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Nursing, from the other side

2014 June 15
by Laura

This past Monday I had a celiac-disease-related procedure to check out how my insides are doing after three years of following a rigidly dedicated gluten-free diet.

I was nervous, but not as nervous as I was the first time. I took my little cab over to the hospital and let the nurses in the GI suite take care of me.

I learned several things from the experience about nursing care. I’ve been lucky enough in my life not to encounter too many nurses “from the other side.” The nurse who takes my vitals and gives me flu shots in primary care, yes. The nurses who taught me for 18 months, yes. Watching other nurses do the nurse thing around me? Every day.

But, it is so, so different to be laying in a bed, scared, and having NO idea what is going on at all times.

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Taking the information I gleaned during my short procedural visit at Georgetown Hospital, I tried to be a better nurse this week.

1. Yup: IVs do hurt.

2. IVs hurt coming out, too. Nurses told me before that it doesn’t hurt when they’re removed, other than the old “tape-pulling-off-all-the-arm-hair” bit. False.

3. Blankets = heaven. When patients ask me for their 40th extra blanket, I’ve found myself confused before. Now I either pre-empt them with four extras to begin with or forgive the fifth request. You’re naked in a gown under a sheet!! I get it now.

4. I forget sometimes that although I (kinda) know the way things work in the ER, many of the patients do not. I know that I come in, then I do stuff to them (take their blood, hang fluids, take them to CT), and then the doctor sees them later. They don’t get that, and I had been neglecting to consistently explain it.

5. People have NO feeling of control when they’re in a hospital bed—even less in the emergency room because they’re in pain or something is wrong. Giving them a choice—”apple or cranberry juice?”—is sometimes enough to make people feel much better. Even the little warning of “hey, this is going to feel cold” is incredibly helpful. (The cardiac monitor leads are cold! Who knew?!)

6. Some patients relate to their nurses more than their doctors. (Just as some patients relate to the doctors way more than nurses.) Even though I had met my nurse Brandy just 18 minutes beforehand, when I was being hooked up to anesthesia, 100 monitors, oxygen, and forced to put a giant bite block in my mouth and turn over, the person I wanted near me was Brandy.

7. Huh: the blood pressure cuff DOES get really tight. All the people who I silently thought were crazy before…I take it back. That thing pumps up hard!

8. I felt slight anxiety about the procedure even knowing exactly the medications (and their side effects and half lives!), the type of procedure it was, what was going to happen, and what I would look like at all times (we do endoscopies in the ER, sometimes, and I’ve been in Brandy’s position before). I can only imagine what patients who do not speak “medical” must feel. It’s always worth speaking in plain English: better to offend someone by overexplaining something simple than to assume they know what you mean.

9. I still find it difficult to imagine being rude or disrespectful to any health care provider, but I’m not everyone. People act differently when they’re hurting, or scared, or if they feel out of control or lonely. I am always as empathetic as possible, and I do try to read each patient individually to determine what they want from me. (Although to be honest, I don’t always have time for that step.)

Do you want my hand to hold? You got it (even if you dig your nails into my hand during the procedure). Do you want me to “stop saying sorry, I know you don’t mean it”? (which was entirely false, because I always genuinely mean it.) Fine. I’ll stop. Want to tell me how to do my job? That’s OK, I’ll forgive you, I won’t snap back, and I’ll do it how I do it anyway. Want to sing to me? Cool! I’ll sing, too. (That last one was fun.)

Remembering that everyone is different is helpful. Remembering that EVERYONE (patients, family, nurses, doctors, pharmacists, techs) in the ER is stressed out is also helpful. But remembering that people are human and usually will apologize later for words they honestly don’t mean to say is the most beneficial in getting me through a rough night or day.

10. The five or six nurses who took care of me last Monday all made a difference in my comfort level and in my experience during the endoscopy. And I didn’t get to say one word to them about how great they were, other than a brief and groggy-anesthesia-faced “thank you.” It is my biggest hope that often I am making a difference to people in some small way, whether I know it or not.

Here’s one word about your nurse: Just like patients, nurses aren’t all roses and rainbows. People are often critical of nurses, people think they are “slow” (as I was called last week) or that they don’t mean it when they say “I’m sorry.” There is no nurse who enjoys hurting a patient, or seeing a person in pain. That is not the vocation we chose. I’m not happy about having to give you an IV. I hate that I have to move you into the hallway—I do. I’m not pumped about giving you the nasty-tasting medication, either, and I am truly sorry that you have to wait 10 hours to get a bed in the hospital proper. I certainly hate inserting a catheter or a nasogastric tube or one of the many other horrible things that could be ordered for you by an ER doc. Everything I do I do because I am trying to help. Always and forever, that is the bottom line: I am trying to help you get better. Forgive your nurses sometimes when they are having a rough day, when they disappear, when they just lost a patient in the room next door, or when they haven’t eaten in 10 hours and have the worst case of the hangries ever documented.

