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.

Two women in KN95 masks perform a WFR mock disaster run

Nurse -> WFR

I’ve been retired from nursing for 12 years now, so I’m a bit rusty with all this stuff. For some reason I thought my nursing background would help my Wilderness First Responder (WFR) course feel easy. But since the WFR works on totally different algorithms than licensed clinical medical care, it was pretty challenging. I had to set aside everything I knew and do it a different way. Of course my understanding of physiology and pathophysiology was a leg-up, but I really had to back out of my nursie head and enter a new headspace. Ultimately this course was geared toward training anyone who wanted to be helpful in the outdoors in a way they wouldn’t get sued and have to sell a kidney in the end. I think it achieves that well. What’s funny is only now am I continue reading…

Cardboard box with colorful quilting cotton scraps inside

Fabric, Fabric, Fabric

When I was a kid, I got to go visit my Auntie Pauline back east a few times during the summers. I enjoyed the weird bugs, warm thunderstorms, and swimming opportunities we just didn’t seem to have in Alaska… and the fabrics. My aunt is a spectacularly talented seamstress and fabric craftswoman, and has a refined taste in textiles. Going fabric shopping with her was a treat. Just being in her magical sewing studio, among her collections of tools and materials, projects and commissions was a treat. I had already taught myself how to sew, but she taught me standards of sewing, and opened up the possibilities. Sad to say that despite our talents we are both mostly making face masks lately, but we’re making well-sewn ones with fun fabrics! Recently I received a heavy box full of miscellaneous cotton continue reading…

Creek Fire smoke in central Nevada

Flu and The Trail, part 2

This post is an update to my March 16 post, Flu and the Trail. It turns out you can thru-hike during a pandemic, but if you’re not still asking yourself “should I?” and considering your impacts on other people, I hope you’ll keep reading and hear me out. After volunteering several months of my life over several years to help thru-hikers on the PCT, I left with a bad taste in my mouth. I met several burned out trail angels who felt similarly, and noticed quite a few hikers themselves abandoning the trail shaking their heads. Why? Because thru-hikers are generally privileged, and often self-involved and entitled. It’s not exactly “rewarding” work to help people who don’t really need help. Bear with me when I explain how I got here. It is based in experience with hikers, and I have continue reading…

two pages print from PDF sewing pattern

Face Mask Sewing Instructions

The following are instructions for the face mask sewing pattern available as a PDF download in the Little Package shop. I drafted this pattern off the Olsen mask design, honing it over a period of several months for easy fit, good looks, and comfort. What I like about it is it allows you to open your mouth without the mask slipping down off your nose. As a former nurse, it’s important to me that people including and around me and my loved ones have functional masks, and so I make them. And you can too!

tiny covid masks for a two year-old

Sewing Face Masks

I’ve been meaning to share the face mask pattern that I adapted from the Unity Point Olson Mask, but it’s not ready yet because it keeps shape-shifting. I keep making small adjustments to it, which probably don’t matter at this point because every face is so different. Anyway, soon I will have it tacked down in PDF format and will share here. [Here it is.] [And here are the face mask sewing instructions.] So far I’ve made >200 masks. I’ve made masks for climbing guides: I’ve made masks for tiny people: I’ve made masks for small people: I’ve made masks for adults: I’ve been handing out free two-layer cotton masks around Bishop, and giving them to friends. Folks who have insisted on paying — their money has been donated to the ACLU and NAACP Legal Defense Fund. The masks have continue reading…

Out-Social Distancing the Rest

The past few months have been… interesting. For everyone. For once we are not entirely alone; we are entirely together being alone, isolated, scared and confused. How scary. In February, against my better judgement, I drove the Westfalia out to North Fork, California, on the opposite side of the Sierra Nevada, to serve another 10-day silent (Vipassana) meditation retreat. We were all aware by then (well, at least the thinking amongst us, or the medically-trained) that a pandemic was possible. On my way I stopped at the hardware store. N95 masks were still on the shelf at a reasonable price, and I was surprised. I felt like a wingnut for believing this could be serious. Meditation practice generally went well for me, though I struggled to be equanimous through each cough in the small-gym-sized room crowded with over 100 people. continue reading…

Nols group GSENM

NOLS Magic

This is about feeling thankful. The day before I met this NOLS crew, I decided to not go into Escalante, Utah for resupply. I *sorta* had enough food to get to my next cache, and I was going to make a run for it and “see what happened.” This basically means I was going to be rationing my food and starving myself. What can I say? I was really feeling the outdoors. . My first thought when I saw ten folks gathered around backpacks was actually more just confusion. Why would anyone in their right mind be out backpacking Grand Staircase Escalante National Monument in late October?! They looked friendly so I asked, “Is anyone here medical?” They all raised their hand. Now, see, I’m a former RN, but I couldn’t see the wound troubling me on my spine. It continue reading…

Collarbone – 6 weeks, 5 days out

So this is my new right collarbone. I’m pretty happy — as happy as one can be, I guess — with the new shape. And I’m proud that I healed it myself, trusting nature to do its job (though that was tough sometimes). There are some fairly good resources online for people with broken collarbones wanting to know what to do. I really had no idea, and never went to the doctor, so I did a lot of Googling. I got the most (but not necessarily the best) information from these two websites: – Pinkbike broken collarbone recovery time Of course that’s the first thing people want to know. How long will I endure this hell? – John’s Clavicle Page Lay expert-ish, though a bit pro-surgery. Some things I learned: 1) It doesn’t matter what sling you use, figure-8 or continue reading…

30% More Work for the Same Pay!

There was a memo in my box at work (Hooper Detox) this morning. The first three paragraphs stated something to the effect that management appreciated the hard and good work …bla bla bla… of admiting nurses. Bla bla bla… The fourth paragraph started with a “But -“ (emphasis my own) and went on to say that since auxillary staff were not performing the search/shower procedure satisfactorily, nurses are now expected to search and shower clients. Nurses are also expected to bring clients upstairs and show them to their bed, locker, and give them a tour of the unit. The primary reasons for auxillary staff being relieved of this duty are that they are supposedly less comfortable with naked bodies, are less knowledgeable in body mechanics, and less familiar with the facility and operations and give incorrect information. Ah, hell no!

When Will It End?

These last two days at work have left my brain floppy. A mixture of doggedness, confusion, passion and apathy have left me in a hazy rage. “One” person totally fucked it up for everyone else this week. She decided to smuggle quite a bit of heroin in in her person and then shared it with other clients, creating total chaos. She got kicked out, and now she’s royally fucked (if it’s true she stole the heroin to begin with). It’s amazing that one person and a stupid decision can create such a tortuous web of destruction and insanity for so many other people. Who did this start with? When will it end?

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 far as you can then breathe out some more 4) hold that exhalation as long as you can. Then, just 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 to just pick up and move?” “Yes, I do it all the time.” “What do you do?” “You mean as 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 slips a finger and seems to linger and I wonder cause she seems to fumble maybe bumble in your gringa 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 lungs are very elastic, spongy, soft, organs made out of connective tissue. Together they weigh about 2.5 pounds. As you 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 up and out, and the shoulders may rise. The lungs expand as well, of course. Expiration is achieved as these 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. As seen in the illustration, the cardiovascular system (the heart and blood vessels) plays a mechanical role in transporting gases, 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 evacuate the blood, but it turns out that carbon dioxide is about 20 times more soluble in blood and alveolar continue reading…

Little Package