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mingez

mingez

Psych, Ortho, Stroke, and TBI
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mingez specializes in Psych, Ortho, Stroke, and TBI.

Enrolling in an NP program in 2012!

mingez's Latest Activity

  1. mingez

    Paleo/Primal Diet?

    Because, portion control as a dietary recommendation has worked SOOO well thus far?? C'mon.... If you're eating hyper-palatable foods that cause insulin spikes and leptin resistance, you will lose the battle with your own BIOLOGY. (Much of that food is designed to encourage over-consumption) People will instinctively fight tooth and nail to avoid hunger pangs, it's our evolutionary programming. Being hungry is not natural. You shouldn't have to control your portions, your body should do it for you. And that's what happens with a clean, paleo, primal, diet. As for exercise, that's a huge part of the lifestyle. Heard of Crossfit? Yeah, most people who discovered this lifestyle did so via functional fitness. And yes, after 2 years, we're enjoying the amazing effects of eating healthy. And that doesn't involve having to actively think about "Portion control."
  2. Hey! I got hired at NVMHI. I'm on their most acute unit, and I'm still on orientation. Once I'm up and running, I'll let you know.
  3. Agreed, but how does your facility handle such situations?
  4. Nothing? I was expecting this to be a hot button topic... :flamesonb
  5. As a nurse who's recently gone back to psych (my true love), I was totally taken aback by the type of training my state psych facility provides. I'm a patient-first advocate, and always concerned for what's right for patients. Patient's should never receive any form of abuse. However, I feel there's a balance between patient's rights and the rights of the staff to be safe and free from abuse. At my facility (which is a state-run facility) I feel as though they've completely sacrificed the rights of the nurse and techs in favor of the rights of the patient. I want to preface this with the understanding that we are assuming all verbal therapeutic communication, and early interventions are exhausted prior to crisis events. Case in point: Blocking a punch in any way if it's directed outward from the body (as happens in any karate tournament, 99% of the time without injury) is considered abuse as it MAY injure the patient's striking arm. There is a difference between assaulting a patient with a punch and a block, however the state does not recognize this difference. To me, this is extreme. 2nd issue: Our state does not provide security personell for interventions. In Colorado, we had a designated security team trained in detaining, restraining, physical and mechanical restraints. BOTH staff and security would intervene and answer distress signals. (Mech restraints were the responsibility of the nurse ONLY, but they were still trained in application) This was back in 2005. In my current state, there is no provision for security, and the staff is to intervene in any and all crisis situations. My unit is VERY acute, and we have physical altercations often. Again, I'm all for "balance". I understand that we are not the patient, and are not psychotic, however I disagree with the idea that the training they provide (which is 2, 6-hour sessions) is enough to be proficient. And even if it WAS enough training, my opinion is that it wouldn't be effective even if one WAS an expert with years of experience in many crisis situations. (qualifier: I'm a black-belt level Jiu Jitsu, Mixed Martial Artist with years of self-defense training) Essentially, I feel as though it guarantees the staff member an injury...eventually. Situation that makes me post this: We had a tech fired for blocking a patient's arm using an open hand out-ward block. We all saw it, we all described it accurately to the investigative team. The patient bloodied the nose of the tech, and the tech NEVER used an offensive-based maneuver, just the block. QUESTION for you all: Is this the way it is at your facility? Are you state-run or private? Is this overly-progressive in your opinion? Please share you thoughts and experiences!
  6. mingez

    Paleo/Primal Diet?

    Yes, there are 2 different camps. One that is of the "Safe starch" variety, and one that is of the low carb variety. Some Paleo folks eat plenty of carbs, but the most popular version of the diet is low-ish carb. And I like to tell people that Ancestral eating is not a diet of knowing what to eat. Because yes, we are all aware, and have debated ad nauseam about the logical fallacy of assuming everything pre-neolithic folks ate was automatically healthy. I think the general consensus is that it's a philosophy, one that doesn't suppose to know WHAT ancient man ate, (although the archeological record is pretty clear) but rather one that understands what they DIDN'T eat. I know we DIDN'T evolve eating doritos, tofu dogs, and sweet'n low. (PS, sweeteners are still on the ADA heart healthy diet list, hence why it's served on most diabetic diet hospital trays) And as such, if one avoids those processed foods, it's pretty safe to say that you're eating foods we were evolved to eat. That being said, the food, soil, and environment of today is very different, and as such, one strives to eat as close to paleo as possible. So yes, it's "Clean" eating largely. Ancestral eating is not a fad diet, but a lifestyle. You'll hear that a lot. If you're going to lump it in with Atkins and Southbeach, then you must also lump in Veganism, Carnivory, and Vegetarianism as "Fad diets" as well.
  7. Well, going tech would be helpful for you to understand what the nursing team goes thru and how the process works. However, I think that if you stayed the course, you'd be fine. You're clearly learned in MH. That will serve you well. However, if someone were just starting out as a nurse, or in psych, with no experience (which you won't be) I'd recommend to most folks to start off as a tech.
  8. mingez

    Switching to Days!!

