Nurse Rachett Interview

Louise Fletcher as Nurse Ratched in the 1975 film. Photo from Wikipedia

Dr. Carm had the pleasure of interviewing a real-life nurse, Nurse Rachett (not to be confused with Nurse Retched from One Flew Over the Cuckoo's Nest, seen above.)

Nurse Rachett has been in the medical field for "40 long years" and is currently a registered nurse at a nursing care/rehabilitation center. She was previously a licensed practical nurse and worked in a hospital. Below is the interview that might interest those who are wondering what it's really like working as a medical professional.

What are some differences you can tell us from working in a hospital and nursing care/rehabilition center?
 Hospital: There are acute ill patients, some with chronic diseases. With new admissions and discharges every day, patients are continually changing. You need immediate action to patients' changing conditions. Also, these are patients, not residents

Nursing Care Facility: These are chronically ill residents, who can potentially change to acutely ill. Residents "reside" there, most for years at a time, until they are called to their eternal home. [This is a nice way of saying the croaked.] Most changes in conditions are reacted to in a leisurely fashion, with the promise that the doctor will see them in the morning



How many patients do you work with on a daily basis?
55-60

 When you first started out as a nurse, what was something that you wish you would have known then that you know now?
I should have been a police detective

In your opinion, what type of person should work in a hospital as a nurse? (What qualities should he/she posses?)
#1 Organizational skills
To be able to set priorities
Compassion

In your opinion, what type of person should work in a care/rehabilitation center as a nurse? (What qualities should he/she possess?)
#1 Compassion
Organization


What's the hardest thing about being a nurse?
Worrying that you've done your best


What is the best thing about being a nurse?
The times you are satisfied that you know you've done your best

Any crazy stories that you are able to share with us (that will not violate the Hippocratic Oath)?
An 85 year old lady insisted that she wanted to get up at 1:00 am to go to church. I told her, "It's only 1 am--church didn't begin yet."
She was becoming infuriated. "I want to go to mass!"
I said, "Mass doesn't start until 11 am--it's only 1 am."
She shook both her firsts and yelled, "Damn it!"

Any advice for the future nurses out there?
Always expect the unexpected--never say I've seen everything--you have never seen everything no matter how long you work

The most important question: How does Dr. Carm look today? Beautiful? Gorgeous? Spectacular?
Simply gorgeous in a little leopard print dress and sandals

How sweet of you!

Interview was conducted on July 22, 2012.

If you would like to be interviewed by Dr. Carm, please email her at drcarmelee@gmail.com

If you enjoyed this article, you might enjoy:
Dr. Carm's Interpretation of the Hippocratic Oath 
Dr. Bill's Guest Post on Hiccups
Beware the Butt Cooties

 

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This could be you!

Can You Read This?

Does this look familiar?

Only great minds can read this

This is weird, but interesting!

fi yuo cna raed tihs, yuo hvae a sgtrane mnid too

Cna yuo raed tihs? Olny 55 plepoe out of 100 can.

i cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg. The phaonmneal pweor of the hmuan mnid, aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it dseno't mtaetr in waht oerdr the ltteres in a wrod are, the olny iproamtnt tihng is taht the frsit and lsat ltteer be in the rghit pclae. The rset can be a taotl mses and you can sitll raed it whotuit a pboerlm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Azanmig huh? yaeh and I awlyas tghuhot slpeling was ipmorantt! if you can raed tihs forwrad it

FORWARD ONLY IF YOU CAN READ IT

This was an email that circulated a while ago. Dr. Carm can obviously read it because she has a great mind (and many other super qualities.) But, is this as awesome as it seems?

Well, first off there was no study done at Cambridge University. Yep, you read me right! According to FoxNews, the email was originally sent out without even mentioning Cambridge University. It was added "after the Times of London interviewed a Cambridge neuropsychologist for comment."  Here are some points of the article:

~Some letters can spell multiple words.  The example used was "ponits" which could be pitons, points, pintos, potins, and pinots.

~Two and three letter words do not change at all, so they are spelled correctly. In the email almost half the words are spelled correctly. This keeps the grammar in control.

~The email only moves the adjacent letters, which is easier to read. Which is easier? Porbelm or pbleorm?

~People can read the email, yes. However, they read it much slower than if it were spelled correctly. A study at Durham found that "the students read 255 words per minute when the sentences were normal, and 227 words per minute when the letters were transposed, a 12 percent decrease in overall reading speed."

