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A Horrible, but Amazing, Abuse of HTML

This goes out to all y'all web developers out there.  You know who you are.  In 1999 while others partied like it was...  1999, you slaved away trying to get your table-based layout working on Netscape and IE.  Thank goodness it's now 2007, and you can just grab CSS-based layouts from A List Apart. But off all the possible abuses of old-skool HTML, I bet you never thought of this one:  using table cells and bgcolor to build an image, one pixel at a time! [youtube]NqFOB77jLaE[/youtube] Link to video for those of you on RSS. Brought to you by Japan and cutesy anime chicks.

Things Every Nursing Student Should Have…Even Through Grad School: Part I

I have stewed over this topic for several months as I am finishing up my second to last semester of my Family Nurse Practitioner (FNP) program. I do not consider myself an expert on this issue; however, there were several things that got me through nursing school that I could not survive without. The following stuff is mainly for an undergrad nursing student. Part II (coming soon) will be more for a nursing student in grad school. 1. A cheap watch that tells military time I am a cheap watch girl because, working with the pediatric population ( & going through 6 watches in 5 years), I have learned that it is not worth it to get an expensive watch. Also, the amount of lifting, moving, bending, carrying, etc. that a nurse (especially the average nursing student, since the nurses on the floors are happy to have students do the grunt work) does makes for a broken watch every 5 months or so. These watches are so cheap, $9.99 at Target. Military time watches saved my life. My husband always makes fun of me for having a military time watch, but it's truly a lifesaver. I never got used to adding or subtracting twelve hours to regular time. This watch made my life so much easier and my documentation much more accurate as a student and nurse. The first time I was truly grateful for having a military time watch was during my first job straight out of nursing school in the PICU (pediatric intensive care unit). It was during my first real code (code blue) ever and I was the recorder. When you watch ER or something, it amazes me that they never show the recorder who has to write down every single thing done to a patient during a code. 2. A good stethoscope I started out with a Prestige Medical sprague stethoscope. I remember an instructor telling us that we should buy a stethoscope with both a diaphragm and a bell in order to hear both high and low pitched sounds. This will be helpful for you distinguishing different breath sounds (rales, rhonchi, wheezing) and heart sounds (gallops, rubs, murmurs). I also (vaguely) remember being told that the shorter the tubing for the stethoscope, the better. This basically has to do with the physics of it all. You'll be able to hear the sound more clear the shorter the tubing is. My prestige stethoscope was a great starter. Once I was able to save up enough money, I got the a Littmann stethoscope. I made the upgrade to the Cardiology II because the difference in my ability to auscultate faint adventitious sounds of the body and checking NG (nasogastric) placement improved 20 times. Well, I was unable to actually measure the difference, but there was a definite difference. If you're the kind of student who feels that you need to have something like this early on (like now), hit those loved ones up, all of them at the same time. My Littmann is approximately 4 years old and still working very well. This is another very good investment for nursing school. 3. Comfortable nursing shoes I was never a trendy "croc" aficionado. Many hospitals don't even let you wear them. I'm a New Balance girl, myself. From working anywhere from 4 to 16-hour shifts, these babies keep you comfy. 4. Pocket protector filled with bandage scissors, many packets of rubbing alcohol, a permanent marker, a highlighter, and (at least) two 4-colored pens This is also something my husband makes fun of me about. It may seem nerdy, but it's going to save you the ink stains. Plus, it acts as a very handy storage area in your pocket. You'll learn to stuff unimaginable things in your pocket just to avoid an extra bag or trip. It's all about the multi-tasking. highlighter- Just highlight the important stuff for patient/family education. The patient is already overloaded. bandage scissors- I'm asked every single day for my scissors. rubbing alcohol- This is for a quick clean of almost any surface...also, those bandage scissors are going to end up in some pretty gross places permanent marker- Labeling meds/IV bags/anything really two 4-colored pens- You'll be surprised how much you might need red ink for taking off orders...depending on your institution. You'll learn that the piece of paper that you have all of your activities recorded for the day (tube feeds vs. PO meds vs. IV meds vs. I's & O's ) will need some color coding. This is pretty anal, but it helps map out your day. I've done this ever since junior high, and it has made me more organized in my thought process. You'll need at least two pens because us nurses are all filthy pen thieves. 5. Mosby's Drug Guide This book was a good starter for me. It has all the info that you will need for when your instructor grills you. The language is easy to understand. The part of the book that I really like (I'm sure it's even better now because I only have the 4th edition from 2002) were the pictures of how to give different kinds of injections. It also gave pictures of different common drugs used in the general population. This is helpful for that those cute little old people taking 15 different kinds of medications per day, don't know what they're for, but can tell you the color of the pill. 6. A PDA Know these initials and know them well. PDA stands for personal digital assistant (for those who always wondered, but felt too dumb to ask), otherwise known as a palm pilot. In nursing school, one thing I hated was carrying around 5 different books to get me through clinicals. After biting the $200 bullet, I got hip to my first palm pilot. The greatest thing about these little devices is that you can carry 10 or more different medical books all on this little device. One thing you may be thinking is, "I can't afford this. She's out of her mind." Believe me, I couldn't afford it, either; however, it has proven to be the best investment (besides becoming a nurse) that I have made for myself financially and medically. This is what you can do. Again, tell all of your family members...I mean all of them, to not get you anything else for your birthday/Christmas except a palm pilot. You will have a vast array of knowledge at your fingertips, your backaches will go away, and people in the hospital (doctors, nurses, patients) will be impressed. Plus, every palm pilot comes with some kind of built-in calculator (another nursing school must), calendar to schedule appointments/meetings, and an address book to help you manage your hectic life. See Part II of this post (will be posted soon) on what to look for when buying a palm pilot and programs/books to put on it. 7. The knowledge that things will get better and that you will overcome this. I didn't want to have to be all preachy, but I wanted to include this because I think it's important. The decision to become a nurse is a very important one. You will hold people's lives in your hands, literally. The pressure between nursing school, your job to make ends meet, possibly kids/family can all seem like it's just too much...not to mention all the blood, vomit, mucous, urine, and poop that you're going to have to put up with. There is something to be said about those nurses that tend to eat their young. It seems like they use you as their own little "fresh blood" punching bag. Someone probably did the same thing to him/her in nursing school or his/her first job, so they feel like they need to pass on the tradition. I don't believe is this bs. This is part of the reason that there is such a shortage, because even some nurses can't appreciate each other and stop the cycle of hate. You need to take it upon yourself to kill that person with kindness and do your job 150%. If you are still thinking of quitting nursing school/nursing in general, speak to a nurse who has been around the block a few times (not sexually) and that truly loves what he/she does. You may not find many nurses that like where they work, but you should find nurses that love what they do. No nurse should be in this profession that is burned out and/or hates what he/she does. When a person comes to this point, this is when they should leave nursing, even if there is a shortage. It's just not fair to the patients. Coming Soon: Things Every Nursing Student Should Have...Even Through Grad School: Part II---palm pilots, programs, books, and websites. Oh My!

