girl in greenwood

new

2012-01-05T20:51:00.000-08:00

It's a new year. I have a new(ish) job. I have a new appreciation for how excellent my life is. I mean, I've had that appreciation for a while, pretty much since I got interested in nursing. But either my life is way more awesome recently, or my new job has sharpened my focus, or maybe both.

So yeah. I'm a hospice nurse now. This is the job I've been working toward since before I started nursing school. I work for one of the smaller hospice outfits in town, albeit the only one with an inpatient center - and I am really loving it. I'm a float nurse, which means that I don't have a regular caseload of patients that I see... instead I go see new patients every day. I could be covering for a casemanager nurse who is out sick or on vacation, I could be visiting because the patient is having a problem and needs a nurse on a day that they're not scheduled to see the casemanager, or I could be admitting a new patient to hospice services. It's kind of terrific - I'm used to meeting new patients and families every day because of my hospital background, and although my role is important for patient care, I am not ultimately the person responsible for the patient's care plan. And here's the best part: I work 7 days on followed by 7 days off. I was scared about working 7 days in a row coming out of the hospital, but it's completely fine. I see between 2 and 4 patients a day depending on their needs, and I usually get home before 3 or 4 PM and finish my charting at home. It feels like a vacation.

I'm rediscovering the joy of simple things like cooking dinner, going out for a drink with friends after work, watching a movie on a work night, and best of all, not being physically exhausted and in pain after every shift.

That's not to say it's been a piece of cake. I actually had a great deal of anxiety last week, which was my first full week on my own after orientation. In fact, I sat outside a patient's home in my car for 15 minutes having a panic attack, complete with chest pain and dizziness. If I had been my own patient, I would have done an EKG and then given some lorazepam. But instead I pulled myself together and went inside - and it was fine. I talked about it in couples counseling and again at the hospice staff support group, and getting it out in the open seems to have helped. I've worked 2 days this week so far and I feel fine.

Today I saw an elderly woman living alone and was blown away by the amount of trust she placed in me - I mean, think about this. I called her and told her I was a hospice nurse and I was coming to see her, then I show up at her (unlocked) door and let myself in, then I told her I needed to listen to her heart and lungs so she unfastened her bathrobe for me... it's a phenomenal demonstration of trust and faith that I was there to help. I feel so touched and honored that (some of) my patients feel that way.

I have a great deal to learn and I'm still a newbie - but I feel for the first time like I'm doing a job that I could do for the rest of my life. That is pretty amazing.

I hope to get back to blogging. I am sure that there will be topics I wish to process and experiences I want to share. This is a good outlet. Any nurses or prospective nurses out there who have questions? I love to talk shop. :)

thankful 2011

2011-11-24T16:42:00.000-08:00

Thankful 2010
thankful 2009
Thankful 2008
Thankful 2007
Thankful 2006
Thankful 2005
Thankful 2004

My heart is so full of thankfulness this year I'm not even sure where to begin.

I am incredibly thankful for my new job as a home hospice nurse, which is what I have wanted to do since I was in nursing school. I feel so lucky that I was able to find this job with such lovely, kind coworkers and supportive management.
I am thankful that my stress level and exhaustion are steadily decreasing as I get further away from my Big County Hospital job... I didn't realize how much it was wearing me down until I walked away.
I am really, really thankful that my husband is doing extraordinarily well in his consulting work, for a number of reasons: he's less stressed than he was either unemployed or working as a full-time Microserf; we're going to be able to pay off a great deal of our debt this next year as well as have a nice nest egg in savings; we agreed that I don't need to try to work 2 jobs anymore; and I am so proud of him for being extremely successful after that horrible Year of Financial Difficulty.
I am thankful for my family and my friends new and old - there is a lot of love and laughter in our lives thanks to all of them, and isn't that what life is all about?
I am thankful that we live in this beautiful house that we enjoy every day. I am also thankful that we can afford to have someone help us clean it, because it's a lot more to clean than anywhere else we've lived.
I'm thankful that R* and I travel so well together, because we did a lot of traveling this year and hope to do more next year.
I'm thankful for our sweet darling furry Kismet kitty, who is a daily delight, even though she occasionally shits on the rug.

Happy Thanksgiving, everyone. Now go hug and kiss someone you love.

dear internets

2011-03-09T22:26:00.000-08:00

I am not dead.

Love,
Emily

Just kidding. I mean, I'm not dead, that is true. But I have a little more than that to say.

-R* has been working as a consultant for a few months and we're feeling a bit less terrified about money.
-We had our taxes done and it looks like our refund should be big enough to enable us to tell the IRS to go eff themselves this year.
-A bunch of my friends have had babies recently and that's a lot of happy. And baby snuggles.
-Work is going fine. I continue to adore my coworkers.
-It's not pitch-dark outside when I leave for work at ridiculous o'clock in the morning!
-I don't feel quite as much like my lungs will fly out of my nose when I try to run, thanks to several months of biweekly workouts.

There are still things troubling me, too, but I'll get back to that another time.

annually thankful

2010-11-26T13:32:00.000-08:00

thankful 2009
Thankful 2008
Thankful 2007
Thankful 2006
Thankful 2005
Thankful 2004

This has been a tough year in a lot of ways. We were stressed and worried and exhausted and frustrated for many different reasons... but still, I have a lot for which to be thankful.

My intact and functional body that pretty much works exactly like it's supposed to - unlike so many of my patients' bodies.

My mental health, which permits me to function in the same world as everyone else and doesn't cause me to see and hear things that aren't there.

My wonderful smart talented silly hard-headed husband, who has made the best of a very difficult year of unemployment.

The job that my wonderful etc. husband landed after that year!

My job, along with the wonderful coworkers and friends I have there. My job would be unbearable without them.

My other job, where I go do temp work at other hospitals and they pay me lots of money. It's stresseful to work more than full-time between the 2 jobs, but I am so thankful that I have the option available to earn more money for my family.

My lovely funny parents and their continued generosity and encouragement in our adventures of home-owning.

Our good friends who have made us laugh and offered hugs and wine and dinner dates when they were really needed.

Our fantastic house that makes us happy on a daily basis.

Our trainer who is slowly but surely kicking our butts into shape and continues her positive attitude and encouragement no matter how much we whine.

Mostly I am grateful that our lives are so ordinary. I know that may sound silly but I see so many people whose lives are extraordinary in some awful way - being normal and boring seems like a gift in comparison.

I hope your Thanksgiving was warm and filled with love.

questions/answers

2010-06-20T13:32:00.000-07:00

Pancreatic pseudocyst - basically, your pancreas gets angry and tries to digest part of your insides. This is, you know, bad. I took care of a patient who had one removed that was the size of a BASKETBALL. Granted, the patient was not a small person, but jeez!

How to invite Ethiopians to dine - phonetically it sounds like "nem la" to me. The person who explained it to me said that it's loosely translated as "let's eat" and that culturally, they are bound to offer to share food with anyone who is around. In the US, many Ethiopians have modified that to offering to share food with other Ethiopians who are around... although now I understand why one of the aides who I've gotten friendly with keeps trying to feed me. I'm one of us now. :)

Commenter Irene, I accidentally deleted your comment! Sorry about that. To answer your question, no, I'm not Chinese. I'm just interested in visiting HK because I think it would be a cool experience, and I'd get to eat lots of interesting food. I love trying new things. Good luck with nursing school.

This weekend I have attended a yoga class that was really above my skill level but made it through without any injury. I've cooked two yummy dinners with my friend who is visiting. I've gotten plenty of sleep. And although I love my husband and my friends and my family, I am ridiculously glad to be spending the afternoon at home alone.

happy/sad

2010-06-13T21:30:00.000-07:00

I'm all about the lists lately.

Things that have recently made me happy:
-My amazing coworkers and their enthusiastic hugs, support, assistance at work, and ongoing admiration for the extra work I'm doing.
-My husband's love, support, and general holding-down of the home front.
-A message from a friend inviting me to come spend time with him and his adorable baby.
-The positive reaction I get from patients and families when I attempt to speak my terrible Spanish with them.
-Learning the polite way to invite my Ethiopian friends to eat with me, and better yet, trying it out on my coworkers and watching them look surprised.
-Waking up at 6:30 on Saturday and still making it to work on time!
-Paychecks from staffing agency work.
-Anticipation of my friend E's return visit to Seattle
this week.
-My house.
-My garden even though it still needs a lot of work.
-Weird flavors of Lucerne light yogurt - Bartlett Pear Mangosteen?

Things that have recently made me sad:
-Glioblastoma.
-War. The entire concept and the individual loss of life.
-Reading all the recent studies about how getting more sleep makes one's life 1,000 times better and being unable to control the fact that if I spend 14 hours on work & transit time, that doesn't leave enough for shower/dinner/quality time with husband/winding down enough to sleep/getting the recommended 9 hours of sleep. Clearly we need 30 hour days.
-Lupus with severe, life-threatening complications in a patient younger than me.
-Lice, scabies, bedbugs, and all their little friends.
-Seizures.
-The IRS
-Colostomies and corn - two things that do NOT go great together.
-Losing my fancy Bluetooth headset like a dumbass.
-Giant pancreatic pseudocyst.

I wish

2010-06-04T21:06:00.000-07:00

-I could play the accordion.
-I weighed 80 pounds less.
-I made more time for yoga.
-And playing the piano.
-I was as kind to my loved ones as I am to my patients.
-I knew how to cook a steak.
-and mix a good cocktail.
-and sew.
-that the pelicans in the Gulf were oil resistant because their photos make me cry.
-that my friend hadn't died last summer.
-that I made more time for friends.
-and less time for worrying.
-that I could make up my damn mind about whether I want to have a baby or not.
-that I could travel to Ireland & Germany & Italy & Spain & Japan & Hawaii & Hong Kong.
-and Belgium.
-and Portugal.
-and San Francisco.
-that we could manage to arrange a time to have dinner with R & M, and have dim sum with K & A.
-and see Andy face to face instead of only through a computer.
-that my garden would produce lots of tasty food instead of getting eaten by slugs.
-that people would stop judging other people because of the color of their skin.
-that everyone in this country had healthcare coverage so no one would have to go untreated.
-that it was easy to tell people when you love them.

remotely

2010-04-15T17:58:00.000-07:00

Just trying this out to see if I can blog from my phone. What's the verdict?

