



Good Evening President Obama!



It's been awhile since I've written you. I believe the last letter was about healthcare.


As I sit writing on this election night, I can't help but reflect back to your election one year ago. Although I didn't vote for you, I did have high hopes that my misgivings about your lack of leadership experience would be overcome. I believe you've let Ms. Pelosi and Mr. Reid run wild with what they (and perhaps you) thought was a mandate a year ago.


By the way, I grew up in a Chicago suburb, and I KNOW about the Chicago Democrat Machine. (My uncle spent time in federal prison for income tax evasion after his mayoral terms ended.)


I believe you've surrounded yourself with some questionable people. The "Czars" are one example of political power & patronage gone awry!


So why am I writing to you?


Listening to Virginians talk tonight they stated their main concern was JOBS!


It dawned on me that this is so SIMPLE!


It's Maslow's Hierarchy of Needs. The bottom of the pyramid is as follows:


PHYSIOLOGICAL:  Basic survival needs; water, air, food and sleep.


SAFETY:  desire for steady employment, (jobs) health insurance, safe neighborhoods


So, while healthcare is definitely important, having a job more imprortant. That job provides food, clothing etc.


There's no doubt healthcare needs reform. ( I'm a nurse.)


But the bills from the House and Senate are not well thought out. It's like they threw a bunch of mud on the wall and they're waiting to see what sticks. Is his really any way to reform healthcare, seeing what crap sticks? I don't think so. Take Time!! Wait! You'll earn more respect with a leaner, smaller & responsive healthcare plan. Be a LEADER!


I write a blog about nursing, my loves, my passion, and well of course, some politics. Yesterday, I posted three blogs. The one I'd like to focus is not the one on Afghanistan. The one I'd like you to read is "Gratitude..."


It features a song that the late Wayman Tisdale recorded on his CD "21 Days."


When I listened to the children say Thank you, it dawned on me that it really is that simple:


Thank you Jesus:



For putting clothes on my back!


For my family!


For my life!


For my food!


For waking us up this morning!


For our schools!


For my sister!


For my brother!


For my Mom!


Jesus Bless this generation!






Keep it simple! Then the rest will follow!


Thanks for the time!


Carol


http://mamababy-queenofhearts.blogspot.com/

Reflections: AVATAR, India.Arie's "Grains" and me

I went to see AVATAR this past weekend and found I really enjoyed it!  I had no idea what to expect and given that there is so much else going on in the world, I didn't read any reviews.
My connection to the movie was "spiritual." I don't mean God, Christ or any religion. For me, it was my belief we are all created from the "same grains."
I can't answer the "what about the pseudo military/mercenaries or the big bad company" portrayed in the movie (But let's face it they were pretty one dimensional.) I also don't pretend to know Mr. Cameron's intent. Who cares what his intent was anyway?
I believe I was created by God from the same "grains" as everyone.  I believe we are given free will to do as we choose. And that "free will" is what creates havoc here on earth.
Having said that, my interpretation (of the movie) is that the Na'avii people understand their connection to their " universe." The scene where they are all joined arm and arm praying(my interpretation,) was emotionally riveting and very moving.

On Sunday, while on iTunes, I came across a new CD (actually it was released in 2009) from one of a favorite songstress: India. Arie.

The 2009 CD is titled:     Testimony, Volume 2: Love & Politics
I love the whole CD, but am drawn especially to her interwoven: Intro, Interlude and Outro  "Grains."

Here are the words:

"Intro: Grains"

I’m grateful that you created me from the same grains from the same things


I’m grateful that you never cease to amaze me the way you love me

"Interlude: Grains"

I am grateful that you never cease to amaze me the way you love me


From the flicker of an eyelash to the furthest star


From the pyramids to the beat of my heart


From a woman in Somalia to a child in Harlem


We’re created from the same things


I’m grateful that you created me from the same grains from the same things


I‘m grateful that you never cease to amaze me the way you loved me

"Outro: Grains"

I'm grateful that now I can see


that I am a part of everything


and everything is a part of me


you've amazed me

I've included a blog post from  months ago.

MY PASSION

Working as a Labor and Delivery nurse for 24 years, I felt blessed and honored to assist women, and their families in the birth of their child(children). Hearing a newborn cry, witnessing a family's joy always touched me deeply. As well, when I was asked to assist women, and their family in delivering a "baby born asleep", their pain and anguish cut like a knife. Throughout all these experiences, I knew this was my passion, my calling in life.
Then I joined Antepartum Testing, and my PASSION grew. I love performing ultrasounds on the fetus'. I love showing the "moms" what their baby is doing.(kicking, sucking, practice breathing)
But most of all I love the following: witnessing the "circle of life;" recognizing we are created equal (can't tell race,religion etc. on ultrasound;) and LIFE is a MIRACLE.

