Portfolio

Cover Letter

            For my Writing Portfolio I included three key things: a revised essay, a writing remix, and hits and misses. These three things are examples of who I am as a writer in many aspects including creativity, what my interests in writing are, and my growth as a writer. Though I think that I have improved greatly as a writer there are still places that I can improve in. I hope to continue as a writer and also continue to be able to express myself in writing.

            For my revises essay I chose to revise my research paper. When thinking about which paper to revise I wanted to chose something that I would enjoy revisiting so naturally I chose the research paper because it was on a topic that I enjoy learning about. Doing this research paper was fun for me because it was on a topic that I am very interested in and it helped me learn new things about that topic. Since I am so interested in the topic of surgeons and surgery I wanted my research paper to be as well developed as possible and show my writing ability stronger than any other thing I have written this year because it is on a topic very close to me and I put a lot of time and effort into it.

            I chose to transform a blog post that I had written on Places and Identities because I felt that it was a blog post with lots of lost potential. When I wrote it I put some thought into it but I didn’t see its full potential. By making this into my remix I think that it gave it a little twist using pictures to explain it and bring it into real life view instead of just having words on a page.

            My hits and misses are just mostly blog posts that I did late at night or they were most likely on a topic that I wasn’t interested in. When this happens I just write and write and most of the time it comes out making no sense at all but was what was going through my head at the time so I post them just to go back and see what was on my mind when I was writing it because in some of them you can feel my mood coming out of the page. I kind of like how these turned out therefor some of them are hits but some of them are misses because it is just a bunch of gibberish.

            I think that I am personally not the strongest writer. I can get the writing assignment done with a descent grade but I am by far not a high-class serious writer. At the beginning of the year I really struggled with finding starting points in my writing but as much as I didn’t enjoy writing blog posts, I think that they helped me figure out how to come up with starting raw ideas that could potentially turn into a well-written paper. I think that I have improved with word choice and getting my full ideas on the page and expressing myself better in words.

            I would have to say that my strength as a writer is my ideas. I feel like I always have good ideas to write about but I don’t always know how to explain them on paper and in formal words. It is sometimes frustrating because I would say that my weakness is portraying what I want to say so I feel that I have all of these good ideas but have no way of telling them.

            I hope that in the future I continue to work on my writing skills and continue to learn and develop my writing skills. Even though I don’t particularly like writing I think that it is a good skill to have to let your feelings out anywhere, anytime, on anything.

           

Essay Revision

Trauma Surgery: The Story Behind the Stress, Fatigue, and the Effects of PTSD

Everyone gets stressed, everyone gets tired, and everyone has memories from traumatic events hanging over their heads; but would you want someone suffering from these things have your life in their hands?  Many medical researchers are beginning to find that the effects of stress, fatigue, and PTSD are leading to risks and questions for the safety of hospitals and their patients.

             When you decide to have surgery it is most likely because you are in a life or death situation or you think that it will improve your quality of life, but if you knew that your doctor had not slept the night before or that they had been up all night preforming an emergency surgery do you think that you would still want to proceed with the surgery as scheduled? Dr. Michael Nurok states: "We have data that shows that sleep deprivation affects clinical performance, and we also have data that show that patients want to be informed if their surgeon didn't get enough sleep, so it's become a patient advocacy and safety issue”.  This makes people begin to think about if they should start asking questions before going into surgery. "When looking at procedures done when a surgeon has less than six hours of sleep, there's an increased risk of bleeding and organ damage," he said. Nurok states that he wants attention to be drawn to the awareness of the hazards of doctors’ fatigue and sleep deprivation. He thinks that making surgeries easier to reschedule and “prohibiting surgeons who have been on emergency call all night from scheduling elective procedures the next day” will decrease the risk of mistakes occurring during surgeries (Nurok). Making this change will hopefully decrease the complications and make procedures safer for patients.

            A new study shows that medical mistakes might be a result of long hours and shifts leading to fatigue. During the study it was found that some surgeons would range from more than 7 to less than 3 hours of sleep (Gever). "This study is the first to quantify resident surgeon fatigue and its predicted risk for error," said study co-author Dr. Frank McCormick, of Harvard Combined Orthopedic Residency Program and Massachusetts General Hospital. "Fatigue levels were higher than anticipated, especially on the night float rotation.” This created worries for many doctors, knowing that their staff was under rested. “Overall, residents functioned at less than 80 percent of their full mental capacity due to fatigue almost half of the time they were awake”(McCormic/Gever). Pediatric surgeon-in-chief Dr. Thomas Tracy Jr. says “the fact that fatigue is common is not startling, ‘but its pervasiveness is a finding we simply cannot avoid and may have paid lip-service to in the past’”. Dr. Jeffrey Rothschild, Harvard University, also lead a study that showed that doctors who preformed procedures with less than six hours of sleep posed an increased risk of complications. Rothschild and his colleagues said, "These data suggest that attending physicians, like residents and nurses, may be at increased risk of making errors when sleep deprived or working extended shifts." (Gever).

