Colorado Adventures!

We flew out to Colorado this week to visit my family. Because I worked both Christmas and New Year’s, there was really no good time to make the trip west… and of course now school is starting and work is ramping up. But we’ve had a WONDERFUL time. First, we had a great visit with my grandparents – a real holiday-style ham dinner! I don’t feel so bad about missing the Christmas and New Years’ feasts after enjoying some home-cooked green bean casserole.

Image

Please note the girls’ side ponytails!!! 

 

Then we took off to Glenwood Springs and the best ski resort ever, Ski Sunlight. “What is this Ski Sunlight?” you may ask. “I have heard of Vail, Beaver Creek, Keystone, Breckenridge… but Ski Sunlight?” You haven’t heard of it because it’s Colorado’s best kept secret (and, unfortunately, no one is paying me to say that!) The lower slopes are gradual and perfect for beginners, but there are also some great intermediate and expert slopes higher up. And at night, when you drag yourself home, you can head to Glenwood Springs hot springs for a soak in the medicinal waters. (Note: we never actually hit the hot spring this time…. but we did hit the hot tub!)

I decided to be adventurous. I have skiied for over 20 years of my life and I can get down the mountain without much trouble. So I decided to branch out, push myself:

 

Image

 

Yes, I learned how to snowboard!! In perfect powder conditions which were great for spending lots of time on my behind (fallboarding)! I actually found snowboarding pretty fun because it is so much about core and balance. The not so fun part: you can’t hike easily with a snowboard. The second day I did a pretty flat green run with my family and ended up hiking up hills 4 times because I either fell or ran out of speed (hikeboarding). 

Except for the first time, I also fell every single time I got off the lift. Every. Single. Time. Let me know if you have any tips!

But all that time spent sprawled in the snow was worth it for the feeling of drifting like a falling leaf down the hillside. No poles. No crossed skis. No baggage. Just me, my board, and the mountain. 

After two days in the hills, we had to head back to real life.  Chris, my brother and I headed to Golden for a day and met my grandmother at Ali Baba for lunch – delish! Then we visited some friends from medical school and their baby in the Stapleton area.

Image

Those babies grow up so fast!

Yesterday my mom brought me along to observe her work as a school nurse. She works at a school for kids with past attendance or disciplinary issues, and I was so impressed at how their school works to accommodate the kids and families. They are working hard to help people and making a difference at a critical time in these kids’ lives. 

Today we went to the Denver Art Museum and saw the Passport to Paris exhibit. It was great to see such a variety of styles and times – my new favorite is British artist Sisley. They had a great Pissaro section with paintings from each decade of his art and it was cool to see how his style evolved and mellowed, from sharp geometrical shapes and “wild-urban interface” pieces to more abstract nature scenes. They also had some cool juxtapositions – a scene of Montmartre when it was all country, and a couple scenes of the wild nightlife there a few decades later. While we were at DAM, we also admired some of Thomas Moran’s watercolors and chromolithographs from Yellowstone. We finished our time downtown with some wine and cheese across the street. 

Lest you think that all we do is travel fun places and eat, Chris also made Mario Batalli’s baked ziti last night and in the process discovered that the pipes around the garbage disposal were clogged. Dirty dishwater was pouring everywhere; buckets, towels, flashlights were produced. But nothing could faze the Bugoshes! My dad ran some diagnostics, my mom snaked the pipes and upon discovering that it was beyond our level of expertise, we turned to Music Man to help Anna practice for the school play.  The new Music Man (2003) is pretty good, I must say, especially since we live so close to Iowa.  And the plumber is on the case right now. 

So it’s not ALL fun and games… but we usually end up having fun anyway!

 

Midnight Munchies

I love nursing but it can be a tough job. Multiple patients, multiple halls. All a manner of needs and issues. Calls to be made, forms to be filled out. Before I know which end is up, five hours have passed without a bathroom break, a drink… Or a snack!

Often I will stagger home at midnight ravenous, even though I ate a perfectly good supper six hours earlier. I will peruse the cupboards, starving for something – I don’t know what – something sweet yet packed with protein and carbs. Something to substitute for dinner with my husband. Something more satisfying than yet lighter than a steak dinner.

Generally although I know it’s not good for me I have craved fat – brownies, cake, cookies. For a long time all I could think about was creme brûlée (not that we ever have that in the house!) Buttercream frosting. Guacamole.

I will eat just about anything. Lean cuisines, leftovers, anything frozen and reheated.

