It카지노 게임 컬렉션s the end of May. Kate Kemplin is sitting in a hotel room near Windsor, Ontario. She카지노 게임 컬렉션s self-isolating for 14 days after spending two months on the COVID-19 healthcare frontline in New York City. Two months of brutally long days, setting up protocols, developing practice guidelines, and caring for patients in a giant enclosed 카지노 게임 컬렉션bubble카지노 게임 컬렉션 on a soccer field at Columbia 카지노게임사이트카지노 게임 컬렉션s campus. All so that she and other former military health-care personnel could take some of the strain off New York카지노 게임 컬렉션s overwhelmed hospital system,which saw more than 72,000 patients with COVID-19 by the first week of April.
Kate can카지노 게임 컬렉션t see her kids yet: they don카지노 게임 컬렉션t even know she카지노 게임 컬렉션s back home in Canada. 카지노 게임 컬렉션It would be mayhem!카지노 게임 컬렉션 she says, if her son, age 4, and daughters, 10 and 13, knew their mom was so close but still unavailable. But she카지노 게임 컬렉션ll be home soon.
And besides, these are resilient kids: they카지노 게임 컬렉션re Army kids. They카지노 게임 컬렉션ve always known a world with one parent being deployed away from home for extended periods of time. And on top of that, their mom is a nurse. And they know that nurses are badasses who get things done.
Here are three and a half chapters in the life of Kate Kemplin: trauma specialist, researcher, professor, and badass nurse.
Chapter One
It카지노 게임 컬렉션s 1997. Kate, born in Canada and raised in the States, arrives in Kingston to begin nursing school. She is 17 years old."My childhood was카지노 게임 컬렉션complex,카지노 게임 컬렉션 she says. 카지노 게임 컬렉션I was 카지노 게임 컬렉션 and still am 카지노 게임 컬렉션 awkward socially and was lacking a lot of life skills. Before coming to Queen카지노 게임 컬렉션s, I was able to skate academically. Not here. I wasn카지노 게임 컬렉션t the best student in Nursing, which, as I recall, then had 66 per cent attrition rate from the first year to graduation.
카지노 게임 컬렉션First year was a gauntlet 카지노 게임 컬렉션 core courses in biochem, anatomy, philosophy, physiology 카지노 게임 컬렉션 most were taken with pre-med and other health sci students. They all kicked me in the teeth. None of our courses were watered down for nursing. This profoundly shaped my view of my profession as a serious and important one. Never have I felt that I am 카지노 게임 컬렉션just a nurse카지노 게임 컬렉션 or academically unequal to physicians. I had to fight for every point in every grade in almost every course. Clinically, I was sound 카지노 게임 컬렉션 I felt at home in hospital and taking care of patients. Professor Cheryl Pulling supervised my first dressing change. Unbeknownst to us, the patient카지노 게임 컬렉션s wound was actually open-chest 카지노 게임 컬렉션 to their sternum 카지노 게임 컬렉션 and very complicated. She said that I turned every shade of grey changing the dressing, but I nailed it.카지노 게임 컬렉션
With the help of classmates and housemates, Kate started to build new skills. 카지노 게임 컬렉션Julie Lorenzin (Artsci'98, NSc'01) and I didn카지노 게임 컬렉션t cross paths initially,카지노 게임 컬렉션 says Kate. 카지노 게임 컬렉션She was a front-row keener and I was the kid in the back row wearing pajama pants.카지노 게임 컬렉션 But they clicked: 카지노 게임 컬렉션Julie taught me to be a scholar and I think I coaxed out her inner rebel,카지노 게임 컬렉션 says Kate, who is still close with Julie, now a nurse practitioner in London, Ont.
But Kate was still struggling.
카지노 게임 컬렉션Theoretical courses were painfully nebulous for me,카지노 게임 컬렉션 she says. 카지노 게임 컬렉션But in third year, my statistics professor astutely referred me for a full neurocognitive testing battery because I was bombing her course. I was so conditioned to being ashamed of my flaws that being diagnosed with disabilities was devastating. I tried to speak of them once to an immediate family member and the mockery was both unsurprising and unimaginable. So I hid them for years, even though logically, I knew they were neurological and not behavioural in origin.
카지노 게임 컬렉션Queen카지노 게임 컬렉션s was a great equalizer for me because everybody was the smartest kid in the room. I think I learned there how to struggle with being average in comparison, and how to persevere. That said: I카지노 게임 컬렉션m white. I didn카지노 게임 컬렉션t have structural or historical obstacles stacked against me, nor did I have to swim against the ostracizing tide of Queen카지노 게임 컬렉션s lack of diversity. I grew up in theAmerican south and distinctly recall how eerily white Queen카지노 게임 컬렉션s was 카지노 게임 컬렉션 and still is. So 카지노 게임 컬렉션struggle카지노 게임 컬렉션 and 카지노 게임 컬렉션persevere카지노 게임 컬렉션 are relative terms when evoked by someone with my racial privilege.카지노 게임 컬렉션
Kate graduated from Queen카지노 게임 컬렉션s Nursing in 2001 and returned to the States. She wasn카지노 게임 컬렉션t sure where she was going next, either in life or in her nascent career. But that September, she figured out her next move.
