Sunday, January 26, 2020

Respiratory System Procedures

Respiratory System Procedures Carol Bailey, MSN, RN Introduction | Task | Process | Evaluation | Conclusion | Credits Introduction You are a nurse working in a PCU. Your clinical unit specializes in the care of patients who are undergoing treatment for pulmonary disease. You often provide care and patient teaching for patients having tests and procedures for pulmonary conditions. Your assignment today includes providing care and education support for 2 patients. You have a student nurse observing in your unit today. As you teach, please be sure to include rationales and answer the student’s questions. The Task Patient 1: Mr. Paul Monary, a 58 year old farmer, was admitted to your unit with complaint of progressive hoarseness, difficulty in swallowing, and loss of appetite over the past 3 months. The medical plan of care involves chemotherapy and radiation therapy. He will need a tracheostomy prior to beginning therapies. Objective data: He smokes 1 pack of cigarettes per day. His weight has decreased from 200 pounds to 180 pounds over the past 3 months. The results of a CT scan and MRI reveal that this patient has throat cancer. Subjective data: The doctor said I would have a tracheostomy, but I don’t really know what that means for me. I don’t know how I am going to manage my farm if I have to have surgery. The nursing diagnosis you must address is knowledge deficit related to lack of information regarding care of a tracheostomy as evidenced by patient’s verbal response. Patient 2: Ms. Flora Vack, a 25 year old female, is a bull rider in the â€Å"Riding Stars Rodeo† that is currently performing at the Civic Center. She was thrown from a bull in last night’s performance and received repeated kicks to her left posterior chest. She was seen in the emergency room and admitted for follow up care. Her chest X-ray reveals a large pleura effusion on the left. You are assigned to prepare the patient for a thoracentesis. Outcome: You assist with the thoracentesis. 1,500 ml of pink tinged pleural fluid is removed. The patient experiences a pneumothorax following the procedure and a chest tube is inserted and connected to an atrium ocean chest tube drain. You are assigned to prepare the patient for chest tube insertion and to manage the chest tubes after the procedure. The Process To accomplish the task, you will review information from the links provided for each patient to fill in the table below. Patient 1 Links: http://www.youtube.com/watch?v=DoSTehS7iq8 http://www.youtube.com/watch?v=Lo74zm3ULyk Tracheostomy regular manual approach http://www.youtube.com/watch?v=6TVOSb6sqL8feature=related Tracheostomy percutaneous insertion http://www.youtube.com/watch?v=SloXwGG2n-Q Tracheostomy – percutaneous view from inside the trachea http://www.youtube.com/watch?v=PhasybkUrzkfeature=related Laryngoscopy (this one was just cool!) http://www.youtube.com/watch?v=iYpDwhpILkQfeature=related effects of smoking: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/ effects all organs of the body http://www.tobaccofreekids.org/research/factsheets/pdf/0264.pdf immediate effects http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Smoking_effects_on_your_body http://www.quitsmoking.com/content/how-smoking-affects-your-body trach care http://www.youtube.com/watch?v=Wimw7bz0fLofeature=related suctioning trach http://www.youtube.com/watch?v=UVuPzhOWxRsfeature=related cleaning intercannula and trach dressing http://www.youtube.com/watch?v=ivUKHnnTKb4feature=related fenestrated trach tube http://www.youtube.com/watch?v=RzYPp5h_vx8feature=related passey-muir speaking valve http://www.hopkinsmedicine.org/tracheostomy/living/passey-muir_valve.html http://www.passy-muir.com/video_page Bottom of Form Click on â€Å"Videos† at the top of the home page. CEUs | Videos | News and Events | FAQs | Contact Us | International Then under – â€Å"Passy-Muir Animations† – There is a play list with 6 videos. View all videos except for the one on mechanical ventilation. Patient 2 Links: thoracentesis demo on real patient http://www.youtube.com/watch?v=noDxydboLrAfeature=related chest tube insertion http://www.youtube.com/watch?v=424M8L5Z_EQ http://www.youtube.com/watch?v=A_0K8o98SPw http://www.atriummed.com/EN/chest_drainage/education.asp Review â€Å"Managing chest drainage† ppt presentation for nursing educators (note: this ppt includes nursing assessment) Under the Product support tab: Along the left column under â€Å"Traditional Drainage† – click on â€Å"Ocean† Under education resources click on â€Å"Set up and Operation video†. Next click on Oasis, then pneumostat section. The video’s on ocean, oasis, and pneumostat are interesting and helpful to understand the function and assessment of a chest tube drainage system http://www.atriumu.com/ Click on the â€Å"Learning† tab Chest drainage 101 chapter 1 – 4 and Managing chest drainage part 1-6 are excellent resources of education developed by Atrium – a common brand of chest drainage system aking chest tube out / closing with a suture http://www.youtube.com/watch?v=4GTecWv5h6cfeature=related Nursing Assessment of the patient with a chest tube. Patient 1: Mr. Paul Monary NANDA: Knowledge deficit r/t lack of information regarding care of a tracheostomy AEB by patient’s verbal response. Client outcomes: Patient will Describe