Saturday, April 9, 2011

I Really Miss Round Rock Hospital

Aloha,

Am just home from the second clinical day in a row for this week, and have only 6 more days (3 weeks) of clinical to do before it’s time for end of semester exams and then summer break……Hallelujah!!

My students are ending their second semester of a four semester Associate Degree Nursing Program. It’s an excellent program with a curriculum that is challenging, evidence-based focused, and patient centered. It is a program that demands students in it and the graduates from it practice within standards of care set by the Board of Nursing for Hawaii, accrediting agencies for nursing programs and for hospitals (NLN, JCAHO), and many professional nursing organizations that set forth standards of care specific to their professional area of practice. So, when patients are taken care of in a hospital, they should be able to expect and receive the best of the current knowledge and skills used by nurses across the nation to help them improve and leave the hospital as soon as possible. That should be a minimum expectation at any hospital facility when someone is a patient. This Hawaii Community College ADN Program (curriculum and faculty who implement that curriculum) does everything it can to ensure that these standards are understood by students and grads, and that they implement the standards throughout the two years as students and then into years of professional employment as RN’s.

I love the students. They are enthusiastic, and caring and compassionate, and sensitive to their patient’s pain, anxiety, fears, needs, and safety. Adhering to these standards reflects those traits which they each bring to the future career of nursing. However, there is always the ensuing element of each student being, technically, a novice and a learner. That means they will require assistance to process and learn techniques and policies or protocols for specific elements in the delivery of care on any assigned unit at any assigned facility. It is then inherent that the professional staff and support staff on these units be open to providing role models to these students, and to take opportunities to instill knowledge gained from their experiences into these future colleagues. Alas, that is not always how the interaction and presence of students on units are perceived by staff members. Today that was brought home to me in a very clear and unambiguous manner…..and by a Certified Nurses’ Aide at that!

I’m not going to go into details about what happened today other than say that in my efforts to follow up on a negative encounter a student had with the aide, this aide was explicit in her declaration of the role she and the other’s that she spoke of in the universal ‘we’ language felt was what they should be doing or rather NOT doing when students were on the floor. She made quite clear that my supervision skills were significantly lacking, and that I didn’t teach in the same way that more established and long standing faculty members did, thus mine was the wrong way to do it. The original trigger had to do with one of those standards and the differing perspectives on how implementation of said standard should be done. Student was chastised for doing it ‘wrong’ and then I was blamed for not teaching the student correctly. OK….ce’st la vive! But then I tried to talk to the aide, and that just blew up in my face. I am very very embarrassed to say that I actually left the unit and cried….I’m sure it’s a hormonal thing, but none the less…..I DO NOT CRY AT WORK….PERIOD!! So what triggered this unprofessional and silly personal reaction to something an aide said??? OK, you asked, and I’ll tell you what I think happened.

My clinical experience in Austin for the last 25 years has been with ACC – ADN students on the general medical-surgical unit at Round Rock Medical Center. I began there when there were less than 50 beds, and have been lucky enough to watch and help it grow to approximately 250 beds today. In that time, I was asked to work some extra time as a nursing supervisor who is the key administrative person in the facility other than the 8-5 M-F that ‘real’ administrators are working. I did that for 10 wonderful years, and gained many personal and professional benefits along the way. Additionally, I was asked to become an inaugural member of the hospital’s Ethics Committee, and when I left the only one of the original members left was the Chaplain who chaired the committee all these years. Lastly, due to the respect of peers on the unit, skills recognized during my stint as weekend or evening nursing supervisor, I was asked by the CEO to join the Board of Trustees, and was then later invited to do a third term because they wanted and needed an RN perspective in Board decisions. That was a total of 9 years on that Board. These and other less prestigious requests for my contributions to committees, continuing education, pre-JCHAO surveys, and staff debriefings were all based upon mutual respect and mutual love of the facility and the quality of care it consistently offers to all patients in it’s area. I treasure those years and the friendships and accomplishments made during that time.

In Hilo, where I have students, I am the newbie on the block. That was a given, and I knew that I would have to earn the respect and trust that I had left at RRMC. But, I have good people skills, and I love nursing. I have respect for each member of the health care team…..a caste system doesn’t help the patient. RN’s need aides to assist with some basic tasks, but RN’s should also do some of these basic tasks when time and situation warrant it. So each helps the other to get the best job possible done for the patient. To that mix you must add additional persons who are not directly giving care to the patients but who support that care…..a unit clerk handling posting of orders, phones, paperwork on admissions and discharges, etc. It also includes the Charge Nurse or on the 7Am to 7 PM shift, the Unit Director. They set the tone, the expectations, the morale level, and the team spirit that is present on any unit. If it isn’t starting at the top, then it’s certainly not present at the bottom…..thus this Unit Director has to be in the know about implied and subtle nuances around them. They need to be the role model for when guests, new employees, students or others are on the unit. That’s how it SHOULD BE. Unfortunately it’s not where I am.

There are exceptions to this sad tale of woe….but they do seem to be the exception. Some of the aides I have been able to win over with my usual style of treating them with respect, thanking them for input and assistance, and just trying to interact as a colleague not some evaluator of their performance. That has paid off with three of them. These three know that if they tell me after a clinical day is over that charting of Vital Signs was not done by student Suzie Student, then I will address it, and it will dealt with in the chart. But, somehow my reverse welcome wagon approach missed the aide I encountered today.

I’m diverging off my point here….why cry? Well, the undertones of questioning my ability as a nursing educator / clinical instructor have been present almost from the beginning. When my students (as second semester students usually do) began to add IV medications to the scope of what they could do in the medication administration skill, I had some catching up to do. Remember, I had only had first semester students for about 15 years now, and therefore had not worked with new equipment and pumps, nor new ways some IV drugs are being dispensed. Now wouldn’t you gain as much as you can from the same lab that the students were taught this topic, and then plan to clarify with staff if you have a question?? Yep, me too. But apparently asking questions was perceived as clear evidence that I was incompetent and therefore should not be there bothering them with my questions. I should come knowing all the answers and only deal with the students. Add to that, many questions came up as students were preparing to give IV meds thus it was added to the growing perception that I am not very smart and that the students were needing the staff to do my job instead of me doing it. The aide today made it very clear that students were not to ask aides or RN’s on the unit ANY QUESTIONS, because they can look in the chart or ask me, the instructor. I should know it or find it in the chart. That includes the location of supplies on the unit, Med Center protocols for Isolation, etc. (Those answers are not in a patient’s chart, by the way.) So, finally the cats out of the bag, the poop is in the bedpan, whatever…… I’m too dumb to work at McDonald’s. Just a last note….when clinical was over, the original student who had the run in with this aide tried to tell this aide thank you for her help and guidance today, and the response was the aide walking away while muttering “whatever”. I don’t think we will win this battle…..my bigger concern is can I win the war?

