Thursday, August 29, 2013

Being a Male Nurse

If you've seen the movie, Meet the Parents, you very early on painfully realize the torture than Ben Stiller goes through as his character Greg Focker is a male nurse. Of course, there is parody and good ribbing from Robert De Niro but what's it really like to be a male nurse.

No, this is not my co-worker.
Evidently, being a male nurse is becoming a little less rare. Male nurses have tripled in the work force since the 1970s and 1 in 10 nurses are male. You can read more about male nursing statistics here

I wouldn't know personally but I do work with one-- yes, just one right now. He really is a great nurse and pretty quirky so I thought I'd ask him-- "What's it really like to be a male in this profession?"

And his first response was, "It's f***ing hell. If I would have known working with this many women would have caused me this much anxiety I would have chosen another profession. Oddly enough, it only took me three years to start menstruating."

As you can tell-- he's somewhat of a jokester. And no, he doesn't use that kind of language around his pediatric patients. They love him . . . seriously-- tattoos and all.

So what is unique about being a male nurse? What does he face that the rest of us estrogen laced cohorts don't?

Here's his list.

1. I'm either a brother or a therapist. I now have two-hundred sisters.

2. I'm asked more often to deal with difficult people-- those that are under the influence or intoxicated. Difficult family situations.

3. I don't know who can handle my antics and who can't.

4. It's the first time I was a minority as a white male. I got tons of money for grad school.

5. If it wasn't for my tattoos it would probably be assumed more often that I was a doctor.

6. I'm not disrespected by doctors like my female co-workers are.

What's it like working with women all the time?

1. Taxing. Because I have to watch what I say. For instance, I got pinched in the butt by a horny old lady in front of supervisors from five different units one time in the elevator. Exactly what do you say?

2. I've got to be careful what I share and I can't be on Facebook. All Facebook did was cause me problems because co-workers would look at my pictures and ask me who I was in relationship with.

3. I want a lot of alone time after I work three twelve hour sifts in a row because I also live with two women. I need to hang out with guys or just have alone time.

4. I receive a lot of unwanted and unwarranted advice.

Any other male nurses out there? What's your experience like?

Tuesday, August 27, 2013

Seven Medical Must-Do's For Fall

If you are like me-- you sent kids back to school this past week and celebrated cried as they walked their book-filled laden backpacks through the school doors.

The start of school generally increases the pace of the pediatric ER. Kids are in closer contact and therefore-- sharing all those wonderful germs with one another.

There's usually an increase in illnesses when school starts-- strep throat and meningitis are a couple. And, if your child starts daycare-- you can expect quite a few illnesses as they adjust to their new germ-filled environment.

I like to do a few things to get ready for the coming viral onslaught that fall and winter bring and I thought I'd do a little public service by sharing these things with you. It's better to do these things now than have to fight weather to go get them when you really need them.

The snow senses when you're not stocked up and will dump three feet of frosty flakes on your house just to prove it.

1. Make sure you have a back-up for your child's medications. Things like rescue inhalers, epi-pens and insulin.

2. Have fever reducers/pain medication that are appropriate for your child. Make sure what you have on hand is not expired. Tylenol for infants under six months. Ibuprofen and Tylenol for infants/children six months and over. No aspirin for any kids unless prescribed by a physician.

3. Stock up on replacement fluids. This would be Pedialyte (or equivalent) for kids two and under Gatorade/Powerade for kids two and up to adult. Don't forget yourself. Usually if one person comes down with something in the household-- everyone else is bound to get it.

4. Kleenex and hand gel. Good hand washing is always the best prevention for illness.

5. Hats and mittens. Snow Pants for those that live in cold climates. Buy a few pairs. It never fails that you won't be able to find any mittens for your six-year-old when the first blizzard hits. I buy a few cheap pairs as extra.

6. Don't forget-- kids playing in the snow should be wearing sunglasses-- particularly at higher altitudes (like when skiing.) 

7. Get your flu shot!

What else do you do to prepare for fall/winter?

Sunday, August 25, 2013

Up and Coming

Hello Redwood's Fans!