Teaching Science and Math with Real World Examples

I ran across a great post at Technocrat titled If We Taught English the Way We Teach Mathematics.
"Suppose that those classes, from elementary school right through to high school, amounted to nothing more than reading dictionaries, getting drilled in spelling and formal grammatical construction, and memorizing vast vocabulary lists -- you never read a novel, nor a poem; never had contact with anything beyond the pedantic complexity of English spelling and formal grammar, and precise definitions for an endless array of words. You would probably hate the subject."
This is a great point, and the post goes on to talk about why it's not just a lack of "real world" examples that makes math and science such boring, intimidating subjects.  Here's the perfect example of how a real world example definitely did not help one student with physics: [youtube]cIIwwCi2zwk[/youtube] So if memorizing facts and formulas is no use, and contrived, often bizarre examples are no help, how should we teach math and science? I'm not sure I have any great insights, but I can give you three examples of what has worked for me. First, I think it helps to have (or to project to your students) an attitude that allows for the real value and usefulness of science and math.  This does not mean that great teachers and students have to be died-in-the-wool atheists or materialists.  But I do think there are some basic ideas without which science and math will never be meaningful or interesting: 1.  The world is more complicated than it might seem; 2.  We can figure out the way it works; 3.  We can put the knowledge to use. As Richard Feynman explained:
"For a successful technology, reality must take precedence over public relations, for nature cannot be fooled."
Doing some googling to uncover the source of the quote leads me to a post on Edward Tufte's homepage, Grand truths about human behavior.  There you'll find a collection of quotes that express this notion better than I can. Second, you cannot study physics, geometry, biology, or any similar subject in isolation.  When I was in high school a lot of the stuff we went over in math class junior year didn't make sense until I took physics senior year.  In college I took calculus I and II as a computer science student and did fairly well, but I forgot everything I had read the day after each final exam.  When I took discrete math, though, the class was so much more interesting because I could see how it applied to CS. Physics od SuperherosFinally, one great way to teach science is through storytelling.  This is a case where extensive Bible study might be perfect preparation for giving a science lecture - Jesus knew 2000 years ago that parables were much more effective teaching tools than lists of facts and figures (or commandments). The facts of the story are not nearly as important as the lesson and the exercise in creative thinking.  One great example of this is The Physics of Superheros by James Kakalios.  This is a great book - the author talks about the origin stories and powers of various super heroes and uses these very fictional examples to illustrate real physics.  He does not do so by brutally criticizing Stan Lee and insulting Superman.  Instead he uses the "miracle exception" to the laws of physics represented by each super power to tell a story about how the world really works. Thanks to The Adventures of the Accordion Guy for pointing out the post on teaching math like English.