The Unit Director is less friendly than the staff or aides, gives every impression of being quite ‘put out’ when students are in her station zone to do ANYTHING….yet, charts are there, info on reaching docs are there, and other documents associated with patient information that are not chart based are there. We just have to occasionally go into her area. I do what I can to minimize any contact with this Unit Director, and definitely work to keep the students from irritating her. But, it will not be a 100% effective effort just because of the nature of the hospital unit.

What is inarguably being impacted here is the future replacement of nurses who leave hospital nursing. The average patient care unit job for RN’s is about 10 years. Look around the next time you go to visit someone at the hospital….what is the average age of the nurses working that unit. Older nurses move to areas that are less physically stressful and arduous, like Out Patient Surgery, or clinics or doctor’s offices. We need more nurses even now on patient units like this Medical-Surgical unit, much less needing them in the future. My students are saying to me that they wouldn’t work on this particular Medical Unit (Post-Surgery Unit is a separate unit one floor below us) simply because of this atmosphere of intolerance and apathy about their learning or their desire to join the ranks of these nurses. I find that very sad.

So, I will persevere for three more weeks. If I’m back there next year, I believe I will approach the interactions with staff differently. Being a colleague who just happens to come two mornings a week and work with students instead of doing the patient care myself didn’t work. I’ll just focus on the separation of church and state so to speak…..I’ll deal with student and they deal with each other.

But, then I doubt I can really pull it off…..I too much a people person who generally likes working with health care professionals like me!!

Thanks for letting me vent,

Janene

Sunday, March 13, 2011

Janene's First Tsunami

It used to be tornados that I would worry about, and track on the weather channel, and scan the skies for during spring seasons in Texas. Last year I traded that concern for a new Force of Mother Nature concern…..TSUNAMI. When you live near or within the Pacific Ocean Ring of Fire, these sequelae of earthquakes are a given. Here on the Big Island, and particularly in Hilo, two specific Tsunami’s in the past 65 years are still spoken of and remembered in memorials and story. The April 1, 1946 ( No Joke!) did considerable damage to the Hilo area. A small town just north and west of here was hit particularly hard. That was Laupahoehoe (pronounced Lowp-a-hoy-hoy). I’ll clip in a section from an interesting web page devoted to this tsunami for you here, but check out the web page as it has some pictures of the point area and school grounds prior to the destruction done by the waves.

Laupahoehoe is infamous for April 1st, 1946 when three towering tidal waves roared over the peninsula at 7:00 AM killing many residents including 23 students and four teachers. The children happily gathered fish deposited from the huge, but not deadly, second wave on the school grounds while the teachers were in their cabin changing back into dry clothes when the final huge (some say 50 feet high) and deadly wave hit. No one had noticed all the water being sucked out of the bay until it was too late. Only two children and one teacher survived. They remained in the water 10 hours while people on the cliff could get a boat for rescue since all watercraft had been destroyed by the tidal wave.
http://www.ghosttowns.com/states/hi/laupahoehoe.html
My friend Beverly Moodie had three of her childhood cousins die in this Laupahoehoe tsunami, and her cousin that is the older brother of the three still lives in the town. He survived because his school was in another area. Today, there is a Pacific Tsunami Museum in downtown Hilo which has tremendous displays on this 1946 tsunami. I hope to volunteer there during the summer.

In 1960, another tsunami was triggered by an earthquake off of South America, rated at about 8.4 quake, and 15 hours later the waves hit Hawaii. Only Hilo Bay was hit the hardest with waves as high as 35 feet. Eight separate waves came into the bay area, and severely damaged or totally destroyed the buildings of old down town area and many residences in the path. After that tsunami, the city rebuilt but put into place a very wide swath of parkland, parking lots, and other non-essential structures between the bay edge and the beginning of businesses. This was intended so that less personal loss would take place if another tsunami hit as directly as the 1960 one did. Today, there are soccer fields, parks, a large gazebo and bus commuter parking lots as well as the bus station located in this area. The down town area was rebuilt and retains as many of the original buildings as possible.

So….that brings me to last Thursday night! For many reasons, including the December 2004 Thailand tsunami, the Pacific Tsunami Warning System has been upgraded, improved, and more emphasis has been placed on disaster preparedness. On the first Sat. of each month, they test the siren warning system…..thank goodness! As a result, I knew exactly what had brought me suddenly to a sitting upright position at 10pm on Thursday evening. It had been a long day, and Nooli and I hit the sack about 9pm after some TV and a bit of reading….OK, and a glass of wine! When the siren went off, I knew immediately what it was. What I didn’t know was when, where, or how it would hit here. My cable TV was on the fritz, so I hit the good ol’ computer. There I was able to learn of Japan’s massive quake, and that we had several hours here before expecting THE WAVE to hit…..specifically 2:59am. (Why to they always say “approximately 2:59” – why not just say approx. 3am???) Anyway, I also knew that I was high enough not to be concerned about my home, but it was pitch black outside so that meant that it would not be a wave landing that I would get to watch…..drat!

