Lisa's Story: Part 1/2

I wanted to share this story of a fellow comrade in arms-- a nurse working in the trenches that likely, only through her efforts, did a patient not succumb to death.

There is so much of nursing that goes unnoticed. What nurses do every day. The battles we fight on behalf of patients and their families that likely are never known by those we care for.

I also like first person accounts because they allow writers to "live in someone else's shoes" for a moment and might make writing from that person's position much more authentic.

Part I will be today and Part II will conclude on Wednesday.

Welcome, Lisa!


I am so happy to share this story, as this is one of my favorite moments as a nurse.

I typically worked the Baylor shift of 7pm to 7am at one of the local hospitals. Even though the story I am telling you happened about 7 years ago some of the details are still so very fresh in my mind. I have always believed there are no such things as coincidences. And this story truly emphasizes that.

I had arrived to the floor, received my change of shift report and was settling in for the night.

Shortly, thereafter we got a call that a young 29 year old woman was being admitted to the floor. I had no empty beds and my co-worker was a male nurse. This young woman was brought up to the floor with an admitting diagnosis of urinary tract infection and possible respiratory alkalosis.

Immediately, the diagnosis just seemed off to me. When the woman arrived I also noticed she was from India, she felt very uncomfortable with the male nurse so I asked him to switch off with me and I would take the admission. I really didn’t understand why she was being admitted to my floor. We were the IICU, intermediate intensive care unit. We essentially took the overflow from the ICU, with the only exception that we didn’t taker arterial lines. We did everything else, from vents, to trach’s, to PICC lines, and countless drips, and we rarely got anyone under the age of 50.

At first glance the woman really didn’t seem that ill. I was rather confused by her admission to my unit. After a few questions, I returned to enter her information into the computer system. I had barely sat down and the bell was ringing. I got up and headed towards the room. I had never seen anything like it. She was ashen, diaphoretic, and trying to make her way to the bathroom due to nausea. As I reached over to help her up she felt like she was on fire. I told her to sit still. I had just checked her temperature not 15 minutes prior and it had been slightly elevated around 99.8. But this time when I checked it, it was over 103. I was shocked and terrified for this poor woman.

I helped her up to the bathroom and helped her get changed and settled her back into bed. I took a look at all the new orders, returned with some Tylenol for her and began looking at the history. Something in my gut was telling me we were missing something. I read and reread her admission paperwork trying to find a clue. I called the hospitalist on call and related my story. He essentially blew me off and said I needed to contact the pulmonologist. Before I had a chance to call, she was ringing the bell again, and this time she looked even worse. Her body was writhing all over the bed, almost convulsing and she had no control over it. I looked at her and asked a simple question.

“Have you traveled outside of the country in the last few months?”

Her reply was “yes”, she and her daughter had just returned from India 2 weeks prior.

 I looked at her, and asked, “How old is your daughter?”

The reply, “She is only 2 years old.” 

Hope you'll join us for Part II on Wednesday to see what this patients mysterious illness is. What might your guess be?

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Lisa was born Lise Amanda Forest on November 19, 1966 in Ontario. She has 2 children, and 1 grandchild. She currently, lives in SC. Lisa speaks French and English. She graduated from College and worked as a flight attendant for a Montreal based airline. Lisa is a world traveler, having been to South America, Caribbean, and all over Europe; Lisa has been employed as an RN for the last 18 years. Lisa has moonlighted as a realtor and interior designer. Now she’s a writer and her debut novel Oracle is in editing. You can visit Lisa at her blog www.lisaforest.blogspot.com.

Author Question: Car Accident Injuries 2/2

We're continuing with Amy's question. Dianna gave her thoughts here. I'm going to give my thoughts from an ER perspective.

Amy asked:

I am putting one of my characters in a pretty major car accident -- a rollover in which she lands on a broken window and ends up with a lacerated back full of broken glass, in addition to a broken leg, fractured ribs, etc. I need a scene to take place in the hospital where she is recovering. With those kinds of injuries, what treatments would she be under? More importantly, how exactly would she be laying in the bed? Obviously not on her back. But would she be on her side or stomach? Perhaps that depends on the other injuries she sustains... but the lacerated back is the biggest one I want her to have.

