Today, the lady who we put a temporary pacer on yesterday for multiple 5-second pauses in her heartbeat was healing from her permanent pacemaker placement that was done late yesterday afternoon. She also somehow mistakenly thought the telemetry unit was a day spa and hung on the call bell (or, alternately, screamed "NURSE!!!" as loud as she could) ALL DAY LONG requesting tea, first iced, then "no, not iced I want hot tea!", backrubs, take the blankets off, put the blankets on, put the pillow under my feet, take the pillow away, I want a turkey sandwich instead of a barbeque sandwich... I want chicken soup and not tomato soup (our dietary staff comes in and personally takes your order for the day in the morning, there was no excuse)... oh and don't forget to rub my feet, they're achey but DON'T cover them with a blanket, but wait now they're cold, do cover them with a blanket then...
Today, I straight catheterized a 80-something-year-old man and discovered how slippery a thing can be when old, wrinkled, uncircumsized and covered in iodine...
Today, I had three different physicians write three different diet orders on the same patient within one hour, causing plenty of extra work for me entering and cancelling orders in the computer system, and confusion for the young lady coming in on the next shift ("NPO til tomorrow morning... wait, no, ice chips only then NPO after midnight... wait, no, clear liquids and then NPO after midnight")...
Today I ran a heparin drip for the first time, and I drew blood from and flushed a chest wall port for the first time.
Today, I got my ass OUT of there on time and with my documentation and hand-off communication complete, and each of my patients comfortable, safe, and well taken care of. I actually kind of felt like a nurse.
Tomorrow, four patients.
Tuesday, February 23, 2010
Monday, February 22, 2010
The horror.
Sometimes, I really wish that the illegal drugs in this country would be contaminated with something that causes infertility in the people who use them. Some people should not have the honor of becoming parents. *shudders*.
Sunday, February 21, 2010
The "new nurse".
This past week was my first as a "real nurse" on the telemetry/PCU unit.
I am more exhausted than I think I have ever been.
Throughout the week I've been continuously evaluating myself, identifying what I need to change, how I need to adapt the knowledge and skills I've gathered in my years of school to the real world. A few highlights:
#1. There is no way that I can give every patient of mine the kind of attention and service that I'd like to when I have 5, 6, 8 of them at a time. It is simply impossible. I need to learn to streamline and prioritize... the sickest patients get the most of me, the most stable patients get the least. Unfortunately, this means that occasionally my patients and their families will simply have to wait for some of the things that they want from me. This reality is very, very hard for me to swallow. I am praying that our unit manager succeeds in convincing the higher-ups to mandate a 1:4 nurse : patient ratio.
#2. "The nurse does the nurse things, the aide does the aide things". This is what my preceptor has been trying to teach me all week. The reality is that I cannot be assisting a patient to the bathroom when another patient needs insulin. I'm struggling with this, as I don't want to be one of "those nurses" who passes off every single bedpan and bath to the aides and makes them feel taken advantage of. I want ALL of my colleagues to feel like I respect and appreciate them. So, I need to learn how to delegate in a way that shows gratitude and grace.
#3. While I must continue to be empathetic and caring, I cannot give 150% of my energy to every single patient, every single day. I've found myself coming home feeling like I just spent the day in the hospital with an MI... I am so completely drained of all emotional and spiritual energy that I have NOTHING to give to the people I love at home. I couldn't even handle my cats coming to me for attention one afternoon this past week. I don't want to live like that. I have to learn to insulate myself from being leached of all lifeblood during my 8.5 hours at work... I need to titrate the amount of energy I give to the people I care for to keep myself from burning out.
Aside from all of that, I am learning an INCREDIBLE amount on a daily basis. I'm building confidence and becoming more fluid and comfortable with the tasks presented to me. I even had a patient I cared for come back after being discharged to bring a nice little snack and thank you note for my "compassionate care". A little encouragement goes a long way!
I am more exhausted than I think I have ever been.