what a tracheostomy is and why it is necessary Describe the purpose of suctioning Demonstrate clearning of the innercannula and trach dressing Identify the effects on cigarette smoking on his current state of health List safety precautions in the use of the Passey-Muir valve Note: Respond to the patient’s questions using terminology the patient can understand. Respond to the Student nurse’s questions using professional terminology. Patient teaching: explain to this patient what a tracheostomy is and why it is necessary for him while having radiation therapy Patient teaching: explain to this patient the purpose of suctioning the trach and how it is accomplished. (explain the in-hospital sterile procedure – in your own works as if you were telling the patient all the steps you are taking and why) Patient teaching: explain to this patient how the nurse will clean the innercannula and why it is done (in-hospital sterile procedure) Patient teaching: explain to this patient, the effect of smoking on the lungs and on oxygenation Patient teaching: explain to this patient, the effect of smoking on the body. Patient teaching: explain to this patient how the passey-muir valve works and list safety precautions Answering the student nurse’s questions: how does the percutaneous insertion of the trach differ from the regular manual insertion? Answering the student nurse’s questions: How is a fenestrated trach tube different from a regular tube? Is there any potential complications with the fenestrated tube? List 3 additional Nursing Diagnosis (in 3 part format) appropriate for Mr. Monary: 1. 2. 3. Note: must list actual nursing diagnosis in 3 part format – not â€Å"at risk for† Patient 2 Ms. Flora Vack Respond to the patient’s questions (using terminology the patient can understand) Respond to the Student nurse’s questions (using professional terminology. Patient question: What is a thoracentesis? A thoracentesis is when a needle is inserted through your chest wall and then into the pleural space (Lewis, 2014). The pleural space is the thin, but large lining of tissue that surrounds your lungs and lines your chest cavity (Lewis, 2014). We do this to take samples to perform some diagnostic testing, remove excess fluid or air and give medications directly to the pleural space (Lewis, 2014). In your situation we are using a thoracentesis to drain the fluid buildup from your lungs by inserting the large needle and letting it drain out (Thoracentesis to remove 1200cc of Pleural Fluid at Harborview). Answering the student nurse’s questions: How do you position the patient for a thoracentesis? What do I do to assist the doctor during this procedure? You need to position the patient with their elbows on over the bedside adjustable table, sitting in the upright position (Thoracentesis to remove 1200cc of Pleural Fluid at Harborview). Their feet should be supported and you can place a pillow across their abdomen for additional support (Thoracentesis to remove 1200cc of Pleural Fluid at Harborview). During a thoracentesis the nurse will assist the doctor by supporting the patient throughout the procedure and answering any questions she may have (Thoracentesis to remove 1200cc of Pleural Fluid at Harborview). Throughout the procedure you will need to ask assessment questions to determine how the patient is tolerating the procedure and to facilitate any alterations in body position, such as resting their head during the procedure if they feel light headed (Thoracentesis to remove 1200cc of Pleural Fluid at Harborview). You will also monitor vital signs throughout the procedure (Lewis, 2014). Also, make sure you ensure the patient is properly oxygenated by administering any supplemental oxygen that may be necessary (Lewis, 2014). After the procedure you will need to make sure you apply a sterile dressing to the puncture site (Lewis, 2014) Patient question: What is the purpose of a chest tube and drainage system? The purpose of a chest tube and drainage system is to drain the air or gas that has built up in the area around your lungs due to your pneumothorax (Chest Tube Insertion part 1/2). The space around your lungs is known as the pleural space (Chest Tube Insertion part 1/2). This is the lining of tissue that surrounds your lungs and lines your chest cavity (Chest Tube Insertion part 1/2). This reestablishes negative pressure in your lungs which allows your lungs to expand properly (Lewis, 2014). Answering the student nurse’s questions: What is the underwater seal of a chest drainage system and how does it work? The underwater seal of a chest drainage system is what allows the air or fluid to leave the pleural space but also prevents the backflow of air or fluid back into the pleural cavity (Chest Tube Insertion part 2/2). The way the underwater seal works is that is contains about 2 cm of water and when the air or gas enters up, or bubbles, through the water it acts as a one way valve (Lewis, 2014). Answering the student nurse’s questions: When do I expect to see bubbles in the underwater seal section of the chest tube drainage system? (what circumstances will cause bubbling in this chamber) Answering the student nurse’s questions: The atrium pleura drain uses the same concepts at the 3 bottle system of chest tube bottles. What is the main function of each of the bottles? Bottle 1 = Bottle 2 = Bottle 3 = Answering the student nurse’s questions: What should I include in the assessment and care of a patient who has a chest tube? (include assessment of the patient as well as the drainage system) Answering the student nurse’s questions: Describe to the student nurse how the chest tube will be removed, how the nurse will assist, and observation and care of the site. Evaluation Your grade for this exercise will be 2% of your grade for this course. Grading will use the rubric below. Maximum points = 36. This webquest is due to be submitted by 1:00 PM, October 17, 2014. Learning Objectives Beginning 1 point Developing 2 points Accomplished 3 points Score Describes the purpose of a tracheostomy including the difference between a regular tube and a fenestrated tube Response reflects limited knowledge of this objective Limited explanation Effectively explains the purpose of a tracheostomy and the fenestrated tube Explains the purpose and steps of trach suctioning and cleaning of the inner cannula Response reflects limited knowledge of this objective Limited explanation Effectively explains trach suctioning and cleaning of the inner cannula using terms appropriate for patient education Identifies the effects of smoking on the respiratory system Response reflects limited knowledge of this objective Identifies only 3 smoking risks on the respiratory system (lungs) Explains effectively to the patient the effect smoking has on their lungs. Identifies the effects of smoking on the body Response reflects limited knowledge of this objective Identifies only 3 smoking risks to the body Explains effectively to the patient the effect smoking has on their body. Explains the purpose of the passey-muir valve and how it works. Response reflects limited knowledge of this objective Limited explanation Effectively explains purpose of a passey-muir valve and how it works using terms appropriate for patient education Identifies safety precautions for use of a passey-muir valve. Response reflects limited knowledge of this objective Identifies only 3 safety precautions Explains safety precautions effectively to the patient. Critiques the difference between the surgical insertion and the percutaneous insertion of the tracheostomy tube Response reflects limited knowledge of this objective Limited explanation Clearly critiques the difference in the 2 insertion techniques for tracheostomy insertion. Identifies 3 actual nursing diagnosis using the 3 part format (diagnosis / related to / AEB) Response reflects limited knowledge of this objective Nursing diagnoses do not include pertinent diagnoses or format is not followed Identifies 3 actual nursing diagnosis pertinent to this patient in proper format Describes the procedure, performing a thoracentesis Response reflects limited knowledge of this objective Limited Explains the procedure effectively including patient positioning Recognizes normal versus abnormal function of the chest tube system Response reflects limited knowledge of this objective Limited explanation Recognizes which chambers bubbling may occur and what that means Describes the function of the 3 bottle chest tube system Response reflects limited knowledge of this objective Limited explanation Fully explains the function of each of the 3 bottles Demonstrates knowledge in the care of the patient with a chest tube drain and chest tube removal. Response reflects limited knowledge of this objective Limited explanation Explains effectively to the student nurse, how to care for a chest tube drain, including assessment of the patient Conclusion This WebQuest will support learning and application of materials covered in Lewis, Chapters 26, 27, and 28. I hope you found the exercise to be a fun, interesting way to learn. In addition to Web links, you may use your NANDA and Lewis books as needed to support your answers. You must cite references for your answers using APA format. Credits References Ackley, B. J. Ladwig, G. B. (2008). Nursing diagnosis handbook: A guide to planning care (8th ed.). St. Louis, MO: Mosby-Elsevier Atrium Chest Drainage Education. www.atriummed.com/Products/Chest_Drains/education.asp Chest Tube Insertion part 1/2. (2012, July 13). Retrieved March 11, 2015, from https://www.youtube.com/watch?v=424M8L5Z_EQ Chest Tube Insertion part 2/2. (2012, July 13). Retrieved March 11, 2015, from https://www.youtube.com/watch?v=424M8L5Z_EQ Lewis, S.M., Heitkemper, M.M., Dirksen, S.R., O’Brien, P.G., Giddens, J.F, Bucher, L. (2007). Medical-surgical nursing: Assessment and management of clinical problems (8th ed.). St.Louis: Mosby-Elsevier. Lewis, S. M., Dirksen, S. R. (2014). Medical-surgical nursing: assessment and management of clinical problems (Ninth ed.). St. Louis: Elsevier. Ocean Drain Education Video. (n.d.). Retrieved March 11, 2015, from http://www.atriummed.com/EN/chest_drainage/edu-files/ocean-video1.asp Thoracentesis to remove 1200cc of Pleural Fluid at Harborview. (2007, November 2). Retrieved March 11, 2015, from https://www.youtube.com/watch?v=noDxydboLrAfeature=related Based on a template from The WebQuest Page

Saturday, January 18, 2020

Leadership Impact Essay