This blog has moved

2010-04-07T20:32:00.001-07:00

This blog is now located at http://girlingreenwood.blogspot.com/.
You will be automatically redirected in 30 seconds, or you may click here.

For feed subscribers, please update your feed subscriptions to
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thankful

2009-11-25T22:25:00.000-08:00

Thankful 2008
Thankful 2007
Thankful 2006
Thankful 2005
Thankful 2004

It has been a very busy year, with lots of good things and lots of bad things too - and yet I have a great deal to be thankful for.

As always, I am beyond thankful for my smart, funny, creative, thoughtful, strong husband. We have held each other up this year in countless ways and I can't fathom life without him.

And equally important, I am thankful for my fun, loving, generous parents who provide unconditional love, handyperson advice and labor, and more laughs than anyone else's parents I know.

I am super-duper thankful for our new house! Moving, painting, and the millions of other projects we've taken on have been hard work and lots of money, but I think it's all been worth it - every day I look around and think that I can't believe I live in such a nice home.

I am thankful for the chances I've had to reconnect with old friends this year - between Facebook, Google, and some fortuitous travel plans, I've gotten in touch with quite a few people who were important to me in the past and that makes me happy. (Keith, I'm looking at you as one example! And Emilie, you & Derek are another!)

I am thankful for the friends I've stayed in touch with after nursing school, and for the new friends I've made at work, because both groups are available for nurse talk whenever I need them.

I'm thankful for all our excellent friends from various other backgrounds who are fun and loving and help us see the world from different angles.

I am thankful for my continued employment in this lousy economic time - and I am even more thankful that my coworkers are so excellent and fun and loving, and that I am proud of the work I do at Big County Hospital.

This may sound strange, but I am thankful that I have had the experience of helping several people pass from life into death this year - because it has strengthened my belief that hospice nursing is the right path for me.

Finally, I am very thankful for the good health that my family and I have. I care for people who are sick and broken in thousands of different ways and I am profoundly grateful that my loved ones are not fighting those battles.

Now I have a request for you, my dear readers. In honor of our beloved friend who died this year, please do one small thing - think of a friend or relative or someone who you've been meaning to call but have been putting off for no good reason, and call them just to say you love them and are thinking of them. You'll both feel good afterwards.

Happy Thanksgiving, everyone.

book report: The House of Hope and Fear

2009-11-13T00:14:00.000-08:00

The House of Hope and Fear: Life in a Big City Hospital
by Audrey Young

I loved this book and read it in a few hours becuase I was so fascinated. I work at the hospital that Dr. Young describes with honesty and affection. In her stories about patients, doctors, families, and aspects of society, the reader gets a view inside a public hospital and the people who work and are treated there.

There are two reasons why I would recommended you read this book: First, it would help you understand why I choose to work at the county hospital and why I am so proud of the work I do. The other reason is more political: reading about the patients who end up at the county hospital seeking primary care - the homeless, the addicted, the mentally ill, the underinsured, the unemployed, the desparate - is the best argument I can think of for universal health care.

Just one fact pulled from the book: the United States spends more than twice as much on health care than any other country, and yet our health outcome and life expectancy statistics are nowhere near the best in the world.

realized

2009-10-07T21:28:00.000-07:00

I was just thinking that when I was a kid, I read several books about patients in hospitals, and always thought "Wow, what a foreign area medical care is, and how fascinating." While reading a review of a new book about the hospital where I work, I realized that now I work inside one of the books I used to read and marvel at. That's pretty neat.

(I know I haven't been blogging much. It's been a busy summer. R* and I bought a new house and have been working on fixing it up. I've been working hard, and am being rewarded for my hard work by being asked to be one of the charge nurses on my shift. R* changed jobs and while that's a good thing, it's another source of stress. If you want to get more frequent updates from me, find me on Facebook or Twitter!)

really, don't

2009-07-21T18:14:00.000-07:00

Conditions I've witnessed and am glad I don't have:

Calciphylaxis in end-stage kidney disease.

A colostomy resulting from a rectal foreign body and subsequent intestinal perforation.

A collection of problems that were all making each other worse: congestive heart failure, acute renal failure, necrotizing pneumonia, and protein deficiency due to lack of interest in eating. Also, did you know that when part of your lung tissue dies, you pretty much have to cough out the dead stuff to clear your lungs?! Gross.

endings

2009-07-16T22:15:00.000-07:00

Today was a difficult day.

My patient was 20.
He'd had a drug overdose.
His family had made the difficult decision to put him on comfort care.
Today was the first day I'd cared for him.
Today was the day he died.

Normally this kind of thing doesn't get to me that much.
But he was so, so young, and the family was so, so heartbroken.
It was tough to watch.
I cried.
More than once.

But you know what?
I did a f*cking outstanding job as their nurse.

The patient died peacefully without signs of pain.
The family was all gathered at the bedside singing and praying.
I reassured the family that the patient's signs & symptoms were normal, that he was very near the end, that their feelings of guilt/anxiety/relief were all nomral, that they didn't need to worry about any logistics, that they were doing the right thing by holding the patient's hands and touching him.
My excellent coworkers took over care for my other patients for a while so I could devote my time to this family.
I got the chaplain, the palliative care doc, and the medicine attending doc to stop by before the patient died.
I did postmortem care to get the body ready for friends and family to see.
I paged a couple other doctors who had cared for the patient so they could visit the family.

The nightshift nurse who had asked for me to be assigned to the patient came in at the end of my shift and we hugged and told each other what a terrific nurse the other was.

I called another of my coworkers on my way home to give her some positive feedback the family had shared with me.

Now I am drinking a large alcoholic beverage.
And wishing there was some way to tell people not to use heroin and aprazolam together.

surreal

2009-06-11T22:32:00.000-07:00

One year ago I was a brand-new nurse scared out of my mind about starting work.

Today I precepted a brand-new nurse (a graduate from the same school I attended) who was scared out of her mind about starting work.

One year ago I could barely handle taking care of two patients.

Today I had a total of six patients with admits and discharges.

One year ago I had successfully drawn blood once.

Today I helped my preceptee try to draw blood for the second time. She didn't succeed. I stuck the patient once and while I had to dig around a bit for the vein, I got the blood sample.

One year ago I had no idea how to put a tele monitor on a patient, much less how to read an EKG.

Today I admitted a tele patient, stuck on the monitor and assessed his rhythm, then called the doctor to report on the weirdness I was seeing without breaking a sweat.

One year ago I was nervous every time I went into a patient's room because I felt awkward and incompetent.

Today I breezed into a patient's room and was greeted by the patient's daughter, who informed me that I was her mom's favorite nurse.

One year ago I was not sure how I would like working in a hospital with lots of people I didn't know.

Today I got hugs and kisses from most of my coworkers, including a doctor.

This job has worked out brilliantly.

hug

2009-06-11T22:29:00.000-07:00

People I hugged today:

-a patient
-a patient's daughter
-a jail guard
-an MD
-a nursing assistant
-5 of my coworkers

I kissed my husband but I didn't hug him because he was still lying in bed when I left for work, and lying down on the couch when I got home from work.

still don't

2009-04-19T11:42:00.000-07:00

More conditions my patients have had that I'm glad I don't:

Huntington's disease. And a big honkin' meningioma as a "bonus".

Multiple enterocutaneous fistulas secondary to surgeries to treat colon cancer.

Diffuse large B-cell lymphoma - this was actually a patient who had undergone chemo in the past, and when it was discovered that the cancer was back, she declined further treatment and went on comfort care. She died on my shift.

therapeutic

2009-04-15T19:23:00.000-07:00

In nursing school, we spent a great deal of time discussing therapeutic communication. We were taught to validate feelings, express respect for the other person, and try to steer the conversation in a productive direction.

Yesterday I heard the following interaction while out with a group of coworkers:

Nurse 1: "You know that guy G*** with the possible mad cow disease, and how he's totally crazy?"

Nurse 2: "Sure, yeah, he calls everyone "f*cking b*tch," right?"

Nurse 1: "Yeah, that guy. The other day I gave him his meds and then asked him if there was anything else I could do for him, and he looked me straight in the eye and said, "Yes. You can suck my dick."

Nurse 2: "HAHAHAHA! What did you say - "It sounds like you're feeling horny right now. Would you like to discuss those feelings?" "

Nurse 1: "No, I just covered my mouth and ran out of the room because I couldn't stop laughing!"

I love my coworkers.

don't

2009-04-07T22:01:00.000-07:00

Recent diseases that my patients have had lately that I am glad I don't have myself:

-Full blown AIDS with Kaposi's sarcoma and C.diff diarrhea as a bonus.
-TTP and resultant amputations of both hands & both feet
-completely out-of-touch with any kind of reality schizophrenia (and a foot infection)
-Median arcuate ligament syndrome. (No, I'd never heard of it before, either.)
-spontaneous pulmonary embolism for no apparent reason.

I think this may become a recurring topic on my blog, since I find new conditions that I really don't want to have on a regular basis.

paging Z in Richmond

2009-03-11T17:07:00.000-07:00

Hey, I'm thinking of you and wondering how your nursing school journey is playing out! Update me when you have a chance. Hope you & yours are well.

eyeball

2009-03-11T16:35:00.001-07:00

Okay, okay, I've been promising this post forever. Consider it a cautionary tale. (If you don't like gross stories, don't read this one, ok?)

I took care of a patient a while ago who was a young woman who had decided to leave her boring suburban life and plans for college to hang out with the wrong crowd. She was using heroin and while her claim was that the massive necrotizing infection in her face started when she just picked at a scab on her forehead... it seems more likely to me that she had either injected or dripped a solution of heroin into her eye. That's right, her eye was the center of the infection. And man was it gross. The eye was swollen shut and continually oozed bloody drainage... when we cleaned it, it drained more, so that it looked like she was was weeping blood. Amazingly, she didn't lose the eye, although she is blind on that side now.