Jordyn says:

The biggest issue here is that she will likely have to lie on her back for a while. Considering her mechanism of injury (MOI)-- the big rollover accident. The EMS crew is going to be very concerned that she may have injured her neck or back and she will be put onto a spine board and C-collar. To alleviate the pressure on her back, they may then tilt the whole board to one side but it's going to cause some pain to lay on that flat board until her x-rays are complete.

Care for lacerations: One, she'll need x-rays of her chest to look for the glass. She'd likely have this anyway for her MOI which could then reveal the rib fractures. If the lacerations are severe and extensive-- she may end up going to the OR so they can be cleaned and stitched up under general but they'd have to be REALLY bad. Otherwise, we irrigate them out with sterile saline. Stitch them up. Antibiotic ointment over top. Make sure she's up to date on tetanus. She would get a shot if she hadn't had any in five years. It's 10 years without injury.

Rib fractures are generally problematic because you don't want to take a deep breath because of the pain which can lead to pulmonary problems. Lung contusions can actually put you on a ventilator if they are extensive enough. If several ribs are broken in succession-- this is actually referred to as a flailed chest which can inhibit the patient's ability to breathe. So, I'd keep it simple with one or two rib fractures so the character mostly has to deal with the pain issue and not the lung issues.

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Amy Drown has a History degree from the Universityof Arizona, and has completed graduate studies in History and Archaeology at the University of Glasgow. An executive assistant by day, she also moonlights as an award-winning piper and photographer. But her true addiction is writing edgy, inspirational fiction that shares her vision of a world in desperate need of roots—the deep roots of family, friendship and faith. Her roots are in Scotland, England and California, but she currently makes her home in Colorado. Find her on Facebook at www.facebook.com/GlasgowPiper.

The Secrets Nurses Keep: 2/2

In the November, 2011 issue of Reader's Digest-- there was an article entitled 50 Secrets Nurses Won't Tell You. I mean, of course, I am going to read this. As a nurse, as an author, and as a blog editor-- I'm going to see what it has to say. Please, take some time to check out the full article.

I thought I'd give my thoughts here on whether or not I agree with the trueness of these statements. I'm not sure that's truly a word-- so don't use it in Scrabble or anything. The items are taken directly from the article-- so credit is given to Reader's Digest for these.

You can read about my first post here.

Item Four: "When a patient is terminally ill, sometimes the doctor won't order enough pain medication. If the patient is suffering, we'll sometimes give more than what the doctor said and ask him later to change the order. People will probably howl now that I've said it out loud, but you have to take care of your patient." A longtime nurse in Texas.

Hmmm.... this one is painful-- no pun intended. First, let me say that I understand where this nurse is coming from. I've been in situations where the patient has needed more pain medication than the physician is willing to order and it is really frustrating because you're the one whom the patient is staring at, begging for relief.

However, the nurse is right about the howling part. Put simply, this is illegal. A nurse who chooses to do this is operating outside her scope of practice. She would be giving a narcotic without an order. An uber-big no-no. She is at risk for losing her license.

Personally, I would not choose to do this. I've never done it nor has it even crossed my mind. What I have done is called the doctor relentlessly and summoned the physician to do a bedside exam so they can SEE exactly what I'm talking about.

Item Five: "Every nurse has had a doctor blame her in front of a patient for something that is not her fault. They're basically telling the patient, 'You can't trust your nurse.'" Theresa Brown, RN.

Sadly true. I've had this happen. I spoke a little bit about this in the last post. A nurse would get in a lot of trouble for doing the same of a physician so there is a double standard. All corrective conversation should never be done in front of a patient, at the nurse's station, etc--- only a private room with reasonable discussion.

Item Six: "Never talk to a nurse while she's getting your medications ready. The more conversation there is, the more potential there is for error." Linda Bell, RN

True...true...true. In fact, this is becoming part of training videos for fellow staff-- to not talk to your co-workers when they are calculating and drawing up meds. It is fine to ask medication questions-- in fact, you should. But wait until you have your nurse's undivided attention.

What do you think of these items?

 

The Secrets Nurses Keep: 1/2

In the November, 2011 issue of Reader's Digest-- there was an article entitled 50 Secrets Nurses Won't Tell You. I mean, of course, I am going to read this. As a nurse, as an author, and as a blog editor-- I'm going to see what it has to say. Please, take some time to check out the full article.

