Thursday, June 28, 2012

Black Bottom Cupcakes From a Box Recipe

  I love Black Bottom cupcakes, who doesn't? How could you not love the moist rich chocolate cake surrounding creamy, cheesecake like filling? The only thing I don't love is whipping them up, it takes forever to get the cake batter done and to be honest I'm a lousy baker. Whenever I make something from scratch it falls flat, sometimes literally, and honestly who has the time to whip up cake from scratch every time you get a craving? I certainly don't!

  The other day I had a HUGE chocolate craving, so I decided to cheat a little and use a box mix instead of trying to whip up cake batter by hand. 

Guess what, it worked perfectly!
Made by Yours Truly with a little help from Betty.

  If you love Black Bottom cupcakes but hate spending the time on them, here is the "recipe"

Black Bottom Cupcakes
1 box of chocolate cake mix (I recommend Devils Food or Chocolate Fudge)
All items necessary to make box cake

1 8oz pkg cream cheese at room temp
1/3 cup sugar
1 egg
2 tsp vanilla extract
1/4 cup chocolate chips

- Blend together cream cheese, sugar, vanilla and egg with a hand mixer until fluffy and no lumps are seen.

- Fold in chocolate chips to cream cheese mixture.

- Make cake according to box directions

- Fill lined cupcake pan to 1/3 full of batter

- Gently drop 1 heaping teaspoon of cream cheese mixture in the center of each cupcake batter. Ensure that each cupcake gets a few chocolate chips in the cream cheese!

- Bake according to instructions (approx 20 minutes) until a toothpick inserted into the cupcake comes out clean.

- Allow to cool and eat!

The batter rises up around the cream cheese and envelops it!

  This recipe for the filling creates a very light and fluffy filling, opposed to the super dense cheesecake like fillings I have had in other Black Bottom cupcake recipes making these supper fluffy and delicate. Bad part of it is you can eat like five and not notice it, trust me!


  Sorry it took so long for me to post this ladies, I know you have all been dying to know who te lucky gals are. We had a lovely trip to Cali, but on return some nasty bug hit the household and blogging was hard to do from the bathroom if you know what I mean!

  Ok so with out anymore delays.

You won the pamper pack with you clever comment.

Misty Venne
You won the pamper pack because 
your comment made me smile!

  Ladies please email me with your mailing info and I will try to get out to the post office as soon as I can to get your goodies off to you. 

  Thank you to all you lovely ladies who entered and stay tuned I will have more goodies to give away soon!

Wednesday, June 20, 2012

Round and Round....

 Last night was the last of four in a row for me, I was hoping for a quiet night where everything ran smooth as butter, unfortunately I didn't get my wish.  Last night I was assigned a tiny elderly woman who was hypothermic and unable to regulate her temperature.  I received my report from the day RN and right after she walked out the door the night took off like a horse at the Kentucky Derby.  She was not the "stable vent" that most newbie nurses get, she was a very unstable vent who could not hold a blood pressure without the assistance of pressors, whose blood gases were severely abnormal and making zero urine.

  I felt like a gerbil running in a wheel for most of the night, never getting ahead of anything. It was kind of like playing some obscene game of whack-a-mole, just when I thought that I had taken care of one issue another reared it's ugly head prompting yet another call to the Doc and yet another page of orders. At some point that night I began to wonder what the hell I was doing with this patient and that I couldn't possibly handle it another second, but I was in waist deep what was I going to do other than keep going and just try and make it to 0700 with my patient still alive.

  Many liters of saline, numerous tests and a number of medications later my salvation arrived. I gave report and finished up what charting I had left and grabbed my bags. My charge nurse had waited to see me out and said to me;

  "I feel bad about that assignment, I really thought it was a stable vent and then by the time we figured it out it was too late to change assignments. But you handled that really well, we were all watching you with her and began joking we should give you more of these types of patients so you don't have time to sit around and complain all night." She laughed and gave me a pat.

