NaNoWriMo Update, or the NaNoWriMo that Fizzled Out and Died

I realize we’re not even at the halfway point of NaNoWriMo, but with me just barely about to reach 6k words, I’m gonna go ahead and say that completing this challenge wasn’t in the cards for me.

One big reason I’m going to point to is my schedule. While I did figure out a way to get some writing done during my commute, I started slipping the day I had to discharge three patients over the span of two and a half hours. Very stressful and very tiring. All I wanted to do was listen to some jams on my ride home and decompress. This is why I’m jealous of writers without day jobs.

Another reason, which I believe everyone can learn from, is my errors in preparing for this project, mainly my plan in having this story being told from two perspectives. The more I’m working through the perspective I added to the planning process a few weeks ago, the more I’m realizing his storyline and voice is getting drowned out by my other voice. I’m forcing words out of this guy’s mouth and it feels wrong. I’m thinking it’s because I didn’t have time to really consider what this guy’s voice exactly would be, but it’s also the fact that my other narrator carries 90% of the main plot. And looking back, I had to force some sort of conflict and interest into the second narrator’s portion of the story to make it worth it to have him talking to me. And you know what? It isn’t working out.

Moral of the story: go with your gut. I wanted this second narrator to have another perspective for a few scenes somewhere around the climax, but it isn’t worth it in the long run. Deep down I knew that, but I was being a greedy little writer.

So now I’m stuck. Because of the roughly 6,000 words I’ve written, about half will need to be cut to get myself back on track. And I theoretically could keep pounding forward with my main narrator, but my plan would no longer be compatible and I’d feel I’d be floundering all over the place a few thousand words down the road.

My plan? Scrap my current outline and plan and rework everything to include my solo narrator. I’m definitely not giving up on this project, because this story makes me really excited and all bubbly on this inside. But I’m being honest that this project won’t be winning NaNoWriMo, unfortunately.

In the meantime, I’m going to work on some medical posts for y’all. First one will probably be on blood transfusions, so keep your eyes out! And I’m always up for suggestions on posts you’d like to see, too.

And good luck to all of you still battling the 1,667-words-a-day to make it to 50k on the 30th! I believe in you!

Countdown to NaNoWriMo

Two days, guys. TWO. DAYS.

And I’m already procrastinating.

As most of you know, Thursday marks the beginning of a grueling 30-day sprint to 50,000 words. It’s going to be fierce, especially with my full-time work schedule, which prompted be to adapt the reverse NaNoWriMo to compensate for my 12-hour shifts. I’ve taped it to the back of my project notebook and kinda looks like the notes of a crazy person. Or, well, you can judge for yourself.

nano sched

NaNo and my work schedule, all in one!

Besides jotting a few notes on this year’s project (which I’m super excited about!) and creating these word count goals, I’ve been putting off everything else NaNoWriMo. This is my last free day since the torture begins, since I work tomorrow and day 1, and as such I made today a day of writing rest. So what did I do today?

AUDIO HUSTLE

Yesterday I downloaded the Audio Hustle commentary from the ever hilarious Muggle Hustle, a 24-year-old guy from Austin who live-Tweeted while he read the Harry Potter books for the first time. He finished book 7 a few months ago, and now he’s starting to offer his witty commentary for the movies. The first movie is only available at the moment, but it’s just as funny as his Tweets. And if you’ve been totally lost with all of this info, just go to his website to read up on his tweets. And if you’re not a Harry Potter, then I’m sorry but I don’t think we can be friends anymore ;)

MANICURE

I’m obsessed with keeping my nails painted, especially before going to work. I do them at home to save money and have a gallon Ziploc baggy full of various nail polishes. Today I went with a super dark gray, which I think I’ll accent with glitter nail polish. Yes, I know this isn’t the most exciting information but it’s what I did today.

