I have determined, at this moment, that I cannot stare at my care plan one more microsecond without a protracted breather and, since it is 12 degrees outside (or feels that way to this Florida boy) and is pitch black at 5:15 leaving no outdoor options, I thought it was an opportune time for a quick posting.
Another week on oncology has come and gone. Still not sure what to think about it. On one hand, it is interesting and makes you really think about blood labs. On the other hand, it can be one hell of a depressing place. A fellow student had a patient she worked with just prior to Thanksgiving pass away. I worked with a patient in end stage renal disease with lymphoma who stated her desire to do the same. These are people with severe, and often multi-faceted problems with recovery rates ranging from pretty good to nearly hopeless. It hammers home ever further what my friend went through and how fortunate he was to come out the other side of it. On a side note, I did get to observe a hemodialysis treatment which was quite fascinating, especially the science behind how they can quickly alter electrolytes, urea, and all sorts of other things within the blood.
The picture is clarifying some in regards to where I want to fit in within the profession. No epitomes, but at least I am thinning the theoretical herd. I am learning what facets of the profession I dislike (bed baths, assisting with activities of daily living, and feces) and what I do like (patient teaching, faster work pace with higher patient turnover, opportunities to work with a collaborative health care team and not solely the provision of direct care). It is hard to be clear when each door you close leads to other opportunities you had not previously considered. I am quite literally learning of another new opportunity each and every week in clinicals. Very exciting.
In far less exciting news, life is still chaotic and school will be a big part of that chaos until the 21st of December (though the bulk of school work will be completed by the end of next week). There is still no close date for the house sale, leaving Tia frustrated and all of us up in the air about move dates. The apartment is officially ours tomorrow, but we have not found a reasonably priced mover as yet and neither of us know enough people in this area to ask to help us move it on our own. That needs to be figured out either this coming weekend or, failing that, probably not until the 21st after Tia returns from a trip out west. Wedding plans continue to be complicated even though we were striving for simple and there is little more to say than that presently because I have been able to dedicate precious little time to it as yet. On top of that there are but the usual nagging concerns of daily life to contend which always seem more overwhelming when so much else occupies your time.
Speaking of time, I am once again running afoul of it. As always, time to get back to work.
Friday, November 30, 2007
Monday, November 26, 2007
M.O.W.
Another blink of the eye and another 10 days gone. I genuinely hope that remains the case for the upcoming 2 dozen. There is a part of me that feels like I should be taking in these experiences and trying to wring all that I can out of them, but there really isn't much time for that kind of reflection in this program......so I try to settle for just making it through by staring directly ahead at all times.
The Thanksgiving holiday was fast but enjoyable in its own small way. Tia and I ended up having our own turkey day after being ostensibly uninvited to our erstwhile friend's home. That is a long and convoluted story, but the moral is don't mix friends with business. We were invited to two other Thanksgiving events, but declined both and opted instead to make a meal at home and watch football. Tia is a mean cook and we ate particularly well. It was pleasant enough, but it was a bit solitary (and the fact that it did not stop raining throughout the day did not help matters). I suppose thats why we opted for an overnight trip to Niagara Falls the next evening. The trip to the Falls was really enjoyable and, in the area we were near, just as tacky as we both recalled. We lost a little bit of money at the casino, an equal amount at an arcade, and saw a gorgeous fireworks a light display in temperatures reaching into the low 20s. All in all, a nice way to close out a brief, but refreshing, holiday.
In addition to the usual holiday stuff, Tia has been trying to get me to love thy neighbor a bit more and volunteer around the holidays. I don't mind doing it, but without her I lack the motivation. Thankfully, she does not. We have volunteered with very positive results in Portland, so we ended up delivering food for Meals on Wheels (MOW) here in Rochester on Friday. We actually ended up delivering food in the downtown region, taking 10 meals to people in 2 separate high rise tenement buildings. The buildings made me thankful for what I have to be sure. Between the flickering dim lighting, the general disrepair, and the smell of decaying food I realized how very good I have things. I hope that I, nor anyone I know, ends up in such a situation.
We also adopted a family for the holidays. It seems a far better thing to do than buy gifts for people who don't have any needs and few wants that cannot be immediately gratified (or if not gratified by them, would be far beyond me to afford either). So the thought went anyway. We both still feel pretty good about it, but it is hard to want to shop for a person who requests things like a Baby Phat jacket and gold hoop earrings (suffice to say we did not pick the family we adopted. Also, no one in this family will be receiving a Baby Phat jacket). It is much easier to shop for her kids which need all the basic kid stuff and some toys to boot.