  I was surprised with the comment, I felt so out of control all night, how could she say that I handled anything well? So I told her how helpless and useless I had felt, barely being able to keep up with the orders that flooded in and not really getting anywhere with the patient. She just shook her head at me and told me this.

  "Your patient is alive because you did what you did last night, that means you handled everything just fine. Did you think in her condition she was just going to sit up and be better? You can only do what is put in front of you to do, that is your job."

  It made me stop and think for a moment and realize that she was right. I did exactly what I had been trained to do, even if it made no visible, immediate difference in my patients condition at that time. In essence, the fact that my patient was still alive, was a victory and a credit to the work I did that night and it did deserve to be recognized. I also realized that I was never once alone that night, she and my co-workers had watched me carefully all night, only stepping in when really needed because I needed to learn for myself what I was able to do. I smiled and thanked her for the compliment, and admitted that in the end I did need the experience to teach me that I could handle the pressure of something more than just a "stable vent" and said;

  "Oh and I do not sit and complain all night! I am very careful to keep it to only half the night."

Friday, June 15, 2012

Dilemma and a Giveaway!

  I have a dilemma, but it is the very best kind of dilemma to have. Mr and I have decided that we need to get away, this will be our very FIRST vacation ever!  So we are now tossing around ideas as to where to head off too. We live smack dab in the middle of two great choices, Las Vegas or California, so where to go? Now you see my dilemma!

  It is two totally different vacations, in two totally different spots. I could head out to the Coast and spend my vacation on the beach, laid back out in the sun and just chill. On the other hand I could head over to Vegas and party it up, shop and let loose with the glam night life. Such a hard decision!!

  OK, so while I consider my trip destination I figured I would offer you ladies a very similar dilemma in the form of a giveaway. (Guys are welcome to join but the prizes are girly stuff, but hey maybe you have a lady in your life who would love them)

  Here's the deal, there are two prize packs to be given away and a lucky winner for each.

The Pamper Pack

This prize contains all a nurse needs to pamper herself after a long shift!

- Simple Moisturizing Face Wash
- Wen by Chaz Dean Sweet Almond Mint ReMoist Intensive Hair Treatment
- Soothing Peppermint Menthol Foot Balm
- Sally Hansen Nail File

The Glam Girl

You may wear scrubs for a living but a girl has to glam it up once in a while!

- 14 Gorgeous Bangles
- Pair of Aviator Sunglasses
- Multi-Strand Rhinestone Necklace

The Rules:
  You must be a follower of this blog either through Google Friends Connect or Google+, your choice. Now leave me a comment telling me which prize pack you would love to win and why you should get it. Make it funny, silly or serious but leave me something to make me decide to give it to you, this will not be drawn at random, my favorite commentors will win the prize. That's it!

  Oh yes, and since I have to choose between vacation spots, you guys have to choose between prize packs, meaning you can only enter for one prize!

  The winners will be announced on June 29th.

(Everyone is invited to enter, this giveaway is not limited to nurses only. US and Canadian Addresses only)

Thursday, June 14, 2012

Another Day in Paradise

  I worked the last couple nights and boy were they crazy. Census has been way up lately, not sure why but our hospital population ebbs and flows like the sea. And let me tell you, just like the sea at high tide don't turn your back on it!

  When I last left my ICU we had 8 patients, which is nearly half full and was thinking that it was looking pretty good. When I came back I saw that we had eight nurses waiting to take report and that we were at capacity, with several vented patients and a couple of wild stories going around about a couple on bath salts and what landed them in our company. 

  It was a crazy couple of nights that included fighting with a doctor over the difference between a draining hematoma vs an active bleed (Nurses 1, Doc 0), a couple of crazy patients trying to dive out of bed (Nurses 2, Patients 0) , another couple of patients who believed that the "H" on the side of the building stood for "Hotel" and not "Hospital" (Nurses 0, Patients 2) and a co-workers birthday that resulted in a small potluck.  By the end of night two the diving patients had been happily settled upstairs and we were able to get some work done. 

  The topper of my couple of nights came just before shift change when I was helping the X-Ray Tech move a couple of patients so he could shoot his films. He got a stat page and took off, he returned 10 minutes later laughing.