I thought I'd give my thoughts here on whether or not I agree with the trueness of these statements. I'm not sure that's truly a word-- so don't use it in Scrabble or anything. The items are taken directly from the article-- so credit is given to Reader's Digest for these.

Item One: "When you tell me how much you drink or smoke or how often you do drugs, I automatically double or triple it." A longtime nurse in Texas.

Jordyn Says: Absolutely TRUE. A person over the legal limit has surprisingly only EVER had 1-2 beers. Always. What I will add to this statement is a teen driver who comes in involved in a minor traffic accident. I always add at least 20mph over the limit they state because they are likely not going to be truthful in front of a parent about how fast they were really going.

Item Two: "We're not going to tell you your doctor is incompetent, but if I say, 'You have the right to a second opinion,' that can be code for 'I don't like your doctor' or 'I don't trust your doctor.'" Linda Bell, RN.

Jordyn Says: This is a tough one for sure. What is the nurse to do? Primarily, we are an advocate for the patient and NOT the doctor. I have been in this situation. Not necessarily with a diagnosis but more with the emergency treatment provided for the patient. I had a sick asthmatic once at a hospital where I worked previously and the doctor was ready to discharge the patient after one treatment when really the patient needed a barrage of treatments and steroids to control the asthma attack. The child was still in obvious respiratory distress. I had the doctor reassess. They didn't agree with my assessment (and clearly-- I'm always right.) At discharge, I told the family, "Look for these respiratory signs that your child should be seen in the ER." The mother says--"Well, she has all those right now." My response, "Exactly." Wink, wink. "I know this ER is open."

A nurse puts herself and the hospital in a bad position and will never outright say a physician has made a poor decision or is incompetent but be mindful of language and if a nurse says-- "do such and such" like get a second opinion or seek out this course of action-- do it.

A nurse can also approach another physician on duty to see if they'll assess the patient and/or they can call a medical director for intervention. I've done this as well when I thought the treatment/or lack of-- would result in a patient's death.

Item Three: "If you're happily texting and laughing with your friends until the second you spot me walking into your room, I'm not going to believe that your pain is a ten out of ten." A nurse in New York City.

Jordyn Says: True. True. True. Amen, brethren in New York!

From the time a nurse goes through nursing school, we're taught that pain is subjective and the only person who can truly assess how significant pain is is the patient themselves. In many situations, the patient overestimates their pain.

The general scale used is 0-10. Zero being no pain and 10 being the worst. I've started to say, even to pediatric patients, "a 10 is like someone took an ax and chopped of your arm." A 10 means you cannot sit still in a chair. A 10 means if I don't do something about the pain, you'd rather die than live with it any longer. You cannot text. You're not laughing and joking. Do we still treat the pain-- yes, but a nurse will report to the physician your demeanor and that does influence the amount of the narcotic you'll get.

A nurse will also advocate for a patient who should get more pain medication or in instances where the patient or family refuses pain meds. I had a girl with an obviously broken arm and her father refused to let her have Ibuprofen. I'm guessing he had a religious objection but wouldn't say it out loud. Normally, I'm all for a parent's right to have a say in their child's treatment but this time I'm practically begging to give this child Ibuprofen. He says--"shouldn't I be able to decide her treatment"-- oh, that's a whole other post for sure. I said, "Well, perhaps if it was your arm that was broken, you might think differently." One of the few times I actually said what I really wanted to say.

What do you think of these situations?

Author Interview: Candace Calvert 2/2

We're continuing today with my interview with medical thriller writer Candace Calvert. Be sure to pick up her latest and greatest novel, Trauma Plan.

Welcome back, Candace!

Jordyn: Tell us about your current release.

Candace: Trauma Plan is the first book in my (Texas set) Grace Medical series. Here’s the back cover blurb:

Sidelined by injuries from a vicious assault, nurse chaplain Riley Hale is determined to return to ER duties. But how can she show she’s competent when the hospital won’t let her attempt even simple tasks? To prove herself, Riley volunteers at a controversial urban free clinic despite her fears about the maverick doctor in charge.

Dr. Jack Travis defends his clinic like he’s commander of the Alamo. He’ll fight the community’s efforts to shut its doors, even if he must use Riley Hale’s influential family name to make it happen.
As Riley strives to regain her skills, Jack finds that she shares his compassion—and stirs his lonely heart. Riley senses that beneath Jack’s rough exterior is a man she can believe in. But when clinic protests escalate and questions surface about his past, Jack goes into battle mode, and Riley wonders if it’s dangerous to trust him with her heart.

