The Stages of Grief

I'd like to welcome back author and counselor Betsy Duffey today as she discusses grief. Don't forget to pick up a copy of their fantastic novel, The Shepherd's Song, if you need an uplifting group of intertwined short stories surrounding Psalm 23.

I'm giving away a hard cover copy of this novel! Leave a comment on this post to be eligible. Winner drawn on Sunday, May 3rd.

Grief is something that is dealt with a lot in novels but did you know that there are some very classic grief stages? These stages can give you some writing fodder for your characters.

Welcome back, Betsy.

When you are writing about grief, it’s helpful to know the emotional stages that a character might experience after loss. The stages of grief were defined by Elisabeth Kubler-Ross in her 1969 book, On Death and Dying. Knowing where your character is in the stages of grief will allow you write more realistically. Here is an overview with some ideas about what your character might say and do in each stage. Remember that people go through the stages at their own pace. Resolving grief can take years, and people can cycle back through the stages as they heal.

Denial: Denial is almost always the first reaction to loss. It looks like numbness or shock. Subconsciously, this is a way for the person to protect themselves. In this stage the person may seem uncaring.

If your character is in the denial stage they will say things like:

I thought I heard him last night.

Every time I answer the phone I expect it to be her.

It must be a mistake.

                     

Bargaining: Bargaining can been seen in two ways. One, the person can’t stop thinking about what they could have done to prevent the loss. The other can be a bargaining with God to reverse the loss.

If your character is in this stage of grief they will say things like:

If only I had stopped him.

If I had gone with her it never would have happened.

God, if you save him I will never  . . . again.

Depression: Eventually most people recognize the true extent of the loss and can experience depression. This can make others uncomfortable and worried, but is an important part of the healing process.

If your character is experiencing depression from grief they will say things like:

I can’t stop crying.

I’m not hungry.

Nobody understands.

Anger: Grief can cause a person to feel helpless and out of control leading to anger. The person can be angry at God or in the case of a death, at the person who died. Guilt often follows the anger. Anger is often expressed at others.

If your character is experiencing anger in grief they will say things like:

Leave me alone!

It’s your fault! It’s the doctor’s fault!  It’s God’s fault!

God let this happen!

Acceptance: As people heal and move through the various stages of grief, they finally will come to acceptance. This can take years and may not ever happen.

If your character is in acceptance they will say things like:

We had so many good times.

I can see God working in this.

I remember when…

The stages of grief can be demonstrated with loss due to death, but people experience other losses that can take them into these stages. Loss of a job, moving from your home, sending a child to college, losing ability through illness. The list is endless. Knowing these stages can add depth to your writing as you take your character through grief to healing.

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Betsy Duffey is a licensed counselor and also a writer. She grew up in a writing family and with her sister, Laurie Myers, began critiquing manuscripts at an early age for their mother, Newbery winner Betsy Byars.  Betsy and Laurie went on to become authors of more than thirty-five children’s novels. Their first book for adults, The Shepherd’s Song, is being released in paperback  April 2015. You can connect with Laurie and Betsy on their monthly newsletter where they send out updates and their popular free devotional books. Contact them at WritingSisters.com  and find them on Facebook, Twitter or Pinterest.

Five Surprising Addictions

I'm pleased to host author and counselor Betsy Duffey who guest blogs today about some surprising addictions you your character may have.

I had the honor of reviewing The Shepherd's Song which is a set of intertwined storied surrounding Psalm 23. It has the feel of a Dan Walsh or Mitch Albom story so definitely pick it up if you like that genre or just need a sweet, inspiring pick me up.

I'm giving away one hard cover copy of this novel! Leave a comment on this post to be eligible. Winner drawn on Sunday, May 3rd. 

Welcome Betsy!

When we think of addictions, alcoholism or drug use come to mind first. As the understanding of addiction increases we see that behaviors can be addictive. A good simple definition of addiction is compulsive engagement in rewarding stimuli, despite adverse consequences. Addiction to a certain behavior interferes with our work, relationships or health. The following behaviors are common behavioral addictions presented with some signs that your character would exhibit.

The Internet  

Not everyone who uses the internet will become addicted even when they use it excessively. Use of the internet can be unhealthy if it replaces real life interaction and causes dysfunction in relationships, health or work. Your character might be addicted to the internet if:

They are on line more than 30 hours a week.