First thing to do? Go see what the neighbors were up to, right?  OK…front windows which look out over the cul-de-sac and straight down Ala Muku St. and then out over the Boys & Girls Clubhouse to the Bay. Great vantage point if it’s daytime. But I thought I would see activity on the street…logical, yes? Well, no….either they are immune to these things or just don’t do that southern thing of gathering in yards to talk. Whatever!! Not a porch light came on, no one got in the car for a quick run to the gas station or grocery store….nada, kaput, nothing! OK…. So, I’ll just stay calm too. Put Nooli on a leash so I had him with me at all times incase we had to leave suddenly….he was actually fine with this arrangement as I think the sirens upset his sensitive little ears. The streaming videos and news radio on my computer kept me well informed of the initial reports out of Japan, and of the preparations going on for the Big Island and Honolulu. Because of the preparedness drills and improvements to the system and plan over the past years, the island and the state were well in control from the beginning. The coast line homes were evacuated by 2am. No one was allowed to opt out of the evacuation. I have since talked to a second year student who was in that ‘Move or Else!’ group. They went to friends’ house so they could take the kids and dog. She said that police came down the street with bull horns and there was follow up with door to door canvassing. EMS and fire were mobilized, and I’m sure that Hilo Medical Center was put on alert too. We only have one hospital on the east side of the island, so I still wonder what would have happened had this really been another Big One.

The rest of the night was a waste. They rang(?), blared (?), set off (?) whatever…the siren every 30 minutes until 3am. That was tons of fun! It only rang, blared, or sounded for one minute each time, but 60 seconds is a LONG TIME when you are getting blasted by a siren tower that is 5 blocks away from your house…..take my word on that. The only time Nooli got agitated and clearly upset was during the siren sounding. Otherwise, he was fine because he was oblivious to the danger…..ah, the life of a dog!

Meanwhile phones were down and I could not get a call out to the girls in Texas or Colorado. It might be my generation or my age, but I just never even thought about Facebook….sorry all you FB fanatics. It wouldn’t have helped much anyway as both girls were asleep. I was able to reach Alisa at about 5:30 her time (which was 2:30 am my time) during a short break in the cell phone system. She in turn got in touch with Kathleen a bit later when K. was up and heading to work….I think that’s how it went down. But, I could get texts, and two students texted to ask if I was ok, and did I need a place to go. They were offering me a safe place if needed. I really appreciated that and it further confirmed that I have made a home here with people and students who care about me. Bev and I had much earlier in my time here talked about if I ever felt the need to get higher up from the bay, I could come to her house which is much further up hill. But I didn’t and she knew that I was very unlikely to get any damage where my house is now.

My one concern was that I had procrastinated…..surprize surprise! …..going to the grocery store so I didn’t have a lot of food in the house. Alisa told me later that all she could envision was the three bags of Chex Mix that I had bought for the New Year’s Day Rose Bowl Game Party that hadn’t been opened and were in the pantry. She figured if anything, I could survive on that, and just never eat Chex cereal in any form ever again. Thank goodness it didn’t come to that horrific ending.

The University of Hawaii closed all campuses on all islands for Friday, and the Community College here also closed on Friday. That gave us a free holiday! Yea!! But, on a side note, the clinical papers that were to be ready for me to pickup at 3pm on Friday didn’t get brought in. So, I’m going to have a lot of papers to grade next week. Oh well, when it’s all taken together, I would rather just have the delay of a weekend, than all the ramifications of a bad tsunami hitting here in the early hours of Friday morning. As it was, Hilo got some nice lapping waves of about 3 or 4 feet hight which would be good surfing waves if anyone was stupid enough to be out in the bay with a surfboard.  So, no damage occured here.  Kona on the West side of the island which faces Japan did get higher waves, and some flooding near the coast in the downtown shopping areas.  Some of the beaches along the main tourist trail (Ali'i Drive) were closed still yesterday due to debris that washed up on them.  But no loss of life here on the Big Island, coincidentally named Hawai'i. 

Thanks again to all of you who were concerned. I have tried to make light of a long night watching my computer screen and trying to get some naps between sirens…..but it is a serious issue. Japan needs our prayers and our help. The video feeds since the start of the disaster have been beyond my ability to comprehend. Entire towns / cities were wiped away in one swoop of water. The loss of life is staggering. And the current issue with the nuclear power plants facing meltdowns is even more mind-boggling. If there is a release of nuclear products into the air, Hawaii is in a fairly dangerous position.

Please keep me and those of us in this 50th state in your prayers as well.

That’s all for now. The weather today is absolutely gorgeous, and is part of why I love living here. Take care where ever you are, and I’ll stay in touch too.

Janene

Saturday, February 12, 2011

Whirlwind Holidays 2010

You Hoo!! Over here!! Yep, your eyes don’t deceive you….it’s a blog posting from none-other than ME!! I’m sure you all thought that I had fallen off the lip of the volcano or somehow been sucked out to sea by the Hilo Bay tides……No, none of those things have happened (Thank Goodness!). It’s just been a whirlwind couple of months, and I’m finally discovering a window of time that lets me sit and write an entry for the blog.

You know, when I announced my plan to move over here, I was told that it would initiate an endless stream of visitors, so “Be prepared.” Well, I’m so glad for the warning because it let me ‘be prepared’ with places to go, things to do, gas in the car, batteries in the camera, snacks and wine in the house. Since mid-Fall it’s been a wonderful stream of loving friends and family, and I hope they have had as much fun as I have had showing them around my new home. Visits have come from church friends, a former student who has just finished the ACC nsg program, a fellow faculty member and good buddy, and, of course, family. A couple of the visits were less than a day and involved a bit of driving around Hilo and wonderful dinners at my favorite restaurant, Café Pesto. Marnie, my teaching colleague from ACC was here a week. She got in on the end of the semester fun and even helped me proctor and grade the Final Exam. Ahhh, a teacher’s work is never done!! Even if you are on vacation! Marnie is a wonderful guest, and one of those people who looks at her watch and says “We’ve got an extra 15 minutes, what else can we go see?” So with that outlook and her detailed perusal of Island Info, we went to the other side of the Big Island and saw the Pacific Ocean from that perspective, down to the volcano area and steam vents, and up to Mauna Loa Observatory Visitors Center and several other places in between. It was fun, educational, breathtaking, and one laugh after another with two old retirement age ladies gadding about like we had some sense. Nooli, the pup, went with us of course, and that added an entirely new dimension to the sightseeing.

