Diagnostic Labs

Monday, April 30th, 2007 On the first floor of Mott
Today I spent most of my time walking around the hospital with Mrs. M and some students. In the end, I was left with Cami, a senior from Huron. We saw a guy who was in First Days in a pediatric ICU area (at least it looked like it because there were about 30 machines on ONE child that had a lot of flashing and blinking lights.) Mrs. Malette wanted me to see if I could shadow him, but he seemed really busy on the phone, so we just left and went down to the first floor of Mott.
I exited the elevators and noticed that there was hardly any chaos. We opened a random door (it seemed like anyone could just open it… okay, the door wasn’t really random, but it felt random to me). There inside a lady sat in front of a computer (from what I could see from afar). After Mrs. Malette asked if we could sit there for half hour (we got there around 9:45am and had to leave around 10:15am). The lady said we could stay (yay, the day wasn’t wasted after all!).
I sat down and saw the stuff on the screen move. I saw a thin little line that wiggled around (especially near the tip). This is the deal.
Hearts don’t usually have deformities. But during the mother’s pregnancy, the heart wasn’t developed correctly. This left a huge hole in the heart in the 5 year girl on the table. Because of this hole, she had problems pumping blood to her entire body. Now, the doctors knew that this young girl had a heart problem ever since she was born. They felt that the kids can usually heal the problem on its own (by age 4, most kids can self-correct). However, since the girl still hadn’t healed, the doctors had to do something about it.
So how did they help get rid of that hole? This was the procedure. They first put the girl under anesthesia. She could still talk, but I think she fell asleep during this procedure. Anyway, they first had to put a catherder by finding the femoral vein and get the wire up to her heart via the vein (how cool is that?). On the screen, the wire had already gone up to her heart. Actually, there were two screens. One you’re looking at it shoulders forward, and the other is the sideview of the young girl. (this way you get more of a 3D view of what’s going on inside the body). Anyway, after they get it up in between the heart, they slip a wire (the other one is very thin tube that you could put something through) up inside the cath and then pull out the cath. They look at the screen to analysis if the end is in the correct spot (which seems a bit difficult because the picture isn’t exactly the most clear. I couldn’t really tell where the heart was but the lady could! I guess that’s why practice is a necessity). Next, they had to measure the size of the hole. They even had to pause for a moment, get out of the OR (I was just outside of the OR room watching in because I wasn’t ‘clean’ and have a potential of spreading bateria), took OUT a measurement tape and measured it right on the screen!! Wow… and I thought that technology would be more up to date. I know in the ultrasound area, you can just click one place to another and voila, you got a measurement. You would think that in a OR area that they would have similar ideas or things. But no… they have to actually measure it themselves!!! AND THEN type in the measurement that they just got (that was very shocking a weird for me). He even used a calculator to convert. So much for having modern technology… Well, anyway, the measurements are to make sure the size of the balloon is correct. The balloon is to block off the hole in the heart (the doctors assume that the heart’s hole will not grow any larger after this point and that the heart will just heal and scar around this balloon). After knowing the measurements, the doctors create the balloon that’s custom for her (kinda neat, eh?). After that, they put the balloon in. Oh man, I forgot one essential step…. they first put CONTRAST in (or in lay terms, dye) to see the area of the hole (that is how they measured it). THEN the doctors put the wire in, and then the balloon go through that. They have a release like thing and it looked like it just blew around. It finally settled and it looked like a space probe thing (interesting). After that, they put the cath back on, the wire out, and lastly the cath out. Of course, it wasn’t like boom boom boom! They had to spend enough time to make sure that the young girl doesn’t get hurt and other pokes occur.
Some would think that the young girl was weak and almost dying. But that apparently wasn’t the case. She loved to talk and was very outgoing. It amazes me how even the best of us can get hurt and end up on the OR table. So not everyone in the hospital is classified as this weak and almost gone human… it’s more like the hospital is full of great people who may have a little problem. With health care providers, it should help make people’s lives the best it can possibly be. This was a lot to learn to see in a half hour time slot, but it was a great opportunity to learn a lot. Oh, also after the doctor came out to make the measurements, the doctor to had to scrub himself clean again (with this yellow stuff).
Overall, though it was short, it was an eye opening experience.