This research paper is written on the Leadership styles and the impact they have on the workforce. My information is based on my direct observation while being employed in the U. S. Air Force. My paper will analyze Leadership styles by using two concepts from Robbins and Judge (2009). The two concepts I have chosen are Leader Behaviors (p. 397) and Vision Statement (p. 415). Leadership Behaviors Being in the military for the past nine years has giving me an opportunity to see many different leadership behaviors. Four leadership behaviors Robbins and Judge (2009) defined are directive, supportive, participative, and achievement-oriented leaders (p. 397). The directive leader defines what is expected of the worker and schedules the work (p. 397). I feel that most people start off in with this leadership behavior until they grow as a leader. The supportive leader is concerned with the needs of their followers and interacts with them (p. 397). I have worked with many leaders that have used this behavior and it make them a popular leader, but can make it hard for them to get work done by some of their followers. I have seen were the workers take advantage of a leader because they feel more like a friend and not a boss. The participative leader takes the input of the follower and uses them before making a decision (p. 397). The Air Force leadership does use this behavior by using a yearly climate survey. The last leader behavior is the achievement-oriented leader. I feel that for the most part the behavior is the hardest to work for. This leadership style does not show much concern for the followers and does not take in their input. The leader is goal orientated and expects the followers to perform at their best to meet the goals (p. 97). Vision Statement A vision statement is a tool that leadership can use to tell why the organization exists (Kaplan & Norton, 2008). Most military units have a vision statement to motivate its members. My unit’s statement is Safety first, By the book, Then on time. Our vision statement put the safety of the workers first and the sets the attitude of how the work is to be done. Robbins and Judge (2009) state that a vision should be value centered (p. 415) and all the military units I have worked for have had a vision statement that puts it people first. I feel it can make it easier to work for someone if they value you. Conclusion Leaders may use any of the behavior styles talk about in the paper. Charismatic leaders will try to set a goal and good work environment for their workers (Fischer). The leaders of an organization will have to ensure they use the right behavior to motivate its workers. In Psalm 28:11 David asks to be taught the Lords way and be lead in a straight path. I think this is how a lot of employees feel and it is the job of the leaders to ensure they know what path the organization is going.

Friday, January 10, 2020

Frostbite Chapter 12

Twelve I WAS OUT OF BED in a flash. We found the entire lodge abuzz with the news. People clustered in small groups in the halls. Family members sought each other out. Some conversations were conducted in terrified whispers; some were loud and easy to overhear. I stopped a few people, trying to get the story straight. Everyone had a different version of what had happened, though, and some wouldn't even pause to talk. They hurried past, either seeking out loved ones or preparing to leave the resort, convinced there might be a safer place elsewhere. Frustrated with the differing stories, I finally- reluctantly- knew I had to seek out one of the two sources who would give me solid information. My mother or Dimitri. It was like flipping a coin. I wasn't really thrilled with either one of them right now. I debated momentarily and finally decided on my mother, seeing as how she wasn't getting it on with Tasha Ozera. The door to my mother's room was ajar, and as Lissa and I entered, I saw that a sort of makeshift headquarters had been established here. Lots of guardians were milling around, moving in and out, and discussing strategy. A few gave us odd looks, but no one stopped or questioned us. Lissa and I slid onto a small sofa to listen to a conversation my mother was having. She stood with a group of guardians, one of whom was Dimitri. So much for avoiding him. His brown eyes glanced at me briefly and I averted my gaze. I didn't want to deal with my troubled feelings for him right now. Lissa and I soon discerned the details. Eight Moroi had been killed along with their five guardians. Three Moroi were missing, either dead or turned Strigoi. The attack hadn't really happened near here; it had been somewhere in northern California. Nonetheless, a tragedy like this couldn't help but reverberate within the Moroi world, and for some, two states away was far too close. People were terrified, and I soon learned what in particular made this attack so notable. â€Å"There had to be more than last time,† said my mother. â€Å"More?† exclaimed one of the other guardians. â€Å"That last group was unheard of. I still can't believe nine Strigoi managed to work together- you expect me to believe they managed to get more organized still?† â€Å"Yes,† snapped my mother. â€Å"Any evidence of humans?† someone else asked. My mother hesitated, then: â€Å"Yes. More broken wards. And the way it was all conducted†¦it's identical to the Badica attack.