In both situations, I really wanted to feel that warmth the spirit of giving is supposed to give you way down deep, but all I really felt was sadness for the people getting MOW food for their paucity of options and a bit offended by the fact that a teenage mom would want more than the basics for herself with two kids to contend with. Not that it is fair to blame anyone for asking, but I suppose I always expect one to sublimate their own wishes for the benefit of their kids. I guess I also don't expect a teenage mom twice over, so people don't always make the best decisions.
I guess it is about that time again, time to load up the backpack and get geared up for another day sitting in an auditorium listening to endless hours of lecture and hoping that some of it sticks. Four weeks and counting until I can sling that aforementioned backpack into the deepest region of the closet to moulder for the better part of a month. I can hardly wait.
The Thanksgiving holiday was fast but enjoyable in its own small way. Tia and I ended up having our own turkey day after being ostensibly uninvited to our erstwhile friend's home. That is a long and convoluted story, but the moral is don't mix friends with business. We were invited to two other Thanksgiving events, but declined both and opted instead to make a meal at home and watch football. Tia is a mean cook and we ate particularly well. It was pleasant enough, but it was a bit solitary (and the fact that it did not stop raining throughout the day did not help matters). I suppose thats why we opted for an overnight trip to Niagara Falls the next evening. The trip to the Falls was really enjoyable and, in the area we were near, just as tacky as we both recalled. We lost a little bit of money at the casino, an equal amount at an arcade, and saw a gorgeous fireworks a light display in temperatures reaching into the low 20s. All in all, a nice way to close out a brief, but refreshing, holiday.
In addition to the usual holiday stuff, Tia has been trying to get me to love thy neighbor a bit more and volunteer around the holidays. I don't mind doing it, but without her I lack the motivation. Thankfully, she does not. We have volunteered with very positive results in Portland, so we ended up delivering food for Meals on Wheels (MOW) here in Rochester on Friday. We actually ended up delivering food in the downtown region, taking 10 meals to people in 2 separate high rise tenement buildings. The buildings made me thankful for what I have to be sure. Between the flickering dim lighting, the general disrepair, and the smell of decaying food I realized how very good I have things. I hope that I, nor anyone I know, ends up in such a situation.
We also adopted a family for the holidays. It seems a far better thing to do than buy gifts for people who don't have any needs and few wants that cannot be immediately gratified (or if not gratified by them, would be far beyond me to afford either). So the thought went anyway. We both still feel pretty good about it, but it is hard to want to shop for a person who requests things like a Baby Phat jacket and gold hoop earrings (suffice to say we did not pick the family we adopted. Also, no one in this family will be receiving a Baby Phat jacket). It is much easier to shop for her kids which need all the basic kid stuff and some toys to boot.
In both situations, I really wanted to feel that warmth the spirit of giving is supposed to give you way down deep, but all I really felt was sadness for the people getting MOW food for their paucity of options and a bit offended by the fact that a teenage mom would want more than the basics for herself with two kids to contend with. Not that it is fair to blame anyone for asking, but I suppose I always expect one to sublimate their own wishes for the benefit of their kids. I guess I also don't expect a teenage mom twice over, so people don't always make the best decisions.
I guess it is about that time again, time to load up the backpack and get geared up for another day sitting in an auditorium listening to endless hours of lecture and hoping that some of it sticks. Four weeks and counting until I can sling that aforementioned backpack into the deepest region of the closet to moulder for the better part of a month. I can hardly wait.
Friday, November 16, 2007
At risk for impaired religiosity
I was looking over my blogs and realizing that, well, the shine is off the proverbial apple. I had wanted a light touch, but it has evolved into a kind of banality that I blame entirely on the limitations placed upon the most precious of all commodities, personal free time. Nothing that can be done about it I suppose. Thanks for the continued patronage in spite of.
At this moment I am staring into the teeth of what will likely end up being another unmemorable weekend of more work than play. Although who would want to play in the scrotum clenching chill that has recently enveloped this region. It strongly dissuades one from going out except to collect only the most vital of necessities. And to think it isn't even really winter yet here. It will be some momentous task to make it through the coldest parts of the year, and I presume harder still to make it through the dark and frosty early morns that await me come January. So, me thinks its prime time for a rant.