So, sorry that you are not as smart or talented as you once thought you were.  Your brain is not as special as you thought (at least with this.)

Obviously, Dr. Carm is still extremely intelligence. [But, you didn't really need to be told that, right?]

Article can be found at FoxNews.com—If You Can Raed Tihs, You Msut Be Raelly Smrat. Published March 31, 2009.



Related Postings:Hiccups by Dr. Bill
Best Medical Schools 
Hippocratic Oath  
Medical Professions
IQ 

Beware the Butt Cooties!

Dr. Carm would like to thank Diana Gabaldon for permitting her to post her writings on butt cooties. Diana Gabaldon…sounds familiar? Well, you’re right! She is the author of the Outlander series, Lord John Grey series, and some scholarly works. For more information about Diana Gabaldon click here

Anyway, I know you are all extremely concerned about understanding butt-cooties, so here it is:

A BRIEF DISQUISITION ON THE EXISTENCE OF BUTT-COOTIES

[Copyright 2010 Diana Gabaldon]


(Gentlemen, kindly avert your eyes)

Having lived to my present advanced age, I've spent a lot of time in public restrooms. And, having been a scientist in my previous professional incarnation, I can't help observing things, and drawing statistical inferences. Which is why I am in a position to inform you that roughly half the female population of the US suffer from the twin delusions that 1) butt-cooties exist, and 2) they will, given half a chance, leap several inches from a toilet seat and burrow into the skin of an unsuspecting buttock, resulting in scrofula, assorted STD's, herpes, and probably leprosy.

I draw these conclusions from the fact that roughly half the time I enter a public restroom cubicle, I observe that the previous user has peed on the seat. Ladies…

I can only guess that at some point in an impressionable youth, these women were told by some female authority figure that One Must Never SIT On A Public Toilet, "because you might catch something." Firmly indoctrinated with this policy, they do not sit on public toilets. They hover. Ladies, ladies…

Look. The skin of the buttocks is actually pretty germ-free, owing to the fact that we normally keep them covered and don't (usually) touch other people, animals, etc. with them. Your butt is much cleaner—microbially-speaking—than are your hands.

Various studies of the bacterial content of public restrooms indicate that there are a LOT more germs on the door of said restroom than there are on any toilet seat therein. You acquire millions more microbes by shaking hands with someone than you would if our social system involved mutual butt-rubbing. (To say nothing of the teeming worlds of microorganisms you acquire every time you accept change from the counter-guy at Burger King. How many of you race to the bathroom and scrub your hands after ordering the meal, but before eating it? )


In order actually to catch one of the communicable diseases with which excrement or other bodily fluids are associated, two things would have to occur: 1) the bodily fluid of an infected person would have to be applied to the toilet seat (which would not happen, if said person would sit her bottom on the potty where it belongs and not spray the thing like a hippopotamus), and 2) an uninfected person's mucous membranes must come in contact with said fluids, within the few seconds that most bacteria and virii can survive outside the human body. You don’t have mucous membranes on your buttocks.

Now, by and large, urine really doesn't contain all that many bacteria (Male urine contains almost none, owing to the fact that its exit is, um, less impeded by surrounding tissue. A good many alchemical and medical recipes up through the early 19th century require "urine of a newborn male child" as an ingredient—this being the most sterile water available). Feces…well, yes. And I have in fact encountered the Really Nasty evidence that there are not only seat-pee-ers, but also seat-poopers (to say nothing of the occasional person who is so afraid of physically encountering a public toilet that they actually don't hit it at all, and leave the evidence of their mental derangement on the floor of the facility), but this is fortunately rare.

All right. In periods of heavy traffic, one might possibly encounter a live bacterium or virus present in the urine that some inconsiderate idiot has left on a toilet seat. Not likely, but faintly possible. Are you going to encounter it with your mucous membranes? Not unless your excretory habits are both Highly Athletic and Dang Unusual.

OK. So if the risk of catching a bacterial or viral disease by sitting on a dry toilet seat is negligible, then plainly, the Thing to Fear must be…Butt-cooties!

Traveling as much as I do, I am in a position to collect international data, albeit in an anecdotal and unstandardized manner. On the basis of such casual observation, though, I hypothesize that while butt-cooties presently have a fairly wide global distribution, they probably originated in the United States. Speaking generally, at least fifty percent of all public toilets in US airports, convenience stores, museums, and restaurants indicate evidence of infestation (judging from the aversive techniques employed by the patrons). European toilets have a much lower incidence—perhaps 10-15%.

