Wednesday, June 29, 2016

Do The Impossible

I recently had a conversation with a friend of mine about the word can’t. And the word impossible. It’s so easy to believe we can’t do something. To believe we aren’t smart enough, or talented enough. Or we don’t have time.

Recently, I’m starting to realize that it has nothing to do with talent. It has everything to do with time and practice. No matter what we want to do, if we’re dedicated, and if we put in the time and effort, we can achieve it.

Case in point?

Last November, I started listening to the Peter Hollens Radio on Pandora when I wrote. I feel like he’s my sweet spot. He does YouTube Acapella covers. I love Acapella, I love covers, and I like YouTube artists. By December, I was listening to it all the time. I was hanging out with my brother, and happened to mention that I wished I could beatbox. It looks like so much fun. I’m pretty good at singing the harmonies, picking up the different vocal parts, but I couldn’t beatbox. I tried, and it was a pretty pathetic attempt.

My brother pointed out a few things, the basic sounds, and told me that it’s pretty simple.

Right. Simple. I couldn’t beatbox. It was one of those talents I just didn’t have.

A few months later, as I was driving to work, I started focusing on the acapella songs, trying to imitate the beatboxing. It was terrible. I understood the rhythm, but getting my mouth to move in that way didn’t work. But I kept going because I needed something to keep me awake on my half hour drive home after working a night shift. It’s been two months since I started trying. I get about three hours a week, half an hour to work and half an hour home.

I’m not fantastic, and I’m definitely not going to quit my day job. But the thing is… I can do it. It’s easier than I thought, once I actually put the time and practice in.


Anything is possible, as long as we are willing to do the work.

Monday, June 27, 2016

Merging Cultures

This month is my wedding anniversary month. You know what they say about June Brides.
Hubby and I have been together for quite a while. We’re coming up on a decade, which is crazy to think. I’ve spent close to a third of my life married to him. I’m not complaining. I like it a lot.

But after all that time, I guess I assumed that we’ve adapted to one another enough that we don’t get surprised. Yes, I was that na├»ve.

Recently, we had something come up that really made me realize how different we really are. I have a CNA at work who’s Bolivian, and we tease him a lot because his favorite phrase is “It’s okay.” About everything. He’s so easygoing that he really lives that way. Nothing ruffles him, nothing stresses him.
My husband is the same way. It really should be his motto too: “It’s okay.”

I don’t live that way. I get stressed a lot, and I’m a perfectionist. Okay isn’t good enough for me. It needs to be right, and it needs to be planned and prepared. Usually, my uptight manner doesn’t clash with his easygoing one too much. Then there are moments when they explode into something we can barely contain.

Recently, we had his cousin and his best friend over for a visit, and I realized all of them were the same way. They were able to go with the flow, adjust without sweating it. I’m sure it’s part of their culture, where they understand that they can’t control everything. In fact, that’s something my husband has to remind me more often than he should. In the US, we’re so focused on getting things done, on staying busy. We don’t really stop to relax, not like we should.

On our first date, he took me to a park. It was fall, and all of the leaves have changed color, and the ones on the ground crunched under our feet. After a little while, he grabbed my hand and asked me where we were going. I was surprised. I hadn’t really thought about it.

“I don’t know,” I said.

He gave me a sweet smile and asked, “Then can we slow down and just enjoy it?”


I’m glad I have someone who’s willing to teach me to enjoy life. Our differences in culture and background makes us a stronger couple, especially when we can find a way to make them work together. 

Friday, June 24, 2016

DNR

I’m a nurse in a long term care facility. It’s not always the easiest of jobs, but it’s one that makes me feel like I make a difference.

Recently, I’ve had a lot of situations where I’ve had to explain the concept of DNR (Do Not Resuscitate) to families and patients. It’s something that seems to have a bad reputation, and I wish there was a way to stop the stigma that comes with it.

In Idaho, we have a form known as a POST – (Physician Orders for Scope of Treatment). In it, the patient can decide what they want to happen if for some reason they can’t make decisions at that point. It’s similar to a medical living will, though it tends to be more specific. Each state has something similar.