Throughout the week I've been continuously evaluating myself, identifying what I need to change, how I need to adapt the knowledge and skills I've gathered in my years of school to the real world. A few highlights:
#1. There is no way that I can give every patient of mine the kind of attention and service that I'd like to when I have 5, 6, 8 of them at a time. It is simply impossible. I need to learn to streamline and prioritize... the sickest patients get the most of me, the most stable patients get the least. Unfortunately, this means that occasionally my patients and their families will simply have to wait for some of the things that they want from me. This reality is very, very hard for me to swallow. I am praying that our unit manager succeeds in convincing the higher-ups to mandate a 1:4 nurse : patient ratio.
#2. "The nurse does the nurse things, the aide does the aide things". This is what my preceptor has been trying to teach me all week. The reality is that I cannot be assisting a patient to the bathroom when another patient needs insulin. I'm struggling with this, as I don't want to be one of "those nurses" who passes off every single bedpan and bath to the aides and makes them feel taken advantage of. I want ALL of my colleagues to feel like I respect and appreciate them. So, I need to learn how to delegate in a way that shows gratitude and grace.
#3. While I must continue to be empathetic and caring, I cannot give 150% of my energy to every single patient, every single day. I've found myself coming home feeling like I just spent the day in the hospital with an MI... I am so completely drained of all emotional and spiritual energy that I have NOTHING to give to the people I love at home. I couldn't even handle my cats coming to me for attention one afternoon this past week. I don't want to live like that. I have to learn to insulate myself from being leached of all lifeblood during my 8.5 hours at work... I need to titrate the amount of energy I give to the people I care for to keep myself from burning out.
Aside from all of that, I am learning an INCREDIBLE amount on a daily basis. I'm building confidence and becoming more fluid and comfortable with the tasks presented to me. I even had a patient I cared for come back after being discharged to bring a nice little snack and thank you note for my "compassionate care". A little encouragement goes a long way!
Sunday, February 07, 2010
Blizzard Breakfast
Luckily, neither Hoopdaddy nor I had to work, so we got to stay home and enjoy the beauty of it.
Today we woke up to a blindingly bright, sunny day. I made a simple breakfast for us that is quickly becoming a favorite: fried eggs and toast, ginger carrot salad, and grapes. I thought I'd post this because it's a cute idea for a Valentine's Day breakfast or brunch.
Neighbordog Luke went romping in the snow.. .and this was after we'd just shoveled!
I guess we won't be eating breakfast in the yard today!!
Start with a good hearty loaf of bread. We used my Birdseed Bread recipe for ours. Cut two nice thick slices. Using a knife or a sharp metal cookie-cutter, cut out a heart from the center of each slice and place all of the pieces in a hot frying pan coated with olive oil.
Crack open an egg into each of the heart-shaped holes (this particular egg came from Cerberus!). Sprinkle with black pepper and garlic salt.
Let set until the white is cooked through. Depending on your preference, you can cook only on one side for a runny yolk, or flip over quickly to cook the rest of the way through.
Turn the heart-shaped toast pieces when they begin to brown.
Serve with fresh fruit, a green salad, or ginger carrot salad (recipe to follow):
Rosella's Ginger Carrot Salad
This recipe was given to me by a friend and neighbor who is an AMAZING chef. Her simple and elegant dishes astound me every time, and this super easy raw salad is a staple in our house.
Shred 4-5 large, peeled carrots into a bowl. Peel and mince or shred a piece of fresh ginger (a piece about the size of your thumb should do it). Mix ginger and about 1/4 c. of golden raisins into shredded carrots and serve! This can be refrigerated for up to 5 days in an airtight container.
Wednesday, February 03, 2010
Vegetarian Enchiladas
This is one of HoopDaddy's favorite meals... and it has very quickly become one of mine as well! We have a great time collaborating in the kitchen... I prep the veggies while he rolls out the tortillas, some good music playing, a bottle of homemade wine chilling in the fridge.