Health Sci Journals

Monday, April 16, 2007 at the University of Michigan’s Otolaryngology Dept.
Today I was paired up with Dr. Bradford. She had just gone on a Spain trip where she apparently had a blast! She loved every minute of it, except the windy weather. She even brought back treats for the clinic (apparently the staff eat there all day!). Anyway, Dr. Bradford is a Head and Neck Cancer Surgeon. I saw a total of four patients; three of them have already received surgery and were just on his 6-month or annual check up.
An older man sat in the adjustable chair with his wife sitting in a nearby chair. Dr. Bradford gave him a thorough exam to make sure that the cancer hasn’t come back. What is even more exciting is that he has made it through 5 years without any complications! A nurse went and got the “5 Year Survivor” pin for him to wear (he was very enthusiastic and happy about that).
The second patient was a younger man who had cancer on the back of his tongue. The surgery left his back third tongue darkened AND the ability to make saliva. Who knew that saliva was such an important thing? During surgery, one of the surgeons couldn’t save his saliva gland. However, the couple said that was a small price to pay since the man was still alive and healthy. The only thing he has to do was to carry a bottle of water everywhere he goes (and of course, drink a sip every 70 seconds or so). This couple showed me that it can truly make a difference to find a way to make life to its fullest (instead of feeling like life isn’t worth it anymore and moping about it).
The next patient was another check up after her surgery. Dr. Bradford looked at her eyes, nose, mouth, and lastly, the ear. This older woman had cancer on the upper part of her ear so Dr. Bradford had to remove part of her ear. Dr. B tried to make the best of things by saying to this woman that her hair blended in and people couldn’t really see anything different (too bad that means she always has to have a hair down, but I guess you have to make the best of everything in order to save your life, right? Everyone believes that they will do great things, or at least have the potential to do wonderful and life changing things, especially parents of children). It surprised me to see that her upper ear removed.
I learned about Dr. Bradford’s work schedule. She has clinical time to check up on patients or diagnosis them on Monday and Wednesday. On Tuesday and Thursday, she has surgeries. On Friday, she researches cancer in the lab. This type of schedule is popular among the surgeons in this department, though some may not do the research part. Some may have Wednesday mornings as clinical time and Wednesday afternoons as surgery time (and alternate on other times). Dr. Bradford seems like a very intelligent individual who cares deeply about her patients who have Head or neck cancer. However, if there’s anything that is not within her specialty, she will push those patients away and care about them less.
For example, a patient came in and claimed that she got really dizzy when she stood up. Dr. Bradford asked a couple of questions and she automatically assumed that the patient just stood up too fast and told her to stand up slower. The patient explained that she had talked to her primary care physician who referred her to an ENT doctor. Now, I know that Dr. Bradford is a Head and Neck Cancer doctor, but I don’t agree that she should turn the patient away and say that ‘dizziness is not my specialty but I believe that you just need to stand up slower.” I assume that Dr. Bradford is really great at what she specialized in, but not too much more outside of that range. It was very pleasant watching Dr. Bradford work with patients.

