Fences

When my brother and I were traveling through California, I got a really cool picture of a fence with an awesome background. It sprouted a series of pictures, as well as a fence-only inspired instagram (https://www.instagram.com/hellokeechy/), that I've taken from all different cities and places. I'll make sure to keep adding as I take new ones. I hope to one day frame these with adding real reclaimed fence metal over top of the fences in the pictures.

The White House

Both of these are views from the shores of Easton looking over the Chesapeake bay.

Dislocation

Netherlands

A passage from Europe in your hands:
Upon obtaining employment,you must register with one of the Dutch insurance companies that will provide you with insurance card and register with so called family doctor and a dentist.  You must also apply for social insurance number , a SOFI, at a taxation office in the place of residency. That will automatically start your contribution of 2% of your salary into Dutch social security system.

The Hussy Hesi

Of course a test cannot be described as an imprudent or immoral female. Or can it? From a handful of nursing students each academic term, it probably could be described in such a way, and I may be an instigator to this definition.

On February 27th, I fell victim to the HESI for the first time. And I almost escaped her wrath. It was like the recent Penguins- Flyers Game 1 of the playoffs. I thought I had defeated her, but she came back and beat me by inches (refer to this video for a visual http://www.youtube.com/watch?v=CcXoSYK8mn0&feature=player_embedded-- I'm the racer with the flailing arms that takes second).

The HESI is typically scored out of 1500 points. It is 160 questions and is cumulative of all the possible topics learned in nursing school- also known as a comprehensive exam. Each school expects a certain score, which correlates with a percent rate of passing the NCLEX. Pitt requires an 850, which guarantees a 92-94% pass rate for the nursing boards.

This test is difficult to study for since the body of knowledge from which the questions are picked from is so extensive. There are, however, strategies they teach you to improve your score. You are supposed to pick out key words in the question, read the entire question, read all the answers, and make your decision based on what information best refers to and opens what the keys of the questions are looking for. It is also helpful to eliminate answers you know aren't right to increase your probability of choosing the best answer.

With all these tricks in mind, the results still did not quite pan out the way I had hoped. On my first attempt I hesitantly clicked submit, answer 160, to find the score of 846 on the screen. My first thought was "you're kidding me". I had spent almost the full 4 hours allowed for the exam and had gotten so close (was one question away) from a glorious accomplishment. Pure frustration, disappointment, and agony set in.

I hadn't hit the benchmark, nonetheless. And so came my second attempt, which was preceded with more case studies, practice questions, and practice exams/quizzes. While the second exam took less time, and I tried to spend less time second guessing my answers, I still managed to fail; 790, even lower than my last score. This test was more difficult with more specific disease processes and required interventions. I felt so unaccomplished and incompetent. How had I done so poorly? This was a test I needed to pass to pass nursing school, according to my professors, but if I am not passing, what does that mean?

Initially, to me, it meant that I was not capable enough to be a nurse. That I hadn't studied hard enough, wasn't smart enough, or didn't have the devotion to becoming what I had hoped to be for the last four years. The nursing school tends to make this test seem like the precipice in the determination of your nursing knowledge.

After hours of contemplation, disappointment, and studying, I realized that this is not at all the case. This test is an important preparation tool for the test that really matters. After a meeting with my professors after not satisfactorily passing the third and final attempt of the exam, I was assured of this even more. This test now means, to me, that some people are simply not good test takers. This test also showed me that the HESI is difficult! It must be if getting a little over half the answers right means you are over 90% likely to pass the nursing liscensure examination.

It is that way for a reason though, and I am so thankful that I was required to attempt this test 3 times, because in the end, the hours I spent studying and the hours I spent reviewing will all lead to a more successful outcome when a lot of money is involved, and my license is on the line in the NCLEX.

So, to any HESI test takers that are reading this: do not be discouraged. This test is your friend, although it seems incredibly intimidating, and immoral, and imprudent at times. It is here to help you succeed. Much like your nagging parents, it wants what is best for you in the end, despite all the transient obstacles it may divert you with in the meantime. Keep your head up.

Belgium

It has been less than a week since I purchased my plane tickets to Europe for the month of May. Among all of Europe, my roommates and my countries of interest include Italy, Spain, France, Switzerland, Germany, Belgium, and the Netherlands. I think it behooves me to read up on the countries to have a general and at least minute comprehension on what to expect from these historic landmarks. I will be sure to post blurbs about interesting information related to my study of independence as I go along.