Then my brother-in-law and sister-in-law, Craig and Susan Jeffery, came for Thanksgiving. It was truly a time for giving thanks…..for family, new beginnings, fast friends in the new world of Hawaii, beautiful views, and most importantly, thanks that Susan fixed the Thanksgiving Meal!! It was my proportional job to ensure that the table was set JUST RIGHT…..napkins folded ever so carefully, silverware on the right sides of the plate so our mothers would all approve, glasses with water situated at the exact angle to allow for easy access but not so easy as to block the wine glass. Whewww!! It was a tough job, but someone had to step up to the charge. Craig did his part by washing dishes after dinner……are these two just the BEST guests a woman could ask for??? YES, I say!!

The highlight of the holiday break, tho, came on Christmas Day when Alisa and Kathleen flew in from Austin. It was so good to see them and to finally show off the world they had heard about but not seen. We went to many of the same places that Marnie and I had gone to in Mid-Dec. but added some new fun to the mix. By Jan. 1, lava was actively flowing near the far south east corner of the island and we were able to view it from areas set up and monitored by security. Actually getting near and standing on ‘cooled’ lava of only a couple of days age can be quite dangerous. But, trails had been marked across firmer lava that had flowed over that spot only 2 days earlier…..we could feel the deep heat through our shoes. It was incredible to watch as new earth was being created by this lava flow. Literally, the Big Island is still growing. It was almost mystical to watch steam rise, and red hot slowly rolling blobs of lava moved along. Pele is still an active goddess, and she is letting us know that.

Kathleen has been interested in Astronomy since she took a college class on it, so we headed up to the Mouna Kea Observatory Visitor’s Center for a night time ‘star gazing party’ that is held each evening. It’s staffed by faculty and students from the Astronomy dept at Univ. of Hawaii – Hilo. You may not know it but this mountain, Mauna Kea, is the tallest mountain in the world – 4 x taller than Everest. But the catch is that the measurement is from the floor of the ocean. That’s just a little trivia tip to help you on your next round of Trivial Pursuit or Jeopardy….whatever! Because this mountain is in the middle of the island, and there are only two real ‘cities’ on the island (Kona and Hilo) the night sky is easily seen without interference from urban lights. For that reason, and the thinness of the atmosphere at just under 14,000 ft above sea level, and other reasons that apply to optics, and stuff I can’t explain they put some internationally owned and run observatories up on the top. For questions, contact Wayne Schade, he will be able to explain this stuff along with the inverse squared ratio. He’s a genius science teacher. The star gazing was really fun. It was fairly cool….about low 60’s or upper 50’s, but they had set up several small but high grade telescopes so we could see a variety of things. Great lessons given in short presentations about what we were seeing, etc. It was another highlight of the trip.

Additionally, the girls went snorkeling and Alisa was treated to a surfing lesson by two of my students. We also had some student company to watch the Rose Bowl on NY Day….TCU played Wisconsin just in case you weren’t aware…..shame on you!!....and TCU WON!!! One of my students was visiting family in Pasadena and saw the Rose Bowl Parade. She brought me back a pennant to commemorate the event. It was such fun having students, some of their incredibly well behaved kids, one boyfriend and more food than an army could eat all gathered at the house. I had a purple and white lei given to me by the daughters, and they wore their TCU shirts. A fun time was had by all!

Well, now the Spring Semester has begun. Same students, just different teaching content and increased pressure to perform in the clinical area (on them and on me). However, faculty is given a voucher for one free class each semester, and I decided to take advantage of it. In some fatigue induced trance –like state, I began to think that I should take an Hawaiian Language class…..sort of Hawaiian 101. Well, what do you know??? There IS a class called “Hawaiian Language 101”. A sure sign from God, you say! Well, God was joking and I didn’t see the twinkle in His eye to know that. Thus….I moved mountains to get the voucher in place and get accepted into an already full class that worked with my teaching schedule. HOORAY!! Well…. It’s eating my lunch y’all!! I mean that seriously, this is a tough language, and just because they only have 13 letters in the Hawaiian alphabet and have no silent letters in any words does not make it simpler or completely phonetic. There are okinos and kahakos and ….stuff! An okino is a glottal stop sound and looks like a backwards apostrophe but isn’t and is used to separate two vowels when they come together in a word. It’s written like you were writing a teeny tiny 6. It sounds like the break in the phrase uh-oh, almost a small hiccup type sound. So, my puppy’s Hawaiian name is Kino’ole and is pronounced Kee-no-oh-lay with the pause glottal stop sound between no and oh. Got that ? Good, cause now we’re off to kahakos. They are the line over a letter that shows the sound should be an elongation of the natural sound of that letter. So as you say a word, you slightly stretch out the sound within the full pronouncing of the word. Example: the state bird is a goose that is called a Nene…but written with a line over each of the Es. It’s pronounced Nay-nay. So, my name in Hawaiian could be shortened to Nene….which Craig immediately did. There is no J in the Hawaiian alphabet, so it becomes essentially an I. Thus Janene = Ianene with the lines over the two Es. Craig now calls me Nene, and the house Hotel Nene. I have honored his wisdom and humor by purchasing small “warning yellow” window signs that warn you not to feed the Nenes. They are very very strictly protected by the state since they are an endangered bird. But……I digress! The class is wonderfully taught by a delightful new faculty member and who is full Hawaiian. She is using the class to teach us about Hawaii, both the state and the island Hawaii, the culture, the myths, and the chants. Ah, yes, the chants!! We have one to learn and be able to do without cheat sheets…..yeah, that’ll happen in my lifetime. The chant we are learning is one of the many mythical stories of the birth of the islands, and includes names of gods, goddesses, and their children as well as each of the main 8 islands. It actually a fun chant to do, but I’m still looking at the sheet due to the specificity of the spelling of the words and names. There are even two field trips planned. The first is to a taro farm. Poi is made from taro, just in case you are wondering what the big deal about taro is. So, I’ll have to keep you posted on my ongoing language development.

I’m going to close out now. You’ve been stuck at the computer reading this blog for long enough.

By the way, the National League of Nursing Accreditation survey went very well, and we were given another 8 years which is Full Accreditation Status. It’s been a real stressor for all the faculty, and we celebrated with lunch on Thursday. Much relief had by all.