But recently I have discovered the best
midnight snack ever. Reheated frozen fruit, Greek yogurt and honey. Mmmm. Sweet, creamy, delicious – with lots of protein and no fat. (Although I think Greek yogurt may be a scam. That stuff has to be sour cream!)

Discussion with other nurses has revealed that I am not the only nurse with this problem. In fact, floor nursing can be very dangerous to the waistline. The temptation towards high fat and high sugar foods, combined with work that, while exhausting and stressful, isn’t exercise, results in unhealthy eating patterns.

I am still looking for other perfect late night meals so if anyone has tips let me know 🙂

Losing my Brain

I lost my brain tonight.

You can’t blame me. It was a long night. I floated to 2 different floors, had 5 patients over the course of the night, and pharmacy wasn’t sending me my patients stuff . I was just starting to get a handle on things when I lost my brain.

No, no, not my mind (though that was fuzzy too). My brain sheet. Most nurses have a “brain” with reminders of what to do when. Mine had everything with everything marked down – what meds, what vital signs, blood sugars, things to follow up on, when to empty drains…

And I lost it!

Thankfully the charge nurse gave me lunch AND found my brain sheet on the floor of my patients room. I felt like a new woman after my blood sugar climbed back into the normal range and I had my scribbled to-do list in front of me.

So that just proves… Something 🙂

Thoughts on the End of A Shift

I write this as I walk through the halls after a long evening shift. Fortunately they are empty.I was busy all night, too busy. Nights like this I wonder: was it me? Or was it the assignment?

I know this shift will haunt me. Fortunately my patients were all fine at the end, but… I don’t know what I don’t know!

There’s a lot of guilt that comes with nursing. We want to be everywhere and do everything for everyone and we can’t. We have to delegate. And I will have to forgive myself and let it go.

All right I’m at my car. Breathe in,breathe out. Thank you God I do love my job. And my patients. Bless them all. Good night.

Music and EAs

I worked an overnight shift on Saturday on a unit I had spent relatively little time on… and it went fine! Overnight shifts are very busy from 7-11 and then quiet down until around 5. I don’t mind them, except for the fact that they are overnight and mess with my sleep schedule. Thankfully I only do them every 6th weekend (for now). 

I slept until 1:30 and then got up to face the day. I had the special opportunity to perform with several other talented musicians and dear friends at the Festival of Music. Our church hosts this series every year and one “episode” is always “Lee Afdahl and Friends,” featuring our talented music director and organist, Lee, and other local musicians. This year, I was one of Lee’s friends!

Our “flute” choir, composed of 4 flautists from our church (one with a piccolo and one with a bass flute!) and a clarinetist, performed a cheerful Celtic ditty. I loved it and in fact it is still stuck in my head. We also had some excellent performances by trumpets, soprano saxophone, clarinet, and voice in a range of styles. Nevertheless throughout the whole concert I had the weight of work hanging over my head. I love my job but on this celebratory Sunday I was dreading having to leave the fold of musicians and go to the hospital.

However by 6:00 I felt ready to head in. I donned my scrubs and headed out to the car. As I started to drive away, I realized I hadn’t eaten anything. I decided I would eat my sandwich while I did my prep work.

Then, as I was about to pull into the parking garage, I got the call. “We had an opening and we can give you an EA. And we’ll give you twelve hours.”

“Awesome!” I cried, turning my car around and heading back to the church to change and then attend a delightful evening with the Festival of Music committee…

***

“Hold on,” you’re saying. “What’s an EA?”

An EA, or Excused Absence, is like Christmas in July. It only occurs when 1) you have signed up to take an excused absence, and 2) they have enough nurses and don’t need you that particular shift.

In this case it occurred at the last minute. And it was PERFECT! I went to the party, drank champagne, and had a lovely evening.

Of course I couldn’t go to sleep until 1:30 because I had slept all day but you know what? It was worth it.

Phlebotomy

Etymology: from Greek phlebotomos “opening veins,” from phleps (genitive phlebos) “vein” + -tomia “cutting of,” from tome “a cutting.” 

I work at the hospital, and I love being a float nurse there. Part of the reason I enjoy it is the teamwork aspect. Need a room cleaned? The housekeeper is already there. Don’t have time fora  bath? Ask the PCA to help. Need a new IV start? IV team. Anything to do with a catheter? Cath team.  Instead, I focus on what I learned a lot about in nursing school: the big picture in acute care nursing. Assessments, critical changes, meds, education, and coordination.

