Miss Mabel

          Six months ago I was "introduced" to Mabel, an English bulldog who had not been treated well during her 4 to 6 years of life. She was the "property" of a backyard breeder, who had used her to produce 4 to 5 litters of puppies during her short period of time. I saw her sweet photo on the Detroit Bulldog Rescue site and from the time of our first true meeting, it's been true love.
          When we brought Mabel home, she was having great difficulty breathing. Watching her breathe was like watching one of my old COPD patients. She had to forcefully exhale and sounded horrible. She couldn't pant--a necessary cooling mechanism for dogs. We were fortunate to find a bulldog specialist who diagnosed her with brachycephalic syndrome. Brachycephalic syndrome is a cluster of diagnoses, including stenosed nares, an elongated (and, in her case, prolapsed) soft palate, and saccules in her trachea. Mabel also had enlarged tonsils and a hypertrophic epiglottis. Mabel also had a horrible fungal skin infection on her belly, mild entropion, hyperkeratotic nose tissue, an ear infection, and a benign tumor on her rear leg. After the vet gave us the "laundry list" of problems this sweet dog had, we made the decision to spend whatever it took to bring her to her optimum health.
          Mabel underwent major surgery within one month. While we noticed an immediate difference in her breathing, we were well aware that she might never be able to function as other dogs. The enlarged epiglottis was not able to be fixed and continues to be a problem. But her belly is again turning pink, we have the tools to keep her ears clear of infection, her teeth have been clean, and she has a cute little nose. The entropion will require constant eye drops to protect her corneas, and her wrinkles will require continual cleaning with special products and Gold Bond Medicated Powder--a true miracle product!
          I heard from a friend with Detroit Bulldog Rescue that Mabel's previous owner denies that this dog or any in her "care" had any medical problems. What an idiot.
          Although we are happy to see her breathing better, the best part of Mabel's life with us is watching her play--possibly for the first time in her little life. She came with toys--none of which held any interest for her. I took her to a pet store and walked her down the toy aisle. She immediately picked out a blue stuffed dog. I tried a Kong, one of the toys our other dogs have loved, but she was completely uninterested. Then, on a whim, I picked up a deer antler. That was the most expensive and most valuable item in the cart. This is her favorite object. She will actually chase it if we drag it across the floor. She holds it in her paws and spends hours chewing on it. This never ceases to make me smile.
          She has started to blossom in her 6 months with us. Recently she chased Bill around the living room--something we never thought would happen. We look forward to the next 6 months and beyond.
          Although her breathing has improved, Mabel's stamina is still not and will never be what we had hoped.  We were so looking forward to taking long walks with our girl. This will never happen on a leash. She's a little slow and occasionally stops and refuses to move. As a result, I am in the market for a dog stroller. Yep. I never thought I'd be one of those dog owners. Our goal is to take her places with us. The stroller is the only way. 
          More to come . . .

Professionally speaking . . .

          Several years ago when I was working in a hospital, I overheard a conversation between a nurse and a patient that I will never forget.  The patient asked a question that nurses hear hundreds of times during a week, "When will my doctor be here?"  Normally the exchange would not have made an impression on me.  Answers like, "Your doctor has office hours today and will be here when he's got a break in appointments or after he's through seeing patients" or "Your doctor was here earlier this morning" don't warrant a second thought.  However, hearing "Honey!  Your doctor's done been here and gone!" was  almost enough to knock me to the ground.

          I know I do not always speak with proper grammar, and I really don't care how a nurse speaks when he or she is with their friends or family.  But how can a nurse be viewed as a professional when they can't speak properly with patients or other healthcare professionals?  It's a question that I hear discussed at almost every nursing conference I attend.

          One student today asked me about don't and doesn't.  When I explained the difference, she then understood that to say "he do not" sounds stupid.  I heard her several times eliminating the contraction and using both words in her speech.  I have to give her credit for trying.  

          Trying to explain "seen" and "saw" is a tougher problem.  Unfortunately, my students have heard "I seen" all their lives and don't have a clue about how to correctly use the words.  Once I explain the difference and talk with them about how to change it, I expect them to use it correctly in their speech and written work.

          One of my students this semester told me that she is going to work hard on it because she knows that "I sound stupid and I don't want to sound that way."  However, the other student with the problem laughed at me and dismissed the suggestion.  Either way, I will continue to try to impact these students and help them speak like they have brains in their heads.

          By the way, the nurse who told her patient that her doctor had "done gone" was once an elementary school teacher.  Oh my!

Tolerance

Betty Ford died last week.  She was one of the most gracious, classy, but outspoken first ladies our country has ever seen.  She opened the eyes of the public regarding breast cancer, substance abuse, and women's rights (in opposition to her husband).  She showed that we could disagree and still be agreeable.

Too often in today's political discussions, there is little or no respect for the other side of the issues.  Those with opposing viewpoints are made to appear ignorant or evil.  Both sides of the congressional aisle are eager to throw their opposition "under the bus" in order to be re-elected.  Good, honest debate about issues facing our country is very seldom heard. 