They are irritable and anxious if they lose access to the internet.

They feel more normal online than in real life.

They try to control their time online but can’t.

Video Games

If playing video games becomes more important than family, friends, work, or school it might be an addiction. Your character might be addicted to gaming if:

They play for increasing amounts of time.

They use gaming to escape from real-life problems.

They lie to friends and family to conceal gaming.

They give up other pleasurable activities to play games.       

Love

Love addiction can seem to be about loving but is more about the need for the person to be in a relationship. Your character might be addicted to love if:

They constantly seek out new love relationships.

They won’t let go, obsessing or stalking.

They will change who they are to be in a relationship.

They will tolerate abuse to stay in a relationship.

Negativity

Brains react more strongly to negative thoughts than positive ones. Some people become addicted to the stimulation of negative thoughts. Your character might be addicted to negativity if:

They see the glass half empty.

They are never satisfied.

They dwell on negative past experiences.

They like to complain but don’t like to take action to fix problems.

Exercise

It’s hard to see addiction when we look at a behavior that is usually positive, like exercising. But even a positive thing taken to extremes can become an addiction. Your character might be addicted to exercise if:

They exercise beyond their physical needs.

They become anxious or guilty when they can’t exercise.

They put their bodies at risk exercising when injured.

They never feel satisfied with the amount of exercise.

If your character is exhibiting symptoms of behavioral addiction there is hope. Recognizing the problem is the first step. Finding help through counseling or a support group is the second.

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Betsy Duffey is a licensed counselor and also a writer. She grew up in a writing family and with her sister, Laurie Myers, began critiquing manuscripts at an early age for their mother, Newbery winner Betsy Byars.  Betsy and Laurie went on to become authors of more than thirty-five children’s novels. Their first book for adults, The Shepherd’s Song, is being released in paperback  April 2015. You can connect with Laurie and Betsy on their monthly newsletter where they send out updates and their popular free devotional books. Contact them at WritingSisters.com  and find them on Facebook, Twitter or Pinterest.

Up and Coming

Hello Redwood's Fans!

How has Spring been treating you so far? Even though Spring ranks low on my list of favorite seasons (it would be 3/4), I do LOVE spring thunderstorms. Anyone else? Not the hide-in-your-basement-a-tornado-is-coming scary. Just the nice gentle patter of rain with flashes of light and thunder.

Anyone else?

I lived in "Tornado Alley" for thirteen years and even though there were tornadoes in Kansas when I lived there, the only two I ever saw and one that our family had to shelter from was in Colorado.

I know, right?

For you this week.

I'm so happy to get to host authors Betsy Duffey and Laurie Myers this weeks. Both have backgrounds in the medical field. Betsy is a counselor and Laurie is a nurse. They've written a truly lovely book of intertwined tales that surround Psalm 23. As readers of this blog know, my go to genre is suspense but I truly loved this book and its sweet stories. If you like authors like Dan Walsh or Mitch Albom then I think you'll really enjoy their novel.

They're visiting Redwood's this week to celebrate the release of The Shepherd's Song in paperback but any commentors on their blog posts this week (including this one) will be eligible to win a hardback copy. Comments will close Saturday, May 2nd at midnight MST time. Winner will be announced on Sunday, May 3rd!

Their posts will discuss addictions and the stages of grief. Great information for the novelist for character development.

Do I Have Measles?

Since immunization rates in many communities are down, the recent outbreak of measles that originated in Disneyland, CA is not going to be a rare event.

We're getting more parents in to the ER with concern that their children have been infected with measles. Thankfully, I've not seen a positive case yet. Generally, it's a rash of some other origin like hives, viral rash, or strep rash.

The best way to NOT get measles is to get immunized-- plain and simple.

But, here's some information straight from the Colorado Department of Public Health about measles infection.

Measles is highly contagious. It is a viral illness meaning that antibiotics aren't going to cure it. We can only do symptomatic support. It causes fever and a distinct rash. The incubation period is 7-21 days. An incubation period means you are infected but are not yet showing signs of illness. Measles is spread via droplets (it can live on surface areas for up to two hours) and airborne via coughing or sneezing.

Early symptoms are fever (over 101.0 F), cough, runny nose and reddened eyes.