카지노 게임 컬렉션When the World Trade Center was attacked, people were dropping what they were doing and heading to New York. A friend of a friend was working for FEMA. He was in our hometown visiting and was heading back to New York.카지노 게임 컬렉션 Kate decided to go with him. She was a nurse and nurses would be needed. Somehow, she could help.
All planes were grounded, so they drove 20 hours to get to Manhattan.
카지노 게임 컬렉션We crossed the Bayonne Bridge on September 12th and could see the financial district from that height. It was so dark. We could see the lower tip of Manhattan, and it was a void: a black pit, with smoke coming out of it. There were lights in other parts of the city, but none there 카지노 게임 컬렉션 except for spotlights.
카지노 게임 컬렉션My hub was Moran카지노 게임 컬렉션s Bar and Grill at the North Cove marina, a short walk west of the site through the Winter Garden Atrium. On my third day there, an FDNY chief seconded me to be medical support to their special operations/dive team living on the Firefighter, a massive fireboat pumping water from the Hudson River into the Trade Center fire. For a few weeks I worked and lived with them.카지노 게임 컬렉션
At first, she stayed on the Firefighter, ready to provide medical treatment to the crew if needed. Kate was easily 20 years younger than any of the guys on the crew. She reminded some of them of their daughter, others of their niece or kid sister. One of them gave her a hard time, saying, 카지노 게임 컬렉션What are you here for, just to sit on the boat and make it smell nice?카지노 게임 컬렉션 Kate pushed back. 카지노 게임 컬렉션Listen,카지노 게임 컬렉션 she remembers saying. 카지노 게임 컬렉션I카지노 게임 컬렉션m not just here to look pretty.I play rugby. I can take a hit.카지노 게임 컬렉션 Unspoken were the words: 카지노 게임 컬렉션I카지노 게임 컬렉션m a nurse. I카지노 게임 컬렉션m not scared.카지노 게임 컬렉션
Kate earned their respect. This feisty kid, right out of university, had showed up. She didn카지노 게임 컬렉션t know what she would be facing, where her skills would be needed, what would be asked of her. But like any one of the first responders, Kate went straight to the hotspot, ready to face the unimaginable disaster that was 9/11.
Kate accompanied firefighters to the pit, the deep smouldering emptiness that was what remained of the Twin Towers. At first, she stood at the edge of the pit, masked and suited up, and watched her crew disappear underground. Later, she went with them, wearing a safety harness and PPE as they did. She remembers climbing twisted girders that once held up skyscrapers. She doesn카지노 게임 컬렉션t go into detail about what she saw there. She says simply, 카지노 게임 컬렉션I returned home just after my 22nd birthday that October.카지노 게임 컬렉션
Looking back now, she says, 카지노 게임 컬렉션I sometimes think about my 21-year-old hubris: who thinks that they can just go to New York and do something meaningful there? Who really has that kind of arrogance?카지노 게임 컬렉션 She pauses. 카지노 게임 컬렉션But I don카지노 게임 컬렉션t even know if it카지노 게임 컬렉션s arrogance. I think it was just faith that I had the background and the training카지노 게임 컬렉션and the backbone.카지노 게임 컬렉션
But when Kate left New York, she found herself unable to fit comfortably back into normal life. She started working at a hospital, but once again, she found herself at odds with her surroundings. Working on a safe, clean hospital floor so soon after being at the pit seemed surreal to her.
카지노 게임 컬렉션I found it extremely hard to relate to co-workers 카지노 게임 컬렉션 and even patients 카지노 게임 컬렉션 who hadn카지노 게임 컬렉션t been affected personally by terrorism. For the life of me, I could not understand their perspectives 카지노 게임 컬렉션 how could anyone complain about anything during that time? They weren카지노 게임 컬렉션t burned alive or forced to jump from a skyscraper. They didn카지노 게임 컬렉션t wake up one morning as usual and were violently widowed by lunchtime.
카지노 게임 컬렉션I was really an island unto myself,카지노 게임 컬렉션 she says ruefully, 카지노 게임 컬렉션intolerant and out-of-place. I was going to change careers카지노 게임 컬렉션and then I rotated to the emergency department and found my people. It카지노 게임 컬렉션s still the only professional environment in which I feel completely at home.카지노 게임 컬렉션
Once again, someone in Kate카지노 게임 컬렉션s network reached out to her, and she seized the opportunity to make a change in her life, to make a difference.
Chapter Two
"Firefighters I had gelled with in New York lived about an hour from the city and a couple of them cajoled me into moving to that area.카지노 게임 컬렉션
Kate began working as a nurse again, this time in a large emergency department in a busy rural hospital. There, she met a handsome young soldier home between Army assignments.
카지노 게임 컬렉션With more emotion than reason, I married him and started to build my career at whatever duty station we were assigned to.카지노 게임 컬렉션 Balancing her work as a civilian nurse for the U.S. Army, Kate also started a master카지노 게임 컬렉션s degree in nursing at Loyola 카지노게임사이트 in New Orleans. Just after she had been accepted in the program, her husband Michael was transferred to a base in Germany.