For example: Belgium requires that ever resident must register in the health insurance system. Contribution amounts depend on various factors. You will typically have to pay 50 euros a year for health care coverage, and around 3.55 % of your salary will go to health insurance (according to www.svb.nlwww.svb.nl). When visiting a doctor you have to pay upfront for a doctors visit and part of it will be reimbursed by insurance later. You do not have to pay anything for hospitalization under a years time.

To be continued...

Books used for information:
 Europe in  your hands
http://www.allbookstores.com/Europa-Dlani-Stanka-Vane-ikov/9788096778362

The Golden Hat

I recently picked up the book The Golden Hat  by Kate Winslet. Recently inspired by an Icelandic documentary titled A Mother's Courage, Kate Winslet had an epiphany while brushing her teeth at bedtime. She thought to herself- what if we created a foundation that could collect many for the good of children and adults with nonverbal autism. The idea for the donation would be a book, filled with the written email relationship that developed between Kate and the mother of Keli, a nonverbal autistic boy. Another component to the book includes multiple celebrities who took a self portrait with the "golden hat". The Golden Hat was born in one of Keli's poems that he wrote. This hat had the capacity to allow autistic children the ability to communicate what they are thinking to the world. And so, many artist photographed themselves with the hat, and gave a quote that defined what they would share to the world and their loved ones about themselves if they only had a few words. I was inspired by this book, and in fact, read it in one sitting. This is a good book to read on a rainy day. To realize and appreciate the little things in life, and the value they have in our everday living. Also to reinstill the fact that people are given dealt unlucky hands. We must be more accepting of people's inescapable differences.

Education: Book vs. Physical

Education and knowledge are multidimensional concepts. In addition, every person learns and retains the knowledge they study in different ways using unique techniques. For that reason, there is no way of choosing the "best" way to learn. In many lessons, there always seems to be a need for balance.

What I have learned in attempting to get through nursing school is that the knowledge I have retained and use in my practice is 90% what I have gained from hands on experience in clinical. One of the things I have retained from textbooks, however, is that knowledge theorists believe there to be many different kinds of knowledge. There is logical, semantic, systemic, empirical, rational, to name a few. There are also different learners. I have come to find that the significance in learning about knowledge itself, is to find out what kind of knowledge I have retained, what strategies are best for me to retain that information and the  relevance it has in my overall intelligence.

From my experience, I have found that I am good at many things. Good at many things, but not great at any particular thing. I like to believe I am good at physical goal acheivement, interacting with others, learning new information, being creative and curious, and experimenting. I think practically. I am impulsive. I am intelligent in topics of my own interest. I like math. I enjoy learning from other people and their experiences.

I need more time, though, to process. Process all the information that is given to me. If there is a time limit, forget it. Reasoning is also not my strong point. Nor is critical thinking. Anyone who knows me is aware that I am incapable of making a decision most of the time.

I have come to find that I am more equipped in learning kinesthetically and enjoy learning about concepts that have physical meaning to me. That link up with an experience I am familiar with, or seen in the past, and am then able to expand on. I am also interested in learning through conversation, application, and peoples expression and emotion of a certain topic. While I can read it in a book, to experience a person in that situation is the type of knowledge that I am able to truly understand.

Homeopath

Story captured while on a gondola ride up the mountain in Whisler, BC.


Gondola and chairlift lines at major ski resorts typically have a singles line, which is a line that moves faster than the line with people standing in groups. By standing in this line, you get placed in a lift that is filled with people you don't know. On one particular ride up the mountain, I found myself listening in on a conversation with a lady sitting across the gondola from me. Typically I would respect her privacy, but we were in a very tight enclosure for a decent period of time and she was talking about remedies, which to me sounded interesting. She was talking on the phone to a friend whose son had come down with a fever. She was recommending that her friend give the son two remedies to cure his illness, before trying Tylenol. The remedies were meant to be given once every hour. Her friend had a lot of questions it seemed since the lady across from me was having to re-explain over and over again the instructions.

She later informed me that she was a homeopath, which I had never heard of before. It is an alternative medicine that is made of diluted substances usually found in a healthy person's body. More information on homeopathy can be found on Wikipedia. I found it interesting to hear this conversation considering the different language and medications I am used to in the modern medicine world. I'm interested to read more about this form of medicine, although it is highly controversial to modern day scientists.

Nursing in Canada

Written from an airplane on route to Baltimore, returning from British Columbia.