The good news is that she stopped using heroin and got into a methadone maintenance program. The bad news is that she came back to us a couple monthes later with abcesses in her thighs... apparently she decided to change things up by injecting cocaine into her femorals. I didn't ask her this, but I wanted to ask why she would risk infection by injecting when she had a perfectly good cocaine nozzle right on the front of her face... I suppose that would be a less-than-therapeutic message?

So, the takeaway lessons here are:
1. If you use heroin, keep it the hell away from your face and eyes.
2. If you want to use cocaine instead, I really can't recommend injecting it.
3. Srsly, college is not that bad. At least give it a try before you turn to drugs & whoring yourself out. Kthx.

And finally, heroin factoid of the day: dealers apparently cut black tar heroin with many things including fecal matter. Yes, poop. Which then users inject. And get nasty infected abcesses, big surprise. Could it get any grosser?

not the newest

2009-02-25T11:45:00.000-08:00

I started this entry back in October... but it's still relevant to me so I'm posting it anyway.

****************************
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:
-introduce myself
-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:
-a bath
-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.

vancouver

2009-02-24T19:01:00.000-08:00

We visited Vancouver, BC over the past weekend and had a marvelous time! I want to make some notes for future reference, and for anyone who happens to be looking for information online.

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.

smell

2009-01-20T18:26:00.000-08:00

Spotted on the fridge in the break room at work. My coworkers are sooooo mature.

go cordless

2008-12-18T18:40:00.000-08:00

Hack Attack: The Cordless Workspace (sort of)

Wow, this is genius! We have that exact desk in our home office. I'm thinking we should do this the next time we have to deassemble and reassemble it.

eyeball

2008-12-17T22:45:00.001-08:00

I can't believe I didn't mention Eyeball Girl before! In the vaguest possible privacy-protecting description, she was a young woman with a heroin problem who got a necrotizing infection of her face.

Okay, now keep voting.

year end

2008-12-17T11:12:00.000-08:00

This year has really flown by. My workmate E* recently pointed out that we've been employed at Big County Hospital for 6 months, which is astonishing. It's turning out better than I could have hoped - I work with a fantastic bunch of people.

I'm somehow surprised to find R* & I still in our rental house - intellectually I know that we planned to spend about two years here, but it's already been an entire year? Wow. This little house has been treating us well - it is completely free of poo in the bathtub and the furnace is working like a dream. Not to mention the guest quarters for anyone who needs to stay with us and the garage storage for bikes and such. We're still contemplating our next move - R* believes the housing market will continue to fall for some time, so the longer we wait, the better deal we'll get & the bigger our down payment will be.

I started this entry wanting to write about work, but I still struggle with knowing what to say about it. Here, I'll give my readers a choice of patient stories, and I'll write first about the one you vote for.

*my comfort care patient who died on my shift (this is the first time a patient of mine has died under my care)

*the reappearance of Eyeball Girl

*the flasher guy who wouldn't go home

Vote in the comments, please!

compensation

2008-12-06T11:00:00.000-08:00

UroStream: Harley riders: beware!

I wonder if us trauma nurses could use this as an additional demotivator for motorcylce-riding patients? We see so many accident victims who were on motorcycles... maybe they'd stop riding if they knew it could break their penises.

thankful

2008-11-27T20:41:00.000-08:00

Thankful 2007
Thankful 2006
Thankful 2005
Thankful 2004

I am thankful for a lot of things this year.

I love my husband and my mom and dad a whole lot.

I graduated from nursing school!

I passed the NCLEX!

I got a job at a terrific hospital, and it turned out that I love it.

And I also seriously love my coworkers!

R* and I are in a financially sound place even as the whole world's economy goes down the crapper.

Time for having a baby is any time now. (No, I don't have an announcement at this time.)

None of my loved ones have any of the horrible problems that I see at work: head injuries, diabetes, addiction problems, colostomies...

In just a few more weeks, Barack Obama will be our president!

Happy Thanksgiving, everyone. I hope you're all happy & healthy.

infectious

2008-11-21T17:10:00.000-08:00

There has been a great deal of outrage at work based on this series in the Seattle Times:

Culture of Resistance

I work at the Big County Hospital prominently featured in the articles. I can tell you that our MRSA infection rate for last month (October) was the lowest that it has been in the last 10 years. This is due to aggressive detection & isolation practices as well as strict hygiene and cleaning measures. The casual statements made in the article about how the hospital doesn't screen or isolate patients is WRONG. All ICU patients are screened at admission and routinely thereafter. MRSA patients are very rarely roomed with non-MRSA patients - and when this happens, it's because the county hospital cannot just close its doors because it's too full. We have to continue to provide care. In these rare instances, the MRSA patient is paired with a low-risk roommate, someone who doesn't have open wounds or a compromised immune system, to try to avoid communicating the infection.

I am appalled at some of the "facts" people are spouting - both in this series and in the comments. For example:

Hospitals don't thoroughly clean rooms between patients.
That would be wrong. Not only do rooms get cleaned in between patients, when the patient has been isolated due to infection, a "terminal clean" is done, which takes about an hour and is very thorough. Every bed is disinfected between occupants.

MRSA, C. diff, and other superbugs are viruses.
No no no. They are bacteria. This means, unlike viruses, they can be treated with antibiotics. This distinction is really important!

Patients with MRSA acquired it in the hospital.
There was a time when this was likely to be true - but these days LOTS of people are carrying MRSA out in the community. So they bring it in to the hospital in their noses or on their skin, then it may flare up into a full-blown infection after trauma, surgery, or some other insult to the immune system. Yes, these carriers need to be isolated, but it's certainly not a given that the hospital made them sick.

What it boils down to is that everyone needs to participate in preventing infections. This means hospital employees, patients, visitors, everyone. So patients, quit refusing your baths. Visitors, wash your damn hands, and don't let your kids sit on the floor. Doctors, take off your white coats and put on the gowns when you go in an isolation room. Everyone, clean your stethescopes between patients.

Now, I would be interested in getting a nasal swab for MRSA because I'm sure it would come back positive!

spit

2008-10-30T22:24:00.000-07:00

I learned a random fascinating fact today: Byetta (a drug used to help treat type II diabetes) was derived from the saliva of the Gila monster. The coworker & I who were looking up the drug agreed that we couldn't make this stuff up!

I also did a good thing for a patient today - the patient had a painful wound that needed to be cleaned and have the dressing changed twice a day. The night nurse told me that it was so painful the patient was literally crying loudly... so before I did his wound care, I paged the doc and asked for an order for topical lidocaine. Which he stopped by and wrote for me almost immediately. So I was able to blast a bunch of numbing medication into this guy's wound - and it made a huge difference in his comfort level for the rest of my shift. That felt really, really good.

Of course, I also forgot to label a syringe of Reglan that subsequently got thrown away, and forgot to hang an antibiotic in a timely manner. This is why I will not be getting too big for my britches anytime soon.

undecided?

2008-10-23T11:01:00.000-07:00

Undecided

I haven't really bought into the whole David Sedaris thing, probably just because everyone in my age group thinks he's the best writer that ever existed, but I have to say this made me laugh out loud. Especially this bit about the undecided voters who keep showing up on the evening news:

"I look at these people and can’t quite believe that they exist. Are they professional actors? I wonder. Or are they simply laymen who want a lot of attention?

To put them in perspective, I think of being on an airplane. The flight attendant comes down the aisle with her food cart and, eventually, parks it beside my seat. “Can I interest you in the chicken?” she asks. “Or would you prefer the platter of shit with bits of broken glass in it?”

To be undecided in this election is to pause for a moment and then ask how the chicken is cooked."

adjustment

2008-10-05T21:34:00.000-07:00

I noticed this week that I'm feeling like I'm getting the hang of being a nurse. I go to work, I get my assignment, I go about my day, and I generally don't freak out about any of the regular stuff that occurs in my shift. I still leave the hospital each day thinking that I could have done better/more/in depth/smarter... but I suppose that's always the case.

I continue to get good feedback from my patients, which is pretty reassuring. And I am really growing to like my coworkers. I already knew I liked the 4 others I went to school with, but I like the ones I didn't know in advance, too.

I did post-mortem care for the first time this past week. The patient wasn't assigned to me, but the nurse who was assigned to him was busy with a semi-emergency and the deceased patient was, well, deceased. So I helped. And I was surprisingly okay with it. I suppose it helped that the patient was elderly and had a do-not-resuscitate order and died peacefully.

On a personal note, I'm finally getting some time off. I didn't work last weekend, but my in-laws were here so I didn't exactly have down time. This weekend, however, I have been lazy as hell, and I have two more days off before I go back to work. Sometimes working 12 hour shifts is so worth it!

Two of the best patient quotes this week:

(little old lady to male nurse) "Don't you touch me, or I will KICK YOU IN THE BALLS!"

(head-injured young patient to the same nurse, on the same day) "Dude, do you think you could get me some weed?"

hilarious!

2008-09-25T18:20:00.000-07:00

Your Urgent Help Needed

Love it.

flow

2008-09-18T09:21:00.001-07:00

Things feel like they're falling into place. I'm getting used to my job, although I still wonder who on earth thinks it's a good idea to allow me to take care of patients all by myself - can't they see I don't know anything? But mostly I'm doing all right as a new nurse. I wish I could figure out how to be more on top of everything that needs to be done... I feel like I'm barely getting all the basics accomplished during my shift, which is frustrating to a perfectionist like myself.

I'm also doing better in terms of taking care of my health. I'm down 22 pounds since NCLEX, we're consistently eating better and getting more exercise and activity. I still haven't figured out how to keep the house from becoming a disaster, but I imagine that will come together at some point.

I find myself wanting to talk about some of the things I see at work, but I'm not sure how to approach them. My impulse is to describe some of the crazy, gory, astonishing physical problems I encounter on a daily basis, but that's only part of the picture. I also have to balance a thousand details, make & receive a thousand phone calls, keep track of a thousand medications and associated assessments (how much insulin does my patient need? gotta check the blood sugar!), and answer a thousand questions. It's no wonder that I come home exhausted.

By the way - don't squirt a solution of heroin into your eyeball. Kthx.

fried

2008-09-04T22:41:00.000-07:00

I woke up late today. Really late. The clock said 6:22. My carpool buddy was supposed to pick me up 2 blocks away at 6:25. I threw on my scrubs, grabbed my keys & my badge, and literally ran the whole way. We made it to work on time.

