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sadbuthappy

sadbuthappy

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  1. sadbuthappy

    Are you conflicted? Ethics in the NICU

    I read this book called Baby at RiskI'm really hoping for a discussion. This book was published in 2006 so it's quite old given how fast medicine moves. And it has me conflicted about the history and how treatment is decided in the NICU. But I wanted to talk to actual nurses in the field to see how accurate it really is. Maybe the book is misleading. Here are some excerpts from the book about how some babies have been saved when maybe they shouldn’t have been considering what a low quality of life they go on to live. Stories like Michael from below scares me. It becomes more complicated when you think about the world’s allocation of resources. I know this is a difficult topic but I hope all of us can remain civil and not try to paint the other person in a bad light Baby at Risk: The uncertain Legacies for Medical Miracles for babies, families, and society. So from the book: none of this is my own words NICUs are horrible, wonderful places. They save many lives and they cause much pain and suffering The question that has hovered around these unites since they were first developed in the late 1960s is whether we can have the good without the bad or if whether the current balance of benefits to burdens is worth it. - one doctor tells the author ​ Dr Siva "If you draw a line \[ NICU rescues\] that is where progress stops. If you push the envelope, things might improve. But it's a catch 22. The questions when do you keep pushing and when do you say 'enough is enough'. ​ " The NICU in the United States today has gotten completely out of hand. When I came into the field in the 1940s, the hospital environment for babies was simple- clean, warm. Nurses would feed the newborn babies. Those who were meant to survive did, and if they did survive they did well. They who couldn't make it were allowed to die; they were said to be stillborn. People in this country act as though there are no limits. Yet there is a limit because human reproduction is an imperfect process.I never wanted to be a neonatalogy to be a speciality because the focus is too narrow. It doesn't allow docotros to see what happens next to the children they save. It doesn't allow them to see the consequences of their interventions as they fulfill their personal rescue fantasties. " Dr. Bill Silverman(a pioneer of the field) told the author. Bill regretted that he has allowed his commitment to an "unshakable obligation to prolong life" to trump all other considerations. Only later did he learn and come to appreciate "that most parents feared disability much than death. They feared overrtreatment and said so very directly. Dr Bill Silverman grew increasingly uncomfortable with the neonatology with the technological imperative that hurt babies that was driving many intensivists to use new technologies because they existed even when they didn't make good sense and the team think approach that was allowing individual interventions to absolve them from personal responsibility for the pain and suffering the interventions were causing the babies and their families. The diffusion of responsibility allowed people not to worry about horrendous consequences of their actions. Author talked about how babies born premature in 1950s were growing up blind from the oxygen gas in their intubators. The ventilators became the archetypal halfway technology getting babies only halfway to where they needed to be to lead healthy lives. A symbol of the first of the many medicines, therapies, the interventions that hurt the babies instead of healing them. Some words from parents with had babies that were NICU graduates "My son David was created by doctors. If the doctors could not give David a reasonable chance for a life of quality they should have let him die. And there's the old story- follow the money My insurance company paid $500,000 to this profit center. The doctors salvaged my son. They didn't save him. There are some things worse than death, an this is it " David was 13 years old when the author talked to him. He was functioning at the level of a three year old. He was born at 24 weeks. ​ Michael weighed one pound and fifteen ounces. He spent nine of his life life in the hospital and his days were fraught with interventions and crises -jaundice, bili light treatments, blood transfusions, brain bleeds, ventilator support, lung damage, poisonous levels of blood gases, breathing and heart problems. Michael is now six years, not toilet trained, will probably always need a feeding tube. His medical chart includes a daunting list: autism, bulbar palsy, behavioral difficulties, severe speech and language disorders, chronic lung disease, immunodeficiences, learning difficulties and so on. ​ Michael's mom Debby tells the author" I have to be honest and say I feel like we live in a prison. We're locked in the house because the outside world is not such a safe place for Michael, and yet neither is home. If NICUs are to continue to save extremely premature babies then the whole miracle baby myth needs to be dispelled. People need to realize that these babies comes at a price. No one warned us, for example, of the difficulties that kids with feeding tubes experience. We thought the tube would be in for a year and then be removed. But I've recently discovered that there is a chances that Michael will be in nappies at night for the rest of his life" ​ The author talked about the 2004 BBC documentary about 314 NICU graduates. 50 % had disabilities by the time they reached 2 and half of those disabilities were severe blindness, deafness, and cerebral palsy. 80 percent were dealing with physical or learning disabilities and impairments or both. ​ The author talked about NICUs had become profit centers and economic centers for certain hospitals. here is an article [https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.0897](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.0897) This passage near the end was thought provoking: ​ The NICU represents an "island mentality suggesting that economic development that improves the lives of a few peopl, while neglecting a vast peripheral population is a sound strategy for coping with the global crisis of resources and population. The NICU must be a temprorary historial phenomenom. Looking ahead fifty years to a world of a doubled population and even more greatly stressed world resources, it is incredible to think we will continue to invest social resources in such an extravagant and unbalanced way; and, if we we may well be charged by the next generations with inhumanity... \[as they\] count the lives that were not saved because our culture neglected the larger picture of life and death" Andy Jameton a philosopher wrote in around 1995. When the author asked him now he said he no longer thought that the NICUs would vanish because "profit centers are not very strict about whom they accept. Andy had come tho think more kindly about "rescue" although he felt that the US investment in rescue at the cost of public and environmental health was still "majorly excessive We need ways to do less and we need community decisions to decide what we are going to do". ​ But perhaps NICUs could make themselves more useful. They could be more discriminating. They could accept only babies whose chance for a healthy life was significant . They could stop accepting micropreemies and other babies, who, in low tech settings, would simply die- the ones who Bill Silverman had told me were once labeled stillborn. They could stop accepting babies whose "cures" were still just fantasies. ​
  2. sadbuthappy