Tuesday, April 17, 2007 at the University of Michigan’s Otolaryngology Dept.
Today I watched Dr. Hogikyan, who is not only a doctor, but also a voice professor at the UM, work with people’s voices. There were a total of two patients. However, they were two completely different patients (quite drastic).
The first patient is very interesting. A resident first attends to the patient (a medical assistant helped seat the patient in the rooms. The MA must also write down which room the patient is in on the pages posted on the board in the office. Each wing (there are four) has different kinds of patient. Each room even has different models of the ears, nose, and throat). But before the resident goes inside, he reviews the questionnaire and history of the patient available to him. Once he’s inside the room with the patient, he questions the patients history again, this time with the patient saying the answers because sometimes what the patient writes does not coincide with what the patient’s actual condition.
What I saw kind of stunned me (though I couldn’t act that way). An older woman had a tube with a circular thing around that padded the opening of her throat. This is what led up to this. This woman had a heart problem so she had to be put under general. After the heart surgery, the doctors wanted to take her breathing tube out. But there’s a catch! Her throat is too narrow. The doctors felt that she wouldn’t be able to breath without the tube because her throat wall would collapse. Thus, the doctors solved this life-threatening situation by putting a trac in. This saved her life. She was just happy to be off the OR table and be alive. But now, after a month or so, she wants more. Wants to be able to talk. This is the situation: there isn’t enough air in the voicebox to produce any air. The reason why there’s not enough air is because the tube in her throat is too large and doesn’t allow airflow on the outer area of her throat.
This woman came with her husband. She couldn’t talk. Of course, she could mouth things out. But in order to convey her concerns, her husband spoke for her (most of the time). Her husband obviously really cares about his wife (they can’t even sleep laying down). What made me frustrated was that the resident said that the patient didn’t have a problem, but her husband had all these complaints. I felt uneasy being in the room where it was a little hostile (since the patient wanted something more than the physician believes is good). However, after I stepped out of the room, Dr. Hogikyan told me about the situation (how it’s really great just to see her breathing and alive). Proceeding with another surgery is risky because her weakened, scarred, and thin tubes may collapse.
The next patient was very different. She’s actually a professor at the University of Michigan. She felt that her throat was scratchy. So this was what we did. We went into a special voice room (you even have to punch in a password). Inside, there’s a small keyboard, a computer, a TV that’s hooked up to the lighted tube (with a camera). Now, this camera is amazing! You can see the vibrations in her voice box as she sang different pitches. The vocal ‘folds’ (since they really aren’t chords) bloat up to allow the air pass through at different intervals.
It’s great to know that Dr. Hogikyan can use his talent in voice and doctor skills to really enjoy his job to the fullest.

Thursday, April 19, 2007 at the University of Michigan’s Otolaryngology Dept.
I spent most of my time today with a medical student, Dr. Jones. When I first saw him, he was examining x ray photos of a man’s head. He was making measurements and consulting a book. He then walked over and talked to another doctor. Lastly, he chatted with Dr. Marentette, his attending physician. They finally went together to see the patient. There was a mass on the left back side of his head. The mass was under his periosteum since I could still feel the skin move across the mass. The MRI also showed the mass had actually craved part of the skull away. If the mass were in the skin, the mass would be hard and skin would not be able to slide over it. An appointment was made. Also, Dr. Jones took some liquid out from the mass (by reverse injecting). This was a pretty neat process that I hope all health sciences students see.

Friday, April 20, 2007 at the University of Michigan’s Otolaryngology Dept.
Dr. Krishnan attended to an old lady. She had hearing problems! Dr. Krishnan did not want to diagnosis without a CT scan of head. Later I asked him why he didn’t want to make any judgments before seeing a CT scan. He replied that usually 9 out of 10 times, patients don’t have any problems, but that 1 out of 10 people do have problems inside their ear. Sometimes a tumor may start growing there. Overall this clinical was an eye opening one. I learned about the health system inside the ENT clinic, how the doctors, nurses, MA and PA act when they aren’t with the patients. I recommend this placement for those who may be interested in surgery or how the clinic works.

Montreal today

montreal today!!!!

This is the weather forecast…
Thu
Apr 26

Mostly Sunny
65°/45° 0%
65°F
Fri
Apr 27

Rain
57°/49° 80%
57°F
Airport Conditions
Sat
Apr 28

Showers
54°/46° 40%
54°F

It’ll probably rain Friday… that’s such a bummer! Oh well.
Anyway, I’m going to rest a little and then start packing (heh, I’m a little behind :P) and shower and eat a big dinner!!!! Okay, ttyl!