As a nurse, one is expected to know a little bit about a lot of things from the jump. Once in the profession, your knowledge base specializes and is honed to a fine edge. You might not be able to diagnose like a doctor, but it appears you can eventually understand them and offer some input. In fact, there are a lot of things that doctors can do that we cannot. I dont begrudge them this right since they did go to school for a long time. However, somewhere along the line, nurses collectively determined that we ought to have our own diagnoses as well. The fact that they border on the ridiculous and flirt frequently with the inane is what truly ruffles me. We cannot say, for instance, that you have a breathing disorder, but we can say you are at risk for impaired breathing. We cannot say that you are anorexic, but can say that you are at risk for impaired nutrition. Some new ones I have come upon, and I shit you not as to there authenticity, are: energy field disturbance, risk for dysfunctional grieving, risk for impaired religiosity, risk for enhanced religiosity, and readiness for enhanced religiosity (where the readiness for impaired religiosity or the risk for dysfunctional religiosity (that one would be prevalent) is I dont know...........maybe the next NANDA update). How or why I would care about levels of religiosity or energy fields is beyond me, but I think it can be agreed upon that you cannot hope to be taken seriously if these are approved diagnoses. I might as well start reading patients' tea leaves or try to discern their aura to determine care. But maybe I am just at risk for impaired intellect from reading them in the first place.
To top off the enhanced ridiculosity (or risk of as the case may be) we are now supposed to incorporate 'cultural considerations' when writing up our care plans. What this means is that, based upon our discussions in class and with our clinical instructor, instead of walking into the room and assessing the patient based on their illness and various co-morbidities, we should assess them on their ethnic heritage as well. So, in essence, we focus not on the 98% of them that is primarily the same as everyone else and the fact that they are in a western hospital seeking medicine, but rather on the fact that the 2% of them that may be different. It is infuriating........but thats probably just my angry German/slavic heritage talking!
Off to grab some sour kraut and a beer before shuffling off to get some sleep so I am not at risk for impaired awakeness tomorrow.
At this moment I am staring into the teeth of what will likely end up being another unmemorable weekend of more work than play. Although who would want to play in the scrotum clenching chill that has recently enveloped this region. It strongly dissuades one from going out except to collect only the most vital of necessities. And to think it isn't even really winter yet here. It will be some momentous task to make it through the coldest parts of the year, and I presume harder still to make it through the dark and frosty early morns that await me come January. So, me thinks its prime time for a rant.
As a nurse, one is expected to know a little bit about a lot of things from the jump. Once in the profession, your knowledge base specializes and is honed to a fine edge. You might not be able to diagnose like a doctor, but it appears you can eventually understand them and offer some input. In fact, there are a lot of things that doctors can do that we cannot. I dont begrudge them this right since they did go to school for a long time. However, somewhere along the line, nurses collectively determined that we ought to have our own diagnoses as well. The fact that they border on the ridiculous and flirt frequently with the inane is what truly ruffles me. We cannot say, for instance, that you have a breathing disorder, but we can say you are at risk for impaired breathing. We cannot say that you are anorexic, but can say that you are at risk for impaired nutrition. Some new ones I have come upon, and I shit you not as to there authenticity, are: energy field disturbance, risk for dysfunctional grieving, risk for impaired religiosity, risk for enhanced religiosity, and readiness for enhanced religiosity (where the readiness for impaired religiosity or the risk for dysfunctional religiosity (that one would be prevalent) is I dont know...........maybe the next NANDA update). How or why I would care about levels of religiosity or energy fields is beyond me, but I think it can be agreed upon that you cannot hope to be taken seriously if these are approved diagnoses. I might as well start reading patients' tea leaves or try to discern their aura to determine care. But maybe I am just at risk for impaired intellect from reading them in the first place.
To top off the enhanced ridiculosity (or risk of as the case may be) we are now supposed to incorporate 'cultural considerations' when writing up our care plans. What this means is that, based upon our discussions in class and with our clinical instructor, instead of walking into the room and assessing the patient based on their illness and various co-morbidities, we should assess them on their ethnic heritage as well. So, in essence, we focus not on the 98% of them that is primarily the same as everyone else and the fact that they are in a western hospital seeking medicine, but rather on the fact that the 2% of them that may be different. It is infuriating........but thats probably just my angry German/slavic heritage talking!
Off to grab some sour kraut and a beer before shuffling off to get some sleep so I am not at risk for impaired awakeness tomorrow.
Wednesday, November 14, 2007
A half-assed entry
I haven't had much time to post lately and it looks like that will continue to be the case until Thanksgiving day or thereabouts.
