#i don’t think students want their resident director hanging around all the time in common areas

[brutefury]

my resident director is getting on my nerves lately it’s not his fault i just think he needs friends outside of this place

#girl do not hang out in the lobby always #Get off campus nowwwww #idc bc i like him a lot but it’s also like #i don’t think students want their resident director hanging around all the time in common areas #even if he’s a recent alumn #and my class is the verrryyyyy last who was in school w him

[watchonlinewds]

An apparent fourth wave of COVID-19 is centered in the East. Will it hit California?

What appears to be a fourth wave of the COVID-19 pandemic has struck Michigan, the New York region and New England, and experts are uncertain if it will remain contained.

“The United States has entered a fourth wave of transmission, and there’s no disputing this. Whether it remains as small regional outbreaks, or whether it generalizes nationwide remains to be seen,” Dr. George Rutherford, a UC San Francisco epidemiologist, said Friday at a campus town hall meeting.

Nationally, there has been an 8% week-over-week increase in the average daily number of newly diagnosed coronavirus cases, rising to about 62,000 for the seven-day period that ended Wednesday, federal officials said Friday. The average daily number of new hospital admissions for COVID-19 patients rose 5% over the same period.

http://downeaststyleboats.com/advert/watch-debris-season-1-episode-6-online-full-episodes/

http://downeaststyleboats.com/advert/watch-kung-fu-season-1-episode-1-online-full-episodes/

http://downeaststyleboats.com/advert/watch-city-on-a-hill-season-2-episode-2-online-full-episodes/

http://downeaststyleboats.com/advert/watch-the-flash-season-7-episode-6-online-full-episodes/

http://downeaststyleboats.com/advert/watch-supergirl-season-6-episode-2-online-full-episodes/

http://downeaststyleboats.com/advert/watch-this-is-us-season-5-episode-12-online-full-episodes/

http://downeaststyleboats.com/advert/watch-the-walking-dead-season-10-episode-22-online-full-episodes/

http://downeaststyleboats.com/advert/watch-shameless-season-11-episode-11-online-online-full-episodes/

http://downeaststyleboats.com/advert/full-watch-shameless-season-11-episode-11-online-online-free/

California is in a much better situation. Case numbers have dipped to levels not seen since the end of last spring; the state is reporting daily averages of 2,500 to 2,700. (During the worst of the surge in the fall and winter, California was reporting 45,000 cases a day.) Additionally, California has had a coronavirus positivity test rate of about 1% over the past week — compared with 16% in Michigan and 9% in New Jersey.

“Here in California, we’re in much better shape — we do not have a spike. But I would point out that we’ve leveled off, and we’re not seeing continued declines,” Rutherford said.

He and others have expressed concern about Florida, the state with the largest concentration of confirmed cases of the U.K. coronavirus variant, B.1.1.7, which is more transmissible and possibly more deadly than the conventional strain. Florida has no statewide mask mandate, and crowds of spring-break revelers are prompting fears that travelers will further spread the U.K. variant around the nation. Florida over the past week had a positivity rate of 9%, and it is climbing.

“We’ll have to see how that plays out,” Rutherford said.

The surge in Michigan has accelerated since it began in mid-March, Rutherford said, and appears to be heading toward a peak similar to the state’s winter high. The Michigan surge appears to be tied to the U.K. variant and may have emerged via high school sports, Rutherford said.

“Elsewhere — in New York, New Jersey, Connecticut, Rhode Island, Massachusetts, Delaware — there’s a series of a kind of interlinked outbreaks, with more modest increases that seem to stem from metropolitan New York and spilling into the neighboring states,” Rutherford said.

Other national experts echoed Rutherford’s concerns.

“We’re heading into the fourth surge. Cases are increasing. Variants are increasing. Variants are more deadly,” Dr. Tom Frieden, a former director of the U.S. Centers for Disease Control and Prevention, said Saturday on ABC’s “Good Morning America.” “We just have to hang on until a larger proportion — particularly of the vulnerable — are well-vaccinated and more of us are vaccinated, or we will have a large fourth surge. We will have a fourth surge, I’m afraid. How large and deadly? That depends on us.”

Some experts disagree, given how many people in the U.S. have either been vaccinated or have immunity because they’ve survived COVID-19.

“I think that there’s enough immunity in the population that you’re not going to see a true fourth wave of infection,” Dr. Scott Gottlieb, a former head of the Food and Drug Administration, said Sunday on CBS’ “Face the Nation.” However, he added that there are indeed “pockets of infection around the country, particularly in younger people who haven’t been vaccinated and also in school-age children.”

Gottlieb said he believes schools can stay open if they adhere to pandemic safety practices: “As one epidemiologist referred to it this week, go the full ‘Harry Potter’ and try to keep students within defined social cohorts so that they’re not intermingling in large groups.”

California has the nation’s fourth highest number of cases tied to the U.K. variant, according to federal data. A hopeful scenario envisions the spread of that variant in the state impeded by the California variant, B.1.427/B.1.429, which has been more common here.