While visiting my dad in British Columbia over the long weekend, I ran into (quite blatantly) a possible topic of interest. We were driving through downtown Vancouver when we heard an ambulance in the distance, quickly approaching. While pulling to the side of the road to allow it to pass, we realized we were stopped directly across from a hospital. St. Paul's, a hospital that is housed in an old stone building built in 1894 (the hospital has since expanded). It made me curious to research what life is like for Canadian nurses. Since Canada has a completely different healthcare system, nurses hold a government position, and all citizens are given public insurance rather than privatized individual plans. So, here is a brief summary of statistics I discovered after further research (all done on British Columbia, in particular, since each province holds separate rules and regulations):

• The salary is generally higher than most average nursing wages in the United States. For British Columbia, the set salary for New Grad Nurses is Canadian $30.79/ hour with a $0.70/hourly evening differential, $3.50/hourly night differential, and $2.00/hourly weekend differential. For every 1879.2 hours worked, you increase a step until the final ninth step which leads to Canadian $40.42/hourly.
• You are required to have a bachelors degree for nursing entry-to-practice (usually 4 years in Canada as well, although they do offer 2 year condensed programs in some places), although it is different in Quebec, where diplomas are still offered in some locations.
• You are given the option of 19 specialty areas and must take a focused/ individualized test for that focused area of study.
• Nurses are given more independence than in many other countries. Nurses are expected to fulfill the role of educator, manager (of disease processes), appropriateness of research implementation on patients, and much more. In fact, in Northern Canada, Community Centers are led by RN's.
• There is currently a nursing shortage in Canada and is prospected to remain that way for the next few years (especially in focused areas like the ER, OR, or Critical Care).
• Licensing for nursing is not done nationally in Canada, but rather in the a certain province or territory.
• To become a registered nurse, you must pass the Canadian Registered Nurse Examination (except in Quebec which has it's own exam)
• In order to work in Canada with a Bachelor's degree in America, one must first get a working Canadian Visa, whose application usually requires an offer of employment prior to submission.
• It is highly valued for a nurse applying for a job in Canada (especially Quebec) to speak both French and English, at the conversational levels. 
• Hours are similar to the hours of nurses in the US, although, working for a union allows less flexibility with certain hours worked and does not allow the nurse to create her own schedule necessarily.
• The ration of practicing RN's to the Canadian population is 1 nurse for ever 136 Canadians.

Wages
CNA
Canadian Nurse Complaints (however keep in mind this article was written in 2002).

Sometimes It Takes Getting Above the Clouds

Written from a plane en route to Vancouver from Baltimore.


"Mindfulness" is a concept and ritual that is important to practice. I'm reading a book titled Wherever You Go There You Are by Jon Kabat-Zinn. This book talks a lot about the Buddhist mindset of being in the present and fully embracing each moment. In the fast paced world we live in today it can be difficult to appreciate each present happening, and easy to forget to notice what is going on and the good in it. It is not necessarily a religious concept, and nor is it being forced, by any means, upon anyone as a religious coercion. It is simply a means of appreciating life. We are often in a bustling fog, with our focus on what has happened before and what we are looking forward to. The question the book challenges us to avoid asking ourselves is the "now what" and instead seeing the importance and significance of what is now.

I am by no means the master of this, but rather passing on the knowledge that I am learning to work with. I think "mindfulness" can be used often to help nurses excel at their profession. I was speaking with a nurse on my floor last week about how easy it can be to lose sight of the good nursing provides, for both the patients and the nurses. The rewards aren't always visible or present. One thing one of the nurses shared with me that stuck came shortly after we had exited a patients room. This particular patient had just shared his graciousness by thanking us in advance for "all the help he is confident he will receive for the duration of the day. You two are very sweet for checking on me."

We had, before entering, just visited with a patient who was very demanding and unhappy with their care. The nurse turned to me and said "see the difference. You have to hold on to the moments like these, to remember all the good we are capable of giving," referring to the second visit. And she is right. The few jobs that provide the employees to nurture their clients, and to heal them, are the few jobs that allow us to pause in certain moments to simply appreciate the good in human nature.

So, I would consider giving mindfulness a portion of your every day routine or ritual. Without it you may not notice the difference you make in someone's day, or the difference they make in yours. It is important to have a grasp on your importance in the world and to be satisfied with that role.




Good is a term I am using to describe any act done by somebody for the benefit of someone else, or just out of kindness.