Where I had 5 patients in the course of my shift, one of whom spoke only Spanish. And was going home. And needed teaching about his new colostomy. My Spanish is really not up to the task.

Then my night-shift coworkers didn't come get report from me until 15 minutes after I was supposed to be gone.

Now I'm going to sleep the sleep of the dead. And luxuriate in my four days off.

first

2008-08-18T22:21:00.000-07:00

Today was my first day on the floor where I was actually hired to work. I had just finished 3 shifts on the unit where I was training... I had such a good experience there that I thought I would be sad to move on. But I had a surprisingly good day, and I feel surprisingly happy about being in this new place. After just one day I already have ideas about how to make things run more smoothly. And best of all, I did not feel like the "new kid". I knew 2 of the nurses on the floor with me, both of the unit secretaries, and one of the aides. And then my classmates E* and O* showed up at shift change and it was truly lovely to see them both. E* and I are sharing a locker in the staff room now, where we will keep a stash of cinnamon Altoids which my husband hates. I don't know if E*'s wife likes them or not.

I also learned today what happens when we call for a show of force from the security department: a whole lot of people RUN onto the unit and scare the crap out of whoever is causing trouble. That was awesome. (Incidentally, the trouble-causers were the friends(?) and family of the patient. The patient himself was way too out of it to be troublesome.)

At least so far, I'm feeling like my preceptorship on the trauma unit prepared me extremely well, and I am going to be just fine. That is a good feeling.

Now I am about to enjoy two days off, followed by a couple of short shifts, and then a weekend with my parents. Life is good.

replying

2008-08-16T11:29:00.000-07:00

I've been working and not blogging. But I appreciate the visits & comments from readers! So here are my replies to some of you, because I have been a terrible e-mailer lately.

UnsinkableMB -
Thanks for the thoughts on shoes, orthotics, and achey hips. I've been trying out different shoes in my closet and haven't found the perfect thing yet - but I'll keep looking. And I think I'll investigate orthotics, especially if my insurance will pay for them!

ThirdDegreeNurse - it's so nice to hear from you! I hope you're doing well in your nurse career, too. I'd love to get an update from you if you feel so inspired.

Emilie - Yes, nurses have to eat either in starving bear mode or in fluttering bird mode. One shovels without perceptible chewing or swallowing, the other zooms through the breakroom and swoops up a few bites of whatever potluck dishes are still left and repeats this move several times throughout the day.

Also thanks for the nice words about my "good" things. I am having trouble remembering the good things when I have a hard day.

Heather - Sorry for the shivers. I will keep posting my helpful tips as they occur to me, but I'll try to keep them tasteful enough for non-nurse reading. :)

Kim - Thanks for my move to the big leagues! And I love the idea that I was giving birth to a career. Hee.

Anonymous Shoreline RN program applier - You absolutely DO need to make sure that your transcript gets to the nursing department, but it doesn't have to be an official copy. Stop by the front office in the nursing building - the secretary for the nursing dept can help you make sure your paperwork is in order. And, at 115 points you should be a shoo-in to get accepted! I've heard that the required number of points is back down near 100 points now. Good luck!

Caroline - Thanks for the compliment! And hey, I know I haven't been commenting on your blog, but it sounds like you are rocking the house. Good for you!

CyNurse - Thanks! And the weight loss continues but slowly. I am down 18 pounds at this point, but I still can't fit into my favorite jeans. Not quite.

GeekRN - Hi there compadre! Nice to hear from a fellow Shoreline grad. Especially since you're still working as a nurse, which means that in several more months I will most likely still be functioning, also. :) So you're Mr. Meow Note?? When I started the program in spring 2006 the management students were passing out CDs of them to everyone. By the time I graduated, that practice had pretty much fallen out of favor. I don't think it was because of the administration, though - I think it had more to do with the fact that the curriculum has changed over time and the notes didn't match up to the lectures as well anymore.

So. I have just a few more days of orientation. And my first day on the new unit is Monday. In a cheery note, I already know that I will be giving report Monday evening to my classmate E*, who is well on the way to being my new work-spouse, after being my clinical boyfriend during last quarter. Yes, I'm being a little facetious, just to annoy my husband.

I'm surprised to find that I'm starting to feel ready to be on my own at work. I'm sure I will still need help, and that I won't be all that happy with my performance on a regular basis, but I seem to have gotten past the pants-wetting terror of my first few weeks at the hospital.

good bad weird

2008-07-22T20:15:00.000-07:00

Good things that have happened at work:

I noticed when one of my patients had early signs of bleeding internally (increased heart rate, low blood pressure...) and got my preceptor involved right away and we ended up calling a rapid response, which culminated with the attending physician coming into the room, taking one look at the patient, and saying something to the effect of "I'll see you in the operating room in 15 minutes". My preceptor congratulated me aftewards, saying I made a good catch.

I freely confess that the only reason I knew what was going on and that I needed to react quickly was because a former coworker told me about a nurse who got fired because they missed the early signs of a patient bleeding internally after surgery, and the patient died. When I heard the story, I promised myself that would not happen when I was a nurse. I had lunch with my former coworker last week and told her about my "good catch" and she was so proud of me. :)

I've been handling three patients relatively independently for a couple of weeks.

Yesterday, a patient who used to be a nurse told me that she appreciated having me as her nurse because every time I came in the room, she and her family felt calmer and more in control. That was super nice to hear, especially considering that she used to be on the other side of the bed, as it were.

I'm down 15.5 pounds since NCLEX. I credit long days of work in addition to dieting.

Bad things that have happened at work:

I've gotten to the end of my shift with little charting done and have had to stay late on more than one occasion.

I cared for a new paraplegic who was so positive and so in denial and he told me "I'm going to work hard and walk again!" and I actually started to tear up, it was so sad. Ouch.

I just worked 4 days in a row and I am tuckered out.

Weird things that have happened at work:

I took care of a person who was in the trouble with the law and was guarded by a series of police officers. One of whom tried to hit on me. That hasn't happened before.

Head-injured patient who is very confused and yells all the time saying to me "I HOPE YOU DON'T THINK I'M A F***ING PUSSY!" after asking me for pain meds. Heh. No, buddy. You've got broken bones, not a lack of courage.

So there you go. Little snapshot of what I've been doing. I'm still orienting through the 3rd week of August, then I will apparently be joining up with my future colleagues on the new unit.

weekend

2008-06-20T21:36:00.001-07:00

Since Meeegan asked - I am working tomorrow (Saturday) for 12 hours. I'm off on Sunday, though!

I forgot one thing on my list of stuff I've learned so far - working as a nurse is excellent for dieting if you can avoid the junk food in the staff lounge. I barely have time to sit and eat my lunch - and I'm not even up to a full patient load yet. Also, I'm down 10 pounds since taking the NCLEX. Just 20 more to go to get back to my pre-nursing school weight. It's like I was pregnant for two years, or something.

Tomorrow I'll be moved up to taking two patients. I handled one today pretty much independently and it went well. So I hope I don't have a meltdown with two tomorrow!

so far

2008-06-18T11:25:00.000-07:00

I've worked on the floor at BCH for 5 shifts and here are a few things I've learned so far:

1) There is a device for cleaning out gnarly wounds called a waterpick. I did not know such a thing even existed before last week.

2) Fentanyl lollipops (excuse me, transmucosal delivery systems) don't look like lollipops at all. They look like an instrument that is the perfect size to shove into a nostril, actually.

3) If you are a morbidly obese diabetic man, you may want to look into personal hygiene, before you develop an infection where the sun doesn't shine. Holy crap, I've never seen wounds like that before.

4) Apparently having a rectal tube (excuse me, fecal continence management system) installed feels like "having a Ho-Ho shoved up [your] butt". Or so my patient informed me.

5) If you inject heroin into your subclavian veins, Very Bad Things can happen. If that's not quite enough information for you, google necrotizing fasciitis. See? Very bad.

6) Working 2 12-hour shifts on consecutive days makes my hips ache by the end of the second day. But with support socks at least my feet don't hurt.

7) I really need to work on my time-management skills.

8) I probably need to make myself a more structured brain sheet/to-do list if I'm going to not forget stuff.

worker bee

2008-06-16T23:00:00.000-07:00

Hello Internet, I have not visited with you in quite a while!

My biggest news is that I started my new job as an RN at Big County Hospital (BCH from here on out). I had 5 8-hour days of classroom orientation the first week, which was shockingly exhausting. My brain felt swollen from acquiring so much information at such a rapid pace. The next week I had an all-day computer training which was excruciating - then I started out on the floor with my preceptor.

This is a little confusing to explain, but I am not training on the unit where I will eventually be working. I was pretty upset about that when I found out, but after I met my preceptor and got started, I was no longer upset. My preceptor is AWESOME. She's been a nurse for a long time, she's smart and funny and encouraging and kind - exactly the kind of nurse I aspire to be. She's been giving me both positive feedback and constructive criticism, which I really appreciate.

So working at BCH is pretty different from working at the Nonprofit Community Hospital. I have seen some shocking, shocking wounds, and I've only been at work for 4 days. Happily I turned out to be interested in gnarly wounds, and not the kind of person who passes out at the sight.

Okay. Another 12 hour shift tomorrow, so off to bed with me.

decorator slugs

2008-05-20T10:10:00.000-07:00

Look at these sea slugs from National Geographic. They're beautiful! You could use some of them as inspiration for interior decorating.

hempy*

2008-05-09T10:43:00.000-07:00

Top 50 'Sesame Street' Moments

Too much fun!

*the way I pronounced Sesame when I was 2

manipulative

2008-05-08T10:45:00.000-07:00

Ooh, interesting. One thing we talked about a lot in school is that labeling your patients as "drug-seeking" or "lazy" or what-have-you affects not only the care you provide, but the care that those around you think is appropriate to provide as well. "Manipulative" is one of those words, but I hadn't really thought about it before. Honestly, I had thought that some patients are in fact manipulative, so why not call a spade a spade?