    I'm on an Admissions unit where the most acute go. We typically get 2-4 admits durring the day, split between 3 nurses. Can be more tho. Groups start at 8 and patients have 7 therapies/day, 3 with a psychologist, OT, or therapist, and 4 group therapies like "wellness", "Goals", or recreation therapy, etc. Typically, if your charge, you won't be assigned to hold a group activity, which I love. Instead, you'll be doing assignments and, and dealing with transfers. At my hospital, charge gets a team of patients. However, we have a LPN who typically does meds. On my unit, charge nurses get less patient contact and tend to have to hang in the office more than the non-charge RNs. EDIT: I'm at a state psych hospital.
  9. mingez

    Paleo/Primal Diet?

    My fault, I didn't realize it was strictly meta-analysis you required. I was referring to a Randomized Controlled Trails with subject over 1,000. Nevertheless, there are some in that list I supplied.
  10. mingez

    Paleo/Primal Diet?

    I've already explained why this doesn't matter, please pay attention. I never said they were. I agree with one thing, you are indeed arrogant. I alone am not declaring that the AMA,ADA, NANP, and IAACN don't know what they're talking about, but rather I stand on the shoulders of many people who do. And I have read hundreds of studies...because it's interesting and research was a big part of my academic past. As for being a new grad, It's true but irrelevant. If you must know seeing as how we're all ad hominem up in here: at 32, (I'm now 38) I went back to school to become a nurse (Gasp! Nursing isn't my first rodeo!) because 1) I like helping people, and 2) A degree in Evolutionary Anthropology just doesn't pay that well. Can you guess what my thesis was about? Mesoamerican Transitional Subsistance Strategy and it's Affect on Paleo-Indian Brain Development. (Sounds kinda "nutritiony" doesn't it?) Now, I'm in NP school...and SOMEHOW I find the time to post on allnurses.
  11. mingez

    Paleo/Primal Diet?