† Her voice was hard, but there was a kind of weariness in it, too. It wasn't physical exhaustion, though. It was mental, I realized. Strain and hurt over what they were talking about. I always thought of my mother as some sort of unfeeling killing machine, but this was clearly hard for her. It was a hard, ugly matter to discuss- but at the same time, she was tackling it without hesitation. It was her duty. A lump formed in my throat that I quickly swallowed down. Humans. Identical to the Badica attack. Ever since that massacre, we'd extensively analyzed the oddity of such a large group of Strigoi teaming up and recruiting humans. We'd spoken in vague terms about â€Å"if something like this ever happens again †¦Ã¢â‚¬  But no one had seriously talked about this group- the Badica killers- doing it again. One time was a fluke- maybe a bunch of Strigoi had happened to gather and impulsively decided to go on a raid. It was horrible, but we could write that off. But now†¦now it looked as though that group of Strigoi hadn't been a random occurrence. They'd united with purpose, utilized humans strategically, and had attacked again. We now had what could be a pattern: Strigoi actively seeking out large groups of prey. Serial killings. We could no longer trust the protective magic of the wards. We couldn't even trust sunlight. Humans could move around in the day, scouting and sabotaging. The light was no longer safe. I remembered what I'd said to Dimitri at the Badica house: This changes everything, doesn't it? My mother flipped through some papers on a clipboard. â€Å"They don't have forensic details yet, but the same number of Strigoi couldn't have done this. None of the Drozdovs or their staff escaped. With five guardians, seven Strigoi would have been preoccupied- at least temporarily- for some to escape. We're looking at nine or ten, maybe.† â€Å"Janine's right,† said Dimitri. â€Å"And if you look at the venue†¦it's too big. Seven couldn't have covered it.† The Drozdovs were one of the twelve royal families. They were large and prosperous, not like Lissa's dying clan. They had plenty of family members to go around, but obviously, an attack like this was still horrible. Furthermore, something about them tickled my brain. There was something I should remember †¦ something I should know about the Drozdovs. While part of my mind puzzled that out, I watched my mother with fascination. I'd listened to her tell her stories. I'd seen and felt her fight. But really, truly, I'd never seen her in action in a real-life crisis. She showed every bit of that hard control she did around me, but here, I could see how necessary it was. A situation like this created panic. Even among the guardians, I could sense those who were so keyed up that they wanted to do something drastic. My mother was a voice of reason, a reminder that they had to stay focused and fully assess the situation. Her composure calmed everybody; her strong manner inspired them. This, I realized, was how a leader behaved. Dimitri was just as collected as she was, but he deferred to her to run things. I had to remind myself sometimes that he was young as far as guardians went. They discussed the attack more, how the Drozdovs had been having a belated Christmas party in a banquet hall when they were attacked. â€Å"First Badicas, now Drozdovs,† muttered one guardian. â€Å"They're going after royals.† â€Å"They're going after Moroi,† said Dimitri flatly. â€Å"Royal. Non-royal. It doesn't matter.† Royal. Non-royal. I suddenly knew why the Drozdovs were important. My spontaneous instincts wanted me to jump up and ask a question right now, but I knew better. This was the real deal. This was no time for irrational behavior. I wanted to be as strong as my mother and Dimitri, so I waited for the discussion to end. When the group started to break up, I leapt up off the sofa and pushed my way toward my mother. â€Å"Rose,† she said, surprised. Like in Stan's class, she hadn't noticed me in the room. â€Å"What are you doing here?† It was such a stupid question, I didn't try to answer it. What did she think I was doing here? This was one of the biggest things to happen to the Moroi. I pointed to her clipboard. â€Å"Who else was killed?† Irritation wrinkled her forehead. â€Å"Drozdovs.† â€Å"But who else?† â€Å"Rose, we don't have time- â€Å" â€Å"They had staff, right? Dimitri said non-royals. Who were they?† Again, I saw the weariness in her. She took these deaths hard. â€Å"I don't know all the names.† Flipping through a few pages, she turned the clipboard toward me. â€Å"There.† I scanned the list. My heart sank. â€Å"Okay,† I told her. â€Å"Thanks.† Lissa and I left them to go about their business. I wished I could have helped, but the guardians ran smoothly and efficiently on their own; they had no need for novices underfoot. â€Å"What was that about?† asked Lissa, once we were heading back to the main part of the lodge. â€Å"The Drozdovs' staff,† I said. â€Å"Mia's mom worked for them†¦.† Lissa gasped. â€Å"And?† I sighed. â€Å"And her name was on the list.† â€Å"Oh God.† Lissa stopped walking. She stared off into space, blinking back tears. â€Å"Oh God,† she repeated. I moved in front of her and placed my hands on her shoulders. She was shaking. â€Å"It's okay,† I said. Her fear came to me in waves, but it was a numbed fear. Shock. â€Å"This is going to be okay.† â€Å"You heard them,† she said. â€Å"There's a band of Strigoi organizing and attacking us! How many? Are they coming here?† â€Å"No,† I said firmly. I had no evidence of that, of course. â€Å"We're safe here.