Disconnecting

/in /by

bansky cell phone love

This is literally what I see everywhere I go. Mothers crossing the streets holding their child’s hand in one hand and glaring at the glowing screen in the other. Couples on dates so disinterested in one another that all they do is stare in to their phone screens. It’s a sad state of affairs. I’m not immune; I’ve caught myself wasting so much time on my dumb phone sometimes that I literally do turn it off. It’s kind of disgusting the time spent on phones. There are some people that are better than others, but many are absolutely tethered to the device. I’d be concerned with how some people would function without them. Mind you, they’re not terrible. They’re very helpful for looking up medications, etc in the hospital or directions for travel. But they become a problem when we’d rather use them then interact with other people. Personally, I’m the type of person that tries to do interactions in person or at the very least via phone call. Important things I try not to handle via text or email. And I try to NEVER bring my phone out EVER in a patient’s room. That interaction is solely person to person with no phone involved. Only once has my phone come out and that was to confirm a parameter for a medication for the instructor. How about everyone else? How do you prefer to conduct important business?

(The painting is by a street artist named Banksy.)

Sepsis Bundles applied in MICU

/in /by

resuscitation-in-sepsis-10-638

The Surviving Sepsis Campaign was designed to create a reliable system to take care of patients with severe sepsis. It is then broken down into “Bundles” to simplify the steps in care. Each hospital can individualize their protocol but it has to have the basics of the bundles.

Bundle one needs to be done within 3 hours. This is usually done in the emergency room.

    1.    Measure lactate level

    2.    Obtain blood cultures prior to administration of antibiotics

    3.    Administer broad spectrum antibiotics

    4.    Administer 30ml/kg crystalloid for hypotension or lactate ≥4mmol/L

Bundle 2 needs to be done within 6 hours.

    5.    Apply vasopressors (for hypotension that does not respond to initial fluid resuscitation) to maintain a mean arterial pressure (MAP) ≥65mmHg

    6.    In the event of persistent hypotension after initial fluid administration (MAP<65 mmHg) or if initial lactate was ≥4 mmol/L, re-assess volume status and tissue perfusion and document findings according to Table1.

    7.    Re-measure lactate if initial lactate elevated.

To evaluate tissue profusion and volume assessment there are two recommended options.

EITHER:

Repeat focused exam (after initial fluid resuscitation) by licensed independent

practitioner including vital signs, cardiopulmonary, capillary refill, pulse, and skin findings.

OR TWO OF THE FOLLOWING:

    •    Measure CVP

    •    Measure ScvO2

    •    Bedside cardiovascular ultrasound

    •    Dynamic assessment of fluid responsiveness with passive leg raise or fluid challenge

I had a patient in the MICU with suspected sepsis and even 24 hours her lactate levels were being measured. She had cultured performed in ER and was being administer broad band abx. We were monitoring her MAP >65 and she had received vasopressors prior to ICU placement. We did give her 2 500ml bolus which increased her pressure and reduced her HR. We performed focus exams every 4 hours and continually monitored her CVP and ScvO2. I didn’t look at the Cottage Hospital sepsis protocol but compared to the  Surviving sepsis Protocol we were following the recommendations.

Protected: Disconnect

/in /by

This content is password protected. To view it please enter your password below:

Disconnecting

/in /by

I was not able to disconnect for a full 24 hours because I had to use my laptop to complete some assignments but I did make some time to get out and enjoy my day. I normally go for a bike ride at night but I decided to go during the day. The route that I take leads me to a senior apartment complex and it was very heartwarming to see the older adults walking with their dogs and family. I really enjoyed seeing them walking and enjoying their day because I’ve been getting used to seeing older adults in a hospital seating. I also decided to go to my parent’s house that day and have dinner with my family instead of just calling them to see how they were doing. It was a great day and it is very rewarding when you actually take the time to visit family (or anyone) instead of just calling or sending a text.

Disconnecting

/in /by

Our assignment this week was to try to ‘disconnect’ for 24-hours. My first thought was, how am I supposed to do that? I have homework, study guides, and papers to type.

As amazing as disconnecting from technology sounded, I realized how difficult disconnecting has become and felt an immediate sense of sadness. So, I decided to take on the challenge to see how long I could disconnect (without loosing too much time for homework of course).