  "Give you one guess who that stat page was for."

 I stared at him blankly for a second, then a light went on in the attic.

  "No way!" I said

  "Yup, your diver finally hit the floor upstairs"

  I cannot tell you how happy I was to be leaving that morning, but strangely I was laughing and I had one major realization, I really love my job.

Monday, June 11, 2012

Please Silence Your Cell

  This weekend I did the unthinkable, I put my cell phone on silence. This crazy move was prompted by a phone call that came in at 7:30 am on my day of. The message went something like this;

 "Hey, we're really short tonight a bunch of people called off. Would you work a shift tonight? Call us back!"

  What followed was an hour of agonizing over whether or not to pick up a shift, it would mean overtime, but I had just worked three back to back shifts. I took the chicken route out and did not call back. Later that day, my phone chirped again  and another message of very similar content was left for me. I began feeling pretty guilty, I hate working short handed and I can always use the extra and with times being this tight who knows when I will get an offer for overtime again?  

  At that point Mr. looked at me and asked me if I wanted  to work an extra shift. Well want to? Heck no, I don't want  to but I feel like I should.  Why? He asked, why do you feel like you need to, we have enough money, why do you need to be the one covering when someone calls off?  

  That made me stop and think, why do I feel this guilt when the staffing office calls? I'm not sure but I noticed that it is something that happens most often in "young nurses". A number of newer nurses on my unit often feel a tremendous pressure to pick up extra shifts, and the staffing office often puts pressure on them by saying things like;

   "You're young you can handle it" 

  The question is, can you? Many nurses take on extra shifts and don't ask themselves this question. We all know the dangers of working while tired, so why do we take the chances? Sometimes I think that we as nurses have a touch of the Superman Complex, we keep telling ourselves we can do it, when the question is should we do it?

  After Mr. asked me if I wanted to take the shift I took a quick self inventory. It was 10 am and I was already wanting to hit the bed again for a nap, I was getting grumpy just thinking about another night in the ER and my back was aching. Did I want to take this shift? Hell no, I wanted to sit on the couch like a lump, nap and perhaps con my husband into rubbing my sore back. That's when it hit me, not only did I not want to take this shift, I couldn't handle it and no amount of overtime would make up for the misery I would feel during and after that shift. 

  At that point I put my cell phone on silence, put it on the bedside table and pointedly ignored it for the weekend. When I looked at it this morning there was another message from staffing asking me if I wanted to pick up a shift on Sunday night. I am glad I did what I did.

Friday, June 8, 2012

Off the Charts

 Going through the order set for my new admit last night I got a good giggle. The Doc's orders read as such;

   "Continue all drips from ED. Infuse 1 unit packed red blood cells. Schedule GI Bleed for AM"

  We all had a good laugh, and when I called the Doc to clarify I couldn't help resist asking him what time he wanted the patients GI bleed to be scheduled for. He was a good sport about it.


Tuesday, June 5, 2012

First Patient Death

  I was an LPN working in a long term care center on a ventilator ward when I experienced my first patient death. It was a 80 or 90 something year old woman who had suffered a stroke and been deemed unable to be weaned from the vent, her husband was unable to care for her at home in this condition so she was sent to my facility.

  I will never forget this patient as long as I live, she stayed with me for 3 months. She was a tiny fragile things with long blonde hair that had faded to silver and ice blue eyes that followed you around the room when you approached. Her body had turned on her and had contracted into a small hunched frame that could barely straighten out. She never spoke, but when you touched her she would contract further into a tiny ball, her blue eyes glaring fiercely at you. We couldn't even give her medications in the traditional way because her G-Tube had become infected and the surgeon had told the family that she was in such bad shape that she would not survive another surgery. She received her nutrition through TPN, and most medications had to be given as a shot, since most nursing homes cannot give medications IV push like in hospitals. We had pain medications sublingual or as a suppository, but you could rarely get her mouth open and turning her onto her side to insert a suppository was dangerous as her oxygen sats would drop dangerously, even on a vent.  Even with all this going on the family refused Hospice care, it took several long talks with a physician before they agreed to sign papers making her status "Do Not Resuscitate".