Not much new of note. Finished up with neuro (big hell yeah!) and began in oncology (looks to be more interesting but, just the same, I would like a break prior to initiating this new and highly incongruent adventure). Day 1 went well at least. Lets hope that remains the case throughout.
We signed on with a new place to live.....a better than marginal, although not spectacular, 2/2 nearer to school. It comes with 72 channels of cable which trumps our current fuzzy four and all the heat and hot water we can handle. Downside is the same with all apartments: thin walls and a motley hodgepodge of neighbors.
Classes are settling down a bit, though not much. I hope my mind will continue to bend and not break. I'll try to expend more effort on the next entry.......no promises.
Gotta run off and do some damn assignment or another I am sure.
Til next time.
Not much new of note. Finished up with neuro (big hell yeah!) and began in oncology (looks to be more interesting but, just the same, I would like a break prior to initiating this new and highly incongruent adventure). Day 1 went well at least. Lets hope that remains the case throughout.
We signed on with a new place to live.....a better than marginal, although not spectacular, 2/2 nearer to school. It comes with 72 channels of cable which trumps our current fuzzy four and all the heat and hot water we can handle. Downside is the same with all apartments: thin walls and a motley hodgepodge of neighbors.
Classes are settling down a bit, though not much. I hope my mind will continue to bend and not break. I'll try to expend more effort on the next entry.......no promises.
Gotta run off and do some damn assignment or another I am sure.
Til next time.
Tuesday, November 06, 2007
While I have a moment
Having just finished a 15 minute assignment for research and evaluation (which is a rarity, of late, most assignments for that course have run into the 8-12 hour range) and having stuff I can do, but don't really feel like doing as my brain is presently having a harder time latching onto the readings than GW has latching onto words longer than two syllables, I thought I would post a quick note.
The usual school = shit continues unabated. It is part stress related from too much to do and not enough time to accomplish it all and part related to validity issues in testing. To illustrate:
Our adult and home health rotation, which encompasses 8 credit hours, is comprised of many facets that make up the whole of our experience. We spend 18 hours a week in clinical (16 on the floor and 2 in post conference), 6 hours a week in lecture, 2-3 hours a week in simulation or home health, and countless hours doing the readings, weekly write ups, journals, and taking exams outside of class time every other Monday. All told, I would say it takes up 35-40 hours of every given week without the class readings included. Maybe another 5-8 hours weekly for the readings. That is possibly a conservative estimate as well because I skim the readings generally, if I have time to do that much. (As a sidebar, the class grade is composed of 70% exams, 20% clinical papers, and 10% home health presentation, with 0% allotted to simulations. What that says to me is that the classroom/book information is far more important than the clinical experience and that the simulation isn't worth concerning myself over. So, the two facets that would help us most in practice upon graduation are the two facets that are given the least credence in grading.......just found that interesting since I won't be able to perform a lot of patient care on paper in the future.)
Research and Evaluation is an ebb and flow type of class where the work varies widely week to week. The class is once a week (Monday evening from 4-7, which follows the adult and home health 3 hour block lecture that afternoon and, every other Monday follows a 90 minute exam as well.......so it is very common to see nearly half the class leave during the break) and thankfully requires little outside reading (a misnomer as well, it is just that nobody ever seems to read the articles we discuss in class for lack of time). All classes include a 4th hour assignment (because the class is supposed to be a 4 hour block lecture) which ranges from 10-15 minutes to 8-12 hours in length. It takes up, on average, about 8 hours a week of our time.
The therapeutics lab is a pretty big cake walk. You have 2 hours a week you have to be there and about an hour a week to prep for it (maybe two if you read the assigned articles, 3 if there are videos to watch). Lets call it 4 hours on average.
All told, for 13 credit hours, there are conservatively 52-60 hours a week spoken for between classes, labs, and clinicals without taking into account any additional time for studying. Some weeks there are less and some more. I dont know how people with children or who are working part time (though they often don't have the research class to deal with) manage. Even in the face of this, sometimes you just say to hell with it and write a blog.
The testing validity issue is the other major stressor. We frequently spend significant time studying for our tests only to have material brought in from other courses, questions about medications that we couldn't possibly know, or an endless number of multiple multiple questions (which are choose all that apply) where if you miss one of the five possible right answers out of eight options you miss the question entirely. No one complains about how hard the class is (Pathophysiology was much more arduous), but we do complain vociferously about how what we learn isn't what we are tested on. Hence, the class average is precipitously low.