Are you like me and maybe celebrating a little too joyously the children going back to school?!? I do love my children but it is nice to have some quiet in the days as well to get back to writing.

I DO love fall and am excited for all things pumpkin to come out over the next several weeks. Autumn is really my favorite time of year. Plus, it's the beginning of the holiday CANDY season-- yep, trainer dude is going to be ecstatic about that, too.

This week is also birthday week-- me and my oldest daughter will celebrate. I think we'll focus more on hers than mine. 

For you this week:

Tuesday: I thought I'd do a little public service and help get you all ready for the fall/winter viral season. This post will be seven things I do to make sure I'm ready.

Thursday: What's it like being a male nurse? My one and only male nursing colleague steps onto the edge to let me know his deepest darkest thoughts-- and it is pretty hilarious, too.

Hope you all have a great week.


Thursday, August 22, 2013

How People Die

Are you curious to know what people die of where you live?

There are tons and tons of websites that can help you get a feel for the leading causes of death in a particular area, a particular age group, a particular race and gender.

I have to give a shout out to my agent's wife, Becky Johnson, for posting this to her Facebook page and I thought it would be an excellent resource for all you medical nerds to bookmark in your research folder.

It's a website called World Life Expectancy. I know-- right? I just got chills.

I've linked you to one particular page that looks at the top 15 causes of death in the US and ranks each state and where they fall.

The state leading in death by heart disease: Mississippi.

How about cancer? That would be Kentucky.

How about something more mundane like accidents? You get the gold West Virginia.

It's like Becky said-- "If you want to live a long, disease free life-- Hawaii seems to be your best bet."

There is literally a plethora of information on this website. Life expectancy-- down to your particular county. It also has lots of data for the WORLD. 

How does your state fair? Does it give you any plot ideas? I think cancer clusters always serve for interesting medical plots.

Tuesday, August 20, 2013

Ideas From the ICU Waiting Room

I have probably seen the inside of a hospital more than I've cared to these past couple of weeks. I have a relative who had surgery-- then a major surgical complication-- for which he had to be admitted back to the surgical ICU.

He is on the mend but continued prayers appreciated.

What was interesting while sitting in the waiting room? I can't help but look at and examine my environment and develop story ideas.

Many of you are probably aware that most medical units use machines to dispense drugs. These go by a few names. Pyxis machines or Omni cells.

When I first started nursing, these machines were mostly used for drug dispensing so nurses on units didn't have to wait for the pharmacy to fill a med order and then deliver it. It's very helpful in situations where the patient is in a lot of pain or say . . . seizing.

These machines have evolved to dispense quite a few things. In our unit, they dispense not only drugs but about 90% of the supplies we use for patient care. Things like suture kits, nasal cannulas, wound packing, etc.

I discovered a Pyxis machine that dispensed scrubs.  How awesome is that!

Now, you may ask yourself . . . "Just why did Jordyn find that soooo fascinating?"

Simple-- how could a bad guy use it to get where he wanted to be in the hospital setting. Or, how could someone use it to disguise themselves to get out.

Awww--- now you see how my devious mind works.

What the machine required was an ID and password because they probably know what devious minds think. Yes, I did punch a few buttons to see exactly how it worked. Research, people.

What ideas have you come up with in waiting rooms?

Sunday, August 18, 2013

Up and Coming

How has your week been?

Mine? Well, you know, never a dull moment.

Yesterday, I participated in the Warrior Dash. It is a 5K with obstacles on the course. Things like climbing over a 10 foot wall. I think there were three of those. It was great fun minus a minor shoulder injury. Just why my shoulders like to gravitate out of their sockets mystifies me. I did finish and here is photo proof. I did clean up a bit.

This summer I've done a lot of physical things I've never done before and those who know me can attest to the fact that I am not a fitness guru. I still would pick chocolate over celery on any given day. Nachos over hummus. You get my drift.

But, I have been trying to get into shape. So, in my wake over the last several months are three 5K's, one 10K and I'm hoping to hike one 14teener (a mountain where the peak is at 14,000 feet.)