† â€Å"Poor Mia †¦Ã¢â‚¬  There was nothing I could say to that. I thought Mia was an absolute bitch, but I wouldn't wish this on anyone, not even my worst enemy- which, technically, she was. Immediately, I corrected that thought. Mia wasn't my worst enemy. I couldn't bear to leave Lissa's side for the rest of the day. I knew there were no Strigoi lurking in the lodge, but my protective instincts ran too strong. Guardians protected their Moroi. Like usual, I also worried about her being anxious and upset, so I did my best to diffuse those feelings. The other guardians provided reassurance for Moroi too. They didn't walk side by side with the Moroi, but they reinforced lodge security and stayed in constant communication with guardians at the scene of the attack. Information flowed in all day about the grisly specifics, as well as speculation about where the band of Strigoi was. Little of this was shared with novices, of course. While the guardians did what they did best, the Moroi also did what they- unfortunately- did best: talk. With so many royals and other important Moroi at the lodge, a meeting was organized that night to discuss what had happened and what might be done in the future. Nothing official would be decided here; the Moroi had a queen and a governing council elsewhere for those types of decisions. Everyone knew, though, that opinions gathered here would make their way up the chain of command. Our future safety could very well depend on what was discussed in this meeting. It was held in an enormous banquet hall inside the lodge, one with a podium and plenty of seating. Despite the businesslike atmosphere, you could tell this room had been designed for things other than meetings about massacres and defense. The carpet had the texture of velvet and showed an ornate floral design in shades of silver and black. The chairs were made of black polished wood and had high backs, clearly intended for fancy dining. Paintings of long-dead Moroi royalty hung on the walls. I stared briefly at one of a queen whose name I didn't know. She wore an old-fashioned dress- too heavy on lace for my tastes- and had pale hair like Lissa's. Some guy I didn't know was in charge of moderating and stood at the podium. Most of the royals on hand gathered at the front of the room. Everyone else, including students, took seats wherever they could. Christian and Mason had found Lissa and me by that point, and we all started to sit in the back when Lissa suddenly shook her head. â€Å"I'm going to sit in the front.† The three of us stared at her. I was too dumbfounded to probe her mind. â€Å"Look.† She pointed. â€Å"The royals are sitting up there, sitting by family.† It was true. Members of the same clans had clustered near each other: Badicas, Ivashkovs, Zekloses, etc. Tasha sat there as well, but she was by herself. Christian was the only other Ozera there. â€Å"I need to be up there,† said Lissa. â€Å"No one expects you to be there,† I told her. â€Å"I have to represent the Dragomirs.† Christian scoffed. â€Å"It's all a bunch of royal bullshit.† Her face set into a determined expression. â€Å"I need to be up there.† I opened myself up to Lissa's feelings and liked what I found. She'd spent most of the day quiet and afraid, much as she had when we'd found out about Mia's mom. That fear was within her still, but it was overpowered by a steady confidence and determination. She recognized that she was one of the ruling Moroi, and as much as the idea of roving bands of Strigoi scared her, she wanted to do her part. â€Å"You should do it,† I said softly. I also liked the idea of her defying Christian. Lissa met my eyes and smiled. She knew what I had sensed. A moment later, she turned to Christian. â€Å"You should join your aunt.† Christian opened his mouth to protest. If not for the horribleness of the situation, seeing Lissa order him around would have been funny. He was always stubborn and difficult; those who tried to push him didn't succeed. Watching his face, I saw the same realization I'd had about Lissa come over him. He liked seeing her strong too. He pressed his lips together in a grimace. â€Å"Okay.† He caught her hand, and the two of them walked off toward the front. Mason and I sat down. Just before things started, Dimitri sat down on the other side of me, hair tied behind his neck and the leather coat draping around him as he settled in the chair. I glanced at him in surprise but said nothing. There were few guardians at this gathering; most were too busy doing damage control. It would figure. There I was, stuck between both of my men. The meeting kicked off shortly thereafter. Everyone was eager to talk about how they thought the Moroi should be saved, but really, two theories got the most attention. â€Å"The answer's all around us,† said one royal, once he'd been given leave to speak. He stood by his chair and looked around the room. â€Å"Here. In places like this lodge. And St. Vladimir's. We send our children to safe places, places where they have safety in numbers and can be easily guarded. And look how many of us made it here, children and adults alike. Why don't we live this way all the time?† â€Å"Plenty of us already do,† someone shouted back. The man waved that off. â€Å"A couple of families here and there. Or a town with a large Moroi population. But those Moroi are still decentralized. Most don't pool their resources- their guardians, their magic. If we could emulate this model†¦Ã¢â‚¬  He spread his hands out. â€Å"†¦ we'd never have to worry about Strigoi again.