Validating Verity

He's educated. He knows enough to be dangerous.

This was said to me while I was receiving handoff report. The day shift nurse was talking about a cisgender male, mid-40s who was admitted for coronary bypass surgery. His occupation was chemical engineering, a departure from our usual blue collar workers. What my coworker meant was he had advanced scientific knowledge that he was applying to his current situation. Nurses find these patients difficult as he was oppositional, only trusted the knowledge of the doctors, and would consult Google for everything. My 18 years of experience means nothing compared to a fancy degree.

Some nurses argue with these patients. Try to prove their competence by using large words. Speak louder to assert authority. Read parts of the doctor's progress notes out loud to verify their assertions.

I did have a hard time taking care of him. He was super anxious. He had read about every complication and was convinced it was happening to him. These patients test my knowledge as I have to go through each waveform on his bedside monitor to explain exactly what it is. Waveforms that took me years to master are reduced to a couple of sentences.

Preoperative education is poor for cardiac surgery patients as the pain is downplayed. These patients are shocked by the postop pain. The surgeons don't tell them their chests are flayed open and hung on meat hooks for 4-6 hours. Then large plastic tubes are inserted to drain bloody fluid for several days. They don't tell them that every breath is going to feel excruciating.

This patient was convinced he was having an MI as he was having severe chest pain. I constantly had to remind him that it hurts to have your chest cut open. I had to show him the segments of the EKG that we monitor for MIs. He was worried about opioid dependence and was refusing pain medicine. Maybe that was contributing to the pain?

Another technique I use is distraction. I started asking the patient questions about himself. I was interested in his occupation. What does a chemical engineer actually do? During our conversation he said something that has stuck with me:

You would be surprised by how much science can change when money is involved. If you make money for the boss, your science will go further.

A heartbreaking confirmation of my suspicions living in a capitalist hellscape. Fuck advancing the welfare of human beings. We gotta make money.

According to The Guardian, last year 10,000 papers were retracted from academic journals for fraud. The most papers ever since this record has been kept. Papers that were peer-reviewed which is supposed to add credibility. This is how vaccines became linked to autism. This is how ivermectin became a COVID miracle cure. How pharmaceuticals are greenlit before safety is adequately established.

Over 15 years ago I was taught pain was the 5th vital sign. Pain will impede healing and opioids are the cure. I was administering postop open heart patients twice daily extended release morphine plus immediate release oxycodone every 4 hours. This was an evidence-based practice. We all now know this is bullshit. I am anticipating in 15 years there will be documentaries about the dangers of Ozempic just like the current ones about opioids. Ozempic causes cancer in rats which we study because their DNA is so close to humans. This little cancer side effect is minimized because, ya know, profits.

One of the the most boooring courses I ever took was advanced research for nurses. I had already read countless scholarly articles, but this course was designed to teach you how to read them. My method had been read the abstract, introduction, and discussion. All the middle, boring parts about the technical study were skimmed. This course dove into the middle parts. It was painful, but I took away a valuable tool: the CRAAP test.

I'm still amused by juvenile toilet humor so I gravitated toward the CRAAP test. Pronounced like the slang word for excrement, it is fun to talk about seriously. Decipher the bullshit with the CRAAP test, a set of criteria for evaluating the credibility of a source (Gray, Grove, & Sutherland, 2017).

Currency: Timeliness of the information

Relevance: Importance of the information for your needs

Authority: Source of the information

Accuracy: Truthfulness and correctness of the information

Purpose: Reason the information exists

This can be applied to anything with a message to communicate. I found myself applying this to movies. I haven't watched Oppenheimer because I don't think it is relevant to my current needs and not sure the purpose it exists. Do we really need to tell more stories of white men by white men?

I've applied it to social media which has cut the amount of people I follow. Why is this person who makes money as a tarot reader constantly posting graphic images of war crimes? Are they the authority on Palestine? In a world of AI and deepfakes, how accurate are these images? Is it relevant to me? Is it important that I see dead children when I already know they exist? What is the purpose of these posts? Raising awareness or virtue signaling? Many accounts are not passing my CRAAP test.

I have applied this test to myself. I have been having a hard time consistently writing because I feel my focus is shifting. I have been thinking about the purpose I started this museletter. Is it current, accurate, and relevant to my authority? What am I a good source of information on? As I meditate on these questions, I keep coming back to my perspective. This is the only thing I am the authority about and I allow myself to let it take up space. Aging and life experience colors my perspective and it is only natural that my writing will evolve with it.

The North Node and Chiron are dancing around my Aries Moon for 2024. I want to grow the healing matrix of my wound around self-expression. I want to be bold in my writing, harnessing the cardinal fire of Aries. I am not here to evangelize. I am not here to exert authority over others. I am not extraordinary. I am a mundane human being, sailing through the Universe on some dirt, trying to keep a spark of sustenance.

The magic in the mundane... (eyerolls so hard my brain hurts). This is a cliche saying in the witchy community, but cliches form for a reason. Last night my patient was on dialysis which is absolutely magical. I mixed potions that circulated through the patient's body and cleansed him of what no longer is serving him. I levitated him off the bed with one hand (OK, I used a mechanical ceiling lift, but still one-handed!). I've done dialysis for many, many years and I am still not sure of all the intricate details, but it keeps the magic alive. Seeking too many answers can ruin the imagination, the most magical place of all.

But seriously, CRAAP test. Next time you are reading a news article, IG post, advertisement, etc, ask if it passes your CRAAP test. This one wild and precious life is way too short to be doomscrolling, watching shitty movies, and dodging propaganda.

Best wishes, dear Reader.

Gray, J. R., Grove, S. K. & Sutherland, S.  (2017). Burns and Grove's the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier Saunders. ISBN 978-0-323-37758-4