The years went by. Kate and Michael welcomed their first daughter, and then their second. As a trauma and emergency nurse specialist, Kate had treated a wide variety of medical issues and injuries, most of which were familiar. But there was something new emerging in her patients, something she hadn카지노 게임 컬렉션t come across before.
카지노 게임 컬렉션Around 2006, I noticed soldiers who카지노 게임 컬렉션d deployed to the Middle East were presenting clinically with non-specific issues: disordered sleep, inexplicable anger, headaches, memory loss, relationship dysfunction. Every single one of them had blast exposure 카지노 게임 컬렉션 often repetitively 카지노 게임 컬렉션 while deployed, but no previous history of head injury or significant psychological abnormalities."
Intrigued by this new phenomenon, Kate shifted the focus of her graduate studies at Loyola to combat-related traumatic brain injury.
Traumatic brain injury 카지노 게임 컬렉션 TBI 카지노 게임 컬렉션 occurs after a sudden trauma or blow to the head disrupts the function of the brain. Most of us are aware of the potential for concussion from a fall or sports injury. A concussion is medically classified as a TBI. But it is not necessary to have been physically hit to experience a traumatic brain injury. Blast exposure 카지노 게임 컬렉션 close proximity of a person to an explosion 카지노 게임 컬렉션 can damage the brain significantly from crushing air pressures. Blast waves can create microscopic tears in the tissue and blood vessels in the brain, with serious consequences. The phenomenon of 카지노 게임 컬렉션shell shock카지노 게임 컬렉션 documented in soldiers in the First World War, once classified as a neurosis or psychological shock from the horrors of war, is now considered to be traumatic brain injury caused by proximity to artillery fire and explosives.
Kate threw herself into her graduate work, focusing her research on 카지노 게임 컬렉션mild카지노 게임 컬렉션 TBI 카지노 게임 컬렉션 카지노 게임 컬렉션mild카지노 게임 컬렉션 being a clinical term she loathes 카지노 게임 컬렉션 and injuries sustained from blast exposure. She developed data sets and extrapolated projected clinical findings.
And then her work came close to home.
Michael was deployed to Iraq. 카지노 게임 컬렉션In December 2007, an explosive-formed penetrator 카지노 게임 컬렉션 a bomb designed specifically to penetrate armor 카지노 게임 컬렉션 detonated under the seat of my husband카지노 게임 컬렉션s vehicle when they drove over and triggered buried sensors.카지노 게임 컬렉션 Michael walked away from the explosion without a scratch.
카지노 게임 컬렉션Michael was physically intact,카지노 게임 컬렉션 says Kate, 카지노 게임 컬렉션but soldiers in the same vehicle had detached retinas and were bleeding from their ears and noses.카지노 게임 컬렉션
Her husband returned to duty within 12 hours.
카지노 게임 컬렉션I knew his regiment카지노 게임 컬렉션s physician professionally,카지노 게임 컬렉션 says Kate, 카지노 게임 컬렉션and I remember sending him an email saying, 카지노 게임 컬렉션I know just enough about TBI to be a real pain in your ass about this.'
카지노 게임 컬렉션But, back then the attitude 카지노 게임 컬렉션 which, honestly, still persists now 카지노 게임 컬렉션 was very dismissive. Unless you were physically injured enough to warrant evacuation to Landstuhl [a U.S.-run military medical centre], soldiers maybe got a night카지노 게임 컬렉션s sleep and then went back to the mission without neurological rest or treatment. Based on what we are seeing now, that practice could prove fatal to many soldiers down the line.카지노 게임 컬렉션
Michael finished his deployment and came home. But he wasn카지노 게임 컬렉션t Michael anymore.
카지노 게임 컬렉션It was like watching my graduate studies of TBI unfold before my eyes: every trope about TBI affecting personality, function, and relationships was happening inside my own home. It was exacerbating my shortcomings and exposing my worst qualities as well. Everything was disrupted.카지노 게임 컬렉션
Kate tried to get professional help for her husband. She knew what was happening to him: she knew the science and, as a nurse, she had the inside connections. But she also knew what she was up against.
카지노 게임 컬렉션Many soldiers will neither seek nor accept help for neurological injuries, because those usually manifest in aberrant behaviour. So getting help for what soldiers perceive as personal shortcomings is often professional hara-kiri,카지노 게임 컬렉션 she says soberly, 카지노 게임 컬렉션despite all the platitudes of support from military public relations outlets. To this day, speaking out can be career-ending. There was a general who spoke publicly about his struggles a year or so ago. He was immediately ostracized by his peers and the military. A general. Now imagine enlisted soldiers trying to fight against that pervasive stigma.