The rash usually begins on the face after 2-4 days of the above symptoms and then spreads from the head down and outward to the limbs. The rash is red, splotchy and raised meaning you can feel it if you brush your fingers over it.

Patients who present to the emergency department should be immediately isolated and placed in negative-pressure rooms if available. A negative-pressure room sucks air into it versus pushing air out into the rest of the department. Also, the room should be cleaned and then quarantined for two hours after the patient is discharged or admitted.

Only healthcare workers who have measles immunity should care for these children.

People at risk for severe illness and complications from measles are infants less than 12 months, pregnant women who don't have measles immunity, and those who are immunocompromised.

Go here to learn more about measles infection.

What REALLY Happens While I'm Under Anesthesia: 3/3

Today concludes a three-part series by guest blogger and CRNA Kim Zweygardt about what really happens in the OR. Kim took on several FB questions regarding anesthesia and the OR that I thought would be great info for writers.

Thank you, Kim for sharing your expertise with us.

Follow the links for Part I and Part II.

7. How aware are you under anesthesia? And I've heard sometimes people wake up during surgery but you give a medicine so they don't remember. Is that true?

Let me answer the second part first. As I mentioned earlier, we give a combination of medicines in anesthesia and some drugs have an amnestic effect. So yes, there are drugs that we give you that provide amnesia so you don't remember what happened. They can be given as part of a general anesthetic or as a sedative. But there are times someone says they “woke up during surgery” when they were sedated not anesthetized.” So what constitutes being asleep for surgery? For us, being asleep is a general anesthetic where you are so deeply unconscious that we are assisting your breathing. But, sometimes the actual anesthetic is a spinal, another nerve block or a local anesthetic. Because most people don't want to know what is going on, we will give you sedation and you take a nap during the surgery. From our perspective, you are not "asleep," you are napping, but from your perspective, you went into surgery and "went to sleep!" That causes confusion. I have patients tell me they woke up during their surgery. When we give you medicines to nap, you may wake up and be aware of what is going on. I tell patients that the difference is if I want to talk to you, I can call your name and ask you how you're doing. You'll wake up and talk to me and then when I leave you alone, you'll drift back into your nap. But if you have a general anesthetic, I can talk to you all day and you won't answer because you are totally unconscious.  As far as awareness, it depends on whether you are sedated (you may remember some things) or have a general anesthetic (you should not be aware during the operation). We've all heard the horror stories about people being awake during an operation. It does happen but is very, very rare.

8. How do you let the doctor know you are awake during the anesthetic?

As I said, true awareness is very rare. When it happens (or when they make awful movies about it) it makes the headlines but don't forget that hundreds of thousands of anesthetics are done every day without awareness. I mentioned before that the amount of anesthetic you need is based on how much surgical stimulation there is (fancy way of saying how much it hurts). Even when you are anesthetized, your body still responds to pain if the anesthesia isn't enough. The heart rate goes up. The blood pressure goes up. You will even have tears when it hurts. That is one of the reasons we are watching you every moment. If we see those changes, we can give you more medicines so that your body doesn't have that stress response. The patient "tells" us the anesthetic needs to be deepened by all those changes in vital signs.

9) What do people say while they are asleep?

When I became a CRNA, we used Sodium Pentothal which was famous in movies as "truth serum." It was a common question then about what they might say during an anesthetic. For “truth serum” very small sedative doses were given so the person was groggy. The thought was they were too drowsy to lie! But for anesthesia, a large dose is given so the patient is asleep in minutes with no time for conversation! I once interviewed a man who questioned me extensively seeking assurance he wasn't going to say anything because of "that truth serum!" He even sent his wife out of the room while he questioned me further! I always wondered what he wanted to hide! Now we use a drug called Propofol. It works even quicker than Pentothal so rest assured, if you are going to sleep (general anesthetic), you're not giving away any secrets!

10. What is the strangest thing you've heard someone say under anesthesia?

I once put a known psychic to sleep. The case was added on to the end of a long surgery day because the patient had forgotten to come for surgery the day before. (Which I found funny since she was a physic. Those of you who know me personally, get my sense of humor!)  She was a very pleasant woman and when questioned didn't mention anything about having problems with anesthesia in the past. She was completely anesthetized when the surgeon stuck his head in the door to ask, "Did she tell you she has a history of recall during anesthesia?" Well, no, she hadn't mentioned that small detail to me! I immediately turned up the anesthetic gas and gave some other medicines and but as I did, in a spooky séance' type voice said, "If you can hear me, let me know!" As soon as the words were out of my mouth, her pulse went up significantly and I am sure she was doing exactly that although I never had the heart to ask after I woke her up! Years later I read a fascinating article about the subconscious mind and anesthesia awareness that made me think of her but that is another post!