Aloha,
Janene ( Nene )

Saturday, November 27, 2010

Letter from K'nooli Jeffery

Bark bark, ruff ruff ruff…
That means “Aloha” in Hawaiian Dog language,

I’m Nooli, well really K’nooli, but my friends call me Nooli (like Moo-lee but with an “N”) and since you are all friends with Mom, you can call me that too.
I’m the newest member of the Hawaii Jeffery clan, and Mom said that I could add a blog entry and introduce myself. So, without any formal typing or writing training, here we go:

I’m adorable!! That’s just my personal opinion, but lots of people keep telling me that, and I trust the judgment of perfect strangers as I assume you do. I am a pretty color of golden-brown, have big dark dark brown/black eyes, and triangle shaped ears that fold over at the point. With my cute little face, it makes me irresistible….at least to people. I’m still working or the lady dogs to notice me, but I remain optimistic.

My Mom got me about a month ago, and since I don’t remember much of that first year as a puppy, neither of us is really sure about my previous life. I just know that I didn’t spend a lot of time whith humans like Mom, so now it’s really nice to have her scratch my tummy and behind my ears. However, it seems that moving into doggy-toddlerhood, I must have missed that serious outdoor potty training ‘cuz Mom seems to be upset with me when I ‘go shishi’ (pee) in the house on the nice redwood floors. By the way, does “Bad Dog” mean what I think it means? Thought so!

But I am really good when I can go out and ride in the car or a cart at a store. I love that! Mom lets me ride in the seat next to her because she says that I’m so good to stay in the seat and just watch things go by. I’m so busy looking that I forget to even bark. And recently Mom went to a big store that had lots and lots of interesting things in it. She called it Wal-smart or Wal-art or something like that. She let me ride in the cart and I thought that was tons of fun. People seemed to think that a really cute doggy in a cart was just the most interesting thing they had seen in a long time, and I was very polite to everyone. Since that day, Mom has let me go into other stores, but she says I can’t go to the grocery store. I think that not fair. I proved I can be good, but Mom said something about food….which I think would be a great place for me to go. But, NO, not the Sack & Save near the house. Oh well.

I love going outdoors. I have to stay on this silly rope-like thing and Mom always comes along. She really crimps my style too. Just when I find a juicy bug and interesting crawling thing, she pulls me back and goes another direction. Why would she do that?? Some of those bugs taste pretty yummy. Next door to us is another boy dog, Bender. He’s bigger than I am and is part pit bull. Nate is his owner and he says Bender is very gentle. Mom tells me she’s not too sure, so I’m not allowed to play with him. Just as well, when we bark at each other over the divide he doesn’t seem to like me telling him to leave me and Mommy alone and don’t come over to bother us. We talk often so I can reinforce this No Trespassing rule. Now the two cats that live a couple of houses over are a whole different story. They like to lie out on the driveway in the daytime sunlight. It drives me crazy!! I just yell and yell at them from the living room windows, but they don’t even try to move. Sometimes I think they just stay there to bug me!! Stupid Cats!!

We had some new people sleeping at our house the past few days. I heard Mom talking about brother-in-law and sister-in-law. They might have been here trying to get away from the police.... I’m not sure what the deal was with the law, but they were really nice to me. I just loved having them here. Only they didn’t want me to jump up on their legs or to practice anything that might be handy to know if a lady dog comes around. Otherwise, the brother guy took me for walks, and once, I even pulled really quickly and my rope-thing popped out of the sister’s hand. NOW THAT WAS FUN! I made it three doors down the street, and my mistake was stopping to tell that family dog to leave me and my family alone if he ever gets to come out of the house. The brother dude caught me and made me come back. And I had some other dogs I wanted to visit!!

Well, I can’t think of much else to tell you about me. Mom leaves me at home when she goes off sometimes. She says it’s to go ‘to work’….but sometimes that really early in the morning. She wears funny clothes on those days and comes home smelling funny. It smells a lot like a Vet’s office, but I don’t think Mom works in a Vet office. Maybe it’s like that but not a dog and cat place. Anyway, I’ll probably never know….she says I definitely can’t go with her to this ‘work’ place. Soooo, I stay here and just talk to the neighbors all day. I tell them lots of things but they don’t talk back. Mom’s lady neighbor next door said that I talked all day when Mom was gone….guess she was surprised that I could have that much to say for so long. Really, I’m just making sure that bad people don’t try to come in when Mom is not here, so I try to sound really big and mean. I think it’s working; no one has tried to come near the house when I’m at the front windows watching.

We just had a holiday for something about Thanks, and so I was thinking that I should say thanks to all of you for being such good friends of Mom’s and then, of course, friends of me. She says you all support her. I’m not sure what this ‘support’ stuff is, but Mom seems awfully glad that you all are there doing it.
I’ll stop now, mainly ‘cuz it’s time for dinner, and I love dinner!! Mom says she will write again soon.

Sending you doggie Aloha’s from Hilo,

K’nooli Jeffery

Saturday, November 6, 2010

HOW CAN THANKSGIVING BE 3 WEEKS AWAY?????

November 6, 2010

HOW CAN THANKSGIVING BE 3 WEEKS AWAY?????

It’s raining in Hilo as I write this blog entry. I’m told to buy several umbrellas, not the wimpy small ones, but big honking tent-type umbrellas, for the ‘rainy season’. OK….I can do that. Actually the rain cools things off, comes in intermittent spurts with some just pouring down, while others you can’t tell it’s even raining until you step out into it. I got to the grocery store today under very overcast skies, and just got the many bags into the house when the bottom dropped out. Great timing…..Go Me! I can gage the intensity in part by whether I can still see the Hilo Bay and large hotel complex from my living room. If they are all gray and indistinguishable, it’s a gully washer on the way fur shur!!

So, despite the onset of rainy season, I’m sitting here wondering where time has gone!! I got here on August 7, started work on my birthday the 16th, and have already done mid-semester clinical evaluations for my group at the nursing home, Hale Anuenue. Great place, by the way. So, Thanksgiving is less than 3 weeks away. My brother and sister-in-law, Kirke’s younger brother, are coming for the holiday. HOORAY!! It will be a fun visit and a chance to show off my new home town that I have grown to love.

But seriously, what have I accomplished in this short fast time?? Let’s see…..humm.