This recipe can very easily be adapted to be vegan (and heart healthy)... use vegetable fat instead of butter, eliminate the cheese and sour cream... they're still delicious even without all of that fat and salt!!!
Wheat Tortillas
1 c. all purpose flour
1 c. whole wheat flour
1 tsp. salt
3/4 tsp. baking powder
3 tbsp. butter
2/3 c. warm water
Mix the dry ingredients together in a bowl. Rub in the butter, stir in the water and knead into a soft dough. Cover with plastic film and let rest 15 minutes. Divide into 12 equal parts and shape into balls. Roll out on a floured surface (I use a silicone mat called a Silpat for this and it works great, no sticking!) into rounds 6-7" across. Recover with a dampened towel to keep moist. Heat a griddle/frying pan and cook each tortilla 1-2 minutes, turning it as soon as it starts to bubble. They should stay flexible, but if they start to crisp up don't worry too much, they'll soften again as they bake with the moist enchilada fillings. Recover with a towel to keep warm and moist.
Veggie Enchiladas
3-4 peeled, medium sized carrots
1 large green bell pepper
1 medium sweet onion
salt
1 c basmati rice
2 c boiling water
salsa
extra sharp cheddar cheese
avocados
sour cream
Julienne the carrots (I love my mandoline for this), dice the pepper, and finely chop the onion (if using a stronger flavored onion, saute in oil until lightly browned). Mix all together, sprinkle with a bit of salt (I use black volcanic salt, nomnom).
Cook the rice in the boiling water, fluff with a fork when done. Fold into the vegetable mixture.
Spoon the vegetable/rice mixture onto the tortilla, sprinkle with a handful of shredded extra sharp cheddar, and roll them up so that the seam is on the bottom. Place them nestled up together in a rectangular baking dish. Spoon some salsa over the top of the enchiladas, sprinkle with a bit more cheese, and bake at 375 degrees for about 20 minutes.
Serve with sour cream, sliced avocado, and some extra salsa on the side. Slice up some ripe pineapple for dessert. Light the candles, pour the wine, and enjoy!
Wheat Tortillas
1 c. all purpose flour
1 c. whole wheat flour
1 tsp. salt
3/4 tsp. baking powder
3 tbsp. butter
2/3 c. warm water
Mix the dry ingredients together in a bowl. Rub in the butter, stir in the water and knead into a soft dough. Cover with plastic film and let rest 15 minutes. Divide into 12 equal parts and shape into balls. Roll out on a floured surface (I use a silicone mat called a Silpat for this and it works great, no sticking!) into rounds 6-7" across. Recover with a dampened towel to keep moist. Heat a griddle/frying pan and cook each tortilla 1-2 minutes, turning it as soon as it starts to bubble. They should stay flexible, but if they start to crisp up don't worry too much, they'll soften again as they bake with the moist enchilada fillings. Recover with a towel to keep warm and moist.
Veggie Enchiladas
3-4 peeled, medium sized carrots
1 large green bell pepper
1 medium sweet onion
salt
1 c basmati rice
2 c boiling water
salsa
extra sharp cheddar cheese
avocados
sour cream
Julienne the carrots (I love my mandoline for this), dice the pepper, and finely chop the onion (if using a stronger flavored onion, saute in oil until lightly browned). Mix all together, sprinkle with a bit of salt (I use black volcanic salt, nomnom).
Cook the rice in the boiling water, fluff with a fork when done. Fold into the vegetable mixture.
Spoon the vegetable/rice mixture onto the tortilla, sprinkle with a handful of shredded extra sharp cheddar, and roll them up so that the seam is on the bottom. Place them nestled up together in a rectangular baking dish. Spoon some salsa over the top of the enchiladas, sprinkle with a bit more cheese, and bake at 375 degrees for about 20 minutes.
Serve with sour cream, sliced avocado, and some extra salsa on the side. Slice up some ripe pineapple for dessert. Light the candles, pour the wine, and enjoy!
Subscribe to:
Posts (Atom)