Resuscitate or DNR? Now it seems like the obvious answer would be Resuscitate. Why let someone die when you could bring them back? Resuscitate means CPR, it means chest compressions, breathing, AEDs… everything possible to keep them alive. Chest compressions aren’t gentle. It’s literally forcing your body to breathe when it isn’t.

For someone who’s healthy, it’s painful. For someone who’s ninety-years-old, it could be a worse alternative. Or their body might not even be able to handle the stress. There’s a very real possibility of cracked ribs, of increased pain when they revive. If they’re intubated (tubing forced down their throat to breathe for them), and they wake up, there are many elderly patients who never come off of it. Obviously there are exceptions, but the older you are, and the higher number of diseases and comorbidities, the less your body is going to be able to recuperate from it.

Often, it isn’t the patient’s wish to stay alive. It’s their family, who doesn’t want to watch them die. It’s hard for me as a nurse, to explain to them that it’s going to be painful. I’ve had so many patients who just wish for death, but their family won’t let them go. I had one patient whose daughter, as the power of attorney, disregarded all of her mother’s wishes, putting her on oxygen, on antibiotics, on everything to keep her alive.

When faced with that kind of a decision, I think the most important question to ask is: what kind of quality of life do they have? Will they be hooked to the machine for the rest of their lives, having it breathe for them? Maybe they aren’t eating. Is giving them nutrients through a feeding tube worth it? Can they handle the stress of getting a tube placed?


It isn’t an easy decision, and every situation is different, but I hope the families remember that sometimes life isn’t living, especially when there’s nothing to look forward to. Sometimes, a patient wants to have relief, not necessarily life.

Wednesday, June 22, 2016

Writing Retreat

Two weeks ago, one of my writing buddies and I decided that we needed to focus on our writing. We need some days of uninterrupted writing time. We were able to use an old farm home, one with no internet and no TV. For three days, all we did was write and talk. Yes, the talking was important, and we were able to connect better, and talk about our lives and frustrations, but the best part was the writing.

Over those three days, I got almost thirty hours of writing done. A lot can be accomplished in thirty hours.

For example:

I finished the cut draft of the last six chapters of Commissioned. And I typed it all up. (Ended up being a little over 28,000 words total edited. And I cut 10% of the entire novel, which is awesome!)

I finished fixing the major plot point errors for two thirds of Hooked. Basically I fixed everything so that now I can go back and do the fine point revision. Beautifying, not fixing. (60,000 words) That’s going to be my goal for July, to get that puppy sparkling so I can send it out to Betas in August.

I finally outlined the final book in the series, which means I now have an ending! It took a lot of struggling, mostly because I felt like after so many epic battles that I’ve already written, this one’s got to exceed all of them. I think I figured out a way to do that. Now for the second draft. Yes, that’s right, I do multiple drafts of outlines before writing. That’s how I can write a 90,000 word novel in 14 days. It’s planning down to an art.

I also started working on character bios for another book I hope to write in November. It’s a retelling of Jack and the Beanstalk, and I’ve been excited to actually start planning it. It’s very different from anything I’ve written before, but that’s the point of NaNoWriMo. I always push myself to try something I’ve never done before.

I wrote four weeks’ worth of blog posts. That’s right, I’ve got a schedule, and I’m keeping to it! No need to worry about it until July. (Ironically, I wrote this post there)

Let’s see… I also wrote the first chapter for that collaborative work I told you about last week. Once that was ready, I sent it out to the group to see what they thought.

And in my free time, I read a book.

Sometimes I need to just let the creative side flow. And having a friend to do it with me doesn’t hurt either. The amazing thing, was that five or six hours could pass by without me even realizing it.  When our brains needed a break, we’d stop and talk, but then we’d get right back to it.


So yes, definitely a productive retreat. I can’t wait to do it again.

Monday, June 20, 2016

I’m Not Asian

Have you ever heard of the phrase impostor syndrome? The one where you feel like you’re faking something and people would be upset with you if they knew the truth? It’s common, especially when someone starts a new career. When I first became a nurse, I felt like I didn’t know anything, and that people would get upset with me if they realized how little I knew.

Sometimes I feel that way about being Asian too. I look the part, there’s no denying it. I’m petite, with dark hair and dark eyes.