Well, #1. I have made a really good friend who has been ready and enthusiastic since I landed at the Hilo International Airport. Bev is one of those truly great friend who will go anywhere, do anything, and help a friend get acclimated to the new world order here. She recently held an Open House to officially house-warm her Vacation Rental apartment that I stayed in when I arrived. During the party, her cousin….did I mention she is a cousin to 98% of Hilo and Hilo area folks?....did an Hawaiian chant, then a blessing in Hawaiian, and then sang the Queen’s Benediction before we ate. Then later she sang native songs with two neighbors accompanying her on ukuleles. THEN…. Bev danced a hula for all the 50+ guests. It was beautiful, and she was so graceful and looked terrific in her slim flowered Mumu. The Hula is a long standing tradition and has survived many changes in the islands over centuries. Watching Bev, and her cousin who danced too, it’s easy to see how much a unique part of this lovely land this story telling dance is.

#2. Home has become my own, not just a feeling of short term vacation rental or hotel suite. The house has come together really well. Remember all that country themed décor I worked so hard to put into the Saber Trail house last spring? Well, no county style here, but no sea shell theme either….Kathleen would harm me if I did that as a theme. But I am making it an Hawaiian theme. Found an ad for Macy’s sale (they have incredible sales!!) on Hawaiian print bedspreads and comforters. The master bed room now has a red & white floral print comforter with red dust ruffle, and red/white/black accent pillows. I love it!! The guest room will have a Black & White Hawaiian theme to it. The spread has a repetitive black geometric-type symbol on a white background. My plan is to order some B&W reprints of old Hawaii scenes from a photographer here in Hilo. They will be the wall decoration to go with the bedspread. I also found accent pillows for that room, and one has a bit of red in it. The kitchen is a red theme too in accessories, and I enjoy the splash of color when I cook. So the house is feeling like a home.

#3. My many years of teaching experience has paid off well, and I am really enjoying the faculty I work with, and the students in the class. It was never my intent to bring ACC’s Nursing Curriculum to HawCC’s program. As a result, I’ve had a really eye-opening experience watching and learning from people who do things differently. What a novel idea!! Do things some other way than ACC…..is this heresy? NO….it’s a relaxed, student friendly, reduced stress, learn without faculty ‘saying’ everything-type of doing nursing education. Lots less lecturing, and even that is supposed to be interactive. The ‘class’ is divided geographically with 22 in Hilo, and 9 in Kona. Lectures are done over HITS which is Hawaii Interactive TV System, I think. Anyway, it’s a new challenge, but one I’m getting used to and enjoying. Labs are very interactive, with Kona doing theirs over there, and our students working with us here. Same exams are given to both groups, so lots of coordination, emails, attachments, and video conferencing goes on to keep everyone on the same page. As I said, my colleagues on the faculty have been gracious and generous with time, information, and friendship. Even the administrative assistant to the Program Chair spent about 30 minutes with me early in the semester driving me around the combined campuses of University of Hawaii and Hawaii C.C. She pointed out buildings, gave me history tidbits, overview of how and where the overlap of facilities occurs, and waited patiently while I picked up my keys…..actually someone from the key dept brought them out to the car so they could chat a minute with Luann. Talk about SERVICE! My office is the back corner of a converted classroom, and Joyce has the front quarter. She has been instrumental in getting me set up with a doctor here who I like very much. She also doesn’t just tell me where something is, like the master key box, but gets up and walks me to the area where it is. I could have found it, but she also gave me some unwritten policies about use, and where to find the key to the key box on weekends if I need it. My keys get me into the main nsg office as well as my office and some other zones. Sharon is level coordinator and she has been a true gift from God. She teaches so well, and I have learned so much from watching her. So, you say, old dogs can learn new tricks, and I say, yes! Laura is the third of our little band of merry educators here on the east side of the island. She is simultaneously working on her Ph.D from UH-Manoa (Honolulu) in an online format. She too has gone out of her way to tutor me through online resources for students, library access via web, school email via web, and many other things. We’ve done lunch and dinner some over the months, and laughed and learned about families, etc. Another growing friendship.

#4. Students!! What a delight. They have adopted me and love my Texas background. But, I’m no longer in Texas so they are trying to teach me a new Hawaiian word (or two) each time we are in class or lab or clinical. That’s a real hoot!! And, of course, introducing me to new foods is another dedicated task for them. My clinical group came to the house on the last day at the nursing home, and brought lunch. Justin wanted me to ‘just try’ some thing! in a dish from the deli. So I picked up a smooth piece of whatever….a SMALL smooth piece, and then made the mistake of turning it over. SUCTION CUPS!! No, NO , and NNOOOOO!! OK, I’ll try just this small piece….sorry, Justin….octopus will never be a food I rush to get at the pu-pu table (appetizers). But the Chicken dish was delicious. Another student has come by and helped me unload some heavy boxes and even set up a small cubical-like organizer for papers, etc. She is becoming one of the student’s that I know I will continue to stay in touch with after graduation.

#5. Added a new member to the Jeffery family. Yep, I got a puppy! He’s a darling small mix of Shitzu & Silky Terrier. Brown, black eyes, 8 lbs, and a year old. One of those great faculty members I mentioned above has connections at the Wiamea animal shelter, and they got him as a rescue dog. I don’t know all the history, but it’s obvious he was left alone a lot of the time. He wants lots of cuddling, and tummy rubs. But he also has not been socialized to strangers, so he growls and barks to show who’s boss when new people are trying to meet him. If they persevere and maybe even bring him a treat or at least let him smell them first, then he settles right down. I named him K’noole. One of the first streets I saw here was spelled Knoole, so the good old phonetic education I received in elementary school kicked in immediately, and I pronounced it Kah-noo-lee. Nope….not right! It’s really sounded out as Keno-o-lay. But I still say Kahnoolie in my head as I travel along it heading to work. Thus, puppy has been tagged as K’noole, or Noolie for short. My sister came up with the short version. I like it. He is responding to this new name finally, and not the old name he had….Yoda. It was because he has ears that make him resemble Yoda. Anyway, he is a great guard dog…too great. Since he can watch the entire front of the house and the length of the street from the floor to ceiling windows in our living room, he makes sure that cats, mailmen, neighbors, other dogs, and imaginary threats all know who’s house this is, and that they better steer clear. Or else!!! At 8 lbs I’m not sure what ‘else’ would be, but just the intimidation factor alone should count for something.

