Analyze some of the key issues facing graduate education, currently and in the future, including nursing's fit within academe, the faculty shortage, faculty workload, economic and resource influences, and the current shifting sands about graduate preparation in terms of the doctorate of nursing practice and if and where it fits. Support your arguments with detail from the literature and personal experience.
Due tomorrow. Don't forget the module responses, the journal article, the powerpoint of the journal article, the discussion responses, and, oh yeah! The other class. Hey, thanks a lot! I really appreciate'cha.
In better news, I got to learn how to do this cool dressing change the other day. Here's what the system looks like, all set up. Basically, for any deep wound with a lot of drainage or, conversely, too little drainage (a dry wound with necrotic gunk), we line it with this foam stuff and then apply vacuum -- the negative pressure draws the edges of the wound together, clears out any pus, etc., and encourages the growth of new tissue in the bed of the wound. It works just like like
The actual dressings look like thick furnace filters. They can be carved down to fit the exact shape of the wound, and little bits and pieces can be jammed in to fill up nooks and crannies and tunnels (just gotta keep track of how many bits and pieces, because new flesh has a tendency to grow through and over the sponges, ew). Then a clear dressing is applied on top to make a seal, and a vacuum hose is stuck on that. When the vacuum machine is turned on, it's so cool -- you can actually see the sponge crush down into the wound, and the edges of the wound draw together, and gunk immediately starts flowing out through the tube into the collection cannister. Not a great feeling for the patient, but the discomfort passes pretty quickly, I'm told.
The patient I did the dressing change on has an ostomy right next to her midline incision, so that made fitting the clear dressing on top complicated. But the sponges and the opsites can be cut to fit any shape, and I just keep remembering my one poor lady back in the day who had the ostomy right next to her dehisced midline, and we couldn't get a good seal on her ostomy pouch because she had many """" rolls of fat, so all the poop kept seeping straight into her incision, guh, and... sorry. More breakfast, anyone? Anyway, a Wound Vac system would have been perfect for her, even though her incision was eight inches deep. Coulda packed that furnace filter right in there, and sucked out any gunk that seeped in. Also, the dressing changes are done only every other day, so that would have saved her from getting her gut packed and unpacked seven times a day, like we had to because of the poop.
Okay, that's plenty of that for today. :(
And in less gunky news (perhaps), Mal has discovered that if he spills a little water out of his bowl onto the kitchen floor, he can get a good sliding surface for the water bowl and the food bowl and himself. So every morning, after I've banished him in the wee hours for singing into my ear ("BRRRRRRRRRTTP" times a million, in many keys), I can hear him and the bowls skating around the kitchen floor and banging into cabinets and the fridge and the stove, and when I get up anymore I have to put on my slippers, because the kitchen floor becomes a lovely soup of mushy cat nuggets.
Oh, hey! One of my friends has a pregnant cat, so I might take one of the kitties. That oughta settle Mal right down, a little friend to play with. Right? o.0