(Point of etiquette: ought one to meet the eyes of, and/or nod to, a person emerging from a toilet cubicle that one proposes to enter? Common politeness would argue for such cordial acknowledgement—but if the next few seconds reveal that the departing patron was possessed of butt-cooties, this might lead one to think harsh and unchristian thoughts of said person, and surely it's worse to think unchristian thoughts (WWJD? I'm pretty sure He wouldn't pee on a public toilet seat, and if He did, He would certainly wipe it off. Ditto the Buddha, and doubtless any other religious figure you care to name) about someone whose face is imprinted in your short-term memory, than of an unknown quantity.)

In fact, we might hypothesize the geographical origin of butt-cooties as having occurred in or near Chicago. On what basis? Well, of all the airports I've been in (and I've been in a lot of airports, from New Zealand to Saskatchewan), only O'Hare International has public toilets equipped with a sliding cylinder of plastic sheeting that encases the seats; you wave your hand in front of a magic button, and voila! The plastic slides round the seat, and you are presented with a pristine surface on which to park your booty. Such is the prevailing fear of butt-cooties, though, that people pee on these toilet seats, too.

Well, there's no arguing with psychological aberration, and thus I make no attempt to persuade Those Who See Butt-Cooties away from their convictions. I would, though, urge them—in the most kindly manner—to address the results of their antisocial psychosis, and thus leave them with this classic advice:

"If you sprinkle when you tinkle—

Please be neat, and wipe the seat."

To see the original posting by Diana Gabaldon, please click here

For more information on her books, click here


This has been posted with permission by the author.

Related Postings:
I Have Fan Art
Patient #9: OCBD
Patient #10: JFFGD

Nails

Your nails tell you a lot about your health. Of course, Dr. Carm is talking about your real nails—not the painted or fake ones. Have you ever noticed when you were at the doctor's how he or she either commented on something (like a ring) or examined your hands? This is because he or she was looking for signs of any problems or illnesses.

So, go clean your nails and removed the artificial gunk off for this next posting. 

When looking at these descriptions you want to look near the base of the nail for the coloring. A normal nail should be smooth and clear (meaning you can see the skin underneath the nail—so slightly pinkish.)

Beau's Line Nails

Beau's lines are indentations across the nails. It can be caused by injury or illness that interrupts the growth of the cuticle. It can also be a sign of uncontrolled diabetes, peripheral vascular disease, high fever, measles, mumps, pneumonia, or zinc deficiency.³

Blue Nails

Bluish nails are a sign that the body is not receiving enough oxygen, which is common in lung infections (pneumonia). In addition, some heart problems cause the fingernails to become blue.²

Club Nails

Club nails are enlarged fingertips with the nails curved around it. This may be a result of low oxygen and various types of lung disease. It is also associated with IBD (inflammatory bowel disease), cardiovascular disease, liver disease, and AIDS.³

Cracked or Split Nails

Dry, brittle nails that crack or split are often associated with thyroid disease. If the nails are also yellow, then this is a sign of a fungal infection.²

Dark Lines Beneath the Nail

Dark lines beneath the nail can be caused by melanoma and should be seen by a doctor immediately.²

Gnawed Nails

Nail biting is often a sign of an anxiety disorder and has also been linked to OCD (obsessive compulsive disorder).²

Pale Nails

Pale nails can be a sign of anemia, congestive heart failure, liver disease, and malnutrition.²

Pitted Nails

A small depression in the nails is common in people who have psoriasis. It can also be related to connective tissue disorders (i.e., Reiter's syndrome), alopecia areata (an autoimmune disease), or inflammatory arthritis.^2,3

Puffy Nail Folds

If the skin around the nails is puffy and red, it may be due to lupus or another connective tissue disorder. Infections are also a cause.²

Separated Nails (onycholysis)

Nails that are loose or separated from the nail bed are sometimes associated with injury or infection. However, it can also be associated with a reaction to a particular drug or product (such as nail hardeners or adhesives). In addition, it can be a sign of thyroid disease or psoriasis.³

Spoon Nails (koilonychia)