Unfortunately, most Americans believe everything they hear on the "news" and read on the Internet, almost all of which is biased.  Everyone is quick to point out bias on the other side, while ignoring the obvious bias of their sources.  Democrats complain about Fox, and Republicans complain about mainstream media.  There has always been bias in journalism, but never has the level of disrespect on both sides been as obvious as it is now.

I have had two interesting experiences that demonstrate this in connecting with old friends via Facebook.  Both have been raised in and around the same area all their lives, both are very liberal, and both are very intolerant of others' opinions.  My old friend from the neighborhood managed to take any post of mine and turn it into a political rant. She hated President Bush and any conservative representative.  After asking several times for her to stop trying to convert me and turn everything into a political issue, I cut ties with her.  The other friend lives an alternative lifestyle--no problem to me.  This man posted several items about how Republicans are ruining the country, including George Bush, who in his not-so-humble opinion, is responsible for everything wrong with the country starting in 1776 until the end of time.  He posted several "news" items from the Huffington Post about the stupidity of every Republican candidate.  I have to admit I posted a few opposing viewpoints from the Heritage Foundation just to make him angry--not my finest hour.  A comical post about welfare abuse apparently was too much for him.  He insulted me as being insensitive and eliminated me as a contact.  The intolerance of these two people, along with their insistence that their opinions are the ONLY opinions that matter, is very sad. 



Betty Ford asked that Cokie Roberts speak at her funeral about the way "it used to be."  When Ms. Roberts' father was a member of congress alongside Gerald Ford (on opposite sides of the aisle), both men could discuss differing viewpoints civilly.  They would apparently go to lunch together and decide ahead of time which issues to debate.  I have a feeling a lot more was accomplished in those days.

Until we start looking critically at the information to which we are exposed, I don't think the incivility will change.  Being able to speak your mind, no matter what you believe, is one of the greatest freedoms we have in this country.  We need to remember that other opinions have always and will always exist.  Being tolerant of other viewpoints is essential in insuring that the right to free speech is maintained for all of us.

Literacy

Today in the Muskegon Chronicle there was an opinion piece about the need for basic education to insure literacy in our high school graduates.  The writer gave an example of an adult who asked for help on a project that had several misspelled simple words.

We have done a wonderful job of making sure everyone feels good about themselves, but a terrible job of making sure they are functionally literate. The papers I grade in my nursing classes are generally well done, but several illustrate that grammar has been moved to the back burner in our schools.  Students are unable to discern between their, there, or they're, or its and it's.  They have no idea when to use an apostrophe.  They don't know how to construct sentences and  think it's completely appropriate to use common texting abbreviations.  Not only are the written assignments sometimes unreadable, today's students don't speak appropriately.

My biggest issue with speech is the improper use of seen and saw.  At least once a day, I hear a someone say, "I seen" or "I done." The people in the media add to the problem.  They frequently interview people who have no command of proper English and don't edit their responses.  Comedians have made fortunes telling jokes about people who are interviewed after their alien abductions and created laughs by making fun of their uneducated way of speaking.  Now we see that way of speaking creeping into the mainstream.

My fear is that we will grow so accustomed to improper grammar that the traditional rules will no longer apply.  I'm not at all perfect, but I try.  I also try to make a difference with my students by correcting them when I see or hear them use the incorrect tense of a word.  Truly, the English language is becoming a lost art.

Going Technical

For the first time ever, I have given the NUR 131 class an online quiz instead of taking time during the class to give a paper and pencil version.  There are still a few people in our department who don't like the idea of doing these online.  In fact, there are people who have problems with technology in general.

While technology is here to stay, many in our profession have a difficult time embracing its benefits, choosing to dwell on snippets of negativity they find disturbing (like the suicide of a student who was cyberbullied). Students were bullied long before social networking sites were invented.  Blaming it on Facebook or Twitter and discouraging their use in the classroom keeps us from using tools available to enhance our connection to our students and keep them engaged.  Students don't check their Email or answer their phones anymore.  However, text them and you get an immediate response. Post a comment or a message on their Facebook page and you will hear from them within 24 hours.  There are now seminars about using social networking in the classroom but closed minds won't consider the possibilities.  They argue that a quiz or exam online will lack security and lead to cheating.  In our field, that is a very serious consideration.  But are paper and pencil quizzes and exams really more secure?

Nursing exams are very secure documents.  In fact, if a candidate for NCLEX is caught discussing specifics of the licensing exam, it is grounds for denying a license.  We try to maintain that same security with our formal exams, though we know students talk. However, quizzes, which are usually given during class time, have never been as secure as our regular exams.  I have had students absent for half a quiz but still get 100%.  I believe that the online format may be even more secure than giving the quiz in an overcrowded classroom where students are right on top of each other making it very easy to cheat.

I believe the format for this first online quiz made it difficult to cheat, though students who are so inclined will find a way.  All questions were randomized, as were all the options.  The students had only 15 minutes to complete the exercise--definitely not enough time to look up answers, and were not able to go back to the quiz if they didn't complete the 10 questions.  A bigger question for me than how we are giving quizzes is why are we giving quizzes?