BAKE

The Engineer is a lucky man because I love making treats. For example, I spent a good of this afternoon making…

cooookies

…candy corn cookies. And my mom made coconut macaroons. Basically I’m about to get diabetes. But it’ll be worth it.

So that’s all I got for now, folks. Happy Halloween and happy writing!

Scheduling and Patient Loads

Inspired by my recent inability to get to the computer to actually start on these posts on a regular basis, I thought my next installment of Healthcare for Writers would talk a little bit about what it’s like to work in a hospital. Because, as I’m sure you can figure out, hospitals are open 24/7/365 regardless of weather or disasters, so there needs to be adequate staff to provide safe care to patients, but this staff also needs breaks to, you know, go home and see their families and such. So selfish, I know ;)

I’ll put a quick disclaimer here that this information can vary greatly from hospital to hospital, or even unit to unit. I also know most about what is required of the nursing staff at my hospital, which I’ll be talking most about, but will briefly touch upon what I know about doctors’ schedules at the hospital. Also, since I work in trauma, I imagine a lot of our policies and systems aren’t in place on other units, simply because we need to be vigilant and prepared in the case of some catastrophic emergency.

Basics

Nursing staff is required to work three 12-hour shifts per week. These shifts do not have to follow three-in-a-row, but in a Sunday to Saturday period three shifts must be worked.  Staff at my hospital work on a rotating schedule, meaning we work both day (7AM to 7PM) and night (7PM to 7AM) shifts. Right now, I am required to work every other weekend, while some other nurses on my unit are required to work every third weekend.  I’m also required to work two Mondays and two Fridays every month, just to ensure we have adequate staffing. During our “busy season” from May to October, nurses are required to serve one weekend on-call shift a month. That means Friday night, Saturday night or day, or Sunday night or day.

Doctors operate on a slightly different schedule, though I’m not positive of the specifics. At the trauma center, we have three trauma teams that rotate coverage for admitting patients each day, one orthopedic team to cover all the lovely fractures we admit, and one soft tissue team for non-trauma patients that have nasty infections (such as necrotizing fasciitis). Within each team there is a conglomerate of attending physicians, nurse practitioners, physician’s assistants, fellows, and residents. Between all of these people (roughly 15-20 people per team), there’s always a group of doctors available for every patient in the hospital.

Patient Load

Nurse to patient ratios vary based on the unit you’re looking at, specifically the acuity or “sickness” of the patient population. Low acuity units, where the patients are less sick or critical, there’s usually four patients to one nurse, although some hospitals may push it to five patients per nurse, whereas intensive care units (ICUs) are often two patients per nurse but can drop down to one-to-one if the patient is super critical. Nurse assignments are made at the beginning of every shift at each individual unit based on available staff for the shift and the type of patients on the unit.

A doctor’s patient load is spread across the entire hospital, versus a nurse’s patients remaining on a single unit. Each patient is assigned a team based on which trauma team was covering when they were admitted. For example, team A is “on-call” for roughly a 24-hour stretch and any patient that is admitted during that time will continue to be followed by team A throughout their hospitalization. Orthopedics picks up patients through referrals from the trauma team, usually when there’s some gnarly fractures involved. So a team may have the upwards of 30-40 patients on their service, but those patients are divided among the various residents each shift.

Night Shift

Staffing is stripped down to its bare bones for night shift, for cost efficiency and allowing staff some time for rest. Nursing really sees no difference between day shift and night shift, except that our manager often isn’t in and our charge nurse (who coordinates patient flow through the unit) may have patients of her own. There’s still a nursing coordinator who looks at patient flow throughout the entire hospital to accommodate for nighttime admissions. Doctors, on the other hand, do have a transition to make. As I hinted earlier, during day shift all three teams (plus orthopedics and various other specialties) are present, whereas only one team and orthopedics are in house at night. That one team, in addition to admitting new patients, covers every patient in the hospital. While this may seem overwhelming, the coverage is mostly limited to emergency situations or orders that cannot wait for the morning.