    i'll make this real simple for you. what you are asking has never been done for any diet...not even the current recommendations by the ada. the largest rct study for a diet was 827 and that was the "diogenes study." (pubmed link) and that favored a paleo macronutrient ratio. so already, you're asking me to show you something that the us government has never succeeded in doing due to the sheer cost! and that, my friend, is the problem! i will, however, site many studies that show correlation to aspects of the diet (and some are paleo specific). such as ketogenic diets, such as high fat low carb, saturated fats effect on gut flora, cancer, heart disease, gluten intolerance, intestinal permeability, gut dysbiosis, leptin disregualtion, insulin resistance, correlations that disprove the current recommendations, etc. because that's all that exists either for or against all diets be they sad, ada, paleo, weston a. price, atkins, whatever. [color=#646464]1. frassetto la, schloetter m, mietus-synder m, morris rc, jr., sebastian a: metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. eur j clin nutr 2009. [color=#646464] [color=#646464]2. jönsson t, granfeldt y, ahrén b, branell uc, pålsson g, hansson a, söderström m, lindeberg s. beneficial effects of a paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. cardiovasc diabetol. 2009;8:35 [color=#646464] [color=#646464]3. jonsson t, granfeldt y, erlanson-albertsson c, ahren b, lindeberg s. a paleolithic diet is more satiating per calorie than a mediterranean-like diet in individuals with ischemic heart disease. nutr metab (lond). 2010 nov 30;7(1):85 [color=#646464] [color=#646464]4. jonsson t, ahren b, pacini g, sundler f, wierup n, steen s, sjoberg t, ugander m, frostegard j, goransson lindeberg s: a paleolithic diet confers higher insulin sensitivity, lower c-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs. nutr metab (lond) 2006, 3:39. [color=#646464] [color=#646464]5. lindeberg s, jonsson t, granfeldt y, borgstrand e, soffman j, sjostrom k, ahren b: a palaeolithic diet improves glucose tolerance more than a mediterranean-like diet in individuals with ischaemic heart disease. diabetologia 2007, 50(9):1795-1807. [color=#646464] [color=#646464]6. o’dea k: marked improvement in carbohydrate and lipid metabolism in diabetic australian aborigines after temporary reversion to traditional lifestyle. diabetes 1984, 33(6):596-603. [color=#646464] [color=#646464]7. osterdahl m, kocturk t, koochek a, wandell pe: effects of a short-term intervention with a paleolithic diet in healthy volunteers. eur j clin nutr 2008, 62(5):682-685. [color=#646464] [color=#646464]8. larsen tm, dalskov sm, van baak m, jebb sa, papadaki a, pfeiffer af, martinez ja, handjieva-darlenska t, kunešová m, pihlsgård m, stender s, holst c, saris wh, astrup a; diet, obesity, and genes (diogenes) project. diets with high or low protein content and glycemic index for weight-loss maintenance. n engl j med. 2010 nov 25;363(22):2102-13 [color=#646464] [color=#646464]9. papadaki a, linardakis m, larsen tm, van baak ma, lindroos ak, pfeiffer af, martinez ja, handjieva-darlenska t, kunesová m, holst c, astrup a, saris wh, kafatos a; diogenes study group. the effect of protein and glycemic index on children’s body composition: the diogenes randomized study. pediatrics. 2010 nov;126(5):e1143-52 [color=#646464] [color=#646464]10. cordain l. saturated fat consumption in ancestral human diets: implications for contemporary intakes. in: phytochemicals, nutrient-gene interactions, meskin ms, bidlack wr, randolph rk (eds.), crc press (taylor & francis group), 2006, pp. 115-126. [color=#646464] [color=#646464]11. cordain l, miller jb, eaton sb, mann n, holt sh, speth jd. plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets.am j clin nutr. 2000 mar;71(3):682-92. [color=#646464] [color=#646464]12. cordain l. the nutritional characteristics of a contemporary diet based upon paleolithic food groups. j am nutraceut assoc 2002; 5:15-24. [color=#646464] [color=#646464]13. cordain l, eaton sb, sebastian a, mann n, lindeberg s, watkins ba, o’keefe jh, brand-miller j. origins and evolution of the western diet: health implications for the 21st century. am j clin nutr. 2005 feb;81(2):341-54. [color=#646464] [color=#646464]14. kuipers rs, luxwolda mf, dijck-brouwer da, eaton sb, crawford ma, cordain l, muskiet fa. estimated macronutrient and fatty acid intakes from an east african paleolithic diet. br j nutr. 2010 dec;104(11):1666-87. [color=#646464] [color=#646464]15. ramsden ce, faurot kr, carrera-bastos p, cordain l, de lorgeril m, sperling ls.dietary fat quality and coronary heart disease prevention: a unified theory based on evolutionary, historical, global, and modern perspectives. curr treat options cardiovasc med. 2009 aug;11(4):289-301. [color=#646464] [color=#646464]16. cordain l, eaton sb, miller jb, mann n, hill k. the paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. eur j clin nutr. 2002 mar;56 suppl 1:s42-52 [color=#646464] [color=#646464]17. cordain l, watkins ba, florant gl, kelher m, rogers l, li y. fatty acid analysis of wild ruminant tissues: evolutionary implications for reducing diet-related chronic disease. eur j clin nutr. 2002 mar;56(3):181-91 [color=#646464] [color=#646464]18. carrera-bastos p, fontes villalba m, o’keefe jh, lindeberg s, cordain l. the western diet and lifestyle and diseases of civilization. res rep clin cardiol 2011; 2: 215-235. [color=#646464] [color=#646464]19. hoppe c, mølgaard c, vaag a, barkholt v, michaelsen kf. high intakes of milk, but not meat, increase s-insulin and insulin resistance in 8-year-old boys. eur j clin nutr. 2005 mar;59(3):393-8. [color=#646464] [color=#646464]20. micha r, wallace sk, mozaffarian d. red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. circulation. 2010 jun 1;121(21):2271-83 [color=#646464] [color=#646464]21. micha r, mozaffarian d. saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. lipids. 2010 oct;45(10):893-905. epub 2010 mar 31. [color=#646464] [color=#646464]22. mozaffarian d, micha r, wallace s. effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. plos med. 2010 mar 23;7(3):e1000252. [color=#646464] [color=#646464]23. siri-tarino pw, sun q, hu fb, krauss rm. saturated fatty acids and risk of coronary heart disease: modulation by replacement nutrients. curr atheroscler rep. 2010 nov;12(6):384-90. [color=#646464] [color=#646464]24. siri-tarino pw, sun q, hu fb, krauss rm. saturated fat, carbohydrate, and cardiovascular disease. am j clin nutr. 2010 mar;91(3):502-9 [color=#646464] [color=#646464]25. siri-tarino pw, sun q, hu fb, krauss rm. meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. am j clin nutr. 2010 mar;91(3):535-46
  12. mingez