Several of us have discussed the rationale of the quizzes we give in our classes.  Apparently the first quizzes were given because the students were not doing well in the courses.  The quizzes were a way to help their grades.  WHAT??  We use the quizzes to inflate their grades?  Say it isn't so!

Nursing is unlike many other subjects in that the application of our content to a real patient situation can mean the difference between life and death.  Inflating the grades and giving students false confidence in their ability has the potential to affect their NCLEX preparation and success.  However, the bigger picture is that "helping" someone pass by inflating a grade might mean harm for a patient because of a future nurse's limited knowledge.  As I've said before, "There is no extra credit in nursing!"

Technology is not the enemy.   We have to tap into technological advances to reach students who are plugged in to the electronic world.  It will require a leap of faith, but our students and our patients deserve nothing less.

Empathic Connection

What is the difference between sympathy and empathy?  I have to teach this difference to our nursing students.  For some students, this is difficult. Sympathy can be very non-therapeutic.  For example, "I'm sorry" can be translated to mean "Thank God this didn't happen to me!"  Empathatic behavior, on the other hand, uses the "I-feel-your-pain" message, that is very effective when used sincerely.

Our empathy is what makes us human--what connects us to others.  Empathetic nurses cry with their patients, laugh with their patients, and grieve with their patients. Demonstrating empathy can cause the nurse to run the gamut of emotions--from the happiest to the saddest--and really requires the nurse to be aware of his or her beliefs, feelings, and ability to communicate effectively.  The roller coaster of emotions can go from high to low in a matter of minutes. 

I have sat with dying patients and laughed with them as they told me stories of their lives.  I have heard horrific stories of war--like the man who at 17 years old was on the beach at Normandy.  I have also served as a cheerleader as they raced toward the end of their lives and passed into the next, only to turn to face their family members as they realize their loved one was no longer with them.  I've laughed, cried, and laughed again--all in a matter of minutes.  Was I sorry that they had lost their loved one?  Absolutely!  But I did more than just say "I'm sorry."  I tuned in to their feelings and felt their loss.

We used to make my youngest daughter remove her iPod and interact with us on trips in the car.  Are young people so "plugged in" that they're not connecting with the rest of the human race?  We see them every day--with either a cell phone or earbuds--avoiding contact with those around them.  Will the nurse of tomorrow be able to demonstrate empathy?  Or will she be too self-absorbed to connect with a patient or family member during life's most important moments?  The Empathic Civilisation, by Jimmy Rifkin, explains how we are all connected.

The Empathic Civilisation, by Jimmy Rifkin

Jimmy Rifkin is a bestselling author, political advisor and social and ethical prophet.  In The Empathic Civilisation, he explains the evolution of empathy and the benefits of living in an empathic community.

Civility

I have found that I am becoming more tolerant of others' opinions as I get older.  While I have my own definite opinions, I have no problem letting other people express their different opinions as long as they're civil and also respect my beliefs.  However, I am learning that not everyone has the capability of being civil in a public forum. 

One of the best things about Facebook is the ability to reconnect with people from your childhood.  I was very happy to find a childhood friend after more than 40 years had passed.  We had a wonderful time reminiscing about the old neighborhood, the old school, and old friends.  However, whenever I posted anything with a political theme, She bombarded my page with lengthy diatribes against the people for whom I vote and support.  Several messages were rambling, angry, misspelled posts that should have been embarrassing to her.  She sent me speeches from members of Congress with the instructions to "watch with an open mind." 

I asked her to stop trying to convert me and refrain from stirring the political pot on my page.  I was accused several times of "drinking the kool-aid served by Rush Limbaugh." I find that reference offensive, knowing how many people died as the result of a madman.  I was accused of being mean-spirited, ignorant (of the facts as she sees them), and unable to make a decision without the help of (as she calls it) "Faux News."  She obviously has bad opinions of public education, too.  Her children are home-schooled.  By her.  Very frightening when you look at her grammar, spelling, and unwillingness to accept any opinion other than hers.

After a while, almost everything I posted on Facebook was subject to her rants about the evil Republicans and how they're destroying America.  I deleted most of them for two reasons. 

(1)   I have many well-educated, compassionate, very nice Republican friends on Facebook who would likely take offense to her nonsense.

(2)I have many well-educated, compassionate, very nice Democrat friends on Facebook who would likely be embarrassed by her nonsense.

 

While I disagree politically with about half of my friends on Facebook, I have never been attacked for my beliefs until now.  Most of my friends respect my opinions, as I do theirs.  It's the fringe lunatics on both sides of the spectrum who make it difficult for this country to come together and take care of the problems we are now facing.  I learned a long time ago to eliminate unneeded stress in my life wherever possible.  So, Laura, I have "unfriended" you.  I am sad that you could not respect my right to have an opinion other than yours.   I wish you much luck and hope you live a long, healthy life.