Weather Emergencies

Hospitals don’t have snow days. Unfortunately. In the case of a blizzard, as was the case downtown a couple years ago, the hospital still needs staff to continue safe operations. When this blizzard struck, a state of emergency was declared. Stretchers were set up in waiting rooms for staff who couldn’t return home and didn’t want to get a hotel room. Job responsibilities were adjusted to cover staff shortages, such as HR reps helping with patient admissions or one of our business folks shoveling snow off the sidewalk. In fact, during my orientation, they suggested I keep a go-bag in the truck of my car during the winter that would have a spare set of scrubs and toiletries. You know… Just in case.

Holidays

There’s still sick people in the hospital, even (sometimes especially) on holidays. On certain holidays, such as Thanksgiving or Christmas, staff may be pared down similar to night shift staffing though not to the same extent. Nurses are required to work every other holiday, which includes New Year’s, MLK, July 4th, Labor Day, Thanksgiving, and Christmas. If you still work 36 hours (or three shifts) during the week of a holiday, you get holiday time which is pretty much just extra vacation time.

You tell me: Curious about anything else with scheduling or patient loads?

I’ve Been Under a Rock, so How About Some Updates?

Hey guys!

So things have been a little nuts in my recent life. For example, my unit at work moved physical locations to accommodate renovations to our old, dingy unit, and so I picked up an overtime shift to help make the transition smoother. It was also on night shift, which always messes up my circadian rhythm and then my free time schedule. I’m on my night shift schedule now (working tomorrow and Tuesday night, and then nights on the weekend), and my body doesn’t know what to do. Luckily it’s been cloudy so sleeping isn’t interrupted too much, but I still have no concept for mealtime or what to do with myself.

A big thanks to everyone who showed up to my AMA on Reddit last month! I think it was a huge success and I had a lot of fun racking my brain for all those answers. Some questions have definitely inspired some future topics I’d like to cover, but I won’t throw a bunch of heavy pathophysiology stuff at you. I’m thinking about still starting small… Maybe the general layout of various units, as inspired by our recent transition at work?

I can’t believe it’s already October, which means it’s almost November, which means NaNoWriMo. Since I’m a crazy person, I will be attempting to compete alongside my work schedule. I’m really excited about my pending project, which you can keep track of here, which will be a rough and edgy NA project. I’ll be putting revisions for my Beauty and the Beast retelling on hold, even though I’ve been making super slow progress with revising anyway. Oh! And I’ll be lurking around Susan Dennard’s NaNoWriMo Bootcamp. My username is zeegasp, so keep an eye out for me!

r/YAwriters AMA starts NOW!

Hello readers!

So today is the day! Here’s the link for you to send any healthcare question that’s been nagging your brain. I’ll be around all day and periodically throughout the week to guide you.

Check it out!!!

Patient Care Staff

Welcome to the first installment of my ongoing educational series that will be providing accurate healthcare information that I believe will be useful for writers.  I thought I would start with a brief overview of people you generally see on an unit, because I know that alone can be daunting and confusing. This list is not all-inclusive by any means, but contains general information about personnel that are most often walking in and out of a patient’s room.

Doctor (MD, DO)

What they look like: Docs often wear one of two things: scrubs (color depends on specialty or location) or business casual underneath a lab coat. The choice is usually personal preference, but usually the docs in scrubs work more directly with patient care.

Specialties: Docs come in as many flavors as you can imagine, and this goes deeper than the Scrubs separation of medical versus surgical. Surgeons can be specialized in areas like cardiac surgeries, like coronary artery bypass grafts (CABG), or orthopedics, meaning fixing broken bones. Medicine can be splint down into anything from infectious disease to obstetrics to family medicine.

Scope of practice: The biggest thing that sets doctors apart is their ability to prescribe treatments and diagnose medical conditions, so therefore they generally direct plans of care for patients. They also perform more complicated bedside procedures, such as placing a central venous line or inserting a chest tube.