    Paleo/Primal Diet?

    agreed. but nobody ever said there was just "one or two" studies. meta-analysis of the studies works, however, when the body of the research is founded on bunk principles (such as the lipid hypothesis, or the china study) with no question as to whether those founding principles are incorrect, meta-analysis results are either flawed or irrelevant. read "good calories bad calories" for a more eloquent argument as to how and why this happend in nutrition. that's a lazy argument. the reasoning here is about reading and critically thinking about the material. this is why one must go beyond the abstract. yet, you have time to argue with me on allnurses at 1 am in the morning? clearly you're swamped. you have time to debate, but no time to educate yourself about the opposite side of the argument. and i'm confused, you cite not having educated yourself or "digested" the material, yet you are perfectly comfortable telling people that the are wrong about their nutritional philosophy? interesting. is that your main argument? i would think that as a nurse you'd opt to critically think about things on occasion rather than just regurgitate dogma. the current lowfat, high carb approach the ada recommends has become part of the zeitgeist. it's an understood "fact," which is never questioned by people who don't need to think about it. but there is a lot of history there which i can only tell you read up about. but conveniently, you have no time for this; with all your allnurses postings and professional endeavors and all. this is the same organization that recommended margarine, trans-fats, saccharine, without any evidence-based research. zero. they can, and have been wrong. is that how you selectively interpreted kalipso's post? give me a break. talk about being captious in argument. kalipso was pointing out, not that the ada is "to blame" but rather that the evidence that the current recommendations are ineffective are all around us. the causes are much more complex obviously, but instead you choose to belittle kalipso's take on the matter with condescending rhetoric. and ps, kalipso was talking about the american dietetic association. ------------------------------ in the end, i'm not asking you to buy in to the idea of an ancestral or evolutionary based way of eating, i'm just suggesting you look in to it. research, then refute, that's typically the order things are done. if one has no basis for their argument other than "governing body 'x' says so," then one has no argument at all.
  13. mingez

    About to start in a Psych Hospital..

    I used to work psych as an LPN about 3 years ago, went to a stroke unit, and then was hired at a state psych hospital this month. Needless to say, a lot is coming back to me, and I am having a lot of "oh yeah" moments. You'll learn to notice when a patient is escalating, and your training (I'm assuming you'll receive some) will help you de-escalate using verbal techniques. Plus, if you're techs are good, they will be proximal to the patient and will/should begin de-escalation techniques. Hopefully, you are amply staffed. It's a tough job, but in a different way from critical care. Trust your preceptor, rely on the experienced nurses and techs, and your experience will grow. Soon, it'll be "old hat." For me, and I'm new again the hardest part has been figuring out where the supplies are, and revisiting paper charting. If your team is unsupportive and you don't have enough staff, that is what makes a psych facility dangerous. If there's a "Nurse who eats his young" type on the unit, that also compromises safety. Be weary of that situation. Otherwise, a good team makes psych the best specialty to work IMO! Enjoy the ride! You'll love it.
  14. mingez

    Addictions vs. Psych nursing

    Thanks for your response! It's nice to find your niche. I have to admit that having an interest in psych, but having worked in a medical area is what made me consider addictions nursing. The combination of the two is enticing. I ended up getting hired in an acute admissions unit at a state psych facility which was my #1 choice on my short list...so we'll see a little bit of that, but not to the extent that a CD unit would. Thanks again!
  15. mingez

    Addictions vs. Psych nursing

    Thanks for responding. So is it the manipulation you don't like? Because in my unit, there are some very manipulative people. It's nice to run in to a nurse that loves psych as well.
  16. mingez

    Paleo/Primal Diet?

    I apologize for my retort to your cynicism as well. I'm pretty passionate about nutrition... Look, I understand. I'm a skeptic too. And the things you mention above about coffee enemas,etc, I agree it's crazy. But I rely on the research and science. I know it sounds like an insane amount of conspiracy theory..but I'm not about homeopathy or blood type diets, acupuncture... If you look at the diet, you'll see that it's not really that weird. The moniker "Paleo" (which I hate BTW) really makes it come off as hokey. The things I talk about are actually practiced in medicine and published in reputable journals. Ketogenic diets are legitamate (and the most effective) Tx for epilepsy. Nutrition research has become a strange hobby of mine as of late.