Jessica

Interview Questions with Theresa Chang, Nurse Administrator

Interview Questions with Theresa Chang, Nurse Administrator
Interviewed by Jessica Chang

Personal
How did you become interested in becoming a nurse administrator?
I have been in a RN career since 1976, working in ICU, ECMO, and many other intense wards in Taiwan, Saudi Arabia, and in the University of Michigan Hospitals. In 1992, as I was getting my health care administration degree in 1992, I gave a thesis: How to find quality home within the community. Because of my thesis, I then became interested in working with the senior care population. After that, I visited many different places and health providers and soon thereafter decided to become an assisted living administrator.

Duties and Responsibilities
What do you do on a typical day in your job?
1. Interact with residents, family, public at large, and health care agencies
2. Attend a lot of meetings with other nursing directors, and facilities mangers for quality care issues.
3. Participate in senior care conferences for quality care purposes.
4. Communicate with resident medical doctors, hospitals, nursing homes, and other assisted living homes via e-mail, phone, fax
5. Walk through the home.

Characteristics of workers
What special knowledge and skill does a person need in this job?
To be an assisted living administrator, you should have a broad knowledge of medical and nursing information to provide senior care needs, knowledge of hotel and lodging (because of room arrangements and home atmosphere) and knowledge of management of restaurants and dietary needs for residents.
The most important thing you need to know is to be able to meet the resident’s physical, social, and spiritual needs by providing them with respect, privacy, and dignity.

Satisfactions and Frustrations
What do you like best about your occupation?
Fulfilling a dream to help others especially the senior population because the senior population is a ‘minority (or discriminated) and seniors are considered ‘the older the wiser’ and you can share their dream and talk with them about their life and opinions.
A good quality senior care services is definitely needed and I wanted to be a pioneer to be able to give all.
Seniors are very appreciative when you can talk to them because they are often lonely.
Be able to implement whatever I feel best is needed such as programs for the seniors and actually getting to see the seniors appreciate it.

Qualifications
What advice would you give someone planning to enter this field?
1. You MUST enjoy want you do.
2. Study hard in ALL fields (esp. psychology)
3. While you’re studying, find part time job or volunteer in assisted living or nursing homes.
4. Prepare for RN board exams by studying hard again!!
5. Able to follow state regulations.
6. Be able to delegate responsibilities to others and follow through.

Salary
What is the entry level salary for a medical administrator?
· Entry level (without RN degree) administrator $30,000-$40,000 annually
· Entry level (with RN degree) administrator $60,000 annually
What are the potential earnings?
· With an RN degree as an administrator, you have a potential of earning ½ millions dollars annually.

Future Outlook
What changes are occurring in this field?
As the baby boomers age and knowing seniors prefer to stay in more home-like environments, the growth in needs for assisted living homes are enormous. We will see more homes in the future and there’s a DEFINITE need for it, comparatively to nursing home settings. Additionally, government and larger corporations are encouraging long term care insurance, which also covers home care (a more humane way to utilize some assistance). There is also a growing seniors population and thus more seniors are entering assisted living homes.

Lifestyles and This job
Can a person work part time or job share in this job?
No, you can’t have part time or job share because of the responsibilities and liabilities involved. However, if you are adventurous, you can become an Assisted Living owner and assign someone as an administrator. That way, you’ll be able to do whatever you want to do to enrich your family and personal life.

Reasons to Give Blood Basics!

Reasons to Give Blood Basics!

  1. Volunteer blood donors are the main source of blood products for hospital patients.
  2. Every two seconds, someone in the United States needs a blood transfusion.
  3. One blood donation may help save the lives of up to three people.
  4. About 20 percent of the blood supply is donated by high school and college students.
  5. Nearly 70 percent of people will need a blood transfusion in their lifetime, yet only 5 percent of those eligible give blood.