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SafetyNurse1968 ADN, BSN, MSN, PhD

Oncology, Home Health, Patient Safety

If I were in charge of the universe, there would be staffing ratio laws and unions in every state and you'd get written up for NOT taking your breaks.

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SafetyNurse1968 has 20 years experience as a ADN, BSN, MSN, PhD and specializes in Oncology, Home Health, Patient Safety.

Kristi Sanborn Miller RN, PhD, CPPS, HNB-BC is A Patient Safety Specialist. She just finished her doctorate in nursing at East Tennessee State University. She is an Assistant Professor at the University of South Carolina -Upstate. She is also a mother of 4 and loves being in the woods of Western North Carolina, when she's not obsessing over patient safety research. Kristi is a board certified professional in patient safety, and a published author. She has over 10 years of experience in nursing in areas like oncology, integrative health and home health with over 20 years of experience in education.

SafetyNurse1968's Latest Activity

  1. SafetyNurse1968

    You Don’t Know How to Argue

    Open Your Mind Have you been on social media lately? Maybe you posted something you thought was pretty benign like, “My daughter is really struggling with depression. I think we should consider having some in-person sessions of school this fall.” After a few thumbs up and heart emojis from close friends, your co-worker posted about an increase in deaths from COVID-19 after Korea reopened their schools and said, “This is a stupid idea.” Their best friend replied with an article about a child who just died from COVID saying, “You never consider things like this”. Your aunt broke out the ALL CAPS to say, “TEACHER’S LIVES MATTER” and your cousin’s mother-in-law said, “you’re heartless, you don’t care who dies.” The final straw was your dad who chimed in, “This is all Trump’s fault.” You ended up lying awake in bed all night fuming, thinking you should just delete your facebook account. I’ve been trying to post well-reasoned information on social media only to be met with what my grandmother would have called, “downright meanness.” I try very hard not to get defensive, and I usually succeed, but it’s got me thinking about how much energy we expend fighting, when we could perhaps be learning something from a well-reasoned discussion. In this article, I’m going to challenge you to open your mind. I’ve got some examples and ideas and I hope you’ll keep them in mind the next time you respond to an article. Who Taught You How to Argue? I’ll bet it was your parents, and I’ll bet most of them weren’t very good at it. My parents argued. A LOT. When they were unhappy, they yelled at each other. My mother would yell at my dad for being lazy and then slam her bedroom door. We’d hear her crying in there and feel just terrible. Maybe there was a well-reasoned argument for why my dad should perhaps get a job…but I never witnessed it. I’m also learning that what they were doing wasn’t “arguing” – they were “fighting” and typically this is the only example most of us have for how to deal with differences in opinion. When I think about effective argument, I think about lawyers and the techniques I see on television and in the movies. They typically use well-reasoned arguments to make a case, though for dramatic effect, you often seem them yelling and getting emotional. I wonder if they do that in real-life? Is it effective to get emotional and raise your voice? Does cutting down your opponent, name calling and “ornery-ness” win an argument? From personal experience, when someone yells at me and calls me stupid, I tend to shut down and walk away. It makes me want to “delete my facebook account.” And everything that goes with it. Classroom Training In the dim recesses of my memory, I know I learned the elements of a good argument in school, but I can’t recall if it was high school or college and I don’t remember many details. Several phrases have been popping up in my brain as I strain to recall useful details. “Straw man argument; appeal to emotion; ad hominem” Do any of these phrases sound familiar? You might have been exposed to argumentation in debate club, or maybe you took an argumentative writing course. I think I learned about it in philosophy 101 in college, but I’m not 100% sure. Luckily for us, there’s the internet – always available to refresh our memory if we know where to look. What is a Logical Fallacy? It’s a fancy name for an error in reasoning. There’s a long list of logical fallacies and they include “Straw man and ad hominem” (I’m pretty excited that I remembered something from my college days!) I won’t go into detail on all of them, but let’s unpack a few of the most common. Insulting comments Ad hominem means “against the man” and is the exact terminology you want when describing a personal attack or shouting match. When you get called “stupid” on social media, logical argumentation has been replaced with attack-language unrelated to the truth of the matter. You are rejecting another person’s view on the basis of personal characteristics, background, physical appearance or other features irrelevant to the argument at issue. It’s not just an insult, it’s an insult used as if it were an argument or evidence in support of a conclusion. You might know it as “mudslinging” in politics. I’m thinking of how some folks have been making fun of our president for slurring his speech. You can Google lists of insults against politicians - I won’t list any here so as not to detract from my argument that we can learn to argue effectively. Ad hominem signals to me that instead of arguing we are now fighting. In the above example, it’s when the original poster was called “heartless” or when their idea was called “stupid.” But I