However, I volunteer at a clinic, and I love volunteering there because it’s so completely different. Different pace, different responsibilities. I had previously volunteered in a different capacity, but yesterday I walked in for the first time as a volunteer nurse. I thought, “I work in a hospital. This will be easy.” But I got a patient’s information, walked into the room, and stammered through my interview.  I’m not used to gathering a history, except informally…I didn’t know what to ask about!

Another new skill at the clinic is, as you might have guessed, phlebotomy. K., the supervisor, mentioned that he wanted me to try a venipuncture sometime that morning and I felt… nervous. In many hospitals, nurses do their own labs and their own IVs but, as mentioned, not at ours, so sticking a needle in someone’s veins is a foreign procedure that feels personal and invasive. He had me practice a few times on a cushion and then asked me if I wanted to practice on his arm.

I wasn’t sure. Maybe I should think it over. Maybe I should study up on it.

Maybe I SHOULD practice on my husband. Maybe when he was asleep. (OK, probably a bad idea). Or could I practice on myself?

I studied K., the clinic supervisor as well as a former classmate of mine. It seemed like a bad idea to stick my boss, even at a volunteer gig, with a big steel needle. Maybe I should wait until A., a less intimidating coworker who boasted of good veins, offered her arm…

But at the same time, I wanted to be brave. “Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the LORD your God is with you wherever you go.” (Joshua 1:9).

Not to mention, “fortune favors the brave” and I wanted some luck to avoid sticking K. twice.

“I’ll try it,” I announced as confidently as possible.

Looking nervous, K. slipped into the chair. I prepared my supplies, tourniqueted his arm with the blue band, palpated, gloved, steadied, prepared my needle…

and got it on the first time!!

As I watched the dark blood spurt into the orange and black tubed vial theycall the “tiger tube,” I felt the rush of success. (Then I tried again on someone else and lost the vein after the first tube, but everyone has a few stories like that…)

***

As I walked out of the clinic after a half day, I felt like my brain was about to explode, but in a good way.  I love learning new skills and information.

Venipuncture seems to be more than another skill. The medical setting allows us to violate that most basic personal boundary – skin.  Causing them pain, tapping into the source of a person’s very life, their flowing blood. Phlebos. Cutting  (tomia) like surgeons once did to “bleed” people to health.

Now we bleed people to read the secrets of their cells. Anemia, diabetes, leukemia. So many stories are written in the blood. Answers in antigens.  We have to hurt to heal.

Tome: From Greek tomos “volume, section of a book,” originally “section, piece cut off,” from temnein “to cut,” from PIE [Primitive Indo-European] *tom-/*tem- “to cut”

Phlebotomy. A tome of blood. It all comes back to the books.

5 Tips for Nursing Students

As a nursing student myself not too long ago, and a nurse who has had a few students now, I have some tips for nursing students during clinicals.

1) Don’t take the nurse’s computer. I know it seems so unfair as a student when you have to stand up to use the computer but… c’est la vie! When you’re a nurse, you can sit down, too. Stop. No. Don’t take my computer! Thanks.

2) Communicate, communicate, communicate. Tell me what you’ve done. Tell me what you’re going to do. I’m sorry if I don’t have time to go through everything with you, but reach out to me anyway. I promise I won’t bite your head off.

3) Jump in there. Don’t stand back – get involved. Offer to help, ask what I need.

4) Be polite. Don’t pretend like you know everything. Things are different in the hospital than in the nursing lab. You can always ask why but ask politely. And if nurses are a little snippy, understand that we are very busy right now. That’s not an excuse but perhaps it’s a little more understandable.

5) Have fun! Drink it in! Figure out if this is what you want to do. There are so many areas of nursing you can go into… is this what you want to do the rest of your life?

I’m sure I will have more to come!

 

Thoughts on Casey Jones

I have had the song “Casey Jones” stuck in my head the past two days. This is the only Grateful Dead song that I own; I bought it after hearing it on classic rock stations. Besides the reference to drug use (“Ridin’ that train, high on cocaine”), the song is all about the disaster in which Casey Jones, a railroad engineer on the Cannonball Express who died in a crash in 1900. The parts of the song that have stuck in my head are “Casey Jones, you better watch your speed… Trouble with you is the trouble with me, got two good eyes but we still don’t see.”

Based on my Wiki-research, Casey Jones was not, as far as anyone can tell, a drug addict – in fact he may have been a teetollar! He was a good engineer with a few rules infractions for speed, normal at that time as the railroad companies were always pushing their trains to arrive on time or early. He was a family man with three kids, just trying to do well at his job. The accident that happened may or may not have been his fault; no one knows for sure. But ultimately, he was a hero who chose to stay on the train and apply the emergency brakes, with the result that he was the only fatality.

