Wednesday, March 29, 2017

Self-Published Vs Traditional

I participate in a lot of writing groups online. I guess the right phrase is that I lurk in a lot of writing groups online. Depending on the group, I may or may not write anything, or participate, but I always learn. It’s a great way to interact and build relationships with other writers. Most are super positive and helpful. We’re all learning the craft after all. There’s always something new we can gain from the interactions.

A little while ago, I read a post that just floored me. It was deleted pretty quickly by the admins, but the commenter asked if there were writers in the group who were serious about their craft or if they didn’t care and planned on self-publishing no matter what.

Over the past few years, I’ve interacted and met multiple self-pubbed authors, and I’ve got to say, they know what they’re doing. They’re putting themselves out there without support of a publisher, and all on their own. They’re brave, and they’re definitely serious about their craft. If they weren’t, then they wouldn’t bother.

Of course, that doesn’t apply to all self-published authors. Years ago, I gave away free critiques, and one of the girls I gave a critique to asked me what she should sell to make the most money. This was around the time that dystopias were big, and she made the comment that she should probably write that because she heard vampire stories are out.

It’s pretty easy to tell which author is serious about their craft, and it has nothing to do with traditional or self-published. It has to do with the effort they put in. Whether or not they’re willing to learn about the craft, and whether they’re willing to take criticism. Those are the authors I admire, no matter which path they choose.

Last month, I read a book by a self-published author, and I was very impressed. In fact, I had no idea it was self-published. The cover was professional, the writing solid, and I fell in love with the story. For those of you interested, it was the Unfortunate Fairy Tale Series by Chanda Hahn.

Professionalism has nothing to do with pathway. It has to do with the end result.

Monday, March 27, 2017

Learning from Point of View

A few weeks ago, I posted about dealing with racism in nursing. It’s something I have to deal with on a regular basis, and I wanted to share my own experiences.

I’ve been quite lucky. I don’t deal with too many overtly rude comments. Most of them are done quite innocently. After sharing that blog post, I had someone make a comment that just floored me. He identified himself as a white male and then told me that he doesn’t see racism where he works. He told me that I’m being overly sensitive and that my patients were trying to make small talk.
Which might be true, I’m not negating that. Except there have been enough situations where I’m positive that’s not what they were trying to do.

I’ve never had someone tell me that I’m not experiencing racism. That I’m being too sensitive. To be honest, I’m one of those people who’s grown so accustomed to it that I didn’t even notice it until it was pointed out to me. But for someone to tell me, as a white, male, that it doesn’t exist just felt wrong. And it made me wonder how many times I’ve done the same exact thing without realizing it to someone  of a different culture, race or gender than me.

Here’s the thing. I may not agree with you. I may see things through a different lens, but from here on out, I’m not going to negate your situation. I’m not going to say that you’re not feeling what you are. Because here’s the thing, I don’t know what you’re feeling.

As a nurse, I’m taught that pain is subjective. A patient may look like they’re in no pain, but if they’re telling me that they’re in pain 5/10, then that’s what their pain is. I can’t tell them that they’re not in pain. I’m not qualified because I don’t know. I’m not them.


I love learning about other people’s experiences. That’s why I share my own, because I want people to see from my point of view. So please, no matter who the naysayers are, please share your stories. There’s always someone out there who needs to hear it. Someone who can learn from you.

Friday, March 24, 2017

Hospice

After working for years in long-term nursing, I’ve become very familiar with hospice. In fact, my first nursing job was on the hospice floor of a facility for Alzheimer’s/Dementia. Not all of our patients were on hospice, but there were quite a few that were. I loved the hospice we worked with. They were involved, and they always worked with the nurses on the floor to make sure that we all agreed on the plan of care.

Often, we had a patient who would go on hospice and would be diagnosed with ‘failure to thrive,’ especially if they suddenly lost weight, or wouldn’t eat.

Here’s the thing though, they didn’t stay on hospice until they died. Often, the doubled effort between the facility and the hospice caused the patient to have increased care and as a result of that, their health usually improved. As a floor nurse, I let the hospice nurse know whenever I had concerns, or if I thought something would be more beneficial. Increasing their protein shakes, or switching them to finger foods.

More often than not, after a few months on hospice, the patient would start to improve to the point that they no longer qualified, and hospice would discharge them into our care.

For me, hospice wasn’t an end of life kind of thing. Of course, it’s for those who have a poor prognosis, or who have been given a short time to live, but that doesn’t mean that they will die within weeks of going onto hospice. Hospice was an assist for the patient and the family so that they could cope, and, most importantly, to make sure that they were comfortable.

Unfortunately, I’ve discovered that my first experience with hospice was the exception rather than the rule. I’ve worked with multiple other hospices since then, and it often feels like the program is created to transition into death. Too often, they’re cut off everything they might need to extend their life because they’re just going to be ‘comfortable.’ All blood pressure, thyroid, or even heart medications are discontinued. They’re cut off because those medications aren’t necessary if they’re going to die. I’ve even seen hospice nurses hurry the process because they want to go home for the night.