카지노 게임 컬렉션That said,카지노 게임 컬렉션 she continues, 카지노 게임 컬렉션retired generals like Gen. Peter Chiarelli put their money where their mouths were and moved the needle on TBI. When I was contracted to develop data capture for the Department of Defense, I was asked by my boss to draft policy and 카지노 게임 컬렉션pretend it카지노 게임 컬렉션s going to the White House.카지노 게임 컬렉션카지노 게임 컬렉션
카지노 게임 컬렉션Sir카지노 게임 컬렉션is it going to the White House?카지노 게임 컬렉션 Kate asked him. She didn카지노 게임 컬렉션t get a direct answer, just a deadline from her boss before he hung up the phone. But shortly thereafter, on Aug. 31, 2012, President Barack Obama issued an Executive Order titled 카지노 게임 컬렉션Improving Access to Mental Health Services for Veterans, Service Members, and Military Families.카지노 게임 컬렉션
카지노 게임 컬렉션About three bullet points and five sentences in that Executive Order may have originated from me,카지노 게임 컬렉션 says Kate. 카지노 게임 컬렉션Nursing science possibly influencing national policy, even within one paragraph? I카지노 게임 컬렉션ll take it.카지노 게임 컬렉션
At home, Kate was fighting hard for 카지노 게임 컬렉션 and with 카지노 게임 컬렉션 Michael, who was still being deployed even as his mental health deteriorated. 카지노 게임 컬렉션I barked up trees and called in favours from command psychiatrists and other medical colleagues who agreed to see and treat Michael off the record. But he had top-level security clearances to protect, and he refused to go to appointments for fear of future polygraphs and mission-specific vetting of his medical history.카지노 게임 컬렉션
Michael went on six more deployments with the U.S. Army.
카지노 게임 컬렉션I pushed unsuccessfully for years,카지노 게임 컬렉션 says Kate now, 카지노 게임 컬렉션and ultimately decided I was the only one I could treat or change. I accepted defeat and filed for divorce three weeks after my doctoral defence in 2013. I had two young girls and the prospect of repeating history by raising them amidst dysfunction and conflict hit too close to home; it was unthinkable, no matter how much love and dedication remained in the relationship.카지노 게임 컬렉션
According to the National Institutes of Health, the U.S. Defense and Veterans Brain Injury Center has reported nearly 350,000 incident diagnoses of TBI in the U.S. military since 2000. Among those deployed, estimated rates of probable TBI range from 11 to 23 per cent. In Special Operations Forces (SOF) like the Green Berets, Navy SEALs, and clandestine units, the incidence is likely much higher: they sustain 83 per cent of combat fatalities and deploy more often and repetitively than conventional forces. And SOF members die by suicide at much higher rates than other military populations.
카지노 게임 컬렉션I think there카지노 게임 컬렉션s some mechanism to overachieve,카지노 게임 컬렉션 Kate says now. She카지노 게임 컬렉션s speaking of both Special Operations Forces and nurses like herself. 카지노 게임 컬렉션Especially those of us with thorny pasts: we need to prove we can reach the mountaintop.카지노 게임 컬렉션 She had just finished a clinically focused doctorate at Loyola 카지노게임사이트 studying SOF medics카지노 게임 컬렉션 care of combat casualties, but 카지노 게임 컬렉션I was annoyed by its limitations. I was told I카지노 게임 컬렉션d never independently add to the body of knowledge. I wasn카지노 게임 컬렉션t prepared at that point to independently lead research endeavours, so I then started a research science PhD at Rush 카지노게임사이트 in Chicago, intending to study clinical cognition in military members.
카지노 게임 컬렉션As my friendships and collaborations with SOF service members grew and deepened, I started to lose them to suicide. First, the hockey player who taught my eldest daughter to skate at Fort Bragg, Army Green Beret Michael Mantenuto [who starred in the Disney hockey movie Miracle] died by suicide in April 2017. Within a day of his death, a Navy SEAL friend카지노 게임 컬렉션s junior medic, Ryan Larkin, died by suicide. Three years into my PhD, with a year off to have a baby, I reversed course and decided to study resilience and suicide in Special Operations, who are assumed to have the highest resilience but are dying by suicide at three times the rate of conventional military populations.카지노 게임 컬렉션
It카지노 게임 컬렉션s June 2019. Kate wakes up on a beautiful Sunday morning. She is on faculty at the 카지노게임사이트 of Tennessee in Chattanooga. Three weeks earlier, she had published her initial findings about resilience and suicide in Special Operations Forces: the first nurse to tackle those topics in that population. She checks her email automatically, as tenure-track junior faculty are compelled to do. There is, unexpectedly, an email from Michael, her ex-husband. Since their divorce, their communications had become fraught. Six years later, they have both moved on. Kate has a new husband, Ben; another child; a new academic career. Cautiously, she opens the email from Michael.
She reads the first sentences, and falls to her knees, gasping. You카지노 게임 컬렉션re experiencing tachycardia, her brain tells her. Move, says her brain. Think.
카지노 게임 컬렉션I knew where he lived, and years spent in emergency medicine enabled me to deduce to which trauma centre he would have been flown. I called the charge nurse line at R. Adams Cowley Shock Trauma in Baltimore, after speaking with Michael카지노 게임 컬렉션s mother and brother.카지노 게임 컬렉션
Things moved quickly. Kate moved quickly.