I have simple tried to adapt as best as I can. I aspire to do well, but i am learning to accept that passing is all that is important and that much I can and will do, even if I am kicking and screaming the entire way. In the end, the result is the same.....cap, gown, and new career.
Just don't ask me about the renin-angiotensin system......I haven't had a chance to read that yet.
The usual school = shit continues unabated. It is part stress related from too much to do and not enough time to accomplish it all and part related to validity issues in testing. To illustrate:
Our adult and home health rotation, which encompasses 8 credit hours, is comprised of many facets that make up the whole of our experience. We spend 18 hours a week in clinical (16 on the floor and 2 in post conference), 6 hours a week in lecture, 2-3 hours a week in simulation or home health, and countless hours doing the readings, weekly write ups, journals, and taking exams outside of class time every other Monday. All told, I would say it takes up 35-40 hours of every given week without the class readings included. Maybe another 5-8 hours weekly for the readings. That is possibly a conservative estimate as well because I skim the readings generally, if I have time to do that much. (As a sidebar, the class grade is composed of 70% exams, 20% clinical papers, and 10% home health presentation, with 0% allotted to simulations. What that says to me is that the classroom/book information is far more important than the clinical experience and that the simulation isn't worth concerning myself over. So, the two facets that would help us most in practice upon graduation are the two facets that are given the least credence in grading.......just found that interesting since I won't be able to perform a lot of patient care on paper in the future.)
Research and Evaluation is an ebb and flow type of class where the work varies widely week to week. The class is once a week (Monday evening from 4-7, which follows the adult and home health 3 hour block lecture that afternoon and, every other Monday follows a 90 minute exam as well.......so it is very common to see nearly half the class leave during the break) and thankfully requires little outside reading (a misnomer as well, it is just that nobody ever seems to read the articles we discuss in class for lack of time). All classes include a 4th hour assignment (because the class is supposed to be a 4 hour block lecture) which ranges from 10-15 minutes to 8-12 hours in length. It takes up, on average, about 8 hours a week of our time.
The therapeutics lab is a pretty big cake walk. You have 2 hours a week you have to be there and about an hour a week to prep for it (maybe two if you read the assigned articles, 3 if there are videos to watch). Lets call it 4 hours on average.
All told, for 13 credit hours, there are conservatively 52-60 hours a week spoken for between classes, labs, and clinicals without taking into account any additional time for studying. Some weeks there are less and some more. I dont know how people with children or who are working part time (though they often don't have the research class to deal with) manage. Even in the face of this, sometimes you just say to hell with it and write a blog.
The testing validity issue is the other major stressor. We frequently spend significant time studying for our tests only to have material brought in from other courses, questions about medications that we couldn't possibly know, or an endless number of multiple multiple questions (which are choose all that apply) where if you miss one of the five possible right answers out of eight options you miss the question entirely. No one complains about how hard the class is (Pathophysiology was much more arduous), but we do complain vociferously about how what we learn isn't what we are tested on. Hence, the class average is precipitously low.
I have simple tried to adapt as best as I can. I aspire to do well, but i am learning to accept that passing is all that is important and that much I can and will do, even if I am kicking and screaming the entire way. In the end, the result is the same.....cap, gown, and new career.
Just don't ask me about the renin-angiotensin system......I haven't had a chance to read that yet.
Friday, November 02, 2007
50 days
That's what it comes down to at this point......50 days (well i was fifty days when I started this post anyway. Unfortunately, I have been too busy to finish it until today. Might be 47 days give or take now. A shame really, 50 seemed much more imposing). Not all of them are class days, but that is the sum total that stands between this moment and the day I walk out of my last clinical experience for this semester. Fifty days isn't much, but lately I feel every one of them. I have heard, though who knows if it remains true since this program goes through more changes than an adolescent during puberty, that the next term is somewhat less taxing. I hope so at this point......or at the very least that the break provides/restores some semblance of balance and sanity. In the meantime, I am just trying to make it to the next holiday (16 days for those who are counting).
A lot has gone on since my last post, foremost amongst the group is my recent engagement to Tia. I ended up carving it into a pumpkin, which she thankfully deemed creative enough to acquiesce to my proposal. I am pretty excited about it....or at least I will be pretty excited about it as soon as I have the time to be. Seems like we are both on board for an inexpensive wedding and an eventual more lavish honeymoon. Assuming I ever make an income again that is.