† â€Å"And Moroi could never interact with the rest of the world again,† I muttered. â€Å"Well, until humans discovered secret vampire cities sprouting up in the wilderness. Then we'd have lots of interactions.† The other theory about how to protect the Moroi involved fewer logistical problems but had greater personal impact- particularly for me. â€Å"The problem is simply that we don't have enough guardians.† This plan's advocate was some woman from the Szelsky clan. â€Å"And so, the answer is simple: get more. The Drozdovs had five guardians, and that wasn't enough. Only six to protect over a dozen Moroi! That's unacceptable. It's no wonder these kinds of things keep happening.† â€Å"Where do you propose getting more guardians from?† asked the man who'd been in favor of Moroi banding together. â€Å"They're kind of a limited resource.† She pointed to where I and a few other novices sat. â€Å"We've got plenty already. I've watched them train. They're deadly. Why are we waiting until they turn eighteen? If we accelerated the training program and focused more on combat training than bookwork, we could turn out new guardians when they're sixteen.† Dimitri made a sound low in his throat that didn't seem happy. Leaning forward, he placed his elbows on his knees and rested his chin in his hands, eyes narrowed in thought. â€Å"Not only that, we have plenty of potential guardians going to waste. Where are all the dhampir women? Our races are intertwined. The Moroi are doing their part to help the dhampirs survive. Why aren't these women doing theirs? Why aren't they here?† A long, sultry laugh came as an answer. All eyes turned toward Tasha Ozera. Whereas many of the other royals had dressed up, she was easy and casual. She wore her usual jeans, a white tank top that showed a bit of midriff, and a blue, lacy knit cardigan that came to her knees. Glancing at the moderator, she asked, â€Å"May I?† He nodded. The Szelsky woman sat down; Tasha stood up. Unlike the other speakers, she strode right up to the podium, so she could be clearly seen by everyone. Her glossy black hair was pulled back into a ponytail, completely exposing her scars in a way I suspected was intentional. Her face was bold and defiant. Beautiful. â€Å"Those women aren't here, Monica, because they're too busy raising their children- you know, the ones you want to start sending out to the fronts as soon as they can walk. And please don't insult us all by acting like the Moroi do a huge favor to the dhampirs by helping them reproduce. Maybe it's different in your family, but for the rest of us, sex is fun. The Moroi doing it with dhampirs aren't really making that big of a sacrifice.† Dimitri had straightened up now, his expression no longer angry. Probably he was excited that his new girlfriend had mentioned sex. Irritation shot through me, and I hoped that if I had a homicidal look on my face, people would assume it was for Strigoi and not the woman currently addressing us. Beyond Dimitri, I suddenly noticed Mia sitting by herself, farther down the row. I hadn't realized she was here. She was slumped in her seat. Her eyes were red-rimmed, her face paler than usual. A funny ache burned in my chest, one I'd never expected her to bring about. â€Å"And the reason we're waiting for these guardians to turn eighteen is so that we can allow them to enjoy some pretense of a life before forcing them to spend the rest of their days in constant danger. They need those extra years to develop mentally as well as physically. Pull them out before they're ready, treat them like they're parts on an assembly line- and you're just creating Strigoi fodder.† A few people gasped at Tasha's callous choice of words, but she succeeded in getting everyone's attention. â€Å"You create more fodder still if you try making the other dhampir women become guardians. You can't force them into that life if they don't want it. This entire plan of yours to get more guardians relies on throwing children and the unwilling into harm's way, just so you can- barely- stay one step ahead of the enemy. I would have said it's the stupidest plan I've ever heard, if I hadn't already had to listen to his.† She pointed at the first speaker, the one who had wanted Moroi compounds. Embarrassment clouded his features. â€Å"Enlighten us then, Natasha,† he said. â€Å"Tell us what you think we should do, seeing as you have so much experience with Strigoi.† A thin smile played on Tasha's lips, but she didn't rise to the insult. â€Å"What do I think?† She strode closer to the stage's front, gazing at us as she answered his question. â€Å"I think we should stop coming up with plans that involve us relying on someone or something to protect us. You think there are too few guardians? That's not the problem. The problem is there are too many Strigoi. And we've let them multiply and become more powerful because we do nothing about them except have stupid arguments like this. We run and hide behind the dhampirs and let the Strigoi go unchecked. It's our fault. We are the reason those Drozdovs died. You want an army? Well, here we are. Dhampirs aren't the only ones who can learn to fight. The question, Monica, isn't where the dhampir women are in this fight. The question is: Where are we?