All posts by Maddie Q


Death and Dying

I think the most significant trend in the care for the aging in my lifetime has simply been the fact that our critical care has become so much more sophisticated and effective, at least in terms of prolonging and maintaining life at all costs. This brings up a whole new need that our aging population perhaps never needed in the past, which is that health care providers and families be educated and familiar with the process of dying, not simply as something to avoid but as something that will happen to everyone! It’s crazy to me that we fight off dying with everything we have, because what are we hoping to gain? And it just causes people to have messy and sad deaths.

This is an opinion that I think is held by many people, and definitely by health care professionals, but it’s hard to act accordingly because so many people, in and out of the health field, simply don’t know the ins and outs of death and what it looks like and what to expect. My concern is that lack of education and willingness to discuss death has caused our society to harm elderly people and cheat them of the peaceful death that they desire and deserve.


Medication Survey

My informal survey was not a very accurate segment of the population because no one in my house is currently taking prescription drugs. However, the common theme in my conversations was that my family members knew what supplements and vitamins they were taking if they were single supplements, but if they were multi vitamins or brand name supplements that were reccomened to them then they often didn’t know exactly what they were. Additionally, only one of the three people were aware of potential side effects, although she fortunately had not experienced them.

My mom has been off and on various meds for years, and I remember that she often knew what side effects to expect but most of her knowledge was from her own research. She frequently spent time researching her diagnosis and medications, which was sometimes a good thing and sometimes a bad thing.

Overall my impression is that, as always, people tend to be less that optimally educated on their medications, and this is  likely to be even more true in other populations such as the elderly or the under educated.


ETT cuff material

During my rotation yesterday with RT at West Hills Hospital I learned a lot about the care of ventilated patients, especially those with tracheostomies. There were two lessons that I learned that I want to talk about.

First of all, if your patient has a speaking valve, which is a one way valve that can be attached to the tracheostomy tube that allows air in but not out and thus forces exhaled air past the vocal cords, it is critically important that you deflate the cuff of the tracheotomy tube, otherwise your patient risks suffocation. This was stressed to me by Carl because some nurses forget that and leave their patients with speaking valves and inflated cuffs.

Secondly, there are now cuffs being made with new, thinner materials such as polyurethane to prevent the tiny folds in the cuffs that allow micro aspiration to occur. This new technology is not yet available at West Hills hospital, but the research is very promising.


What’s an MI?

I interviewed my sister-in-law today (very quickly and casually) to get a sense of her understanding of the cardiac events that we have been talking about:


What does “Cardiopulmonary Arrest” mean to you?

“When your heart and your lung stop working.”

Do you know what an MI is?


What do you think happens during “CPR”?

“It’s keeping the blood flowing to the brain and to the lungs to make sure oxygen is getting to the brain.”

This interview was intended to get a sense of whether the basics of cardiac disorders such as MI are common knowledge. I think that it’s hard as nurses for us to have a sense of what the public is really aware of, versus what we only know because of our education and experience. This is important information to have because I don’t want to take for granted what my patient will know. My sister-in-law was not the perfect choice of interviewee in terms of getting a sense of the general population, because she is constantly exposed to me talking about what I learned in school. However, it was helpful to me to discover that MI is not something that most people hear about. When I said it was a heart attack she was completely on board and could accurately explain what it is. Which is another important point, that shorthand and code terms for conditions, although they make things easier for health care professionals, need to be avoided when discussing health concepts with the general public in order to prevent confusion.


Cardiac Diet

Today I tried to be conscious as I went through the day of what I was eating, and whether or not the food choices I made were compatible with a heart healthy diet. For the most part I actual tend to choose foods that are heart healthy For example, I love salad and vegetables and I don’t tend to enjoy fatty and salty foods. Prepackaged foods and fast food are not usually on my menu, just because of my upbringing and my current housemates. I think that my diet tends more to be heavy in carbohydrates, meaning that I should be focusing on a diabetes prevention diet versus a cardiac diet. Today the most sodium came from the turkey that I had, because sandwich meats are often high in sodium.

Almond milk: 110 mg sodium, 3 g fat

Wheat cereal: 10 mg sodium, 1 g fat

Greek yogurt: 70 mg sodium, 10 mg fat

Turkey sandwich: 2000 mg sodium, 4.5 g fat

Nutella crepe: 620 mg sodium, 48 g fat





Welcome to Critical Care!

Well, our final semester begins this week, and I am excited and nervous about critical care! I hope that I will be able to figure out how to study for the exams, that I will remember how to perform all the clinical skills and time management, and that this semester really prepares me for life as a registered nurse. Looking forward to the adventure!


Blood Typing Game

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Just going to see if this works 🙂


Connect – Disconnect

I’ve been thinking a lot about the assignment for this blog entry, and trying to notice how much I “connect” electronically as opposed to in person. It’s an interesting thing to pay attention to, and it’s not a black and white issue. Human interactions are so so important to all of us, whether that’s family, friends, work, school, world news… Anything or anyone that we want to “keep up” with.

I started to wonder, “Do we disconnect with the people that are important to us, by using electronics instead of face to face?” I think that answer is yes and no. We’ve all been tempted, when hanging out with someone, to check our phones to pass the time. In that situation we are passing up an opportunity to really spend time with someone, and we all realize at some point that those opportunities are not as permanent as we think they are.

UnknownBut on the other hand, I notice that most of the texting and social media that I use is to connect with people that are the most important to me. For me, it’s my family. My immediate family is very big and we are all really close, but people move away or just spend a lot of time away from the home. Social media is actually becoming more and more important to me as my sisters move on with their lives and I spend less time at home.

So my conclusion: Sometimes we need to disconnect in order to connect better, but often technology allows us to stay connected with the people that are really important.


Five Fun Facts: Femur Fracture with Traction

5 Fun Facts about: Femur fracture with traction


  • Early complication of fracture: Shock, fat embolism, compartment syndrome, DVT
  • Late complications: Restricted knee motion, delayed/mal/non union, avascular necrosis of bone, complex regional pain syndrome, heterotopic ossification
  • Nursing priorities for traction: pain management, neurovascular assessment to prevent skin breakdown, nerve damage, circulatory impairment.
  • Bone must be Immobilized but tissue must be allowed to swell
  • Traction must be continuous in order to be effective. Do not disconnect unless life-threatening event.

Videos for Kids

CHLA has a lot of educational material for parents who are taking their children home and need to know how to take care of them. For instance, I found this page on G tube care for children:

The information listed above is certainly very helpful for parents who want to have resource in order to make sure their kids are well cared for and that nothing goes wrong. But we’ve talked a lot in various classes about different learning styles, and the importance of presenting information in a manner that will be understood. So what about videos? Sometimes just reading the words doesn’t bring it home enough. So I found some good videos for parents to watch.

What about the kids, though? If I was a little kid and I was coming home from a scary hospital experience with a tube into my stomach, I would be very nervous and upset. I think maybe learning more about what’s going on inside, and the reason why the tube is helping me to get better would help me to feel more comfortable.

I had no luck finding a fun, simple video that just explains what a G tube is, why it’s there, and what it’s doing, as well as why the stomach needs it. I found a lot of dry videos with a pediatrician explaining G tube care, but I think there’s a need for Sesame Street style health care videos for kids that are going through health problems.

At least, that’s what I think I would want.