City Mouse-Country Mouse

And I'm Done

2010-12-18T11:24:00.004-05:00

After 18 long months, it is over. Now what? I think I'll start with sleeping in and catching up on reading. But while I contemplate what I really want to do, I'll leave you with my speech from the other night that I delivered to a group of nursing alumni from my alma matter.

As I sat and attempted to write this speech I struggled with how to organize my thoughts. In-between submitting my paper on global health financing initiatives and another paper on cryptosporidium, I realized that this was the first non-academic or work related thing I had written since finishing school....as in this past Tuesday. How could I possibly write something with no formatting guidelines, no page limit, and no profound questions to analyze? What is a girl to do? But then it came to me….SBAR.

Here we go.

Situation:
I’m a xx year old Penn graduate, now 3 ½ years out of getting my BSN. I work full time as a senior staff nurse in the Burn Unit at BigNameHospital. As of this past Tuesday, I completed graduate school at Columbia earning and MPH with a concentration in health policy and management. Despite, two fancy degrees I still don’t know what I want to be when I grow up.

Background:
I don’t know about all of you, but when I applied to college I questioned if I really wanted to be a nurse. In all honesty, I was choosing between architecture and nursing. (Yes, clearly I had some internal conflict). But then I went to an open house at the Marriott hotel in Newton, MA and met M.S. who sold me on Penn and nursing. So I guess you can blame her for having to listen to me this evening. But I also have to thank the Hillman foundation for it’s integral role in my transformation from country bumpkin (as my mother affectingly liked to call me) to city lover. I don’t know if I would have chosen NYC on my own, but I can't imagine living anywhere else and I’ve had so many amazing experiences here. When I tell people that I work in the burn unit, I get one of two responses: “ WOW! You are a saint. or Eww! Why did you chose that?”

Here’s how I got there. During college I spent one summer living at home working the ED at BigTeachingHospitalBoston and I was hooked on the adrenaline rush. I loved the train wrecks, the codes, and drunks (they really did have the best one-liners). The following summer I externed at FancyChildFocsuedHospital on the surgical trauma floor and realized that although I loved the kids, maybe I didn’t love their parents. But then came my senior year of college and I had to make a big decision, where to do clinicals? Of course I chose the ED at BigNameHopital. I walked in the first day to mass chaos. I was assigned to preceptor who wanted me to dive right in. He told me that I better learn to walk the walk and talk the talk. And I did just that. But when it came time to get a job, working in the ED would mean getting into the ED nurse residency program. I thought it was a sure thing. I mean, I was a student there. They loved me, right? And I had a degree from Penn! Wrong. It wasn’t in the cards. But that’s okay. After I cried for about a week thinking my life was over, I got a call from the recruiter asking me if I wanted to interview for the Burn Unit. I hopped on the train and interviewed. A few days later they offered me the job. Now here we are 3 ½ years later.

Assessment:
I must admit, I secretly thought that by working in the Burn Unit I’d meet a nice firefighter for a husband. I’m sad to report, though, that hasn’t happened YET! But back to being a nurse. Orientation was rough. I had 38 different preceptors, yes I said 38. The one on the first day called me useless. The second day I passed out during wound care of a patient whose extremities had been blown off in a 3rd rail electrical accident. I was off to a great start. Somehow I made it through my 16 weeks of orientation. And then it happened, I had got my first big admission. A 5 year old kid with 60% TBSA. He was a mess and we thought he was going to die that night. I was there when his mother saw him for the first time and helped catch her as she collapsed into hysterics. However, the worst was yet to come. That night, the kids father was escorted to the bedside from Rykers shackles and all. I listened to him say goodbye to his son. But somehow he made it through the night and the countless surgeries, bouts of sepsis, and the rehabilitation that occurred over the next four months. And then I came into work one day and experienced a true gift. I found out that he was going home and I had the privilege of discharging him. I felt like everything had come full circle.
I could tell more stories about patient miracles and tragedies, or the frustrations of the being the charge nurse, or the comedies precepting, but we all have those. That's the beauty of nursing--something new and different everyday--even if some of them make you go prematurely gray!
When I decided to go back to school full-time last September (and stay working full-time) everyone asked me why and called me crazy. To be honest, I wanted to see where else I could apply my nursing background and in what other ways I could influence both patients and healthcare. I did gain some valuable skills in the classroom, but it was my experiences outside of the classroom during my summer internship and doing consulting work for clients that gave me the most fulfillment. This past semester with two classmates we developed an evaluation strategy for all ambulatory care network programs at BigHospital and last spring I evaluated a multiplayer data reporting project for the NYBGH. Did you know that nurses are involved in disaster planning? Me neither until this summer when I was asked to join the taskforce. But what is my point? My time at the beside has provided me with not only an invaluable set of skills, but also real world experience that gives me a unique perspective to healthcare and health systems issues that can be applied outside the 4 walls of a hospital room.

Recommendation:
Keep an open mind. Don’t close yourself off to opportunities. Absorb as much as you can, but there will always be more to learn. Be proud to be a nurse.

Ooooo, my password still works!

2010-11-20T16:10:00.002-05:00

One day shy of eight months since I last updated. eeks! But fear not, in 24 days I'm graduating, returning to civilization, getting my life back, getting a haircut, going to the dentist, picking up clothes that have been at the dry cleaner for 7 months, cleaning out my closet, returning to cooking, training for a marathon, and oh yeah and returning to the blog world. See ya then. :)

Becuase I Don't Have Time....

2010-03-14T12:32:00.002-04:00

to write the long elaborate posts that are brewing in my mind, I've decided to add an "Only in New York" feature. Briefly, it's a recap of all the ridiculous things I hear and see on a daily basis while minding my own business. Maybe someday I can turn all of these sights into a book that will make me rich and famous, but for now they will be published purely for your reading pleasure.

Only in New York
While waiting for the train at 168th street at 9pm a woman is screaming at the top of her lungs that all cops should "suck her b@lls." (Didn't make sense to me either!) Then she gets up in some man's face and yells some more, except she acts the expletive "f*ck*ng". Turns out this man was an undercover cop, because he whipped out his badge and handcuffs. Arrested her and then chained her to the stairs while he waited for backup. During this whole time, the woman continues to scream, but starts demanding her second amendment rights (really, lady???) and is clanging the cuffs against the stairs. When the cops arrived, she got carried up the stairs by three officers because there was no elevator and she refused to walk. I could hear her yelling even as the train pulled in........

i'm just saying...

2010-02-21T07:29:00.000-05:00

Your friend asks you to be in her wedding. (YAY!) It's supposed to be in July in 2011. But then said friend and fiance decide to to buy a house and realize that it's much cheaper for them to fill the house with wedding and shower presents, and they proceeded to move the wedding to July 2010.

You are still working full-time and going to school full-time, free time left your vocabulary along time ago, but you will be present for all shower and wedding festivities. Oh yeah, minor detail: this is all taking place in Massachusetts.

When said friend called you up two days and told you that the date of the bridal shower just happened to be in smack in the middle of final exams, like on a Sunday afternoon at 2pm, you lied through your teeth when you said that the date was great and you were super excited.

But surely the best part of all of this is the bridesmaid dress, right? What girl doesn't love dress shopping? Because you live out-of-state you had to order yours over the phone. Well, you were told that the dress is bright pink, strapless, and chiffon. That would be great if you were tall, tan, and even slightly busty, but maybe it will look good on a petite, pale, flat chick. I'm sure I'll get lot's of use out of the dress, right? Isn't that what bridesmaids always tell themselves.

hello 2010

2010-01-10T11:11:00.005-05:00

Oh my poor, neglected blog!
Oh my poor, neglected ~~readers~~ three people who read this blog in an attempt to assure I have not gone off the deep end!

It's been so long (three days shy of three months) since I last logged in I forgot my password. But I am back. At least until next week when classes resume.

You are surely giddy with excitement over my return and eagerly awaiting the updates of all the wonderful and exciting things going on in Nurse Kelly's life! Without further ado, or in the words of Captain Sully: "Brace for Impact"...

I made it through first semester! I won't discuss quality of my life these past few months, you would all need a prescription for Prozac after reading about it, but I will tell you that I got straight A's (still waiting on the grade for one class) and got a job promotion (now I'm senior ~~bed pan changer~~ staff nurse). I'm pretty impressed with those two accomplishments given that I'm working full time and going to school full time.

I decided that I don't like Columbi@, but that I'm going to stick it out. I actually realized my dislike of the school my first day of orientation, but was in denial until midway through the semester. At that point, I marched myself into the office of dean of students office, sat in his chair, and very articulately, but respectfully expressed all of my concerns with the program and the inadequacies of some of the faculty. Essentially, I don't feel like I am am developing a skills set that I can take away from the program and I'm very troubled by the fact that I sit in a seminar class for three hours, taught by the "best professors in the field", yet they are unable to engage the students in discussion. It's painful. I should be excited to there! I told him that I wouldn't hesitate to leave and change schools. I think he was shocked, but he actually thanked me for my feedback. I'd like to mention that now, whenever I have a question or concern, administration is much more approachable and willing to work with me. I didn't go to the dean for special treatment, I went out of genuine concern for me and my classmates. We are spending a lot of money ($55,000) to get an education. Second semester starts next week, we'll see how it goes.

I didn't have to work on Christmas this year so I went home and celebrated with my family! It was the best Christmas present ever. I didn't realize how lonely it had been these last two years coming home to an empty apartment on Christmas Eve and Christmas Day. Spending the holiday with my family was the highlight of 2009!

I rang in the new year in my sweat pants after a long day of work. It may not have been a night full of glitz and glamour, but I was able to sit back and relax and a night like that was LONG overdue.

I have not fallen of the face of the earth (yet)

2009-10-12T18:26:00.004-04:00

Phew, I managed to post befre a month passed. I don't know where to begin, but I guess I'll start at the most logical place...
where did September go? Furthermore, how are we already halfway through October?

I've given up any semblance of a normal life. Here's a recap of the previous week:
Monday- class 12-2;
Tuesday- class9-1:30, work the night shift
NO SLEEP
Wednesday- class, and meeting with my advisor, get home at 5pm and go to sleep after being awake for 36 hours.
Thursday- class ALL DAY till 9pm; biostatistics project due
Friday- class in the afternoon, work the night shift
NO SLEEP
Saturday- class 1-5; in bed at 6:30pm
Sunday- class 9-1, study for midterm on Monday

Ah yes, this is my life.

Today I took my first midterm, not too bad. Three hours to ~~write~~ type four essays; technology is so awesome.
I was't going to write about this, but I think it's important. Everyone is asking me if I like school; I tell them this: I'm still waiting for that "ah-ha!" moment when I realize how and when I will be able to use all of this information. Don't get me wrong, I like most of my class (Health Policy and Management Seminar, Policy Analysis, Epidemiology), with a few exceptions (Biostastics and Economics) but I don't find the administration very helpful or organized. Actually, they are so UN-organized. It's a 180 from PENN who was so organized that they sometimes anticipated my problems before I did....yeah, that was freaky.

However, one thing I must credit Columbia with is their impeccably clean bathrooms. I'm not kidding. Even at the end of the day, trash barrels are emptied, toilet paper is stocked and there is never any "tinkle sprinkle" on the seats. I know you know what I am talking about! So if nothing else, for my $55,000 a year, I am gaurenteed a clean bathroom.

But in all seriousness, life isn't that bad. I cannot compare my experience in graduate school to my experience undergrad. Back then, I lived on/near campus and school was my job. My weekends and weeknights were full of friends, going out, class board meetings, sorority events, drinking (sometimes too much), and ~~making bad decisions~~ gaining life experiences. Now, I'm a working professional, a real grown up. I have a beautiful apartment in a great neighborhood, brand new furniture, a fantastic employer, amazing friends (even if I never see them), things are shaping up. It will be pretty great to be 26 years old with two Ivy League degrees.

I can do this. I can do anything for 16 months. One day, one class, one paper, one test at a time.

because I've got nothing but time

2009-09-16T08:52:00.004-04:00

Friday:Class 2-5,
Saturday: class 2-5,
Sunday: class 9-1, work 7:30p-8a
Monday: off work at 8a, class from 12-2.

That was my weekend. To top it all off, that night that I worked was horrible. I was in charge, plus had an intubated ICU patient, plus another patient coded and died (that's what happens when you have necrotizing fasciatis on 65% of your body), plus another patient who was crazy. And by crazy I mean, screaming at the top of his lungs that we should call him MARY and then screaming that he wanted to leave despite just having had a fasciotomy to one of his extremities. Psych had to come up to the floor and declare him incompetent and then every-time the patient threatened the nursing staff and/or tried to leave we had to call security. They came to the unit 7 times in 12 hours. By the time the morning rolled around, I couldn't wait to leave. I surely miss my night shift coworkers, but I DO NOT miss the insanity.

Now, I'm sitting on my couch watching Live with R & K waiting for my new furniture to arrive. No, not another new living room set, but a new bedroom set. You see, given the amount of school work that I have and the lack of table space I have (we don't even have a kitchen table) I needed to get a desk for my room. Problem: Where to put it? Solution: Thanks to a fabulous suggestion from O I purchased a loft bed for my bedroom. It comes with a built in desk underneath, so I maximize my space. Thankfully I have very high ceilings in my bedroom, so I can sit up without hitting my head on the ceiling.

I'm trying to think of more stuff to type, as I really don't want to start my economics homework, but I'm running out of ideas. Guess it's time to hit the books.

School Days

2009-09-02T17:25:00.000-04:00

As of 8:31 am today, I am an official graduate student at Columbia University. I'm registered for classes, I'm ordering books, I'm meeting new people, and I'm scared shitless. Because I worked so much this summer, the reality of school starting didn't hit me. However, as I sat in the Alumni Auditorium surrounded by my 504 classmates, and listened to the Dean's welcome, I realized my life was about to get crazy, real crazy.

Classes Monday-Thursday//Work Friday and Saturday//Homework on Sunday. And just to spice things up, one weekend a month I have a class taught Executive style (i.e. Class on Friday and Saturday 2-5 and Sunday 9-1).

Are you tired yet? I am. The Director of Academic Affairs said that when they submit coursework to the curriculum committee, the expectation is that for every 3 hours spent in class, 9 hours should be spent out of class doing work. Here's how that math works out.

Class Hours: 15 hours
Work Time for those classes: [(15/3)= 5 (x9)]= 45 hours
Total Time needed for school related stuff each week: 60
Weeks per semester: 14
Number of Days off: 3 (72 hours)
Days spent at work: 2 (26 hours: 2x13 hour shift)
Free day (no work or class): 1 (24 hours)
Minimum sleep requirement: 4 hours

45-20= 25 hours work of work that I simply won't be able to do.

When I break it down financially:
15 credits per semester at $1248/credit= $18720/(14x60)
I'm paying $22.29 per hour to be in class and do work.

So just in case I disappear from the blog sphere, don't get worried. You, me, and my social life will reunite in 16 months.

730 Days of Being A Nurse (and counting)

2009-08-29T18:28:00.003-04:00

I've now been a nurse for a little over two years. There were times when I wanted to quit, run away, and get a cushy job (like a M-F 9 to 5 gig) but Sucked it, put my big panties on, and stuck it out. I'm glad I did. As of late, my role is much more than "just a nurse"-some of which I like, others not so much.

1. I'm a preceptor . The nurse managers and the nurse educator approached me, and said that there was a particular new grad who was really struggling with time management and attention to details. They thought that I would be the perfect preceptor for her because I'm not only efficient and organized, but I'm also calm and patient. At first I was flattered, but once I met my little "project" I really wished I wasn't so anal retentive and organized. I struggle with how disorganized and flaky she acts, but I never raise my voice. I constantly have to focus her and prompt her to prioritize patient needs. She is making small strides, but progress none the less. If nothing else, I've learned a lot about my self.

2. I was recommended by my managers to become a senior staff nurse. My application, performance improvement project, committee involvement, and inservice lesson plans are being submitted on Tuesday.

3. I advocate for my patients no matter what.
I called for a palliative care consult on a patient with lung cancer that metastasized to the bone and brain who subsequently sustained 3rd burns to 65% of her body. The resident told me that I had no night to go over the burn services authority. I pulled up the policy on WHO can make a palliative care referral and under What grounds. Guess who was right? Me. The family thanked me and the attending said on rounds, this consult was a smart idea.

4. My coworkers asked me if I would be interested in being a permanent charge nurse. Dear friends,< that would have to be a big pay raise hell no!

Life may be crazy. but I wouldn't give it up for anything.

Informed Consent

2009-08-17T16:11:00.009-04:00

So much of the healthcare world revolves around informed consent. Hospitals consider informed consent part of their best customer service, but essentially IC is a right. Patient and their families always need to be informed. But what about their health care providers? There was so much that nursing school didn't inform me about being a nurse. Sure nursing school taught me about anatomy, physiology, pharmacology, and ethics, but there's a lot that was never brought to my attention...

That patient's will test your patience.

That being able to identify a specific bateria by it's smell isn't a skil that makes you more attractive to the opposite sex.

That just because I'm comfortable talking about bodily functions, doesn't mean that it's appropraite dinner conversation

That Id both feel and hear ribs crack when I performed CPR but have to keep going

That I'd be so tired after a thirteen hour shift the thought of walking home five blocks makes me ~~want to cry~~ contemplate taking a cab

That my feet and ankles would swell so much flip flops are the only comfortable shoes to wear after work

That I'd have spider veins by the time I was 25

That I'd be verbally abused my patients and their families

That I wouldn't sleep more than 3 hours inbetween my 12+ hour night shifts

That Uncle Sam would take almost half my paycheck

That money in the bank is no good when you don't have the time to enjoy it.

That I'd only get to spend one holiday with my family over a two year period

That I'd be exposed to lethal infections on a daily basis

That prophylactic antiretrolvirals following a needlestick injury would keep me in the bathroom for the better part of a month.

That doctors and nurses don't have sex in the suppy room. They have it in the on call room (kidding)

That I'd have to fight with the doctors when advocating for my patients

Looking back, if they had shoved a paper in my face and told me everything that being a nurse entails, I think I would have paused, thought about and signed anyways. Becuase even though nursing school didn't teach me any of they above, they also din't teach me...

How amzing it is to deliver a baby on the side of the FDR highway while doing a shift with the paramedics.

How gratifying it is when a patient says "Thank you for being you."

How satisfying it is to successfully run a code

How phenomenal it is to see some one survive after being burned on 90% of their body

How special it feels to be the first one a patient sees when they wake up from a coma

How nice it feels when a doctor says they are happy to have you caring for their patient

How awe inspiring it is to see a person walk on two prosthetic legs for the first time

How fulfilling it is to come home, exhausted after your shift, and know that you made a difference

a ramble

2009-08-07T20:33:00.004-04:00

This post is going to ramble, so please bear with me. Over the last few weeks I've had several great ideas for posts; however, by the time I get home from work, my brain is mush and I choose a hot shower and my bed over my blog.

Work has been crazy lately. As the final weeks of summer approach, so many of the surgeons go into overdrive and book a million OR cases so they can go away on vacation. Makes sense, right? Wrong! What it means is that the OR's are overbooked, the PACU cannot absorb all the patients, and the ICU's end up absorbing the patients as "boarders". This past month, we have been getting a ton of ENT/Plastic patients with flaps. In the last week alone we got three of them fresh out of the OR (anywhere from 9-14 hour long surgeries). Aside from the regular tasks of recovering a patient, these patients come back on the ventilator and have q15min pulse checks It's agony. Last weekend I was in charge, had an intubated 75% burn, had an uncontrolled diabetic on an insulin gtt, and had to take a flap patient. Assignments were so horrendous I could do nothing but ~~go home and drink wine, lots and lots of wine~~laugh. Okay, I drank some wine too! Later that same week, things got ugly. We only had 11 nurses for 36 patients; given that four of them needed 1:1 care and each had at least a two hour burn care/dressing change each shift, plus a pediatric ICU patient who on the verge of being intubated, we weren't in a good place for accepting these boarder patients. We got our managers involved and they talked to their managers. We were told that we can't refuse to accept a patient due to staffing. Which is funny, because we weren't refusing, but we were stating that accepting these patients is a huge safety issue. Oh well, guess they'd rather risk a lawsuit than give us an extra nurse or let us hire more nurses. Right, because that makes much more sense....

Other notable work related things-
1. Commenting to a family member of a patient with 75% burns and a 104 degree fever that "She's burning up."
Poor choice of words, and I felt like an ass.

2. Celebrating Danielle's birthday on Long Island.
After a terribly long work day, we all ventured out to Long Island for a night of drinks and celebrating. Getting chauffeured by our DD in her huge new Pathfinder, Leslie went ass of teakettle into the 3rd row seat while wearing a dress. We danced to cheesy coverband music that we proudly sang along with, we had cupcake/frosting fight in the bar, and then took shots of Jaugermeister and SoCo and Tequila. But by far, my favorite part of the night was when we returned back to the city and Alison was walking down the street yelling, "MB (aka Dr. Matt)? MB? Where do you live?" Then she and Leslie accompanied me to Paulas's apartment so we could feed her cats while she is away on her honeymoon. I think we probably freaked the cats out...three drunks girls, winded from climbing the five flights of stairs, whispering "here kitty kitty." Wonder what the security cameras thought of us that night.

Non-work related things-
My friends got married this weekend in Westchester. Of course it was an adventure getting there. I accidentally grabbed the directions to the reception, NOT the hotel where I was staying so when we got to the Country Club and tried calling the hotel for directions, we got so lost. The girl who answered the phone was quite a airhead who was clearly directionally challenged. She told us to go south the the CC Expressway and then head east on 119. However, we really needed to go north of the CC Expressway and then head west. After 2 hours of driving around Scarsdale, we finally made it to the hotel just in time to change and take the party bus BACK to the country club. Thank God it was 6 hours of open bar because my nerves were shot. Did I mention that the party bus was too wide to make one of the turns so we took out a few tree branches and then still couldn't; make the turn so we almost missed the ceremony! The dancing and DJ was awesome. So much so that I ruined my bargain silk dress with sweat and wine. Let's hope the dry cleaner can take away all my sins!

must accessorize

2009-08-03T18:55:00.004-04:00

About a nine months ago I was in this same predicament. I have to go to a wedding in less than a week and I still have no shoes, no accessories, and no time to go shopping. Last time I needed a pair of black, peep toe pumps and green jewelry. This time I need silvery/taupe shoes and pearl jewelry. It's never a problem finding a dress, but finding the coordinating accessories on a budget kills me. I always find a great deal on a dress, but then end up spending more money than I saved trying to accessorize my bargain dress. Time's running out and if I don't get my act together I'm gonna have to go to this wedding in a moo-moo and sneakers.