“Hopefully, we’ll be able to dodge this bullet, because this [U.K. strain] is a more transmissible strain and possibly a strain that causes more severe disease,” Rutherford said.

More than 32% of Californians have received at least one dose of a COVID-19 vaccine, and more than 15% are fully vaccinated.

Recent data show that the currently available vaccines still offer good protection against the new variants.

The vaccines produce an immune response “way more” than you need for the conventional strain of the coronavirus, Rutherford said. Even when they show diminished effectiveness against variants — the South African B.1.351 and Brazilian P.1 strains — the vaccines produce an immune response “two to three times more than you need,” Rutherford said. “So far, so good.”

Despite the positive news on vaccination, the leading health official in Northern California’s most populous county, Santa Clara, warned that the decline in daily case numbers there is slowing.

“We are now seeing our case rates flatten, and in some cases ... some indication that they’re beginning to tick up. So we may have gotten as low as we’re going to go,” said Dr. Sara Cody, the health officer and public health director for Santa Clara County. “Unfortunately, we still all need to be very aware and very cautious to prevent any surge or even a swell. We don’t want that to happen.”

The likelihood of another surge — or a milder “swell” — hitting California will depend on vaccine supply and the behavior of residents.

“Vaccines are going to help, but we need more supply so we can get it out faster,” Cody said. “And we need people to just hold on for a little bit longer: Keep wearing your mask, delay your travel, don’t indoor dine, don’t go to indoor bars, don’t host an indoor gathering at your home. Even if it’s allowed under the state rules, don’t do it. It’s not safe. Not yet.”

Health officials have acknowledged the apparent contradiction in easing restrictions while at the same time voicing caution about a rise in cases. However, some mixed messaging is to be expected when dealing with a new virus, according to Dr. Muntu Davis, L.A. County’s health officer.

“This is naturally what happens inside of a pandemic,” Davis said Friday. “As you start to see how the virus acts, as you start to see when you have new countermeasures, whether that be vaccine or treatment, then we start to learn more. But until we have that information, we have to operate with a lot of caution, because everyone is at risk.”

[newstfionline]

On Campus, Failure Is on the Syllabus

By Jessica Bennett, NY Times, June 24, 2017

NORTHAMPTON, Mass.--Last year, during fall orientation at Smith College, and then again recently at final-exam time, students who wandered into the campus hub were faced with an unfamiliar situation: the worst failures of their peers projected onto a large screen.

“I failed my first college writing exam,” one student revealed.

The faculty, too, contributed stories of screwing up.

“I failed out of college,” a popular English professor wrote. “Sophomore year. Flat-out, whole semester of F’s on the transcript, bombed out, washed out, flunked out.”

“I drafted a poem entitled ‘Chocolate Caramels,’ “ said a literature and American studies scholar, who noted that it “has been rejected by 21 journals … so far.”

This was not a hazing ritual, but part of a formalized program at the women’s college in which participants more accustomed to high test scores and perhaps a varsity letter consent to having their worst setbacks put on wide display.

“It was almost jarring,” said Carrie Lee Lancaster, 20, a rising junior. “On our campus, everything can feel like such a competition, I think we get caught up in this idea of presenting an image of perfection. So to see these failures being talked about openly, for me I sort of felt like, ‘O.K., this is O.K., everyone struggles.’”

The presentation is part of a new initiative at Smith, “Failing Well,” that aims to “destigmatize failure.” With workshops on impostor syndrome, discussions on perfectionism, as well as a campaign to remind students that 64 percent of their peers will get (gasp) a B-minus or lower, the program is part of a campuswide effort to foster student “resilience,” to use a buzzword of the moment.

“What we’re trying to teach is that failure is not a bug of learning, it’s the feature,” said Rachel Simmons, a leadership development specialist in Smith’s Wurtele Center for Work and Life and a kind of unofficial “failure czar” on campus. “It’s not something that should be locked out of the learning experience. For many of our students--those who have had to be almost perfect to get accepted into a school like Smith--failure can be an unfamiliar experience. So when it happens, it can be crippling.”

Ms. Simmons would know. She hid her own failure (dropping out of a prestigious scholarship program in her early 20s; told by her college president that she had embarrassed her school) for close to a decade. “For years, I thought it would ruin me,” she said.

Which is why, when students enroll in her program, they receive a certificate of failure upon entry, a kind of permission slip to fail. It reads: “You are hereby authorized to screw up, bomb or fail at one or more relationships, hookups, friendships, texts, exams, extracurriculars or any other choices associated with college … and still be a totally worthy, utterly excellent human.”

A number of students proudly hang it from their dormitory walls.

Preoccupied in the 1980s with success at any cost (think Gordon Gekko), the American business world now fetishizes failure, thanks to technology experimentalist heroes like Steve Jobs. But while the idea of “failing upward” has become a badge of honor in the start-up world--with blog posts, TED talks, even industry conferences--students are still focused on conventional metrics of achievement, campus administrators say.

Nearly perfect on paper, with résumés packed full of extracurricular activities, they seemed increasingly unable to cope with basic setbacks that come with college life: not getting a room assignment they wanted, getting wait-listed for a class or being rejected by clubs.

