student health care

18.02.17 • 15:21PM pretty happy with how this turned out, self care ideas in my bullet journal ~ click to see higher quality photo

Edit: I’ve since fixed the spelling mistake

public transport productivity 🚎

at some point, the vast majority of us will use public transport. It takes time to go from A to B, and that time can be used more productively than scrolling social media endlessly, believe it or not! Try these:

• revise notes
• work on assignments
• map out weekly timetable
• read emails / announcements
• review deadlines + make sure you’re tracking okay
• research anything you’re struggling with
• find out about new / uncommon study techniques
• write a to-do list
• arrange a study date with friend(s)
• order any existing to-do lists in terms of priority
• listen to motivational music / speeches
• make a list of readings to do / books to pick up
• write out everything that you’re working so hard for
• meditate / work on mindfulness
• plan a physical activity for the near future
• think about healthy foods you can grab / make
• reflect on all of your achievements to date: you’re doing so well!
• make a list like this to share with study buddies
• organise folders / backpack
• research a new study space (eg library / cafe / park you haven’t visited yet)
• think about / research all the ways that you can improve your study space at home (eg organisation, lighting, minimising distractions, plants & candles?)
• close your eyes and spend a few minutes thinking of things / people to be grateful for
• break down the mountain you’re trying to pass in your head: can you turn it back into a molehill / smaller tasks to conquer ?
• think about your finances: can you increase your savings and still get by? How much can you spend this week on self care / treats?
• what NEEDS to be done FIRST as soon as you arrive where you’re going? (eg homework, submissions, messages, chores)
• is there anyone you need / want to check in on?
• is anything that you can change stressing you out / upsetting you? Is it costing you more than it’s worth?
• look up a funny comedian / find a picture that makes you giggle. It’s good to detox with laughter!
• are you eating 3 serves of fruit and 5 serves of veg per day? Can you change this if not?
• are there any clothes that you NEED to get? are there any clothes / items that you can donate?

callout post to myself + @studyblrs

Let’s keep this short and concise. You are NEVER, and i swear to god, EVER going to get where you want without the right attitude. You want those top grades? Great, amazing; you will get them but not without some serious sweating and re-evaluating your life (ok that’s perhaps a lil too dramatic)

1) YOU ARE NOT A SPECIAL SNOWFLAKE

Some parents tend to think their child is a precious gold nugget descended from the gods themselves. And boy do they show it, taking it upon themselves to remind others and the child this repeatedly. This is not healthy. I repeat THIS IS NOT HEALTHY. After being told how extraordinary you are your entire life, the real world comes as a shock that there are people that are better at something than you. You find yourself struggling as you see yourself falling down the grade ladder down into the depths of despair and confusion as to why this is happening. I’ve seen this happen countless times, both in real life and on tumblr. And it hurts.

This is not your fault. It’s how you were raised. It’s hard to accept- heck i still get jealous when i see other people doing better than me. But that’s the way the world works. There will always be people better than you and me. And you know what? It’s ok. This is about you and your story of success.

  • remember that you are still valid
  • it’s ok to slip up sometimes, you can learn from your mistakes and become even more powerful
  • create a new mentality: “I’m may not be the best now, but i’ll try damn hard to become better than i am now”
  • work your butt off. You’ll have to sacrifice things such as a few social activities
  • remember it’s worth it. you will succeed

2) YOU ARE NOT WORTHLESS

On the other end of the spectrum, we have kids who’ve spent their entire life being told they’re “not enough” or they’ll “never amount to anything” and of course the favourite “you’re stupid” when they don’t achieve the things others wanted them to. Quite often it’s the parents instigating this.This is even more prominent in cultures where a child’s worth is almost solely based on what grades and what career they pursue. 

  • remember that you are still valid
  • it’s not ok to be treated like this. you are worth more than what parents/others say. however you will likely have to put up with this until you move out
  • create a new mentality: “I’ll show them” or “I’m gonna do this for myself”
  • work your butt off. You’ll have to sacrifice things such as a few social activities
  • remember it’s worth it. you will succeed

3) YOUR OPINION MATTERS

whether you think you can or you think you can’t, you’re right so get yourself in check and create a healthy mentality that serves to fulfill you instead of one that demonises you

last step: work work work


share positivity around u lil nuggets

Burn Percentage in Adults

Rule of Nines:

This rule is used to help guide treatment decisions including fluid resuscitation and to determine transfer to a burn unit.

You can estimate the body surface area on an adult that has been burned by using multiples of 9.

For example, if both legs (18% x 2 = 36%), the groin (1%) and the front chest and abdomen were burned, this would involve 55% of the body.