Then I read this piece from Maria. Here's a quote:

"Consider striking the word “manipulative” from your vocabulary. Just describe what people are doing. “She says that she will kill herself if I don’t give her Vicodin” is a lot more informative than “She’s manipulative”. Furthermore, brainstorming ideas and conferring with others (including the patient) to solve this dilemma is much easier when everyone knows the specific details of the dilemma. How does one solve a problem around an adjective?"

Aha! Of course. You can't make a measureable outcome in the care plan for manipulation. :)

RN!

2008-05-01T13:49:00.001-07:00

I passed the damn test!

I did that.

2008-04-30T17:04:00.000-07:00

Took the NCLEX today. It shut off at 75 questions, which is the minimum. I think I feel okay about it. I won't know my results for a couple of days. Stay tuned!

Afterwards, I went for burgers and beers with two classmates, then we went over to classmate E*'s house and drank beer and watched a movie, until more classmates arrived and we gave up on the movie and gossiped instead. It was fun.

still here

2008-04-23T23:13:00.000-07:00

Still here. Still studying. One week to go.

I know of 5 classmates who have passed so far. There are 3 more who have taken the test but haven't gotten results yet.

I really can't think about anything else. Sorry to be boring.

Yoga Today

2008-04-14T12:19:00.000-07:00

Yoga Today

I did not even know this site existed! They post new approximately hour-long yoga videos for free. Just click on 'em and do your practice. Very cool.

wow

2008-04-09T09:48:00.000-07:00

This is a collection of science-related tattoos. Awesome!!!!

Now I'm wondering if my dad will get some phospholipids tattooed on his arm or something...

study

2008-04-01T23:05:00.000-07:00

It has begun: the studying for the NCLEX. I took inventory of myself and my study habits, and then picked up the phone and called two my favorite, most focused classmates and asked them to study with me. R* and E* are both going to be my coworkers on the same unit at Big County Hospital and we will be going through orientation together as well. We conferred on which review books we had and how we should tackle this huge body of knowledge, and yesterday we started. Today we continued with an extra bonus classmate C*. So far we've gotten through 8 chapters of the Kaplan review book and have repeatedly exclaimed "why didn't they tell us this in school??" We also learned that Maslow's hierarchy allegedly contains sex on the most basic level, right next to food, water, oxygen, and protection from extremes in temperature. This led to amusing conversation about how we've never seen any doctor's orders written for sexual interventions, and how if sex really is a basic need, as a group of stressed-out nursing students with long-suffering spouses, we may all be clinically dead.

Then since my brain wasn't quite full enough, classmate R* went home and classmates M* and D* showed up and we played RNtertainment for quite a while. There was much moaning and bitching about how the questions from the game wouldn't be on the NCLEX itself, but I wrote down 5 or 6 items to look up because I couldn't remember a single thing about them. Electromyography? Anyone? Anyone? Yeah, me neither.

And THEN, because I wasn't exhausted enough from using my brain for 8 hours, I went downstairs and worked out and then showered and cooked a healthy dinner and now I really wish someone would rub my back and hand me a chocolate chip cookie.

On that note, I spent the last 8 days watching everything I put in my face, working out more than I have in the last three months combined, logging all my food into Weight Watchers... and I got on the scale yesterday morning and there was no. change. at. all. Gahhhhhhhh. But hey, my body feels pretty good, so I guess I'll just keep at it.

test ahoy

2008-03-27T10:42:00.000-07:00

I scheduled my NCLEX-RN exam today. I will be taking it on April 30. Now I kind of feel like peeing my pants in terror... not so much because tests are scary to me, but because it means I have a hard date that I cannot procrastinate about.

ALL DONE

2008-03-23T07:51:00.000-07:00

And that is that!

I graduated on Thursday. It was the strangest feeling. Possibly because I got drunker than I have ever been in my LIFE on Wednesday with my classmates. I've been trying to make up with my liver ever since.

I have a lot of mixed feelings right now - I'm glad to be done with school and its tests, papers, and other hoops through which I had to jump... I'm both excited and terrified about starting my new job in a couple months... I'm very relieved to have some free time to myself until the job starts... I'm oddly anxious and sad about not being around my beloved classmates all the time, and am trying to feel out the right way to stay in touch with my favorite people without being annoying and clingy. The one thing that I am NOT troubled about is taking the NCLEX. I know it's a big deal, and I know I need to prepare for it, but I am completely confident that it will be fine.

one more!

2008-03-17T18:21:00.000-07:00

I'm feeling so much better today. I still have an alien mucous creature living in my nose, and I make funny sounds when I cough, but my energy level is normalizing and I don't feel like I need to sleep 80% of the time.

I had my last regular test at school today - it was surprisingly not that hard. Or maybe I studied effectively, although since all my studying was done while high on cold medicine, I'm not convinced that's the answer. The good news is that all of my classmates who were worried that they might not pass the class did really well today and are most likely going to be fine and graduate with us!

Now I'm off to go on a hot date with my husband.

mmmmmmmmmmm

2008-03-16T14:32:00.000-07:00

LUSH -- Fragrance: Silky Underwear Solid Perfume

Wow! I've been waiting for this perfume for years, ever since my first trip to a Lush store in Victoria. I adore the scent of Silky Underwear powder but I'm not much of a powder wearer... this is the perfect product for me!

Now I just need to go downtown and hit my local Lush.

six days

2008-03-14T23:34:00.000-07:00

I only have six days to go. I am much sicker than I have any right to be - coughing up gross stuff and everything. Ridiculous. I did not let that stop me from going out after clinical with my classmates tonight, though, because it was the very last day of our very last clinical!!! Thank goodness.

All that I have left for the quarter are two more exams for med-surg. They're going to be tough but I fully expect to pass them and graduate. I know several of my classmates are sweating it, though.

fault

2008-03-13T00:10:00.000-07:00

I overheard an interesting point of view tonight at clinical. A patient was admitted to the floor, apparently had been nauseated and over-sedated in the ER, came to the floor and complained of major pain, then began to projectile vomit. Lovely. The nurse was advocating strongly for the patient, saying "I need pain meds for this patient, they are hurting badly" and generally agitating to get the patient's meds ordered right away. But then behind closed doors, I heard the same nurse saying that she didn't feel any sympathy at all for the patient, because the chronic pain issues are the result of blown-out knees secondary to morbid obesity. In fact, the nurse said something along the lines of, "I feel sorry for the patients with brain tumors because they didn't do anything to bring it on, but the ones with problems from obesity I don't feel sorry for at all because they made that choice."

Wow. That's not very compassionate. And it made me wonder: Is this attitude okay? Does the patient with morbid obesity deserve less sympathy than anyone else? The nurse didn't appear to TREAT the patient any differently... but her attitude was pretty clear. And I also wondered if it's even fair - once someone gets overweight for whatever reason, it is really really hard to lose, especially if you have blown out your knees and can't exercise effectively.

What do you think?

feets

2008-03-11T14:17:00.000-07:00

World's Softest Support Socks

Beloved classmate M* gave me a tip about these new support socks she just got and says are extremely comfortable. They look excellent and aren't even spendy! Want.

hey, shut it!

2008-03-08T20:03:00.000-08:00

In Our Own Words: Anti-Complaining Campaign

I think this is a great idea. One of the reasons I'm so excited about my future job is that because it is a new unit, I will be able to have an immediate effect on the culture of the unit. The number of people from my class who will be on the unit is up to 4, with a few more still in the interview process. All of us who have been hired are non-complainy people, so I hope that we can carry that positive vibe forward!

two weeks

2008-03-06T10:57:00.001-08:00

Graduation is two weeks from today.

My last med-surg clinical is halfway over.

I think I'm finally starting to understand how to administer IV medications. Stupid IV pumps.

I've got 3 more exams and 1 more nursing process paper to write in the next two weeks.

One of my very favorite classmates got a job on the same unit as me! She may not be able to work days with me initially, but we'll be going through orientation together. That makes me really happy - she is the one person in my class who I am certain I would have been friends with even if we weren't in nursing school together.

Yesterday afternoon one of the boys in my clinical group said, "Hey guys, two weeks from now we'll be standing in [Classmate A]'s yard with beers in our hands." Unbelievable.

kidlets

2008-02-29T11:07:00.000-08:00

I haven't been updating this here blog. I've been busy with lots of other stuff. 21 days to graduation!

Yesterday I had an observation clinical at the inpatient pediatric unit at Downtown Nonprofit Hospital. I worked with two completely awesome nurses (one was a graduate of my program!) and had a wonderful time. I love babies, I really do... and I totally don't want to work in pediatrics. It is so sad to see sick kids - and most of the kids I saw weren't even that sick. So I'm adding peds to the list of nursing specialities I don't wish to pursue.

Okay, now I have to go write write write before I leave for clinical tonight. And tomorrow is my last day of work at Neighborhood Hospital. A normal real life is so close I can taste it!

things I think I need to be a nurse

2008-02-17T18:52:00.000-08:00

More support stockings.

More UnderArmour to prevent chafing.

A fancy clipboard with a calculator on it.

This book.

A pocket security blanket, because when in doubt, I do research.

I am scared to death of starting my new job, actually, in case you couldn't tell!

I made a decision

2008-02-12T20:06:00.000-08:00

I accepted the job at Big County Hospital today. I had an interview at University Teaching Hospital that actually went really, really well... but even so, I think I will be more comfortable with the BCH job. The UTH job was on a very busy mostly surgical unit, and I was frankly intimidated about the idea of trying to learn about all these complex surgical patients while at the same time trying to figure out how to be a nurse without passing out from anxiety. I like the idea of learning from the ground up with all the other new staff. I really like the idea of being in a position to help develop a positive culture on a new unit instead of stepping into established political crap. And I like the idea of having mostly medical patients. Diseases are interesting.

But, the experience of having a really good interview and having the nurse manager offer me the job on the spot was extremely affirming. I had this irrational fear that the nurse manager at BCH was hiring everyone with a pulse just to staff her unit... but today's experience gave me a lot more confidence.

Now I just need to finish the quarter, pass the boards, and get a license. You know, piece of cake. Haha.

P.S. to Doug - 0.9 means 90% of full time, in this case 36 hours/week in the form of 3 12-hour shifts. That means FOUR DAYS OFF every week, rock!

a wealth of options?