Because, as an adorable older gentleman reminded me last week, “Isn’t it just so nice when everyone gets along?”

I’m 29!

2014 June 9
by Laura

I didn’t really realize I was 29 until I saw it printed on a form today and I went, “Oh. That’s not right.” Then I got sad and realized, Oh, yes it is. Even though I have been calling myself 29 out loud for 6 months now, it still seems different somehow to really be 29. There are DEFINITELY more crows’ feet involved already.

I spent one of my best ever birthdays with my favorite people and things at the shore—goldens, family, Someone, sunshine, cake, wine, snow crabs, and OITNB.

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getting some help from the goldens to blow out my candles

My people sure do know how to make a girl feel special. Look at all these cards, for cryin’ out loud! Whoever said that snail mail was going out of style surely doesn’t have friends and family like mine.

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My mom found some old glamour shots of me as a 3 year old, so she brought those and hung them up for us all to laugh at. The funniest was realizing that I still make this sassy-pants face pretty often.

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I got some wonderful gifts for our new apartment — a kitchen table, a pizza maker (more on that later) and hand-pasta crank (homemade GF ravioli!), and a table set for our patio. Add in some string lantern lights and a mini fridge and our little outdoor bar and bistro is nearly complete!

One of my favorite gifts was this caricature of Riggins. My parents went to a gala a few weeks ago where an artist drew this from a photograph on my mom’s cell phone that I took of him last year. The resemblance is uncanny, right?

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He really captured Goofy-goo’s personality in that picture. And the original photograph, for anyone who wants to be amazed:

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So here I am at 29, more blessed and grateful than ever, and exactly where I want to be. Cheers!

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30 seconds between a bad-a$$ and a total screw-up

2014 June 1
by Laura

What’s up?

Night shift is up. The end of orientation is up. My tenure in my current residence is up.

But let’s start in order, shall we?

1. Night shift. SUCH A LOVE-HATE RELATIONSHIP! I summed it up to my coach the other night: I am always hungry, I am always tired, and I never sleep.

Her response: “Yup.”

wine and oatmeal cookies: just one of my random 10 p.m. cravings

wine and oatmeal cookies: just one of my random 10 p.m. cravings

Why night shift is awesome: Less busy, sort of, but mainly a different kind of busy. It is a busy that is stacked in the beginning, so that you’re all gravy by 5:30 a.m. and can sit down for a second and think. You can laugh with colleagues and have time to process and learn and think about your nursing practice. It’s not as difficult as I thought it would be to “prepare” for the whole “no sleep for 24 hours” part of the beginning of a three-night stretch. It’s a really cool culture and I like to be a part of it.

the traffic-less commute home Memorial Day morning

the traffic-less commute home Memorial Day morning

Why night shift is not awesome: After coming off a stretch of three nights in a row, it’s difficult to convert to the normal life of being awake during daylight hours. Like, impossible. It’s kind of like how you get worse jet lag from traveling east than you do when you travel west. Scientific studies have proven it takes one day to adjust a body clock backwards by just two hours. In theory, then, it would take six days to get back onto a normal schedule. When you’ve only got three days before you go back to nights, it seems pointless. So I am a crank monster. ALL THE TIME.

pre-night shift ritual: iced coffee, nurse jackie.

pre-night shift ritual: iced coffee, nurse jackie.

2. Orientation is over. I have my final evaluation tomorrow evening, one shift left with my coach (best coach ever), and then I’m on my own like a baby bird flying from the nest.

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This is both exciting and terrifying. I am eager to “own my own practice,” as my educator would say, but I’m also going to have about 100,000 questions per night (no exaggeration) and will doubt and second guess my decision-making skills all the time. There is a lot of autonomy involved in emergency nursing, and the wisdom and acumen to take care of patients successfully is both inherent and learned. With experience it will get better, but the beginning is surely to be a rough road.

There are so many highs and lows: pleasant patient interactions and combative ones, happy moments and devastating, days when you get the hard IV start and days when you blow every single vein. Moments where you catch something important and others where you miss something obvious. It’s all part of the whirlwind 12 hours that make up the shift. I can say that where I’ve come in the last 3 months is nowhere near where I started, and I know the journey will continue.

3. I forgot how much moving sucks.

That is all.

 

Chickpea Chocolate Cake

2014 May 23
by Laura

CHICKPEAS?” Someone exclaimed with a mouth full of chocolatey goodness.