But there’s so many things that I can’t rely on genes for. So many things that makes me feel like I’m not as Asian as people think. Yes, I play the piano, and I skipped a grade or two of math. Yes, I took advanced classes in high school, and speak two languages. But none of that has to do with being Asian. It has to do with my parents and how they raised me. Many of my cousins, ones who are definitely not Asian have accomplished the same feat.

Then I look at the things I can’t do. I’m absolutely useless with chopped sticks. My second language isn’t Japanese, it’s Spanish. I can’t code, and my Bolivian husband is the one who deals with electronics.

Except are those Asian things? Or just stereotypes? It’s hard to know.

I recently had a conversation with someone over twitter, one that really got me thinking. She said that when people ask her, she says that she’s Asian and makes them ask why she doesn’t consider herself an American. I’m the opposite. I tell them I’m an American, and most of them ask why not Asian.


But then there are days when I feel more Asian than American. It’s nice that there’s the option for both. I’m an Asian-American.

Friday, June 17, 2016

Nursing Shortages

Recently, I heard rumors of a nursing program that might not be able to support its nursing students for much longer in my area. It’s disappointing to say the least, but it also casts a very real light on the issues with nursing shortages.

About a year ago, I went to a training for nursing management within the state of Idaho. We talked about many different things, and one of the things that really stuck out to me was the reality of nursing shortages. There’s so many different levels that cause it, and when added together, it looks disastrous.

First, we’ve got a lot of nurses who are thinking about retiring. These are the baby boomers, the ones who’ve kept in the field their entire careers. We can’t keep them forever, and as they start to retire, there’s a lot more openings that are going to start appearing in the nursing field.

Second, there’s not enough graduates coming into nursing. The projection they gave was that there’s double the number of nurses retiring than nurses entering the field. Why is that? I feel like I’m always talking to someone who wants to get into a nursing program, who wants to study nursing. With all the desire, why don’t we have enough nurses to fill the void left by our veteran nurses?

Here’s where the statistics get a little more concerning. We don’t have enough nursing instructors. When I was at Saint Louis University, the majority of our instructors were close to retiring. One even came back from retirement because there wasn’t anyone else to teach the subject. Unfortunately, most nurses who graduate with a degree want to work in the field. Plus, there’s a better chance to rise in ranks and earn more money. New nurses don’t have the experience or the desire to teach, they want to get in the field and experience it themselves.


The retired nurses, the lack of graduates, and the depletion of nursing instructors creates a very real crisis. I’m seeing more and more ads for nurses, and recently, I’m seeing almost double the number of recruiters contacting me about positions with high benefits and sign on bonuses. Personally, I feel like the nursing shortage is a real thing, and some areas, like long term, are getting hit the worst, especially as more and more baby boomers become ill and need assistance.

Wednesday, June 15, 2016

Collaboration

One of the things that I’ve come to love over the past few years is having a strong writing group. Having other people who understand what I go through makes me continue to work at the craft, no matter how hard it gets. They also challenge me to try new things, ones that I might not have tried otherwise.

Recently, I started a brand new project, one that’s definitely unique to my writing experience. I’m working on a collaborative effort. Five of us have come together, created our own characters, and have started plotting the world within we want to create our story. We’re a guinea pig group for a publishing company, experimenting with whether or not writing together, and critiquing our writing as we go can help us as writers.

I’ve got to say, it’s a whole different beast. There’s a lot of compromise, and a lot of discussion that goes into it. I can’t control what kind of characters they have, just like they can’t tell me what kind of character I have. We went into this without any idea of what we’re doing, and I’ve got to say…

I’m really having fun with it. Yes, there’s misunderstandings, different things that I would like to change, but I’m happy with the results we’ve got so far. Plus, the amazing thing about having all of our backgrounds in the story means that it’s diverse without even meaning to be. We have characters from across the world, as well as from the US. We have different motivations, different reactions to just about everything we’re going to throw at them.

The one thing about collaborating with someone else is that we have to plan a lot. We have to know what direction we’re going in, and the rules that each of our characters have to follow. And we have to make sure that we’re communicating our thoughts effectively with one another so that we’re all on the same page.


I hope to let you know when this is ready to read! It’s definitely fun to work on!