Day At the Ball Park

2009-07-21T16:13:00.005-04:00

I got this email last week:

Kelly,
I'm writing to see if you would like to join me at a Yankee Game next Saturday July 18 at 1:05.

You were picked because the staff identified you as someone who embodies our values at NYP .
I can't guarantee how the Yankees will play, but I can guarantee wonderful seats and refreshments in the luxury box that we have for this game.

Please let me know by Monday end of the day.

Thanks.
Laura

I read the email. I reread the email. I read the email for a third time. Yes, this was an email from the Vice President, Chief Medical Officer of the hospital. I was shocked and (obviously) flattered. Before I could write back, I realized that I was scheduled to work that Saturday. I called my bosses, who were thrilled to hear the news, and without hesitation they gave me the day off. I knew this must have been a big deal because staffing for Saturday was real crappy and to simply take me off without as much a hesitation meant a great deal.

As Saturday approached, I got nervous. What do I talk about? Is it going to be awkward? Who else will be there? I had to pick my ticket up at her office on Friday; I'd never been to the "executive offices" before. I received the ticket from her secretary and did a double take. It was twice the size of a normal ticket with shiny gold embossing. I felt like a kid who just found a Willy Wonka goledn ticket.

I took the 6 train to the Bronx on Saturday afternoon. It was a day I will not soon forget. Not only was it my first time at the new Yankee Stadium and my first time at a Yankee's game,

When I finally made m way into the stadium I was lost. I had no idea how to find my way to the luxury box...thats so not how I'm used to experiencing baseball games. However, after what seemed like an endless walk down carpeted, air conditioned hallways lined with plaques and giant mahogany doors, I arrived at luxury box 156. I opened the door.......fully stocked bar( beer, wine, hard liquor, soda, water), salads, paninis, hot dogs, hamburgers, chocolate covered fruit, popcorn, cookies, peanuts, pork chops, steak, grilled chicken, giant soft pretzels, a gastronomes delight! Once I got over the shock of it all, I realized that it was a rather intimate gathering. Maybe 20 or so people, a minute fraction of the ten thousand employees currently employed by NYP. I was greeted warmly by L (Dr. F). We chatted and I continued to mingle and meet the other people. There were a total of three nurses, myself included. The other two nurses were male- one worked in the PACU and the other in the Neuro ICU.

Although the game was rather slow, the Yankee's did pull out a 2:1 win over the Tigers. After the game, some people left,others lingered and chatted. Knowing that the train would be a zoo, I was in no rush to leave. I sat and talked to L some more. I was telling her about starting school at Columbia in the fall. She asked what nursing program I was doing; I told her that I wasn't enrolled in the school of nursing, but rather in the school of public health with a degree in policy and management. She stopped, put her hand on my shoulder and said, "Kelly! That's the program I did. You will love it, it's an amazing place and a fabulous credential." I smiled. We chatted a bit more, I thanked her, and then I left.

I couldn't stop grinning on the way home. I'd been quite nervous with my decision to go back to school, but suddenly I felt at ease. I realized that I'm not only happy and secure with my job, but also my future holds so much potential.

Who would have thought that a day at the ball park was all I needed to ease my mind.

The Good Life

2009-07-13T11:18:00.004-04:00

After a wonderful tropical vacation, I worked a four day stretch, had one day off, then worked another four days. Had these been night shifts, I would have been exhausted and slept away of days off; however, now that my vampire days are over, I've been living the good life.

I can go out after work becuase other people are home! Have you ever tried to find a group of people who work M-F (9-5) who are free on a random weekday morning for ~~dinner~~ breakfast? Let me save you the trouble, it's impossible. Plus there's the whole issue of I'm craving a glass of wine to calm my nerves when the're focusing of a cup of caffeinated delight to perk them up!

I'm running. Long and steady, I'm thrilled!

I have plans to see my family more often than every six months!

I'm doing thing that I otherwise wouldnt do, just becuase I can!
Having picnics in the Park for breakfast! Good book + coffee + sunshine= bliss
Seeing the Philharmonic orchestra with my coworkers on a random weekday night.

I'm doing things that I love to do, but just didn't jive with my schedule before!
Cooking.
Baking.
Blogging.
Talking to people on the phone versus having to send them an email. No one appreciated a phone call at 3am just becuase it was convenient for me.

See....life is good.
Continnuing on with things that fit back into my life....

I finally made it back to Philadelphia this weekend, and boy was it a long overdue trip! I got to see the L's. R and J are getting SO big. I can't believe it has been six months since I'd see them. It was the longest stretch of time I'd gone without seeing them. Highlights of my 24 hour visit were: eating with a group of people around a table, baking with the boys, playing flashlight tag, snuggling up in the big cumfy chair to read books before bed, coming downstaris in the morning to: "Good morning Nurse Miss Kelly. Did you have a nice sweep?", pancake breakfasts, and spending a lovey afternoon at the pool. My trip was over much too soon, but I already feel revived.

When I was living in Philadelphia, I escaped the city at least once a week and spent time in the suburbs; my longing for greenery and quiet was always fulfilled. I'd forgotten how much I enjoyed my urban escapes.

I've got six more weeks of bliss, before ~~life gets crazy, (again)~~ school starts. I realize two things. First, I need to enjoy the rest of the summer and do whatever it is that makes me happy. Second, I simply cannot go another six months without seeing my family and without seeing the L's!

2009-07-07T09:06:00.003-04:00

Where are all my posts? I wrote a bunch of short posts to autopublish over the last few weeks, but it looks as though they never published and now they are gone. Hmmm....guess I'll try and recap:

1. NO MORE NIGHT SHIFTS! I'm officially working full time days.

2. My Aruba vacation was amazing! It was so great to see my family after six months.

3. It's been 13 months since I fractured my pelvis and I'm finally back in action.

4. The Pink Panther sofa is GONE. The new furniture is beautiful and I am very satisfied.

As I get my life back in order, I'll write more. Please be patient. =)

FFoF #79

2009-06-14T10:54:00.002-04:00

Here are this week’s four questions. If you want to play go here!
Oh hey, that's my question as #1! Yay.

#1, Kelly’s question. What is your favorite memory associated with the smell of a certain food? As in, you smell it, close your eyes and are instantly drawn back to a magical moment in time….
Pumpkin and apple pie baking in the oven. Immediately draws me back to the fall season in New England and spending holidays with my family...something that hasn't happened in two years.

#2. Name something red that is in your cabinets.
The cover of my PAM spray.

#3. Ice. Do you have an ice maker, use ice cube trays or buy by the bag?
Buy it in the bag. It's a habit of my roommate.

#4. Pepper. What kind do you use most often? Is it in a grinder or a shaker?
Black, from the grinder. Love that grit!

When Futility Wins

2009-06-04T14:55:00.008-04:00

We got a notification at 9am on Thursday morning that a Jane Doe, approximately 60 years old, found down at the scene with 90% TBSA burns was being transferred. We set up the room, the ventilator, the pumps, etc, and then we waited. Four hours passed before we heard anything else. We assumed that the patient didn't make it, as it was reported that the other person in the fire was pronounced dead on the scene. However, at 1pm, EMS called and said they would be there in 15 minutes. We gowned up and organized ourselves.

As the trauma elevators opened, the smell of charred flesh filled the corridor. We listened intently as the paramedics gave us report. Turns out the patient had been identified by neighbors and was not 60 years old, but rather in her late 20's. The dead person at the scene was her mother. To make matters worse, the patient had Cerebral Palsy (CP) , an uncontrolled seizure disorder, and the cognitive function of a middle schooler. Her mother was her primary caretaker. It's always hard to deal with breaking the news of loved one's death, but when there is a cognitive delay and/or deficit it's even harder. Thankfully, as crass it it sounds, this patient was unconscious and we didn't need to tell her yet.

Upon arrival her vital signs were stable, but she quickly decompensated. We placed an arterial line to monitor her blood pressure, a central line with cordis for venous access, and a SWAN to monitor her hemodyamic stability. Her blood pressures plummeted, despite liters of fluid. Her oxygenation dropped due to an inhalation injury. She was cold, 34.0 Celsius, despite fluid warmers, a heat shield, and a bair hugger. Her coags were out of control, INR = 2.6, and we were pretty sure she was in DIC. We lost pulses in her bilateral upper extremities and performed escharotomies at the bedside. She became anuric (stopped making urine), her bladder pressure soared to 35, and we opened up her belly at the bedside.

The first 24 hours were tenuous. Administer blood products- give fluids- check labs, check ABG's-adjust the ventilator. We were fighting a loosing battle. We were able to contact the family, maternal aunt, uncle, cousins, etc. They sat vigil at the bedside, but knew were this was going. They made the patient DNR. Many people not in the health care field are scared of DNR's. They think that's the equivalent of "puling the plug" or removing life support, but they are wrong. DNR- on a already intubated patient, simply means that if the heart should stop, no CPR would be given.

By Saturday afternoon, the patients' prognosis was dismal at best. Given her % burn, her lung injury, her preexisting conditions, and hemodynamic status her survival rate was less than one percent. The family listened as the doctors and nurses talked. When I came on shift that night, the aunt pulled me aside and said, "It's not good, is it? I just want her to be comfortable. She wouldn't want to live like this..."

I hate these moments. I looked at her and said, "She's sick, very sick. Even if she were to survive the next day or so, she'll never be the same. She has no skin and will likely develop an infection. We don't know how much damage her brain suffered when she was unconscious at the scene. She is currently maxed out on medications to sustain her blood pressure. We have no other options."

And then she made the toughest decision of her life. She decided that she wanted to withdraw care. However, it was not quite that simple. She wasn't the patient's health care proxy, so we needed to have two attending physicians write notes of medical futility and get approval from the administrator on call. There was nothing we could do but wait. Until that paper was approved, signed, and placed in the chart, we had to keep treating her. Around 5:30 am as the sun was rising and the sunlight was streaming into her room, her heart rate slowly began to drop; her blood pressure soon followed. When she didn't respond to any medication, a few of us nurses went in and sat with the patient at her bedside. She had no family there, but we talked to her offering words of comfort. We told her it was okay to go, that her mom was waiting for her. We talked, and talked, and talked. I swear she heard us. At 6:05 am she passed away.

As hard as it is to see someone so young die, it's even harder to think about ethics behind medical futility .

A Bond Unbroken

2009-05-29T09:13:00.000-04:00

We are both female.
We both have blue eyes and brown hair.
We have the same parents.
We grew up under the same roof.
We went to the same high school.
We both love dogs.
The similarities end there.

I'm the serene intellectual; she's the social know-it-all.
She's the jock; I'm the recreational athlete.
I'm a planner, she's spontaneous.
She thrives on chaos;I like cleanliness and order.
I'm an endorphin junkie; she likes her sleep.
She'll hold her ground and never back down;I hate conflict.

I've always been fascinated at the differences between my sister and I. Same sex siblings tend to fall into one of two categories: best friends or arch enemies. My sister and I are neither. We grew up differently, and we have a unique relationship.

I'm seven years older than her. I was in first grade when she was born. By the time she was in first grade, I was in Junior High. When my college friends hosted their siblings for the weekend, I stood by and watched- my heart aching that my sister couldn't be there too. Twelve year old + fraternity party+ alcohol+ boys= lawsuit waiting to happen.

My friends would always ask what it was like to have a sister so much younger than myself, but I never knew anything different. We didn't have much in common; we weren't into the same things. We existed in different worlds. She was playing dress up and I was going to formals. Don't get me wrong, I love her to death, but I always felt more like a mom than a sister to her. But then something happened- I didn't come home from college in between my junior and Senior year. And suddenly, our relationship changed.

She called me one Thursday afternoon in late June. She was giddy with excitement. "Kel. I think he likes me! He told J, who told A, who told me! Isn't that cool?" My heart melted. Her first crush. And she called me. Instantly, she grew up. She was no longer that little girl, she was a teenager. Despite our separation that summer, our relationship grew. We talked on the phone, she became my friend on facebook (yeah, that was weird), she asked me advice, etc.

That September she started high school. I vividly remember talking to her on the phone the night before school started and telling her that it would all work out. She wouldn't be late to class, she wouldn't get shoved into a locker, and she wouldn't sit alone in the cafeteria. I recalled my first day of high school and I remembered her sitting in the living room bay window waving as I walked down the driveway. Suddenly, my heart ached and I realized that I wouldn't be there to see her off.

When I was in high school, I used to go to all her soccer games. I enjoyed spending a few hours each weekend at the soccer fields watching her evolve from a amateur to jock; however, I only made one of her JV soccer games freshman year. The weekend that I graduated was the weekend of her Freshman Dinner Dance. She skipped the after party so my family could dive down to Philly fr my graduation festivities.

She turned sixteen that September. I had to work. I missed Christmas that December. I had to work. She called to tell me that it didn't feel Christmas without me. I wasn't there to hold her hand as we walked the steps to see what "Santa" left us. I wasn't there to sit next to her at church and giggle as the cantor reached a note that would break glass. I started to cry. Although I made it home the next day to celebrate, it wasn't the same. I thought she would be okay without me on a holiday (I hadn't been home for Easter in four years), but I was wrong.

Over the next two years, we grew closer and closer. The age gap seemed to narrow and although i still harbored motherly feelings, I felt more and more like a sister. I gave advice, I spoke from experience, I didn't judge. The first time she came to visit me in New York, without my parents, I showed her city life. She told me that she felt "so grown up", I told her, "Because you are."

Tonight is her first prom and no I won't be there. The date was changed, no one informed me, and I couldn't get the night off. I want her to know that I don't value my job more than my relationship with her. I want her to know that there's a piece of my heart there with her tonight, as always. We may be separated by distance, but the love is there and stronger than ever.

Colleen- You've become such a smart, wonderful, loving young woman...I'm so proud to call you my sister. I love you.

Out With The Old

2009-05-25T16:59:00.005-04:00

I've got spring fever. I'm cleaning out closets, organizing cabinets, and rearranging, obsessively. You all know about the ugly couch, aka "The Pink Panther" .... And yes, unfortunately, it's still with us.

Despite numerous hours spent searching for the perfect chocolate leather sofa and matching love seat, I haven't found "the one." I'm skeptical to buy something online, because I want to be give it the "but test" before purchasing. Also, because my roommate and I are both short, we don't want any furniture that when we sit down , our feet won't touch the floor.

This past weekend, Memorial Day sales GALORE, would have been the perfect time to purchase furniture; however, A was out of town and ~~she didn't trust me~~ I didn't want to make the decision myself. So what did I do instead? I redid our bathroom. It went from a sleek and modern black and white powder room to a page out of the Pottery Barn catalog. Yes, I know that store is overpriced and I could buy knock offs at Tarzhay, but the Manhattanite in me took over. I bought a shower curtain, towels, rugs, baskets, and decorative soaps. Yes, you read that correctly- decorative soaps. Ahh, what was I thinking?

Although redoing the bathroom was fun, if not a drain on my wallet, I just need to buy a couch. It will be much cheaper than redoing every other room in the aparment to compensate for the ugly "Pink Panther."

Any suggestions on buying furniture??

Four Foods-Memorial Day Edition

2009-05-21T09:23:00.002-04:00

It's been way too long since I last played! But with summer coming, I'm hoping to get back on track! If you want to play FFoF, go here!

#1. Do you celebrate Memorial Day with a picnic, cookout, road trip or some other way?
Growing up, we always went to our neighbors house for a pool party and cookout. But as of late, I'm usually working. Exciting, right? haha.

#2. What are staples at your summer time cookouts?
Big watermelon slices and icy cold beer.

#3. What drink do you find most refreshing on a hot summer day?
Ice cold water with fresh lemon slices.

#4. Share a recipe for a picnic side dish.
Chocolate Covered Strawberries
Ingredients
4 ounces (about 3/4 cup) Chocolate Chips- I like to do 1/2 white and 1/2 semi-sweet
12 strawberries

Method
Line a plate with wax paper or parchment. Place chocolate chips in a glass bowl or measuring cup and microwave on high, 1 to 2 minutes, or until melted and very smooth, stopping to stir about every 20 seconds. One at a time, dip strawberries into melted chocolate and place on the prepared plate. Refrigerate about 10 minutes to harden. Store covered and refrigerated up to 1 day.
To pack: place in flat bottom container with fat lid r and place a bag of ice on top and below)

Changes

2009-05-18T15:36:00.003-04:00

Dear ~~loyal readers~~ few people who follow this blog-

Please excuse the lack of posts lately, life's been happening. Guess I'll catch you up on what's been going on.
1. Grad School
I'm going to Columbia! Classes start the end of August.

2. Work
I'm going to full time days starting June 21st! Two years of ~~hell, holy hell~~ nights will finally be over.
I'm going to stay working full time while I go to school. I'm banking all my vacation and holiday time to use September through December. It works out that I'll get paid for a full time work week, but only actually working part-time. The way I see it, my life won't suck any more than it has the past two years.

3. Vacations
I'm joining the family in Aruba for six days. Because I have no vacation time to use, I will be working the four days prior and three days after. Oh well, it will be worth it to get rid f this pasty white goodness otherwise known as my skin.

4. Dating
I'm still single. Dating still sucks in NYC. Please send any ~~intellectual, tall, dark, and handsome men with a great sense of humor~~ remotely good looking men my way.

5. Health
I'm still chronically exhausted but I found out that I'm quite anemic. My TIBC (total iron binding capacity) is very elevated compared to my actual iron level indicating that my body isn't properly utilizing/absorbing the iron. Now I'm taking iron pills. Hello constipation! Sorry if thats TMI. But it's all worth it, if it will boost my energy.
Regarding my fractured pelvis, I've had no further complications (knock on wood). I won't have another bone scan until next year, but I've finally gotten back to running just about year since my injury. After a five month wait, I saw the endocrinologist and found out that my vitamin D level is low. Now I'm taking additional vitamin D pills.
Yes, I've turned into the vitamin popping princess.

I'm sure that a lot more has transpired over the last month, but those are the highlights.
Thanks for checking in!!!

i've heard it all

2009-04-08T13:27:00.003-04:00

No big surprise, our ICU census was full last night- all 20 beds occupied. Our step-down unit was only 3/4 full- 15 beds occupied. So when we got the EMS phone call at 3 am that we were getting three smoke inhalations, guess what?!?!, our three "stable" ICU patients (non vented/demented/etc) needed to head to the step-down unit.

Our prospcects were grim..
- two vneted patients over the age of 90
-two patients on CCVHD, also vented-duh!
-one fresh 30% degloving injury with history of dementia
-one 60% deglving injury, vented, in DIC
-new purpura syndrome admission with GI bleed
-fresh post op of STSG to bilateral legs on heparin gtt for a PE
-fresh extubation with signs of anoxic brain injury from initial carboxy hemoglobin > 50
-quadriplegic wound management patient with a 12% ejection fraction (systolic heart failure, ya think?!?!?)
-etc, etc,

And just who were the lucky three???

1. Thitry something year old man who refused to leave his room stating that it was Passover and that he had hired a cleaning service to come in and purify the room and it's air. Nope, under no circumstance would he leave his room to be sent to a "dirty and unholy hell hole" -direct quote.

2. Middle aged man with severe MR that likes to streak in the hallways and jump up and down naked when moaning and screaming when we do his burn care. Oh yeah, you can forget going near him with a needle for labs, let alone for IV placement...too bad he is going to the OR today for surgery.

3. Older woman with extensive history of ETOH, only 6 hours past the threshold for severe DT's. Did I mention she's obese and refuses to wear bipap so she essentially goes apnec every two minutes.

So glad that shift is over! Never a dull moment.

update

2009-03-31T18:27:00.002-04:00

Update on this post....

The dumb shit resident that I saw never called back with my lab results. I got annoyed after trying to call her back for a week and just looked them up myself. Maybe I wasn't supposed to do that? eh, oh well.

Called 11 times to get an appointment with an attending: hold, transfer, hold, hold, ANSWER, nope transfer, click.......fuck!

Called on the 12th time this past Friday from work in the same hospital where the practice is located:
One ring....
Secretary: Hello? what department are you calling from? What can I do for you?

Me: Hi this is Nurse Miss Kelly from the burn unit, I'm a former patient of Dr. W's, I need to make an appointment with Dr. C?

Secretary: Oh do you work here in the hospital?

Me: Umm, yes?

Secretary: Marvelous. How's this Tuesday at 10:30am?

Me: Seriously? That's great.

Secretary: Would you like us to call you if we can an earlier cancellation?

Me: I'd love that! (thinking am I dreaming?)

Secretary: Okay, I can reach you at this number?

Me: Actually my cell is better xxx-xxx-xxxx. thanks.

Secretary: Oh, okay. Well then I'll note that. Bye bye.

lesson learned: make an internal phone call, work the system!

FFoF #72

2009-03-30T11:16:00.003-04:00

#1. Suggest a question for FFOF. Something fun is in store for the one whose question is chosen.
What is your favorite memory associated with the smell of a certain food? As in, you smell it, close your eyes and are instantly drawn back to a magical moment in time....

#2. Share instructions on how to make your favorite smoothee or shake.
Breakfast in a Glass~my banana mango smoothie

2 frozen, ripe bananas (freeze WITHOUT the peel!!)
1 mango, peeled and sliced
1 cup orange juice (any kind will do- I prefer tropicana light plus calcium or fresh squuezed)
1 cup fat free vanilla yogurt
*1 tsp of vaniila extract and a dash of cinamon can be added to enhance the flavors*

Cut banana into chunks. In a blender, combine all ingredients and blend until smooth.
If the smoothie is too thick, thin with a little more orange juice. Pour into 4 glasses.