Sadly, I am still not a size four. Nor will I ever be but this summer of mostly fun physical activity got me thinking about writing goals. Just how do you try and achieve something where the finish might not be as glamorous as you imagined. A finish like you've published almost three books and still can't quit your day job.

Here are my thoughts:

1. Striving toward a goal gives you confidence. When you accomplish little things (like running a 5K)-- you believe you can do the bigger things (like running a 10K.) Words will add up to sentences. Sentences will add up to paragraphs. Paragraphs become chapters! Once you pile enough of those up you will have a novel.

2. Sometimes the step in front of you is all you can focus on. When I ran my first 10K-- I lasted about 5.5 miles. I had run six miles before but I was mentally having a bad day-- like my friend who was walking still had a faster pace than me jogging. At one point-- all I was doing was looking at the sidewalk and counting to four. Four steps was the distance between the cracks and meant that section of sidewalk was finished. I would count to four again. I must have done this for a mile just trying to take the next step. Focusing on the large picture can be overwhelming. What is your next step?

3. Finishing is fun! It is great to have that moment where you cross the finish line. You have a completed book. People like the book! Your words touch someone. Sometimes visualizing those moments can help you take those small steps.

What is a goal you're working on?

For you this week!

Tuesday: I've spent a lot of time in the hospital with a sick family member this month. Just what got my authorly wheels turning?

Thursday: A GREAT resource for writers with LOTS of information on death. I know-- but this is how suspense authors think.

Also-- I am getting ready to launch my newsletter! Subscribe and be eligible to win the WHOLE Bloodline Trilogy, $50.00 in gift cards and some nifty home-made items in time for Halloween!

Thursday, August 15, 2013

Medical Critique: James Patterson's Kill Alex Cross 2/2

Last post and this post I'm doing a medical critique of James Patterson's Kill Alex Cross. Usually, I don't mention the book or the author's name but I'm hoping James will spend a little of his cash on a medical consultant and am also probably losing out on a chance that he will endorse one of my novels.

Oh well, living on the edge . . . that's me.

If you have not read the book this post may contain some spoilers you'd rather not know so you have been warned.

At one point in the book, a suspect is kidnapped and he is given "truth serum" in order to get him to divulge the location of the president's kidnapped children.

The prisoner is given scopolamine.

Well, hmmm. This did cause me to scratch my head a little bit. Why? Well, come to find out this was a drug used once for this purpose in the early 20th century. Where did I discover that? Well from the CIA's own website. Interesting what a little research will show.

Now-- the CIA should know about good truth serum. Here's what it says about scopolamine:

Because of a number of undesirable side effects, scopolamine was shortly disqualified as a "truth" drug. Among the most disabling of the side effects are hallucinations, disturbed perception, somnolence, and physiological phenomena such as headache, rapid heart, and blurred vision, which distract the subject from the central purpose of the interview. Furthermore, the physical action is long, far outlasting the psychological effects. 

And that was my thought-- there are much better drug choices.

What scopolamine is used for most these days is as a patch for motion sickness. That's really the only use I'm aware of.

What James Patterson did say in his book is correct: "Lying is a complex act."

What "truth serum" drugs really do is loosen inhibitions and makes lying more difficult-- not that it can't be done.

Some better drug choices? Sodium thiopental or some of the benzodiazipines. I revealed something very personal under the influence of Versed given prior to surgery once that I normally would have never disclosed.

Yes, indeed, that was a fun time.

Let me just say-- never have surgery at a hospital where you are employed.

Tuesday, August 13, 2013

Medical Critique: James Patterson's Kill Alex Cross 1/2

I am a James Patterson fan. I've restricted myself lately to the Alex Cross and Michael Bennett novels.

I just finished Kill Alex Cross. You can read my Goodreads review of the novel here.

This post is to discuss the medical aspects of the novel and what I find suspect. Come on, James. Hire me as your medical consultant-- I think-- no I know you can probably afford me.

In this post we'll deal with a male adult that is involved in a motor vehicle collision. The character was driving a van at a high rate of speed and took a header into a bus.