  One night I was helping our aid Janet bath her. I loved working with Janet, she had been an aide for over 20 years and her love for her patients always showed. She looked at me and said,

   "She needs permission to go, she's only hanging on because she's worried about leaving her husband and he's not going to give it to her."

  Janet was right, this little ladies husband would come in faithfully every morning at 7am on the dot and stay holding her hand until 7pm every night, we would often hear him begging her not to leave him.

  Janet leaned over and gave the woman a soft kiss on the forehead and looked into those angry eyes and said,
"If you need to go darling, go. He will be OK, we will take care of him until it's his time. But you need to go, so go." She stroked her hair and looked at me, "isn't that right, we'll take care of him?"

  "That's right" I said, "we'll take care of him, you just do what you need to."

  Later that night the aid assigned to vitals rushed over to me, she got a blood pressure of 60/30 and was distressed. I got up and headed into the room and knew instantly. I had never seen a deceased person before, but somehow looking at this woman I just knew she was gone. There was no code, no rush of people to save her, the charge nurse and a respiratory therapist came in to confirm what I already knew. 

  I feel like that was the night I "grew up" as a nurse. The charge nurse knew that the husband knew me best and asked me to call him with the news. When I called I learned that night that I could keep my voice from shaking as I told him that she went peacefully in her sleep and assured him that I would meet him by the doors to let him in. I learned that night that death isn't always a terrible thing that we must fight blindly, that it can be a merciful thing that allows suffering to end. That night I ceased to fear death and see it as an enemy but as a natural part of life, only made unnatural by the way we approach it.

 To this day I still carry those beliefs with me and they help me deal with the deaths that I have since in my new position.  I will never forget that patient and what she taught me that night.

Saturday, June 2, 2012

The Power of One

 My phone rang last night at 630 and it's the staffing office. Why on earth would they be calling me? I pick up and immediately get asked to work an extra shift in the ED, they as desperately short and could use the help. After confirming with the supervisor that it DOES mean overtime I grab my scrubs and somehow manage to get to work by 1904. Just in time for huddle.

  The night is insane, I usually work Fast Track when in the ED but they decided it was sink or swim time and they gave me four curtains of "major medical". Chest painers, over doses, abdominal pain, that sort of thing. I muddled my way through somehow without screwing up too badly. My biggest mistake all night was giving Rocephine IM instead of IV, and the Doc just laughed at me and changed his order after asking me what was wrong with the lovely IV that was in the fella.

  As the night went on the ICU numbers kept going up and up and since I am "on loan" from the ICU, there came a point when they had had enough of the admits and demanded that I come back. So the Supervisor sent me back, with another patient, with an hour left on the day to help everyone catch up. I trotted over there and cheerfully hung meds, did accuchecks and turned patients to help my team mates catch up. 

  It was a long and exhausting night, but the team did good work so I was feeling good. That was until one person decided to ruin it. A family member of a patient pulled the House Supervisor aside and complained about me. She had taken offense to the fact that when she was let in to the unit I had had the gall to ask what room she was heading to, as per policy. Apparently I was "Loud and obnoxious" in my questioning. That just made me blow my stack. After rearranging my night, taking sick patient after sick patient AND coming back to be a team player in the unit, this was my thanks. Of course the House Sup wasn't going to defend me, there's that whole customer satisfaction thing everyone is worried about. So I got dressed down, to satisfy her.

  Honestly, I give up. I felt like saying to this woman, instead of worrying about the quality of care,  your loved one is receiving you feel the need to nit pick on the fact that I asked what room you are heading to when you enter a locked unit, wow you really have your priorities straight.  Really I understand that people are stressed when a loved one is in an ICU, but seriously don't you have better things to direct your attention to than the nurse who greets you at the desk? Sheesh. Whatever happened to "if you don't have anything nice to say, don't say it at all"?

  It only takes one person to totally ruin a good night.