Well, enough for this posting. Hope your Fall is going as well as mine, and if I don’t get another post up before the 25th, Happy Thanksgiving!!

Aloha,
Janene

Saturday, October 23, 2010

THINGS THEY HAVE IN HAWAII THAT ARE NOT IN TEXAS

Oct. 23, 2010

Aloha friends and family,
I continue to love being here in Hilo, and am finally a ‘real’ Hawaiian…..I passed the paper and pencil Driver’s Test and am in possession of an Hawaiian Driver’s License!! Hooray!!! My picture on it is even a good one! One more sign that I am in the right place at this time in my life.

As acclimation to this new world continues unabated, I thought I would share some things that are now in my realm of awareness which you are missing. Let’s start with….

COQUI FROGS

You may or may not know that the Horned Toad or Horned Frog is the mascot of TCU. So, I am reasonably familiar and mostly comfortable with frogs in general. However there is a specific variety here that I had not encountered. The Coqui frog was accidentally brought to Hawaii from Puerto Rico. They are very very small frogs (less than 2 inches in length) which live within the leaves of plants where they can be hidden by folds and rolls of the leaves near the attachment point on the stalk. OK, so you say “what’s so bad about tiny frogs?” Since you asked, I’ll tell you. It’s the noise they make as they try to attract female companionship. For many people, the cacophony is sleep disrupting and quite annoying.

Allow me to describe an average evening here at my wonderful house on the cul-de-sac. These frogs sleep during the day….lucky little critters that they are. So, about 4pm or so they begin waking up and planning for an evening with friends. A few practice mating calls are heard, but they are sporadic and scattered over the foliage behind the house. By sundown the party is in full swing and hundreds of little frogs have begun to compete for the attention and whatever of the local girl frogs. These male frogs are hoping to strike it lucky with one or more loose women in the Coqui neighborhood. So they try to be louder and more interesting in their calling sounds. Squeaks, chirps, clicks (like a large toe nail clipper at work) and other variations on these sounds will be heard. Some sound like birds and can be misleading in that way. Friends from Austin who have heard them in the background when talking with me over the phone mention hearing a bird. No telling what they think when I tell them it’s not a bird, but a frog.

Now, I am not in the group who dislike the noise at night….and the joint is jumping through to early morning. Actually I sleep better with some type of ‘white noise’ in the background and usually have a fan on to create this very thing. So, the cocqui night club outside my open window actually contributes to this steady hum (?) of background noise. By about 2am the party has pretty much broken up, I assume because the guys got lucky or gave up trying because they were getting hoarse. Yet, there is usually one or two optimistic stragglers still calling into the darkness in hopes of hearing a returning….something….from that last, probably ugly, girl frog. Then things settle down for that day until the next night when the Coqui Club opens again for business. Check out Coqui frogs on Google, and they have links to sites where you can hear their calls.

PURPLE SWEET POTATOES

Yep, PURPLE Sweet Potatoes! Yesterday in the faculty meeting, my colleague, Laura, was eating one for lunch. The outside looks like a regular brown potato but the inside is the color of the TCU school colors. As I watched her eat it I had the strangest feeling. Do you remember hearing about a study done in which people were tested for likes or dislikes of regular foods which had been colored a very different color yet without changing the taste in any way? Green milk, blue mashed potatoes, etc.? People wouldn’t eat the foods or claimed they tasted different. Our perception of food and the taste of that food are closely linked to the colors we grew up seeing and eating. Right now, there is a move in America to introduce Red Celery to the public, but there is concern that people won’t buy it because of the unique color.

OK, back to purple sweet potato. I was almost getting sick watching Laura scoop out the purple potato ‘innerds’ and eat fork after forkful. She swears it tastes just like any other sweet potato. But as I was trying to pull my eyes away from this train wreck of a lunch, I remembered having ordered a lunch just a week or so ago that said it came with sweet potato salad. Sounded good. But when it arrived, it didn’t look orange. Instead it looked white with purple ‘stuff’ mixed in. Texture was all the same, but it never occurred to me that the purple ‘stuff’ was actually the sweet potato. OK, tell me why I could eat that salad, but not watch Laura eat all purple potato from its shell?? It’s a conundrum for sure!

MONKEYPOD TREES

Oh my heavens, these are gorgeous trees. They grow easily in Hawaii, and when they are growing in open areas of parks or greenbelts, they can get to be enormous. The leafy portion grows in a way that makes them look like huge umbrellas. They have a natural stop level for the lower branches so that they spread out with a horizontal edge at the base of the leaves, and a large corresponding sized arch of leaves over the top of the leaf section. Many of these are growing down near the Hilo Bay in the buffer zone of parkland that was established after the last Tsunami in the ‘60s.

Monkeypod wood is prized for use in wood working. You can pay quite a bit for large monkeypod bowls and trays, and such. They have a pretty grain so the wood item looks decorative and then the item itself is functional. If you come into possession of such a wooden décor item, treasure it. These are unique and will last a lifetime and beyond.

MORE FOR ANOTHER POSTING….

I’ll save the details about Paddle Surfing and Scuba Diving with Manta Rays for later. The former are fun to watch as these young people stand on their surfboards and paddle along on areas of calm water near the Bay. The latter is a nighttime tourist option in Kona, and Alisa says she wants to do that when she and Kathleen come to check on me at Christmas. I have elected to remain on shore for that little tourist attraction. Maybe on another visit…..yeah!!

Hope this finds you all doing well. School is moving quickly along here. My nursing home tour with students ends this coming Tuesday, and two weeks later, I get a new set of students who will go with me to the Cardiovascular Unit (read: Intermediate Step-Down / Telemetry Unit). That will be challenging and interesting. The unit is physically small, crowded, and has a high level of acuity (meaning very sick patients). It is very different from my comfy area at Round Rock Med Center…..but that is part of why I came over here. It will be interesting and I’m looking forward to getting more specific experience with that category of patients.

Hugs to you all,
Aloha,
Janene

Friday, October 8, 2010

WELCOMING PARTY

Aloha

Lots of things going on here, and I’m staying in the middle of most of them. I love it here!