Initial treatment of the victim was good. Jaws of life. C-collar in place. Suspicion of drug use based on dilated pupils-- specifically PCP which is an accurate bodily response.

All good until this line: "The van driver was out on a gurney now, hooked up to a nasogastric tube and IV."

Anyone know what is wrong with this sentence?

Simply put, EMS is never going to put down a nasogastric tube.  Are paramedics trained to do the procedure? Yes. Have they ever in the field? Not that I've seen in twenty years of specialized nursing.

Now-- a flight team on a long transport-- maybe.

An nasogastric tube (or NG tube) runs from your nose to your mouth. It is used to drain/vent secretions and air from the stomach. If the stomach is retaining a lot of these things-- it can impact on the patient's ability to breath. A secondary use is as a feeding tube though there are many more comfortable styles (like a cor pak which is thin and flexible but doesn't drain well.)

All this sounds very good for the patient, right? Why not put one in in the field?

One-- patient priority is different in the field than in the hospital. It's basically secure the airway, breathing and circulation and get on your way . . . fast. Placing an NG would simply slow down scene time and they can be difficult to place.

Impacted Nurse
There are also contraindications to an NG tube placement. One is a basilar skull fracture. We all have bones that line the base of our skull. If these are broken-- there can be a direct conduit from your nose into your brain. Signs of basillar skull fracture are misshapen face, fluids (blood and serous drainage) leaking from the ears and nose. Mid face fractures.

That's what we don't want-- an NG tube in the brain. Yes, it can happen as evidenced by the photo that comes from this article which discusses just such a case.

Really, James, call me. 

Sunday, August 11, 2013

Up and Coming

Hello Redwood's Fans!

How is your week going? Is your summer winding down? Getting ready to go back to school?

I have recovered from camping, horse back riding and white water rafting. Looking back I think those were the easy things.

Coming up for me are my first 10K race (well, I am just hoping to finish) and a Warrior Dash-- the muddy 3-mile long obstacle course.

Yes, I am insane. But you knew that already.

For you this week.

I am taking on author James Patterson. Usually I don't rat out authors or their books if I give a medical critique of their scene. However, James is unique because he can certainly afford a team a medical consultants so I tend to give him a lot less leeway.

This week we'll look at the medical woes in one of his latest Alex Cross books-- Kill Alex Cross.

Have a GREAT week.

Thursday, August 8, 2013

News Stories for Authors: The Black Death Returns

Rats. Cute, right? Unless you think about the diseases they help to transmit. Here's a short list here.

Evidently, the Black Death or Plague has not died. Well, perhaps it never did but a curious thing is that it disappears for years on end and then . . . it . . . comes . . . back.

Which always makes for a good medical thriller.

But now, it seems that the Black Death is popping up on the West Coast. Some interesting points from this article.

1. In LA county, a squirrel tested positive for bubonic plague or The Black Death. It is genetically similar to the organism that killed 200 million people in the 14th century.

2. Plague is spread from fleas, to rodents and then to humans. You can read further about transmission here.

3. There have been almost 1,000 cases of plague in the US. New Mexico sees almost half of these cases.

4. The pathogen responsible for bubonic plague is Yersinia pestis. It can be successfully treated with antibiotics. It's death rate is around 11%.

5. There is a season for plague (just like flu and some other viruses) that runs from late spring to early fall. My guess is because that's when rodents are active and not hiding in the snow during winter.

6. Untreated, the bacteria will spread through the body in one to six days. When it reaches the lungs-- it can then become airborne and is then called pneumonic plague which is why some think it would make a good biological weapon.

7. Death can occur in as short as three days.

The question is-- why does it disappear? What factors cause this to happen? Do you think there could be a true pandemic of The Black Death again?

Has the Black Death returned? Click to Tweet.

Tuesday, August 6, 2013

News Stories for Authors: Cure for HIV?

What would you think of a miracle cure for HIV that was too expensive and too labor intensive to cure most of the people who have HIV?