카지노 게임 컬렉션Emergency nurses are mafia-esque in taking care of their own,카지노 게임 컬렉션 says Kate wryly, 카지노 게임 컬렉션and this was no exception, even though they didn카지노 게임 컬렉션t know me personally. They put the phone next to Michael카지노 게임 컬렉션s ear before transferring him to intensive care, and I was able to tell him to hang on, that I was on my way. Gone was the bullshit we카지노 게임 컬렉션d put each other through 카지노 게임 컬렉션 everything superfluous falls away when a one-sided conversation occurs with the hum of a ventilator and squawks of monitors in the background. I got off the phone, grabbed my go bag, and assured Ben I카지노 게임 컬렉션d be home soon and safely.
카지노 게임 컬렉션The drive from Chattanooga to Baltimore should take ten hours at minimum. Living in Germany among autobahns trained me well; I arrived in under eight. Members of our Army family spoke to me through Bluetooth as I pushed my turbodiesel to its limits through Appalachia. 카지노 게임 컬렉션Michael never came back from Iraq,카지노 게임 컬렉션 said one friend to me. 카지노 게임 컬렉션He never landed.카지노 게임 컬렉션
카지노 게임 컬렉션When I walked into the neurotrauma ICU, monitor readings were grim. Intuitively, I noted about a dozen vasoactive and sedative drips and their infusion rates, vital signs, and ventilator settings 카지노 게임 컬렉션 and Michael himself.
카지노 게임 컬렉션Patients카지노 게임 컬렉션 families have told me 카지노 게임 컬렉션 and millions of other nurses, I카지노 게임 컬렉션m sure 카지노 게임 컬렉션 that their loved one waited for them to arrive before dying, that they sensed a change when they walked in the room, that the patient 카지노 게임 컬렉션knew카지노 게임 컬렉션 they were there. And most of the time, when I heard this, I would nod compassionately and evoke some semblance of therapeutic communication while I kept their loved one clinically stable. Yes, unconscious patients can hear you, even when heavily sedated. But I usually put more stock in quantitative data and clinical assessment than feelings. Michael카지노 게임 컬렉션s injuries were incompatible with life and he was maxed out on every drip and vent setting. There was no clinical explanation for him still being alive.
카지노 게임 컬렉션As I approached the father of my two girls and my first real young love, I kept one eye on the monitor mounted above his head. The energy in the room told me all was forgiven between us: the fights, the emotional fractures, me leaving him. As I spoke into his ear, his heart rate approached the low end of 카지노 게임 컬렉션way too high.카지노 게임 컬렉션 His cardiac rhythm started to show detectable P-waves. His arterial blood pressure, too low for decent organ perfusion, rose. It was nighttime and we only had until morning, when surgeons would take him to the O.R. and harvest his organs.
카지노 게임 컬렉션I did what Queen카지노 게임 컬렉션s taught me to do in the start of second-year clinicals. While exercising incredible mastery of delivering the complicated calculus that is patient care, nurses restore patients, starting with attending to their dignity. It was Michael카지노 게임 컬렉션s last night on Earth and as powerless as I was to fix anything else, as a Queen카지노 게임 컬렉션s nurse I카지노 게임 컬렉션d be damned if he wasn카지노 게임 컬렉션t pristine in death. I loaded Michael카지노 게임 컬렉션s favourites on my iPhone and turned the music up. Two nurses 카지노 게임 컬렉션 two, in a busy major urban trauma ICU 카지노 게임 컬렉션 stopped what they were doing when I asked for a wash basin and supplies. Without moving him and jeopardizing his intracranial pressure, we washed him head to toe. And then we hugged each other and cried.카지노 게임 컬렉션
On the way home to Tennessee the next day, Kate got a phone call from Michael카지노 게임 컬렉션s psychiatrist. He described to Kate a symptom constellation he had seen in Michael; that set of symptoms triggered a memory for Kate. 카지노 게임 컬렉션Dr. Dan Perl of Walter Reed/Uniformed Services 카지노게임사이트 had found astroglial scarring in Ryan Larkin카지노 게임 컬렉션s brain post-suicide and in other post-mortem brains from soldiers with chronic TBI who died by suicide. My apologies to the laboratory intern who answered the phone and heard me blurt out, 카지노 게임 컬렉션My ex-husband had TBI from combat and died by suicide yesterday and you have to go get his brain and analyze it.카지노 게임 컬렉션 But by golly, Stacey Gentile of the Center for Neuroregenerative Medicine activated an incredibly compassionate organ harvesting team who made it happen.카지노 게임 컬렉션
Chapter Three
It카지노 게임 컬렉션s March 2020. Kate has moved back to Canada with Ben and their children. She has accepted a position at the 카지노게임사이트 of Windsor. She카지노 게임 컬렉션ll be teaching research methods and quantitative statistics, to both undergrads and PhD students. She카지노 게임 컬렉션s looking forward to it: she loved teaching research in Tennessee. As a professor, she upholds the rigorous standards embodied by her Queen카지노 게임 컬렉션s nursing profs. She also infuses her teaching practice with self-effacing encouragement, remembering her own academic battles as an undergrad. 카지노 게임 컬렉션Students often 카지노 게임 컬렉션 and incorrectly 카지노 게임 컬렉션 think professors have done everything right the first time. When I have students who are struggling, I offer to show them my transcript from Queen카지노 게임 컬렉션s, because how you start out doesn카지노 게임 컬렉션t dictate how you end up.카지노 게임 컬렉션
School starts again in September. Kate is looking forward to the summer to hang out with the kids and settle into their new neighbourhood.