#3. What’s in your favorite panini?
Eggplant, portabella, zucchini, roasted red pepper, and goat cheese

image

#4. Share a recipe for potato salad.
For all those of us who aren't big on mayo!
Roasted New Potato Salad
Ingredients
2 pounds new potatoes, cut into chunks
6 tablespoons plus 1 teaspoon extra virgin olive oil
Salt and pepper to taste
1/4 pound green beans, stemmed and sliced
2 tablespoons red wine vinegar
1/2 cup basil
1 garlic clove, finely chopped
2 medium tomatoes, chopped
1 cup salad greens
12 pitted Kalamata olives

Method
Preheat oven to 400°F. Toss potatoes with 1 teaspoon of the oil, salt and pepper and transfer to a roasting pan. Cover and roast until tender, 35 to 40 minutes. Set aside to let cool.

Meanwhile, bring a large pot of water to a boil. Add green beans and cook until just tender, 3 to 4 minutes. Rinse in cold water and set aside.

Put vinegar, remaining 6 tablespoons oil, basil, salt, and garlic into a blender and purée until smooth to make a vinaigrette. Toss potatoes, beans, tomatoes with vinaigrette together in a large bowl, then spoon mixture onto a plate arranged with salad greens. Garnish with olives and serve.

tah dah!

2009-03-23T18:25:00.002-04:00

I must make this quick, I'm on my way to work (night 4 of 5), but I just got the final word.....

Grad School Acceptance:
YALE: yes
HARVARD: yes
COLUMBIA: yes
EMORY: yes

Now onto the million dollar question: Where do I want to go?

Four Foods 69

2009-03-12T19:22:00.004-04:00

#1. Olive oil. What kind do you prefer to use?
Extra Virgin. I don't use much oil., so I splurge and buy the expensive aged stuff. You use less, when it's more flavorful!

#2. Meatballs. Do you make them from scratch, buy premade cooked or buy premade frozen?
I make meatballs from scratch for others and use frozen "meat-less ball" for myself

#3. Do you use napkins at home? Paper or cloth?
I use papertowels. I know, please don't send the green police after me.

#4. Share a recipe for a white sauce.
Heat 3 TB milk in a saucepan, add 8 oz of cream cheese. Stir, stir, stir, add seasonings to taste, stir, stir, stir. As soon as smooth, turn heat down to lowest setting.
*add in seasoned and cooked chicken or fish
* toss with pasta

Go here to join in on this meme.

A Little Appetizer

2009-03-11T12:28:00.000-04:00

Looking through my refrigerator and cabinets with only thirty minutes until my friends arrived, here's what I came up with!

Goat Cheese Stuffed Dates with Rosemary Balsamic Reduction

50 Large Dried Organic Pitted Dates

4 oz Goat Cheese, room temperature

2 teaspoons freshly ground black pepper
1 tablespoon olive oil
2 tablespoons minced shallots
1 teaspoon minced garlic
1 cup balsamic vinegar
1 large or 2 small rosemary sprigs

Reduction
Set a 1-quart saucepan over medium heat and add the remaining 1 1/2 teaspoons of olive oil. Once the oil is hot, add the shallots to the pan and sweat until translucent, about 1 minute. Add the garlic to the pan and sweat for 30 seconds. Pour the balsamic vinegar into the pan and bring to a boil. Add the rosemary and allow the balsamic to gently boil and reduce until only about 1/4 cup of balsamic remains, about 10 minutes. Season with 1 teaspoon of salt and 1/2 teaspoon of black pepper. Remove from the heat. Remove the rosemary sprigs before using.

Assembly
-Place dates on large platter or cookie sheet.
-Fill a medium size tipped pastry bag with soft goat cheese.
-Place tip of bag into each date and fill until goat cheese starts to peek through the other end of the date.
-Once all dates are filled, lightly drizzle balsamic reduction over the top.
*tip: use a large spoon to easily drizzle the reduction.

I Dream Of....

2009-03-05T11:11:00.003-05:00

School?

I had the strangest dream last night. I found myself running across the junior high school parking lot frantic that I'd be late for the first day of my senior year,, only to reach the sidewalk as the homeroom bell rang. I walked into the school, up to the office window and said, "I'm sorry I'm late, I was picking up my parents at the airport. Can they send in a note later?" I think the office clerk mumbled something about needing it now. Next thing I know I'm wandering the hall of the junior high looking for room 3005. When I finally find it, its filled with kids from my graduating class, and they are starring at me. Matt came up to me and said, "Yeah, you freaked us out in high school and that's why we wanted to ruin your prom." Before I could open my mouth, our elementary school librarian was handing out locks and schedules telling us that our lockers would be located here in the Junior high, but that all of our classes would be at the actual high school. Right because that makes so much sense..... Before I could retort such an insane proposal, I found myself amidst w whirlwind of people in a multilevel maze trying to navigate my way to my classes. I walked into the library and cut through to the gym only to find that I had no gym clothes. Then I was sitting in math class realizing that I hadn't been to a math class in over a semester and I freaked out. I asked to be transferred to another class, but my teacher only spanked my hand with a ruler and said get out and go back to community college. Then I was sitting in the principals office and he told me that he was disappointed in my choice to be fifth in my graduating class, he said I'd never go anywhere in life...

And then I woke up.

I think the anxiety of waiting for schools is killing me.

Dear Nurse Miss Kelly

2009-02-23T16:19:00.009-05:00

If you aren't in the mood to read a rant, than I suggest you file this post under "to be read at a later date."

I work in healthcare. I'm going to graduate school for public health. I understand the healthcare crisis. I have money taken out of my paycheck every cycle to pay for my health insurance. I don't have complex medical issues. SO WHY CAN'T I GET A DOCTORS APPOINTMENT?!?!?!?!

Last year I found a GREAT internist/gynecologist. I also found a great dermatologist. After much angst I did find a dentist, but after my visit, I decided that I wouldn't be going back there ever again. In December, amongst holiday cards and holiday bills, I get a letter from the dermatologist:

Dear Nurse Miss Kelly,

It is with deep regret that we tell you that as of Jan. 1, 2009 Dr. N will no longer be with the practice. She has decided to relocate to Florida. Please call xxx-xxx-xxxx to book an appointment with the doctor who will be taking over her patient load.

Noted. Due for my annual checkup at the end of January, I called to book an appointment "with the doctor who will be taking over her patient load." What does the secretary tell me? Our conversation went something like this:

"Hi. This is Nurse Miss Kelly. I'm a patient of Dr. N's. I'm aware that she has left the practice, so I was hoping to book an appointment with whoever took over her patient load."

"Oh, well you see, you are going to have to wait. It's a four month wait to be seen as a new patient."

"But I'm not a new patient, I've been to the office before! I have records there. I just need to change doctors."

"Yes. But you are new to the replacement doctor and she will need to do a workup. What do you need an appointment for?"

"Just my annual skin check. I'm sorry, I'm confused. All patients of a doctor who left must now wait to be seen as new patients?"

"Correct. You can be seen in four months. How does April 29th sound?"

I concluded our call with, "Let me check my schedule and I'll call you back."

I was pissed. Not only did that not make any sense, but also this lady was clearly very misinformed. What did I do? First I looked to see the names of the other physicians in the practice to book an appointment with them. Then I called back, spoke with a muffled voice, what if the same wacko picked up, and booked an appointment with another doctor. Yes the wait was two months, but that was much more reasonable.

Crisis averted.

Not even two days later, I get another letter in the mail.

Dear Nurse Miss Kelly:

As of January 1, 2009, Dr. JW will be leaving WCIMA and joining a private practice. She will continue to admit her patients to xx hospital. Dr. PC will join WCIMA in February 2009 and will be responsible for your care. It is expected that she will participate in the same insurance plans that Dr. JW has participated in. Please contact us at xxx-xxx-xxxx to arrange to see our new physician.
If you wish to continue your care with Dr. JW here information is listed below..

Great, I'll call and book an appointment with her new practice. I mean, I never thought that she wouldn't take my insurance, after al it's expensive to be in private practice, so the more patients the merrier, right? WRONG.

Since I fractured my pelvis last summer, my lifestyle has been chaotic, at best. I broke up with a boyfriend, was studying for the GRE's, worked ALL the holidays, had a fight with my best friend, applied to grad school, etc. Through it all, I continue to work nights, sleeping less than four hours a night. My energy levels have bottomed out. It takes all my will power to get out of bed. I have no stamina and my workouts, once my sanity saver and favorite pastime, are awful and I hate the thought of the gym. My runs have dwindled down to nothing. I haven't run in over three weeks.

I've continued to eat my vegetarian, almost vegan diet and be very conscious of what and how much food I put in my body. So I was concerned that I started gaining weight and more and some more. I don't weigh myself, I go by how my clothes fit, but I'd estimate that I've gained 15 pounds since I graduated from college. And that freaks me the hell out!

Recently, I've began having some other symptoms:
-dry scalp and skin
-swelling of the hands and face
-gas and bloating
-thinning hair
-increased exhaustion

When I woke up the other morning and my hands were so swollen I couldn't get my rings off, and I also didn’t fit into any of my pants, I knew I had to go to the doctor. Something isn't right.

I pulled the letter out of my files and dialed the number of my old doctors new private practice. After explaining that I had been a former patient of Dr. JW's, I asked the secretary if she was taking my insurance plan.
"Um, No. I'm sorry. She's not accepting any managed care. But she will gladly see you for a physical. Would you like to come in today?"

"Hmm, well. How much is a physical? I would like to continue my care with her if possible."

"A physical would be $1000. And lab work is about $400."
I cough and scoop my jaw off the floor

"I think I'll pass. Thanks though."

No way in hell was I going to pay $1400 out-of-pocket when I have insurance! Guess I'll call the old office. After being hung up on twice, transferred twice, and then on hold for 15 minutes I finally managed to speak with someone. I told her that I needed to make an appointment with Dr. PC. And then, like something out of a sitcom, she tells me, "Well. Right now we don't have a doctor covering. Dr. PC's joining the practice has been delayed, twice. In the meantime you can be seen by a resident until we get an attending on staff."

A resident? A resident?!?! No way, lady. I get that this is a teaching hospital, and I'm all about higher learning, but this is serious. It's my health we are talking about and I want an attending!

Frustrated beyond belief, I agreed to see a resident at 2:30 that day; nevertheless, I did insist on the name of the resident's attending to have for reference.

Two hours and four vials of blood later, I walked out.

Hopefully they can figure out what's wrong with me.

Hopefully I can figure out what's wrong with our healthcare system.

Four Foods- Salty!

2009-02-22T11:49:00.002-05:00

Another week of late posting. Bad me! Check out everyone else's timely posts here.

#1. Potato chips. Flavored? Regular, ridged or stacked?
Baked, anyway they come.

#2. Cheese doodles. Yellow or white? Puffed or crunchy?
Pirate Booty, so white and puffy.

#3. Pretzels? Your favorite shape? Favorite flavor?
Honey Wheat Rods

#4. Share a recipe for salsa or dip.

Chipotle Chickpea Dip

1 large clove garlic, peeled
15 ounces (1 1/2 cups) chickpeas, drained and liquid reserved
2 tbsp. lime juice
1/2-1 tbsp. chopped canned chipotle peppers (adjust according to how spicy you like it)
1 tbsp. chopped red onion
1 tbsp. tomato paste
1/4 tsp. chili powder
1/4 tsp. cumin
salt to taste
more red onion for garnish

With the food processor running, drop in the garlic and process until chopped. Add the chickpeas and lime juice and begin processing. If it's too dry, add 1-2 tablespoons of cooking liquid from chickpeas or, if you're using canned, just use water. Add the remaining ingredients and process until smooth. Adjust salt to taste. Serve garnished with chopped red onions.

Oops

2009-02-19T08:53:00.005-05:00

I must admit, I enjoyed a glorious four days/nights off. I did laundry, polished china, cleaned out my closet, filed for financial aid for grad school, caught up on t.v. (oh how I <3 DVR!), and slept. However, yesterday was a blah weather day. Gray skies, cold and windy, with bouts of sleetish (sleetesque?) precipitation and I had a headache. I took a power nap before leaving for work, but my head was still a pounding.

I'm not one to take much medicine, so my "medicine" cabinet is mostly hairproducts, toothpaste, and only two bottles of pills-Tylenol and Tylenol PM. After my powernap, I rushed into the bathroom to grab something to kick my headache before what was sure to be a busy night at work.

I popped open the bottle, grabbed two pills and swallowed them with my water. As I was putting the bottle back in the cabinet I froze... "Tylenol PM". Uh, oh.
Not really sure what to do (I've never been very good at making myself throw up), I sighed, walked out of my apartment, and walked into the first coffee shop I passed on my way to work

6:45 pm......triple shot of espresso
I'm going to tell you all something now, a valuable lesson if you will, espresso does not negate the effects of Tylenol PM.

8:30pm.....cup of coffee from the overpriced starbucks in the hospital lobby

9:30pm.....2 cups of green tea

10:30pm....bottle of diet pepsi (uck, I haven't drank soda in over 2 years!)

11:30pm....diet red bull (man, that stuff is gross)

12:30pm....at this point in the night, my bladder is ready to explode, my heart is racing, and my eyes are so heavy that I need life preservers to keep them open!

With each hour that passed at work, my eyes got heavier and heavier. Thank God my patient was sick and VERY busy becuse if I had one moment to sit down, I would have been out cold.

Waiting on His Steps

2009-02-13T10:16:00.007-05:00

A moment.
A bad accident.
A very tragic injury.
A young life changed forever.
A broken family grasping for hope.

But what can we do for them?
Will faith conquer impending death?
Does modern medicine prevail?
Believe in God?
They do.

To trust.
They must believe.
We will try everything.
It is a long road.
One that many do not survive.

But they sit at bedside vigil.
And sing against the tune
Of the musical alarms.
She will live.
They pray.

We hope.
Our actions suffice
And instincts are wrong
But fear lingers ever present.
Each day brings a new change.

But no more can be done.
We join in their prayer.
Medicine is not God.
We know this.
Trust him.

-KS 2009
I'm not an overly religious person, but lately I've been rocked back into my faith. Life is precious.

Four Foods on Friday 65

2009-02-07T10:44:00.002-05:00

Here are this week’s four questions. Check out the FFoF meme for yourself.
Let’s talk about foods that sound funny.

#1. What’s the funniest sounding food or ingredient you know of?
Maybe I'm immature, but I still chuckle when people order the "Pu Pu Platter"

#2. How do you pronounce “cavatelli”?
(cah)-(va)-(tel)-(lee)

#3. How do you pronounce “gnocchi”?
(know) (key)

#4. Share a recipe that calls for mozzarella cheese.
Mozzarella Salad
Ingredients
4 ears sweet corn, in the husk
1/4 cup extra virgin olive oil
2 tablespoons sherry vinegar
1 teaspoon Dijon mustard
1 clove garlic, finely chopped
2 tablespoons finely chopped fresh chives
Sea salt, to taste
Freshly ground pepper, to taste
1/2 pound fresh mozzarella, cut into 1/4-inch cubes
2 ripe avocados, halved, peeled and cut into 1/4-inch cubes
1/2 pint grape tomatoes, halved
1/2 cup cooked black beans
10 large fresh basil leaves cut into thin strips
5 cups baby arugula, spinach or romaine lettuce for serving

Method
Preheat oven to 400°F. Soak corn in the sink or a bowl filled with cold water for 10 to 15 minutes.

Meanwhile, prepare vinaigrette by whisking together oil, vinegar, mustard, garlic, chives, salt and pepper. Set aside.

Once corn has soaked, place on a rimmed baking sheet lined with parchment paper. Roast for 25 minutes, until kernels are tender. Cool to room temperature, then discard husks and silks. Cut the kernels off the cobs and put them in a large bowl. Add mozzarella, avocados, tomatoes, black beans and basil.

Drizzle the dressing over the salad. Toss gently to combine. Season with salt and pepper and serve over a bed of greens.

2009-02-04T17:37:00.003-05:00

I've worked the last six nights straight.
i had to stay 5 hours late on my last morning becuase a nurse didn't show.
two nights with sickest patient on the unit, four nights as charge nurse
bed census: full! (40 patients)
toal work hours = 82
total sleep hours =24
work to sleep ratio: > 3:1

my eyes are puffy
my ankles are swollen
i have no clean underwear
my refrigerator contents: ketchup, soy sauce, applesauce, soymilk, beer
number of unanswered emails: 35
number of times I've seen my roomate in the last week: 1
my neighbors upon seeing me in the elevator: "Ouh, rough night?"

what I want to do most? sleep
what am I going to do? sleep
why am I still typing this? who knows, goodnight!

ZzZZzzZZZzzzZZZZzzzzZZZZZzzzzzZZZZzzzzZZZzzzZZzzZz

"I got no strings to hold me down"

2009-01-23T20:25:00.003-05:00

Two weeks ago I got an email from Columbia…

Dear Kelly,

Happy New Year. I hope this email finds you well. The admissions committee is in the process of reviewing your application file and I was asked to see if you would be willing to take the biostatistics placement exam. It will help the committee in their decision-making process…

I nearly shat myself. My heart started racing. Biostatistics? Test? Now? Are you kidding me? It didn’t help that I read this email at 8 in the morning after a four night stretch at work. As tempted as I was to just shoot back and email saying, “NO!.” I knew that was essentially writing my own rejection letter. I did the next best thing and called the woman who sent me this email. Of course she wasn’t in the office, so I left a voicemail. Boy do I wish that she had the option to delete and re-record because I rambled and babbled and stumbled. I managed to leave her my number and the best times to reach me, but I hung up with a pit in my stomach.

Thankfully, I managed to fall asleep for a few hours that morning. I got up and went about my day (gym, grocery shopping, post office, shower, date with the firefighter). After a late night, I didn’t wake up until the 11 the next day. What’s waiting for me? A voicemail from the admissions woman. I had only missed her by twenty minutes; I quickly called her back. She picked right up. She sounded so happy and perky; I, on the other hand, sounded like a hoarse, stuffy nosed sick person. I apologized for my rambling message and she said, “ Well after reading your application it sounds like you have a very intense and exhausting job. No excuses necessary.” Phew! That made me feel better. I told her that I was glad we were able to speak in person. I had a few questions and felt that speaking was much more personal than email (bonus points?)

But onto the real issue at hand. What I wanted to know was if they wanted me to take the test because of a shortcoming on my transcript/performance, or if it was something they were asking all candidates to take? She quickly summarized why she had contacted me. She was a member of the admissions committee and they were in the middle of reviewing my application. They were very impressed with my undergraduate transcript (Ivy League, Magna Cum Laude), my letters of recommendation (two PhD’s well known researchers & the worlds best nurse- BSN, CCRN, MSW, NC, Reverend –I forget all of his other credentials), and my personal statement. However, what they were rather concerned about was my quantitative GRE score. My scores just didn’t match up with my other credentials. That being the case, they felt that they needed me to take a placement test to determine my quantitative (math) capabilities.

I took in a deep breath and said, “Sure. When would you like me to take the exam.” She said, “Great! Here’s the name of the woman you need to contact about the test. Best of luck, Kelly.”

I hung up and sat motionless in my bed. I hadn’t taken a statistics class since my sophomore year of college, but I did get an (A). When I contacted the exam woman in the afternoon, she said that the sooner the better. I looked at my calendar. This was a Wednesday, that Friday I was beginning a 5 night stretch. I told her that due to my work schedule the earliest I could take the exam was the following Thursday. And that was that. Thursday at 10am. I no sooner hung up from her and ran out to the store to buy a review book.

Over the next week I did nothing but work (and study), work-out (and study. I’m sure the other gym members were like who’s the nut on the treadmill reading a statistics book?), and “sleep”/have nightmares of linear regression models, T-scores, and Z-scores.

Before I knew it, Thursday had arrived. I got up early that morning and was at the gym by 5 (sans review book). After a good sweat and steamy shower I set out for 168th and Riverside Drive. Oh yeah, WAYYYY up there across town. Knowing that public transportation would take almost an hour, I opted for the cab (gasp!). What I didn’t account for was morning rush hour traffic. I left my apartment at 8:50. I caught a cab at 9:20. Absurd! My stomach was in knots, my heart racing. The cab driver asked me if I was okay- I guess my voice was shaking as I told him where I needed to go. He was sweet and dropped me off right at the door, wishing me good luck as pulled away. I made my way to the sixth floor, knocked on the door, and then- test time!

The woman’s chipper personality made me more at ease. She led me to a barren room, I said a quick Our Father and Hail Mary and began. Forty minutes later I emerged and handed in my exam. She asked me to sit outside as she graded it. I could hear her turning the pages, it seemed like an eternity. She emerged from her office, paused, then said, “Congratulations, Kelly! 20 out of 21.” My stomach flopped, my head buzzed, I felt all warm and tingly. It may have been just a test, but it was a sweet victory for me.

And now all I have to do is wait for their decision….

Four Foods on Friday 64

2009-01-23T10:17:00.005-05:00

Here are this week’s four questions.
Let’s talk about things that might not be quite the usual fare.

#1. What’s the oddest thing you’ve ever made with bread?
A gingerbread house. We didn't have any graham cracker, nor molds to make gingerbread so I improvised. I toasted it, then sprayed it with shilack (did I spell that right?)

#2. What’s the oddest thing you’ve ever done with mac and cheese or pasta?
Dried Pasta Jewelry. Go here for instructions

#3. Is there a food you eat other then it is intended?
Sometimes I take boxed cake mix and add it to some canned pumpkin, stir and eat. It's (almost) guilt free. May I suggest you try it with Namaste brand spice variety

#4. What’s the weirdest food you’ve ever seen?
It's not weird, but my phobia is. You know those "eyes" on overripe potaotes- they freak me out.

(photo credit Food Boom)

Do you want to play? Check out Valmg's FFoF blog feature!

Four Foods on Friday 63

2009-01-16T15:41:00.004-05:00

Here are this week’s four questions.

Let’s talk about Chinese food.

#1. Do you prefer to eat Chinese food in the restaurant or to have it delivered?
Delivered. Chinese restaunratns scare me. Cat foo yong.. any one?

#2. Do you prefer wonton or egg drop soup?
Neither, too much salt.

#3. What flavor fried rice is your favorite?
I'd say vegetable.

#4. Describe your favorite item on the Chinese food menu.
This is so lame, but my favorite is steamed veggies. Since I don't eat meat and the tofu isn't recognizable in most dishes, I stick to the green stuff (and the occasional carrot). =)

What about you? Go and check ou Valmg's FFoF blog feature.

One Final Prayer

2009-01-13T15:44:00.003-05:00

My last two shifts were non stop, but they are two shifts that I will never forgot.