“We’re not talking about flunking out of pre-med or getting kicked out of college,” Ms. Simmons said. “We’re talking about students showing up in residential life offices distraught and inconsolable when they score less than an A-minus. Ending up in the counseling center after being rejected from a club. Students who are unable to ask for help when they need it, or so fearful of failing that they will avoid taking risks at all.”

Almost a decade ago, faculty at Stanford and Harvard coined the term “failure deprived” to describe what they were observing: the idea that, even as they were ever more outstanding on paper, students seemed unable to cope with simple struggles. “Many of our students just seemed stuck,” said Julie Lythcott-Haims, the former dean of freshmen at Stanford and the author of “How to Raise an Adult.”

They soon began connecting the dots: between what they were seeing anecdotally--the lack of coping skills--and what mental health data had shown for some time, including, according to the American College Health Association, an increase in depression and anxiety, overwhelming rates of stress and more demand for counseling services than campuses can keep up with.

It was Cornell that, in 2010 after a wave of student suicides, declared that it would be an “obligation of the university” to help students learn life skills. Not long after, Stanford started an initiative called the Resilience Project, in which prominent alumni recounted academic setbacks, recording them on video. “It was an attempt to normalize struggle,” Ms. Lythcott-Haims said.

A consortium of academics soon formed to share resources, and programs have quietly proliferated since then: the Success-Failure Project at Harvard, which features stories of rejection; the Princeton Perspective Project, encouraging conversation about setbacks and struggles; Penn Faces at the University of Pennsylvania, a play on the term used by students to describe those who have mastered the art of appearing happy even when struggling.

“There is this kind of expectation on students at a lot of these schools to be succeeding on every level: academically, socially, romantically, in our family lives, in our friendships,” said Emily Hoeven, a recent graduate who helped start the project in her junior year. “And also sleep eight hours a night, look great, work out and post about it all on social media. We wanted to show that life is not that perfect.”

“For a long time, I think we assumed that this was the stuff that was automatically learned in childhood: that everyone struck out at the baseball diamond or lost the student council race,” said Donna Lisker, Smith’s dean of the college and vice president for student life. “The idea that an 18-year-old doesn’t know how to fail on the one hand sounds preposterous. But I think in many ways we’ve pulled kids away from those natural learning experiences.”

And so, universities are engaging in a kind of remedial education that involves talking, a lot, about what it means to fail.

“I think colleges are revamping what they believe it means to be well educated--that it’s not about your ability to write a thesis statement, but to bounce back when you’re told it doesn’t measure up,” said Ms. Simmons, the author of two books on girls’ self-esteem who is publishing a third, “Enough as She Is,” next year. “Especially now, with the current economy, students need tools to pivot between jobs, between careers, to work on short-term projects, to be self-employed. These are crucial life skills.”

If it all feels a bit like a “Portlandia” sketch, that’s because it actually was one: in which Fred and Carrie decide to hire a bully to teach grit to students, one who uses padded gym mats to make sure the children don’t actually get hurt.

Add “teaching failure” to nap pods (yes, those exist) and campus petting zoos (also common), and you’ve got to wonder, as a cover story in Psychology Today questioned last year: At what point do colleges end up more like mental health wards than institutions of higher learning?

“Look, I don’t think there’s anything fundamentally wrong with trying to create experiences that are calming,” said Adam Grant, an organizational psychologist at Penn. “But I’d like to spend a bit more time figuring out what’s causing those stresses.”

Researchers say it’s a complicated interplay of child-rearing and culture: years of helicopter-parenting and micromanaging by anxious parents. “This is the generation that everyone gets a trophy,” said Rebecca Shaw, Smith’s director of residence life. College admissions mania, in which many middle- and upper-class students must navigate what Ms. Simmons calls a “‘Hunger Games’-like mentality” where the preparation starts early, the treadmill never stops and the stakes can feel impossibly high.

And there’s the adjustment, for many high-achieving students, of no longer being “the best and brightest” on campus, said Amy Jordan, the associate dean for undergraduate studies at Penn. Or what Smithies call “special snowflake syndrome.”

“We all came from high schools where we were all the exception to the rule--we were kind of special in some way, or people told us that,” said Cai Sherley, 20, seated in the campus cafe. Around her, Zoleka Mosiah, Ms. Simeon and Ms. Lancaster nodded in agreement. “So you get here and of course you want to recreate that,” Ms. Sherley said. “But here, everybody’s special. So nobody is special.”

Social media doesn’t help, because while students may know logically that no one goes through college or, let’s be honest, life without screw-ups, it can be pretty easy to convince yourself, by way of somebody else’s feed, “that everyone but you is a star,” said Jaycee Greeley, 19, a sophomore.

It is also a culture that has glorified being busy--or at the very least conflates those things with status. “There’s this idea that I’m not worthy if I’m not stressed and overwhelmed,” said Stacey Steinbach, a residential life coordinator at Smith. “And in some sense to not be stressed is a failing.”

