Leaning In, Leadership, Ladies!

I just read Sheryl Sandberg's book Lean In about women in leadership positions. She is a very good author, but an equally articulate speaker. I found this TED Talk a powerful reminder of how social change is both an individual and societal act. Enjoy!

Thinking outside the box: Fighting Fire with Fire- using HIV to fight Cancer.

How to start a movement

Gratitude and Happiness: Say thank you today!

Why are American health care costs so high?

Games: for your health

This video by Jane McGonigal is fantastic. It talks about the value of playing as adults, but also about this woman's struggle with illness and how creative play gave her a tool to help her help herself through the healing process of a traumatic brain injury.

I found her discussion on post traumatic growth to be insightful because some people do persevere and recover from a traumatic event and those people are thought to be 'lucky' or 'resilient.' Rather this shows that they are simply using a different set of tools. The nice thing is tools can be shared, like McGonigal talks about here.

here is a link to here to her website as well: https://www.superbetter.com/

Body language: a good lesson for new nurses and old nurses alike

In an earlier post I had mentioned the power of body language to influence our behavior and feelings. We have known for a long time that forcing our selves to smile makes us sound nicer on the telephone and can cheer us up. As a dog owner, I learned the equivalent of this with my dogs that you can hold their tail up when they are scared and that this cheers them up too. Our moods are incredibly responsive to our body's actions. It is counter intuitive in many ways, but biology often drives behavior.

I stumbled across this TED video and it made me think about how hard it is to teach communication to new nurses. I felt that I learned next to nothing in my nursing communication course except for how to prepare an SBAR (that will be for another post). I don't think the communication and confidence "thing" clicked until I started my job and realized I had other people's well being in my hands. I emulated my coworkers and quickly learned what did and didn't work.

There is very little, apart from life experiences, that can prepare you for the occasional dose of crazy patients, aggressive doctors, or bullying coworker nurses. I thought this video was a great reminder to how to not read only others, but to read ourselves in the great game of communication. Enjoy!

Kidneys: the water treatment plant of your body

It seems some things come in waves. A few weeks ago every time I got an admit it was a GI bleed, in the last 2 weeks it's been kidney/renal problems. 

For some reason I find kidneys to be mysterious organs - maybe it's because it seems like they are hiding back behind the rest of the organs like they have a secret? Or the fact that you have 2 of them, but can live with 1? Anyway, I thought it was a great opportunity to review the basics. 

First, this short 45 second video is a great big overview of the kidney (plus the English accent is funny- especially the word for capillaries):

All right, so we know the kidneys produce urine. But that's not the only thing you kidneys do!

Here are some of the other very important and necessary functions of kidneys:

Excretion of waste:

Kidneys remove waste produced by your body's metabolism. Major waste products would be urea (that makes up uric acid) and nitrogenous wastes. To much of either of these waste products does intense damage to the body and brain. Often times in renal failure people will present with altered mental statuses because of the build up of waste products that starts to affect their level of consciousness or even personality.

Acid/base balance:

Our body tries to maintain a neutral pH. Carbon dioxide (CO2) and hydrogen ions (H-) are both acidic substance in our bodies. Bicarbonate (HCO3) is a basic substance in our bodies. Our lungs regulate the CO2 through breathing. Our kidneys can regulate HCO3 by not filtering it out of the blood and into the urine. The kidneys can also regulate acid by filtering out H- from our blood and into the urine.

Fluid volume regulation:

The entire goal of the human body is to reach homeostasis. With everything. Really, your body is like Goldilocks, it doesn't want things too hot or too cold, too acidic or too basic, too full or too empty. Fluid volume is another one of these markers. 

The body- more specifically the hypothalamus in the brain-  is constantly monitoring your fluid volume and telling the kidneys through hormones messages - "okay - we are too full, take more fluid off " or "we haven't had a drink of water all day - get rid of waste, but hang on to the water!!!"

Blood pressure:

This is related to fluid volume, but also to your body's needs. If you go for a run, your blood pressure is going to go up because your heart is pumping and your muscles are demanding more oxygen and want to get rid of waste. Blood pressure at the kidney level has to do with the retention of sodium. When we need our blood pressure to increase, the kidneys get a signal to retain sodium, because water follows salt. When you keep your sodium, you keep your fluids and your blood pressure increases. 

In cases where someone has high blood pressure because they are unhealthy or sick, one medication that is often prescribed is a diuretic. These medications often cause the kidneys to release the sodium into the urine. Again- water follows salt - the salt leaves, so does the extra fluid, and voila - your high blood pressure patient's blood pressure decreases and they have to urinate fairly frequently.

Production of red blood cells:

So far we have talked about hormonal messages traveling to the kidneys to activate a response. However, kidneys are responsible for releasing their own messenger called  erythropoietin. When the kidneys sense they are not getting adequate perfusion (meaning their own red blood cell/oxygen supply is not sufficient) this hormone is released and sent to the bone marrow to stimulate the production of more red blood cells. In patients with renal damage, they tend to be anemic because this function is damaged and the bone marrow never gets the message to make more red blood cells.

Now go drink some water and appreciate everything your 2 kidneys do!