In conclusion, I hear, see and understand my life through movies and songs that help me reflect on my life  journey.

I believe we are created equal. I believe we have free will. I believe there is evil in the universe. I claim no understanding of God's Plan for me. I just know in my heart I am on a journey. I know and believe that God wishes me well on my journey to eternal life. He Promised and I Believe. 

Wednesday, January 20, 2010

Peggy Noonan's WSJ Op Ed: adds more "D's" to my Obama grade: Disconnect,Detachment,Distance

Slug the Obama Story 'Disconnect'

The first thing I learned in journalism is that every story has a name. At WEEI News Radio in Boston, the editor would label each story with one word, called a "slug," and assign a writer to write it for air. This week's devastating earthquake would be slugged "Haiti." A story about a gruesome murder might be "Nightmare."




We're at the first anniversary of the inauguration of President Barack Obama, and the slug, the word that captures its essence, is "Disconnect."



This is, still, a surprising word to use about the canny operatives who so perfectly judged the American mood in 2008. But they haven't connected since.



There is a disconnect, a detachment, a distance between the president's preoccupations and the concerns of his people. There's a disconnect between his policy proposals and Americans' sense, as expressed in polls, of what the immediate problems are.



I'm not referring to what is being called the president's rhetorical disconnect. In this criticism, he is not emotional enough when he speaks, he doesn't wear his heart on his sleeve, he is aloof, like a lab technician observing the movements within a petri dish called America. It may be true that this doesn't help him, but so what? In a successful presidency, his cool demeanor would be called an interesting facet, not a problem. And Americans don't really need presidents to move them, when you think about it. They need them to lead, and in the right direction.



Nor am I referring to an iconic disconnect. In this criticism, the president refuses to or is unable to act as a paternal figure. "A president is a father," say these critics. "He must comfort us." But, actually, your father is your father. In any case he always seemed like the bright older brother, not the father.



You want a competent chief executive with a deep and shrewd sense of the people. Americans want him to be on the same page as they are. But he's on a different page, and he may in fact be reading a different book. Thus the latest Quinnipiac poll, which puts his approval/disapproval at a descending 45% to 45%. Pure hunch: The approval number is probably slightly high because people don't want to disapprove of their new president—the stakes are so high!—and don't like telling pollsters they disapprove of him.



The real story is that his rhetorical and iconic detachment are harped on because they reflect a deeper disconnect, the truly problematic one, and that is over policy. It doesn't really matter how he sounds. It matters, in a time of crisis, what he does. That's where the lack of connection comes in.



The people are here, and he is there. The popularity of his health-care plan is very low, at 35% support. Someone on television the other day noted it is as low as George Bush's popularity ratings in 2008.



Yet—and this is the key part—the president does not seem to see or hear. He does not respond. He is not supple, able to hear reservations and see opposition and change tack. He has a grim determination to bull this thing through. He negotiates each day with Congress, not with the people. But the people hate Congress! Has he not noticed?



The people have come alive on the issue of spending—it's too high, it threatens us! He spends more. Mr. Obama seems at best disconnected from this anxiety.



The disconnect harms him politically, but more important it suggests a deepening gulf between the people and their government, which only adds to growling, chafing national discontent. It also put the president in the position, only one year in, only 12 months into a brand-new glistening presidency, of seeming like the same old same old. There's something tired in all this disconnect, something old-fashioned, something sclerotic and 1970s about it.



And of course the American public is reacting. All politicians are canaries in coal mines, they're always the first to feel the political atmosphere. It was significant when the Democrats lost the governorships of Virginia and New Jersey two months ago. It is significant that a handful of House and Senate Democrats have decided not to run this year. And it is deeply significant that a Republican state senator in Massachusetts, Scott Brown, may topple the Democratic nominee to fill Ted Kennedy's former seat, Martha Coakley. In a way, the Republicans have already won—it's a real race. (Scott Brown Did WIN)



Mr. Brown's whole story right now is not about disconnect but connect. Massachusetts has an 8.8% unemployment rate, and graduates of the commonwealth's great universities can't find work. An old Boston Republican hand said of the race, "It's 100% about policies—health care, taxes, what's the plan on the economy?" Mr. Brown charges that Ms. Coakley's support for cap and trade and health care will amount to $2 trillion in taxes in the next five years.



Ms. Coakley has the advantage—Massachusetts is the heart of blue-state America—but in a way her advantage is her curse. Because she is the candidate of a party that for 40 years has been used to winning, reigning and winning again, she looks like the same old same old, a standard old-line liberal, the frontwoman for a machine, a yes woman for the Obama-Pelosi era.



It is interesting that Ms. Coakley, too, has been told by pundits the past week that her problem is that she's not emotional enough. She should show passion and fire! She should cry like Hillary!