didn’t say that! In the strawman argument, someone attacks a position the opponent doesn’t really hold. It’s an easy way to make your position look stronger than it is. Often this type of argument is accidental because the offender doesn’t realize they are oversimplifying a narrow, cautious claim as if it were broad and foolhardy. In the original post about going back to school, the original poster (OP) wanted to look at the idea of re-opening. The “straw man” is that the OP suggested schools should reopen “no matter who dies.” Some of the others… Appeals to ignorance – claiming that because something hasn’t been disproven then it must be true. Example: “There’s no evidence that kids can spread the virus, so it’s okay to reopen schools.” False dilemma/False dichotomy – either-or fallacy limits the options to two when there are in fact more options to choose from. Example: “We can either reopen schools and kill people or keep them closed and save lives.” Slippery slope fallacy – moves from a seemingly benign premise or starting point and works through a number of small steps to an improbable extreme. It suggests that unlikely or ridiculous outcomes are likely when there’s not enough evidence to think so. Example: “If you reopen schools, millions of teachers and caretakers will die.” Circular argument – when a person repeats what they already said and doesn’t arrive at a new conclusion. If A is true because B is true, B is true because A is true. For example, “My daughter is depressed, and reopening schools will help, so we should reopen schools.” Hasty Generalization – a general statement without sufficient evidence to support it. The statement, “You never consider things like this.” is an example– using always or never is a generalization. A simple way to avoid this is to add qualifiers like “sometimes”, “maybe”, “often” or “it seems to be the case that…” Red herring fallacy – a distraction from the argument with something that seems to be relevant but isn’t really on-topic. It’s common when someone doesn’t like the current topic and wants to detour into something else instead. Derailing the topic of possibly re-opening schools with a comment about President Trump is a good example of this strategy. How to Argue Effectively Be prepared Know when to argue and when to walk away Think about how you’re saying what you want to say Listen. Repeat. Know your audience – what kind of argument might they find convincing? Watch out for logical fallacies Maintain relationships – when in doubt ask the person to explain their thinking Admit weakness – acknowledge when you are wrong I’m looking forward to your comments about arguing vs. fighting. Maybe you’ll share some examples I’ve missed, point out some of my errors or share frustrations or successes. As always, thank you for reading! References The Proper Way to Argue: The purposes and pitfalls of arguing - Psychology Today Logical Fallacies - Purdue University
  2. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    You sound like you are in a lot of pain and really hurting. I hope we can find a way to communicate.
  3. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    I am asking you to answer the original question of the post which was "Do Black nurses have a different experience?" If you are discussing that topic, then I welcome your post. I'd like for you to do it in a civil and reasonable way. Help me understand where you are coming from. Your words seem full of anger. Are you angry? I'd be happy to talk to you off post in a private message. Would you be willing to state your opinion without being unkind?
  4. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    My personal Tick specimen TC-15013 tested negative for the presence of Lyme disease, ehrlichiosis and Rocky Mountain spotted fever.
  5. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    I have to say as sick as I am right now, these little comments really bring me a lot of support and joy thank you. Spiked an axillary at 103.5 and barfed -if I spike again I’m headed to the ER. Will keep you posted! Suddenly feeling much better now that my fever is coming down. So many positives- O2 sat high, no shob and Tylenol works- just not long enough. Maybe 3rd dose of doxy will do it!
  6. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    Thank you! I really needed that- good convo is a good outcome. IKR! Not back yet- will post as soon as it comes in! Thanks for your support.
  7. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    Please scroll up -I did reveal the answer and it is Lyme disease!
  8. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    A great article describing how racism is a pandemic - I agree.
  9. SafetyNurse1968

    Racism and Covid-19: The Unmasking of Two Pandemics

    Thank you for bringing this important issue to light. We must continue to advocate for better health outcomes for people of color. I have been carrying around a quote I found on a Black Lives Matter website: "We are not all in the same boat, but we are all in the same storm." Some of us are in yachts, some of us are in dingies, some of us are holding onto the edge of a packing crate that is going under. Also, wanted to share an article I wrote on this topic: I will post a link to your article in mine as well.
  10. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Thank you for sharing your story. No need to mute or ignore - I appreciate anyone who reads my articles - it helps me hone my abilities to debate and pushes me to find evidence and resources for my opinions. I spent an hour online with a librarian today and have a long list of research articles about racism and Black nurses in America. I'll be writing it up soon. Thanks for your support.
  11. SafetyNurse1968

    Differential Case Study: Lyme Disease or Covid-19?

