Thursday, May 31, 2012

Top 10? Who Me?

Take a look at this. It's's

Yes, that is me!
I was so shocked and humbled. Half of the other blogs mentioned on this list are ones that I follow! Wow! Talk about an honor that this little blog made it up there with company like this:
If you have not had the chance, check out these other blogs, the nurses who write them have a ton of interesting insights and great stories. Also, a HUGE thank you to everyone who reads this blog! I'm hoping that you are enjoying my little posts and hope that you will continue to follow my Adventures in Nursing.

Wednesday, May 30, 2012

Post Code Management

  Why is it that after every code, the next day I feel like I have been hit by a Mac truck? I don't want to imply that I have been involved in a whole ton of codes but when you work the ICU and float to the ED on a regular basis, you see more than your average floor nurse.

  But seriously, my experience has been that the day after my whole body aches, I'm exhausted and want to do very little other than sleep. The problem is settling down, my mind goes over and over what happened, analyzing what happened and storing it away for later. What could I have done better? What was done right?  It's not like I'm beating myself up, I've come to accept the fact that when you deal with critically ill patients, it is inevitable that one will code on you. But codes are so infrequent that I have to replay the events over in my head to learn how to better execute the next one.

  That is the biggest problem with a code, if everyone is doing their job well you rarely see them, so you don't get a chance to practice for them. Back in nursing school I think we had one simulation code and it focused more on the CPR aspect, making sure we all knew how to rotate out and keep compression's at the right depth and speed. They never made us rip open a cart and look desperately for the Epinephrine while people are yelling orders at you faster than you can process. 

  How do you practice something like a code?  You can go through the motions in a simulation but honestly you can't ever replicate the feeling of helplessness that you can feel, during a real one when you watch the monitor and see that vicious rhythm that won't convert back to something life sustaining or as you have pushed what feels like your millionth Epi and you still see a heart rate of 10 bpm. How do you teach students to prepare for that? 

  How do you replicate the chaotic feeling, the rush of activity? How do you teach a student how to anticipate where the Doctor, RT and other bodies will be so that they can move deftly around the bodies constantly in motion around the patient. It's amazing sometimes to stop and think about how many people are moving so quickly and somehow no one runs into the other. How do you give a person a chance to develop this skill?

  The answer is, you can't. There is simply no way of exposing a person to the complexities of a code until they are part of one. Sure in nursing school I was able to stand in on a code once at a clinical rotation, but you are really an outsider looking in. I remember being in awe that day of the nurses, doctors and respiratory therapists. It seemed like some of coordinated chaos, where each person was part of some loosely choreographed dance, weaving around one another. Honestly I will say it was beautiful, while the tension in the air was thick enough to cut, there was a calm, assured manner about they room as each team member knew their role and carried it out. It was beautiful.

   In my short career I have been part of some ugly codes, where nothing seems to go right and I have been part of some beautiful ones where the team just clicks.  I have learned that not one code is like another, each is it's own unique entity that leaves you feeling different each time. Sometimes you feel on top of the world, other times you just want to lie down on the floor and close your eyes, sometimes there are nights when humor finds itself into the room and we laugh for some reason.  

  I am starting to learn the steps of the complicated dance, and how to move with my partners. Last night I found myself moving through the cart without a feeling of desperation, my hands falling on all the right things without having to think. I knew what was going to be needed, I anticipated what was going to happen and was prepared. Things flowed last night, people moved with purpose and when it was all over we were able to say things were good. The night went on and the team was closer that night then usual and when I left in the morning I was feeling exhaustion setting in.

  Today I ache, my body hurts all over. I'm still exhausted even after sleeping 12 hours. My mind keeps going over the events, rehearsing for the next time.

Thursday, May 24, 2012

Pure Randomness

  Sorry for the lack of posting this week. I don't even have a really good excuse because I some how ended up with five days off, in a row and I didn't even miss a shift! But don't think I haven't been busy, I've been catching up on life in general. It's been a pretty random, but busy week off full of appointments (I really couldn't put that Dr's visit off any longer), gardening and a weekend of actually seeing Mr (I think we had almost forgotten what the other had looked like).

  Here's a bit of the randomness that I encountered this week:

A whole family of quail wandered on to my pool deck. Problem was although the cute little babies were able to make it down the stairs, they couldn't make it back up the stairs into the back yard. We had to devise a ramp system so they could get back into the yard and under the gate to leave without scaring the babies so badly that the ended up falling into the pool. It was touch and go for awhile. 

          Aren't the babies cute?

  After watching the solar eclipse on the deck, we noticed some odd lights moving across the sky. They were orange and there were about a dozen, I grabbed a shot of one with my phone.
No I'm not ready to start accusing the military of secret experiments 
or subscribing to UFO Daily, but it was really cool.

Yes even the roses were handmade, 
and it took me the better part of a day to assemble.

One of my co-workers is having a little girl. Her baby shower is this week and I have ambitions of making a diaper cake for her filled with goodies. So I made a set of these to tuck into the "cake".
Because every baby deserves a handmade set of booties,and I love girly things.