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Kim Zweygardt always knew she wanted to be someone special.  Her heart’s desire when she was 7 was to be a famous ballerina but when she read their toes bled from dancing on them, it became a less desirable career choice. Then Kim decided to be a famous lawyer solving mysteries and capturing the bad guys just like Perry Mason, but as she got older she discovered sometimes it was hard to tell just who the bad guys were.

Instead Kim chose a career in medicine practicing the art and science of anesthesia as a Certified Registered Nurse Anesthetist in rural Kansas, Colorado and Nebraska.

Kim is married to Kary, the man of her dreams, who has done a fabulous job of making all her dreams come true. They have three children but an empty nest and enjoy conversation with friends over good coffee and great food. They enjoy travel, the arts and taking a nap.

Member American Christian Fiction Writers, International Speakers Network, www.bookaspeaker.net, www.womenspeakers.net

What REALLY Happens While I'm Under Anesthesia: 2/3

I'm continuing with a three part series written by guest blogger Kim Zweygardt on what really happens while you're under anesthesia. Great information for authors. 

You can find Part I here.

Welcome back, Kim!

4. Why is my throat so sore after anesthesia? (The actual question involved us ripping your throat out under anesthesia but I niced it up!)

With almost all surgeries, you are breathing extra oxygen that isn't normally humidified and can really dry your throat out and cause it to be sore. Sorry about that! With bigger surgeries, we insert devices to maintain your airway. Anesthetics depress your breathing and these devices allow us to breathe for you to make sure your body gets all the oxygen that it needs. They are made of soft plastic, but they can irritate and cause a sore throat after surgery. And some people have anatomy that makes the insertion more difficult and that can also cause a sore throat. As a general rule, the sore throat is gone in about 24 hours. Treat it like a normal sore throat--pain meds and warm fluids help lots.

5. I love going to la-la land, but why is it so hard to wake up? (I've also heard this--"I just wanted to sleep and the nurses kept making me wake up in the recovery room! How come?")

I could give you lots of technical mumbo jumbo about how drugs are metabolized but I think the more important thing to remember is this: We give you medicines based on your weight and that health history we took but also based on what type of surgery you are having and how uncomfortable that surgery is! It's not the same amount of pain to have eye surgery or your gall bladder out. We give you these drugs so you will be comfortable and/or asleep, depending on what the surgeon is doing--that even varies at different times during the surgery because some parts of the operation may be more pain producing than others. A few minutes later, the surgery is over and what was the perfect amount of anesthesia now has you really sleepy because that stimulation is gone. We can reverse some of the medications but we also let your body gradually metabolize them so you are groggy and comfortable after surgery. And just like when you are fast asleep at home and someone wants to bug you? You'd rather be left alone!

6. I was told to think of something pleasant as I went to sleep and I woke up great! The doctor said how you go to sleep is how you wake up. Is that true?

There is a lot of truth to this. When you are anxious you release all kinds of stress hormones into your bloodstream and that can translate into a very rocky anesthetic including wake up. Thinking of something pleasant causes you to release endorphins which is like the body’s own morphine. That sense of wellbeing carries over as well not to mention the power of positive thinking! One technique I use with teenagers who tend to wake up wild is to explain to them pre-op how it will feel waking up and what I want them to do. Because they have had a chance to think about it ahead of time, when I tell them surgery is over and they should lie still, they do it because even through the “waking up fog” their subconscious remembers my words. Anything we can do pre-op to allay anxiety makes for a smoother waking up.

Tune in next post for Part III. 

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Kim Zweygardt always knew she wanted to be someone special.  Her heart’s desire when she was 7 was to be a famous ballerina but when she read their toes bled from dancing on them, it became a less desirable career choice. Then Kim decided to be a famous lawyer solving mysteries and capturing the bad guys just like Perry Mason, but as she got older she discovered sometimes it was hard to tell just who the bad guys were.

Instead Kim chose a career in medicine practicing the art and science of anesthesia as a Certified Registered Nurse Anesthetist in rural Kansas, Colorado and Nebraska.