9

I get a ton of messages basically asking the same question: How do I make myself the best applicant to medical school I can be?

1. Most imporantly: Do everything in your power to be a well rounded applicant
- Pick a major your interested, does NOT have to be a science major!

– Just because you want to be a doctor or work in healthcare doesn’t mean only science topics interest you! You can be an art major and still take all the courses required for premed. Ex. I did anthropology and Psychology, I have premed friend who were engineering and music majors. 

- Volunteer in the community with organizations that you are passionate about, NOT just ones that look good on an application

– These should be diverse but should be things you are passionate about, if you get more out of planting trees than volunteering in a hospital gift shop, thats okay! Volunteer in different groups and organizations, some should be medically related but they don’t all have to be! Showing a commitment to life long service doesn’t just mean in medicine. 

- Shadow: different fields of medicine and not just doctors, look into dentistry, nursing, psychology, social work –> figure out what type of healthcare provider you want to be. Contacting people may seem scary but it never hurts to ask, look for positions available, write them an email talking about the strengths and skills you have, maybe you don’t have a lot of experience but you can still be a fast learner and hard worker! 

- Research: if this seems boring to you, find someone researching something you’re interested in so you will actually enjoy it! I appreciated the results of research but always thought working in it would be boring and it was just another thing I had to do to put on my application. I was very WRONG! I found something lab researching a topic I was interested and it consumed me, I now have a greater understanding research and how fun it can be exploring a hypothesis! 

- Extracurricular: again do what your are passionate about, everything does not have to be about medicine, different life experiences teach you different life lessons. I learned different things from being VP of my Doctor Who club vs.  in my medical internship vs. being a ski instructor! 

- Study hard: create study groups, find tutors or be a tutor! If you are struggling in a class, study groups are shown to be a very effective way of studying, or spend the money on getting a tutor because it will be worth it in the end. When you are struggling in a class, especially a premed class, it can be a good time to reflect on whether this is a career for you. Being a doctor means a lifetime of learning, school, and tests. Seriously look into other career you might be interested in, its okay to change your mind about medical school, there are other careers in medicine, or other professions you might enjoy more. Everything in life takes hard work, its finding what you can endlessly work hard for. General Chemistry made me seriously look at whether of not this was the right path for me. After some serious self reflection, there was nothing else I could work this hard for. 

- Time management: Managing work, school, social life and everything else can be hard, don’t take on too much, figure out your limits, remember to ask for help when you need it and to take care of yourself. If you push yourself too hard you will break, we are not invincible. Its okay to say no, to take time for yourself!

Keep a detailed resume of all your actives, exact dates of when they started and ended, who to contact about them and a detailed summary of what you did and what you learned form your experiences! This will help you immensely when filling out your AMCAS 

If your application isn’t perfect or not very well rounded (lacking in areas), I highly recommend taking time off to fill those gaps. The biggest reason people who apply straight out of college don’t get in, even with great applications is maturity level. You may think, I am adult, I am mature! But just because you can act professionally doesn’t mean you are mature. The maturity they are looking for is achieved through life experiences. Many college kids really haven’t had much life experiences other that college, what adversities have you overcome, do you even really know who you are yet outside of your college experience. 

I have take two years off, even though I had a pretty good application before, it has only become stronger and I have lived life, I thought I knew who I was before but I really had explored that until I was out of college on my own.   

Optional: Take time off before applying (Recommended)
- Gaining more life experiences: Maybe move to a new place or Travel 

- Get a Masters Degree: this can help boost your GPA if it is not competitive 

- Work: doesn’t have to be in medicine but if you lack hand-on patient experiences than this is great opportunity to chance that! If you have never worked a job, than I highly recommend taking time off and working for a living to experience what its like to pay your own bills

- Learn about who you are: this will help you appear more mature when interviewing and make you more confident 

The Process of Applying 

- Competitive MCAT Score: you don’t have to pay for a course, do what works best for you. I believe the examkracker books were most helpful, Kaplan tend to have the hardest BS and PS practice test but Examkrackers is the best for VR. If you don’t do well the first time, figure out what went wrong and retake it! Learn from this experience because your future in medicine will require many more standardized tests so figuring out how to best prepare for them now will help you in the future! 

- Picking Medical Schools: pick 15 schools, have a few reach schools and a few back up school and then the rest ones you can reasonably get into. Take into account their curriculums, locations and if you are thinking about a competitive speciality look at the what residencies their students are matching! If you are interested in research, or rural care, looks at schools that over special programs for these paths. 