And then COVID-19 hits. It hits New York City particularly hard.
카지노 게임 컬렉션When New York started to deteriorate under the strain of this virus, I knew I카지노 게임 컬렉션d be going back there in some capacity. It was just a gut feeling. I started prepping the kids at the end of March, saying, 카지노 게임 컬렉션You know, I카지노 게임 컬렉션m probably going to have to go help there. I카지노 게임 컬렉션m probably going to have to go help people. I카지노 게임 컬렉션m a nurse, and this is what nurses do.카지노 게임 컬렉션카지노 게임 컬렉션
Once again, someone in Kate카지노 게임 컬렉션s network reached out to her, and Kate was ready to show up. 카지노 게임 컬렉션Missy Givens and I had worked together in emergency medicine at Madigan Army Medical Center about 15 years ago. I later learned that I was her charge nurse on her first night shift as an attending.카지노 게임 컬렉션
Colonel Melissa Givens, MD, MPH (카지노 게임 컬렉션Missy카지노 게임 컬렉션, to Kate) had recently retired as an emergency room physician with the U.S. military. She and Kate saw what was unfolding in New York: its health-care system was buckling under the weight of COVID-19, and they were compelled to act. Missy and Kate put together a team of six and started videoconferencing daily about developing larger teams of highly trained former SOF medics to head to New York to alleviate pressures on individual critical care units카지노 게임 컬렉션 staff. Through colleagues, Missy learned that New York-Presbyterian (NYP) Hospital had a field hospital ready to handle patients with COVID-19, but no one to run or staff it.
카지노 게임 컬렉션Missy called me and said, 카지노 게임 컬렉션I told [NYP] I could be medical director but would need a chief nursing officer. How do you feel about running a 220-bed field hospital?카지노 게임 컬렉션 I tried to think of a nurse who카지노 게임 컬렉션d worked with SOF medics, studied their practices and philosophy, knew their clinical capabilities, who would be willing to drop everything to work and live in a pandemic epicentre카지노 게임 컬렉션It dawned on me that I was that nurse. So I grabbed one of the kids카지노 게임 컬렉션 hockey bags, packed it with clothes, tossed it in the car, and started driving.카지노 게임 컬렉션
Working in the bubble
Close to Columbia/New York-Presbyterian카지노 게임 컬렉션s Allen Hospital is 카지노 게임 컬렉션the bubble,카지노 게임 컬렉션 a tented soccer field belonging to Columbia 카지노게임사이트 Athletics. Kate and her advance team were responsible for turning it into a functional hospital for patients with COVID-19. 카지노 게임 컬렉션I ultimately had responsibility for about 130 people, both civilian nurses and Special Operations medics functioning as nurse equivalents in their assigned roles,카지노 게임 컬렉션 she says. 카지노 게임 컬렉션All the medics assigned to specific clinical roles 카지노 게임 컬렉션 who were already the best-trained in the military 카지노 게임 컬렉션 had undergone additional training in prolonged field care, which had prepared them to provide nursing-equivalent critical care in circumstances where you can카지노 게임 컬렉션t evacuate casualties. Ironically, I was part of the initial efforts that developed prolonged field care during its inception, and I was now seeing it applied to a pandemic.
카지노 게임 컬렉션These medics are also used to deploying out of the back of a truck or in a really remote village. So when they walked into the bubble, it카지노 게임 컬렉션s bright, it카지노 게임 컬렉션s shiny, there카지노 게임 컬렉션s linoleum, there카지노 게임 컬렉션s electricity, there카지노 게임 컬렉션s oxygen, so they were like, 카지노 게임 컬렉션Wow, this is like the Ritz.카지노 게임 컬렉션카지노 게임 컬렉션
Prior-service military personnel were also well-trained in suiting up in protective equipment, essential for treating patients with COVID-19.
카지노 게임 컬렉션In developing PPE procedures, we assumed airborne transmission, based on reports from overseas and so we implemented really strict protocols for being in the bubble. At all times, you had to cover your hair, you had to wear eye protection, you had to wear a surgical mask over your N95, and don what we called the bunny suit and shoe covers and two pairs of gloves and all these other layers. Head-to-toe PPE. And the medics were just like, 카지노 게임 컬렉션Okay, no problem.카지노 게임 컬렉션 To my knowledge, none of our staff contracted COVID-19 from working at the field hospital.