Nurse Practitioner (NP)

What they look like: Like docs, NPs wear either scrubs or a lab coat depending on their area.

Specialties: Many NPs work in a family practice or clinic setting as a cheaper alternative to doctors. There is an increase in acute care NPs who work in hospital units.

Scope of practice: This actually varies state to state, going from independent practicing for NPs to the requirement of needing to work under a doctor. NPs can write meds and diagnose, but sometimes their prescriptions need to be cosigned by a doctor.

Registered Nurse (RN)

What they look like: Pretty much all nurses wear scrubs. Some hospitals have color requirements (usually navy), others allow nurses to wear whatever color or pattern they want.

Specialties: Many nurses just hold their basic RN licensure, but some nurses can get specialty certificates for things like wound care or diabetes education or critical care. Advanced degree nurses, who have earned a master’s degree or higher can, specialize in things like healthcare administration and management.

Scope of practice: Nurses tend to provide the bulk of patient care, ranging from medication administration to daily assessments. The major role of nurses is to provide patient advocacy through plan of care decisions with any member of the healthcare team. Registered nurses are responsible for the administration of blood products.

Patient Care Tech/Nurse’s Aide (PCT)

What they look like: Techs (as they’re most usually called) wear scrubs. If they’re color coordinated, I’ve most often seen a dark red color.

Scope of practice: Techs serve to help patients with their activities of daily living, or ADLs for short, to lighten the load of the nurse. This includes helping with bathroom privileges, assisting with meals, and obtaining vital signs. They’re not allowed to administer any medications and cannot perform any typical of assessment. They can, however, perform simple procedures such as an uncomplicated dressing change or Foley catheter insertion in a stable patient.

Physical Therapist (PT)

What they look like: Most of the PTs I’ve seen wear nice looking workout-style clothes, since they’re working physically with patients.

Scope of practice: They look specifically into the physical rehabilitation of patients. They’re used often for patients with physical injuries that will require assistive devices such as walkers or crutches after discharge, but can be used for any patient.

Occupational Therapist (OT)

What they look like: Some OTs wear workout stuff, others wear business casual, others wear scrubs.

Scope of practice: While PTs work on physical rehab, OTs look at the broader picture, helping patients achieve independence for their ADLs after discharge. This includes things like ensuring proper bathing routines with dressings or splints.

Respiratory Therapist (RT)

What they look like: They usually wear scrubs, and the color I’ve seen is a royal blue color.

Scope of practice: Most RTs work in intensive care settings, since many of those patients are on ventilators and they’re there to monitor patient’s respiratory status related to their ventilator. Some RTs also make rounds to lower acuity units to administer respiratory medicines such as inhalers.

Social Worker (LSW, LCSW)

What they look like: In a hospital setting, they can wear a lab coat over business casual or just business casual.

Scope of practice: Social workers coordinate services for patients. Sometimes they have extra clinical training to perform counseling, but mostly social workers in a hospital are providing resources from in-house consultations to outside programs like Meals on Wheels or home health care.

You tell me: Did I forget anyone?? Any specialty you’re wondering whether it exists or would be useful in a hospital setting?

BONUS!!!

Mark your calendars! One week from today (September 2) I will be hosting a medical AMA over on r/YAwriters starting at approximately noon EST, so get your questions ready! And stay tuned for more installments of healthcare knowledge.

Finished the First Draft!

After a little over two months of work, I’ve completed the first draft of my MS.

The project is a big step for me, since it’s really the first serious MS I’ve written completely from start to finish. It also comes a pretty unique time in my life; I started it as a release for studying for the NCLEX and have completed while I’m crawling closer to the end of orientation at my first real job. And with my first adult paycheck in my bank account, I’m readying to dish out a couple bucks to get it printed to start revisions!