It’s what Ms. Simmons calls “competitive stress”: the subject of her afternoon workshop on the campus lawn, to which she was luring students with ice cream and bingo.

When students arrived, the sundaes were there. But the bingo cards were a little different--filled with things like “I have 20 pages to write tonight,” “I’m too busy to eat” and “I’m so dead.” It was called “Stress Olympics.”

“It’s basically a play on competitive suffering,” said Casey Hecox, a 20-year-old junior. “It’s when we’re like, ‘I have three tests tomorrow.’ And then someone’s like, ‘I have five tests tomorrow, and all I’ve eaten is 5-hour Energy, and my dog is sick.’”

#failure #teaching failure #Smith College #competitive stress

[bluesyemre]

The €101m Forum building is part library, part meeting space, part science museum and part recreational hangout. Photograph: Oliver Balch

The Forum complex in the Dutch city Groningen is trying to show that town centres don’t need to sell to survive…

Four-year-old Joris Niekus hops excitedly in front of a wall-sized flatscreen as his dad loads up an interactive version of Roald Dahl’s BFG (known as GVR in Dutch).

Seconds later, face beaming, his digitised silhouette is bopping across the screen together with Dahl’s gangly giant.

It’s just one of many experiences on offer at a new downtown development in the Dutch city of Groningen that is seeking to reinvent urban hubs for the post-consumer age.

The €101m, trapezoid Forum building is part library, part meeting space, part science museum and part recreational hangout – a 10-storey “multi-space” designed to resonate with citizens who know that shopping is not necessarily the answer. It’s a new-look department store that doesn’t actually sell very much.

But with high streets feeling the pinch across the developed world, with shops shuttered and town centres wondering what they are for any more, the Groningen experiment is being closely watched.

Nowhere is that truer than in the UK, where more than 16,000 retail stores closed last year at the cost of more than 143,000 jobs. The picture in the US is similar, with more than 9,300 shops going to the wall in 2019 as shoppers increasingly move online.

In Europe, city centres are being emptied of life as skyrocketing rental costs push low-income residents out to the peripheries. In cities such as Paris, Stockholm, Copenhagen and Luxembourg, for instance, 80% of citizens say affordable housing is hard to find.

It’s early days, but the Forum certainly feels like it is working. More than 700,000 people – three times the city’s total population – have visited the library since it opened late last year. So, what’s the big draw?

There are books galore (92,000 in total), but they are for rent, not sale, distributed liberally across multiple mezzanine floors with a joyous disregard for Dewey decimal discipline. Geography on one floor, history on another, mathematics … somewhere, presumably.

For the non-bookish, there’s plenty besides: a six-screen cinema, two exhibition halls, a couple of cafes, a museum (about comics, no less), a 250-seater auditorium, and a hip (but not overly hip) top-floor restaurant and bar. Oh, plus a rooftop “market square” with panoramic views over the whole of Groningen.

“Every day when I pick him up from school, he asks to come to the Forum. He just finds it so much fun,” says Joris’s dad, Marcel, an archaeologist, who cuts his working day short every Tuesday to accommodate his son’s request.

Right to roam

The comment is music to the ears of Dirk Nijdam, the Forum’s director, who readily admits that lending out books has never been his priority. Instead, what’s driven his thinking since he took on the project six years ago is the idea of creating a space where anyone and everyone can wander in, kick back and collectively feel at home.

“If people walk in and say, ‘Wow, Groningen has got a new library’, then we’ll have failed,” he says. “If you want to come in and just hang out, you should feel just as welcome as if you’re going to an exhibition or taking out a book.”

This notion of “hanging out” gets to the real function of Groningen’s artful new creation: namely, helping fellow citizens mix and mingle and – who knows? – perhaps even taste that nebulous yet ever-necessary thing called “community”.

It’s a mission born, in part, out of Groningen’s struggling city centre. The hope is that the Forum will revitalise the main market square, which, after the German occupation during the second world war was home to a dingy car park for decades.

At the same time, the project marks a bold riposte to the effects of modern-day capitalist society: first, in its promotion of an individualistic society; and second, in its commercialisation of public space (ie with malls and coffee bars gradually replacing libraries and community centres).

Four-year-old Joris Niekus and his father, Marcel, use an iPad in the Forum in Groningen. Photograph: Oliver Balch

The Forum is a splendid example of form following function. Clean and contemporary, the final design shouts anything but library. Hotel lobby, perhaps? Department store, even? From the luminous circular information desk, to the free-floating elevators, to the immense, cathedral-esque atrium. It’s all quite discombobulating and really rather marvellous.

Once through the door, the challenge is to make people stay. It’s all about “the experience”, says Nijdam, borrowing from big retail’s mantra de jour. So no security beefs on the door, no blaring Tannoy announcements, no endless queuing. Instead, it’s all soft furnishings, mood lighting and make-yourself-at-home courtesy.

Signposts are also kept to a minimum. Exploration, not explanation, is the building’s guiding motif, says Kamiel Klaasse co-founder of NL Architects, an upstart Amsterdam-based firm that beat off an all-star list (including the late Iraqi-British architect Zaha Hadid) to win the design contract way back in 2006.

