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Category : Nursing

in 2002, I graduated Summa Cum Laude with a Bachelors of Science in Nursing from Oregon Health Sciences University in Portland, Oregon. I then practiced, mostly as a travel, agency and float nurse, until May 2009 when I decided the U.S. health care system is beyond broken and nursing is not good for my sanity. I sometimes wrote about it, but most the stories cannot be told. My training still applies to daily life situations, though.

Breathing & Respiration

A friend was telling me her rhythms were off. I’m wondering if that might be because she’s been holding her breath and crying more lately. It’s hard to get by an entire day breathing. The hardest things are what should be the easiest! Breathe! Hey, and this is helpful: from ftrain.com, “How to breathe deeply when you’re nervous.” This brief article provides brief (illustrated) instructions on how to reboot your autonomic nervous system’s breathing patterns, per se. These instructions are similar to advice I give people suffering from hiccoughs. What I tell them is, 1) breathe in as much air as you can and breathe in some more 2) hold it as long as you can 3) breathe out as… continue reading

The Best Pickup Line, EVER

This morning at the patchouli-smelling hippy food co-op, I found myself STARING at the bulk chocolate items. My eyes honed in on chocolate-dipped crystalized ginger, but were also cognizant of a toothsome man hovering behind me to my left. He said, “Do you like chocolate?” I said, “I haven’t had any in days, and I’m fixated.” Several moments later, he uttered, “Do you live in Ashland?” “No, Medford.” “I’m new to the area.” “Where from?” “The East Coast.” “Where on the East Coast?” “New Jersey.” “Where in New Jersey?” “Why, do you know the area?” “Sure, I’ve been through a couple times.” “Ok. Englewood.” “Close to the city. So why did you move here?” “Just to move. Isn’t it okay… continue reading

Human Pincushion

(Something traumatic happened as a nurse watching another nurse work in Medford, and I wrote a poem about it.) take a look at you Os in your nose thigh high tight hose belly is swelly O negativity one hundred red CCs drip hourly old bladder overflows but you can’t let go pushing but helpless toothless big mess heifer big bess mooing through hellishness can’t show compunction to use this unction it’s a smart nurse’s solution a rubber tuber a one eyed noodle some lube and toodleoodle! slather it lather it poke it farther in this little fucker will father it spread those, easy show nursey your pursey lungs rattling you tattling? we must meddle in your rusty kettle so she… continue reading

Week in Nursing

So far this week I: – took care of at least 22 different people between two units on three days; – rubbed someone’s shoulders who just found out she had cancer; – went along and pretended to be a patient’s girlfriend for a few seconds while walking in the hallway, a patient who got sick after ingesting $12 in coins; – accidentally brought another vial of Dilaudid home; – and got my new charcoal grey hi-top converse sneakers (just like old times).

Breathing, Part I

You’ve probably noticed already that breathing and respiration have a lot to do with chemistry, and that because you’ve most likely taken it for granted, it is surprisingly complex, dynamic, and interesting… This website is an overview of what happens as you breathe, starting with some basic anatomy and working into chemical principles that govern every breath you take. Take a look at this picture. A “conducting zone,” or pipeline consisting of the nose, pharynx, larynx, trachea, and bronchi, and terminal bronchioles, allows ventilation (facultated by the diaphragm) and a “respiratory zone,” consisting of respiratory bronchioles, aleolar ducts, and alveoli, permits gas exchanges essential to respiration. Are they like empty balloons? Maybe you never even thought about it before… The… continue reading

Breathing, Part II

What makes lungs expand and contract? Are they muscles? No, the lungs aren’t muscles. *Special* respiratory muscles “make” breathing happen. Normally an involuntary act, breathing can also be consciously controlled and altered, thank goodness. Although technically many muscles of the thorax can participate in breathing, any decent yogi will tell you that the diaphragm is the prime and proper breathing muscle (Vishnudevananda 235). Here’s how to do it: Relaxed, the diaphragm is dome-shaped. Upon contraction it flattens inferiorly, expanding the thoracic cavity and lungs. This is inspiration. The muscles shown between the ribs in this illustration are the external intercostals; they aid inspiration by elevating the rib cage. In a full inspiration, the belly will protrude, the chest will expand… continue reading

Respiration, Part I

Breathing and respiration aren’t the same thing, but they go hand in hand. Breathing is a simple mechanical process whereby air enters and exits the lungs due to volume and hence, pressure changes. Respiration* is a more complex process of delivering oxygen to the tissues for cell metabolism and carbon dioxide to the lungs for removal. The image at left shows blood being oxygenated at the lungs (red) and traveling through the heart to the systemic circuit. The gas exchange at the alveoli/blood interface is called external respiration. Gas exchanges between blood and tissue cells is termed internal respiration. Deoxygenated blood (blue) flows from the tissues in the systemic circuit back to the heart, the lungs, and CO2 is exhaled…. continue reading

Respiration, Part II

We’ve explained why air enters the lungs, what components flow in/out and why, but we still haven’t discussed internal and external respiration! Regard the image at right. Find the sad face. Here the blood is CO2 rich (45 mm Hg) and low in oxygen (40 mm Hg). This sad blood is being delivered to the lungs, where the alveolar PO2 is 104 mm Hg and the PCO2 is 40 mm Hg. See? You probably know right away that fresh oxygen will rush across the respiratory membrane into the blood and refresh its supply to 104 mm Hg. But the gradient of PCO2 is only 5 mm Hg. It would seem then that carbon dioxide would have a lesser tendency to… continue reading

Respiration, Part III

Oxygen and carbon dioxide are carried in the blood, pumped by the heart, and shifted through membranes by partial pressure gradients. Oxygen dissolves to a much smaller degree than carbon dioxide, so that at rest, the PO2 would only help provide 6% of the body’s O2 requirements. There must be another way. The hemoglobin molecule comes to the rescue. Hemoglobin is made of globin, a protein, and four heme groups consisting of an iron atom surrounded by an organic group. Four polypeptide chains make up the globin, each bearing a red-pigmented, disk-shaped heme. Each heme group binds one oxygen molecule, so each hemoglobin molecule binds four oxygens. Considering one red blood cell holds ~ 250 million Hb molecules, it can… continue reading

Respiration, Part IV

Successful respiration requires a delicate acid-base equilibrium in bodily fluids. H+ concentrations, however meager they may be, significantly impact fluid pH. Furthermore, hydrogen ions are highly reactive and react with many compounds, often disrupting their shape and function. Hydrogen ion concentrations must be maintained at ~4.0 x 10-8 in order to keep blood pH at its slightly alkaline value of 7.4. Acidosis, caused by accumulation of CO2 in the blood, is a drop in blood pH. Shallow breathing may cause acidosis. The opposite condition, alkalosis, is a rise in pH due to excessive CO2 excretion. Alkalosis is commonly caused by hyperventilation, but is much less serious than respiratory acidosis. We can say that concentrations of CO2 in the blood are… continue reading

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