Wednesday, February 25, 2009
not the newest
You know what's funny? I precepted a newer-than-me nurse this weekend. And it went really well. I think that was partly because the new nurse is EXCELLENT. She was a nurse tech at Big County Hospital for the last year, so she is already very familiar with the work environment. Partly it was because I am so recently finished with orientation that I remember it keenly, and have lots of opinions about what makes for good vs. bad experiences. At the end of the first day together, she thanked me for helping her have a good day... which made me feel great.
Otherwise, I'm doing all right. I've been in kind of a funk at work lately - I think I'm reaching the point where I need to shake up my expectations for myself. Right now, I feel like I do a decent job with basic nursing care like making sure that my patients get their meds, have good pain control, get fed appropriately, get blood sugar checks if necessary, get their braces cleaned and adjusted if they have 'em (we have quite a few patients in spinal braces of various shapes & sizes)... which is all good. I'm pleased with that. But! Remember how I was talking about how I feel like there is so much more I could be doing? I have quantified some of that for myself. (I apologize that this is going to be boring for non-nurses, but I've got to get this stuff in writing before it gets away from me!)
In a perfect day, I would go into each patient's room and do the following:
-update the whiteboard (we use these to write the nurse's name, the patient's name, the date, and any other assorted information like questions or goals)
-check vitals, assess for pain
-listen to lungs/heart/abdomen
-ask the silly orientation questions (do you know who/where/when/why you are?)
-check their name band
-if they're someone who needs to be turned every two hours, go ahead & turn them unless the night nurse told me they were just turned.
It doesn't sound that hard. But I don't think I EVER actually get all of that done in one visit.
Later on in a perfect day, all my patients would get:
-teeth brushed or oral care; frequent oral care for unconscious or trached patients
-lotion applied to dry skin, especially feet
-room tidied & organized
-turned/repositioned every two hours like clockwork
-education packets on pertinent health conditions
-a chart review that included not just med checks, but tracking down details like the location of their belongings and starting discharge paperwork
-new IVs if the old one(s) was due to expire
-their freaking disgusting nails trimmed (if applicable)
-whatever sort of wound care they may need
-an offer to help fill out their menu requests (if applicable)
I'm sure there is more that will come to mind over time.
Tuesday, February 24, 2009
We took the train from Seattle to Vancouver - it was cheap and easy. Actually, we got on in Edmonds, which was a good choice because only a few other people got on at the same stop, so there was not much waiting in line. We did have to wait for a quite a while to get through customs at the Vancouver train station, but oh well. It was nowhere near the 2-hour wait at customs at Blaine that some of my work friends described recently.
Wedgewood Hotel - Absolutely marvelous. The room was spotless and comfortable, the service was excellent and cheerful, and the massages we had the spa were lovely.
Bacchus Restaurant and Lounge - the lounge is intimite and cozy, with lots of dark wood, cushy chairs, heavy drapes, and soft lighting. The drinks are expensive but delicious, the lounge menu is tasty, and the breakfast & afternoon tea are quite good. However - the main dining room is overpriced and underimpressive. It's not that the food is BAD - it's just that it's uninspired and costs much more than it should.
Diva at the Metropolitan Hotel - we had lunch this trip, and had a prix fixe dinner on a previous trip. I remember being wowed by dinner, but that was years ago and I'm sure my tastes have gotten snootier. We had a prix fixe lunch this time, and it was quite good. There were three courses - the appetizer & dessert were quite excellent, but we felt the main course was somewhat off the mark. Not that it was bad, it just didn't work as a cohesive dish. However! I would go back just for cocktails. I had one they called a "Poire Belle" and it was AMAZING, like the essence of pears distilled with vanilla and a hint of spice, incredibly smooth.
Cioppino's - don't let the generic-sounding name turn you off - we had a really terrific dinner here. The chef is considered one of the best in the city, and I can see why. We had a mushroom & chestnut soup that was to do die for. I had a bowl of cioppino for dinner which was hands down the best I've ever eaten, and R* had duck which came in 3 different preparations on one plate and was outstanding. At dessert, R* had the house tiramisu which put all other tiramisu to shame - like we may consider driving back to Vancouver just for dessert, it was that good.
Vancouver Symphony - Put Seattle's symphony to shame. The hall is run-down and chilly, the bathrooms are a little yucky, but the orchestra is terrific. Louis Lortie was the guest pianist, playing two Lizst pieces (not for the faint of heart or small of hand!) and he was stunning. I'm so pleased we went to this performance.
Kirin Seafood Restaurant - we went here for dim sum and discovered that we've only eaten cheap crappy dim sum in Seattle! The food was excellent, the staff steered us through the experience since we obviously didn't know what we were doing, and the restaurant was full of Chinese people chowing down. I would love to go back with a bigger group so we could try more dishes. (Note, the dim sum is of the order off the menu variety, not the wheeled around on carts variety.)
Vancouver Art Gallery - we visited this art museum the last time we were in Vancouver and had the same reaction: the building is lovely, the collection is nothing special, and the museum store is the best we've ever seen - and that includes MOMA and the various Smithsonian/National Gallery stores. Good news: you can shop at the museum store without paying admission to the gallery.
Bill Reid Gallery - Bill Reid was a half-Haida (Native or First Nations group) artist who put a phenomenal amount of effort into reviving and publicizing his people's native art forms, as well as bringing many of the native motifs into modern media. The collection is really lovely and features lots of multimedia stations such as videos, interactive displays, and audio recordings that help place the art in context.
Chambar - Amazing Belgian restaurant. The menu features crazy cocktails, a nice variety of Belgian beers, moules et frites in multiple preparations (yes, I am in love with mussels!), gorgeous entrees, and artistic & tasty desserts. I wish we could have gone back at least twice more.
We also bought some nice stuff at Danier Leather (R* got a coat, I got a purse) for ridiculously good prices, and I stocked up on tea at Murchie's.
All in all, a terrific vacation. Wish we could go back every couple of months.