“The brief talked as much about searching as about finding and we interpreted that as an incentive to let people roam,” Klaasse says.

Community connector

The Groningen resident and social activist Ritzo ten Cate is an early cheerleader for the project. Describing the Forum as “one big welcome gesture to us as citizens”, he points to the diversity of the building’s users as proof of its communitarian qualities.

The evidence seems solid. On any given day, you’ll find students working at their laptops, mums with their toddlers, school kids on assignment and grannies reading newspapers. All of them together, under one roof, seemingly as one.

Nor is it just Groningen’s well-heeled citizens who make use of the space. On his many visits, Ten Cate regularly spots friends from the city’s homeless community. Some come to read or use the free internet, while others are after a warm corner to kill time or take a nap.

“The Forum only opened a few months ago, but it’s already doing its job as a connector,” says Ten Cate, who has plans to run a large-scale hackathon there in June.

Two men playing chess in the Forum in Groningen city centre. Photograph: Oliver Balch

But as much as the Forum brings people together, is it serving to create community.

For Paul de Rook, an alderman on Groningen city council, it’s a crucial question. More than just shared physical space, genuine community is about a shared understanding of one another, he argues. “That’s why it’s really valuable to create spaces where people … can see what is going on in other people’s lives.”

In a nod to this reality, the Forum seeks to orient all its cultural activities around a common thread. Whether it’s the current exhibition on artificial intelligence (recently on show at the Barbican in London) or Spike Jonze’s futuristic film Her at the cinema, everyone is collectively inching towards the same page (“optimism about the future”, in the Forum’s case).

Dr Ward Rauws admires the sentiment but harbours doubts. An assistant professor of spatial planning at the University of Groningen, he notes that the core building blocks of community – social capital, civic culture, place identity and so forth – start first at a street-by-street level and expand out from there.

Even so, he remains a big fan of Groningen’s Forum because of its role in helping foster “familiarity”. Echoing De Rook, he defines the term as a state of awareness that “other kinds of citizens exist who might think differently or look different, but who are part of the same community”. It’s a salient point for a university town such as Groningen, where town-gown tensions are a feature of daily life.

Groningen’s audacious experiment in urban planning isn’t without its detractors, most of whom gripe about the final price-tag. Joris’s mum is in that camp. Her son begs to differ. Done with the BFG, he’s now playing a spelling game on one of the library’s iPads. His dad watches on patiently, albeit with half an eye on the upstairs cafe. “Afterwards,” he whispers, “we go for cake.”

https://forum.nl/en

https://www.dezeen.com/2020/01/19/forum-groningen-nl-architects-cultural-centre/

https://www.archdaily.com/930102/forum-groningen-multifunctional-building-nl-architects

https://www.rug.nl/education/student-blog/a-students-review-of-the-groninger-forum-17-01-2020

https://www.stylepark.com/en/news/nl-architects-forum-groningen

https://www.visitgroningen.nl/en/location/482052751/groninger-forum-library-art-house-movie-theatre-events

https://www10.aeccafe.com/blogs/arch-showcase/2020/01/15/forum-groningen-in-the-netherlands-by-nl-architects/

https://www.theguardian.com/world/2020/mar/11/dutch-mall-groningen-netherlands-forum-urban-hub

#ForumGroningen (The new-look shopping mall that doesn’t sell stuff) The €101m Forum building is part library, part meeting space, part science museum and part recreational hangout.

#forum groningen #holland #library architecture #library buildings #library design #shopping malls #The Netherlands

[hottytoddynews]

This story was reprinted with permission of the Ole Miss Alumni Review.

Brittany Boolos (BSN 15) was in the hospital for two months, unable to talk, walk or feed herself. Decades later, she turned that situation into a defining moment.

“I was born at 27 weeks … three months early,” Boolos says. “I spent two months in the Neonatal Intensive Care Unit. My passion for neonatal nursing was rooted in that. I tried to give every (career) a fair shot, but I wanted to give back for the care I got.”

The care Boolos received as a newborn helped give her a start with very few of the complications that premature babies typically encounter. Now as a registered nurse in the Neonatal Intensive Care Unit (NICU) at Wiser Hospital for Women and Infants at the University of Mississippi Medical Center, Boolos can name those common preemie complications from both work experience and her education foundation.

Born prematurely at 27 weeks, Brittany Boolos spent two months in the Neonatal Intensive Care Unit. Photo courtesy of Brittany Boolos

Preemies often have a low birth weight, and many suffer respiratory problems due to underdeveloped lungs. Sometimes they struggle with feeding issues. To help both preemies and full-term babies in a NICU, daily teamwork takes place at facilities throughout the country. Doctors, registered nurses, nurse practitioners, residents and a host of other hospital staff members must come up with care plans.

Birth of Neonatology

That big team is a far cry from the years when NICUs were in their infancy. Until the mid-to-late ’70s, an established blueprint for specific preemie care did not exist. The full development of neonatology as a specialty was still years away.