    Sorry I didn't post the final results sooner, but I seem to have some kind of infection...folks, it’s getting weird over here. Over the weekend I developed the exact same symptoms I described in Lakeith (fever, aches and pains, chills, headache). I had a tick bite 2 weeks ago, though no bulls eye rash. I just got tested for Covid-19 this morning at an urgent care clinic, and I’m waiting to hear back from my primary care provider (apparently, they don’t call you back the same day anymore!) I’ll keep you posted on my case, but in the meantime: Lakeith’s Lab values: ALT 150 (normal is 7-55 U/L) AST 105 (normal is 8-48 U/L) Bilirubin 3.5 (normal 0.1 to 1.2 mg/dL) All other blood work was normal Elevated liver enzymes are common in both Covid-19 and Lyme disease, so this isn’t a good differential. A study I read showed 76.3% of 417 patients had abnormal LFTs and 21.5% had liver injury with Covid-19 (April 13, 2020, https://www.journal-of-hepatology.eu/article/S0168-8278(20)30218-X/fulltext). They had ALT, AST, total bilirubin and gamma-glutamyl transferase levels elevated to more than 3× the upper limit. Patients with abnormal liver tests of hepatocellular type or mixed type at admission had higher odds of progressing to severe disease For practical and efficient screening of large populations for a viral infection like Covid-19, reports from China recommend including white blood cells (WBC) and C-reactive protein (CRP) in laboratory examinations for early monitoring of infection (Lu, L. Interpretation of 7th edition of COVID-19 diagnostic and treatment guidelines. Lifotronic webinar: Diagnosis Guidelines for COVID-19, March 19, 2020 https://onlinelibrary.wiley.com/doi/10.1002/ajh.25774) Their analysis revealed that on admission (so this would be for patients much sicker than Lakeith), most patients had a normal CBC (normal Hb, WBC and platelet count) and lactate dehydrogenase (LDH). And, no patient presented with moderate or severe thrombocytopenia that is frequently observed in other viral illnesses such as dengue fever. However, reports from China are showing high levels of lymphopenia (Absolute Lymphocyte Count < 1 × 109/L). Those requiring ICU care had a lower ALC and higher LDH. Lymphopenia (ALC) and lactate dehydrogenase (LDH) have both been significantly elevated in hospitalized COVID-19 patients in a small study of 96 confirmed COVID-19 cases in Singapore. Lyme Disease In the U.S., Lyme disease is caused by Borrelia burgdorferi and Borrelia mayonii. The most common tick-borne illness, Lyme disease is transmitted by the bite of an infected deer tick. Lakeith’s nurse practitioner ordered an ELISA test for Lyme, though an ELISA test might not be positive during the early stage of Lyme disease. The rash is distinctive enough to make the diagnosis without further testing in people who live in areas infested with ticks that transmit Lyme disease (New York State is a hot spot for Lyme disease). In addition, the ELISA test can sometimes provide false-positive results, so it’s not the sole basis for diagnosis. Lakeith’s ELISA and subsequent Western blot both came back positive. Signs and Symptoms of Lyme A small, red bump, similar to the bump of a mosquito bite, may appear at the site of a tick bite or tick removal, but this may occur with or without Lyme disease. Erythema migrans (bullseye rash) is one of the hallmarks of Lyme disease, although not everyone with Lyme disease develops the rash. Other symptoms include Fever, chills, fatigue, body aches, headache, neck stiffness and swollen lymph nodes. If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months (https://www.CDC.gov/lyme/signs_symptoms/index.html). These include bouts of severe joint pain and swelling, especially likely to affect the knees, but the pain can shift from one joint to another. Weeks, months or even years after infection, meningitis can cause Bell's palsy, numbness or weakness in limbs, impaired muscle movement and problems with mentation and memory, so it is important to diagnose Lyme early. Delayed diagnosis increases the risk of Post Treatment Lyme Disease Syndrome (https://www.cureus.com/articles/24863-lyme-disease-with-erythema-migrans-and-seventh-nerve-palsy-in-an-african-american-man) and other long-term complications from Lyme disease. Antibiotics are used to treat Lyme disease. In general, recovery will be quicker and more complete the sooner treatment begins. Many signs and symptoms of Lyme disease are often found in other conditions, so diagnosis can be difficult. Covid-19 False Negatives Researchers at Johns Hopkins have found that the chance of a false negative result -- when a virus is not detected in a person who actually is, or recently has been, infected -- is greater than 1 in 5 and, at times, far higher. The researchers caution that the predictive value of these tests may not always yield accurate results, and timing of the test seems to matter greatly in the accuracy. https://www.sciencedaily.com/releases/2020/05/200526173832.htm. Lakeith requested a second Covid-19 test, which was also negative. He is currently taking a two-week course of oral Doxycycline. Health disparities and Lyme A recent study finds that African Americans who contract Lyme disease are 10% more likely than Caucasians to exhibit symptoms such as neurological or heart problems, and they are 30% more likely to suffer from arthritis as a result of the disease. Whites were nearly six times more likely than African Americans to have detected a bull’s-eye rash, according to the study, which may be due to darker skin color that hides the bull’s-eye rash. Because skin tone may hide this key indicator, African Americans may remain untreated longer and therefore suffer more complications from Lyme disease. This highlights the need for increased health care education on Lyme disease in African-American communities. https://minoritynurse.com/darker-skin-tones-slow-detection-of-lyme-disease/ Health disparities and Covid-19 Twenty-two percent of U.S. counties that are disproportionately black account for 52 percent of the nation’s COVID-19 cases and 58 percent of COVID-19 deaths (https://directorsblog.nih.gov/2020/05/14/covid-19-brings-health-disparities-research-to-the-forefront/) In another study, 33% of hospitalized patients were black, compared to 18% in the community, and 8% were Hispanic, compared to 14% in the community. These data suggest an overrepresentation of blacks among hospitalized patients. Death rates among black/African American persons (92.3 deaths per 100,000 population) and Hispanic/Latino persons (74.3) that were substantially higher than that of white (45.2) or Asian (34.5) persons. (https://www.CDC.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html) Racial disparities are a major issue with Covid-19. Evidence has emerged that doctors are less likely to refer African Americans for testing for covid-19 when they exhibit symptoms (https://www.washingtonpost.com/outlook/2020/05/18/most-medical-professionals-arent-racist-but-our-medical-system-is/). U.S. Senator Elizabeth Warren (D-MA) and Representative Ayanna Pressley (D-MA) have called for more thorough collection of racial data, faulting the government for “currently failing to collect and publicly report on the racial and ethnic demographic information of patients tested for and affected by Covid-19.” (https://www.nejm.org/doi/full/10.1056/NEJMp2012910) Thanks for commenting and liking - I so appreciate it. I'm going to take some acetaminophen and go back to sleep. Ugh. I thought it would make for an interesting and informative discussion. Thanks for reading and commenting.
  12. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Please let that be true. I hope we can keep the momentum going. I joined a group of Black women fighting for positive change several years ago. My goal was to sit and listen and learn. My biggest takeaway is that as a white woman, I can never understand how uncomfortable it is to be Black. I try to remind myself of that every day.
  13. SafetyNurse1968