“Yes! Chickpeas!” I replied, with an equal amount of moist cake in my mouth.

“No way.”

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Ohhh, yes way, my friends. And only 5 ingredients!

  • 1.5 cups semi-sweet chocolate chips
  • 1 19-ounce can chickpeas, drained and rinsed (this is about a can and a third, unless you can find the correctly sized can)
  • 4 eggs
  • 3/4 cup sugar
  • 1/2 teaspoon baking powder
  • confectioners sugar for sprinkling on top

Preheat the oven to 350. To begin, mix the chickpeas and eggs in the bowl of a food processor and blend until smooth. Add in sugar and baking powder, blend again until smooth.

In a microwave-safe bowl, melt the chocolate chips by microwaving them in 20-second intervals, stirring in between each one. Stop when there are still some melty chips left, when you stir it all together those will melt. (Chocolate scorches very easily, so don’t be overzealous with this step!)

Pour the melted chocolate into the food processor bowl. Mix together until combined. Pour into a greased 9-inch cake pan. Bake for 40-45 minutes, until a knife comes out clean. Let the cake rest in the pan on a wire rack for about 20 minutes, and then turn over onto the serving plate.

Dust the top with confectioners sugar, serve and enjoy.

Small announcement

2014 May 22
by Laura

Someone and I are moving in together in 38 days!

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The welcome mat above was my anniversary present from Someone. We found a 1 bedroom/sunroom/balcony apartment about 1 block from where I currently live, and we are beyond excited for the next step in our relationship and our lives.

I can’t wait to live with my best friend! Any advice from you other cohabitators out there about moving in??

Nope, not dead!

2014 May 22
by Laura

Just working night shift. Woof.

Night shift is WEIRD. My body is so confused, all the time.

Baseline: Tired. I drink coffee at very bizarre times, I eat strange foods at very strange times. I never know what day it is.

Night shift is also AWESOME. Really cool people work the night shift (and work ONLY night shift). My favorite experiences in nursing so far have been on nights. It’s pretty chill. Busy as hell, no matter what time of night, but still—more relaxed.

If only I could work night shifts AND have a life!! Alas, not possible. Sleeping the day before to prepare, sleeping during the day three days of the week, and then sleeping the day after = no time for anything else. The sample day looks like:

Work 7 p.m. to 7:30 a.m.
Drive home: get into the apartment around 8ish.
Eat whatever sounds most appealing to me at that time: a bagel? Some pasta? A banana? Make tonight’s “lunch” — sandwich, apple, pretzels, yogurt, popcorn. Make coffee to put in the fridge so it’s icy when I wake up.
8:30ish: Close curtains (and tape them to the sides of the wall), turn on sound machine, get out earplugs and eye mask, turn on fan.
8:35 Get into bed, read a bit, check e-mail, try to unwind and fall asleep.
9ish-1: First round of sleep. Wake up confused around 1, try to fall back to sleep.
2-4: second round of sleep.
4-4:15: Lay in bed, check e-mail again, Facebook, try to wake up and pretend I feel OK.
4:30-5:15: Shower, get ready, put on scrubs.
5:15-5:45: Eat leftovers for dinner that I made ahead, if I feel like it, or eat “breakfast.”
5:50: Check Waze, see what route will have the least amount of traffic.
6:00: Leave for work.

As you can see — not too much free time in there. Working days has the illusion of more time to yourself — I’m not sure if it’s because when you leave you get to say “See you tomorrow!” and not “See you tonight!”, or if the darkness helps with the idea that more time has passed than about 10 hours. But no TV time, no exercise time, no Someone time, no time to cook.

Overall, can’t complain. They’re not half as bad as I had imagined. And I’ve seen some preeetttyyyyy crazyyyyyy stuff.

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One year

2014 May 1
by Laura

One year ago today, a lonely, jaded, kinda pathetic single girl walked across the street to the divey Mexican place in the strip-mall her date had selected. Little did she know that the night would be one she would remember forever.

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Someone met me outside the restaurant, smiling broadly. He gave me a warm hug that felt not-at-all awkward, even though most “this is a blind date and we met on the Internet and you’re a stranger but a handshake would be weird” hugs on dates such as those are awful. He smelled good. He was tall. Mama likey.

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What followed was a few margaritas and a lot of conversation. Someone told me that no one had ever asked him questions the likes of which I had in my back pocket (and if you know me at all, you know that giving people the accidental third-degree is kinda my M.O.). We were flirty. We laughed and smiled. I looked at him across the table and thought, “Hmm, could be.”