Hospice was create for the patient and family to have support. So that they’re not alone in the experience. I’ve been there, and it can be scary, especially when you don’t know what to expect. But in the rush to help with death, I fear that too often they forget to allow life.

Wednesday, March 22, 2017

Critique Partners

I know I’ve talked about this quite a bit, but I just want to talk about it a little more. I love my critique partners. They’re really just some of the most awesome people I work with.

Here’s the thing, I love what I write. On most days. There’s also the days where I think I’m writing just plain crap. On both kinds of days, I need someone to pull me to reality. I need someone to pull me off my pedestal and point out my shortcomings, or pull me out of my funk and help me see my strengths.

Writing is an art. It’s a very subjective medium, and at some point, there’s going to be someone who hates it. There’s going to be someone who loves it. To be honest, that’s not what’s important. What’s important is that I create the best kind of art that I possibly can. Most of the time, I’m so involved in my story and in my characters that I don’t necessarily see all of the flaws.

I’ve had some amazing critique partners over the years who have pointed out character inconsistencies, or plot holes or even just a lack of voice. Seeing my manuscript through someone else’s eyes is so absolutely essential and I appreciate them so much for putting in the time and effort.

I’ve been thinking about this recently because one of my critique partners, Valerie Bodden, posted something on Facebook that I absolutely loved. She commented on how she appreciated my critique and feedback because I get her book.

It’s true. There’s been many critique partners over the years, but not all of them have been long term. I need someone who can see the end goal. Someone who loves my story as much as me, and is willing to let me bounce my ideas off them.


So for all my critique partners, thank you! You’ve made me the writer I am today.

Monday, March 20, 2017

Hello Kitty

Growing up, I never really dealt that much with Racism. People knew I was Asian, but they didn’t mention it that much, and they didn’t use a lot of stereotypes around me. Probably because I wasn’t raised as an Asian.

When I moved to Spain, all of a sudden, I was treated very differently. People came up to me on the metro and started speaking to me in an Asian language, and I would have no idea what they were saying. I earned the name “Chinita” among a lot of my friends because that’s how I looked to them. Like a little Chinese girl.

I think the most bizarre situation though, started a few months after I moved to Spain. I walked to school every day, and halfway there was a newspaper stand. The guy who worked there was very friendly and would wave to me, and often make odd and suggestive comments. After a few weeks, when obviously I wasn’t responding to his advances, he started yelling at me every time he passed.

“Hello Kitty! Hello Kitty!”

After our multiple interactions with one another, I knew that he didn’t speak English, but I think he’d figured out that I did. Except it didn’t feel like an English thing, it felt like him trying to get my attention by calling out the only thing he knew from Japanese culture.

I started taking a different route to school soon after that.


Friday, March 17, 2017

Never Enough

This week, I'm talking about Jodi Picoult's Small Great Things, a book about a nurse who was sued because a family member saw her performing her job and didn't understand what was happening. They saw what they thought was abuse and because they had already asked for her not to touch his son (because she was black), they thought she was hurting him on purpose.

On Wednesday, I talked about how this book made me think from a racial standpoint. Today, I want to talk about the nursing side of it. Ironically, this is the side that I'm more nervous talking about. Not because I don't have anything to say, but because I'm very cautious about what I say online about work. I'm very conscious about HIPPA, and about protecting the integrity and reputations of where I work and where I used to work.

Here's the thing, I've worked in multiple facilities, mostly long term, as a nurse and CNA. When people are sick, they're not themselves. I understand that. Patients are dealing with pain, dealing with a new diagnosis that has flipped their lives upside down, or with loss that they can't quite accept yet. In a way, it makes sense to lash out at the people taking care of you. They're right there, after all. But in many other ways, it doesn't make sense.

At least, not to me.

My typical workday consists of a twelve hour shift. I usually get to work half an hour early so that I can read up on charts. So that I can prepare myself and know the information necessary to properly take care of my patients. After my shift, I give report to the next nurse, so that they know what's changed, and to promote the best possible care for my patients. Some days, things get hectic. I might have to stay late to chart, or to finish my responsibilities. Maybe one of my patients had a sudden change in status right before I leave. Either way, my typical shift tends to be closer to thirteen and a half hours -- on a good day.

I'm there all the time. It may not seem like it, especially if I'm in someone else's room, but that doesn't mean I don't see what happens.

The problem is I'm only one person. Just one nurse, and even though most of the places I work have great support systems, a lot of the responsibility falls on me. I understand that and I accept it.

There are just too many days when I feel I'm not enough. With my knowledge, with the skills that I'm still perfecting, I'm still never exactly what my patients need. There's so many instances in my shift when I have to make a decision, when I have to choose between two patients who need me. Maybe it's more than two. I can't count the number of times I walk out of a room to see the entire hall lit up with call lights, and know that no matter how fast I work, no matter what I do, I won't get to them in the time that they want.