X was accepted as in international transfer five weeks post burn. Although I've seen many patients with his % burn survive, the fact that at five weeks out none of his wounds were closed was not favorable. When X finally arrived in New York at the beginning of December, he was in renal failure, maxed on dopamine and norepinepherine for his blood pressure, thrombocytopenic, in respiratory failure and ventilator dependent, and in septic shock. Additionally a MRI of his brain revealed an acute cerebellar infarct. He had six surgeries for debridment and skin grafting but none of them took as his body was invaded with fungus and bacteria. I took care of him the better half of the last two weeks and grew to know his family well. They halted their lives abroad and moved here to keep vigil at his side. They waited and prayed and waited and prayed and waited and waited and waited and prayed.

In the last two weeks, X grew sicker and sicker. He had showed some signs of improvement early on (return of some kidney function with oliguric output, improved ABG's, improved coagulation, fewer bacteria invading his wounds) but he took a turn for the worst...

Pseudomonas in the sputum, blood, and urine.
Acetinobacter in the sputum.
Candida on the skin and in the blood.
Thrombocytopenia
ARDS
Pulmonary Edema
Acute Renal Failure
Collapsed Lung
Sepsis
Acidosis
20 kilos of fluid overload with edema making him unrecognizable

In those 25 hours of work I administered 8 units of blood, 8 units of FFP, 10 units of platelets but he remained thrombocytopenic.
The ventilator was on 100%FiO2 and he was still lethally acidotic.
He required continuous deep lavage suctioning that involved removing him from the ventilator and breaking PEEP causing his blood pressure to plummet.
He was so unstable we couldn't turn him to put him on dry sheets, yet he was putting out 11 liters a day in bed drainage (yes, we suction and measure this).
He was two days overdue for day #5 post-operative dressing (POD) change.
His eyes were dilated and minimally responsive.
He was maxed out on Dopamine, Levophed, Neosenepherine, and Epinephrine.

I arrived at work on Monday and was partially surprised to find X still alive. The three hours prior to my arrival his blood pressure was resting around 68/40, his heart rate tachycardic in the 110's, and his O2 sat around 73%. The attending physicians held a discussion with the family during the day and I thought they were leading in favor of DNR, but in a desperate twist of fate the father disagreed and said he wanted "every thing possible" to be done.

During the day, the family had kept vigil at the bedside, never more than three visitors at a time. In the middle of report from the day nurse, Xs alarms sounded, his O2 sat was 65%, he needed to suctioned. The day nurse (J) and I went in and prepared to suction. We no sooner finished when his heart rate began to plummet: 110-90-80-75-70-60-55......

J yelled to get some atropine began bagging the patient. I hopped up to begin compressions. In rolled the code cart and so began the code. His venous access lines ( a right internal jugular TLC, a left femoral TLC, and left femoral Aline) were a mass of "spaghetti" coming from the 13 pumps running on either side of his bed; however, when the atropine arrived J started pushing meds, I continued compressions ,and the fellow took over bagging. I felt ribs snap, I saw my artificial compression "V-tach" heart rate on the monitor, my triceps and deltoids tightening with every blow. And then it happened. The mother came running down the hall, stopped in the doorway, and yelled, "Stop! NO More! I'm his mother." We all looked up- all hands off the patient. At this point the attending physician was also in the doorway and he and the fellow clarified with the mother what stopping CPR would mean and verified that this indeed was her wish. With tears streaming down her face, she sobbed, "Yes. Yes." And with that we turned off the pumps and stepped back. I stood there holding the mother as we watched the agonal heart rhythm on the monitor...28, 23, 10, asystole. We checked- no pulse. And he was gone.

The monitor no sooner read asystole and the sister came running back in. She threw herself over her brother and let out a blood curdling scream. The crowds started to dissipate from the room and the fellow, J, and I began to comfort the family. After turning off the monitors and stocking the room with tissues, we all left and let the family grieve. I called the priest. It broke my heart as I watched the father pace frantically outside the room, refusing to set foot inside. After the priest left, I heard a noise coming from the room. I looked up from my paperwork and started walking towards the room...

Oh Dios de quién Único Hijo nos ha otorgado los beneficios de la vida eterna, concédenos la gracia que te pedimos mientras meditamos los Misterios del Mas Santo Rosario de la Bienaventurada Virgen María, debemos imitar lo que contienen y obtener lo que prometen, a través del mismo Cristo Nuestro Señor. Amen.

Over the last two weeks I'd listened to X's family chant prayers at his bedside, but suddenly I was moved. Not overly religious, but still connected to my Catholic roots, I stopped to think about what they were saying.

Let us pray. O God, whose only begotten Son, by His life, death, and resurrection, has purchased for us the rewards of eternal life, grant, we beseech Thee, that meditating upon these mysteries of the Most Holy Rosary of the Blessed Virgin Mary, we may imitate what they contain and obtain what they promise, through the same Christ Our Lord. Amen.

Jesus died at 33, their son didn't even make it to 30.

The post mortem care that followed was grueling. It took over 3 hours. Removing the dressings churned my stomach. X's skin was green with infection and textured with fungus. When all was said and done, I called the family in one last time to say good bye. As they kissed him their final goodbyes, I stopped the mother in the doorway and took her hand. I opened her clenched fist and placed something in it. She brought her hand closer to her face and opened her fingers--an ID band. She threw her hands up around my neck and sobbed, "Thank You. Thank You." I may not have been able to save her son, but I sure hope I can preserve his memory.

WEEK 62: Four Foods On Friday

2009-01-09T13:43:00.005-05:00

And I've been out of the loop for over a month. Life has been quite busy and work, well, overwhelminng. But it's a new year and I'm trying to get back on track. Valmg's been in a funk too, so hop ov over to here meme, check it out, and leave her some love.

Here are this week’s four questions.
#1. Waffles. Do you usually eat frozen or homemade?
What do you consider waffles made at a restaurant? I guess they are "restauarnt" made- but those are the only times I eat waffles

#2. Eggs. Do you buy brown, white, or it doesn’t matter?
Whatever is on sale, but I always buy organic, cage free eggs.

#3. Oatmeal. Do you usually make instant or cooked?
Cooked. Call me a snob, but I'll forgo the oatmeal if I dont have time to cook it. Cooking tip- Old Fashioned Cooking oats are MUCH Better in cookies.

#4. Bacon. Share instructions or a recipe that you use bacon in.
PASTA WITH SPINACH, BACON AND MUSHROOMS
1/2 lb. thick sliced bacon
2 tbsp. butter
1 c. onion, chopped
1/2 c. sweet red pepper, diced
1 c. sliced fresh mushrooms
1 bouillon cube in 1 cup hot water
Salt and pepper to taste
1 lb. pasta
10 oz. fresh, washed spinach (about 4 c.)
1 c. grated fresh Parmesan cheese
Cook bacon until crisp in skillet. Discard fat. Place bacon on paper towels. Add butter to same skillet (do not wash). Saute onions and peppers for 2 to 3 minutes. Add mushrooms, saute for 1 minute.
Over high heat, stir in broth. Bring to a boil. Lower heat and simmer for 2 minutes. Taste and add salt and pepper. In a large pot, cook, then drain pasta well. Return pasta to pasta pot.

Add the vegetable sauce and spinach. Toss over medium heat until spinach is wilted and most of the sauce is absorbed. Divide onto 6 plates. Top with crumbled bacon and Parmesan cheese.

2k9 MEME

2009-01-01T16:31:00.006-05:00

I got this MEME from O, who got it from All & Sundry. It's my last day off for the next five, so I figured what the hell-let's waste some time on the computer.

1. What did you do in 2008 that you’d never done before?
took the GRE's

2. Did you keep your new year’s resolutions, and will you make more for next year?
Is it a bad sign that I can't remember if I made one last year?

3. Did anyone close to you give birth?
two of the nurses that I work with, two of the girls I went to highschool with, and Anjali

4. Did anyone close to you die?
yes, one of my coworkers. RIP Tara. Miss you.

5. What countries did you visit?
St. Martin, St. Barts

6. What would you like to have in 2009 that you lacked in 2008?
Sleep and a social life; weird combination I know.

7. What dates from 2008 will remain etched upon your memory, and why?
December 19th- best Christmas party ever!
December 1st- I dischared the first pediatric trauma that I ever admitted
June 14th- I fractured my pelvis

8. What was your biggest achievement of the year?
Staying healthy

9. What was your biggest failure?
Not staying in touch with my friends becuase of my crazy schedule

10. Did you suffer illness or injury?
Fractured Pelvis

11. What was the best thing you bought?
My blackberry

12. Whose behavior merited celebration?
Amy: new job as a VP= all grown up

13. Whose behavior made you appalled and depressed?
The parents of my patient who pressed their child's face against the radiator. It made my blood boil.

14. Where did most of your money go?
Rent, rent, rent. Did I say rent?

15. What did you get really, really, really excited about?
The prospect of getting a permenant day position (too bad it was only a prospect).

16. What song will always remind you of 2008?
I don't know.

17. Compared to this time last year, are you: 
a) happier or sadder? neither, I'm content
b) thinner or fatter? fatter and it's really stressing me out
c) richer or poorer?Richer. That's what happens when all you do is work and have no time to play!

18. What do you wish you’d done more of?
Stayed in touch with my friends, gone to church, slept (in no particular order)

19. What do you wish you’d done less of?
Stressing over the future

20. How did you spend Christmas?
At work. Hospitals never close.

21. Did you fall in love in 2008?
Someone won my heart over, but then broke it.

22. What was your favorite TV program?
The Biggest Looser (a guilty pleasure, I know).

23. Do you hate anyone now that you didn’t hate this time last year?
No.

24. What was the best book you read?
Quantum Wellness

25. What was your greatest musical discovery?
Our tiny little bathroom has great acoustics for shower singining

26. What did you want and get?
a complement

27. What did you want and not get?
a permenant day position

28. What was your favorite film of this year?
Rachel at the Wedding

29. What did you do on your birthday, and how old were you?
I worked, but at least Dr. MAtt was there *cue the dreamy music*! I turned 24.

30. What one thing would have made your year immeasurably more satisfying?
Working days so I could see more of my friends and family, sleep more, and make dating easier

31. How would you describe your personal fashion concept in 2008?
Hospital issued 50/50 Cotton, Poly scrubs; gym clothes; a conglommerate of J.Crew, Gap, and Bloomingdales

32. What kept you sane?
Escapes to the suburbs to see the L's or my family, late night talks with Natasha or AMy, and Wednesday Night Dinner Club

33. Which celebrity/public figure did you fancy the most?
I can't decide if the numerous adoptions and procreations of Jolie-Pitts is admirable or insane

34. What political issue stirred you the most?
The shit show otherwise known as our health care system

35. Who did you miss?
My family, my sorority sisters, Sarah, Memegrl and family, Shestartedit and family

36. Who was the best new person you met?
Cheryl. I'd be lost without her friendship

37. Tell us a valuable life lesson you learned in 2008.
Life is best lived with a little spontaneity.

38. Quote a song lyric that sums up your year.
Don't get all worried but if you remember this post, I'd say these lyrics just about sum it up:

What's wrong with me?
Why do I feel like this?
I'm going crazy now

No more gas, in the red, can't even get it started
Nothing heard, nothing said, can't even speak about it
On my life, on my head, don't wanna think about it
Feels like I'm going insane, yeah
-Rihanna, Disturbia

9 things About Me for 2009

2009-01-01T10:00:00.003-05:00

1. I like green grapes but red wine
2. I can't fall asleep with dirty dishes in the sink
3. I can wiggle my ears
4. I don't play any musical instruments
5. I haven't eaten meat in 8 1/2 years
6. When applying to college I was torn between architecture and nursing
7. I floss after I brush
8. I prefer flats to heels
9. I'd rather go to bed at 10pm and be up at 5am, than go to bed at 1am and sleep till noon.

the final countdown

2008-12-21T08:58:00.006-05:00

Christmas is in less than four days It's three days, fourteen hours, and two minutes to be exact, but who's counting, right?

Per usual, there has been no rest for the weary. I worked four days this past week and they were no less exciting than my previous post. Also, I made a mad dash from work on Thursday night to get across town to babysit. That was fun in rushhour, not! Thankfully the R's were home before midnight, so getting up at 4:44a.m. for the gym and work on Friday wasn't impossible. Friday night was our Christmas party. Now it's a well known fact that us nurses love to party and have a good time...sometimes just a wee bit too much. That's what happens your life is more work than play -the play is way overdone.

Our party was nothing fancy, nor was it free. It was at a local bar that many of us go to frequently. For $30 we had 4 hours of open bar from 8-12. I was determined to get there early this year because last year I missed most of the party while waiting for N to dilly dally getting ready. Too bad my plan wasn't quite in line with the hospital gods. I had to work Friday day but I figured I'd be out by 7:50ish. Or not!?!?. Brief recap of what happened between 4:30 p.m. and 8:45 p.m. when I finally left work.

-Four patients came back from the OR
-One patient got discharged
-Two patients arrived from outside hospitals as transfers that were so not necessary
-A patient needed to be transferred to the pediatric floor but had no family at the bedside to travel with them
-A patient was extremely hypotensive and had a critically low Hemoglobin and Hematocrit (5.5, 15.5!!!). Said patient needed to be transferred from a stepdown room into an ICU room and get two units of blood rapidly transfused. But first needed to have a type and screen sent because the initial one expired. The type and screen was sent but one line of the sheet wasn't signed so the lab rejected and threw out the sample and another one had to be sent (have you ever tried to get blood from an exceptionally hypovolumic person?) I'm still in shock that I go an IV into their arm. Additionally the cardiac monitor was not working in the patients room so they had to be on a portable monitor.
And the most exciting, although rather traumatic...
-A patient blew their anatomises and ruptured their carotid artery. You know those scenes on TV where blood is squirting out everywhere? Real life is way more intense! After that patient got rushed to the OR, and I settled the patient with the low H&H into the room, and I transferred the patient to the pediatric floor, and I did the admission history and assessment on one of my new admissions, and gave report to the night staff on my other patients, I rushed home, took a 49 second shower, put on my new party dress, straightened my hair, and hopped in a cab to my party. I arrived at 9:20 p.m. Now that people is a speedy party prep!

I was barely in the door and someone put a drink in my hand, followed by another and another and another. I'm a two drink drunk on a good day, so four drinks on an empty stomach meant the super chatty, quick witted,flirty, confident Kelly was out in full force. I don't know where the night went. Before I knew it, the party was coming to a close and it was close to 2am. As I left, I think I hugged and kissed on the cheek every firefighter that was there, plus all my coworkers-even the ones who I only sorta like, haha. Two, very nice, older, as in could be my father old, firefighters walked me out and got me a cab home. My party dress was barely off (that sounds so dirty) and I passed out. I didn't wake up until 10:30 Saturday morning and, to be quite honest, I wished I had just kept sleeping. My head was pounding, my throat was killing me, and my eyes were crusty with Friday night's makeup.

I managed to rally after a multivitamin and two cups of tea. And by rally I mean go to the gym for a jog, shower, and attempt to Christmas shop;however, he latter was a huge failure because with every store I walked into and saw a line, I turned on my heels and walked out. Which brings us to the present.. T-minus three days, fourteen hours, and two minutes until Christmas.

What do I have to do before then?
1. Buy gifts for: my cousin, one of our fellows, my roommate, my dad, my mom, my trainer, my grandfather, my cleaning lady, my water delivery man.

2. Mail the already stamped and addressed holiday cards (hey, the post office is 2 blocks away)

3. Bake Christmas cookies

4. Wrap the few gifts that I have purchased

5. Do laundry so I have clothes to bring home

6. Find a Christmas Eve mass AFTER I get out of work, but BEFORE midnight

7. Get in touch with the L's so I can finally give them their Christmas AND Birthday
presents

8. Book a train ticket home for the day after Christmas

9. Work Tuesday, Wednesday, and Thursday

Wow, I've got a lot to do and not much time. On that note, I'm out. Wishing you all a happy, healthy holiday and new year!

Exhausted

2008-12-14T20:56:00.000-05:00

Holy Moly, I’ve been MIA and I have lots of catch you all up on. First, the entire month of November I was feeling really down. Some days it took all the energy I had just to get out of bed. I wasn’t excited about anything, nor did I want to do anything. I even hated going to the gym or running (yes, you read that correctly). I was rather concerned. I knew it wasn’t normal to feel that way; however, I didn’t care much about anything.

When my family saw me at Thanksgiving, they thought I looked bad. My schedule wasn’t helping my case. I was working 5 nights a week, 12+ hours a night, and not sleeping more than 3 or 4 hours in between shifts. I don’t care what you say, sleeping during the day does not even compare to sleeping at night. Plus, all this exhaustion was wreaking havoc on my body.

I’m very conscientious about what I eat, how my clothes fit, my weight etc. So when my pants started getting tighter ,and I knew I hadn’t changed my eating habits or how much I exercised, my stress only increased. I finally reached my breaking point when N called, asking me to dinner, and I broke down and cried. I told her that I’m just miserable. I hate working nights. It’s lonely. It’s isolating. I can go an entire week without seeing my roommate. I don’t do that much for myself and the few things that I do (i.e. working out, running, cooking) I no longer enjoy. After an hour of her listening to me sob and sob and sob, she convinced me to go out for sushi in the Village. It was freezing cold outside, but I needed the fresh air. After another restless night’s sleep (that’s the other problem, now that I’m used to staying up at night, I can’t sleep on my days off) I called my doctor. Not being one who EVER takes medication, I now have lovely prescription for some @mbien. Magic.Little.Pill.

Even better than the fake sleep that I’ve been getting is the fact that I’m doing a month long rotation on days. It’s heaven. They’ve also been giving me a lot more responsibility at work. In addition to acting as charge nurse, I’m also precepting some of our new nurses. It’s extremely flattering to be given so much responsibility after only working in the BICU for 16 months.

My transition from nights to days was a little hairy. I worked Thursday and Friday nights, had Saturday off, then worked Sunday, Monday, Tuesday days. Despite the fact that I hadn’t worked a day shift in a year, I was in charge on Sunday, Monday, and Tuesday. Let the games begin!

I won’t bore you with the details but we were slammed with boarder patients from the PACU, two of which were extremely unstable and ended up getting emergently intubated and rushed back to the OR. One patient died. One patient coded six times over 48 hours. The repeat coder also ended up swanned (twice, after the first one was defective), had a transvenous pacer placed by cardiology, then had a GI bleed, then stopped oxygenating his body as indicated by his PO2 of 45 from his ABG.

On top of all this activity, we had another patient who came in intubated with an unknown medical history; she was found down in a house fire after smoking and drinking in bed. Turns out this lady had quite a history with IV drug use and alcohol abuse, so she was damn near impossible to sedate due to her high tolerance of narcotics. Her magic cocktail turned out to be 150mcg of Fentanyl and 50mcg of Propofol.

The above situations kept all of us doctors and nurses very busy, but I had a very emotional experience on Monday. I can’t remember if I ever posted about this patient, but back in July I admitted a five year-old boy started a house fire and ended up with 65% total body surface area full thickness burns. He was intaubted and sedated, teetering the line between life and death.

The night I admitted him, I thought-on more than one occasion- that we were going to loose him. His mother was the first parent I had to address regarding life and death. I took off all my surgical garb, took her by the hand, and walked her into her son’s hospital room. I explained, in lay man’s terms, the physiology of burns. My knees knocked, but my voice never faltered, as I told her that the first 72 hours were the most critical. I caught her in my arms as she broke down; she wept on my shoulder like baby.

I took care of this boy four nights in a row and countless times over the next few months. His hospital stay was complicated by infections, sloughed graphs, respiratory and neurological issues, but every time I took care of him I felt a sense of pride and hope. I was there the afternoon they extuabted him; I watched him take his first non- ventilator assisted breath; I teared up.

This little guy became a fixture on our unit. Everyone knew him, and he knew everyone. Two weeks ago he celebrated his 6th birthday, it was a 24-hour, non-stop party. Everyone from the attending physicians to the house keeping staff joined in the celebration. I knew he was getting better, but the idea of him leaving never crossed my mind. So when I found out that he would be discharged to rehab on Monday, my stomach knotted.

Monday morning I went into his room and had a long talk with him. I told him that although I was very sad to see him go, it was a very special day for us both. For him it marked astounding progress, for me it was a happy ending to a six month journey. I can’t begin to express how meaningful it was for me to discharge the very patient who I thought I would loose.

As I reviewed the mounds of paperwork with his mother, she looked up at me and started to cry. Much like the first night I met her, I caught her in my arms and she wept on my shoulder. However, this time her tears were that of joy not fear. She looked at me, as I wiped away her tears, and mouthed “thank you.” And it was that moment that reminded me why I do what I do. It makes the long hours, the back-breaking work, the stress, and the frustration all worth it. I must have some angels up in heaven, because this reminder couldn’t have come at a better time. Once again, I feel at peace, ready to take on whatever comes my way.

Week 58: Four Foods on Friday

2008-12-05T09:08:00.003-05:00

I'm back this week. Check out everyone else's meme entry here.

#1. Does your family usually eat meals in the kitchen or somewhere else?
Well, we eat in the living room around the coffee table. Hey, it's city apartment living!

#2. Who usually does the dishes in your house?
Me, I'm OCD about dirty dishes in the sink.

#3. What’s your favorite small appliance or tool in the kitchen?
Blender. With limied space, I use it to chop, puree, mix, and of course blend

#4. This one’s for my son. Share a recipe for chili.
Can't take credit for this one, it's from 28cooks

Tempeh Chili

1 (8 oz) pkg tempeh

Marinade
2 tbsp soy sauce
2 tbsp water
1 tbsp Lousiana-style hot sauce
1/4 tsp garlic powder
1/4 tsp onion powder
1 tbsp sesame oil

4 tbsp oil
4 cloves garlic
1 cup onion, chopped
1 tsp Italian seasoning
1 tsp mustard powder
1 tsp cumin
1 tbsp chili powder
1 tsp salt
1/4 tsp freshly cracked pepper
2 (14.5 oz) cans diced tomatoes with green chilies
1 (15 oz) can black beans
1/2 c water

In large ziploc bag, combine all marinade ingredients. Add tempeh, seal bag, and refrigerate for 1-8 hours (or longer). Grate tempeh with large grater and place into medium bowl with remaining marinade. Heat olive oil over medium-high in large pot. Add garlic and onion, and saute until almost tender, about 5 minutes. Add Italian seasoning, mustard, cumin, chili powder, salt, and pepper, and stir for 30 seconds. Add tomatoes, beans, tempeh, and water. Stir well, bring to a boil, then lower heat. Simmer, uncovered, stirring frequently, for 30-45 minutes, until chili is thickened. Serve and enjoy!