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I remember us talking about Bill Clinton and college; I remember us going to the bathroom at the same time because we thought it was silly to leave the other person alone because of a social standard. I remember talking about the weirdest foods we have ever eaten and the craziest places we’d ever been. I remember delighting in the fact that he knew and used big words correctly, and we both edited the menu of the restaurant out loud. We stayed out way past our bedtime, and when the night was over I didn’t want to leave. He walked me home (the whole 200 feet) and kissed me. It was perfect.

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That night I remember tossing myself onto my bed like Cher in Clueless and texting a friend that he was “cute and funny, and maybe a little too smart for his own good.” I smiled with glee when I got his text, 5 minutes later, telling me he had a great time. He wrote: “I want to take you out Saturday night, to a weird Russian place.”

And the rest is kind of history.

Happy Anniversary to my one love, my Someone, my rock and my best friend. I have had the best year of my life with you and cannot wait to have many more!

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Waze

2014 April 28
by Laura

Best app ever (and it’s FREE): Waze. It’s a social-media based traffic and GPS app. It might not sound like much, but trust me.┬áIf you’re not using Waze to get around, you’re losing at life. Seriously — it is that awesome.

I first heard of wonder-app because a few of my coworkers use it religiously to get to work. I got Someone hooked because you can send another Wazer an ETA of your arrival and they can actually track your GPS progress on the map. I am committed for life because it has saved me from some horrendous traffic jams and found me a route to work that gets me there in 19 minutes flat, instead of the 26-30 minute route I was taking before.

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Things that are great about Waze:

1) You can report traffic light cameras, speed traps, and police activity for other drivers. “Be careful—speed trap ahead,” says the Waze lady.

2) You can report road closures, vehicles on the shoulder, accidents, traffic, etc. Other drivers get alerted by the pleasant lady who says “Watch out: Heavy traffic reported ahead.”

3) Waze will find you the fastest route at the time of day you’re leaving, based on the traffic reports from its other users. It also really knows the HOV restrictions well, so you will always be directed to avoid those routes.

4) Want another route? Click “Routes” and Waze will tell you 3 other ways to get there.

5) Want to save on gas? Waze has community-reported gas prices so you’ll always know the cheapest place to fill up your tank.

Go get Waze. It’s still free (remarkably?) and even if it weren’t, it would be worth a membership fee. Save yourself time, headaches, and frustration! Report incidents, traffic, and hazards to help other drivers, and they’ll help you back.

 

Disclaimer: I am not paid by Waze.

Weight loss

2014 April 22
by Laura

I’ve lost 15 pounds since January 1st.

Nursing school wasn’t kind to my body, and neither was I. I never made time for working out or exercising and the stress of it all made me eat and eat and eat. Additionally, the lifestyle of a student is pretty sedentary: sit in class, sit in lecture, sit and study. Sit sit sit. No wonder my butt got so big! It needed extra padding for all that sitting!

At my heaviest point at the start of the new year, I knew I needed to make a change. It started with using MyFitnessPal, and has continued with the more active nursing job (walking 5 miles per shift!), additional crazy amounts of stress, and making the time in my schedule to Zumba and Body Pump it up.

The last time I stepped on the scale, I was 15 pounds lighter than I was before, and I feel AWESOME. Clothes fit me again, I no longer hate wearing everything in my closet, and I feel like a spry little thing. I am stronger and healthier. It’s easier to lift patients and run around at work. I sleep better when I’m exhausted physically and mentally, and although I am still controlling portion sizes and the quality of the food I am eating, I can have a piece of chocolate cake without feeling terrible about myself later.

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(Nursing school graduation, above, at my heaviest. EEK.)

But now here I am!

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Looking and feeling MUCH better.

I don’t think I will ever be the kind of person who doesn’t have to watch what I eat and how often I work out. It will always be work. But it’s comforting to know that I can do it, even at an age where losing weight is significantly harder than it once was.

Birthdays, Easter

2014 April 22
by Laura

Rounding out the two holidays I had yet to share with Someone in the calendar year since we met (hint: the big one-year anniversary is rapidly approaching!) were his birthday and Easter.

Up to Annapolis we went to spend time with Someone’s family and bask in the sunshine and spring-ness of the weekend. We walked around the adorable little shops (Someone was appeased since we went into many a bookstore and nary a jewelry store), sat on the dock for a bit, and grabbed cocktails in a garden before eating dinner at a “small plates lounge” and heading back to his parents’ for cake.

Although it was the first Easter I spent not with my own parents, it was exciting and different to start new traditions as a couple. I made us a ham on Easter evening, and we sang good old Methodist hymns together in a pew at church. I facetimed with the PA fam (poor substitute), and went to bed full and happy.

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Hope your Easter was lovely and simple, too!