If you are interested the pattern can be found 
(you need to sign up to access the pattern, but it's free)

And this is the tutorial video I used to learn to make those roses.

Wednesday, May 16, 2012

Ravioli Al Fresco Recipe

Ravioli Al Fresco

  This dish came about due to part laziness and part heat exhaustion on my part. Let me explain, I live in a desert and currently it is reaching temps of a balmy 95 degrees with promises of it only getting hotter. This means around May we stop cooking because the oven can heat the house up so badly. When it gets this hot I really don't want to move I just want to plop down on the couch and sip at a cold drink, unfortunately that often means that we end up doing the take out thing and that is just not going to help me in my goal to lose 20 lbs this year.

  So I have been messing around in the kitchen on my days off trying to find yummy recipes that will use as little heat as possible and yet not kill my waist line. This particular dish was inspired by the Filippo Berio Olive Oil that was sent to me from BzzAgent. I am trying to follow the Mediterranean Diet and eat more vegetables, and get my starches from whole grain breads and pastas. 

  This dish is super easy to make as there is very little prep involved and is a nice light tasting pasta dish with plenty of veggies that make it not to heavy for those hot days. Please remember these measurements are not exact, as I rarely measure when cooking. Don't stress if you add a little more or a little less as it won't kill the recipe.

Ravioli Al Fresco
1 small bottle Marinated Artichoke Hearts
1 bottle Roasted Red Peppers
1 cup (roughly) Broccoli Florets (fresh or frozen your choice)
1/2 cup (roughly) Carrots Cut into Match Sticks
1 package of Fresh Ravioli (your choice in flavor I like chicken or lobster for this dish)
1 Large Handful of Basil Leaves
6-10 Kalmata Olives
Extra Virgin Olive Oil (I used Filippo Berio)

Step 1:
Chop your broccoli into bite sizes pieces like this and roughly matchstick your carrots. Then cook/defrost your veggies until they are tender crisp then dump them into ice water to stop the cooking process
Step 2:
Cook your ravioli according to package. While the ravioli is cooking cut the Roasted Red Peppers, Marinated Artichoke Hearts and Kalmata Olives into small bite sized pieces, make sure to reserve the oil and marinade the Artichokes come in. Toss them with the cooled veggies into a big bowl and combine. Tear basil into shreds and toss in too. It should look like this.

Step 3: Drain your ravioli in a large strainer and rinse well. Shake off the excess water and drizzle the pasta with olive oil and toss gently to coat. When the pasta is no longer hot add to the veggie mixture.

Step 4: Pour the marinade that the Artichokes came in over mixture and toss gently to coat everything. Drizzle with a touch more olive oil and season with sea salt and fresh ground pepper to taste.

  I recommend letting this dish sit in the fridge for at least an hour before serving to allow the flavors to meld. 

Even better you can make this dish the night before and serve it up the next day, if you do this I suggest allowing it to sit out at room temperature for about 30 minutes before serving so it's not stone cold and serve with a nice crisp white wine

You can also sub the ravioli for some fusili or rotini and turn this into a great pasta salad!

Tuesday, May 15, 2012

BzzAgent Review of Filippo Berio Olive Oil

  Remember how I keep talking about how much I love being a BzzAgent? I get to try all sorts of great products and pass them on to my friends.

  BzzAgent recently invited me to try Filippo Berio Olive Oil. It was like they knew that I was trying to eat better and had set a goal to lose 20 lbs this year. On top of that work had us all take a Biometric screening this year to help us get an idea as to where were stand health wise. They checked our glucose, and our cholesterol levels. While mine are OK, they could be better so I am trying to make smarter choices in what I eat. One of the easiest choices is to cut out butter in my cooking as it is high in cholesterol and saturated fats.

  If you head over to Filippo Berio's website you can even find a hand substitution chart that shows you how to sub olive oil for butter or margarine. I had no idea that you could use olive oil in baking but apparently you can!

  They also have a large library of really awesome recipesI tried the Broken Spaghetti With Shrimp the other night and it disappeared so fast that I didn't have time to snap a picture to share it with you. 

  I'm working on some recipes of my own, 
here's a sneak peek of one I have coming up!
Stay tuned for the recipe!

Legal stuff: I was provided with this product compliments of BzzAgent for testing and review purposes. The opinions contained in this blog about said product are solely mine 

Monday, May 14, 2012

10 Things Nursing Has Taught Me

10 Things Nursing Has Taught Me.

1. I am stronger that I think I am

2. All fears can be conquered

3. A 20 gauge will work almost every time.

4. Coffee ceases to work after cup #5

5. You can laugh or cry, laughing is way more fun.

6. A good team can turn even the worst situation into a great night

7. There is nothing wrong with not knowing the answer, and everything wrong with not learning what it is.

8. You are not alone.

9. You can't fix stupid

10. Sometimes Thank You and a smile is the best payment I get for doing my job.

What has nursing taught you?