In Which I Try Something New

2008-11-28T12:12:00.007-05:00

Hold your breath. I actually had a holiday off! Yes, you read that correctly. Nurse Kelly was nowhere near New York's big medical center. When I found out that I didn't have to work, I immediately phoned my family. Instead of my mother fussing over what my travel arrangements, she laid a shocker on me. She announced that her, my father, and my sister would be traveling to New York. My first thought was "Sweet!", my next thought was, "Holy Shit. HOWAMIGOINGTOCOOKATHANKSGIVINGDINNERINMYTINYTINYAPARTMENTKICHEN???? I think my mom sensed my apprehension because she quickly said, "and how about we go out to dinner? That would be lovely."

Shocked at my mothers suggestion, I agreed an quickly set out to find a reasonably priced Thanksgiving dinner. My search took about a week. Apparently, ~~some people~~ New Yorker's don't bat an eyelash at $109/per person prixe fix holiday dinners that do not include alcohol. I finally found a place with a varied menu costing only $55/per person for a three course meal. I made a 4:30pm dinner reservation, sat back, and then thought.....what am I going to do with my family all.day.long?

This issue continued to stress me out. Did I mention that my family was going to be staying in my apartment? Yes, my roommate was going home, but at $725 a night for a hotel, I was not about to kick my family out. My stress was exaggerated because preceding thanksgiving I worked 11 out of 15 days (uh, hunh not kidding).

Before I knew it, it was last Sunday and my mom was giving me all the details (sometimes I love having a mother who's as type A as me!) They would be arriving Wednesday afternoon, probably late because my sister was playing in the powder puff football game and they couldn't leave Boston until 11 and they were anticipating mucho traffic. My mom then suggested that we go see the balloons be blown up for the parade. So touristy, she and my dad both wanted to check out the Macy's Day Parade on Thanksgiving morning. We'd wing the rest of their visit. In my state of exhaustion, I just agreed and went about the week.

Before I knew it, it was Wednesday at 2pm and my family was buzzing my apartment. Wow! They made it in record time. I went down to help them bring in their stuff. My jaw almost hit the floor when they showed up: two jumbo suitcases, pillows, tools (I needed my dad's drill), gift bags, garment bags, etc. You would have though they were traveling overseas. I soon learned that one entire suitcase, plus one of the duffel bags was full of my sister’s clothes (oh to be 16). They came up and settled in. I must admit, I was having a mild anxiety attacked with their stuff everywhere, but I played it cool.

After catching up, we humored my mothered and headed off through the park to the west side to see the balloon inflation. Direction said to check them out between 77th-81st on Central Park West. Umm, so weren’t we surprised when we were looped up to 81st, across CPW to Columbus, across Columbus, down Columbus to 78th, back across Columbus, down to 77th only to realize that if we wanted to see the balloons we would essentially have to walk that same route AGAIN, except in the opposite direction on Central Park West. Oh the crowds! It was insane. Umm, at that point, we threw in the towel and decided to get something to eat. We were right at Isabella's so I tired to go in and check out the wait time. But I couldn’t get past the cop who told me the restaurant was booked until 10pm. And off we went down to 72nd so we could go back acorss the park. And we walked and walked and walked. My mom said a few times, “Kelly, where are we going? We are going in circles."

I really hadn't been paying attention, as we were talking all the way. Suddenly I noticed this LARGE, long building. And then I stopped, dead in my tracks, and laughed. We walked to the street corner "85th and 5th." Whoops. We had accidentally walked diagonally through the park up to 85th! At least we were back on the East Side!

Famished, we headed to a big Italian family style restaurant. We were seated promptly. We all needed a drink, so we ordered a pitcher of Sangria. Doesn't the waitress come back to the table, with our huge pitcher of yummy sangria, and say, "Four glasses, right?" My mom tried to prevent her jaw from hitting the floor. The waitress poured the four glasses and walked away. That's when Colleen, picked dup her glass and said, "Cheers!" She's sixteen! Not wanting to make a big deal my parents let her drink it, after all it was in a controlled environment, but it was just comical.

At this point it was time to order out food. Being the only vegetarian in my family, and this was a family style restaurant, I pretty much stayed out of the conversation and said all I wanted was some linguini and steamed broccoli. My family all agreed on chicken parmesan but for some reason my sister was putting up a fight over the veal. She lost the battle and my parents ordered a half size portion.

When the food came, there were lots of plates on the table. After some rearranging the veal parmesan ended up in front of my sister. I jokingly offered her some and she looked at me, dead serious and sad, "You know I don't like fish!"

My parents and I burst into laughter. My sister, the child prodigy seriously thought that veal was fish. After a good chuckle, we ate our meal and drank our sangria-all four of us.

It had been a long day, so we came home, put on our pajamas and lounged around. Sleeping arrangements were interesting. My sister and I slept on my roommates bed, my mom slept in my bed, my dad slept on the blow up aero bed. None of us slept well. It seemed like had just gone to bed when my dad pops his head in at 6:40 a.m. and announced that it was time to get up. We threw on clothes and headed off to the West Side to see the parade. We were at 72nd and CPW by 7:15 and the parade didn't begin until 9.

The streets were PACKED. People were pushing, shoving, yelling, moaning, and groaning. We ended up finding a spot behind a relatively open area, closed for CNN VIP's. We thought we hit the jackpot. Boy were we wrong. Turns out, this was also the spot to enter and exit the viewing stands for the porta-pottys. For the next two hours and all through the parade we were shoved, pushed, and untimely sandwiched in between two trash cans and six porta-pottys. We didn't even get to see Santa because they ushered us out of the area so they could clear the stands. We trekked home cold, but not defeated. Many of our friends texted us that they were looking for us on TV and asked us how the parade was live. We texted back to look for the porta-potty's and that the parade probably looked better in HDTV.

Walking home, we decided to stop and get breakfast and bring it back to my apartment. For most of the afternoon we lounged around. My sister napped and then we all showered and got ready for dinner. We decided to walk 30 blocks to the restaurant and worked up an appetite. Seated promptly, the meal was delicious from start to finish. We took a cab home. Then came what I dreaded most...a lull, with nothing to do.

We flipped back and forth on the television but nothing was appealing. It was only 6:45, but I put on my pajamas curled up on the couch and fell sound asleep. I woke up a few hours later and crawled into bed. The following morning I could smell fresh brewed coffee and freshly toasted bagels. I was quite impressed that my family finagled their way around my kitchen AND ventured outside to the bagel store. It was a bit comical when my dad opened the refrigerator to get cream for his coffee and all he saw was soymilk and opened up the sugar jar only to find splenda. Sorry dad. However, the best part of waking up was walking into my living room and seeing my little Christmas tree all decorated. It warmed my heart.

After my family showered, they packed up the car and left. I got a wee bit emotional but I know I’ll see them again in a month. Although this past Thanksgiving was different from any other holiday I've experienced, it was great to try something new.

Taste of Something New

2008-11-23T09:28:00.000-05:00

Maybe it's because it's almost Thanksgiving, or maybe because it's chilly outside, or maybe because I've had two days off in a row (cue to choirs!!), but whatever the reason I've been playing with the foods inside my ~~pantry~~ food cabinet. I had a can of pumpkin, a bag of craisins, and some rice that I wanted to use.

Here's what I created...

Pumpkin Cranberry Risotto

1 onion. diced
1 tbsp olive oil
2 cups arborio rice
1 cup white wine
4 cups vegetable broth
1 1/2 cups canned pumpkin
1/4 cup real maple syrup
1 tbsp orange zest
1 tsp nutmeg
1 tbsp margarine
salt and pepper to taste
1 cup craisins

Mix pumpkin, orange zest, and maple syrup and place into 350 degree over for 20 minutes.
Sautee the onion in olive oil over medium heat until soft.
Add the rice. Allow to cook, stirring, for a minute or two. Slowly add the wine- CAREFUL when pouring alcohol onto heat.
Add the vegetable broth, 1/2 cup at a time, allow the moisture to cook off before adding the next 1/2 cup. Stir frequently. Add in salt and pepper.
Once all the liquid has been added, fold in pumpkin mixture, nutmeg, margarine, and craisins.

Enjoy!

Four Foods on Friday

2008-11-22T09:02:00.002-05:00

I'm running late with this post again. I need a vacation! But nevertheless here are this week's questions

#1. What’s the worst tasting food you’ve ever eaten?
That would be Walden Farms fat free, calorie free peanut butter. Yes, you read that correctly It was metically tasting and sharp smelling....kind of tasted like fertilizer smells. I should have known that it sounded to good to be true.

#2. Share a funny or embarassing story about a meal you’re made.
Um, the huge bath of pumpkin bread that I made for the holidays two years ago. I accidentally grabbed the paprika instead of the cinnamon. You should have seen my grandfathers face when he took a bite.

#3. What food do you burn or have problems cooking most often?
I said it before, but I cannot make brownies. I've tried to make them from scratch and from the box but never had any luck. They are mushy in the center and charred on the edges. MAybe it's my pan??

#4. Name two foods you’ll be eating on this Thanksgiving.
We're trying something new this year. My family is coming into New York (yay!) and we are going out to eat. Here's our menu selection:

SOUP
Soup of butternut squash, hazelnut, apple and roasted seckel pear

SALAD
Organic baby mesclun mix, toasted walnut and fall squash vinaigrette

ENTREE
-Crisp skin long island duck breast, sweet potato and maple puree, garlic sauteed brussel sprouts
-Whole wheat rigatoni with fall vegetables, fresh red and yellow tomato sauce, roasted olives
-Roasted organic amish turkey, sweet potato puree, brussels sprouts, cranberry chutney, chestnut stuffing, mashed potatoes and giblet gravy
-Stuffed farfalle with sundried tomato pesto, grilled sweet italian sausage
-Slow braised beef short ribs with cheddar cheese mashed potatoes, roasted root vegetables
-Fennel crusted north atlantic salmon, scallion and celery root mashed potatoes, warmed grapes and caperberries
-16-oz ny strip steak with roasted garlic and herb butter, crispy french fries and belgian dipping sauce
DESSERT
-Machintoch apple, cinnamon raisin cobbler with cinnamon ice crem
-Individual pumpkin pie with fresh chantilly cream
-Flourless chocolate souffle with vanilla bean ice cream
-Italian blood orange sorbet

Want to join in? Check out the FFoF Meme HERE

4 Foods on Friday-Thanksgiving Edition

2008-11-14T12:13:00.003-05:00

Hard to believe it's already mid-November and that Thanksgiving is 2 weeks away! See what everyone else is drooling over on their Thanksgiving menu....

#1. Stuffing. Boxed or from scratch?
Boxed, but all doctored up with apples, celery, craisins, and onions

#2. If you were served the perfect Thanksgiving dinner what would it be?
Well, mine would have no meat, but the ideal Thanksgiving meal that I would serve to all my carniverous friends and family would be....Roasted turkey with hickory maple rub, stuffing (see above), mashed sweet potaotes with crushed pineapple and cinnamon, steamed green beans, sauteed spinach with garlic, homemade chunky cranberry sauce with fresh grated orange zest, and warm fresh baked honey wheat bread

#3. What’s your favorite Thanksgiving leftover?
Sweet potatoes reheated in the oven with just a dab of maple syrup

#4. Share a recipe using turkey.

Turkey Gobble-Up

1 large ripe avocado, peeled, pitted
1 tablespoon lemon juice
2 tablespoons mayonnaise
2 tablespoons sour cream
1/4 teaspoon hot pepper sauce
12 slices cooked turkey breast meat
12 slices tomato
12 slices American or cheddar cheese
12 strip bacon, halved, cooked, crumbled
6 English muffins, split and toasted

In a small bowl, mash the avocado; add lemon juice, mayonnaise, sour cream and hot pepper sauce.

Spread over muffin halves; top with turkey, tomato, cheese and bacon.

Broil 6 inches from the heat for 3-4 minutes or until cheese begins to melt.

Yield: 6 servings.

Thrifty In the CIty

2008-11-13T09:15:00.005-05:00

Just about every blog that I ~~stalk~~ read has been posting on ways to save money. And let's face it, with the state of the economy, it's a good idea. Here's my two cents...

One of the greatest gifts my parents gave me was instilling me with a strong work ethic, emphasizing that money doesn't grow on trees (at least not in our backyard). I received an allowance, but only when I did chores. My parents had this " Three Can System." I got $15.00 a week, but I had to divide it three ways (spending, savings, special). At the end of every month I had to put the "savings" into my bank account and was given a choice about the "special." Some months I chose to add it to my spending money, but other months I put it in the bank to earn the interest and get "free money" (i.e. interest). I was so used to this savings method, that when I got my first job, I didn't bat an eye at putting my pay checks in the bank. I made great tip money, so I used that as my spending and gas money (back in the day when gas was $0.99/gallon) ::sigh::

Flash forward to college. Not going to lie, I went to college with kids who came from money. I swear, some of them had mobiles of dollar bills hanging over their cribs as babies. I'll never forget the day I was shopping in Rittenhouse Square and one of my friends whipped out mommy and daddy's AMEX to pay her $200 charge at J.Crew. I mean, yes, I too had one of my parents credit cards but it was for things like groceries, plane tickets home, etc. I came from a modest background. My parents both worked and my sister and I never wanted for anything, but we didn't live beyond our means. My parents didn't bat an eye at footing my tuition bill (all $200,000) of it, but they weren't about to pay for frivolous, spur of the moment shopping sprees. I worked on campus in student services and babysat all though college to earn my spending money. Yes, it sucked when I saw my bank account getting down to single digits by the end of school year, but I had a summer of work to replenish my account. It was a good system that I had worked out. In college, in addition to my parents credit card for necessities, I got my own credit card to build credit. I didn't charge much to it, but I always paid it off in full at the end of every month. I got countless offers in the mail from companies each trying to offer the biggest and best rewards with 0% interest on balance transfers, but I politely shredded each and every one of them.

Then I graduated from college. Suddenly, I was a grown up and found myself moving to one of the most expensive cities...New York City! When I got my job offer, I was tickled pink with my starting salary. Trust me, it was WAY more than most of my friends would be making with the exception of a few investment bankers. My enthusiasm started to dwindle when I realized that I'd be spending upwards of $22,000 a year on rent. Add to that food, travel, and fun oh yeah and all of this AFTER taxes! Suddenly felt more like a popper than a princess.

Even though all this overwhelmed me, my childhood habit of saving persevered. I set up both a savings account and an IRA, and after my 3rd month of work I started putting money into both accounts. Our hospital doesn't have a 401k, we have a 403b which they don't match, because they invest into their own plan for each employee, so that’s why I choose the individual IRA. I set up a budget and tried my best to stick to it. It took a while to figure out how much was reasonable to budget, but all my time and efforts paid off. I made lists of the foods that I ate frequently and went around to all of the little markets in my neighborhood to compare prices. I made an excel spreadsheet (yes, I'm that anal) and figured out where I could get what for the cheapest price. Thankfully, anything and everything that I could possibly ever need is within walking distance or only a few subway stops away. I cannot express how thankful I am not have to fret over gas prices. My price comparison experiment proved interesting. I found out that it's cheaper to buy fresh organic produce at the local farmers market than it was to buy regular produce from the mass chain grocery stores. I also quickly realized that buying coffee on the run, as metropolitan as it may seem, is completely UNeconomical.

There were a few issues that still bothered me though. #1-the cost of toilet paper, laundry detergent, cleaning supplies, etc; #2-the inability to buy in bulk due to location; #3-the inability to by in bulk due to space/storage limitation; #4-a lack of coupons.

Although strange, I am a 24 year old who cuts coupons-usually for things like laundry detergent, toilet paper, personal products, etc. Theoretically, it's a good way to save money; however, coupons only come out in the Sunday newspaper. The Sunday new paper costs $4.00. Most weeks the savings I'd accrue would only be about $3-$4, thus it doesn't really make sense to pay for my coupons, especially because I wouldn't otherwise buy the paper. I read it online in my continued effort to be more "green."

Okay, so what about buying in bulk? I can say this, with certainty, because I did the research. For items that I use on a daily basis- toilet paper, paper towels, soy milk, peanut butter, rice cakes, tea bags, coffee, shampoo/conditioner, the bulk cost is about 50% less than buying the individual items, at least at city prices. But did I mention that there isn't a Costo/BJ's/Sam's Club in a reasonable distance from here? Oh yeah, there isn't even a T@rget close by. Grrrrrr. Thus I have to rely on visits from my parents to bring me these essentials. Which brings me to the issue of storage. What to do? Buddy up! My friend N and I split the bulk items. So we get the savings of buying in bulk, without having to fret over the storage!

Now some of you may be aghast that I list paper towels as a necessity, but the nurse in me must object. Hand towels are DIRTY, nasty breeding grounds for germs. Don't believe me? Read this Okay, so what if I changed the towels every day. Well by the end of the week, I'd have 7 towels from the kitchen and 7 towels from the bathroom- that's a load of laundry. The cost of laundry is $2.00 to wash ad $2.00 to dry. Paper towels, at $1.07 per roll x2 rolls per week, is by far a cheaper and cleaner option for a household of two.

Finally, I still have the same one credit card from college. Every week I a lot myself $50.00 for "free spending" (this includes meal out and cabs/transportation) and I take this money out in cash. All other spending (i.e. groceries, gym membership) I put on my credit card to track exactly where, when, and what I'm spending money on. I pay off my bill in full at the end of every month. My credit card has great reward options. In fact, I was able to get my roundtrip ticket to Seattle for free, plus still have more than 1/3 of my rewards left over.

This post has been all over the place. But I hope that it has given you some perspective on how I live thriftily in the city.

leaps and bounds

2008-11-10T21:13:00.005-05:00

Call me crazy, but when I walked into my patient's room and saw all this, I got excited.....

Salem Sump to wall suction- bilious drainage

Jejunostomy tube- acting as feeding tube with Osmolyte @ 60cc/hr

Trachestomy- #6 shiley, cuffed

Right femoral arterial line

Right femoral triple lumen catheter- Brown: CVP; Blue: Insulin, TPN, & Lipids; White: Ativan, Fentanyl, Dopamine,& Levophed

Left femoral triple lumen catheter- Brown: Sodium Bicaronate; Blue: Polymixin/Tobramycin/Linezolid; White-heparin drip

Foley Catheter-transducing bladder pressures

Rectal tube-(ah, do you need a description?)

Wound Vac to Abdomen

Wound Vac to right and left foot

3 canisters to wall suction- weeping wound bed drainage

There was a point in time, not too long ago, where patients like this made me shudder with fear. However, at some point in the last 16 months, I became a nurse- a real nurse. One who's excited at the challange of caring for the sickest patients, helping them along the fine line between life and death. Yes my loyal readers, it's all coming together.

Won't You Be Are You My Neighbor?

2008-11-08T11:10:00.000-05:00

I live in a building with approximately 60 apartments but only one elevator. Given that there about as many studios as there are two bedrooms, plus a few three and four bedroom apartments, there are about 100 people living in my building. So what I want to know is why I only ever see the same people in the elevator. It's not like I'm a hermit and never go out. I'm in and out of my aparmtnet at all hours of the day (and night). I've worked different shifts (day and night)...but I swear I only see the same 20 people. When I posed this question to my roomate, who has lived here longer than me, she agreed with me. She did offer that maybe people take the stairs, but I quickly pointed out to her that I, too, frequently take the stairs (um, one elevator for 10 floors= a long wait and I'm just not that patient).
Maybe this would have been more appropriate at the beginning of this entry, but I began to deeply ponder this subject when two days in a row I let the building's door close in the face of my "neighbors" (mind you I have never seen them before). It was quite embarrassing.

Apartment culture is different from that of a neighborhood. People don't come knocking on your door to bring casseroles or freash baked cookies. In fact, unless you are really chummy with the people moving out, you may not ever notice that the apartment has changed owners.

What about you? Have you moved to a place ad wondered who your neighbors are?

Week 54 of FFoF

2008-11-07T16:10:00.002-05:00

My life's been sorta hectic lately and I feel like I've been neglecting my blog. I'm trying t get back in the swing of things. However, why don't you pop on over to Fun, Crafts, and Recipes to check out a blog that's always updated.

#1. Name a food you like that uses a red sauce or anything red in it.
Garlic Roasted Spaghetti Squash with Chunky homemade red sauce, yum!

#2. Name a food you like with whipped cream in it or on it.
no food necessary, I'll eat it right out of the can (so lady like, right?)

#3. Name a food you like with blueberry in it.
Lemon Blueberry Muffins

#4. Share a recipe for pasta or dessert or a beverage.
Capellini with Roasted Vegetables inspired by WholeFoods

Ingredients
8 ounces capellini pasta
1 (8-ounce) bag cippolini onions, peeled, diced
10 whole garlic cloves, peeled, split in half
Freshly ground black pepper to taste
2 teaspoons extra virgin olive oil
1 large fennel bulb
3 large roma tomatoes, cut in 1/2 inch pieces
1/4 teaspoon dry whole oregano
Pinch crushed red chili flakes
1 cup red wine
1 tablespoon balsamic vinegar
1/2 teaspoon arrowroot
4 teaspoons romano cheese (optional)

Method
Preheat oven to 375°F. Place onions, garlic, and pepper in a glass baking dish, toss with olive oil. Bake 15 minutes, stir, bake 15 minutes more. Stir in fennel, tomatoes, oregano, chili; bake 15 minutes. Add wine, vinegar, and arrowroot; bake 25 minutes. Prepare pasta according to package instructions. Serve vegetables and sauce over pasta; sprinkle with cheese.

Just Putting It Out There

2008-11-04T10:44:00.003-05:00

I FINALLY had a night off last night, meaning that I got to sleep in this morning. For all those of you lucky enough to work days, you have no idea how exhausting working night can be! Nevertheless, I went to bed at 9:30 last night and slept until 9:30 this morning. A whole 12 hours! WOW! That's 3 1/2 times MORE sleep than I usually get...kinda sad, right?