Texas Children’s Hospital in Houston was the rst hospital to treat pediatric respiratory failure with home mechanical ventilation. That development enabled at-home treatment instead of prolonged hospital care. The beginning of neonatology service followed.

“Back then is not that far back,” says Dr. Michael Speer, a neonatologist at Texas Children’s Hospital and a professor of pediatrics and medical ethics at Baylor College of Medicine. “The modern neonatology program was not established until about 1973. We didn’t have a ventilator for babies with lung disease until 1972. If a baby had lung disease, we had to use an incubator, and we didn’t have a ventilator to breathe for the baby.”

Some high-profile cases highlighted preemie health care needs, which contributed to care advances on a large scale. President John F. Kennedy’s son Patrick, who had been born premature, died in August 1963, just a few months before his father was assassinated. Patrick’s death put a spotlight on respiratory distress syndrome and other conditions common among premature babies. That spectrum includes babies born many weeks early and those who are nearly carried full term.

“The death of JFK’s baby Patrick … that baby was only about five weeks premature,” says Annie Rohan, an assistant professor and director of pediatric research at Stony Brook University’s School of Nursing in Stony Brook, New York. “There wasn’t a specialty of neonatology at that time. We learned that the use of oxygen is not always a good thing. (Musician) Stevie Wonder was exposed to too much oxygen.”

As funding for research and development increased, doctors gradually gained ground in the effort to improve preemie outcomes. The late Dr. Mary Ellen Avery’s pioneering research found that preemies often struggled with breathing due to lacking a lung protein called surfactant. Being able to supply that artificially in a NICU setting became a huge step forward. Other vital tools came into play as facilities were able to devote additional resources to address the nutritional needs of preemies.

“We had no formulas on hand in the early ’70s designed for premature babies,” Speer says. “We had no breast milk banking. We had primitive forms of nutrition [programs]. The mid-’70s was a hotbed of innovation and acquisition of knowledge.”

Whole New World

Boolos now works as a registered nurse in the Neonatal Intensive Care Unit (NICU) at Wiser Hospital for Women and Infants at the University of Mississippi Medical Center.

While doctors and nurses were making progress, another group still had plenty of catching up to do to become familiar with a typical NICU setting: the parents who were anxiously waiting to hear good news about their respective sons and daughters. Boolos has experienced the environment as a patient and as a nurse. She knows the visual aspects and the sounds of the NICU can be jarring for many new parents.

“One of the big things for me is to help the parents,” Boolos says. “For a lot of them, this is their first child. It can be very scary for them. There are a lot of cords and alarms in the NICU. Then teaching them how to care for a preemie — everything is so different.”

Boolos says her own parents, Todd and Tammy, were in that sort of situation when she was born in Vicksburg. The absence of a local NICU meant that 2-pound, 7-ounce Brittany had to be transferred to Methodist Medical Center in Jackson (now Merit Health Central).

“I always ask my parents questions about that NICU,” Boolos says. “My parents had hardly known about the NICU. Every baby is different. Babies of the same gestational age can have two totally different journeys.”

Prior cases and pattern recognition give doctors tools to recognize the illness process and the rigid science behind it. Sometimes the journey does not end as every patient and parent wants. Often, complications occur, and short-or long-term mental or physical impairments are possibilities.

“We have some babies who have medical conditions that we can address but not cure,” Speer says. “We sometimes are not able to do wondrous things.”

Sometimes the outcome is death.

“It is very gratifying to have the medical tools that we have,” Speer says. “But just because we can do something does not mean that we always should do something. Sometimes the best medicine is to say we cannot do anything for the baby, and we have to allow the baby to die with dignity and without suffering.”

Boolos witnesses many of the ups and downs experienced by babies and parents. Her reward often comes from seeing a baby that “you don’t think will make it through the night” hang in there and move closer to survival. When a patient is able to do things like switch to bottle feeding or start wearing clothes, those moments may not seem like a big deal on the surface. However, they are major milestones for preemies.

“It’s all part of it when you work in the NICU,” Boolos says. “It’s hard to see them fight for their lives. When you see their parents, it’s one of the hardest things.”

Answering the Call

Boolos witnesses many of the ups and downs experienced by babies and parents. Her reward o en comes from unexpected improvements in her patients. Seemingly minor advancements such as switching to bottle feeding are major milestones for preemies.

It is difficult logistically for organizations such as the National Association of Neonatal Nurses to track an exact figure representing the number of preemies who grow up to become medical professionals who work in a NICU. Rohan at Stony Brook estimates hundreds if not thousands of people have made that transition from being a patient to becoming a care provider.

“People have choices when they get out of a general nursing program,” Rohan says. “If you have emotional connections to that environment … preemies who have listened to stories about the NICU go into it.”

Once that decision is made, the process of getting accustomed to the ins and outs of a NICU begins. Students who are exposed to the new environment face linguistic challenges.

“There is a lot of new language at the NICU, and getting around the language is tricky,” Rohan says. “Sometimes younger students could be intimidated by the skills of a neonatal nurse practitioner, and they are challenged by the conversations. Sometimes the news is not interpreted by a family the way you want it to be.”