† Tasha was shouting by now, and the exertion turned her cheeks pink. Her eyes shone with her impassioned feelings, and when combined with the rest of her pretty features- and even with the scar- she made a striking figure. Most people couldn't take their eyes off her. Lissa watched Tasha with wonder, inspired by her words. Mason looked hypnotized. Dimitri looked impressed. And farther past him †¦ Farther past him was Mia. Mia no longer hunched in her chair. She was sitting up straight, straight as a stick, her eyes as wide as they could go. She stared at Tasha as though she alone held all the answers to life. Monica Szelsky looked less awed, and she fixed her gaze on Tasha. â€Å"Surely you aren't suggesting the Moroi fight alongside the guardians when the Strigoi come?† Tasha regarded her levelly. â€Å"No. I'm suggesting the Moroi and the guardians go fight the Strigoi before they come.† A guy in his twenties who looked like a Ralph Lauren spokesmodel shot up. I would have wagered money he was royal. No one else could have afforded blond highlights that perfect. He untied an expensive sweater from around his waist and draped it over the back of his chair. â€Å"Oh,† he said in a mocking voice, speaking out of turn. â€Å"So, you're going to just give us clubs and stakes and send us off to do battle?† Tasha shrugged. â€Å"If that's what it takes, Andrew, then sure.† A sly smile crossed her pretty lips. â€Å"But there are other weapons we can learn to use, too. Ones the guardians can't.† The look on his face showed how insane he thought that idea was. He rolled his eyes. â€Å"Oh yeah? Like what?† Her smile turned into a full-fledged grin. â€Å"Like this.† She waved her hand, and the sweater he'd placed on the back of his chair burst into flames. He yelped in surprise and knocked it to the floor, stamping it out with his feet. There was a brief, collective intake of breath throughout the room. And then †¦ chaos broke out.

Thursday, January 2, 2020

Great Ideas to Make Your 21st Birthday Memorable

Turning 21 is a rite of passage for Americans  since its the age when its finally legal to drink alcohol. Its the last milestone of official adulthood, with the right to vote set at 18, the right to marry varying by state, and the right to drive extended to kids as young as 16.   Getting stone-drunk on your birthday may sound like fun in theory, but it may make memories of the evening hazy later on. So here are some ideas to bring in your big 21 like a mature adult. Travel Someplace New Make your 21st year the year of globe-trotting. You dont need a big budget to travel. Ditch the lavish hotels, and go for small, inexpensive ones, or even check out hostels. You can also connect with friends abroad and stay with people you know. That way, you get to experience the local flavors and a great cultural experience.   Even if your budget doesnt allow for overseas travel, try to find a way to get out of your comfort zone for a while, to meet new people and experience new things.   Visit Your Childhood Home If you have relocated since your childhood, visit the place you were born. Meet old neighbors, family friends, and people you once knew. Perhaps they have pictures or stories to share with you. When you revisit your place of birth, you realize what a long way youve come.   Of course, if its not possible to make the visit, or if childhood memories of your birthplace arent happy ones, you can take some time to reconnect with old acquaintances and family you havent seen or spoken to in a while. Birthdays are a good time to look back on all youve achieved.   Donate to Charity How about giving away all the stuff that you have grown out of? Find a charity organization that will be happy to collect your old belongings. There is a certain joy in giving. You will cherish this memory forever. Drink Responsibly If you plan to go out partying with friends, make sure to have someone sober to drive you home safely or that you have a smartphone to contact a taxi or a ride-share service. No driving after youve been drinking alcohol. Reflect on Your Milestones and Plan Ahead As you grow older, you are also supposed to grow wiser. Your 21st birthday is the perfect occasion to plan your future. Look back at the milestones you achieved and ponder about your life ahead: What do you want to do over the next year? How do you plan to improve your life? What are the mistakes you never want to repeat? Quotes About Getting Older And finally, here are a few quotes that may give you inspiration for your 21st birthday: The man who views the world at fifty the same as he did at twenty has wasted thirty years of his life. – Muhammad Ali When a man is tired of life on his 21st birthday it indicates that he is rather tired of something in himself. –​ ​F. Scott Fitzgerald At twenty years of age, the will  reigns; at thirty, the wit; and at forty, the  judgment.   –  Benjamin Franklin Live as long as you may. The first twenty years are the longest half of your life. – Robert Southey Nature gives you the face you have at twenty, but its up to you to merit the face you have at fifty. – Coco Chanel How swift have flownTo me thy girlish times,A woman  grown  beneathMy heedless eyes!In vain I rackMy fancy to believeThe almanac,That speaks thee twenty-one.– Charles Lamb