My weekend began with grocery shopping. I went old-fashioned and handwrote my grocery list (which I usually type on my phone). While at the store, I could not help but notice that the only ones carrying paper lists were older people. They were also the only ones who smiled when I walked by. This was also the case at the art supply store I went to later in the day.

That evening, my fiancé and I went to visit his family, since his sister was visiting from Georgia. It was the perfect opportunity to keep me from going back to my computer/phone screens.  I also made a point to not take my laptop or any books (which I usually do) so that I could devote my entire attention to spending quality time with family.

It was interesting to hear everyone’s reactions when I told them what my assignment was. And by the end of our night, they even mentioned how difficult, almost impossible it was for them to even try it for a few hours.

Overall, I was grateful to have had an excuse to disconnect, even if it was less than 24 hours.

Dix on Revision

/in /by

revision eraser

What is Revision?

  • Rewording
  • Deletion
  • Adding
  • Substituting
  • Proofreading

Revision IS a Creative Process. It requires one to reflect on what is written, what is meant, and what is missing. Is not just crossing your T’s and dotting your I’s. It is part of it, but not the most important part.

DIX STUDY


Proposed two types. Text Based. Surface.

Text-Based (T) – Meaning of the writing.
Surface (S) – Spelling, Grammar without changing meaning.

Revision Structure

Study looked at three writers, and how they revised. They were tasked with one Poetic piece and one Transactional.

Poetic – “creative” story, poem, etc
Transactional – “academic” essay, how to, etc

 

1. Wiremu – Aware. Comics, Dairy, Songs.

Poetic – 22S 18T – Picture book about wizards. Mostly Text based, meaning changes. 

Ex: “The army of goblins and stuff were coming towards him,” but then I thought they didn’t know that I was inside the mansion, so I said, “Inside there was an army of goblins, wolf-weres, vampires, and evil wizards and fighters marched towards them.”

Meaning-preserving substitutions, such as changing thought to wondered.

Transactional – 9S-4T –  Debate. There was a checklist. Teacher was the judge. Easier to stick to guidelines. To hit all points.

“He was metacognitively aware of his revision practices—he recognized that many of the changes he made with his poetic writing were to manipulate, create, and refine his ideas. However, the revision changes he made to his transactional writing were in response to meeting the criteria of the genre as well the demands of accurate use of spelling and punctuation conventions”

Wiremu does not see it as proofreading at the end. It is something always happening

2. Anna – Observant. Narratives, Journaling, Flow.

Poetic – 32S – 14T. Poem school camp. Big on addition. She adds more and more to imagery. She goes back and forth.

Transactional – 17S 18T. How to make a paper tree. Paragraph to steps. Added diagrams. Capitalization.

“basically I made it a bit more precise in basically all of it, so that it’s just easier to read.” – Anna

“She was aware that revision changes involved two key processes and that it was acceptable to rework large amounts of text, which would ultimately involve Text-based changes, as well as to correct the Surface features for accuracy.”

Anna used addition and substitution to make the poetic poem to build imagery and get her point across. The transactional was input from outside.

“Anna wanted her writing to be more interesting.  Driven by a need to match the written text with her intended text. Content to play with words and construct a particular image.”

3. Jon – Structured. Assignment, End, Non.

Poetic. 17S – 1T. Poem about experience. Unsure what to write. “What color are leaves” Once he figured what he wanted, he stuck with it. No deviation. Generating/Organizing.

Transactional. 24S – 5T. How To, Paper Tree. Accuracy was the goal. “Roll paper vs Tightly Roll” – microstructure changes.

“The checklist, it just tells what you should have done, and if you’ve done it, you tick yes, or no if you haven’t done it.” – Jon

“He perceived revision as a procedure done at the end of writing, requiring the writer to ‘get it right.’… revision was to read the finished draft, making sure it made sense and correcting Surface errors.”

Jon decisions at planning and organizing. Hesitant to create ideas. Saw no reason to make major changes to the meaning of his text.

My Thoughts on Revision
Cat Fear

I am someone who has trouble with surface corrections. I can work on text based with ease. The grammar and spelling is the hard part. It can seem immense because I don’t know all the rules.