I’ve learned a lot from this project, specifically about perseverance and maintaining motivation. The last few thousand words were absolutely brutal, mostly because I had started work which was making me dead tired and I didn’t have any huge scenes left to write. But when I had started this MS, I knew inside that there was something different about it and I made the promise to myself that I’d get to the end of it. And you know what? I did!

One of the tools that helped me stay on top of my game was my word count spreadsheet, which I’ve talked about before. And not only did it help me track my progress as I was writing, it’s also given me a nice little pile of statistics. For example, this project has a completed length of 83.2k words with an average words per day of 1,571. My most productive day was interestingly enough Monday (bringing in an average of 1,788 words) and my least productive day was Friday (averaging 1,348 words). My weekly writing goals varied each week, but there was only one week that I didn’t meet my goal and that was when I had taken my exam.

Anyway, typing “the end” at the end of this manuscript was a cathartic experience. I miss building this story, but I’m also really looking forward to ironing this sucker out and making it a jillion times better!

In other news, I received some positive feedback between the poll here and my thread on Reddit regarding a series teaching healthcare related topics for writers. I’m putting together my first post that I’ll put up within a few days, so keep your eyes out. I’m also working with one of the mods of r/YAWriters to host a thread where you can bring any questions and I’ll answer them for you. There’s no specific date yet, but I will absolutely keep you posted!

You tell me: Where are you in your MS? How’d  you feel after you finished your first draft?

Healthcare for Writers?

I brainstormed this idea awhile ago, and with my job starting, I thought I would reintroduce the idea.

As I have talked continually about, I am nurse working at a major hospital in downtown Baltimore. I love working in healthcare because the human body simply fascinates me and being part of a team that literally saves lives every day is unbelievable. Working in healthcare also gives me the sometimes annoying privilege of pointing out when healthcare is depicted inaccurately.

It sort of struck me, though, that writers are writing about what they know, and there aren’t very many writers out there who have an intimate working knowledge of our complex healthcare system or had to take multiple credits of college level courses on human anatomy and physiology. The Internet (read: Wikipedia) is a great resource that even I use from time to time, but I can believe folks getting lost in paragraphs of medical terminology and abbreviations and deciding that you as a writer is just gonna wing it.

And for that, I entirely can’t blame you. But this is also where I’m deciding to step in. I’ve completed four years of nursing education, spent a month and a half studying this material, and am about to hop in and apply everything I know. I love teaching people, and I think I could additionally be a great resource for all you writers out there.

I have an idea list of possible topics, in case you’re wondering what they heck I would be talking about in these series of posts. Some of the more general ones:

  • People who work in a hospital and what their job is
  • Layout of a general hospital unit
  • How CPR works and when it’s used
  • What a DNR (do not resuscitate) means
  • Difference between brain death and vegetative state
  • Miscellaneous disease processes
  • Patient movement through a hospital (from admission to discharge)

I’m also entirely open to any suggestions you might have, which can be sent to me through the comments section here (or any posts of the series) or directly to my inbox by emailing me at z.gasparotti@gmail.com.

I will be rounding this post out with a yes/no style poll which will literally take less than 5 seconds, just so I can gauge interest. If you have any questions or want me to expand on this idea at all, let me know! I’ll also be posting this idea to r/YAwriters, the subreddit for YA authors and writers, so you can go there to for more discussion or questions.

You tell me: What are your thoughts on this inside? Any medical gaps in your current WIP?

Orienting and Sweating

I haven’t been doing very much awesome writing-related stuff, so full disclaimer: this post is mostly an update on what’s been going on, and you’ll probably see why writing has been bookmarked for the past couple days.

This week I completed the Human Resources orientation for my brand new spanking job. It was two full days of sitting in a conference room with a mob of other healthcare professionals as we were talked at about every policy, procedure, and benefit at the hospital. Some presentations were more interesting than others, which is to be expected, but mostly it just hit me that I’m a real person. I’m going to be setting up a 403(b) retirement plan for Christ’s sake!