Well, that may be exactly what has occurred for two patients who are seemingly testing negative for the disease after receiving a bone marrow transplant for lymphoma.

Now, if that's not a medical thriller, I don't know what is.

Here are some of the highlights of the article that discusses this "cure". I put that in quotation marks because two patients with no evidence of disease (NED) does not a proven cure make. Much, much more research needs to be done.

1. Evidently, when people with HIV receive bone marrow transplants, they stop taking their HIV meds. In these two cases, the patients continued to take their HIV medication.

2. From #1, it is theorized that continuing to take their HIV medication kept the virus from taking hold once the new immune system was transplanted because the viral load was kept low.

3. Since the bone marrow transplant, both patients stayed on their HIV medication for a period of time but have now stopped taking their medication. One for seven weeks and the other for 15 weeks and the virus has not returned. This does not mean that it won't at some point but this does sound very promising.

4. One patient was transplanted with cells that carried a mutation, CCR5, that evidently prevents infection with HIV by blocking it from infecting the immune system. This is an area of interest for research in gene therapy.

All good news, right?

Well . . . maybe. From the article . . .

"Many clinicians would agree, however, that the three possible treatment options described in the article-- including that used in the two highlighted cases-- are not practical in a treatment setting, or may present too many safety and tolerability risks for the vast majority of HIV- infected patients."-- emphasis mine. 

My thoughts: Bone marrow transplants are arduous procedures. They are timely and expensive. It's hard to find donors as they have to be an HLA match. Hence, donor registries.

According to the CDC, nearly 1.2 million people are living with HIV in the US alone. World wide there are 33.4 million people.

Sadly, what it will come down to if this proves to be a cure is who can afford it or not. This is one thing I fear with more and more health systems being run by governments. It's pencil pushers deciding who gets treatment or not. Who gets the cure or not.

What do you think? If this proves to be a cure, how does everyone get it? Should everyone get it despite the expense?

A true cure for HIV or just another plot for a medical thriller? Click to Tweet.

Thursday, August 1, 2013

Fungal Fright: Sprial by Paul McEuen

I wish I could say exactly how I discovered Spiral by Paul McEuen. I want to say it was a Goodreads review and I'm always looking for new medical thriller authors-- particularly ones that can back it up with good sound expertise.

Paul is a professor at Cornell University and has received the Agilent Technologies Europhysics Prize, a Packard Fellowship, and a Presidential Young Investigator Award as listed in his bio. I am just guessing he's one really smart dude.

This debut medical thriller also won the International Thriller Writer's Debut Category for 2012. Strong work, Paul-- as I like to say.

Spiral begins the first part of the book in the past-- specifically a close examination of two war ships in the ocean-- of a few men in a raft-- and the large gun ship swiftly disposing of them because they want to come aboard.

The reason they aren't rescued-- and actually murdered-- is because of the fear that they have been infected with a deadly fungus named Uzumaki.

The early scenes of the novel-- from the terror realized as the infection manifests, to the other ship trying to "quarantine" the fungus in the middle of the ocean until one stray bird lands on the infected vessel . . . and then takes off. . . 

I never thought a bird landing on a ship would lead to heart palpitations-- seriously.

Fast forward and the young military fungal specialist is now a well-acclaimed university professor specializing in fungus and one of the few who know about Uzumaki-- and now others want the fungus born again for nefarious reasons.

What I really liked about this novel was it reminded me of the early Robin Cook books. Take a medical concept and take it to the worst case scenario. Or take something theoretical, somewhat expiramental and think about the way it can run amok on humanity. I think that's what makes a medical thriller--- well-- thrilling!

I liked learning about fungi and the tiny robots called microcrawlers (and how deadly they can be!) In fact, I wanted to look up some of these concepts to see how "true to life" they really were. I also liked the examination of how prevalent antibiotic usage can be detrimental.

I would have enjoyed more of the fungus unleashed on humanity. Instead, there were only a few infected people. The story centered more on the family and how the secret of the fungus was kept hidden.

Overall, a good read for medical thriller fans. I'll be excited to read this author's future works.