Adventures in Home Buying

Apparently what needs two six-hour classes on the first two Saturdays of spring can be summed up within a couple paragraphs (at least in a couple installments) on a slightly successful somewhat humor associated blog. I am, of course, referring to the first time home buyer class my lender has required me to attend in order to obtain a state subsidized mortgage. I’m not knocking the program as it is meant for first time home buyers. But the elementary view and information this class provides these hopeful and somewhat naive homebuyers is almost worthless. At first I assumed the audience was somewhat knowledgeable in regards to personal finance. I mean, this is a class for people ready to make the biggest purchase of their lives. However, I was seriously surprised when more than a few hands raised to notify the teacher that they didn’t know what a “Credit Score� was. As I sat in the freezing room filled with plastic folding chairs listening to a real estate professional, a home inspector, and a real estate lawyer try to drum up business for themselves instead of educate home buyers, I decided to put down on paper the important lessons and intricacies that may be useful to a somewhat more educated, or simply alive, first time home buyer that I’ve discovered not only during the home buying process but also through my experience as a former loan officer and what I’ve learned while preparing to sit for the Real Estate Licensing exam in Ohio. Today’s topic – Preparing your financials for a Mortgage Preparing for a loan is, I think, the most important part of the process. Hopefully you’ve made some decisions as far as where you’re going to live and what type of house you’re looking for. A little bit of research around these assumptions will help you determine how much of a loan and down payment you’re going to need. Preparing yourself, or more importantly your finances for a loan, may take months or years depending on how far off plan you are. The two most important things that the bank will look at will be your debt-to-income ratio and your credit score (hopefully you know what that is). Your debt-to-income ratio simply is your month debt payments divided your gross income divided. Now for the most part you want to pay off debt in order of the highest interest rate, by the way, if you’re carrying credit card balances, you’re not even ready to begin thinking about buying a home. Work on a budget to get your credit cards closed and make yourself debit-dependent instead of credit-dependent. When evaluating your debt-to-income your bank will mainly look at monthly required payments and then debt balances, but the two measures that matter most are your debt-to-income ratio using only your new house payment, taxes, insurance, and possibly condo fee, and your total debt-to-income ratio including all monthly debt payments and your new house payment, taxes etc… These two ratios should be under or close to 28% and 36% respectively. Now this is where some creative financing takes place. The two determinates you can effect in these equations are your income, which is not as controllable as most of us like, and your current monthly debt payments. Like I said before, normally it’s prudent to pay off your highest interest loans and debts first, but when trying to improve your debt-to-income ratio by reducing your monthly debt payments this may not be true. Consider two student loans, one at 8% and one at 4%. Most people’s first instinct is to payoff the first loan with the 8% interest because the interest is higher. However let’s also assume that the 8% interest loan is amortized over 5 years with a balance of $5,000, and the 4% loan is amortized over two years with a balance of $5,000. The payment on the 8% loan is $101.38 and the 4% loan is 217.12. The lower interest rate loan has a higher payment due to the amortization time. After you’ve decided how much money you’ll need for down payment, closing costs, reserve funds, etc… any extra funds should be applied to your highest monthly payment to balance ratio. In other words, the 8% loans ratio is 101.38/5000, or 2% while the 4% loan is about 4.3%. This will lower your debt-to-income ratio. This theory should be applied to all your debt balances and monthly payments that have the same tax advantages. Notice how I compared two student loans instead of a student loan and a car loan. Normally the student loan will have tax advantages over the auto loan, because you can deduct the student loan interest you pay. This theory may also have negative effects in the future. Essentially in the scenario above you’re sacrificing a loan with a lower rate to afford a better home. If you had paid off the 8% loan instead, you’d pay less interest over time. These are all things that should be considered on an individual basis and they unfortunately don’t fit easily into a widely flexible calculation. Paying off any debt will also improve your credit score. The calculations that determine your FICO score are very complicated and outside of the scope of this writing. What I can tell you is that if your FICO score isn’t above 700 you can expect to pay a higher interest rate or points on your loan than what the market is advertising. Also, with all the problems with the sub-prime market if you’re FICO score is below 600 you may not have a prayer finding financing. Based only on my experience alone, the most diligent efforts to improve a bad credit score can only rise a score by 50 points a year at best. Based on that and your own knowledge of you credit history you should be better able to determine what your timeframe is before you apply for a mortgage. And like everyone says but almost no one ever does, you should check your credit score at least once a year and with all three major reporting agencies. Maybe the most helpful thing to do when you want to start preparing for a mortgage is to play with the numbers. Using something like Excel, list all of your debt balances, payments, terms, etc.. along with your income. Make some quick formulas to automatically calculate your debt-to-income ratio and then run through a few scenarios. Playing with the numbers will give you a better idea of what you need to do to improve your debt-to-income ratio and provide you with a better timeline of when it'll be proper to apply for a loan.