Meme me baby!

Keep Breathing just posted on a new meme circulating around the blogosphere.  The rules say thus:

Pass it on to five other bloggers, and tell them to open the nearest book to page 56. Write out the fifth sentence on that page, and also the next two to five sentences. The CLOSEST BOOK, NOT YOUR FAVORITE, OR MOST INTELLECTUAL!

I have an issue with this.  First, I’m on the couch and the closest “book” is a video game booklet.  Second, since nursing school, my relationship with books has been tenuous at best.  Somedays I can read voraciously, other days I have the attention span of a gnat.  Third, I tend to read more magazines than books right now. I get into heavy books so I can only do a couple a year.  Since I don’t have a book handy, I’ll do the next best.  An excerpt from Wired, November 2008:

“From a decommissioned bomb shelter four stories beneath Los Angeles City Hall, this 23-year veteran is singlehandedly hauling the city’s fire department into the Web 2.0 era.  He has about 80 projects in the works – involving everything from Twitter to BlogTalkRadio – that will not only help broadcast urgent information to the public but also gather crucial intel to assist first responders on the ground.”

From, “Smoke Detector: The LAFD’s one-man geek squad.”

Yes, I’m a geek.  That said, I’m not going to nominate anyone else.  But if you want to play along, go right ahead!

Conference Notes and a Meme

Instead of going to work last Thursday and Friday, I got the chance to sit, learn, schmooze, soak up free stuff, eat bad hotel food, reconnect with an old friend, drool over HDTVs and not work. Sure, my boss didn’t pay me to attend the conference but rather paid my way for it – which is almost as good. It was incredibly fascinating. Over my head, but fascinating. The conference was geared towards ICU nurses, but I was able to get a lot out of some of the presentations. Some went completely over my head and had no impact or bearing on my practice.

The highlights:

A presentation about CA-MRSA.

Considering the latest hoopla in the news, this was a welcome bit of science. The speaker differentiated between Community Acquired and Hospital Acquired MRSA, most notably the “Panton-Valentine Leukocidin (PVL)” toxin found predominantly in CA-MRSA. This is a nasty, nasty toxin. He showed slides showing normal rat lungs, rat lungs without PVL and lungs with. While the lungs of non-PVL MRSA were injured, the necrotizing effect of the PVL literally turned the lungs to mush. Not a pretty picture. He also showed histological samples of white blood cells attacked by the bug literally leaking fluid contents out through punctured plasma membranes.The speaker also presented statistics showing the uptick in cases of CA-MRSA and increasing mortality rates especially in MRSA pneumonia. One especially sinister aspect to the PVL+ CA-MRSA is the speed it can progress. One of the case studies presented showed a rapid consolidation in the lungs leading to death approximately 36 hours after presentation due to respiratory failure and septic shock. He also noted in the research notes that approximately 50% of skin infections in the community are due to CA-MRSA.

Another presentation was about unhealthy work environments. While there was a lot of “kum-by-ya” touchy-feely stuff, there were a couple of great take aways. First, was the concept that on a unit, “no one sits until we all sit.” Meaning that everybody pitches in to help and make usre that no one is left behind, struggling or just plain lost. As nurses we’ve all had those nights where 2 or 3 of our co-workers (or aides…) are sitting surfing the web while you’re running around like a maniac trying valiantly to at least keep your head above water. Second was a quote about ratios where basically, “if you have time to sit at the bedside and look you patient in the eye and truly learn their needs your ratio is ok.” One of my biggest issues with my unit has been ratios. I think we’re staffed too short for the acuity of our patients. But when I take that idea into mind, it seems like it might be OK. At least lately.

There were others like a presentation on hypothermia post-cardiac arrest, acute renal failure in ICU settings, spectacular trauma cases (which was waaaay cool!), some stuff on nutrition and one on clots and clot busters. It was a great experience. Perhaps the highlight though was in talking to the Stryker rep, found out that my unit is getting new beds. Very, very, very nice new beds. Evidently our manager had gone to bat for us (as a unit) that we needed beds of a higher caliber than what we had been using. Sound like she really went out of her way and fought hard to get this. These beds are amazing. All have bed alarms, bed weights, will turn your patient for you, convert to a chair and allow one tiny nurse to push a 550lb. patient to Xray. These beds are going to save our backs and make life a little bit easier.

The other take away from the conference was how it made me feel. It made me want to step up my game as a nurse and take a greater interest and active role in the way my unit is run. Maybe instead of bitching about all the things that are going poorly, maybe actually work to try to change those things and make it a better place to work. I came away with a renewed sense of excitement and hope. Of course that will last all of about five minutes when I walk in the door nest night I work and see nothing but geri-chairs and tent beds all down the hallway…

Read the meme after the jump…