Kim is married to Kary, the man of her dreams, who has done a fabulous job of making all her dreams come true. They have three children but an empty nest and enjoy conversation with friends over good coffee and great food. They enjoy travel, the arts and taking a nap.

Member American Christian Fiction Writers, International Speakers Network, www.bookaspeaker.net, www.womenspeakers.net

What REALLY Happens While I'm Under Anesthesia: 1/3

A fellow writer and good friend of mine is a CRNA-- certified registered nurse anesthetist. That means she was first an RN and then specialized in anesthesia. Kim works in a rural setting delivering primary anesthesia care covering thousands of patients. If it weren't for CRNA's like Kim, people living in rural communities would likely have to travel hours (or be transferred by EMS services very expensively) for even minor procedures.

Kim put out a call on her FB page for questions about anesthesia that I thought would be good info for Redwood's readers.

Welcome back, Kim!

Let's start with the boring stuff:

1. Why do I have to answer so many questions before surgery?

One common misconception about anesthesia is that we just give you some magic drug that makes you sleep for as long as surgery takes. It actually is a lot of different drugs that work in different ways and that your body metabolizes in different ways. Some drugs last different amounts of time. Some drugs depress the heart or aren't good for people with lung problems. We ask all those questions so that we can give you the best anesthetic for you! And that's another thing--we don't really care or judge you about things you do or don't do. We just want to take the best care of you so don't lie to your CRNA! If you have had something to eat or drink, taken a medication, or if you drink, smoke or use drugs, tell us! It could be life or death!
2. I thought only doctors gave anesthetics. What is the difference between a CRNA and an anesthesiologist?

Nurses were the first anesthesia providers and have been safely providing anesthesia since the late 1800's. We were the first Advanced Practice Nurses and have the most autonomy of any nursing specialty.  CRNAs provide anesthesia in all 50 states and our military men and women are cared for by CRNAs around the world. Over 60% of all anesthetics are given by CRNAs. The main difference is where our training begins. A CRNA goes to nursing school, works as an RN in Critical Care and then completes both clinical and didactic training in anesthesia to become a CRNA after passing boards. An anesthesiologist goes to medical school and then completes a residency with clinical training in anesthesia. Often the cases and textbooks used are the same and many large teaching hospitals train both CRNAs and their doctor counterparts side by side. Over and over studies have shown no difference in safety and outcomes between CRNAs and MDs, so no, you don't have to be a doctor to do anesthesia.

Now for the more interesting stuff!

3. Where do you go while I'm asleep?

Nowhere! We monitor you heart beat by heart beat and breath by breath to make sure you are getting exactly the amount of anesthesia that you need. Our only job is to take care of you during surgery! We don't leave you from the time you come into surgery until we take you to recovery. And, we don't leave you in the good hands of the recovery nurse unless you are stable. We are your advocate, asleep or awake!

We'll continue with Part II next post. 

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Kim Zweygardt always knew she wanted to be someone special.  Her heart’s desire when she was 7 was to be a famous ballerina but when she read their toes bled from dancing on them, it became a less desirable career choice. Then Kim decided to be a famous lawyer solving mysteries and capturing the bad guys just like Perry Mason, but as she got older she discovered sometimes it was hard to tell just who the bad guys were.

Instead Kim chose a career in medicine practicing the art and science of anesthesia as a Certified Registered Nurse Anesthetist in rural Kansas, Colorado and Nebraska.

Kim is married to Kary, the man of her dreams, who has done a fabulous job of making all her dreams come true. They have three children but an empty nest and enjoy conversation with friends over good coffee and great food. They enjoy travel, the arts and taking a nap.

Member American Christian Fiction Writers, International Speakers Network, www.bookaspeaker.net, www.womenspeakers.net

Up and Coming

Hello Redwood's Fans!

How has your week been? Mine? Rough. Seriously-- I'm battling the third illness this winter. We in medicine are still calling it winter (at least in pediatrics) because RSV has not died off yet for the season.

I don't know what "bug" is out there but it's been wrecking havoc and this might be the only reason I'm calling for sunshine and flowers (those who know me know I like dark and rainy) is so all these viruses go into hibernation. I'm not sure why the viral world is different from the animal world but viruses tend to die off over the summer time-- or maybe not just shared as generously because people are outdoors.