- Letters of Rec/Committee Letter: hopefully in college you made meaningful relationships with professors you had (you should definitely do this!), you will need a science class professor letter of rec, if you did research you will need one from your PI, if you worked with a doctor for an extended period ask them to write you one or if you worked with a volunteer organization for a long period.  Write them a nice letter in why you are asking them, provide them with your resume and all the information they need to know as well as where to send it to. Its okay to send emails reminding them to write it, they are busy people and reminding them shows it is important to you. Also figure out if your school offers a committee letter and be diligent about keeping up on every thing you need to do for it. 

Primary Application AMCAS

- Personal statement- make it personal, talk about experiences that have lead you hear today, but most importantly what you learned from them. This is about you, WHY YOU? vs. everybody else who is applying. This is a Persuasive essay! 

- Academic Record- make sure to request you transcripts to be sent as soon as possible so AMCAS can verify them quickly 

- 15 Activities - out of everything you have done you have to pick the 15 most important activities you have done and briefly talk about them. Then you get to pick three that were most important 

Secondaries 

- Strong Essays- These are your chance to show again why you!? highlight your strengths when you can, make sure they are concise and well written free of grammatical errors. Ask friends to read them over for you. 

- Resume - Remember that detailed resume I told you to about keeping! Many schools allow you to upload addition documents like a resume! Now beyond your 15 they have a list of all the actives you have ever done and what you have learned from them! 

- Headshot- passport photo size, 2 x 2 inches. Dress profession, SMILE, only should show show just below the shoulder and up. Remember this is their first glimpse of you, putting the face together with your application! 

- Research abstract - if you did research, make sure to have a document with just your abstract to upload if the offer additional documents area. 

Interviewing

1. Practice - Practice answering interview questions, use examples, highlight your strengths! Try limiting your answer to two to 3 minute: look up “Elevator Speech” - pitch to the ceo a great idea on an elevator ride of only 4 floors! 

2. Reading - the more you read the smarter you are! Reads books about doctors and their experiences, how to apply to medical school, affordable healthcare act, current events, current events in medicine, NIH, read papers on tough ethical topics, read papers published by people from that school, read everything you can on their schools website! Schedule a mock interview, video record yourself answering questions. 

3. What to wear -
Females - professional fitted pants suit or suit with skirt no more than an inch about knees with skin tone matching stockings. flats or heels no more than 2 inches high, make sure you can walk all day in them. simple jewelry, studs and a necklace, no more than one ring on each hang. nothing big and distracting. suite should be black, navy, or gray. Blouse or profession top not showing cleavage. If you hair is long wear it back. Make up, light. You don’t want anything distracting from what you’re saying!
Males- Well fitted suit, tie (safer) or bow-tie, pick a professional one that is not busy looking or distracting. Suit color: black, navy or gray. business professional shoes. Belt and shoe color must match. 

Don’t wear fragrances (but wear deodorant!), bring a briefcase or similar size professional purse or professional folder (just need something to hold business cards and papers). Look well manicured make sure nails are trimmed and neutral colors only. 

Remember to be professional, have a firm handshake, ask them for their business card at the end to write them a handwritten thank you letter. Sit up straight, smile, be you, and don’t forget its a conversation so don’t be over rehearse your answers. If you don’t know the answer to a question, say “I honestly don’t know the answer to that”. Come up with a list of your 3 strengths and weakness and examples of each as well as what you are doing to work on your weaknesses. 

Good luck! One day your hard work will pay off, there will be bumps along the way but each one will teach you something and bring you closer to your dream of going to medical school! 

“People with great passion can make the impossible happen.”

Classification of burns

Burns occur when some or all of the cells are destroyed by heat, cold, electricity, radiation, or caustic chemicals.

According to the depth of tissue injury: superficial or epidermal (first-degree), partial-thickness (second degree), or full thickness (third degree). Burns extending beneath the subcutaneous tissues and involving fascia, muscle and/or bone are considered fourth degree.

Superficial: only the epidermal layer is involved. They do not blister but are painful, dry, red and blanch with pressure. An example would be the sunburns.

Superficial partial thickness: Form blisters within 24hrs. Painful, red, blanch with pressure. Scarring is rare but pigment changes may occur. Fibrinous exudates and necrotic debris may accumulate predisposing to bacterial colonization.

Deep partial thickness: Damage hair folicles and glandular tissue. They are painful to pressure only, almost always blister. They don’t blanch with pressure. These burns cause hypertrophic scarring, if they involve a joing, dysfunctions are expected.

Full thickness: They destroy all the layers of epidermis and often the subcutaneous tissue. They are usually anesthetic or hypoesthetic. Hairs can easily be pulled. Blisters do not develop. Scarring is severe with contractures.