카지노 게임 컬렉션The days were really long. In the beginning weeks, I카지노 게임 컬렉션m pretty sure we did sixteen 16-hour days straight. It was just very, very intense. Opening a hospital typically takes years; we did it in six days, with personnel from all over the country with vastly different backgrounds. Prior to putting our leadership team together, I contacted Amanda Brandon - a really fantastic mental health practitioner and colleague familiar with the Special Operations community and expert in treating traumatic stress. One of my first actions was hiring her to be the mental health lead for the staff. She was absolutely crucial because we anticipated what the stress and the strain could be, going in. I don카지노 게임 컬렉션t see how we could have pulled this off without her. Just being able to have a quick hallway consult if you had a challenging meeting or needed to talk to someone about something sensitive....It was amazing to have a dedicated person there to ground you and help you talk through things, even if you were just having a rough day.카지노 게임 컬렉션
The bubble gets a name
카지노 게임 컬렉션When Missy broached naming the hospital, I thought, why don카지노 게임 컬렉션t we name it after Ryan Larkin? Because in our academic community for Special Operations medicine, most people knew who Ryan was, and how he died. Because he was a medic, his death hit very close to home. He was such a caregiver and really compassionate guy. I reached out to Ryan카지노 게임 컬렉션s parents whom I knew because we are part of this club that nobody wants to belong to: military family members who카지노 게임 컬렉션ve died by suicide. His parents are very private, but were enthusiastic to name the hospital after Ryan.Inadvertently, that sent out a bat signal 카지노 게임 컬렉션 when you name a field hospital after a fallen Special Operations medic, everybody in that community intuits your mission.카지노 게임 컬렉션
The Ryan Larkin Field Hospital treated patients from every borough in New York City. Special Ops training came in handy here, too. 카지노 게임 컬렉션Special Operations soldiers all have to learn, with a fair degree of fluency, a foreign language. Some learn French, some learn Spanish, some learn Russian or Korean. So we would be treating a patient from Eastern Europe and we had a medic fluent in Russian: he could speak a lot of different dialects. Others spoke Mandarin or Tagalog. I mean, it was kind of uncanny. When we really needed that kind of language service, these medics just came through.
카지노 게임 컬렉션That카지노 게임 컬렉션s at the heart of being a holistic caregiver,카지노 게임 컬렉션 says Kate. 카지노 게임 컬렉션The first thing is you have to speak to patients in their own language. Medics who카지노 게임 컬렉션ve been to war, very tough and battle-hardened clinicians, were shaving patients카지노 게임 컬렉션 faces and bathing them while providing top-notch care. You can카지노 게임 컬렉션t teach that kind of patient-centred compassion. But it카지노 게임 컬렉션s not surprising: these patients were separated from their family카지노 게임 컬렉션 like soldiers and military families often are 카지노 게임 컬렉션 and military-adjacent people tend to treat others in the same boat as our de facto family, regardless of DNA.
카지노 게임 컬렉션Patients were actually surprised that we interacted so closely with them, or when we spent prolonged amounts of time in proximity to them. Before transferring them to us, hospital staff didn카지노 게임 컬렉션t initially know if our patients were COVID-19 positive or negative and had to take precautions of distance. Whereas we knew we were walking into a positive-pressure and completely COVID-positive patient care environment: all of our patients had COVID-19. So we were able to just get right up in there with our patients like normal, except that we were wearing all this protective gear.카지노 게임 컬렉션
Sending patients home
카지노 게임 컬렉션Because we were in a bubble, if you played music in one corner, every patient could hear it. We ordered a nautical bell, as an homage to Ryan, who was a Navy SEAL. In the Navy, when you카지노 게임 컬렉션re done your tour on ship, you ring the bell three times.We had it engraved and hung on a platform. And whenever patients left, they got to ring the bell.
카지노 게임 컬렉션And then when we closed the hospital, we rang the bell for the last time.카지노 게임 컬렉션
The beginning of chapter four
It카지노 게임 컬렉션s mid-July. Kate is out of quarantine, and back at home with her family. She카지노 게임 컬렉션s also hard at work on her latest research. She and fellow Queen카지노 게임 컬렉션s grad David Barbic (Artsci카지노 게임 컬렉션02, MSc카지노 게임 컬렉션04, Meds카지노 게임 컬렉션08) are exploring moral injury and quality of life in emergency clinicians in the age of COVID-19. David is a professor of emergency medicine at UBC. 카지노 게임 컬렉션Emergency and critical care clinicians are viewed as typically very tough and unflappable regardless of traumas we witness and treat. That hyper-resilient and impermeable stereotype, similar to how people perceive Special Operations Forces, can invoke stigma in clinicians who are mentally struggling while caring for incredibly ill patients during a resource-devoid pandemic.
카지노 게임 컬렉션The predicate for moral injury,카지노 게임 컬렉션 says Kate, 카지노 게임 컬렉션is a shock to your psyche or to your mores. It happens when you see things 카지노 게임 컬렉션 or do things 카지노 게임 컬렉션 within a certain context that chip away at your institutional trust, your belief system, your ability to make appropriate clinical and moral decisions. Physicians and nurses in the er already see the worst and the best in humanity. If you ever want to see which community is having an overdose crisis or a violent crime problem, stop in at your local emergency room. We카지노 게임 컬렉션re the first people to see it.카지노 게임 컬렉션
The same goes for patients with COVID-19. The additional strain 카지노 게임 컬렉션 the moral injury 카지노 게임 컬렉션 dealt to clinicians practising during the pandemic can occur from stressors at home, rationing care, practising without enough PPE, and witnessing leadership failures during the pandemic. Clinicians are often unable to do what they are meant to and trained to do during this pandemic. And it카지노 게임 컬렉션s taking a toll on health-care workers.