    RN with Athabasca

    In what way are they more challenging?
  3. This program is in Edmonton Alberta and they have a both seated program and an online program. And I wanted to know if any of you had done the program and what was your experience like with the program another thing to be helpful is if you were able to get jobs after the program
  4. I'm really interested in case management and I am going to talk to an actual nurse that works with my mother. I wanted to ask her things like what's the best way to get into this field Can you do this field as a social worker? (is there any overlap) What is your average day? Can you get into this field straight from nursing school? What makes a good ur nurse? things like that. Pros and Cons of the jobs. Any suggestions would be appreciated. And I also want to make a good impression which is hard because I tend to be awkward. So any tips on that would be nice as well
  5. sadbuthappy

    Do They Think I'm Old?

    I would want to retire by 65. I hate that the economy is so bad and there is such a surplus of labor that people can't retire. I mean it's different if you want to work but I guess I had a different picture in mind. The world has changed a lot. Retirement as we knew I guess is sadly gone. I'm hoping I can still retire by 65 somehow. Anyways please don't feel inferior. I wonder if older guys ever feel that way about younger guys. I doubt it. Sexism. Why is so much of our worth tied to age and looks. I mean I'm the same way. I have gained some weight and got some wrinkles and it makes me very depressed. One of the reasons I want to be paid well is so I get afford some botox and laser treatments.
  6. sadbuthappy

    Health care administration - non nurses

    I'm sorry but I don't think it necessary that they need to have clinical experience. No offense but this seems just like more lobbying about how nurses are needed at every position. Nurses can make great administrators but non nurses can too
  7. sadbuthappy

    Feeling like giving up..

    I think you are being so hard on yourself. Maybe your working environment is not the best for you. And you are also a nurse otherwise it wouldn't be in your title. You might feel better if you went ahead and got your rn and feel like you are progressing .
  8. sadbuthappy

    Is there a pay gap in the nursing field?

    Since there is largely a female field I wonder if there is any difference. Also let's widen the discussion. How about for asians, blacks, and latinos. Is there a pay disparity there? I have heard a lot about the pay gap in hollywood (I don't know if you guys heard about American Hustle) so it made me curious about nursing. Also how do you guys think we can close it. I don't know about any wage gaps but for me what is more interesting is the abuse nurses get from doctors or patients or other nurses. To me that seems like one of the biggest problems in the field. I've heard stories about surgeons throwing knives at nurses, nurses being pushed by patients, nurses often get the blunt of it in a sense. Anyways your thoughts?
  9. sadbuthappy

    Better Looking females get better grades?

    well according to this study... it didn't make a difference with men!
  10. sadbuthappy

    Nursing or Speech Pathology

    Nursing adminstration pays very well (frankly better than SLP)and your MBA experience would really shine through. And again the options in nursing makes it a no brainer in my opinion. Plus speech pathology programs are very expensive while most nursing ones are not.
  11. sadbuthappy

    Is it worth it to go get your MS in Clinical Informatics?

    It also depends how well you excel on the program. If you do good in this field and excel then it would be worth it. IT people can make a lot. However it more about skills and excelling in the career rather than getting the degree. I know a lot people who don't even have degree but making big bucks because they are so good at this stuff.
  12. sadbuthappy

    Better Looking females get better grades?

    I know this isn't a direct nursing article but nurses spend their fair share of time in the classroom and many on here are still students and wanted to know your thoughts on this. What do you guys think? What has been your personal experience in the matter? Attractive nurses do you think you get special treatment? I thought this was sad. I think the difference is worse when it comes to earnings. Why even in this day and age are still so much emphasis put on a female's looks. More attractive female students enjoy higher grades in the classroom.
  13. sadbuthappy

    Anatomy and Physiology

    The nursing school you apply will accept online classes. None of them at Northern California do! Where are you located may I ask? You are so lucky!!!!
  14. Does anyone know of anyone or any opportunity for a desk job with someone who has an associate degree in songraphy. With additional pursuit of a BS in healthcare management online. Please help
  15. I have been having this fear since late 2011 and it has really held me back academically, socially,etc. I don't know it's this fear of people belittling, putting me down, passive aggressive behavior. And since nursing can have more of this behavior (from what I have heard) I really haven't been able to pursue this career even though I think it could something I could. Any input would be helpful . Thanks in advance.
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