This comes not only from pundits but normal people, and if you contemplate the meaning it is, weirdly: You're not good enough at manipulating us! We want more theatrics!



Both national parties are trying to pour in money and resources, but the most obnoxious intrusion must have been the fund-raising letter this week from New York's Sen. Charles Schumer, who tried to rouse the troops by calling Mr. Brown a "far-right teabagger." Does that kind of thing even work anymore? Doesn't name calling put off anyone not already predisposed to agree with it?



In a time when the people of Massachusetts have real concerns about their ability to make a living, stuff like the Schumer letter is just more evidence of a party's disconnect.



Politics is about policy. It's not about who's emotional and who cries or makes you cry. It's not about big political parties and the victories they need in order to rule. It's not about going on some ideological toot, which is what the health-care bill is, hoping the people will someday see and appreciate your higher wisdom.



In a way, Mr. Obama's disconnection is a sign of the times. We are living in the age of breakup, with so many of the ties that held us together loosening and fraying. If the president wants to lead toward something better, he should try listening. If you can't connect through the words you speak, at least you can do it through your ability to hear.



Printed in The Wall Street Journal Europe, page 15

Sunday, January 17, 2010

I give Barack Obama a "D"

Dishonest, Disgusted, Disillusioned and Disheartened

Was it really almost a year ago that Barack Obama was sworn in? Even though I didn't vote for him, I was hopeful that the new President might change how government functions.


And guess what? He has!


But it is not what I expected. Silly me. I grew up in Chicago.I should know better. Mr. President is a Chicago politician. Behind closed door deals, strong arm politics and patronage jobs are just SOP for him. ( Dishonest )


It seems each day I read about another assault by this administration and Congress on the Constitution. ( Disgusted )
But I didn't vote for him!


Imagine how those people that did vote for him feel?


My mother who was born, raised and still lives in Chicago voted for Obama. She now says she is so sorry she did! She bought his rhetoric about change. She says he's worse than anyone who's been president in her lifetime. She tells me of how many folks/family are out of work back home. She's angry that she got taken in by all of his campaign promises. She's a senior on limited income and now realizes she will have less with Obama.
(Disillusioned & Disheartened )


I am sure she isn't the only person who regrets their vote.


It seems that the President ( and the Democratic Congress ) is more concerned with their Legacy, ie: Healthcare Reform, than with the economy and jobs.


So here's a suggestion: Let's get off the "D" list.


Use the 2010 midterm elections to FIRE the current lawmakers who are not listening to their constituents.


Then get ready to FIRE President Obama in 2012!


In the meantime,  let's HIRE Scott Brown! Get him elected in Massachsetts!

Monday, January 11, 2010

ER vs. Vicodin

I'm in bed nursing a sore back. In July 2008 I was diagnosed with spinal stenosis,dorsal tears around some discs, herniated discs, etc. I had severe pain in my left hip, back radiating and burning down to my knee. Childbirth was easier to manage than that pain! 2 epidural steroid injections and 3 months of Physical Therapy later, I returned to my nursing position @ Hoag Memorial Presbyterian Hospital.

I've had "twinges" in my back. And some little pains that I always have been able to remedy through what I learned in Physical Therapy. Most recently in October 09, I discovered wearing the wrong shoes caused me problems. At that time I tried to see my orthopedic md. I was told no appts were available until the following week. Here I was in pain with good insurance and couldn't get an appt.
I managed to treat myself and things were ok until this weekend. Actually I think part of the problem stemmed from how busy we were on Friday @ work. I didn't sit down for lunch or visit the lady's room until 7 hours into my shift. We normally don't get breaks, so I am used to the pace. I can usually grab some water and bathroom time. ( I suppose some people might call those breaks! ) On Friday that wasn't the case. I came home exhausted and had heart palpatations from fatigue and not hydrating.
Saturday still feeling tired, went for a beachwalk. Then on Sunday repeated the walk. I did feel twinges in my right hip, back and groin area on Friday night and Saturday. But on my Sunday walk I had to lay down on the sand and stretch and wait until I could walk home.
I took 2 vicodin and slept Sunday afternoon. The pain was lessened, but not gone.
This morning I called the doctor, told the appointment lady that I was in pain ( I always tell them I'm a nurse@ Hoag hoping this would get me in to see the doc. It never works!) She then asks me my insurance.( it's a PPO.) I also tell her that I'm in enough pain to go to ER, but I find that to be a misuse of medical benefits! Guess what? She tells me she can't get me into see anyone!
Am I crazy? I have insurance. I want to see a doc in an office setting. I have never been one to use the ER for care. That's why ER is so overcrowded. I hung up and started to cry! Said Screw it! And took another Vicodin! If the pain overtakes the pills, I'll blog from ER!
Otherwise, it's time for me to sleep!



- Posted using BlogPress from my iPhone