On a bright writing spot-- I've progressed to round 2 in the Love Inspired Blurb2Book Contest. This is definitely outside my writing zone. I'm good at suspense-- love writing dark and scary but the romance part is always a challenge for me so I'm using this contest as a chance to hone a new writing skill. Can't ever hurt to broaden your writing horizons.

And yes, my indie book, The Cipher's String, will still be releasing this October!

I'm so honored this week to have my good friend Kim Zweygardt stop by to share all she knows about anesthesia, the OR and "going under". Kim is a certified nurse anesthetist and brings a wealth of information for any novel that might have an OR scene or an OR setting. She'll be here the next three posts.

Have a GREAT week.

New Alzheimer's Discovery: Using Ultrasound Waves to Improve Memory

Alzheimer's might be the second most feared disease behind cancer. Most of us, even those outside the medical profession, have come into contact with someone suffering from this illness. Alzheimer's affects 50 million people worldwide.

Australian researchers have come up with a potential treatment using ultrasound to break down the amyloid plaques that form between neurons.

This ultrasound technique uses sound waves, but alters the frequency that they're delivered at, to open up the blood brain barrier. This barrier protects the brain against against things that could kill it-- like bacteria.

In this case, opening up the blood brain barrier stimulates waste-removal cells, called microglila cells, to begin clearing out these plaques.

Now, this has only been tested in mice but researchers state that 75% of these mice had fully restored memory function and no brain damage to surrounding tissue.

The team hopes to conduct human trials by 2017.

You can read more in-depth about this medical discovery here.

Using Polio to Kill Brain Cancer

Rarely, am I super impressed with medical discoveries.

I can't say that for this piece I just saw on the news magazine 60 Minutes.

Cancer treatment has gone through various stages. First surgery. Then came the advent of radiation therapy followed by chemotherapy.

But now, the newest frontier in the fight against cancer is your body's own immune system which makes the most sense, right? If we could train the immune system to seek and destroy cancer cells like it does bacteria and viruses then whole hosts of people wouldn't have to face death related to this, often times, devastating diagnosis.

I've blogged here about the use of the measles virus in treatment of cancer.

Now, researchers at Duke University are using a genetically modified polio virus to kill brain cancer . . . and it's working.

Glioblastoma is a particularly aggressive, nasty brain tumor. As stated in the piece, it's usual for this cancer to double its size in 2-4 weeks.

What I learned about cancer cells in this piece that I didn't know before is that they are smart. I remember learning in my pathophysiology class in college that cancer cells were merely your own cells running amok-- dividing uncontrollably and invading normal functioning tissue. Perhaps this is why our own immune systems don't attack it as the potential killer that it is-- because it is our own cells.

The doctors at Duke University are attempting to change this. They took a small group of patients who had glioblastoma for the second time. These patients had already been through standard therapy at it failed.

They surgically implanted a catheter into the center of the tumor and then gave the patient an infusion of modified polio virus directly into the tumor.

What happens is two things. One, the body recognizes the polio and begins to attack it. Second, the virus seems to also strip the protective coating of the cancer cells so the body recognizes it and begins to attack it as well. The body amounts an impressive immune response and MRI's initially show massive inflammation around the tumor, but then, over a period of 4-8 months, the body's immune system begins breaking down the tumor.

Two patients who received this treatment first are now cancer free for nearly three years. That is unheard of with this kind of brain tumor. I mean-- it is miraculous.

After the researchers had success with the first several patients, they attempted to double the dose to see if they could get a better immune response. In fact, they did get a massive immune response but it proved to be too much for the patients and several of them died.

Now, they are using smaller doses and it remains to be seen if this is a cure but it's so promising that in a year, the FDA may cut their red tape to make it available to lots more patients.

Truly, truly impressive. I mean for us medical nerds-- it is jaw dropping.

Now, of course, there is always worry that modifying viruses could lead to potential breakouts of untreatable illness. That's definitely fodder for any medical thriller.

But today, let's bask in the glory of this amazing discovery and what it could mean for patients who receive this deadly diagnosis.

For more information on this study you can view the piece here.

Up and Coming

Hello Redwood's Fans!

Happy Easter to you! Today, is my second favorite holiday right behind Christmas. It's the day Christians celebrate the resurrection of Jesus. Have you thought about that? Ever? Really, thought about it?