Fourth degree: Deep and potentially life-threatening that extend into underlying tissues such as fascia, muscle, and/or bone.

An ode to nurses, from a palliative patient

As I lay here, in my hospital bed, awaiting to die, I develop a routine.
The mornings, I awake with a dry mouth and a wet pad,
My lungs ache with tiredness, and my bottom is sore.
My family comes to visit each day with sadness on their face,
and my doctor comes in, with pity, as he knows the end I will face.
It all becomes familiar.

But you, dear nurses, do not.
Each day, a different face enters my room, just as caring as the last, just as understanding of my fate.
But always, the kindness seeps through.

First, the seasoned nurse enters with a look of knowing - she has seen patients like me too many times before.
Her hands are skilled, her pace is steady. She is efficient, yet attends to all my needs. With her, I feel safe. I know that I am in good hands, and that if I pass with her, I will pass well.
I can tell that though she has a big heart, she is careful of letting me in. It has broken too many times for a patient before.
Her reservations do not annoy me, as they may with some, but instead tell me a story of her life full of service to others.
She knows the signs of passing, and knows that though I am near, it is not quite time yet.
It will not be her who is with me when my time comes.

Next enters the “new grad”. Her face is young and beautiful, but shows a special kind of hope that the nurse before her did not share.
Oh, you know my fate as well, but you are still hopeful. For what I am not sure, but I see that it drives you.
You are not the one who is with me when I pass, but almost.
You are there when my blood pressure plummets, pushing drugs you never have pushed before.
Instead of a steady hand, it is anxious with worry. But alas, young one, you comfort me as well. For if your face was the last one I were to see before I died, then I would see the face of hope. And that would be a good last sight.
You are so studious, taking my vitals more than any nurse before, asking me how I feel, and scolding me when I say “fine.”
“I’m here for you” you coo, “don’t try to be so tough. Be honest with me.”
For unlike the nurse before you, you still let yourself become attached. And when you hear of my death, you cry. But take heart, my dear. I will miss you and your kindness the most.

Then, comes the end. I can feel it coming. I can feel my bones becoming stiff, my lungs becoming full, and my heart becoming weak. The next nurse can feel it too. This nurse and I are one in the same, and he understands my will to be strong until the very end. But he knows as well that the pain meds he convinces me to take, despite my protests, are the only things that are keeping me calm. He is keeping me calm, he is preparing me for death.
His strength makes me feel as though he is my protector, willing to fight with the gods to keep me pain free, to make my last moments comfortable. And he does.
All shift, I cling to life, keeping him on his toes. But finally, at 0600, with his brow furrowed with acceptance and sadness, I close my eyes one last time.
Too early for my family to be at my bedside, it is only him.
I use all of my last ounce of strength to try to communicate to him with my eyes a thank-you. To ask him to tell the other nurses I appreciate them. Though all different, they all cared for me tremendously. And I can feel them all here, with us, as I take my last breath.

*this was written by me, after an experience with a palliative patient that touched my heart. The words are written on behalf of him, by the emotions he communicated to me during his last days*

What’s in my Nurse bag?

Inspired by @nursegif, I put together a little bag full of goodies! I plan on bringing this bag everywhere I go, not just those long shifts. It’s portable and chock full of on-the-go travel size necessities. The little bag itself was only $10 and while spacious, is very practical.

Make sure your bag is convenient for you. You never know when you’ll need some of these items! For example, I have panic disorder. I randomly get diarrhea, I get sweaty, and as you can imagine, it’s unpleasant.  Imodium and feminine wipes to the rescue!

Medication:

·         Cortizone-10 cream

·         Neosporin ointment

·         Pepto-Bismol caps

·         Aleve tablets

·         Tylenol tablets

·         Imodium tablets

Hygiene:

·         Floss

·         Hand sanitizer

·         Wet wipes

·         Feminine wipes

·         Pads & tampons 

Beauty:

·         Matte shine control powder

·         Moisturizing lotion 

·         Bobby pins

·         Dry shampoo

·         Mints

·         Deodorant

·         Hairspray

·         Eye drops

·         Make-up removing wipes

·         Nail clippers & tweezers

·         Moisturizing lip balm 

Miscellaneous:

·         Tissues

·         Bandaids

·         Tide stain remover wipes

·         Pair of latex-free gloves

Other things you could include: money, pen & note pad, zip-lock baggies, a snack bar, extra phone charger, gum, q-tips, hair ties, sanitizing hand wipes, and kids & adult allergy medication

Gallstones

Gallstones are of two types, cholesterol stones and pigmented stones. 