Tia's parents came to visit for a brief, but enjoyable, weekend. Had an opportunity to go out to see the museum of glass which was far more interesting than I thought it would prove to be. I would recommend anyone who ends up in the frigid climes of western NY to visit it. We had intended to go to the Bodies exhibit as well, but her parents ended up helping tie up a few house projects and I ended up typing a single study review and carving the aforementioned pumpkin.
I finally got to visit the OR on Thursday. The procedure I witnessed didn't lend itself overmuch to ogling and there were more people in the surgical room than there were F-bombs in Scarface, but it was fascinating nonetheless. The procedure was a Laproscopic Cholectystectomy & Laproscopic Myotomy with partial fundiplication. It was done to repair a motility problem in the esophagus (severe GERD and swallowing problems) and to remove the gall bladder. They essentially punched 4 holes in the patient's belly (which they filled with a gas to distend), put plastic reservoirs in the holes to keep them open, and then stuck an endless stream of cameras, clamps, harmonic blades, flushes, and suction tubes through the holes. It was beyond interesting. I have no idea how the surgeons master these tools and the extremely fine motor control required to use them to cut through layers of adipose tissue, connective fibers, and arteries to remove the gall bladder and then stitch up wounds inside the body with use of cameras, the aforementioned clamps, and a small curved needle and thread which they have to be meticulously careful with to avoid puncturing anything else. Just prior to stitching up the patient, they yanked his gall bladder through one of the small holes, like a macabre magic trick with human organs. Very cool.
Tia's house is through most of the required processes for sale. The last issue is approval from the govt for the house loan for the buyer. Tia's parents, Tia and I cleared up what issues we could including fixing some windows to slide easier, removing the pool (done by someone who got a free pool out of it), and locating and removing two dead birds from the attic (I swear this was a request). The next step will be finding a new place to live and then relocating our belongings to it in the middle of winter. The party doesn't stop up here.
I need to get back to writing up a care plan and doing innumerable other school related tasks.
16 days until Thanksgiving!
16 days!
16 days!
A lot has gone on since my last post, foremost amongst the group is my recent engagement to Tia. I ended up carving it into a pumpkin, which she thankfully deemed creative enough to acquiesce to my proposal. I am pretty excited about it....or at least I will be pretty excited about it as soon as I have the time to be. Seems like we are both on board for an inexpensive wedding and an eventual more lavish honeymoon. Assuming I ever make an income again that is.
Tia's parents came to visit for a brief, but enjoyable, weekend. Had an opportunity to go out to see the museum of glass which was far more interesting than I thought it would prove to be. I would recommend anyone who ends up in the frigid climes of western NY to visit it. We had intended to go to the Bodies exhibit as well, but her parents ended up helping tie up a few house projects and I ended up typing a single study review and carving the aforementioned pumpkin.
I finally got to visit the OR on Thursday. The procedure I witnessed didn't lend itself overmuch to ogling and there were more people in the surgical room than there were F-bombs in Scarface, but it was fascinating nonetheless. The procedure was a Laproscopic Cholectystectomy & Laproscopic Myotomy with partial fundiplication. It was done to repair a motility problem in the esophagus (severe GERD and swallowing problems) and to remove the gall bladder. They essentially punched 4 holes in the patient's belly (which they filled with a gas to distend), put plastic reservoirs in the holes to keep them open, and then stuck an endless stream of cameras, clamps, harmonic blades, flushes, and suction tubes through the holes. It was beyond interesting. I have no idea how the surgeons master these tools and the extremely fine motor control required to use them to cut through layers of adipose tissue, connective fibers, and arteries to remove the gall bladder and then stitch up wounds inside the body with use of cameras, the aforementioned clamps, and a small curved needle and thread which they have to be meticulously careful with to avoid puncturing anything else. Just prior to stitching up the patient, they yanked his gall bladder through one of the small holes, like a macabre magic trick with human organs. Very cool.
Tia's house is through most of the required processes for sale. The last issue is approval from the govt for the house loan for the buyer. Tia's parents, Tia and I cleared up what issues we could including fixing some windows to slide easier, removing the pool (done by someone who got a free pool out of it), and locating and removing two dead birds from the attic (I swear this was a request). The next step will be finding a new place to live and then relocating our belongings to it in the middle of winter. The party doesn't stop up here.
I need to get back to writing up a care plan and doing innumerable other school related tasks.
16 days until Thanksgiving!
16 days!
16 days!
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