Tuesday, May 8, 2012

Why I Became A Nurse

  Want to know a secret? I never wanted to be a nurse, in fact as a child I though it was one of the most horrible jobs in the world. I mean who wanted to do mean things to people like give them shots that made them cry, not me! As I grew older I viewed nurses as nothing more than mean spiteful people who were grumpy all the time in spite of earning a decent paycheck. So I never gave nursing a second thought as a career.

  So now you are wondering how on earth I ended up with the letter RN attached to my name and blogging about it? Well it wasn't really all that eventful, no major epiphany or light from above, it was necessity.  I was stuck in a sales job that just wouldn't pay the bills and my husband was getting nowhere with a real career, so we made a huge life changing decision. We moved from Canada to the United States and my husband began his studies at a large University. This means we came down on student visas, which basically only allow you to study, working was not an option. After a couple of months of sitting doing nothing I began to go crazy, I needed to do something. A family member offered to help me pay for school if I wanted to go back and get a degree, she suggested nursing. It was a logical suggestion as the degree could transfer back home and just about anywhere we went, so I'd always have a good career to fall back on.

  Nursing? Me, the one that wants to crawl under a table at the mere sight of a needle, as nurse. It was almost laughable, absurd really. Somehow I got talked into attempting the pre-requisites. It was terrifying going back to school at 30-somthing and facing my demons like math and chemistry. With a ton of help and patience from my husband I made it through the pre-requisites, but there was a waiting list a mile long for all the programs in the area. We decided I would enroll in a CNA course and get my feet wet to see if I really liked healthcare. It was love at first class. The weeks flew by and I found myself looking forward to every clinical day even though it meant dragging my butt out of bed at 5am. 

  The CNA certification allowed me entry into an LPN program which I loved even more. Though I will admit when we started learning to give injections my heart rate must have jumped into the 200's. After I graduated LPN school and received my license I was able to obtain a temporary work permit and began working in a long term care center for patients on ventilators. I loved my job. Many people find what I did depressing, many people in that place never went home, we often talked about the only way out of that place being "celestial discharge", but I loved it. I found so much joy in the talking to the residents, becoming a familiar and welcome face and a part of their routine and ultimately their lives. I also found great peace in caring for a someone in their last days, ensuring family and friends as well as the patient were together and comfortable for those last moments. When my work permit expired I returned to school to complete my RN.

  I now work in a local hospital. I didn't choose a big, shiny teaching facility, there are many here in my city. Oh no, I work, literally in an inner city ghetto. The neighborhood is slowly trying to fight it's way out of the depths of poverty and gang violence, trying to become a place where children can grow up without the sounds of gunshots and not fear playing outside. I chose this place because I can truly help people here, I can make a difference in their lives. I feel that if perhaps one person treats these people like people, tells a drug addict that someone believes in them or tells a little kid they can become a Doctor and not a gangbanger, that maybe they will believe it and believe in themselves.

  Why did I become a nurse? Because I needed a job. Why do I continue to be a nurse? Because I believe I can make a difference in peoples lives.

Monday, May 7, 2012

Happy Nurses Week 2012!

Say it loud and say it proud my fellow nurses!
Happy Nurses Week!

  All kidding aside I wanted to say thank you. To all you wonderful people who give up your days and nights to take care of total strangers, you all rock! I also wanted to put in print a shout out to all my instructors, preceptors, friends and most importantly the patients who helped this every day gal become a nurse. Without your help, guidance and encouragement I would never have gotten to where I am.

  To all you student nurses out there, take time to celebrate this week. You are on the most incredible, life changing journey. This week take a moment to look back to the day before you started nursing school and then look at yourself now. I bet you will be shocked to see how far you have come already. Good luck to all of you, but as my dad says you won't need it because you all have brains!

   Oh yes and head on over to this super cute blog 

Anna is giving away a lovely package of great stuff
in celebration of Nurses Week.

Happy Nurses Week everyone!

Wednesday, May 2, 2012

That Little Rat!

Walking by my living room window yesterday this is 
what I happened to see.
I was under the impression that I was feeding the birds.
Guess I will need to get a trap now.
Personally, I think he's kinda cute.

Tuesday, May 1, 2012

ABG Tic Tac Toe

  I remember the first time I was presented with ABG's, I nearly cried. I could figure out the pH part, acid vs alkaline was pretty simple I had been testing the acidity of pool water for a long time by them. But the metabolic vs respiratory boggled my mind and hurt my head, and forget compensation. No way!

  Obviously I figured it out, I wouldn't have graduated if I hadn't. And now I specialize in ventilators, so it's kind of second nature. But I realize how intimidating it is, and after a little digging I found this work sheet that an instructor handed out in class. 

 I hope it helps!

Common Lab Value Interpretations

  A friend of mine is starting into the RN half of nursing school and was saying that she needed to brush up on labs. That got me sifting through my files and I came upon this handout a teacher put together for us. She made a list of common labs and what a high or low result could mean. There are no lab values for norms but that should be relatively simple for you guys to find yourselves. Remember the best way to learn is by doing.

  As always I take zero responsibility for the content contained within the pages being correct. If something doesn't seem right please check it out for yourself. Also when sharing please give credit to Cheryl Cipriano RN, MSN for all her hard work