To me, Easter is mind blowing. There are few people in this world that I would willingly lay my life down for. I mean, I could probably count them on one hand.

Yet, Jesus, willingly gave up his life for everyone. Even evil people-- I mean serial killer types.

One of my most favorite blog posts was written about Easter. About substitution. You can read it here and I hope that among the Easter egg hunts and Sunday brunches you can ponder about how Easter came to be and what it means for you.

For you this week it's a week of amazing medical discoveries. I depend on interesting medical breakthroughs for my novels. I like to think of the next possible step-- usually a harrowing step for humanity-- and I think we always have to imagine what medical breakthrough could cause potential harm. However, this week we're celebrating new medical discoveries.

Tuesday: Using polio to kill brain cancer. It's true. This is amazing.

Thursday. Ultrasound and Alzheimer's. How could one help the other?

Have a blessed week.

Jordyn

Nine Reasons You're Waiting in the ER

I thought I'd do a few posts on life in the ER. What's it really like behind the scenes and provide some explanations on those things we can't really say to patients but might be an explanation of why things are not moving as expediently as patients, parents and families would like. 

So, exactly why are ER wait times so long in some cases? 

1. Patient Load. Keep in mind there are only so many rooms in the ER and we can't stop people from walking in. This is unlike EVERY other unit in the hospital that can close their doors and keep patients out. A ward unit or an ICU can say-- we can't take any more patients.

An ER is not like this. Sure, we can stop ambulances from coming. This is called going on diversion (and hospital administrators really hate that because it's medical dollars going to another facility.) However, the ER must at least address every patient that walks through the door. 

It's easy for an ER to become overwhelmed. Sometimes, this is seasonal like in the winter when the flu virus hits. When patients outnumber the staff and beds then ER wait times are going to go up.

2. The acuity is high. Acuity is how sick the patients are. The higher the acuity-- the more sick. At times, there are few patients but those that are there are quite ill. The sicker the patients are, the more time it takes for the doctor to evaluate them and develop a game plan. The doctor may have to be at the bedside longer than normal to help stabilize the patient. More nurses are likely to be in that patient's room doing multiple procedures to bring them back from the brink. This will create a back log for the other patients in the department.

3. A slow doctor. In all honesty, some people just don't work as hard as others. Some doctors are very quick and efficient. Others, not so much. If the department is full, but the nurses are all sitting at the desk-- this could likely be the problem. The nurses are waiting for the doctor to write orders, or develop a medical game plan, or give them an idea of how long the patient will be observed for. 

4. A slow nurse. Nurses can be the same. Just slow. Or, they have a heavy assignment and are working the best they can to get through their doctor's orders.

5. A Code Blue. Most things will come to a halt when there is a code blue. All resources will be needed for that one patient. Radiology. Pharmacy. Lab. All hands on deck. One code blue is going to set the whole department back because that patient takes up a lot of staff and resources. It takes time to recover from those events. Also, the ER is generally responsible for sending a couple of their team members to code events that happen outside the ER which decreases the staff able to help in the ER.

6. Staffing shortages. It's usual these days to be short staffed. That coupled with a heavy patient load is going to increase wait times. 

7. Emergency care doesn't mean expedient care. Illness doesn't cure in an hour. Our true goal is to find the one thing that might kill you in the next 24 hours. I know the goal of all patients, regardless of complaint, is to be out and completely well of their illness in under an hour. This is not a reality, even for the most minor illnesses. It takes time to evaluate a medical condition. Do you have this same expectation when your car is getting fixed? Often times, medical conditions can be kind of dicey to sort out so we'll hold patients to watch and see how things develop. This is for your safety . . . not to irritate you.

8. Slow specialty response. If your care hinges on hearing back from the expertise of a consulting physician-- then everyone is waiting. Us. You. Everyone.

9. Overwhelmed support services. Support services like lab, radiology and pharmacy aren't just accountable to the ER but to the whole hospital-- including outpatient services. So, if they're overwhelmed, it will cause delays in the ER. There can be other critical patients than those just in the ED.

Hopefully, this gives some insight into why your ER wait time may be more than you'd like it to be. Although the current culture has equated emergency room care with expedient care, our goal is to treat the sickest patients first. 

Maybe consider waiting a gift. It means you're likely not going to die today.