But it’s awesome. I’m so excited to get started on my unit this Friday with my first full shift with my preceptor. This excitement made orientation tolerable, but I ultimately welcomed my time in the generic ballroom because, with perfect timing, the air conditioning crapped out at home in time for the hottest week so far this summer. Baltimore is a professional at creating the muggiest, suckiest summer days, and with no option but to keep our windows open that all came inside. I took cold showers just to catch some relief, only to feel freshly sticky by the time I hung my damp towel on my door.

It reminded me of when I worked at a Girl Scout camp in high school, where there was absolutely no air conditioning anywhere and the cook rated days based on how many showers she took, tallying dives in the pool as a half point. If I could, I would have slept in a bathtub of ice water to get relief. Instead, I retreated to my basement that was noticeably cooler so I wouldn’t be up all night staining my sheets with sweat.

Luckily, the air conditioner technician popped up this evening and waved his magical engineering wand. The house is cruising around 83 degrees as I’m typing this, which compared to the past few days is almost sweater-worthy. As someone who would always rather be cold, I’m feeling so much more like myself. I’m tired from commuting three days in a row, which has made me lazy with my writing, but I’m prepared for an action-packed BICHOK day tomorrow on my day off.

And what’s the status on my MS? I’m just shy of 75k, which is the farthest I’ve ever made it in a manuscript ever. I’m close to rounding out my climax point, and will be cruising through my denouement within one or two writing sessions. I’d say I have roughly 10k or less left, and then I’m going to let this heap of words percolate for a little while. My tentative plan is to start revisions after I get my first paycheck so I can throw down on a print out for read-through and mark-up purposes. It’s hard to say whether I’m more excited to polish this project or start work.

You tell me: How’s your WIP going? What’s life throwing at you these days?

Reddit for Writers

I don’t think I’ve talked about this before, but the Engineer got me hooked on Reddit about a year ago.

For those of you unfamiliar with Reddit, it is the “front page of the Internet.” Millions of user participate in submitting links to anything from news articles to Grumpy Cat memes. Content is separated into things called “subreddits,” which serve to organize links into categories. Some of these categories are more broad, such as r/pics or r/funny, while some definitely serve tighter niches such as r/firstworldanarchists or r/yawriters.

For more about how Reddit works, YA author Beth Revis does a fantastic job outlining the website and how to use it here.

Anyway, I’m going to focus this post on how I’m using this website for writing, because, let’s be honest, you probably don’t need another means for procrastination. And with Reddit’s automatic scrolling feature, you’ll find yourself wasting infinite amount of time.

I’m actually fairly new to the writing side of Reddit. I’ve subscribed to r/writing, and am still kinda a newbie over at r/yawriters, but these places are awesome. I’m sure there are plenty of other message board-type sites available for writers of any genre, but there’s something that feels like home about having a place on Reddit to talk about my writing. It serves as a source of inspiration and motivation as well as a tight-knit, supportive community.

One of my most recent findings is r/IAmAFiction, which in broad terms conducts character interviews. I’ve always gone back and forth on character interviews because sometimes I feel like they can be a bit forced and contrived. The thing that I love about r/IAmaFiction is that the questions are coming from other people, so it eliminates those questions that you as writer might create to deliver a very specific answer. Plus, I’m seeing so many cool idea floating on this subreddit that it helps stimulate my creative juices.

I haven’t hosted a character AMA (which stands for “ask me anything”) because I’m not quite ready for one yet. With the end of the first draft of my WIP drawing near, I might host one with my MC in a couple weeks, so keep an eye on my Twitter and blog. I’ll announce it here beforehand in case you want to participate ;)

Anyway, if you’re looking for a different kind of community for your writing, I would definitely suggest Reddit. There’s a lot out there for you to participate in and it’s a great place for collaboration and critique. And if you’re wary and need a hand to hold, let me know. I’m here for you!

You tell me: Are you on Reddit? What other online writing communities are you part of?

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