But I digress. I made some coffee and settled onto the couch under my big fluffy blanket to watch some morning television. After an uneventful LIVEwithREGISandKELLY came the RACHAELray show. Yeah, she can be hoakey, and a little quirky, but she is harmless. She's best known for her 30minuteMeals, but the cooking segments on her talk show are usually pretty okay. Maybe it's just me and my semi health conscious perspective, but today's meal was just wrong. Her inspiration dish was the Cobb Salad (aka lettuce + ~~blue cheese, bacon, chicken, avocado, creamy high fat salad dressing~~calories galore. What did she do to it? She turned it into Cobb Pasta. So let me get this right, she replaced the one low calorie item (lettuce) with a much higher calorie item (pasta). I guess she was trying to "winterize" the dish by making it a hot one, but still it's over the top. Props to her on the creativity, but with the holidays coming and most people wanting to look sleek in that little black dress (or pants suit) we really don't need this calorie overload. Furthermore, I'm not sure if I even like the idea behind this pasta concept. A signature of the Cobb Salad is the conglomerate of textures-crunchy, creamy, and moist. Why wreck a good thing?!?

Maybe you disagree. Maybe you are salivating over her dish. But I'm just sayin' Ms. Ray, I think you have outdone yourself this time.

Restless

2008-10-31T21:40:00.001-04:00

Do I have it in me? Can I do this? Will this make me happy? Oh the debt?!?!

I've been very hush hush about this, but I figure it's time to let the cat out of the bag. I'm going back to school. Actually, currently, I'm applying to programs. I spent most of September and October prepping for the GRE-not fun, took the GRE today-temerity, pure temerity, and now I'm polishing my essays. It's a wee bit stressful, all of this waiting and prepping, but I'm excited for the future. After much debate about what degree I wanted-MSN?, MBA?, MPH?- I decided on the MPH. Careful research lead me to schools with excellent programs and the option of a joint degree...just in case I'm bored and want to really have no life.

When I moved to New York, I had a two year commitment. Hard to believe that it's been over a year, time sure does fly. As luck may have it, when the 2009 fall semester begins, my commitment will be fulfilled. It's not that I want to leave the bedside, who wouldn't want the glamour of bedpans and bodily fluids, but I'm frustrated with my job. I feel stifled. I show up to work, do my job, learn as much as possible, but then I think about my patients and the plights that brought us together. I'm sitting there, taking patient histories, speaking with the fire and police departments, ruminating over what could have been done differently. Was there access to healthcare? Was there a language barrier or a knowledge deficit? Did socioeconimic status play a part in the accidnet? Regarding a MPH degree, I hope to focus on injury prevention while working to not only expand health care but also increase the ease of accesibility. Sure it's easy to grant someone the right to health care, but what if they don't have a car to get to and from, or if they work 3 minimum jobs to make ends meet and can't take time off? These are all things that you and I take for granted.

So where am I applying?
Columbia, Harvard, Yale, and Emory. Columbia, Yale, and Emory all have the options for a MSN/MPH or MPH/MBA dual degree, and although Harvard only offers the latter....I figure it would be cool to at least say, "I got into Haaaaavaad." (Maybe my Boston accent will return?)

All of the schools have unique opportunities-

Columbia- uh, location? I won't have to move! Dual degree with a great nursing program, opportunity to work with a professor who currently has a NIH grant in exactly what I want to focus on.

Yale- a super unique MPH with a concentration in health management. 1/2 business classes, 1/2 MPH classes. It's like a 2 -for-1 degree! Plus, I'm still only an hour and a half ouside New York, and I'm also only an hour and half from my family in Boston.

Harvard- my hometown ad my family! Opportunity do do research with their prestigious Medical school. Plus, to quote one of Memegrl's friends, "Going to Harvard is like getting "SMART" tattooed on your forehead

Emory- warm climate! Slighty cheaper tuition than the above mentioned schools. Uh, best of all the CDC is like righ tin their backyard! And for someone getting a degree in public health, the CDC is not an amazing resource but also incredible opportunity for making conection. Plus, I'd be close(er) to SheStartedIt's family and I sure do miss them!

A recurring theme, if you hadn't already noticed, was the issue of location. Although living in New York is great-where else can you get a whopping 400 square feet for $1700 a month?!?!?!-I'm not sure if it's worth staying and foregoing a amazing education opportunity. Tons of my friends from college live here now, but many of them are either in schoool or going back to school, so everyone is living in limbo. LC, MD (2nd years) and LR (1st year) are currently in law school, EM is starting law school in the fall, but hasn't decided where yet. Three of my friends from work are in grad school at Columbia and only working part time, but aren't sure if they will stay here after graduation. I have a friend in Dental school at Columbia, one in medical school at NYU, and another one at NYU's nursing school. See how complicated this is? I know most of you are probably thinking, quit whining, but true to my Type A-ness, I want to plan everything out and have it go smoothly.

Late one night at work, my friend K gave me some great advice. He told me that although many of the schools don't require it, to reqeust a personal interview. That way, I can get a better sense of them and they will get a better sense of me. It's easy to forget someone on paper, but when you have face to put with all that paperwork....

This is just the beginning of my journey, and I'll be sure to keep you updated. Any suggestions, advice, comments are welcome.

*Look out people, some day you are going to see Nurse Kelly changing the face of healthcare.* Now there's a bombastic comment.

Things 1 through 13

2008-10-30T15:29:00.007-04:00

A letter to my patients:

To all of you who managed to burn yourself, be it by tragedy or plain self stupidity, I'm giving your fair warning Nurse Kelly may not be her usual cheery self this weekend. Don't get me wrong, I love my job and I'm usually pretty OK with getting shafted and working ~~the shitiest hours~~ weekends, but this weekend is the one weekend that I wanted off. Not only are all of my sorority sisters venturing back to Philly for a ChiO reunion, it's Penn's homecoming football game, but also by some miracle of God, the Phillies won the world series this week and there is a huge victory parade tomorrow. It's torture that I'm stuck here in New York with all that fun stuff going on. Here's a quick run down of what I'm going to be missing, in chronological order, except for maybe a few additional stops at Allegros for 40's..

1. Phillies Victory Parade

2.ChiOmega reunion

3. Happy Hour at Mad4Mex

4. Halloween Party @ Bone's apartment

5. Drunken Spectacle at the Blarney Stone

6. 7 am Mimosas at SMOKES

7. CHiO Homecoming brunch

8. Keg stands, 40's, and bottles of Andre in "the lot" @ 4047 Spruce

9. Stumbling to Franklin Field to throw toast on the field at PENN's homecoming football game

10. Power nap before going out again with the girls

11. Allegros and/or Greek Lady at 2am

12. Waking up wondering why my feet are black then remembering that I spent most of the night singing, dancing, and playing
beirut and flip in the Pike basement

13. Eating brunch at Izzy and Zoes

Sigh....I guess there is always next year.

Best Salad Ever

2008-10-28T14:25:00.000-04:00

After a great run yesterday morning and a few hours of studying, I was restless and decided to run some errands. I figured I'd head downtown to run a few errands. So I walk to the xxth street subway stop, swipe through the turnstile, ad then hear: "Due to someone needing medical attention at xxth, all local 6 downtown bound trains are halted. We are sorry for the inconvenience." Aww, gee thanks.
I walked out and asked the man at the ticket counter if there was another way for me to go downtown. I told him that I needed to get to Union Square. After he rolling his eyes and letting out a big sigh (uh, isn't this your job jacka$$???) he said, "Well, you need to take the local 6 train uptown one stop. Transfer to the 4 or 5 express, and then take it downtown to Union Square."

45 minutes later I made it down to the UnionSquare Farmers Market. My top priority was picking up a birthday treat for my dad (he's obsessed with this chunky orange marmalade from Beth's Farm Kitchen) but of course, this particular stand is only there on Friday and Saturday.

Not wanting to waste the trip (and what it a travel adventure it was), I perused the fruit and veggie stands. I went a little overboard and bought way more produce than I could comfortably carry home. By the time I arrived home, I had worked up an appetite from carrying the heavy bags. I immediatly got to work chopping, slicing, and dicing....

-baby spinach
-1 baby zuchini, diced
-2 medium carrots, grated
-1/4 avocado, diced
-1/4 baked sweet potato, cubed
-1/2 cup cherry tomatos, chopped
-1 small cucumber, halved and seeded
-1/2 cup jicama, chopped
-1 cup blanched broccoil, chopped
-1/2 cup white mushrooms,chopped
-1/4 cup purple onion, finey diced
-1/4 cup corn
-1/2 Fuji apple chopped

*I tossed in some dry roasted edamame for a little crunch
and dressed it with some sesame miso dressing.

Although I didn't get what I set out to buy, I was able to make the best of the day and now have a yummy salad for lunches and dinners this week. And on that note, I'm off to work.

Four Foods on Friday

2008-10-24T22:00:00.002-04:00

It's that time of the week again! Check out this meme here:

#1. Name something you use cream cheese in/on.
Blush pasta cream sauce

#2. Do you use yogurt in any recipes?
Yup. I use it as a substiute for sour cream.

#3. Macaroni salad. What do you like/put in yours?
cucumbers, grape/cherry tomatoes, chopped carrots, chopped purple onion- with Ken's light Ceasar dressing

#4. Share a recipe that you use sour cream in.

Summer Tomato and Crab Salad- from Wh0leF00ds
2 1/2 pounds ripe heirloom tomatoes, cored and chopped
1 pound cooked crab meat
1/4 cup chopped chives
1/4 cup lemon juice
1 teaspoon lemon zest
Salt and white pepper to taste
3/4 cup low fat or regular sour cream
2 tablespoons chopped dill
1 tablespoon Dijon mustard

Method
Put tomatoes, crab, chives, lemon juice, zest, salt and pepper into a large bowl and toss gently to combine; set aside. Stir together sour cream, dill, mustard, salt and pepper in a small bowl.

Spoon tomato and crab salad onto plates and serve with dollops of the dill sour cream on the side.

Take A Step Back

2008-10-21T17:47:00.004-04:00

The following is a link to a blog- the blog of a fellow nurse, an alumna of my alma matter, a mother, and a victim to scleroderma. In one of her final blog entries, now published in the Washington Post, she captures something I've yet to put into words.

Diary of a Dying Mom

Please check it out.

Although I didn't personally know Michelle, her touching story and heartfelt words will forever linger in my heart. Both she and her family will remain in my thoughts and prayers.

Always an Adventure

2008-10-20T21:44:00.001-04:00

Dear Mr. Cab Driver,

First let me commend you on your driving skills. You ability to from 0-60 in between lights is astounding and putting the car in park at every light? Fabulous. Can we discuss your cologne? Maybe I'm wrong, but you drive the cab to work, not find a wife. Please do all of your riders a favor and limit the number of cologne squirts in the morning to two? thankyouverymuch. I know it's a bit of a windey trip to JFK Airport, but you win the prize for most roller-coaster like taxi cab ride. Remember when you had to say , "Mizzzz, Mizzz.. Ve arh haair." two times, and you saw that I was curled up in a ball in the back of your cab? Well that's because I was trying not to vomit all over your cab. Puh leaze, don't give me that pissed off look because I only gave your a five dollar tip! Your driving was a ghastly and the ride cost $50.00.

Dear TSA Personnel,

Why must your be such a paininthea$$? I get it. You hate your job, but why must you make my life miserable? All of my toiletries fit into the little baggie, so did it really matter that my expensive hair cream, hair gel, body wash, and face wash were 3.15 ounces each? I hate that you made me throw them out. Do you know what it's like travel across the country for a wedding without your usual beauty products? Well let me give you a clue...$&@(@*#&( &#&#(#&$(#* *#^$*(@)@&$^$*#)#&$!!!

Dear JFK Airport,

Why? Why? Why? Why must your hire the most unfriendly, grouchy TSA personnel? Wait, I already addressed this issue. Oh yes, onto your layout. Can I please have the name of the architect who designed you? I'd be fascinated to know their rationale behind making the A terminal 30 gates long and shaped like a "U" where the drop off is at one end and not in the middle. Maybe this wouldn't have been so annoying to me if I weren't at gate 30 with all the international departures and having to listen to each and every announcement in 3 languages. Did I, already, ask you why the prices at the St@arbucks inside the airport are 25% more than the already inflated Manhattan prices? Now onto the taxiing on the runway? WHATTHEFUCK. Your runways are like a convoluted circuit...up, down, left, right, backward, forward, diagonal, inside, outside, loop de doo. Umm, yeah, 55 minutes later (the 22nd in line to take off), we are up, up and away!

Dear Delt@,

At first I was floored by the great deal that I got on my flights, $379.00! In fact, had I waited 3 more weeks to purchase them, they only would have cost me $325. Granted, the economy is crashing and gas is cheaper but then again, I really shouldn't be spending excessively. BI understand that on a 6 hour flight it's not necessary to serve a meal, but peanuts, only peanuts? Now maybe you are trying to pacify the Atkins followers, but I couldn't;t relax for the entire flight for fear that some person with a peanut allergy would go into anaphylactic shock. This was a vacation for me, I really didn't want to play Nurse Kelly.
Also, what's up with having to PAY for a movie- $6.00 bucks? It's cheaper for me to rent a movie at home, bring it on the plane, and watch it on my computer. Suck it up! And for the sake of entertaining your customers, especially if you want them to be return customers, include a movie in the cost of the ticket.
Do you have a screaming baby policy? Would you have kicked me off the plane if I offered the mother of a SCREAMING baby some Benadryl? Or do you strategically place screaming kids to increase the number of alcoholic beverages that your patrons purchase? With regard to the latter -did I tell you how much I enjoyed my ~~one Margarita~~ Margarita and Cosmo and Corona. I'm also curious about your policy on deodorant. Is it mandatory? I'm guessing not, considering the woman next to me on the way home was was of the most pungent smelling people I've ever met. How about when you hand out blankets you also give out a complementary nose plug. Please feel free to take my advice to heart. PS-i left my trash in the seatback pocket, hahah- jokes on you.

Thank You Very Much.

Nurse Kelly

Well Worth It

2008-10-19T23:34:00.001-04:00

Flight to Seattle: $379
Taxi cabs to and from the airports: $195
Perfect little green dress: $186
Last minute shoe and jewelry purchases: $110
Toiletries becuase the damn airport security people said your were over the size limit: $35
Bottle of water purchased AFTER the security check point: $4.25
Batteries for the digital camera: $14
Wedding Present: $150
Total Cost of less than 48 hours in Seattle: $1073.25

Dancing the night away and celebrating with your soroity sisters at Shelby's wedding: PRICELESS!!!

*What are my chances of M@asterCard using this for their next commerical and me earning some of my money back????

#50 FFoF

2008-10-10T09:34:00.002-04:00

Week # 50 of this meme! Time sure does fly. Check it out for yourself....
#1. Pasta. How do you tell when it’s done? Do you cook on medium or high?
when it's fork tender. i cook on medium high.

#2. Deep frying. What kind of oil do you use?
i don't deep fry, but peanut oil does wonders for crisping!

#3. Grilling. Do you grill on foil or directly on the grill?
depends on what i'm grilling.

#4. Share a recipe that involves cooking something two different ways.Example, for lasagna you might fry the meat and bake the whole dish.

Slow-Baked Tofu with Stirfry
from The Healthy Kitchen: Recipes for a Better Body, Life, and Spirit

Ingredients
3 cups Toasted Grain Pilaf or brown rice

MARINADE
1 teaspoon toasted-sesame oil
3 cloves garlic, sliced
1/4 cup of natural soy sauce (such as tamari)
2 tablespoons peeled, sliced fresh ginger
1 tablespoon Dijon-type mustard
1 tablespoon ground cumin

16 ounces packaged firm tofu

STIR-FRY
1/2 head broccoli
1 large onion, sliced and peeled
2 garlic cloves, sliced
2 carrots, peeled and cut match-stick style
2 tablespoons olive oil
1/4 pound snow peas, strings removed
1/2 cup sliced mushrooms
2 tablespoons natural soy sauce (such as tamari)
1/4 cup purified water or vegetable stock

GARNISH
1 1/2 cups peanut dipping sauce or 2 tablespoons sesame seeds

Instructions
Preheat oven to 300°F

Whisk all the marinade ingredients together in a baking dish. Drain the tofu and slice it vertically into nine 1/2-inch segments. Lay the tofu slices in the marinade and turn them gently, using a spoon, to completely coat each one. Bake on the top rack of the oven for 30 minutes.

To cook brown rice takes about 45 minutes, so unless you are using leftover prepared rice start preparing it now.

Turn the tofu over and baste the tops with the marinade in the baking dish. Continue to bake for another 30 minutes, until the tofu slices puff up, turn light frown, and become slightly hard. Remove from the oven and let cool for 15 minutes. When completely cooled, cut into cubes.

Cut the florets off the head of the broccoli, slicing the large ones in half so they are all more or less the same size. You should have about 2 cups. Discard the stalks or save them for another stir-fry or for soups.

Sauté the onion, garlic, and carrots for 3 minutes in the olive oil in a wok or sauté pan over medium-high heat, being careful not to burn the oil. It should not smoke. Toss in the broccoli, snow peas, and mushrooms. Stir with a wooden spoon to keep the vegetables moving for another 2 minutes.

Stir the soy sauce into the vegetables, then add the water or vegetable stock. Drop in the cubed tofu, toss a few times, cook for 2 more minutes, then turn off the heat. Cover the pan with a lid and let the vegetables steam for about 6 minutes. Place 1/2 cup prepared rice on each of 6 plates, cover with equal portions of the stir-fry and top with some peanut sauce or 1 teaspoon sesame seeds.

Oh Where, Oh Where, Has Nurse Kelly Gone....

2008-10-07T00:12:00.002-04:00

Oh where, oh where, can she be?
With her job all consuming,
And social life null...
Oh where, oh where, can she be?

Sorry for my lack of posts as of late, but I've been out straight. After returning to NYC from a lovely few days with my family, I jumped right back into the grind...work, workout, sleep, swim, work, workout, sleep, swim, work, work, work, work.... (no seriosly).

When I arrive home from work Wednesday morning, I will have been at the hospital 10 of the last 13 nights. Anyone want to trade social lives? I'm looking forward to my four nights off. Hopefully I'll rejoin civilization and have something of substance to write about. But until then, I'm off to ~~sling bed pans, answer call bells, listen to the staff bitch and moan, debride wounds, give meds, draw and send labs~~ save lives.

Another Week of FFOF

2008-10-03T18:00:00.002-04:00

#1. Turnips. Love em or leave em?
I'm truly indifferent. If someone else makes them, I'll eat them, but they aren't a staple in my diet.

#2. What’s your favorite roasted dish?
Veggies!

#3. Salsa. What kind fo you like?
Medium-Hot extra chunky. Peach/Mango salsa is delicious in the summer.

#4. Share directions on how to make your favorite quick meal, meaning start to finish in about 30 minutes or less.
This is just perfect for the fall.

Faux Corn Chowder

finely chop 1/4 of purple onion, 1/2 red bell pepper, thinly slice a portabella mushroom, half a dozen cherry tomatoes. Briefly sauté in pan with 1TB EVOO with 2 tsp minced garlic just until veggies are tender.

put 2 cups of frozen corn in the food processor, puree until smooth.

pour corn mixture into saucepan with 1/2 c milk, slowly bring to simmer.
Add veggies, simmer 5-8 minutes. Add salt and pepper to taste.

enjoy with a hearty seeded roll and baguette.

Four Foods on Friday

2008-09-25T09:17:00.002-04:00

I think I've missed the last two weeks, glad to be back at this. Click here to join in on the fun. Here are this week's questions:

#1. Melon. What’s your favorite kind?
Watermelon. So refreshing.

#2. Orange citrus. What’s your favorite - oranges, nectarines, navel oranges, tangerines, etc.
Oranges. I love the fruit, but I'm not a fan of orange jucie

#3. Oreos. What kind is your favorite? (Don’t eat Oreos? What about olives?)
I rarely eat them, but when I do it's only eat the middle, so it has to be double stuffed.

#4. Pot pie. Share a recipe. (No pot pie recipe? What about a casserole or some other hot meal you bake?)
I've published this one before.

Vegetable Pie
- 1TB organic extra virgin olive oil
-1 c. canned organic soybeans
-1 c. organic carrots, diced
-1 c. organic onion, chopped
-1 c. organic sweet corn (1 large ear stripped of kernals)
-1 c. organic broccoli, chopped-
-1 c. organic red bell pepper, diced
-1 lb fresh organic spinach, cooked, drained and chopped
-2 cloves organic garlic, peeled and chopped
-1 tsp nutmeg
-sea salt, to taste
-ground black pepper, to taste
-1/2 c. organic pecans, chopped (optional)
-2 frozen pie crusts, or recipe for two-crust pie
-1 c. grated mozzarella cheese or cheese substitute
-2 tsp organic sesame seeds
Sauté vegetables in olive oil until tender-crisp. Add garlic, nutmeg, salt, pepper and pecans. Cook on medium heat for 5 minutes until the flavors blend.
Oven: 350 degrees for 20–30 minutes or until the crust turns brown. Allow to sit for at least 5 minutes before serving.

1) Line a 9-inch deep-dish pie pan with one prepared crust.
2) layer the vegetables with the cheese beginning with the cheese and ending with the vegetables.
3) Top with another crust, seal with a fork and trim excess pie dough. With a sharp knife, poke vent holes in the top of the crust. Sprinkle top with sesame seeds.

It's The Little Things I Miss

2008-09-21T10:44:00.005-04:00

This past weekend I went "home" for the first time in over six months! It's not that I don't love my family, but we all live such busy lives time seems to escape us. However, that is no excuse.

A part of the issue is me. I have never transitioned well and I need to feel settled. I always used to feel torn when I went "home." There was so much to do, so many people to see, I felt like I was tying up loose ends. But this time was different. As much as I hesitate to write this, I wasn't stressed because didn't feel like I was going home as an absentee member of my family. I knew I was going home as a beloved guest. I was going back to my hometown, but I wasn't torn up over doing it all.

Yes, Massachusetts is where I grew up, it's where my family lives, it's a place that will always be comforting and familiar, but now it's not my home. I haven't really lived there since 2003. They say home is where the heart is... my heart is in New York. It's where my job, my social life, and my friends live. I've built a new life for my self here. I feel truly blessed, I have the best of both worlds. An exciting city life, with a supportive, loving suburban family who welcomes me back as a guest with no expectations of permanence.