Jordyn: What's one thing readers might be surprised to learn about you?

Candace: Like the nurse heroine in Trauma Plan, I’m also a certified lay chaplain.

Jordyn: Most embarrassing moment while nursing? Most triumphant nursing moment?

Candace: Embarrassing: I once walked into an ER treatment room, glanced at the partially clad young man on the gurney and asked, “Can you expose your upper thigh without taking off those bicycle shorts?”  He stared at me for a moment, then struggled to do that: healthy skin exposed. Confused, I asked him where his “infected boil” was. It turns out that the clerks had put the wrong ID sticker on this man’s chart. He was there for a sore throat. I can’t tell you how many times nurse friends STILL snicker and ask me, “Can you expose your thigh . . .”?

Most triumphant: Once there was a woman brought in as a possible overdose, she was unconscious, pale, rapidly deteriorating. We were about to intubate, give reversal agents and lavage. In talking with the husband, I learned that she’d also taken Benadryl because of a “sudden rash and itching.” She was in anaphylactic shock, but too far gone to show the hives. We turned her around in moments with the appropriate interventions. It was a small “triumph,” but I always think about the “what ifs” had we proceeded along that OD path instead.

Jordyn: Most embarrassing writing moment? Most triumphant writing moment?

Candace: Most embarrassing: Probably my first submitted manuscript years ago. After I mailed it off (snail mail era), I was looking through the Word file and realized that I’d accidentally pasted a huge chunk of Internet research smack in the middle of a scene. To this day I always check my manuscripts compulsively, then still hesitate and take a deep breath before pushing the “Send” button. Submission PTSD.

Triumphant: The most obvious would be getting that first call from my agent Natasha Kern saying she was interested in signing me. But, in truth, the moments continue. Not so much the starry reviews or awards, but rather the connections I make with readers; the incredible notes that say my stories have touched their lives, made a difference, offered hope in tough times. For me, this is exactly like “the best part” of nursing.

Jordyn: What are you writing now?

Candace: I’m currently writing (working title) First Responder, the third book in the Grace Medical series.

Jorydn: Any final thoughts?

Candace: I’d like to say how very happy I am that medical drama has found its place in today’s Christian fiction market. I love teaming with talented writers like Dr. Harry Kraus, Hannah Alexander, Dr. Richard Mabry and Jordyn Redwood (!) to invite readers into our exciting world. And help “Grey’s Anatomy find its soul.”

Thank you for hosting me here, Jordyn. It’s a pleasure to connect with your readers. I invite them to stop by my website: candacecalvert.com or visit me on Twitter and Facebook. Happy reading!

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Candace Calvert is a former ER nurse who believes love, laughter and faith are the best medicines. Her Mercy Hospital and Grace Medical series offer readers a chance to “scrub in” on the exciting world of emergency medicine—along with a soul-soothing prescription for hope. Wife, mother, and very proud grandmother, she makes her home in northern California.

Author Interview: Candace Calvert 1/2

I can't tell you how excited I am to be interviewing Candace Calvert today and Wednesday! She's a fellow medical thriller writer, a great mentor and true friend. Her novel, Trauma Plan, just released so be sure to pick up your copy.

Welcome, Candace!

Jordyn: Tell us a little about your nursing/writing path. Were you always an ER nurse? Have you always written stories? Or, did writing come after nursing?

Candace: I was an ER nurse for more than 3 decades. Yes, (laughing) I was drafted into this calling as a mere child. Writing has always been an outlet for me, and in school I was one of those rare (and possibly odd) students who welcomed essay assignments as a treat. Though I tinkered with creative writing off and on during my adult years, it was a near-death experience that actually launched my publishing career.

In 1997, I was thrown from a horse and eventually landed “on the other side of the stethoscope” in my own trauma room. I’d suffered thoracic and multiple rib fractures, a bleeding lung, cervical fractures and a spinal cord injury. The inspirational account of that event—“By Accident”—appears in Chicken Soup for the Nurses Soul and was my first published work.

Jordyn: What was your favorite part about nursing? Least favorite part?

Candace: Favorite part: That heart-warming and goose bumpy moment when you know that “being there” for a particular patient has made a big difference in that person’s life. Least Favorite: Inflicting physical pain during necessary treatment, especially with children.