  • Cholesterol stones are more common up to 80%, risk factors for them are the 5Fs: Fat, Female, Forty, Flatulent, Fertile, and others.
  • Pigmented stones are either black or brown in color, they are calcium based, risk factors for them are cirrhosis, biliary stasis, and chronic hemolysis

Gallstones are usually asymptomatic (80%) but if the symptoms are present they are composed of biliary colic, steady, severe dull pain in epigastrium or RUQ for minutes to hours, crescendo-decrescendo pattern, frequently after fatty meal or at night, nausea, and/or vomiting. 

Evaluation is by ultrasound which is the test of choice of gallstones disease. Treatment of gallstones is cholecystectomy.

More medical content here!

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19/04/17 109/365 days of productive 🌼

Today I’ve done some revision for media and health and social care coursework.

Total number of hours revising:10

This morning a blog post came up on my Facebook by a lady who had her child 7 years ago. The title was something like “why I will never forgive the midwives who cared for me.”
It was poorly written to say the least (if you’re going to reference drugs such as pethidine, at least google how to spell them before you mention it about 5 times in your blog post).
I have written several articles for leading UK midwifery magazines about compassionate care. I would never, ever talk to a woman nastily or belittle her or her body, but we are HUMAN.

The doctors, nurses and midwives looking after you are human. Yes we can make mistakes! Yes, sometimes we might wrongly assess your cervical dilatation, has this member of the public ever even felt a cervix? It’s bloody difficult, we’re assessing for dilatation, effacement (sometimes we’re feeling for a paper thin bit of cervix), sometimes we have membranes bulging, sometimes we don’t. Then we have to feel for the station, for the presenting part, any sutures or fontanelles. It’s difficult. I’m sorry the midwife assessing you only found you to be 1cm when in fact you were 7. We are human. We spend our whole careers learning.

Working in healthcare is the sort of profession where you could have been in the job for 35/40 years and you haven’t seen it all and you don’t know everything. There is always something to learn, always a new technique, a new procedure, a new product, a new concept, a breakthrough or new information disseminating through the medical world.
That being said, just because your care giver looks young, please don’t judge their professionalism or knowledge. I’m 23, I look 12. I take pride in what I do and doing it well. I would hate for a woman or her family to judge me based on something as individual and irrelevant as my appearance as opposed to the brain in my head and my experience.

We work 12.5 hour shifts often without a break or gratitude. We work for little money, despite the stereotype we’re not loaded, my family struggles month to month.
I cannot tell you how wonderful it is to receive thanks from a woman or her family, because it’s honestly so rare.
We work so hard doing everything we can, giving so much of ourselves to help others and to care for others; years of study, poor working conditions… and yet from every angle people seem to want to criticise (including our own government).

I adore what I do. I love supporting women, I love learning and constantly being amazed when I find out something new about pregnancy and birth. There are good and bad in every profession. I have seen bad practice and vowed to never practice like that. But the majority of us try so hard. Please do not paint everyone in my profession with the same ‘evil’, 'uncaring’, 'incompetent’ brush.

We are humans behind these titles of our professions.

yo fellow students, sufferers of neurological/cardiovascular issues, anxiety sufferers and generally any folks who get headaches easily
today i’ve got a neat little tip for ya
if you ever start to feel that meh feeling when you know a headache/migraine is approaching but you’re not in pain just yet, it’s just your head feels kinda weird and heavy and disgusting, you know what you should consider doing? 
of course, the staple rituals won’t hurt: have a break from whatever you’re doing, hydrate, get a fruit snack, wash your face but what i’m about to tell you is not a common thing to do and you may even think i’m a fucking weirdo but it helps me greatly and i hope it helps you
get some vicks vaporub and rub some on your face, focusing on the forehead, massaging the parts where it usually hurts the most, you’ll feel which ones. for me sometimes it’s temples, sometimes the middle of the forehead or areas above my eyebrows. just rub that shit in. be sure to avoid the eye area and not put too much too close to eyes as the vapour may bother your eyes. 
this provides a nice cooling sensation, it’s a bit tingly and really refreshing. the scent of eucaliptus, mint and whatever other shit that’s in there also energizes you a whole lot and it’s always nice to inhale some of that whether you’re sick with cold or not. for me it usually helps to avoid getting the headache, increases productivity and just generally feels nice. try it if you’re not allergic to and don’t hate the smell of vaporub.
hope this helps! your fellow 5th generation migraine sufferer and uni student exposed to insane levels of stress whose blood vessels are literal shit.