2008-02-05T16:19:00.000-08:00

Job stuff update:

Big County Hospital offered me a 0.9 day shift position with orientation starting June 2. I have not told them yes or no yet, although I did send them an email letting them know that I got the offer, I am interested, but I have another interview scheduled. The reason they have day shift jobs, which is an excellent jaded cynical old nurse question, is because it's actually a new unit. The hospital is expanding and this is one of the new units that will be opening up when the construction is complete, so they're hiring for all shifts right now, both new grads and experienced nurses.

University Teaching Hospital is interviewing me next week. If I understood correctly, the interview is with the nurse manager on the ortho unit where I had clinicals a couple quarters ago. I didn't love that unit but didn't hate it either. So we'll see how that interview goes, and then I'll make a decision. I feel so lucky that I may well have a choice of jobs.

In other news, I am sick sick sick with a cruddy cold that has robbed me of my speaking voice and filled my head with snot. I dragged my arse out of bed this morning at 5:00 to get to clinical by 6:00 where I supervised 1st quarter students for a few hours, then went to campus and took a terribly difficult test (I passed! Not all my classmates did so!) and stayed for lecture. And now I am home and I am going to bed. Night night.

well, crap

2008-02-02T12:07:00.000-08:00

Don't be fooled by the myth of John McCain

nothing definitive

2008-02-02T09:22:00.000-08:00

I went to my interview at Big County Hospital yesterday - I met with the HR nurse recruiter and with the nurse manager for the new med-surg unit that is yet to open. The manager from the tele unit cancelled on me, not because she was disinterested, just a scheduling conflict (according to the recruiter). That was fine - tele was my second choice.

So I interviewed with the med-surg nurse manager, and she was very nice, calm & low-key. She was looking at my resume and saw that I went to KSU, and it turned out that she was born half an hour away from where I grew up. Small world. She asked me a bunch of those interview questions ("how do you deal with conflict?" and so on) and then we toured the unit that will be converted into the new med-surg unit. I had clinical on that floor in the past, so it was familiar. I asked the NM lots of questions, too, and I was pretty pleased with her answers.

So. It wasn't True Love at First Sight, but it seemed like a pretty good option. There are several factors in the plus column: a long preceptorship (12 weeks!), day shift hours are available, it's a vibrant academically-oriented environment, the patient population is highly variable, the pay is competitive. There are a few minuses - there's nothing swanky about this hospital including the cafeteria, it's in a kind of crummy part of town that does not make me feel safe, parking in the hospital garage is expensive. Still, it would be a fantastic experience.

Then when I got home I had a request for references in my inbox from the University Teaching Hospital. I applied for three positions there and I'm apparently being considered for two of them. I don't know if anything will come of it, but we'll see.

Oh, and as a special bonus from being in the nursing home full of sick people all week, I seem to have come down with a cold. I'm taking fistfuls of echinacea and other herbals as well as Advil Cold & Sinus, and chugging vast quantities of liquids. I don't have time to be sick!

extremely quickly

2008-01-31T23:13:00.000-08:00

I have been getting up way, way, way before dawn to go to clinical this week. What I've learned: I really like mentoring the first quarter students. I am flattered and encouraged by the confidence the faculty is placing in me. And I really, really don't want to be an RN in a nursing home, because it is all about paperwork and hardly any patient care. That is actually good information for me, because I previously thought that I would be interested in nursing home work.

I have two interviews at Big County Hospital tomorrow morning. One for med-surg, one for telemetry. Both are for new graduate RN positions, which I imagine will have a long & thorough training and preceptorship period. I will know more about that tomorrow. I do know how much their starting pay is, and it is not too shabby. Also, both of the units I'm interviewing with have day shift positions available! That's pretty great, considering that most new grads end up working nights until they earn some seniority.

More tomorrow.

clinical coming up

2008-01-23T20:59:00.000-08:00

First of all, I want to say hi to rosebuttons and Z* and SN Jack. Thanks for your comments and ideas! Especially about preschool waiting lists... I'm sure every decent preschool in Seattle is already booked for the next 3 years. Also, Z*, you are welcome to write a book on my blog anytime you want. I think it's so cool that we're on this same nursing journey.

I had a good series of conversations with my coworker nurses at work on Saturday. They all urged me to take a new grad job at a hospital in order to establish a good experience base and take advantage of the extra coddling that new grads receive during residency. I said, "but what about if I get pregnant and can't finish a full year of work?" They laughed at me... and said that it happens all the time, and I would most likely be welcomed back or transitioned to another position (like the float pool? or a per diem position?). So. That's what I will try to do. I'm applying to several different hospitals' residency programs for med-surg type jobs, and I'll just have to see what happens.

As for school, I went with one other classmate today to do our "self-orientation" at the long-term care facility where we are doing our management clinical starting next week. What does that mean? We will be there Monday & Tuesday mornings with first-quarter students, supervising & mentoring them along with one of the first-quarter instructors. Then Wednesdays and Thursdays, we'll do an entire shift independently... and I believe it will be as though we are additional supervisory nurses. We're not replacing or shadowing a nurse on the shift. We're supposed to be assessing residents, directing resident care by LPNs and CNAs, passing meds to a whole set of residents twice, performing treatments like wound care... and doing a whole lot of paperwork. I think the idea is to immerse us in the world of an RN in long-term care.

I'm feeling surprisingly not anxious about this clinical. The staff made us feel very welcome today, and I'm looking forward to mentoring the new kids in the program. It makes me realize that I'm come a really long way in a really short time. That's cool.

licensure

2008-01-15T19:26:00.000-08:00

In class today we filled out applications for the college for graduation, got the contact info for the state nursing commission so we can start sending them information about ourselves, got the contact info for the testing company so we can go ahead and send them a pile of money for faster test authorization now, and got the order forms for our pins. I think we all started to hyperventilate a little.

My biggest issue right now is that I don't know what kind of job I want to look for. One reason I wanted to go into nursing is because of the flexibility, but now that I'm getting ready to step into the work world again, I feel like there are too many choices. Most nurses & teachers have told me that getting a year of general med-surg experience is smart because it allows greater adaptability going forward, but I've also heard people say that if you're interested in critical care, go ahead and take an ICU job as a new graduate. I have ruled out some things - I don't want to work in labor & delivery, I don't want to work in the ER, I'm not very interested in working in ortho (although it would be a decent new grad job). But I don't have a burning passion for one particular area of practice. Some of the nursing students I know have a thing that they want to do, like oncology or trauma or NICU or psych or whatever. I don't have a thing like that.

Additionally, I am trying to balance the whole finding a new job thing with the whole spawning a smolt thing. We're not trying to have a baby just yet, but neither of us are getting any younger. So I feel kind of pressured to get work ASAP, so I can get a good chunk of work experience under my belt before I take time off for having a kid. And I would like to be able to go back to work part-time in a per-diem position or on a "traveler" contract, so we wouldn't have to put our baby in day care. I don't know how to balance all the variables.

o hai

2008-01-15T10:35:00.000-08:00

welkum to mythbusters

It takes a very special kind of nerd to appreciate this one. I laughed so loud I scared the cat.

hello again

2008-01-09T21:25:00.000-08:00

I've been neglecting my poor blog! As my pathetic short posts have probably hinted, I've been just overwhelmed with everything that's been going on, both good and bad. So here's a quick update on several things in my life:

School. This is this first week of 6th quarter, which is my LAST quarter of nursing school. Graduation is scheduled for March 20. I have two courses with two clinicals - advanced med-surg and nursing management. For med-surg, I'm going to the big downtown location of my employer, which will be interesting. For management clinical, I'm going to a nursing home where half the week I will supervise first-quarter students during their first clinical, and the other half of the week I will manage care for the residents and also manage the staff (CNAs et al) who work there. I am scared to death about the management part - I feel like I don't know enough to tell other people what to do!

House. We're getting settled into the house. I rearranged the kitchen cabinets today, and found a place to plug in the dustbuster. One of our friends asked R* if we were happy in the house, and his answer was "Um... happier than at the apartment? We haven't lived at the house long enough to know." I concur. I think the house is going to be fine but I haven't been here long enough to be sure.

Apartment. I probably shouldn't talk too much about this, but suffice to say that we've found a lawyer and are investigating our options.

Health. Remember how I signed up with Weight Watchers October 1st? Yeah. I stuck to it just fine until the whole Sh*tland thing got underway. And when we were worrying about where we were going to sleep that night or whether we'd have poo in the bathtub, I didn't give a crap about what I ate. So I haven't lost any weight. At least I've managed not to gain any, either. I worked out today for the first time since we moved into the house... I am really out of shape. But it felt good.

Also, remember how I was having too much anxiety? I finally got my act together (and powered through my anxiety about making phone calls) and saw a psychiatric nurse practitioner who specializes in medication management and counseling. After discussing my symptoms and my family history, she agreed with me that I seem to have a biochemical issue that is probably genetic, and changed my medications. It's only been a few weeks and so far, so good.

Kitty. Our Kismet kitty has been such a trooper through all of this upheaval. She didn't like the night she spent in a hotel with us, but she was well-behaved. And she was downright cheerful about staying in the rental condo for a week, even though she didn't understand why we were bothered by her clawing the upholstered chair. (She doesn't do that at home!) Today I took her to the vet for her annual checkup, and the doctor told us she's perfectly healthy, but Kismet registered a complaint with the vet techs. I have never heard her hiss, growl, or yowl before, but she did all three while she was getting her nails trimmed. Goodness. She is a furry purring ball of love at home.

Car. The dealership service center patched my tire and charged me $19. And they vacuumed my floor mats and left me a new bottle of water. Awesome.

Books. I've read a lot of books during my time away from school. The kind you read for fun. You can read about the books I've read and what I thought about them on my shelf at Shelfari.

Las Vegas. R* and I went to Vegas for 3 days right before Christmas. We stayed at the Bellagio and saw 4 shows and ate lots of fantastic food and drank way too much and played slot machines for no apparent reason and generally had a great time. We pretty much avoided the skeevier parts of the Vegas experience altogether. I'm just a little bit bummed that I didn't see any Elvises. (Elvisi? Elvi? Elvoose?)