Let me tell you about the big party that was given for all new faculty at Univ. of Hawaii – Hilo and the Hawaii Community College – Hilo last week. There is a group in town that was formed specifically to create community links with and between the University / College and the businesses and public leadership of Hilo. One of the important areas they see in this role is that of making new faculty welcome to the community and helping us assimilate into our new hometown. With that in mind, they annually throw a party for the new faculty and have speakers, fun information about the cultures and cuisines of the area, and entertainment (what would a party in Hawaii be without Hula Dancers??) as well as a feast of local delicacies and traditional dishes that would make your hair stand on end. Speakers included the Chancellor for the University system Hilo facilities, the Community College chancellor, and the immediate past University Chancellor, along with the Mayor (he was a hoot) and other important community leaders. Several state representatives were there but, thankfully, they didn’t speak.

Now…..about Hawaiian dancing…..!! Let’s clarify something right off the bat. I can’t sing (some of you are only too familiar with that deficit of mine) and I clearly have no rhythm for dancing. Stick figures look more graceful. There were two dance groups who performed, and both pulled those of us sitting near the front up to join them for part of the …dare I say ‘entertainment’? It was hard, sad, humiliating, funny, embarrassing, and tons of fun. Swaying hips only look easy. It took me months to learn to Twist in the 60’s and about that time the dance fad passed on to other fads. But I can still Twist with the best of them…..which of course doesn’t help a bit with doing the Hula. The second group was a younger age group (young to me anyway) who had on tight black outfits with silver hanging spangles around their hips. They combined some of the swaying of the Hula, but added much in from Tahiti where fast and suggestive hip shakes are the norm. Now picture me trying to do a tamed down version of this exotic and erotic dance style……STOP THINKING, it will make you go blind. But, despite not being able to do line dancing, hula or Tahitian dancing, I did get up there and try!! That’s what counts, right?? Please say yes to that.

They also introduced us to unusual local fare of the various cultural groups. Each was supposed to be very different from the mainstream dishes known around the world, and were said to be favorites of the ‘real’ people of those ethnic groups. We were reminded that many of these dishes came from years ago and were the outcomes from economic needs to not waste anything from an animal consumed for food. I’ll just let your imagination run with that for a few seconds………ok? Got it?? Yep….you got it. Well, they wanted a new faculty member to come up to try each dish as it was presented, and the idea was that this faculty member was adventurous and a good sport…..cuz some of these things tasted awful. Ok, I’m game for some things, and when I heard the word peanut in the name of the dish, I volunteered to try it. My first clue about this error on my part was when I got to the table, the comedian who was doing the MC’ing of the whole thing said, with a big grin, to his partner “I bet she thinks there are peanuts in this!!” Uh Oh!!! Too late to go back now. Actually, it was a piece of meat….mystery meat for sure, but it looked like a small chunk of pork, and tasted like that…..Thank Goodness! It came with a single Okra which I also ate. Got my well deserved round of applause and a nice little gift for agreeing to be a target, and finally got to sit down. Some folks had things that were much worse, like Chicken Tail and other dishes made from the far end of the animal. One woman just said “It’s an acquired taste” when asked about her taste test. But all in all it was a rare chance to learn about some innovative ways to ‘use all of the animal’ so that none goes to waste. I gained a great deal of respect for such ingenuity and perseverance in times of need. Today those dishes are family traditions at gatherings and special meals. Sort of like some of our special dishes we fix for our family gatherings….maybe my Cranberry Salad at Thanksgiving and Christmas would qualify for this sort of category.

At the end of the evening, they instructed (begged) the new faculty to take TWO of the table centerpieces home with us. Each one was different, and had fresh local flowers done in a beautiful arrangement. I took two that had such flowers as Antheriums of red and white, Bird of Paradise, and various greenery. They are still beautiful a week later. We also were given a tote bag full of lots of fun stuff along with a Tee-shirt for our College or University. I did feel welcome and appreciated at the end of the evening, and that was a first for me in any teaching setting. I love this place!!

On a more somber note, tho, at the beginning of the evening I had seen one of my students there who explained her boyfriend was a new HawCC faculty member and she had come to see him introduced. A few minutes later after going through the appetizers (pu-pu) line, I saw someone rush up to the edge of the pavilion where we were and in a clearly panic shouted that she needed a knife quickly. One was immediately grabbed from the food line nearby, and she rushed off. Seconds later, Anna, my student was at my shoulder whispering that there might be a need for medical help out in the park area. I followed her out and we walked about 20 yards to a covered picnic table area where some men were cutting down a young man who had tried to hang himself. The issue was that the rope was still too tight around his neck and they were working to loosen it when Anne and I got up there. That was successful, and they lowered him to the ground at which time the young man began to jerk and writhe and wrestle with those trying to hold him down to keep him safe. It did not demonstrate the usual seizure movements, and with his panicked look and struggling against the men it was more apparent that there was either some O2 deficit issues and/or drugs on board factors. Police and EMS had been called earlier by bystanders, and police got there quickly. The young man had no friends or family who came looking for him, but did have a wallet on him. I left when the ambulance pulled into the parking area adjacent to that spot in the park. It was obvious he would survive the attempt, but at what cost to cognition and emotional status is only a guess. This was a first for me, and I am still thinking about it a full week later. I have since learned that suicide among the youth and young adults in Hawaii is very high. It is a sad fact of living in this beautiful and caring part of the world. My hope is this young man can get the help he needs and look past the pain of the short time to a better long time in life.

Enough!! School is going well, my clinical group is doing well except for one poor soul who is just too tunnel-visioned to see the RN-level of big picture. He has not been successful in the learning lab, and is likely to not pass this semester clinically. Others in the group are not having difficulties, and are fun, funny, and enthusiastic about this new career they are starting. They make it worth my time to be on site and alert at 6:30AM…..and most of you know I’m NOT a morning person!!

With that update on some of the things in Paradise that I’m enjoying, I will let you quit reading for now. I promise to get back with a blog about my drive up to Wimea and the breathtaking coastal landscape that I drove along to get there. This island is magnificent, and I am looking forward to more exploration soon.

Aloha to all of you,
Janene