My mom had tears in her eyes when she picked me up at the train station.
My dad squeezed me and held an embrace when I first saw him.
My sister (the child who loathes family dinners) and I talked non stop for two hours over dinner Friday night.
My ~~puppy~~ dog whimpered and jumped onto my lap when he saw me.
We laughed, as a family, more than we have laughed in a long time.
And then my trip was over. Back to New York, back to reality.

My parents never thought I'd become a city girl, but they have shared in my joy as I've grown to love it. And they are the first to admit that they love the perks that come along with their oldest daughter living in the Big Apple.

To be fair, though, there are a few things that city life doesn't afford me. I captured them on film, and figured I'd share them with all of you....

Our golden retriever, Tyler...isn't he handsome?

All that greenery and landscaping my dad prides himself on...

Basking in the sun! (Without all the smog and urban noise)

What about you? What are the things that you miss about "home"?

I'm the Lucky One

2008-09-15T22:34:00.004-04:00

I don't say it enough, so I'll say it now... I'm the lucky one. In this fast paced world that we live in, it's easy to loose yourself in the chaos, wallow in self pity, and take for granted all the little things.

After last week's bomb, my friends were truly amazing. They didn't have to say anything, they were just there. We went out, laughed, giggled, shared some great drinks (and stories). It brought me back to the college years when friends were all that mattered. Not that my friends aren't my world now, but we all have our own lives and our lives are more like Venn Diagrams than interlocking puzzle pieces.

I also just returned from a great 36 hour trip to Philadelphia. I left early Sunday morning and spent the afternoon with K, C, and L. Hard to be live that I hadn't seen C since graduation! Our conversation was bountiful and hilarious, like always. It was so incredible to see how much we've each come into our own in just 16 months. K in in the midst of her thesis for a double masters; C has moved to "Chi Town" and is loving mid western living; L is amazing us with her intellectual work as an author for a biotech company; and I'm thriving in the Big Apple saving lives one hospital bed at a time (well, almost).

A bonus to my Philly trip was spending Sunday night and Monday with the L's! No matter where I go, or what I do, they are forever a part of my life. R and J are getting SO big; however, it's not only their size that's growing but also their independent spirits and zest for fun. I can't tell you how much it warmed my heart to see R bolt down the stairs after his nap, and run through the living room yelling, "Hi Nurse Miss Kelly. I'm so happy to seeee you!" Spending time with O and T was also amazing. O is more than a "sister" she's a mentor and true friend. And T, he's always got an ear to listen and has great perspective on the challenges of my job.

*R &J: I know that you are too young to read this but you boys mean so much too me. It's been an extreme joy to watch you grow. J, you are now older than R was when I first met your family. Time flies! My "real job" can be stressful and upsetting, but You boys keep me grounded and remind me that it's okay to giggle uncontrollably for no reason, sing along to the music~even if I'm off tune, run around with underwear on my head, and climb on the playground.

So to everyone who's ever supported me, thank you, thank you, thank you! You are all amazing and I truly am the lucky and blessed.

Another One Bites the Dust

2008-09-12T17:38:00.004-04:00

I have a 6th sense about people. Maybe it's a facet of my job, but I can tell when something is up, when there's an elephant in the room, and/or the atmospheric mood (oh, poetic!) is a changin'.

My vacation started last night at 5pm. I worked Monday, Tuesday, Wednesday nights, didn't sleep, and then took day #2 of PALS thursday day. When class got over at 5pm, I'd been awake for 29 hours and all I wanted to do was relax! G and I had plans for something around 8pm. I had texted him from class and asked if he would be terribly upset with a low key evening; he said that was exactly what he in mind.

In my twisted little mind, I thought that I'd (miraculously) be energized if I went and worked out before we met up. AFter 2 hours at the gym, I really wasn't energized, but the bags under my eyes matched the shirt I was planning on wearing. I took a quick shower and lied down on my bed to read my book...it was 7:45. At 8:54 my phone was chimining (Ohhh, We're half-way there! Whooo-oa livin' on a prayer!). I picked it up, it was G telling me that he was downstaris. I got up and buzzed him into the building. Then I looked in the mirror and realized that I had fallen asleep on my book ; I had a huge imprint of the book on my face. Now there's a way to greet a boy.

I opened the door. He came inside. I sat on the couch. He sat on the couch. He asked me how I felt. I told him I was tired, but thrilled to be on vacation. I flashed him a smile. I asked him about his day. He told me it was shitty. He played poorly and then taught two lesson that were awful. I expressed my sympathy and then looked at his face. Oh boy, here it comes. I knew he had sounded funny on the phone this past week.

"Umm, that's actaully what I wanted to talk to you about...about us, this relationship, about just how far it can go....."

I swallowed, hard. I so wasn't ready for this talk. Not in my state of exhaustion. This was not how I wanted to begin my vacation.

"Don't get me wrong, I think your're perfect, and you have been more than great about this relationship, but I just don't think this is something I can do now. These last few weeks ,I've been freaking out. I'm playing poorly. I'm not here [as in this relationship] enough. I don't feel like it's fair, like I can't give it 100%."

"Umm. Did I do something?"

"No, no it's not you."

If anything, I've been so laid back about this relationship. All those of you who know me, know that I'm a tiny bit anal retentive, love to plan things, and content with a scheudle. However, things with G could not be like that. I was okay with waiting until the day before to make plans. I was okay, not knowing where we were going and/or what we were going to do until we were out and about. I was smitten with his company, his conversation, his affection. I felt so liberated flying by the seat of my pants...even it it meant that there were stretches of time (36 + hours) that I couldn't sleep. I understood that we had very different schedules, but I was willing to adapt. Don't get me wrong, I thought it sucked that sometimes we would go 2 weeks without seeing eachother, but I wasn't clingy. I didn't whine and complain. I never told him that he should come see me instead of going out with his friends. I made the best of the situation. I guess that's why I was so blown away by his admission. I never asked for more of his time.

He told me that his friends thought he was an idiot and that they were going to be so mad at him, becuase they loved me. I wanted to tell him that it wasn't about his friends. He needed to be the one interested in the relationship.

I told him I felt sick to my stomach when he said, "I'm not playing well." , I never intended to hurt his career, to be a distraction. He came back with, "It's nothing you did. I just can't handle a relationship right now."

And then I started to cry. I couldn't believe I did that...I don't cry; however, exhaustion got the best of me....and maybe I was more attached than I thought.

The "It's not you..." was supposed to make me feel better, but it only stung more. I always seems to play the nice girl who gets walked over and hurt.

"Well, it is what it is. What else do you want me to say?" I mumbled and blotted back some tears.

"I still wanna be friends. I love your company and ~~hooking up~~ hanging out . It's been amazing."

Listen up boys, that's great that you still want to be friends, but that's a senstive issue and it takes time. It's hard to go from dating (and all that it entails) to being 2 people who hang out, throw back some beers, and watch a football game.

"We'll see. I mean we were already friends with the same peopple before all this, so I'm sure I'll still see you out.

We talked for a few more minutes, I won't bore you with the details. Eventaully he got up, gave me a hug, and I walked him to the door. I turned the lock, put my back up against the wall ,and slid to the floor. I let the tears flow. I'm sure he heard me, the elevator hadn't come yet. I tried so hard to compose myself, but I was hurt and upset. After a few minutes, I got up and walked to my bedroom through my dark apartment. I put on my pajamas, pulled back the covers, and went to sleep.

I'd love to say that I was bright eyed and bushy tailed this morning, but that wasn't the case. My puffy eyes and stuffy nose were a painful reminder of what occured the night before.

Not wanting to dwell on this saga, I turned to my stress relief. I threw on my bathing suit, went to the pool, and then laced up my shoes and hit the pavement. I was gone for 3 hours. I feel a little bit better now, but mt heart still hurts.

I guess it's takes loosing something to realize how much it meant. The night I met G, I wasn't looking for a boyfriend, I didn't even like the outfit I was wearing. I had been out all day running errands. Not wanting to be late for my friends birthday dinner and party, I dropped off my parcels and headed out the door. When we first started seeing each other, I was torn. I didn't want to like him, but I couldn't help it. I got butterflies in my stomach when I saw him and my heart jumped when I saw his name on the caller ID. He won me over.

But now I'm lost.

Bye Bye Bullet

2008-09-09T22:57:00.003-04:00

I've written many times about my mom's minivan. But just in case you have missed out, here are the highlights....

It's a 1999 (I was in the 8th grade when we got this baby!)
It's silver and always dirty.
Over the years it's acquired many dings and scratches. My mom loved to "bump" the car's hood against the wall of the garage, and let's just say that when learning to drive, I wasn't the best at avoiding the brush and shrubbery that lines our super long driveway!)

A little summary of where the "Silver bullet" has been:
Back and fourth to Virginia 4x;
Back and fourth to D.C. at least 2x;
To and from Philly well over 10x;
Plus back and fourth to NY at least 5 or 6x!
And those are only the longer trips. My mom hauled us kids all over the state, New England, and of course around town.

The car has had it's fair share of issues...
There was the leak that flooded the drivers side floor,
the broken drivers side electric window,
the broken ash tray/cup holder from an over excited dog slamming his paws onto it,
the short circuited dash board,
the radio that wouldn't seek the channels,
the CD player that would over heat after 2 songs,
the broken rear electric widows (hello cold draft in the winter!), the broken windshield wipers in the hurricane and their consequential backwards installation causing them to stall in the up, not down position,
the tail lights that all blinked when you stepped on the brake,
and the spastic spare tire that always rattled a little tune under neath the car.

Was I embarrassed by this car? You betcha! But then again, I proudly rocked the minivan my sophomore year, before I got my own car. Do you know what I concluded that spring/summer? Cops don't pull over soccer mom's driving minivans!

We always gave my mom shit and called her car the 'traveling trash can', but she really didn't deserve that. After all, my dad wouldn't be caught dead carting around the dog, the soccer team, groceries, gardening items, etc in the back of his new SUV. So the bullet picked up the slack.

My mom had said that she would drive that baby into the ground. I always assumed that my mom and dad would be driving that car when they drop my sister off at college in the fall of 2010;however,I guess I was wrong.

Today I got that phone call.... that my parents are breaking down and laying the bullet to rest. My mother's tone, made me worry at first that something was (seriously) wrong, but I should have known.
So what happened to spur this whole new car idea? That leak that caused the short circuit is back and the cost to fix it is the same as the car's value (pending nothing else shits the bed). Plus now the airbags had to be turned off and your can't use the air conditioner. (You all know, or do now, that my mom is getting to that lovelyt age of menopause. For her, A car without AC is like a sundae without a cherry!)

I'm still sort of in shock, after all htat car has been a part of my life for the past 10 years!

They're nor sure what they're going to buy, probably something fuel efficient and not at all luxurious, but no matter what they choose, it will never have the character, or the memories of the Silver Bullet.

RIP pal, It's been real.

Preparation

2008-09-08T17:50:00.003-04:00

I guess I worked straight through last week and completely missed getting my FFOF answers together, whoops! Anyways, here are this week's answers. Pop on over to Valmg's blog and see what others are writing about...

#1. Egg salad or deviled eggs. How do you prepare?
Hard boil eggs, allow to cool, remove shell, coarsly chop, add Nasoya, finely chopped celery and carrots, salt and pepper.

#2. French fries. Do you make homemade or frozen?
Homemade. I love to make baked sweet potato fries.

#3. Gravy. What do you use - homemade, jar, can or from a package?
For the rare occastion that I need it, I make it from scratch with the pan juices.

#4. Share a recipe for a hot (temperature, not spice) dish.
Green Curry Tofu from WholeFoods
Serves 4 to 6
Take advantage of summer’s fresh herbs and make a homemade green curry with chiles, mint and cilantro bound together with coconut milk. Serve this curry over steamed basmati or brown rice instead of noodles, if desired.

Ingredients
1 (14-ounce) package extra-firm tofu, drained
2 tablespoons flour
6 tablespoons canola oil
Salt and pepper to taste
1 small head broccoli, cut into florets
1/4 pound green beans, trimmed
1/2 bunch cilantro, stems removed
1/2 bunch mint, stems removed
1/2 bunch basil, stems removed
1 (14-ounce) can light coconut milk
2 Thai chiles, seeded and roughly chopped
1 (1-inch) piece ginger, peeled
1 (1-inch) piece lemongrass, peeled
1 tablespoon brown sugar
1 (15-ounce) can baby corn, drained and rinsed
6 button mushrooms, sliced
7 ounces “pad thai” style rice noodles, cooked according to package instructions
3 green onions, thinly sliced
Lime wedges

Method
Arrange tofu between several layers of paper towels on a large plate. Using the palm of your hand, press down gently to remove as much liquid as possible from the tofu. Change out the paper towels and repeat a second time. Cut tofu into 1½-inch cubes and toss gently in a bowl with flour. Heat oil in a large skillet over medium heat. Shake excess flour off of tofu then carefully transfer to skillet. Fry tofu, turning occasionally, until golden brown all over, 5 to 6 minutes total. Transfer to a paper towel-lined plate and set aside.

Bring a large pot of salted water to a bowl. Add broccoli and cook until just tender, 2 to 3 minutes. Using a slotted spoon, transfer broccoli to a bowl of ice water until chilled then drain well. Repeat process with green beans; set aside.

Put cilantro, mint, basil, coconut milk, chiles, ginger, lemongrass, sugar and ½ cup water into a blender and puree until smooth. Transfer to a large skillet and bring to a simmer over medium heat; season with salt and pepper. Add corn, broccoli, green beans, mushrooms and tofu and cook just until warmed through, about 2 minutes. Divide noodles between bowls and top with curry, tofu and vegetables. Garnish with green onions and lime wedges.

Easy as ABC

2008-09-07T14:30:00.002-04:00

Looking back over my last post I realized that I posted the unedited version. I'm mortified that all the spelling and grammar errors were present. Sorry about that folks.

Love 'Em, Don't Leave 'Em

2008-09-05T23:24:00.005-04:00

I took report on my patient tonight and my heart sank.

80% burns, self inflicted.

He didn't feel loved, so instead he doused himself in lighter fluid and struck a match. If I have learned anything in the last 13 months, it's that suicide by fire is a long, painful, and not usually successful (initially). Instead, the patient waits until their body sucomes sepsis.

He's got a machine breathing for him.
His blood pressure is dependant on high doses of medication.
He requires continuous sedation of fentanyl and ativan.
His skin has been excised and cadaver skin is temporarily grafted onto his body.

Why did he do it? He's not awake to tell us. But we did learn from his friend that he recently came out of the closet...it wasn't well received. His family couldn't accept his way of life. He had failed- in their minds, to be the masculine ideal people hold on a pedestal. His family turned their back on him and now they risk loosing him. They couldn't see their son for all that he was. They were blinded by the gender issue.

I watched them sit at his bedside today, tears flowing. I heard them say, "I just don't get why he'd do this to us." I had to try hard to bite my tongue. They truly believed that their son did this to spite them, never considering that maybe it was his cry for help and longing for love.

And now I ask you all to do this. Love your kids for who they are, no what you think they should be. Let them live. Let the little girls play with cars and roll around in the dirt. Let the little boys play with the kitchen sets and put on dress up clothes. Cherish the time you have with them.

guilty as charged

2008-09-03T16:45:00.002-04:00

Tonight is Wednesday night dinner club and I need to bring dessert. I found a recipe that I created a few summers ago...bread pudding with apples, raisins, and cinnamon. It comes out best with day old bread, but since I've worked the last 5 nights my mind really hadn't planed ahead.

So today, after having been awake for 28 hours I made my way to Agata and Valentina to peruse their fresh breads. I love this store because they have little samples of all the breads and cheeses so you know what you are getting, I picked out a crusty raisin walnut bread that was just perfect...my mouth watered as I thought about dessert. I asked the lady how much it was and she said (in her thick foreign accent) that it comes in mini loaves and they are "Two fiftty." I was shocked that they were so cheap, but I put up 2 fingers, said "Two?" and she nodded. She gave me the package and I put it in my basket. I grabbed a few gala apples and got in the line...the LONG line.

I waited 12 minutes.

The cashier rings up the two items. "Twenty six, thirty five."
WHAT?!
She repeated herself slowly, speaking to me as if I were mentally challenged. I asked her how much the bread was and she said, "Twelve fifty. AND you have two of them."
UNh, uh. No No No. I wanted 1 loaf for "Two fifty." I stood there for a second, and sighed. A $25.00 dessert? I think not. I'm sure I could buy something premade for that cost.

But I didn't want to look cheap. This IS the Upper East Side of Manhattan...

And then it came to me. I don't know why I said it, but I blurted out, "Shit! I don't have my wallet. And I just waited in this line...I'm running too late to go home and come back."

I looked at the lady, gave her my best, "Oh my God, I'm so embarrassed face", apologized, and walked out of the store empty handed.

Barely out the door, the hugest grin came across my face and I started laughing. I don;t know how that idea came to me and/or where it came from. So unlike me.

I walked down the block and into the bakery. I picked up 5 jumbo gourmet cupcakes, paid $12.00, and left.

And on that note, I'm off to dinner.

in need of a good read

2008-08-30T17:32:00.002-04:00

I'm a bit stingy when it comes to spending money on things like books. It kills me to pay $25.00 for a hardcover when I know in 3 months that it will go to paperback and only cost between $9-$14. If the wait list for the new books at the library wasn't months long, I'd march right over to the New York public library and check the books out there.

Over the last few years I've taken to going to the "bargain book" section at Barnes&Noble and picking up a few seemingly good reads. It's largely hit or miss, but I have managed to snag a few good ones. For all you history buffs, I highly recommends "On Hitler's Mountain" by Irmgard Hunt. The beginning is slow, but the overall concept and insight into Nazi Germany is intriguing.

So, now, I'm asking a favor...

Does anyone have any good suggestions on some good reads? And/or how I can get exposed to some books aside from the best sellers that are a drain on my bank account?

thankyouverymuch

All About Potatoes

2008-08-29T09:21:00.003-04:00

Here are this week’s four questions. They’re about potatoes. Check out the FFOF Meme

#1. Potato Chips. What kind of chips are your favorite?
I'm not much of chip girl, butif forced to choose, I'd say baked lays BBQ

#2. What’s your favorite thing to dip chips in?
All about the spinach and artichoke dip- I love it on fresh veggies

#3. What’s your favorite way to eat a baked potato?
With a very crispy skin and salsa

#4. How do you make mashed potatoes?

boiled, cubed yukon gold potatoes
skim milk
lowfat cream cheese
salt, pepper, garlic salt, fresh chives

to sleep per chance to dream

2008-08-29T09:04:00.002-04:00

it's 4:49 in the AM, I'm not at work, and I'm WIDE awake. I went out with G, we came back home, he left, I went to bed, and I tossed and turned and tossed and turned and tossed and turned. This saga began at 12:50. In the last 4 hours I've...
*watched 2 episodes of without a trace,
*self medicated with benadryl
*read the last 2 issues of Bon Appetit Magazine,
*worked out my budget for the upcoming months without a calculator,
*drank 3 bottles of water,
*ate 5 almonds,
*got up to pee 3 times (maybe I shouldn't have had the water?),
*turned my AC down to 67,
*counted backwards from 100 (5) times,
*organized my bookshelf,
and,
*text messaged my friends that i was annoyed to be wide awake (payback for all their phone calls when I'm trying to sleep during the day).

Ugh. If I don't fall asleep in the next 11 minutes, I say screw it. I'm getting up, getting dressed, and going to the gym.

So just in case you see me out, I'm not ignoring you, I'm just exhausted.

with grace

2008-08-24T18:04:00.004-04:00

my arms hurt.
my back hurts.
my neck is cricked.
I had a long night.
no! Get your mind out of the gutter.
we coded a patient (for an hour) twice.
i may be small, but i'm certainly mighty.
i broke ribs.

maxed out on levo, dopa, dobutamine,and epi, we never got her back from asystole.
she didn't make it.

RIP

hip hip horray (literally)

2008-08-23T17:20:00.002-04:00

It's been 13 weeks since the injury occurred. I've been going crazy. Even though I've been allowed to resume my usual activities, the running wasn' happening. It was painful. It's been 2 weeks since I was cleared, and I've only logged 4 miles. Ehhh.
However, today I had a surprise brunch with GI Greg (my trainer) who's home for the weekend from training. We were talking and I just had a good feeling. So after our brunch, I laced up my sneakers and hit the gym to run. And run I did. 5 1/2 miles @ an 8:15 pace. Far from my previous pace, but still not awful. When my workout was over I felt like a wight had been lifted off my shoulders. I hope today wasn't just a fluke, and that I'm finally on my way.

Olympic Edition FFOF

2008-08-22T10:40:00.003-04:00

Valmg's FFOF questions were inspired by the Olympics this week. See what everyone is blogging about here:

#1. What do you drink to rehydrate in the heat or after working out?
When working out I drink water. Post workout I drink Powerade ZERO and/or crystal light.

#2. What do you eat to help boost or create energy?
Before my runs I eat 1/2 banana with 1 TB Better'n'Peanut Butter

#3. What’s the healthiest snack you eat?
I love carrots and hummus or an apple with almond butter.

#4. Share a recipe or instructions for your ideal three course meal.
Normally I would insert a very detailed descritpion here, but since I'm on my 3rd overtime shift this week, my brain isn't up to par. Here's my suggestion: menupages.com.

I Should Get Paid for This

2008-08-17T18:21:00.010-04:00

Even before I knew ANYTHING about being a nurse (i.e. NSO during freshman orientation) I got asked silly nurse questions. Not going to lie, I had no clue when I answered these questions...

"Am I going to die from drinking this Jungle Juice?"
IF you die, so will the thousand other people drinking from this barrel. Fill 'er up

"Can I drink and take Tylenol/antibiotics/birth control"
I'd skip the Tylenol, but if you are going to drink and want to avoid an "accident" I'd go with the birth control

"Will I get herpes from sitting on the toilet in the dorms?".
No greater chance of getting it from the toilet seat than from that sketchy frat boy you hooked up with last night.