Preemies make up a fairly large portion of a NICU patient population, but many other full-term babies also are there who are dealing with setbacks such as infections or kidney issues. Many of those babies will have a few days or maybe a week on antibiotics and a relatively short-term hospital stay before heading home.

For those parents of preemies who face a longer path, they can find many examples of success, stretching from New York to Jackson to Houston. Rohan has some advice for them.

“Try to take your fear and sadness that this wasn’t the original plan, and put it on the back burner,” she says. “Try to hear what the care providers are telling you. There are a lot of resources in the NICU. Embrace those resources. Don’t be afraid to ask the same question to two different people. Sometimes an issue will be unclear. Be part of the care team for your infant.”

Video monitoring of preemies is a way to supplement cell phone calls and verbal communication.

“We don’t have the ability to transmit bedside monitoring to parents, but we can set up a TV monitor and Skype,” Speer says. “There is not the technology to transmit minute to minute, so we are still dependent on cell technology if parents can’t be at the hospital.”

The tense moments are not only part of the parents’ routine.

“When I started nursing school, I had no idea what I was getting into,” Boolos says. “I never thought about how attached you can get to a patient. When you realize how fragile these babies are, it’s a lot of emotional investment. I catch myself thinking about patients, and sometimes it’s hard to leave work at work.”

Boolos always sort of knew that she wanted to do something in the medical field, and the NICU allows her to experience a wide variety of cases.

“The NICU is a whole di erent world from the rest of the floors,” she says. “Most of what people know about hospital settings is dealing with other adults. We take care of very small preemies from 23 weeks up to older babies with chronic conditions.”

As treatment tools have improved, so have the odds of a good outcome for those smaller babies.

“We have technology that allows smaller and smaller babies to survive, go home and become contributing members of society,” Speer says. “Unless we have a major malformation or major catastrophic illness, more than 90 percent of babies should be very normal at 1,000 grams and 27 to 28 weeks of gestation. If you get down to 23, 24 or 25 weeks, a significant portion of those babies will not survive, or the survivors will have major disabilities in learning, vision or hearing that may last their entire lives.”

Boolos is in a unique position to keep the lines of communication open with parents who are anxious and looking for progress.

“If it’s appropriate, I tell them about my journey to give them hope.”

By Brian Hudgins. Photos by Joe Ellis.

This story was reprinted with permission from the Ole Miss Alumni Review. The Alumni Review is published quarterly for members of the Ole Miss Alumni Association. Join or renew your membership with the Alumni Association today, and don’t miss a single issue.

For questions, email us at [email protected].

Follow HottyToddy.com on Instagram, Twitter and Snapchat @hottytoddynews. Like its Facebook page: If You Love Oxford and Ole Miss…

The post Baby Steps: Alumna Grows from Preemie to Neonatal Nurse appeared first on HottyToddy.com.

#hottytoddy #olemiss #oxfordms #oxford ms #mississippi #university of mississippi #the grove

[morgensternmd-blog1]

Medical School: The Top 5 Takeaways

Today I donned my short white coat for the final time.  In less than two months I will trade my tattered, waist-length remnant of a coat in for a crisply-pressed, long white coat signifying my transition from student to physician.  As I look at my now off-white coat hanging in it’s final resting place, I can’t help but to reflect on some of the blood, sweat, and yes, tears, absorbed through those fibers.  

I think of my favorite patients - the ones who bring me joy to this day as I remember how I helped them in one way or another.  I think of my many mentors and the lessons learned from them.  I think of the frustrations of wanting to do more, but knowing I couldn’t.  I think of the thousands of hours reading, studying, and answering questions (I try not to think of those as much...).  But as I step away from the medicine and the book-knowledge gained over the last four years, I can’t help but reflect on the most important things I learned - which coincidentally have just as much of an impact on my life outside of medicine as they do within it.

Be kind, always.

It is easy to think you are a nice person.  It is even easier to see yourself in this way when you are in a profession where your primary job is “helping” people.   But my experiences, especially in the last two clinical years of medical school, have challenged that notion.  As I progressed through my training, I found myself getting frustrated at patients for one thing or another - they kept smoking, they hadn’t lost weight, they continued using drugs, etc.  For example, I would be excited and eager to see my otherwise-healthy and “normal” elderly woman who fell and broke her hip, but would wait until the last minute possible to see my disgruntled heroin addict who had cellulitis. As physicians, we are taught to be empathetic - to put ourselves in the patient’s shoes and share in their experiences - but I found it difficult to maintain empathy for patients whose lifestyle differed so greatly from my own.  But at the end of the day, I have a duty and an obligation to care for my patients despite these differences.  I had to learn to recognize my biases, check them at the door and see each patient as a person who was in need of help.  And help them I shall, regardless of their background, attitude, or decisions they make outside the hospital.