Christmas. We went to my parents' house and they made Christmas for us. They'd gotten a tree and decorated and put up lights and Mom even got stockings and stuff to put in them. We played games and cards and ate homemade food and took naps and went to see "The Golden Compass" and went for a walk in the snow and generally had a lovely family time. It was really good.

Leavenworth. Because I worked New Year's Day, I didn't want to do anything major on New Year's Eve, which turned out to be just fine since the Space Needle fireworks didn't go off as planned. At all. We had planned to spend the night in a hotel downtown with a view, but we cancelled it in advance. Thank goodness. It would've been a real letdown! So this past weekend before school started, R* took me to Leavenworth to see the winter wonderland. It was so snowy and beautiful! It's not like city snow - everything was covered in this thick puffy blanket of marshmallow cream snow. Because the town is so small, the snow doesn't get all dirty and gross from air pollution and lots of traffic. We went for a walk on the grounds at Sleeping Lady prior to having dinner there, and it was so neat. The snow was about waist deep and they dug out paths between all the buildings. I felt like a mouse in a burrow. The stars came out and they looked so huge and bright because we were out in the mountainy woods - so pretty!

Anyway. I've got to get to bed. I've got clinical orientation tomorrow, oh joy. Oh snore.

AAA

2008-01-02T16:47:00.000-08:00

When you go outside and discover that you have a flat tire and it's getting dark and raining, it is very nice to know that you can call AAA and they will send a nice guy out in a tow truck to put the spare on for you.

settling

2007-12-28T17:27:00.000-08:00

The last few weeks have been a whirlwind. My mom came out to help us unpack, and worked so hard. We were so impressed. If it weren't for her, I think we'd still be sleeping under piles of newspapers or something with all our stuff still in boxes.

We spent 3 nights in Las Vegas seeing shows and eating and drinking too much. It was a super good time but I'm not sure I ever need to go to Vegas again. What a strange place.

After coming home briefly, we drove out to eastern Washington to spend Christmas with my parents. It was a really, really nice visit. We exchanged gifts and cooked meals and played cards and just relaxed a lot. R* and I really needed that kind of downtime. The fact that my parents gave us nice presents was just icing on the cake!

Now we're back at the new house and working on getting settled in. I've got just over a week before I have to go back to school. I'm hoping to go back with a clean house, at least.

moved!

2007-12-12T17:31:00.000-08:00

Departed: Shitland
Arrived: Boxville

packed

2007-12-11T22:51:00.000-08:00

My feet hurt.

I can't concentrate long enough to write whole paragraphs.

The movers came to the apartment today and packed everything. We helped. They were done before 1:00.

We moved a few things into the house and bought some rugs and talked about where to put stuff.

One of my friends from school called me and we talked for a few minutes. Then a short time later another classmate called and asked if I needed any help moving or use of her truck. When I said no, she asked what else she could do, and I asked her to make sure me & R* get fed tomorrow night. She said, "I'm on it! I'll call you tomorrow afternoon." These two phone calls were not unrelated.

I am so lucky to have such good friends.

Crate and Barrel has really nice stuff for not as much money as I expected.

You should never, ever go shopping at University Village during the lead-up to Christmas. Fortunately no lives were lost during our shopping expedition.

Movers come tomorrow to get everything out of the Sh*tland apartment and move it into the new house.

My mom is flying in on Thursday to help us unpack. I am so grateful that we will have her help!

My feet hurt.

for your information

2007-12-09T22:27:00.000-08:00

If you own an apartment where a recent sewage incident occurred, and you are currently avoiding your tenants who are trying to politely dissolve the lease secondary to said sewage incident, I recommend against posting an ad for the apartment that advertises the rent as being $100 more per month, presumably to attempt to recoup costs related to all the major appliances that have broken down in the last few months. Dumbass.

three keys

2007-12-07T13:13:00.000-08:00

I currently have keys to three different living places.

1. The apartment of poo, where most of our stuff is waiting for the movers to come pack on Tuesday and move on Wednesday.

2. The weekly rental condo near downtown where we are staying in a studio apartment until the move, complete with Kismet kitty and our groceries.

3. The rental house we are going to move into on Wednesday. It has 2 bedrooms upstairs and 1 bedroom downstairs and lots of storage.

I am so, so tired.

warm fuzzy

2007-12-07T13:04:00.000-08:00

I just had an unexpected niceness happen to me. I'm sitting in the hallway at school, waiting for my classmates to finish the final exam we had today so we can go to lunch. My clinical instructor from last quarter walked by and said hi, then turned around and sat down next to me and said, "I was talking with the 5th quarter faculty the other day, and one of them said, 'You know who I really like? That Emily. She is so well-rounded and smart and with it.' "

What a sweet, sweet thing to say!

multiplication

2007-12-05T09:06:00.000-08:00

[previous equation]
TIMES
landlord tries to do laundry even though drainage is obviously compromised
EQUALS
raw sewage all over our bathroom and kitchen floors and another night in a hotel.

We think we've found a place to move to.

Cotinue to stay tuned.

equation

2007-12-04T10:36:00.000-08:00

broken furnace
PLUS
broken space heater
PLUS
new furnace that is stupidly loud
PLUS
dryer that doesn't dry
PLUS
toilet won't flush
PLUS
sewage backup in bathtub
EQUALS
we're looking for a new place pronto.

Stay tuned.

book report: Baby Catcher

2007-11-30T21:04:00.000-08:00

Baby Catcher: Chronicles of a Modern Midwife
by Peggy Vincent

I enjoyed this book so, so much! One of my classmates recommended it to me while we were in our labor & delivery clinicals in nursing school. I was fascinated and moved by the author's description of her work as a nurse-midwife. I had several realizations while reading this book: I am not cut out to be a labor & delivery nurse; it's a shame that the medical establishment is reabsorbing the homebirth movement; I really don't want to have a medicalized birth when I have my own child; and I feel like my labor & delivery clinical experience was a freakin' joke.

I'm not cut out to be an L&D nurse because I feel too inexperienced. I know that the author of this book went into the field without having birthed her own children yet, but I really don't feel I could do that. I'm also not sure that I want to become such a specialized sort of nurse, especially considering my anti-medicalized birth rant that is forthcoming.

Part of what Vincent writes about in this book is her experience with being an L&D nurse in San Francisco during the 1970s, where she met women who wanted to take charge of their own birth experiences and refused drugs, IVs, and confinement to bed. She was frustrated with (mostly male) doctors who imposed their concepts of how labor "should" progress on women in labor. Most memorably, one of the doctors told Vincent that a normal birth was always a retrospective diagnosis, and that he considered birth to be complicated and unsafe until proven otherwise. Inspired by these women, Vincent went to midwifery school and started her own business as a midwife and delivered thousands of babies at home.

But as medical malpractice cases increased and insurance carriers refused to insure nurse-midwives, practitioners like Vincent found themselves unable to continue their businesses. Vincent is upfront about the fact that she continued to deliver babies for friends and previous clients, but informed them that she was uninsured ("going bare"). There are still midwives available in some places, such as here in Seattle, but medical insurers are making it more and more difficult.

Which brings me to my personal preferences... I am well aware that I have never given birth, so all of this is basically a**talk. But it's well-educated a**talk. When I think "hospital birth," I think IV, continuous fetal monitoring, contraction monitor, limited ability to get up and move around, doctors wanting to deliver the baby in a certain timeframe and on a certain schedule, encouragement to use narcotics or an epidural, nothing to eat or drink throughout the entire labor, episitomy, 30% or higher rate of caesarean section, and delivery flat on my back with my feet in the air. When I think "midwife birth," (and let's be clear, I have no intention of giving birth at home, I would much prefer to go to a birth center) I think eating & drinking what I want, intermittment fetal heart monitoring, no drugs, no IVs, ability to move around, get in the shower or tub, get down on the floor if it feels right (knowing what I know, I would NEVER get down on the floor in the hospital!), and laboring at my own pace in the positions of my choice. This sounds way more comfortable to me. I fundamentally trust that my body will know what to do and do it well, and I don't need a hospital for that. If something were to go wrong, there are more hospitals in Seattle than you can shake a stick at, and I could be transferred by ambulance in a very short time.

Finally, I feel really let down by my clinical experience after reading about Vincent's student nurse experiences. I did witness one baby's arrival during my clinicals, but it was a c-section and the mother was not in hard labor at the time the decision was made. I didn't see any women in serious labor. I didn't see any vaginal births. I didn't even care for any postpartum women who had had vaginal births, so I didn't even get to see what stiches that repair lacerations look like. I thought it was going to be a really educational, uplifting quarter and it just wasn't. All I learned in the hands-on way was that I really don't want to give birth in a hospital.

My nurse opinions aside, this is an excellent book and I would recommend it to anyone wanting to read honest and open descriptions of lots of different births, including a few that didn't go well. Plus there's a bonus recipe in the back of the book for caramels that sounds really yummy. And there's a lot of resources for additional information - articles, websites, and other books.

zip

2007-11-28T18:41:00.000-08:00

ZipSkinny

Really interesting! You can type in a zipcode and get demographic information about the population there. And you can do side-by-side comparisons of different zipcodes as well. I compared the zip where I grew up to the one where I live now... worlds of difference. I was shocked to find that 25% of the population in my hometown is below the poverty line. I'm guessing that's because my hometown is a college town and most students have little income... at least I hope that's what is going on. Another big difference is that the median age in my hometown is about 24 years old, while in my current location the median age is 37.

thankful

2007-11-22T20:04:00.000-08:00

Thankful 2006
Thankful 2005
Thankful 2004

I'm at my parents' house where there is snow outside. My tummy is full of turkey and stuffing and mashed potatoes and I'm eating a piece of pumpkin pie that I made with my mom last night. R* is here too and we're all hanging out together in the living room. I am thankful that I have my family all together for the holiday. I'm thankful that I am almost done with 5th quarter of nursing school and that I only have one more quarter to go before graduation. I'm thankful that we have our new Kismet kitty in our lives, which has helped ease the pain of losing Booshka and Kadydid last year. I'm thankful for my classmates who continue to rock in so many ways. I'm thankful for the blog readers out there who offer support from all over (especially SN Moxie who came all the way to Seattle to have coffee with me! Okay, so she was also present for the birth of her cousin's baby...) I am thankful that we sold our house before the housing market crapped out. I am thankful that R* has a good job and continues to support me while I finish up school. I am thankful that I have a job that is allowing me to get some experience in nursing before I find my first job. I am thankful that the time for having a baby is getting closer (but not quite yet).