Monday, June 13, 2016

Immigration Heritage

My name is Krista. My last name is Quintana. And I’m Asian. Most people assume Quintana is an Asian name, mostly because of how similar it sounds to katana. (The Qu is like quesadilla, or quiche. Has a hard K sound. Also, it’s Spanish, not Japanese.) No one even questions my last name.

My first name is a different story. I can’t count the number of times people are surprised by it. I had a patient’s husband come up to talk to me, and after we talked about the patient, he looked at my nametag and said, “Krista with a ‘k’. That’s different.”

I replied with, “Yup. It’s because of my Swedish heritage.”

He laughed. “Swedish, right.” After that, whenever he saw me, he would say, “There’s that Swedish nurse.”

He thought I was joking. But aside from my mother, who was adopted from Japan, the most recent immigrant in my family heritage is my Great Grandmother who came from Stockholm, Sweden. In fact, after Japanese, I’m probably the highest percent Swedish.

I’m proud of that heritage. I love my Great Grandmother, and I’ve learned about her life. I even wrote an essay about her when I was in sixth grade. She’s one of my role models, even if I don’t look like her.

We are all children of immigrants. They all came to the US for different reasons, but they all gave us a legacy. I’m grateful for the sacrifices they made for me.


Friday, June 10, 2016

Patients That Changed My Life: Jessie

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here.

I want to tell you about Jessie. She was ninety years old, and had Alzheimer’s. By the time we met, she’d lost basically all function and sat in her high back chair day in and out. Every once in a while, she would say something, but not very often. In this facility, almost every single one of our patients were feeders, which mean that we had to spread ourselves out to feed everyone on time. I would take a whole table of patients, usually 3-4, and each CNA would take the same number.

When I first started, the nurse before had sat at Jessie’s table. I found pretty quickly that she wouldn’t eat. I tried everything I could, but I couldn’t get this sweet lady to eat. It took several months before I realized that she would drink. She liked the small cups, but if I took my time, she would drink close to 600 ml of supplemental health shakes.

I sat with her for over a year and a half, feeding her every night. We grew a very special bond. There were some nights that would be difficult, when she would clamp her lips together and refuse to eat. Then there were nights that she would drink. I talked to her about random things, about my own life, about what was going on. Whenever she was having a good night, she would give me the brightest smile when I talked. Every time I saw it, my entire night went well.

That’s all she gave me. She never spoke, she never said anything profound. She just smiled, but I still remember that smile, even years after it happened.


Sometimes, a smile really can change a person’s life.

Wednesday, June 8, 2016

The Best Gummy Bears in the World

Creating something takes time and talent. Making it go viral takes good planning, the right storm, and good publicity.

I don’t think I really understood how things can happen so accidentally until recently. I work with some awesome people. During night shift, we often eat to keep ourselves awake, and we like to share what we like with other people. A few months ago, one of our nurses, a part time nurse, shared her favorite gummy bears with another nurse. She loved them so much that she went out and bought some for herself. At that point, they were only being sold at one particular chain of gas stations, and only in one or two of them.

She then shared it with the rest of us. Slowly, but surely, we all started eating them because she kept sharing them with us. Soon, we were starting to buy packs of our own. Then the day shift started to notice that night shift was eating these gummy bears. Not long after that, I noticed some of the day shift nurses bringing them in at the beginning of their shift.



During nurses’ week, our DON had a jar full of these gummies, just because everyone in the building loved them so much. Most of us started buying two or three bags a week. Some were buying up to ten.

But it didn’t stop there.

I started buying them and sharing them with my family. I took them to write-ins with my friends. I wanted them to try it because it was so good. I was talking to my coworker, who told me that she noticed that another store started to sell them.

This week, I saw them at our grocery store, in a neighboring town, and they were flying off the shelves.

That’s how things go viral. I never once heard a commercial for them, and I never saw an ad. It was word of mouth. The product was good enough that everyone wanted to share it.


That’s encouraging for me, as a writer. I just need to make the best product I possibly can, and if I can create that perfect storm, it will be shared.

Monday, June 6, 2016

My First Movie in a Foreign Country

Learning a new language has a steep learning curve. Just when you think you’ve got it, you’re thrown into a situation where you realize you don’t know anything. I took three years of Spanish in high school, and I studied on my own with my Spanish teacher once I decided to study in Spain.

Then I got to Spain. I had no idea what anyone was saying. But I slowly began to adapt until I could at least get by.