Jordyn: What do you think are some common misconceptions about nurses-- or ER nurses specifically?

Candace: People think that nurses get “tough” and immune to the pain and tragedy they experience in their careers, that there is some protective psychological flak jacket we pull on to distance ourselves. It’s so not true. As a peer counselor for Critical Incident Stress (“burn out”), I saw the profound effects that painful scenarios have on staff. One of the main reasons I write medical fiction is to reveal (and honor) the compassionate hearts behind the stethoscopes.

Jordyn: What made you decide to pursue publication?

Candace: In truth, my husband. I’d been dabbling, dreaming. One day he signed me up for an online writing class, saying, “Stop talking about writing a book and just do it.” Pushy and wonderful man.

Jordyn: What are some common medical inaccuracies you see when you read novels or watch television?

Candace: One of things that irks me most, is when a young, healthy person is the victim of trauma (gunshot, MVA, etc.), drops to the street of a huge city (meaning LOTS of hospitals!) and someone does a quick pulse check and then says with wisdom and melodrama, “He’s gone.” Excuse me? I’m sure it’s plot effective to get rid of that victim, but no CPR, no 911 call, no transport to a nearby trauma center? Where’s that “Golden Hour”?  A witnessed collapse and no one does anything. Makes me crazy.

We'll continue with Candace on Wednesday. Looking forward to seeing everyone for Part II!

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Candace Calvert is a former ER nurse who believes love, laughter and faith are the best medicines. Her Mercy Hospital and Grace Medical series offer readers a chance to “scrub in” on the exciting world of emergency medicine—along with a soul-soothing prescription for hope. Wife, mother, and very proud grandmother, she makes her home in northern California.

Nurse Assisted Deliveries: Heidi Creston

Babies come when they want to, not necessarily when we want them to. Every labor and delivery nurse and OB provider are well aware of this fact. Nurse assisted deliveries happen daily.

The primary reasons for nurse assisted deliveries are:

1. Physicians are over extended.  They have more than one patient delivering at one time or are  covering OR and/or ER as well as OB.
2. They are not on site due to office hours.
3. Precipitous Deliveries (baby comes quickly).

Labor and delivery nurses are specially trained to monitor and keep close observation on a patient's status in order to notify the OB provider in a timely manner. Most patients are kept on continual electronic fetal monitoring. The pattern on the fetal strip provides information concerning both fetal and maternal status to include how soon delivery may be.

Sterile vaginal exams or cervical examinations to monitor dilation is another skill that L&D nurses are trained to perform. Nurses also educate their patients to report any signs of increased pressure.

It is always preferable for the OB provider to be present for the delivery, due to the increased risk to the patient (possible birth complications such shoulder dystocia), but in the event the provider does not make it, labor nurses are trained to deliver.

The L&D staff will make every effort to contact the provider, they will stop any measures taken to induce labor (turn off pitocin, instruct patient how to breathe thru contractions), provide support, and set up for delivery.

If the delivery is imminent, the nurse will guide the patient in her delivery, guiding the head, checking for nuchal cord. A nuchal cord is when the  umbilical cord is around the neck.  In some cases the cord can be untangled by hand.  Tight cords need to be reduced, clamped and cut.

Nurses also must be careful of other body parts being entangled by the cord as well. Delivery of the body is usually rapid once the head and shoulders are out.

If there are no complications with the infant, nurses will usually leave the baby on the mother’s chest with an uncut cord for 3-5 minutes. Nurses do not attempt to deliver the placenta, but if the placenta delivers spontaneously they place it in a container for the provider.

After delivery, if the provider remains unavailable, the nurse will clean the perineum and assess for tears and bleeding. Given the situation (excessive bleeding) the nurse may restart the pitocin, give a dose of methergine or hemabate, provide continuous fundal massage, and or perform a vaginal sweep. Upon arrival of the provider, the nurse will give them a full report.

Although most deliveries are uneventful, there are many things that could go fatally wrong with the delivery itself or during the post partum period. These include but are not limited to: malpresentation (ie: breech, compound limbs), cord prolapse/cord accidents/nuchal cords/body cords, placental abruption, and post partum hemorrhage.