My point is this - people are different.  And because of these differences, it is easy to form biases toward a person who is different from us in some way - political views, religion, gender, race, lifestyle habits, socioeconomic status, you name it.  It would be great to not form biases in the first place, but that is easier said than done.  By accepting the differences for what they are - differences - and finding the common ground of humanity beneath those differences, we can keep our self-formed biases at bay.  And when our biases do arise, we can recognize them within ourselves and try that much harder to see the person beneath the biases we form.

Life is fragile.

This lesson is pretty self-explanatory.  The point of this takeaway is that life can be taken from anyone at any time.  Through my four years of medical school I have seen patients with chronic conditions who knew their time was near - that their life was coming to an end.  This situation is sad, of course, but nowhere near as traumatic as the healthy patient who was fine two weeks ago or even twenty minutes ago whose life is forever changed, or worse, ended.  Take some lessons from a few of my patients, as I have. 

From my 82-year-old patient with macular degeneration, don’t take your ability to see for granted.  He will never see his great-grandchildren walk for the first time.  From my 32-year-old patient in a car accident, don’t take your ability to walk for granted.  He will never escort his daughter down the aisle.  And from my 52-year-old patient with a heart attack, don’t take life for granted.  He will never know what could have been.

Balance will keep you sane.

Learning in a hospital is time-consuming and complicated.  On top of the book work, lectures, and studying for the knowledge base necessary to be a competent physician, we also learn the interpersonal communication skills and situational awareness necessary to be caring and empathetic.  The only way to learn, as one of my mentors put it, is to “be there”.  There have been times in medical school where I have worked 12-, 24-, and even 40-hour shifts (thankfully the 40-hour days I got at least a few hours of sleep in the call room...).  Beginning residency in June will be no different - I will spend more time inside the hospital than I will outside of it in any given week.  Because of the demanding lifestyle, balance is key.

I learned this lesson during second year when I was studying for the first step of the USMLE (United States Medical Licensing Exam).  I was 3-4 months in to intense studying and was stressed, isolated, and at times, depressed.  There were days it didn’t feel worth it.  There were nights I couldn’t sleep because I was so anxious about this damn test.  After seeking advice from an older student who gave me two simple words of advice - “stay sane” -  I realized that I wasn’t going to make it if I didn’t take time for myself.  I started playing golf again.  I started working out again.  I started seeing my friends again, even if it was in the library for a game of chess or group study session.  And by finding that balance, by being able to take time for myself while not neglecting my responsibilities and studies, I was able to make it through.  Find balance in your life, and you will stay sane.

We are all just a kid from somewhere.

I promise, I’m not getting paid from Powerade to write this (Google “Powerade Derrick Rose commercial” if you’re confused...).  It has become one of my favorite phrases in the past six months.  Traveling to different institutions across the country for away rotations and interviews this past fall and winter, I have met people from all four corners of the United States.  Before these travels, I was naive enough to think that in order to be a “big-name” physician or in a position of power on a national scale meant you were from a big city or a powerhouse institution - Yale, Harvard, Mayo, Stanford, Cleveland Clinic - you know the kind.  The “big degree and even bigger ego” kind of people.  

But I quickly learned I was drastically mistaken.  So many people I met and worked with were from smaller towns in Illinois, just like me, and were kind, humble, and passionate.  A program director from Alton, Illinois.  A department chair with an undergraduate degree from Knox College in Knoxville, Illinois.  A former President of a national orthopaedic organization that went to my former high school. Just because I was from Peoria, Illinois (where unless you are from the Midwest or a geography buff you probably don’t know exists) and got my degree from a less-prestigious university (no offense, Bradley - I had a great experience there but it doesn’t compare to Stanford or Yale), doesn’t mean I am limited in what I can do with my career - and neither are you.  Follow your dreams, throw away the preconceived notions of “I can’t”, and go for it.  Because no matter if you are from Po-Dunk Illinois, Chicago, or New York City, we are all just a kid from somewhere.

Enjoy the ride.

This last lesson is probably the most important.  It was a piece of advice given to me on day one of orientation of first year of medical school.  Looking back on my medical school experiences, I cannot agree more.  Medicine is the king of delayed gratification as far as careers are concerned.  Four years of undergraduate studies, four years of medical school, and now five years of residency, before finally reaching the goal of a practicing physician.  Hundreds of thousands of hours of work and hundreds of thousands of dollars in debt, it becomes so easy to focus on what lies on the greener pastures after training.  And don’t get me wrong - having goals is of utmost importance - but don’t forget to enjoy the time and experiences you have right here, right now.  If there’s one thing I’ve learned, it’s that the pasture may be greener, but there’s always another pasture.  What’s the destination? Where does it end?  When will you finally be happy if you don’t take the time to enjoy where you are in the present?

It’s easy to say I’ve learned a lot over the past four years.  From the biochemical pathways in cells to the ultra-rare diagnoses, I will forget a lot of things (hell, I’ve already forgotten some of those things - don’t tell anyone).  But there are a lot of things I won’t forget - most importantly, the life lessons learned along the way:  Be kind to those around you.  Be grateful for your life and health.  Find your balance.  Don’t sell yourself short.  And lastly, enjoy the ride.  

Four years of medical school condensed into five life lessons.  And yet, who knew I would learn so much?