            Many people are begging to think that the answer to medical practitioners fatigue is limiting the work-hours of practicing physicians. After about 10 years since the introduction of a limit of how long doctors can work, an 80-hour workweek has been set as the time limit for practicing interns and residents by the ACGME. As Danielle Ofri, M.D. wrote in the New England Journal of Medicine, “limiting residents to 80 hours per week wasn’t as simple a panacea as it seemed”. The ACGME has recognized that even with the 80-hour workweek, the amount of sleep doctors got and the number of errors made did not change (Ofri).

            Another issue that many surgeons suffer from is stress and burnout. Many believe that long training periods, high stakes, and a fast moving workplace are some contributors to surgeon stress and burnout. Other factors include: workload, long working hours, and responsibility lead to questions of personal well being, work performance, and patient safety (Bittner). To study the stress that surgeons undergo, Japanese surgeons practicing in Kitakyushu, Japan were asked to take two surveys. One from NASA and the other, Stress Arousal Checklist along with a urine test to measure the amount of stress they are under. With this they found that surgeons are more stressed during surgery when they are in a surgery that lasts more than three hours or if patients loose a lot of blood in the surgery. During the study they found that completing multiple surgeries in one day, being the main surgeon in the surgery, or performing conventional surgeries lead to no rise in the stress markers (Kaplan). Surgeons and physicians find that coping strategies for stress, found to work for most people, do not work for them. Research shows that many of these surgeons and physicians have a hard time coping with their stress because they have a hard time seeking help to deal with their workload; they try and disregard their symptoms of stress and burnout (Bittner).

            Many people suffer from Posttraumatic Stress Disorder (PTSD), and the effects are generally the same, however some people face different problems than others. PTSD leaves many people feeling hopeless, like death is the only way to seek peace. Many people attempt or commit suicide to escape this disorder (Daniel). Dr. Tara Dixon, who was deployed as an army trauma surgeon in Iraq. Throughout her time in the war, she began to suffer from PTSD. Dixon found the outlet of running as a coping strategy claiming that she would run up to 80 miles a week. "..it messes with your mind a bit.." Dixon said. She talks about treating "the guy I had breakfast with that morning,” and making decisions in seconds that would normally take minutes or hours; such as amputating a limb in the field or choosing to transport them to a hospital first. Dixon remembers having to treat abused children and sexually assaulted women, who requested that she not report the incident. Upon returning home she was faced to remember these moving incidents leading to her diagnosis of PTSD (Daniel).

            When you begin to think about what you trust people to do in our lives, you begin to see that we trust people with more things than we realize. From trusting someone to clean your house and drive your kids to school, to trusting someone to preform life saving surgeries on your body. When you trust someone to do something you also trust him or her to do it to their full capacity, to do it the best they can. If you knew that someone was doing something for you and they were not in their top condition, not doing it the way they are supposed to or not doing it the way that you expected it to be done you get frustrated. Sometimes there are consequences to not doing something the right way; some greater than others; some might include people getting frustrated and require a do over, but others could end in a situation where there are no do overs. An example of this is when you have surgery, if your doctor is not in their full potential, there could be complications that could end in death or something close to it where there is no redo’s.

Works Cited

Bittner, James G., IV M.D., et al. "Stress, Burnout, and Maladaptive Coping: Strategies for Surgeon Well-Being." Bulletin of the American College of Surgeons (2011): n. pag. Web. 24 Jan. 2013. <http://www.womensurgeons.org/aws_library/surgeonburnout.pdf>.

Carollo, Kim. "Should Sleepy Surgeons Disclose Fatigue to Patients." ABC News. N.p., 30 Dec. 2010. Web. 14 Jan. 2013. <http://abcnews.go.com/Health/Sleep/sleep-deprived-surgeons-disclose-lack-sleep/story?id=12500360>.

Daniel, Lisa. "Army Surgeon Shares PTSD Struggles to Help Others." U.S. Department of Defense. American Forces Press Service, n.d. Web. 14 Jan. 2013. <http://www.defense.gov/news/newsarticle.aspx?id=118034>.

Dawdy, Philip. "Losing Patients: A Portland surgeon's troubles raise questions about who's watching the docs." Willamette Week: n. pag. Web. 8 Feb. 2013. <http://www.wweek.com/portland/article-939-losing_patients.html>.

Gever, John. "Surgeon's Lack of Sleep, not Long Hours in OR, Predict Problems." MedPage Today. Ed. John Gever. MedPage Today, 13 Oct. 2009. Web. 14 Jan. 2013. <http://www.medpagetoday.com/Surgery/GeneralSurgery/16405>.

Kaplan, Karen. "What Stresses Surgeons Out?" Los Angeles Times 23 Mar. 2011: n. pag. Web. 8 Feb. 2013. <http://articles.latimes.com/2011/mar/23/news/la-heb-surgeon-stress-20110323>.

Ofri, Danielle, M.D. PhD. "The 80 hour resident work week balances fatigue and independence." KevinMD.com. Ed. Kevin Pho. Kevin Pho, 10 Aug. 2010. Web. 15 Jan. 2013. <http://www.kevinmd.com/blog/2010/08/80-hour-resident-work-week-balances-fatigue-independence.html>.