The song and story show me that speed can be killer (and I’m not talking about the drug although that’s also true). Rushing is dangerous. Rushing through life, through work, causes us to take shortcuts and lose sight of the meaning and intention of what we are doing.

I think God is reminding me of this because I have recently had a few over-committed days. Many times I will look at a blank day on my calendar, and – quick! – try to fill it up with activities, instead of allowing God to own my time and guide my decisions. And what’s the result? Things fall out! The grocery shopping or laundry doesn’t get done. I never have time to make that phone call I meant to make.

In medical settings, rushing can be VERY dangerous for a variety of reasons, and that is why you will very rarely see doctors or nurses running anywhere except a code. Usually, we have more of a “speed walk” going to prevent both panic and falls.

Speed forces us to take shortcuts. Shortcuts may endanger patients. As it says in the song, “We got two good eyes but we still don’t see.” How many times have we missed something that, if we were rushing, we would have known was serious?

Because speed isn’t everything. Integrity is. We have to take time, take responsibility, take a breath and prioritize.

Casey Jones didn’t see the signals, if there even were any; he turned the corner and saw the caboose and knew a collision was imminent. As it says in the song “Come round the bend, you know it’s the end…” He stayed on the train because that was his responsibility.

In nursing, we don’t abandon our patients who need us, even if it’s lunch time, even if shift is over. Even if we are really really busy. No, we find the time, make the time, to pay attention. In life and nursing we prioritize. Time is a gift.

How are you using your time?

I’d Like to Thank…

After my pleasant shift yesterday, fate had it in for me. Any day in which you have to ask “is this what x bad symptom that I’ve never seen before looks like?” is a tough day.
But I got through it to my oscar watching party with some help from my fellow nurses. Who am I kidding? A LOT of help.

First of all, a big thank you to everyone who answered my endless questions “where are-”

Thank you nurse that took care of one nearly fainting patient when I was taking care of another.

Thank you PCAs for helping so much with baths, bathroom, vitals, and everything. I’m sorry I was always running out of the room to answer phone calls.

Thank you to those that covered while I took a 20 minute lunch… And not rolling your eyes too much…

And thanks to the (float!) resource nurse who offered to take a blood sugar to make my day better.

Thanks to my patients for being (mostly) patient and chill.

Thank you HUCs for putting that patients sandwich in the fridge for me.

Thanks to the charge nurse for advocating and wasting with me and giving me a sweet admit at the end.

Thanks to the services for being polite and responding quickly to my incessant pages.

Thank you God for getting me through…

Thank you!!!

Lunch in the Time Warp

12 hour shifts are timeless.

In all honesty, I would rather work 8’s. I quite enjoy my 3 8-hour evenings a week more than I would enjoy 3 12’s. Why, you ask? It comes down to quality of life. After a 12 hour day shift, I have maybe 4 hours of productive off time before I have to fall into bed and be ready for the next day. Whereas with 8 hour shifts, I have 8 hours, that’s TWICE AS MUCH down time, to read/run errands/do laundry/spend time with my husband.

(Sure, mathematicians, I get paid 2/3 as much but money isn’t everything…)

But when I am working a 12 hour shift, I really don’t mind it. I find myself in a time warp. I know I’m going to be at work all day (or all night) and I may as well accept it. The day streams by in its series of neat boxes; medications, treatments, vital signs, lunch, repeat. Before I know it, the next shift nurses are swarming like – something loveable and friendly that swarms – to get report and I can go home.

Today the time warp was nicely broken up by lunch with some float colleagues. As floats, we don’t see the same people day after day. We get to know nurses on different floors but it takes a little more effort to build friendships when both the people and the territory change every shift.

But coworker hang-outs are totally worth it! I can’t express how relaxing it is to chat and commiserate with other float nurses. We can discuss the idiosyncracies of our different floors, complain about switching between days and nights, and share notes on all our mutual float friends that we rarely see.

I am very thankful for my job because, from what I read, a guaranteed 30+ minute lunch is not common in many nursing environments. But it adds so much to job satisfaction. That chance to step away from the craziness of the floor, leaving my patients in another nurse’s capable hands, eat, drink, go to the bathroom, and talk… After a good lunch I can return to work refreshed ready to run my behind off for the rest of the shift without any problem.

Thank God for nursing lunch!