Happy Thanksgiving!

checkbox

2007-11-18T19:25:00.000-08:00

I've checked off a few more things for this quarter:

Done with clinicals.
Done with care plans.
Done with teaching project.
Done with term papers.
Done with going to work the day after my last day of clinical which really sucked for the record.

Still left to do before the quarter is over:

Take several exams.
Write approximately twelve thousand more log entries to turn in on Tuesday. (Actually, I'm almost done with this, but I cannot stand to write any more tonight.)
Go to see my parents for Thanksgiving wherein there will be eating of pie and turkey and stuffing and potato chips and much sleeping in and much drinking of tasty beverages. I can't even express how much I'm looking forward to this.
A one-night stay at the Salish Lodge on our way back after the holiday, wherein there will be snuggling in front of a fire, soaking in a bathrub, and hot stone massages.
And some more exams.

It's really close. Graduation is four months away. Unbelievable.

dream

2007-11-08T10:42:00.000-08:00

I had a dream last night that I was taking a new class - I don't know what the subject was - and one of my classmate was Bob Dylan. I was so excited about it that I excused myself from class for a minute to go to the bathroom so I could text message my mom to tell her. But there was no cell service in the bathroom.

I have no idea what this means.

HAha!

2007-10-31T19:42:00.000-07:00

Awesome.

happy halloween!

2007-10-31T19:23:00.000-07:00

which way did I go

2007-10-25T23:42:00.000-07:00

It's been a whirlwind couple of weeks. I realized today that this week and next week are the busiest weeks of the quarter, so I'm actually feeling really positive.

Last week was my first week of labor & delivery clinicals. I haven't seen any births. I did get to assess a newborn and her mom, though, which was awesome. I love babies. I also got to hang out with a mom who was in for observation due to pregnancy-induced hypertension - she had me feel her baby kicking, which was really cool. The census is pretty low at this hospital, and the c-section rate is pretty high, so I despair of actually witnessing a an old-fashioned birth. We shall see.

Over the weekend, R* and I went out to Port Townsend for a couple of nights. His band played a show Saturday night, but we went up on Friday so we could have some downtime. It was nice but too short.

This week in addition to classroom time, I've been out on the road with hospice nurses as part of my community health clinical. I'm actually really, really enjoying it and will write more about it soon. Also for community health, I'm doing a teaching project with 3 of my classmates on Monday and Tuesday. Then I've got three days in a row of L&D clinical, and then I'm going to lie down and sleep a great deal. After that, things slow down significantly - I do have a few more days of L&D clinical, and half a day with a lactation consultant, but that's about it. It will seem like a luxury to be done with clinical a month before the quarter is over!

Oh yeah, and I'm working on Saturday. I'm seriously trying to figure out how I can swing by the hospital tomorrow and put my name in the "please let me have a day off if you don't need me" book.

darn

2007-10-22T16:04:00.000-07:00

Eczema

Shoot. I guess it's okay that I don't have any hounds.

presso

2007-10-16T11:09:00.000-07:00

Presso Coffee|Latte|Espresso|Cappuccino Maker

This is neato burrito! It looks a lot easier to manage than a full-on espresso machine.

random

2007-10-16T10:55:00.000-07:00

My first week doing Weight Watchers I lost 1.5 pounds.

I ate fewer points this past week and yet did not lose an ounce.

Maybe there is something to the whole working out idea.

Clinical starts this week and I am scared to death.

Going to work on a Saturday and having an extremely crazy day is a good way to limit one's calorie intake.

A fun-size Butterfinger only has two points.

That Progresso light soup that has zero points per serving is actually pretty good.

A can of smoked trout from Trader Joe's is only 90 calories! I'm assuming they expect you to pour off the canola oil it's packed in.

My mom says that putting inulin fiber powder in all your beverages makes it so you're never hungry. I will have to try this.

amen, sisters

2007-10-15T09:25:00.000-07:00

Knitting in the dark: Word.

Nurses, take a minute to read Head Nurse's entry today. It'll make you mad. And I am with Rosebuttons in backing up Jo's anger, especially regarding the VA "treatment" she describes.

of course

2007-10-14T15:58:00.000-07:00

Report ranks jobs by rates of depression

See, it really is depressing to wipe butts. I still stand by the assertion that wiping butts is better than building spam, however.

handymen

2007-10-09T23:05:00.000-07:00

Handymen
by Cornelius Eady

The furnace wheezes like a drenched lung.

You can’t fix it.

The toilet babbles like a speed freak.

You can’t fix it.

The fuse box is a nest of rattlers.

You can’t fix it.

The screens yawn the bees through.

Your fingers are dumb against the hammer.

Your eyes can’t tell plumb from plums.

The frost heaves against the doorjambs,

The ice turns the power lines to brittle candy.

No one told you about how things pop and fizzle,

No one schooled you in spare parts.

That’s what the guy says but doesn’t say

As he tosses his lingo at your apartment-dweller ears,

A bit bemused, a touch impatient,

After the spring melt has wrecked something, stopped something,

After the hard wind has lifted something away,

After the mystery has plugged the pipes,

That rattle coughs up something sinister.

An easy fix, but not for you.

It’s different when you own it,

When it’s yours, he says as the meter runs,

Then smiles like an adult.

I admit to getting a warm fuzzy feeling when I read this poem n the New Yorker... for the time being, I do not have this problem.

anxiety

2007-10-09T22:06:00.000-07:00

I have experienced a resurgence in my anxiety level all of a sudden. In the past few days I've had that intermittent tightness in my chest and the feeling like my eyeballs might pop out of my head. It usually passes if I sit quietly and breathe deeply, but I don't like it.

I'm not entirely sure what the source of the anxiety is... I'm still a bit mystified about school this quarter, but a lot of stresses have been removed. We sold the house, we're out of debt, I have a plan to address my health and so does R*, and I even have the free time to read for fun. I had my first exam of the quarter today and I did just fine on it. I am forced to conclude that the anxiety is biochemical and not situational.

I suppose it's time to get off my high horse and ask for some medical help. Not that happiness comes in a pill, but perhaps a pill will smooth out the edges. Stay tuned.

loss

2007-10-08T12:50:00.000-07:00

I've started back on Weight Watchers online. It's been one week. I've lost a pound and a half. I suppose that's a good start.

I am really tired of struggling with my weight. I'm embarrassed that I gained back all the weight I lost a couple of years ago on the Super Duper Extreme Weight Loss Program. I have made lots of bad health choices since I got into nursing school - I stress-eat and I haven't been getting nearly enough exercise.

One of my motivations is that if I want to have a baby in the next year or two, I need to be in better shape. I know that obesity interferes with fertility, and being out of shape makes giving birth more difficult.

Another motivation is to be supportive of my husband. He was recently diagnosed with asthma and gastric reflux, both of which would be improved by losing weight. He is very motivated to exercise and eat healthy so he will feel better, and I want to support him in his efforts.

And on a more vain note, when we moved, I packed an entire box of clothes for storage that were one size too small. ~~If I can~~When I lose about 20 pounds, I can go retrieve that box and have a whole new wardrobe!

baby

2007-10-02T15:50:00.000-07:00

All this talk about babies and breastfeeding in class is making me want to have a baby.

That is all.

crush

2007-09-29T12:37:00.000-07:00

Eating Seattle: Crush

I recently went to Crush with my husband and parents, and it was fantastic. I wholeheartedly agree with this positive review.

back to school

2007-09-26T08:41:00.000-07:00

I'm back at school this week for my next-to-last quarter of nursing school. This quarter the courses are Childbirth and Community Health. I am looking forward to the labor & delivery stuff because I think it's interesting, even though I have no intention of being an L&D nurse myself. The community health coursework is really boring to me... a lot of it is about policy and health care access and all that wonky sort of stuff that just makes me feel impotently angry. However, I think I'm going to be able to shadow a hospice nurse for my clinical for that class, which will be great.

Right now I'm still feeling very confused. I'm pretty sure I know what dates I'm supposed to be where, but that's about all I know. I'm not even sure what paperwork I'm supposed to turn in tomorrow! I hate feeling lost.

CNA vs. nurse

2007-09-20T10:04:00.000-07:00

I've had an interesting experience at work in the last week - I worked two shifts masquerading as a CNA rather than my usual team-nursing nurse tech role. (Why would I do such a thing? One day I got called in because of a scheduling mix-up, and I was available so I went, and the other time was because I'd agreed to cover a CNA who needed a day off.) At my hospital, CNAs are responsible for about 8 or 9 patients, and take care of the basic caregiving stuff such as: checking vital signs, bathing, changing beds, ordering meals if patients need help, helping patients eat if necessary, toileting, monitoring intake and output, refilling water pitchers, emptying catheter bags and wound drains, toting meal trays to the tray return cart, taking out laundry bags, and answering call lights (which ends with, "I'll tell your nurse" about 50% of the time). Okay, so since I usually do primary care for my own patients, I do all that stuff on a usual day, but not for 8 patients!

Things that I didn't have to worry about as a CNA were: attending report, passing meds, assessing pain, troubleshooting IVs, talking to doctors, or documentation.

One of the RNs who precepted me earlier this summer asked me which I thought was harder - the CNA role or the nurse role. I actually hesitated quite a while to think it over - and I'm still not sure. I felt busier as a CNA, because I had to see to the needs of so many different people. But I felt like I was much more superficially involved with each patient - I didn't even know what many of their diagnoses were, and I did no followup whatsoever on their plans of care. I just covered the basics and passed the buck for anything else to the nurse. I actually found that deeply unsatisfying, because I wanted to know what was going on with the patients. Were they getting better? Worse? Would they be discharged tomorrow? Were they getting medicines that might be causing unpleasant side effects?

I think this means that I am thinking like a nurse. This is a good thing.