Pearson, Catherine. "Sleepy Surgeons: New Study Shines Light On Risks Of Surgeon Fatigue." Huff Post Healthy Living. Huffington Post, 21 May 2012. Web. 15 Jan. 2013. <http://www.huffingtonpost.com/2012/05/21/sleepy-surgeons-new-study_n_1534410.html> 

Detailed Description

            To improve my research paper I knew that there needed to be a series of steps taken to improve it to its full potential so I knew that I was going to have to think outside of the box and read it like an outside reader so that I could find mistakes that I, being the writer, wouldn’t normally catch or awkward wording that I, again being the writer, would make sense of in my head.

            The first step that I took was reading my paper straight through to get a fresh idea in my head of what it was about and from there I went through and found areas where I thought that the word choice or structure could be better, where the transitions could make a little more sense, and also the formatting of the citations. Once I went through and found these things I decided that I wanted to focus mostly on the word choice and sentence structure aspects. Knowing this I took the places that I had found that I felt needed improvement and brought my paper to the writing center.

            While in the writing center I focused on these areas. Together, the writing fellow and I created an improved paper that I feel better shows who I am as a writer. We went through paragraph by paragraph, me reading aloud, and after each one we would stop and I would give my opinion of what I thought needed to change and then she would say that she agreed or disagreed. The writing fellow also helped me in parts of my paper that I wasn’t exactly pinpointing to look at but it helped with the overall outcome of my paper.

            In the end I ended up not changing as much as improving existing aspects of my paper. I found word replacements for overused words and also took out, added in, and improved the placement of key sentences or phrases. Mentioning author’s names an excessive amount of times was something that was pointed out to me as something I could improve so I corrected that on the side to try and make my revision as improved as possible.

            Overall I think that going to the writing center was helpful to my overall revision because it taught me about things in my paper that I would have never thought twice about and it also gave me ideas on what to do when writing other papers.

 Analysis of Rhetorical Situation

Audience: Who is the audience for your project?  Why did you choose this audience?  How is your project tailored for this audience?  How did the audience change from the original piece of writing?

           

The audience I chose for this project is all age groups from the youngest to the oldest. I chose this     audience because I feel that the more people that you target the more appreciation you can get for it. I think that including all age groups makes the situation feel real like it can relate to anyone because it is something that we all experience no matter what our story.

It targets all ages with intriguing pictures that anyone can relate to because most of them include things that you see in everyday life. By using these pictures you draw the attention of many different people because of the different scenes, using almost opposites to draw more attention to the factors in the photos. The audience changes from a more adult situation of mood and not feeling comfortable in places and coming across as a different person to a more unique way of showing that there are ways that you see the world and using the photo of the men using their phones outside of the jail cell shows that things aren’t always as they see. The audience is more widespread because of the use of pictures because not everyone can interoperate words, but everyone can see the beauty of photos.

Purpose: What does that audience need to know or do?  Why are you communicating with them?  What do you hope is the outcome of your rhetorical act?  Why is this an appropriate purpose for your particular topic?  How has the purpose changed from the original piece of writing?

The audience just needs to look at the collage with an open mind and let their imagination do the rest. The attempt is to get the imagination of the audience to envision what they feel is happening in each scene. Who is there, what is happening, and how they would feel if they were there. My hope for this rhetorical act is that it shows that you don’t always have to express yourself through words, that sometimes when you are silent you can do greater things than if you were trying to explain with words.

It is appropriate for my topic because my topic is about judging people out of their place and changing you from you and changing your actions from your own. By creating another big picture with other ones I think that it was like putting people out of their place by putting pictures that you wouldn’t put together in the same big picture. The purpose has changes because at first it was just a statement and now it is a vision that I have about what I wrote about looks like.

Stance: What attitude or approach toward your topic do you convey, and how?  Has your stance changed from the original piece of writing, and if so, how?

The attitude I convey towards my topic is now that your first reaction of something might not be the right one. When you look at something you have to analyze it before you can make assumptions and you have to take those assumptions and analyze them again from different points of view.

My stance has changed from being a harsh, this is this way when something is like this, to taking a step back and looking at the big picture and seeing the changes that something or someone has made to make a situation work for them.

Genre/Medium/Design: How do you use genre and medium to reach your audience and accomplish your purpose?  What are the features and strategies of the genre you chose?  What design elements are incorporated in your project, if any?  How has the genre, medium, design, and/or strategies changed from the original piece of writing?

I used genre to make a more artistic stance on the writing. I took a boring piece and put it into an artsy form of pictures. I chose the artsy stance because it is opposite of what you would expect the writing to be like. The genre has changed from boring and bland to intriguing and easy and interesting to look at. 
           
This piece features many aspects of everyday life that I drew out of the writing to make into something different than what I read in the text. I thought outside of the box in order to force others to do the same when viewing this piece. 

Hits and Misses

     Hits: 

What I Want Most in the World- Blog Post 

Poem- Blog Post

Research Paper 

Places and Identities- Blog Post 

   Misses

Plane Crash Activity- Blog Post

Free Post, Addictions- Blog Post