    MNA and Nurses Respond to the Killing of George Floyd by Police

    Regarding the statistics you've presented, what do you believe are some of the reasons that blacks commit more crimes than whites, besides socioeconomic reasons?
  14. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    @Ella26, thank you for sharing your stories. I am grateful that you took the time to educate me on the injustices you have experienced. It saddens me that even anger is taken away from Black women. I'm here to listen and learn.
  15. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    Thank you for sharing. I'm sorry you've experienced this. I am fighting for an America in which racism doesn't exist. We are a long way off...
  16. SafetyNurse1968

    Do Black Nurses Have a Different Experience?

    I disagree with you that black disparities are no more important than LatinX, Asian, Gay, Male and Caucasian. I believe that black people in this country are suffering. They are the only group I can think of that is facing a history of slavery in this country. What Black Americans have suffered at the hands of white people in this country is an injustice. We must stand up for our Black brothers and sisters and work every day to dismantle the systemic racism that plagues our country. As an example, I would ask you to look at what happened during the Tulsa race massacre in 1921 - it is just one example of how institutionalized racism has resulted in the torture and death of black citizens. What baffles me is what white people are so afraid of. I look forward to a United States that is run by Black, LatinX, Asian and Gay folks - I'm hoping we might see universal health care and fewer health disparities. https://www.tulsahistory.org/exhibit/1921-tulsa-race-massacre/ Thank you for sharing your experience. I am sorry this happened to you.

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