These are soft nails that scoop out. The middle of the nail is dented enough to hold a drop of liquid. Spoon nails are a sign of iron deficiency anemia or hemochromatosis (a liver condition that makes your body absorb too much iron from food). It can also be a sign of heart disease and hypothyroidism.³

Terry's Nails

If the tip of each nail has a dark band, it can be due to aging; but more serious conditions can be liver disease, congestive heart failure, or diabetes.³

White Nails

White nails with darker rims are a sign of liver problems (hepatitis). In this case, you might also notice your fingers might also be jaundiced (yellow).²

Yellow Nails

Yellow can be a sign of a fungal infection. If the infection is not treated, it may grow worse causing the nail to become thick and then crumble. Other conditions that cause yellow nails include severe thyroid disease, lung disease, respiratory disease (chronic bronchitis), diabetes, lymph edema, or psoriasis.^2,3

Some Final Facts¹:

• Fingernails grow an average of only 0.1 millimeter (mm) each day, whereas toenails grow 1 mm per month. Individual nail growth rates depend on age, time of year, activity level, and heredity.
• Nails grow faster on fingers — especially on your dominant hand — than toes.
• Women's nails grow more slowly than men's, except possibly during pregnancy.
• Nails grow more rapidly in summer than in winter.
• Nail growth is affected by disease, nutrition, medications, trauma, chronic illness, fever, and the aging process.

If you have any concerns about your nails, please see your physician.

¹American Academy of Dermatology (2012). Retrieved from http://www.aad.org

²Martin, L. J. (Sept. 2011). Nail health picture slideshow: What your nails say about your health. Retrieve from http://www.medicinenet.com

³Mayo Clinic (Dec 2, 2011). Retrieved from http://www.mayoclinic.com

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What Does Your Hair Say About Your Health 
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Dr. Carm and You

Dr. Carm wants to hear from you! What are some things you want to see on her blog? What are things you really love (because she knows you don't hate anything)? Any thoughts? Random words that you feel you need to express to someone but you don't know who?...post away!

You can comment down below (anonymous options are available) or on Dr. Carm's Facebook page: Click


Next posting is scheduled for the 25th. Medical Facts: Nails....
Want some quick funny stories? See posting like this one: Click

Quick Facts: Best Medical Schools

For those of you who wish to be like Dr. Carm (and I know all of you do!), it takes a lot of time and dedication. And if you mean to practice medicine, you want to get the best education out there. Dr. Carm has found the top medical programs in the world. Not everyone can be naturally smart as Dr. Carm, so this should help.

Top 50 worldwide medical schools of 2011:

1.       Harvard University (USA)

2.       University of Cambridge (UK)

3.       Massachusetts Institute of Technology—MIT (USA)

4.       University of Oxford (UK)

5.       Stanford University (USA)

6.       Yale University (USA)

7.       University of California, Los Angeles—UCLA (USA)

8.       John Hopkins University (USA)

9.       Imperial College London (UK)

10.   University of California, San Diego  - UCSD (USA)

11.   California Institute of Technology—Caltech (USA)

12.   University of Toronto (CANADA)

13.   McGill University (CANADA)

14.   Duke University (USA)

15.   The University of Melbourne (AUSTRALIA)

16.   Columbia University (USA)

17.   University of California, San Francisco (USA)

18.   National University of Singapore—NUS (SINGAPORE)

19.   University of Chicago (USA)

20.   The University of Tokyo (JAPAN)

21.   University of Pennsylvania (USA)

22.   University of Michigan (USA)

23.   Cornell University (USA)

24.   University of Washington (USA)

25.   University College of London—UCL (UK)

26.   Karolinska Institute (SWEDEN)

27.   Rockefeller University (USA)

28.   University of Edinburgh (UK)

29.   The University of Sydney (AUSTRALIA)

30.   Kings College London (UK)

31.   University of British Columbia (CANADA)

32.   The University of Manchester (UK)

33.   The University of Queensland (AUSTRALIA)

34.   University of Wisconsin—Madison (USA)

35.   Boston University (USA)

36.   Monash University (AUSTRALIA)

37.   The University of Texas M. D. Anderson CancerCenter (USA)

38.   Kyoto University (JAPAN)

39.   The University of Auckland (NZ)

40.   Washington University in St. Louis (USA)

41.   Humboldt-Universitat zu Berlin (GERMANY)

42.   Erasmus University Rotterdam (NETHERLANDS)

43.   Leiden University (NETHERLANDS)

44.   McMaster University (CANADA)

45.   University of Hong Kong (CHINA)

46.   Australian National University (AUSTRALIA)

47.   University of Helsinki (FINLAND)

48.   University of Bristol (UK)

49.   New York University—NYU (USA)

50.   Ruprecht-Karls-Universitat Heidelberg (GERMANY)  

For more information on the top medical universities of 2011, please visit here


Missed the last quick story? Click here
Next quick story: Massive Myocardial Infarct on July 29, 2012