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Adelheideh Creston lives in New York. She is former military and married military as well. Her grandmother was a WAVE and inspired her to become a nurse. Heidi spent some time as a certified nursing assistant, then an LPN, working in geriatrics, med surge, psych, telemetry and orthopedics. She’s been an RN several years with a specialty in labor and delivery and neonatology. Her experience has primarily been with military medicine, but she has also worked in the civilian sector.

 

Heidi is an avid reader. She loves Christian fiction mysteries and suspense. Though, don’t recommend the gory graphic stuff to her… please. She enjoys writing her own stories and is yet unpublished.

STAT C-sections

I'm so pleased to announce a new guest blogger here at Redwood's Medical Edge. Adelheideh Creston (I call her Heidi) is an RN specializing in obstetrics and neonatology. Her expertise will be an excellent addition to adding medical fact to your fiction. Today, she focuses on what the general guidelines are for vaginal delivery after C-sections. All right men... no blushing.

STAT Sections, TOLAC, VBAC, Let's think about all that.....

STAT C-section definitely gives your story drama, critical hysteria in some cases, just what you need to keep your readers turning pages except....

For the patient who has had only one prior cesarean section for an indication that no longer presents itself in her next pregnancy (for example, if her first baby was breech, but the second baby is not), then the patient may ask the physician for a trial of labor (TOLAC). These patients that delivery vaginally are then referred to as successful VBAC (vaginal birth after cesarean section). The patient however will undergo a TOLAC for each succeeding pregnancy thereafter.



ametherell/PhotoBucket

 Midwives, physicians assistants, and nurse practitioners cannot manage the care of these patients alone. There must be a physician present during the labor process. It is important to note that the physician has to agree to the TOLAC, if the doctor does not agree to it then it is the patients’ responsibility to find another physician who will. Some physicians do not carry the insurance for TOLAC or (VBAC). There are some states and countries that do not offer TOLAC or VBAC option regardless. Some hospitals do not carry TOLAC or VBAC insurance due to the maternal risks and expenses associated with these procedures.

The first thing to remind everyone is that cesarean sections are major abdominal surgeries. There is nothing lackadaisical about it. Given that information, any time a muscle in our bodies is cut torn or otherwise altered, that muscle is weakened permanently. During a cesarean section the abdominal muscles are both cut and then torn. The uterus is a muscle, the physician cuts into the uterus in order to remove the baby.

There are two commonly used incisions: lower transverse (aka bikini cut) and the Classical Incision (aka T-cut). Lower Transverse is the preferred, most common and least damaging of the incisions.

The uterus can develop a uterine window, a fragile site on the uterus that can lead to medical emergencies for the mother and baby. Partial and full abruptions and ruptured uterus are the most lethal and common complications associated with TOLAC and VBAC procedures.

An abruption is when the placenta dislodges from the uterine wall prior to delivery. In this case, without emergency intervention (imminent birth or emergency cesarean section), the baby will die.

A ruptured uterus is a breakdown of the uterine wall, in which case both mother and baby are at risk for sudden death. Cesarean sections leave the uterus in a compromised state, the more c-sections a patient has, the more compromised the uterus is, which leaves the patient more a risk for abruption and or rupture.

In my experience, patients having had two or more cesarean sections, regardless of the indication, a TOLAC or VBAC are not an option. At this point the risks outweigh the benefits. This risk is so prevalent neither the hospital nor the physicians are willing to accept that responsibility. The physician and hospital will go to great lengths to explain the risk associated with a TOLAC to the patient.

Ultimately the decision is up to the patient. The patient can go against medical advice. Proper paperwork must be filled out indicating that the patient is cognitively aware of their decision and understands the risks involved. The physician and hospital can also file a legal petition to a judge concerning the patient’s decision.

What plot scenario can you think of using these guidelines that will still have a lot of conflict?

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Adelheideh Creston lives in New York. She is former military and married military as well. Her grandmother was a WAVE and inspired her to become a nurse. Heidi spent some time as a certified nursing assistant, then an LPN, working in geriatrics, med surge, psych, telemetry and orthopedics. She’s been an RN several years with a specialty in labor and delivery and neonatology. Her experience has primarily been with military medicine, but she has also worked in the civilian sector.

Heidi is an avid reader. She loves Christian fiction mysteries and suspense. Though, don’t recommend the gory graphic stuff to her… please. She enjoys writing her own stories and is yet unpublished.