That's when it sometimes feels like it's too much. When I already know I'm doing everything I possibly can, it's hard to hear patients and families complain that I should be doing more. I'm not allowed to tell you what I'm already doing, or what the other patients need. There's no way for me to tell them that I have a patient next door that's going septic and might need more serious intervention in the next few minutes. Or a patient who's confused and jumping out of their bed, and I want to keep them from falling and getting seriously injured. I can't tell them about the patient who broke my heart because no matter what I do, I can't seem to control their pain. Or the patient who's detoxing from drugs and hasn't stopped screaming at me since I arrived on the floor.

Nurses carry a lot of what they experience in their hearts. I've seen it in so many coworkers. It's a taxing job, and there are times we snap. I know I have, though I've been fortunate that it's never been in a patient's room. There are moments when I have to leave the floor because I can't deal with it anymore. It's frustrating, and often not because of the patients but because of the situation.

My husband often tells me that either you cry or you laugh. He tells me that whenever I'm angry or annoyed. He says "Do you want me to cry or laugh?" That's how it is with nursing too. We have to get these emotions out. Often, it comes out in the form of jokes, in a way of relieving the pressure that we feel. It has nothing to do with what we're really thinking, it's a coping mechanism, one that helps us to be the best we can be with the circumstances around us.

I think the hardest part is knowing that often, the most memorable experiences are the bad. If a patient is upset with their care, it doesn't matter how much we've done for them. It's what more they wanted us to do. Often, I feel like I'm measured by my shortcomings, rather than by my actions.


Wednesday, March 15, 2017

Racism in Nursing

On Monday, I mentioned how I wanted to talk about Jodi Picoult's Small Great Things this week.

When I first started the book, I honestly thought it was from the 50's. The white supremist family felt off to me, because I don't deal with it on a regular basis. Ruth seemed to take offense with everything, and acted like people treated her differently because of her race.

The more I thought about it though, the more I realize that it still happens. I don't deal with the same kind of racism, just because I'm Asian, not black. Even so, I do deal with prejudice from my patients constantly. Not just my patients, but from my workplaces as well.

I honestly can't count the number of times that someone has said something that I've blown off. I heard them, and I always assumed that they didn't mean any harm by it. I've had patients call me the 'Little Chinese girl' and 'that Asian one,' and I even had one sweet patient call me his 'Little Indian' every single night. For me, it almost felt like a distinction. I am Asian, I'm not going to deny it. If they don't remember my name, then it's an easy way to describe me.

Then there's the ones who aren't quite so nice. I've been screamed out of a patient's room and as I left, her closing comment was "Get out of here... Yoko!" Which for me, didn't hold quite the same impact. I wasn't alive during the Beatles' time, and I have no idea if people actually hated Yoko Ono, or if it was the only Asian my patient knew. I've been called a Jap before, which, again, because I was exposed to very little racism growing up (I think in large part due to my parents), it doesn't sting the way I know it should.

I had one patient who was very sweet to me, but when I returned to work the next day, I was given all the same patients back -- except for her. Her family had stated that no Asians could take care of her. It wasn't put in the chart, I don't think, but it felt a little strange to me. She'd let me take care of her the night before, and I felt I had done a good job. Her family took me aside and told me that I didn't need to feel bad, because for some reason, seeing me gave the patient flashbacks to WWII.

Here's the thing. I never feel guilty. If someone has an issue with my race, or the way I look, I'm not going to apologize. I'm not going to assume that it's my fault. It's such an odd way to look at things, to think that the person who's receiving the prejudice might feel guilty.

Along with the obvious signs, there's also some odd things that have happened with some of the management that I've worked for. I remember very clearly arriving to work one night when a patient had been admitted. No one had started the admission, and they decided to give the patient to me. The reason? He didn't speak English. Which is fine. I speak Spanish, but it turned out the patient didn't speak Spanish, he spoke a very rare dialect from a South Asian country. He couldn't mime because he was blind, and it was assumed that I would have an easier time doing his admission.

Why?

Obviously because we're both Asian.

I'll admit, I joke about it a lot. I don't get offended. I tried, about a year ago, and it was exhausting. To assume that everyone has an ulterior motive, or to assume that everything that someone says is a jab at my race or said to be rude. My husband and I enjoy being different, and we accept that we are. I believe that's why, when I started Small Great Things, I was confused. I didn't see racism because I didn't focus on it, even though it's all around me.

I'm sure there's a fine line. I do need to recognize when it's inappropriate, but in the workplace, a lot of times, there's nothing I can say or do to change it. My patients... well, they still need care. In a day or two, I'll probably never see them again. Besides, I need them to like me, just so that I can get good reviews and avoid the situation that played out in small Great Things.