Revision has a bad connotation. I see it as having to correcting something wrong.  I don’t like to feel like I have made a mistake.
tumblr_inline_mz5vhw8PiA1r88s7d

Writing creatively is a form of art and art isn’t bolstered in school. I was taught there is one “right answer” so I search for that in my writing and revision. That there is a series of sequential steps with revision always at the end. It’s possible to unlearn that.

Revision is a creative process. I claim, that Revising IS writing.

Take away
  • Yes, surface revision is a thing, but that is minor for what we call ‘creative writing’.
  • The rules are situational. No one person will know all the rules of writing, how can you?
  • Context of revision matters.
  • Don’t be too focused on hitting the notes (surface editing). You can be Mariah Carey or Katy Perry. It’s all fine.

When you see a sculptor working on statue, you cannot tell if they are creating or “revising”. To them, creating is removing the material in the way of their vision. That is their artistic process.

sponge bob sculting

 

You “revise” the ideas in your head into what you want to say. You put those onto paper, and make what is written match what is in your head.

Revision is the process of writing.
Don’t be scared of it. You are doing it already.

Questions

Are you more Wiremu, Anna, or Jon?
Do you think revision has a negative connotations?
Do you think of revision as writing?
Do you think Revision as a creative process?

Works Cited

Dix, Stephanie. “I’ll Do It My Way: Three Writers And Their Revision Practices.” Reading Teacher 59.6 (2006): 566-573. Academic Search Premier. Web. 28 Oct. 2015.

Revision as Re-“Vision”

/in /by

After noticing a trend toward linear models of writing being taught in schools, Sommers decided to take a look at the way these models changed the way students thought of, approached, and viewed the revision process. She compared the opinions expressed by student writers to those of experienced adult writers, and her findings were rather interesting.

  Linear Model of Writingclassic-process

  • specific stages
  • prewriting, writing, rewriting (Gordon Rhoman)
  • conception, incubation, production (James Britton)
  • modeled on speech
  • leaves little to no room for revision, except as an afterthought

Revising-1Student Writers’ Revision Strategies

  • shied away from the term “revision”
  • predominantly concerned with vocabulary
  • viewed revision as a “rewording activity”
  • believe the ideas are there, and revision is simply a clarification of those ideas
  • eliminating repetition
  • unable to “see” revision as a process
  • unable to “re-view” their work with different eyes
  • lack “a set of strategies to help them identify” what is missing
  • view their writing through the eyes of former teachers and textbook rules

Experienced Writers’ Revision Strategiescsg_writing-the-revision-process-tone

  • finding the form of their argument
  • 1st draft as an idea generator
  • 2nd draft as way to establish patterns and further develop ideas
  • meant to confuse
  • view their writing through the eyes of an imagined reader
  • strategic
  • discover or create meaning in their writing
  • allows writers to change their writing as they change their idea/vision
  • recursive process
  • narrow topic in first revision
  • stylistic concerns addressed in later revisions
  • view writing as a discovery

Discussion Questions

What are your revision strategies? Do they fall more in line with the student writers or the experienced writers in Sommers’ study?

We seem to keep bumping into this idea that mainstream education is misleading students when it comes to writing. In elementary school, we are taught to put five sentences in a paragraph. In high school, they tell us that five paragraphs makes an essay, and all along the way, we are told that writing is a linear process. In college, we find out that none of it was true. At what point should the teachers of writing begin to break down these barriers? Is college the right time? Is it too late? When is too soon?

Personal Connection

At the start of my college experience, I was—without a doubt—revising at the level of the student writers described in Sommers’ article. At the time, revision and editing meant the exact same thing to me. Revision was simply a clarification of ideas, or a rewording of specific thoughts, but never a re-envisioning of my work. While I have gotten far more comfortable with the thought of revising my work, I still rarely do as much as the experienced writers in the article claim to do. This course has served as a much needed reminder that writing is about far more than putting words on a page, and this article—like Flower and Hayes’—reminded me once more, that writing is not a series of steps on a ladder, leading to a perfect product at the top. In fact, writing is far more akin to a jungle gym with steps going up and down along the way. After all, the most fun jungle gyms from my childhood were always the most complicated and varied ones.

Works Cited

Friend, Christopher R. Digital image. Process vs Product in Composition.         University of Central Florida, 9 Feb. 2010. Web.