That’s about the time that my friends decided they wanted to go to the movies. I figured I’d be okay. I’d been able to communicate at least a little bit with my friends, and I could figure out they wanted to go watch a movie, so it wouldn’t be that hard, right?

My advice to anyone watching a movie in a different language is: Make sure the plot is easy to understand. Something like a Disney movie would be perfect.

We went to see Stardust. For those of you unfamiliar with the plot of Stardust, there’s actually three different plots, or maybe more, I’m not sure. About twenty minutes into the movie, I realized I had no idea what was happening. There were king-type men killing one another for no real apparent reason, and old women turning young, killing animals, and then there was a boy with a candle that did… well, I wasn’t sure. By the time we got to the sky-pirates, I didn’t even bother to try and figure out what was going on.

Movies may depend a lot on setting and plot, but without dialogue, most don’t make that much sense. At least ones with multiple plot lines and characters.


Friday, June 3, 2016

Nurse Staffing Ratios in Long Term Nursing

I don’t know how many of you have been paying attention to the nursing news lately. There’s a movement that’s been building over the past few weeks, known as #nursestakeDC. There’s finally honest conversations about nurse-patient ratios and the risk that it puts both on the nurse and on the patient.

Many of the statistics focus on hospital nursing, which has been steadily creeping up over the past few years. When I interviewed with the hospital last year, they told me that they’re being forced to have nurses sometimes have as many as eight patients a shift because of demand.

Imagine their surprise when they found out that I’ve never had a nurse-patient ratio that low.
In long term care, the numbers can become even more terrifying. A few weeks ago, because of low census and low staffing, I ended up having 23 patients for my evening med pass, which included all dressings, skin assessments and Medicare/Medicaid assessments. This number is more than the norm.

In fact, I had a patient’s family member mention to our DON that they knew we were short staffed, and she responded with:

“We are not short staffed. We have better staffing than any other long term facility in the area.”

Scary thing is, she’s right. In long term facilities, we’re dictated by Medicaid, which decides if we’re spending too much time in a patient’s room. If a patient is able to toilet themselves, and if they don’t have wounds, we shouldn’t have to be in there for too long, right?

But the amount of help they need to toilet, or to dress doesn’t dictate how many times they pull their call light. It doesn’t say whether or not they want a hot cup of coffee every ten minutes, or if they want their window opened and closed as they try to get to the right temperature. Some nights, as we’re trying to help people into bed, there will be six or seven lights going off, and when I only have two CNAs plus myself, we can only answer them as best we can.

When you’re spread that thin, even when it’s for patients that are considered ‘low risk’, an emergency can become fatal.


Let’s let our leaders know that setting these standards are not only putting our patients at risk, but also our nurses. Burnout and fatigue are real. 

Wednesday, June 1, 2016

Captain America and Secondary Characters

A few weeks ago, hubby and I went to see Captain America. I was super excited, mostly because I’m almost always impressed by the way that Marvel makes things feel fresh, even when it’s a story almost identical to one we’ve already seen before.

The thing with this movie is that it had the chance of feeling like a sequel. It had that chance of feeling like it was just a filler, since it’s using all of the same characters that we’ve already seen. There was the fact that they were going to fight one another, but we’ve seen that before. They’re not known for getting along for very long.

I was pleasantly surprised, again.

I think the best thing about each additional movie is that they always add at least one or two more characters to the group. It changes the dynamics and makes us see them all in a new light. Honestly, the fight scene at the airport wouldn’t have been as entertaining if they’d all done this before. You have Ant Man and Spider Man trying to figure out how they fit into the group. In fact, the veterans take time to let Spider Man know that he’s doing it wrong.

Adding additional characters can be a double edged sword. You don’t want things to feel too stale, with the same characters over and over, but you also don’t want to overwhelm the audience with so many bodies that they can’t keep them all straight.


The biggest thing to remember is that each character needs to have a purpose. They can’t be there as a mere body, one to add to the battle, or to the body count. They need to have a reason to be there, one that matters to them. And they need to have some kind of relationship with your main characters. Otherwise, they’re in the wrong story. Secondary characters, just like main characters, need to be crafted with care, and given a personality and a reason for the audience to root for them.