카지노 게임 컬렉션Moral injury has roots in the military, with regard to traumatic stress and negative health outcomes 카지노 게임 컬렉션 including suicide. Dr. Lorna Breen, the ER director at the Allen Hospital supporting Ryan Larkin Field Hospital, died by suicide while we were in New York. Not only did she contract COVID-19 and likely suffered from its neurovascular after-effects, she reportedly felt powerless to save so many sick patients. Even without knowing her personally, that hit very close to home for all of us working at a field hospital named for a Navy SEAL who카지노 게임 컬렉션d died by suicide, and for those of us otherwise affected by suicide.카지노 게임 컬렉션
카지노 게임 컬렉션In March before leaving for New York, I was matched with three amazing medical students from Western studying at the UWindsor campus who were interested in trauma research: Hailey Guertin, Kylie Suwary, and Matthew Bentley (Artsci카지노 게임 컬렉션18). We launched an international study of emergency clinicians카지노 게임 컬렉션 moral injury during the pandemic, which was only possible because of their incredible scholarship and dedication, and because David took the reins from Vancouver while I was in New York.카지노 게임 컬렉션 Currently, Kate and David are working on defence grant applications to further study moral injury with nurse scientist Audrey Steenbeek from Dalhousie.
Reflecting back on the first chapters of her life, Kate says,카지노 게임 컬렉션You know, when I first went to New York, and I was 21, I helped in a very small way. Now, almost 20 years later, with some education and practice under my belt, I was able to go back to New York and help stand up a facility where hundreds of people could be part of the fight against COVID-19.
카지노 게임 컬렉션Queen카지노 게임 컬렉션s does, in essence, teach its students positive entitlement. By virtue of rigour, prestige, and tradition, Queen카지노 게임 컬렉션s grads either have a place at the table or we카지노 게임 컬렉션ll bring our own chair. So, whether I was 21 or 40, I knew I could contribute in situations of duress, while under stress, and I can enable other people to contribute, too.카지노 게임 컬렉션
Dr. Kate Kemplin is many things. She has one hard-earned BNSc from Queen카지노 게임 컬렉션s 카지노게임사이트. She also has an MSc in Nursing, and what she calls 카지노 게임 컬렉션an overabundance of doctoral education.카지노 게임 컬렉션 She카지노 게임 컬렉션s been in the pit at the World Trade Center days after 9/11. She카지노 게임 컬렉션s practised with military and civilian patients on two continents.
She is a professor. She is a researcher. She is a mother. She loves Led Zeppelin. She has bad days. She has neurocognitive disabilities. She has an innate need to rock the boat, to challenge the system. She is complex and flawed.
카지노 게임 컬렉션We have to be flawless in providing patient care. Yet many people think you can카지노 게임 컬렉션t be a nurse or a physician unless you카지노 게임 컬렉션re personally flawless, which is ridiculous. Even during this pandemic, clinicians are still reluctant to seek professional care for their mental health, despite knowing that the mind needs as much attention as the rest of the body. And in my experience, patients prefer clinicians who are proficient professionally, but also human. It takes stability and opportunity to secure an education in health care. Many clinicians and academics may have limited experience with dysfunction, have not faced discrimination, been single parents, or been housing- or food-insecure. Those lived experiences may therefore be somewhat theoretical to current leaders in health care, absent more women, immigrants, and BIPOC in leadership roles. Regardless of our own experiences, we have to insulate and rally around colleagues, instead of isolating them, during times of struggle.카지노 게임 컬렉션
So Kate Kemplin has a message for all those badass nurses-to-be, especially those students who think,
카지노 게임 컬렉션I don카지노 게임 컬렉션t get this course카지노 게임 컬렉션I don카지노 게임 컬렉션t fit in카지노 게임 컬렉션Maybe I카지노 게임 컬렉션m not good enough.카지노 게임 컬렉션
She says, 카지노 게임 컬렉션I never believed successful people who said 카지노 게임 컬렉션I카지노 게임 컬렉션ve failed as much as I카지노 게임 컬렉션ve succeeded카지노 게임 컬렉션 until I had some spectacular face-plants myself. When you push the envelope and take risks 카지노 게임 컬렉션 whether by taking a new professional role, researching sensitive topics, or by challenging how things have always been done 카지노 게임 컬렉션 some failure is likely. 카지노 게임 컬렉션Spit the dirt out, dust yourself off, and ignore the haters who will judge or discourage you. Keep going, because you usually have to take the leap before you can see the net below you. I still don카지노 게임 컬렉션t know what I want to do when I grow up, but I know it카지노 게임 컬렉션ll be quite the ride getting there."