Rothfuss, Patrick. Digital image. Patrick Rothfuss. The Tinker Packs, 16 Aug. 2010.  Web.

Sommers, Nancy. “Revision Strategies of Student Writers and Experienced Adult  Writers.” College Composition and Communication 31.4 (1980): 378-88. JSTOR.  Web. 28 Oct. 2015.

Middle School Student’s Perspectives of and Responses to Strategic Revision Instruction

/in /by

Summary

Elizabeth Dinkins realized that revision, thought it is an important element of writing, is often ignored by not only students, but teachers as well. She conducted a study along side a teacher to see if an effective teaching method for revision could be found.

Other studies show that revision is “recognizing a dissonance between what is written and what is meant” and then being able to use your knowledge to make the appropriate changes (76). It is important that students see revision as not just a way to get a final product, but as part of the process. Most students viewed revision as a chore and would often skip it entirely.

Dinkins found that in many classrooms pre-writing was emphasized much more than revising. She found that students had a limited understanding of revision. They focused mainly on “neatness, word replacement, and mechanical error correction” (77).

The teacher chose to teach the CDO-ADM revision strategy. This is a three-step process which includes comparing, diagnosing, and operating.

  • Comparing: Read each sentence and ask “Is this what I meant?”
  • Diagnosing: Mark sentences that need work.
  • Operating: Add, Delete or Move text.

They focused on five eighth grade students who were at different writing levels. The teacher taught the revision strategy using Self-Regulated Strategy Instruction which has six stages:

  1. Develop Background knowledge
  2. Discuss the Strategy
  3. Model the Strategy
  4. Memorize the Strategy
  5. Support the Strategy
  6. Independent Strategy Use

students

My Connection

I have never done very much revising when it comes to my own writing. I relate a bit to Stephanie because I have always felt that I just revise as I go along. Looking back, though, I can’t remember ever being taught how to revise. I do wonder now if I would be more comfortable revising if I had been taught a strategy like this one early on. 

Questions

  1. Do you relate to any of the five students when it comes to your views of revising? How?
  2. Do you think a larger focus should be put on revising in schools? Why or why not?

Works Cited

Dinkins, Elizabeth G. “Middle School Students’ Perspectives of and Responses to Strategic Revision Instructions.” Middle Grades Research Journal 9.2 (2014): 75 – 90. Web.

Unplugging

/in /by

This unplugging exercise was very interesting to me, I was wondering if most people within this day and age actually need to have an assignment in order to unplug from technology. Since I live far from my boyfriend and most of my family whenever I am with them I unplug without even realizing it. I think it is so essential to spend quality time with the ones you love without being on your phone constantly. I am seeing a lot of families out for dinner often with iPads or phones, paying more attention to their devices than each other. This makes me truly sad because support and relationships are what make life so incredible. I also believe there is a balance with technology. For instance, since I live far from my loved ones I am so glad to have technology to be able to communicate and stay connected to them even when I live multiple hours away.

Disconnecting!

/in /by

This week I was able to disconnect on two separate occasions for a total of 7 hours. Both occasions took place at my home. The first occasion was when my parents returned home from a week long vacation. I spent two hours (with no technology) talking to both of my parents about my past week, discussing clinicals, simulation lab, the cancellation of lecture, my other classes and assignments and of course, the details of their vacation. I spent my time catching up with my family and reflecting on the week; mine and there’s. I always enjoy spending time with them. I can tell that they appreciate spending time with me because most of the time I am up in my room studying. Another time I was able to disconnect was when my aunt came over for dinner. She came over on a Sunday night with her dog and I took a long break from studying and spent it socializing with my aunt, who I had not seen for a while. I love catching up with my aunt because she is a retired nurse and a blast to be around. I get to talk to her about my clinicals and how my experience is so far in the nursing program and it allows me to “see” the light at the end of the tunnel. Overall, I value the time I get to spend with my family and with school, that time is often limited. I have found that balancing my study time with family/social time can be challenging but is so worth it because it allows me to take a break from school, relax and refocus. My family always explains how much they enjoy it when I can spend time with them. Our time is filled with laughing, joking and sentimental discussions about life. I think this friendship and relationship I have with my family is what assists me to be a good (student) nurse. It helps me to converse with patients easily, while also picking up on subtle ques.