Guest Post by Dr. Bill: Hiccups

Dr. Carm would like to welcome a guest poster, Dr. Bill. [Holds up "applause" sign]

 Dr. Bill is not a certified doctor but has medical knowledge from working in a pharmacy. He also has an array of experience with journalism. Today he is going to discuss his medical smarts about hiccups.

Dr. Bill, if you please....

 Hiccups

    The stereotyped drunk hiccupping on a cartoon is not that far off from the truth.  Hiccups can be triggered by drinking too much alcohol, as well as eating too much or eating spicy dry foods, drinking carbonated beverages, becoming too excited or laughing too hard, and reacting to stress or sudden temperature changes.

    Technically speaking a hiccup is simply an involuntary contraction of the diaphragm, the muscle tissue that allows us to breathe.  When the diaphragm contracts, it creates a suction to pull air into the lungs and vice versa, when it expands it pushes air out of the lungs to allow you to exhale.  The “hic” sound of a hiccup is simply a sudden rush of air being pulled into your lungs and the rapid closure of your vocal cords to allow this to happen.  The sudden contraction of the diaphragm also causes that jerky movement you make when having hiccups.
 
    Usually hiccups last only a few minutes.  The longest lasting hiccup endured by a person was by Charles Osborne for 69 years and five months.  Don’t try to beat the world record; hiccups lasting longer that 48 hours need to be addressed by a doctor.  Long term hiccups could be a sign of a brain tumor, kidney failure, diabetes, pneumonia, inner ear problems of the vagus nerve which can cause cardiac problems, stroke, multiple sclerosis and meningitis.  After ruling out these issue, long term hiccup treatment would include Chlorpromazine, Metoclopramide, or Baclofen.  If these drug treatments do not work, surgery to block the phrenic nerve or the use of electric stimulation of the vagus nerve can be used.

    Fortunately, most hiccups go away on their own, or with a little help of home remedies.  The moment a hiccup occurs most people immediate hold their breath until the hiccups stops.  Rarely does this remedy work.  The thought here is to prevent the diaphragm from contracting.  Others insist on drinking large amounts of water.  I find this method worse than the last and poses the problem of hiccupping water into the nose. 

    There are five home remedies that I have found to work the best:

    1.  Put a spoonful of sugar on your tongue and let it slowly dissolve

    2.  Put a spoonful of peanut butter on the roof of your mouth

    3.  Sit in a chair, put your head between your knees and look up to the ceiling

    4.  Sing as loud as you can tolerate yourself

    5.  Laugh loudly

Although these methods will make you look like a lunatic, they seem to work well.  Mainly they work by forcing  you to unconsciously control your breathing.

    Q.  Are hiccups on the same order as a burp?
    A. No. A hiccup is caused by a muscle spasm, a burp is caused by gas released from the stomach.

    Q.  Are hiccups caused by people talking about you behind your back?
    A. No, although when they see you sitting with your head between your knees looking up to the ceiling, they may start talking about you!

    Q.  Was this article helpful?
    A. I hope so….

Disclaimer
This article is not intended to diagnose, treat, or prevent any illnesses. Please seek medical attention by a certified physician for any legitimate concerns




Dr. Carm would like to thank Dr. Bill for his posting and giving her a day off to relax.

Related Postings:
Beware the Butt Cooties 
Nurse Rachette Interview 
Sweets and Sugars 
Sneeze Record

Short Story: Getting Older

An elderly gentleman had serious hearing problems for a number of years.  He went to the doctor, and the doctor was able to have him fitted for a set of hearing aids that allowed the gentleman to hear 100% . The elderly gentleman went back in a month to the doctor and the

doctor said, "Your hearing is perfect. Your family must be really pleased that you can hear again."

The gentleman replied, "Oh, I haven't told my family yet. I just sit around and listen to the conversations. I've changed my will three times!"

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Elderly Woman
Appendicitis