As the years passed, I grew more knowledgeable and was able to actually give some helpful advice. I have no problem when my friends come to me with "health questions", I always just hope I have an answer. I guess in a way it makes them feel better, even if I just tell them what they already know (i.e. "I'd say you need to go to the ER for an x-ray, the bone IS sticking out.")

Last week, Craig approached me with a nurse question. He pulled up his pant leg and said, "Do you think these are infected?" I swallowed hard as I looked at the welts on his legs, covered in green scabs with blanching red rings around them. Did I mention the edema in his leg and ankle.
(original image from wikipedia)
ME: "Craig! You are on your way to nasty case of cellulits. You need to go the doctor and get some antibiotics. We admit patients for cellulitis, you don't want it to go systemic."

Craig: "You mean I can't just take some Tylenol and put on some cream?"

ME: "Uh, has it worked yet?"

Craig: "No. Oh I guess you're right. I'll go to the doctor. Wait, I don't have a doctor here. Am I going to die?"

ME: "No, you just need to See a doctor. So go to the ER"

Craig: "But isn't that going to be a long wait?"

ME: "Well it's going to be a lot longer if you don't get it treated and have to get admitted to the hospital for a course of IV antibiotics."

Craig: "Okay, thanks nurse Kelly.I'll go"

ME: "Call me if you need anything. I'll check in with you later."

4 hours later

Craig: "Nurse Kelly. You were right. They checked me all out and gave me some antibiotics. Thanks."

ME: "No problem Craig. Feel better. See you tomorrow."

36 hours later, 8am
MY cell phone goes off, it rings again, and again. I hop out of bed, thinking something is truly wrong. It's Craig. I call him back.
"Hi Nurse Kelly. Did I wake you?"

ME: "Uhhm, well I guess I had to get up anyways."

Craig:"Good. Well, okay, so yeah like I started the antibiotics and my legs are looking better but now I have this hard lump under my belly button and it's red and kinda sore."

ME: "Is it itchy?"

Craig: "No, just hurts and looks gross. Do I have skin cancer?"

ME: "Take some benadryl, and Tylenol, and put a cool compress on it. If it's not better in the morning or is getting worse, go to the doctor."

Craig: "But Nurse Kelly, I don't have a doctor."

ME: "Well then, I guess you'll have to go to the ER (again). Have you thought about getting a doctor in the area? What is your insurance, I'll look into it for you."

Craig: "Do you think I can get in and out quick because I was just seen there? Like a preferred patient?"

ME: "Craig, we aren't talking about some luxury hotel chain, we are talking about a hospital. You (and your belly button ailments) will have to wait like everyone else. haha"

Craig: "Okay, guess you are right. I'll call you later."

ME: "Sounds good. Feel better and keep me updated."

I managed to dose back off for an hour or two, but it wasn't quite the restful sleep I was longing for. I kept dreaming about Craig's weird belly button issue. Just another day in the life of Nurse Kelly.

I made his day

2008-08-16T17:16:00.003-04:00

Last night I had plans to go and see Pineapple Express with G, J, M, E, and others at 9 p.m. G was going to meet me before hand at 7:15 and then head out for drinks and meet up with the rest of the crew to see the movie. G's express train got stuck on the tracks, so he didn't get here until 8. No biggie.

We went to the Stumble Inn and got a quick drink. Of course, it was raining cats and dogs, so we copped out and took a cab to the theater. The cab ride was quick (from 76th to 32nd) and cheap ($7.10). I whipped out my wallet and handed the cabby a $10 and asked for a $1.00 back. G and I walked into the theater but didn't see any of our friends. G called them; they were already inside. Oh well, we waited in line to get tickets. Just as we were about to walk up to the counter, I looked up and saw SOLD OUT SHOWS: Pineapple Express 9:00. Ugh, okay. Now what? Oh well, could have been worse,. G called J and told him the situation, I think J felt bad, but we made the best of it. We bought tickets to the 10:15 show, went around the corner, got a few more drinks, and then came back to see the movie. I'm not complaining...after the last month of G's traveling and my work schedule, a little extra 1 on 1 time was fine with me.

The 10:15 show wasn't crowded at all, I guess everyone opted for the earlier viewing. We settled in and the movie rolled. Don't get me wring, there were a few good one liners, but for the most part the movie was a lot of violence and monotonous antics surrounding getting high and smoking ~~weed~~ pineapple express. The movie was LONG, well over 2 hours, but the company was good, so it all worked out. G and I came home, watched the Olympics and fell asleep only to be woken up by the alarm at 6:45 so G could make his early morning T time with the boys.

After he left, I fell back asleep until 10:30. After an amazing workout, I headed to St@rbucks for a soy milk latte (yum!). I pulled out my wallet to pay and did a double take. Where is the $20 that I took out of the ATM the day before? I see the $10, but the 20 is gonzo. Oh no I can't believe it. Yup, in my haste to pay the cabbie the night before, in the dark no less, I handed him the $20, for a $7.10 fare and only asked for $1.00 back. No wonder he pulled away so fast. Oh well, guess I made his day.

All about Appetizers

2008-08-15T07:54:00.002-04:00

Here are this week’s four questions. This week they’re about appetizers. See what others are ~~salivating over~~ writing about here

#1. What is your favorite appetizer?
I love spinach and artichoke dip.

#2. Do you eat enough appetizers that you get full and can’t eat your meal?
No, we always get one to share with the table

#3. Do you usually make frozen or fresh appetizers?
I make them. I love the convenience of the premade or frozen, but they are so high in sodium and fat that I prefer to make my own.

#4. Share a recipe or instructions for an appetizer.
Yet again, from my wholefoods recipe stash...

Dried Fig, Brie and Rosemary Bites
Serves 4 to 6

8-12 large plump dried figs
2-3 ounces Brie, cut into small pieces
2 teaspoons extra virgin olive oil
1 tablespoon fresh rosemary leaves
sea salt, to taste
ground pepper, to taste
If the figs are very dry, plump them in boiling water for 5 to 10 minutes. Drain and cool them. Trim the stems and make a slit in the side of each fig. Push a piece of Brie into each fig. Place in a bowl and toss gently with olive oil, rosemary, salt and pepper. Serve at room temperature or heat in a 350°F oven until warm and cheese melts, about 8 minutes.

Metamorphosis

2008-08-14T20:29:00.007-04:00

While working out in the gym today, I overheard a conversation that got me thinking. The conversation was about keeping a diary. Did/do you keep a diary? Growing up, I had a diary (yes one of those girlie ones with a "lock and key" that could easily be picked with a bobby pin). I wrote about lots of things, but I'm pretty sure most of it related to things about my friends, boys that I liked, things I maybe regretted doing, and/or things that I wanted to do. The preteen years were perfect for a dairy, a place to write about stuff and then guard it under lock and key.

As I got older, it sort of fell by the wayside, but I started scrap booking. My teenage years were captured on film and then later digital memory cards, but either way I had pictures to look back upon and recollect what was going on in my life. My teenage years were marked by milestones and things perfect for images (dances, proms, beach trips, vacations, cars/driving, parties, college visits, etc.) When it comes to socializing in the teenage years, a picture (for better or worse) really does say a thousand words.

When I arrived at college, I entered a whole new world. It was a time of firsts and milestones (much like my teen years) but similar to my preteen years, I was full of hopes and dreams and crushes on boys. (Oh how much I loved when the crew team ate in my building's dining hall and when the frat boys sat on their leathers couches along locust walk). Before I left for school, I bought a journal to write about my college years; however, I was so busy with ~~school work~~ socializing that I didn't have much time to write about anything [fun] (espescailly with my writing seminar from hell!) I took lots of pictures and they were plastered on Websh0ts and Faceb00k. Even more than being a way to capture memories they were a way to fill in the ~~blackouts~~ nights that lasted into the dawn.

As I began my senior year of college, this blog was born. I started feeling nostalgic and wanted to keep track of my thoughts and of things that couldn't be captured on film (mainly work and clinical experiences...HIPPA anyone?). However, I didn't dig that dusty journal out of storage, I chose to start blogging. I spent so much time on the computer, anyways, it just seemed like a practical idea...plus I was enamored with the idea of an audience. Like I've blogged about before, the content I blog about is varied, but I like it that way. I can talk about my hobbies, my personal life, my job, my friends, etc...the possibilities are endless.

I have but a few regrets with my choices over the years..
*I wish that I had more pictures from my preteen years because like Dan was just sooooo dreamy in the 6th grade
*I wish I had taken the time to write about some personal things in my late teens and early twenties because let's face it, some thigs weren't meant for public viewing and certainly weren't appropriate to be captured on film (the closet incident, the whip cream fiasco, the first time I had sex, the infamous taxi cab ride, etc). Okay, now that I've given you all TMI...
*I wish that I wasn't leery of sending this link to all of my friends. As much as I love them, there is a part of me who wants to keep this mine, or maybe I'm afraid of what they'd say.

But in the end, when I'm old and gray and my memory isn't what it is now, I'll have something to look back upon and remember who I was, what I did, and all that I aspire to do.

What about you? what made you start blogging? did it stem from a lifelong passion for writing or was it something that just seemed like a good idea at the time and now you're hooked?

what happens when you get septic

2008-08-10T21:25:00.004-04:00

this is night #5 of a 7 consecutive shift stint with the sickest patient i've ever taken care of (I think).

some highlights of the clinical situation thus far:
*maxed out on dopamine, added levophed drip
*H/H =7.0 / 21.2...2 units PRBC transfused
*gram negative sepsis as seen in the blood stream and BAL...Aztreozam Abx therapy
*pre-renal failure (>10cc/hr for 15 hours) despite fluids going at 1000cc/hr
*patient CXR showing patchy infiltrates and fluid: patient not oxygenating or ventilating well
*SWAN Ganz inserted. Cardiac output > 13, Wedge high 20's, CVP 28-34.
*septic shock
*started on Xigris
*PTT > 150...xigris stopped...4 units FFP transfused
*ABG: 7.22/55/67/18...FiO2 on 100%...8 sets of ventialtor changes made
*8 liters of bed drainage per shift
*1 liter of diarrhea in 3 hours, C.Diff samples sent~positive growth...rectal tube inserted

stay tuned. 2 more nights to go.

My Road to Recovery

2008-08-08T15:32:00.000-04:00

6/14: 13 mile run, followed by left groin pain. Iced it and popped an anti-inflammatory
6/15: Tried to run. OUT OF CONTROL pain. Cross trained instead. Taking Aleve RTC (round-the-clock)
6/16: Still couldn’t run. Decided to switch up my marathon training schedule and take off the week of 6/15-6/21 instead of 6/22-6/28
6/18: Now having pain without activity. Decide to try acupuncture-minor relief noted.
6/20: Acupuncture session #2. Again, short lasting relief.
6/22: Attempt to run. MISSION FAILED, the pain is excruciating. Cross training is boring as all hell. Emotionally distressed. Leave for Philly for a few days.
6/23: Cross train in the AM, minor discomfort. Go to playground with the boys and make the mistake of chasing after them. (Hey, what fun is hide-n-seek if you don’t chase them??). Pain sets in and doesn’t leave.
6/24: Wake up really stiff, unable to bend/squat to put on my sneakers. Cross training is now downgraded to Yoga and Pilates. Ugh! Decide that I need to be seen for this pain. I start a frantic search to find an sports medicine orthopedist who takes my insurance. By some miracle of god, I get an appointment with the guru on running injuries for the following day. Sad that my trip to Philly is over, but relieved to be getting my pain checked out.
6/25: Appointment Day! Before the MD even sees me, I’m sent for x-rays. Within 5 minutes of speaking to the MD, he’s 99% sure it’s a stress fracture on the neck of my femur, but only an MRI will confirm. Must get that scheduled. In the meantime, no running, no strenuous activity, “nothing that causes pain” (direct quote), and need to get fitted for orthodics.
6/26: Sweet! Get an MRI for 7pm tonight! Wow, that was a long 90 minutes.
6/27: Call to speak to the “Guru.” He can’t see me and he’s going away for the entire upcoming week. Next appointment I can get? 7/10.
6/27-7/10: Agony (emotional and physical). Waiting. Bitchyness.
7/10: Follow-up appointment. So the diagnosis surprises the doc and myself…it’s not a femur fracture, it’s a pelvic fracture! Which means: another month of no running, no cycling, no stairs, minimal extra walking; swimming pool here I come; PT 3x/week; a bone scan; and Tylenol (yup, Tylenol. Did you know that anti-inflammatories slow bone regeneration.)
7/11: Start PT. It’s brutal. Let my bosses know the test results and find out that I don’t qualify for medical leave because I haven’t been employed for a year (2 weeks short).
7/12: Make the emotional plunge back into the pool. Not as bad as I thought.
7/14: Start my 2 weeks of “desk duty” at work. ( QA , chart review, and protocol compliance)
7/17: Bone scan day.
7/18: Day without pain. WOW.
7/19: Climbed stairs without pain. Able to bridge on left leg (5 PT sessions in the making!)
7/20: No pain medication! Making progress.
7/21: Finally seeing definition in my quads and hammies again. Still really tight. Finding alternate ways to stetch, haha. No comment. Marks 5 weeks since initial injury.
7/25: Desk work completed. Will resume patient care next week.
7/26: No pain today. 70 minutes of cardio! Getting strong one day at a time.
7/28: Wore heels ALL day. First time out of flats in 6 weeks! No pain.
7/30: Fist night back at work taking care of patients.
8/2: Sqautted to check a foley catheter...ouch, that hurt.
8/3:Ran across the street to make a red light, NO PAIN! Alleluia!
8/4: Crossed my leg (horrible habit, I know). Holy moly! I've got a decent range of motion!
8/6: Begin my 7 night straight stretch.
8/8: 8 Week Follow Up! Bad News: I've got osteopenia. Good News: I'm CLEARED TO RUN AGAIN! PHILADELPHIA MARATHON 2K8 HERE I COME!

If I Could Tell You

2008-08-06T10:39:00.003-04:00

Dear Family of Patient X,

I will not say that I know how you feel, because I don't.
I will not say that everything will be fine, because it won't.
I cannot promise anything,
I cannot control the actions of others.

I come here to do my job, and take the best care possible of your loved one. Please let me do that.

I know the beeping and chirping of the the monitors, ventilators, and pumps is bothersome, but they are they for the patients safety...please don't take it upon yourself to silence them. They go off for a reason.

When I explain that I need to step out of the room to get a 2nd RN to check the blood that needs to be transfused, that is not the time to scold me for a missing blanket. Your loved one has a 103 degree fever and surrounded by ice packs, a blanket is contraindicated. I've made sure that they are covered, discretion and modesty of course.

I know it's hard to digest all that is going on with your loved one, but they really are getting fed. They can't eat through their mouth, they are on a ventilator and sedated. See that little tube in their nose, connected to that pump with the hanging bag of that creamy liquid? That's their food, I promise. Please don't berate the dietary worker who delivers food when she skips your room. It's not her choosing.

My age really isn't important. I am fully capable of taking care of your loved one. If anything, the fact that I am new(er) makes me pay even more attention to detail because I'm still "by-the book". But if it gives you a piece of mind, I have a BSN from an Ivy League school where I graduated Magna Cum Laude. All of my ICU credentials and certifications are adequate and up to date and because I know you are still wondering, Reagan was president when I was born.

Yes, we do take a lot of xrays. No, we aren't trying to give your loved one cancer. They have fluid in their lungs and we need to see if our methods to remove it are working.

I know it seems like I'm sitting at the computer a lot, but Im completing all my charting and documentation. There's a lot of information that needs to be charted hourly (175 items, actaully). I swear I'm not checking out YouTube,

Visiting hours are 11am-7pm. I have alredy bent the rules by allowing you to be here until 8pm, please stop begging and pleading with me to let you stay longer. You know that you can call at any time, give me the password, and I'll update you. Yes, I still have your home number, cell number, work number, beeper number on the whiteboard, in the patient's chart, and on the computer system . I know how to use a phone, I'll get in contact with you if anything happens.

Like I said before, I come here to do my job and provide the best possible care. Monitors will alarm, pumps will beep, xrays will be taken, charting will be done.....

But here are some things that you may not be aware of:
I treat all my patients the way I would want my loved on treated. I talk to my patients, letting them know what I'm doing and/or what will happen, even when they are unconscious. I gently bathe them and perform hygenic care. I comb their hair and clean in their ears. I cream and powder them up so they smell fresh and clean and then when it's all said and done, I take their hand in mine, give it a little squeeze and tell them, "I'll pulling for ya. Don't put those boxing gloves away, the fights not over yet." I place their hand back at their side and continue about my night.

So now, dear family, as I send you on your way, please know that I may not have the same relationship with the patient as you do, but that's okay. You are their past and future, but I'm in on their present. I'm here for them, just like you. So let's work together to get them through this....one day, one minute, one breath at a time.

Sincerely,

Nurse Kelly

Banumpkins

2008-08-06T09:20:00.001-04:00

(Banana Pumpkin Muffins) I just created them and they are so good.

1 ripe banana mashed
1/2 can pumpkin
1/4 c. applesauce
1/2 vanilla soymilk
1/2 c. packed brown sugar (I used turbinado)
1 egg

1 3/4 c. whole wheat flour
1 tsp baking powder
1 tsp baking soda
1/4 tsp salt
1 tsp cinnamon
1 tsp pumpkin pie spice

1 banana, quartered and chopped

mix all the wet ingredient together, sift in dry ingredients, add in banana chunks.

preheat oven to 375. Prepare a 12 muffin pan with non stick cooking spray. Fill cups 2/3 of the way. Bake 20 minutes. Enjoy!

chopped walnuts or pecans would be great in this recipe too. the natural sugars of the mashed ripe banana really mellow the strong pumpkin flavor.

Fly On the Wall

2008-08-05T11:08:00.003-04:00

Going to the pool and gym yesterday was the first time I had left my apartment since arriving home from work Sunday morning. After my workout, I came home, showered, and put my pajamas back on. In dire need of doing laundry, I put on sweat pants (it was only 70 degrees but I had my AC cranked) and a big baggy t-shirt from college. Still exhausted from my 52+ hours of working in 4 days, I lounged around my apartment all afternoon. However ,around 9pm I suddenly foudn myself craving seltzer water. I gave up soda over a year ago and never crave it, but occasionally long for some fizz. I couldn't fight the urge, so I put down my book, got up off the couch, laced up my sneakers, and grabbed my purse. IT wasn't until I was outside and walked by a window that I stopped, checked myself out top tobottom, and burst out laughing. I looked absurd.
Bandanna headband with wildy curly hair
Baggy gray t-shirt (Penn Soccer), no bra of course!
Baggy gray sweatpants (not the same shade as tshirt) with SWIM on the butt (left overs from high school)
Fleece socks (I wear them as slippers)
My running sneakers
and one of my "going out" Kate Spade handbags (really cute, got this last week)

I whipped out my phone and called N to leave her a pictoral description of what her best friend was currently sporting out in public!

I prayed the the store wouldn't be crowded and that I wouldn't get picked up by some homeless bum thinking that he just found his sugar mama.

Oh well, that's what exhaustion will do to you.

Top Dog

2008-08-04T06:07:00.000-04:00

"Charge nurse pick on 6xxxx"
"Can I speak to the charge nurse?"
"Have the charge nurse call the nursing supervisor."
"Ask the charge nurse if she can help you."
"See if the charge nurse will go speak to the disgruntled family in room X"
"Ask the charge nurse where XYZ is located."
"Tell the charge nurse that you found a discrepancy in the pixus system."
"If you don't like your assignment, speak to the charge nurse."
"Didn't get a meal break? Tell the charge nurse"
"Not enough nurses to take care of all the patients? Tell the charge nurse."
"Resident is MIA/not returning pages/being a jack ass! Tell the charge nurse"
"Couldn't obtain the blood work for labs that the docs ordered....tell the charge nurse"
"Patient just spiked a fever/vomited/pulled out central line/fell out of bed/stopped peeing/dropped his blood pressure... Tell the charge nurse"
"Patients trash needs to be emptied...tell the ~~charge nurse~~ housekeeping staff

Get a sense of where I am going with this entry?

It's a rule in the ICU that you can't be the charge nurse until you have been working on the unit at least a year, have all of your additional ICU credentials (ACLS/PALS), and aren't ~~a complete pompous asshole, arrogant bitch~~ unapproachable.

It's always suspenseful to come on shift and see the name of who will be charge. Some are FABULOUS and some are ~~completely awful, unhelpful, lazy, and rude~~ less than fabulous.

I never hesitate to ask the charge nurse a question and I always keep them updated on my patients conditions. AFter all, they can be a huge help if when shit hits the fan and/or you feel overwhelmed or frustrated. I'll admit it, I've asked a series of assaine questions; however, for the most part I try not to abuse the charge nurse...they have enough to handle.

So how surprised was I when my nurse manager approached me Friday night and told me that I would be orienting to charge nurse? Very surprised, especially since this was my first week back taking care of patients since fracturing my pelvis plus Friday was night #3 of a 4 night stretch.

When orienting to charge nurse, they pair you with a senior nurse who gives guidance and explains the ins and outs of the job. However, they largely let you fumble through the night and get your feet wet. I lucked out because my senior nurse was very experienced and helped me anticipate what might happen, but I still worked myself to the bone. During report from day shift, we were told that there was a pending transfer from an OSH of a circumferential arm burn. The resident still needed to sign off on the acceptance and decide what patient we could move off the unit to accept it, but the ball was in motion. Our night began when we got a call from the transfer center that we needed to accept a pediatric patient with bilateral palm scald burns from a hot iron. (That's 2 beds we need to free up). To accept the circumferential burn we needed to move someone out of the ICU onto step down. To accept the pediatric patient, we needed to transfer out an adult step down patient. Confused yet? Try being the one to coordinate all of this.

Just when I thought I had worked all of this out with the resident and admitting bed officer, a stretcher rolls onto the floor. WTF? Who is this patient? Oh, well this is the adult transfer....who we haven't accepted yet! We don't have a bed! Neither the resident or the nurse received report on this patient! this is going to get ugly. Not sure what to do, the patient was admitted into the system and kept in holding (sort of like an ER patient) until we could open up a bed. Eventually (3 hours later), crisis averted.
THEN
Patient in room XYZ decides to plug his ET tube and is sating 88%....STAT page respiratory and the resident,disconnect ventilator, bag the patient, deep lavage suction..............where is the resident? where is respiratory...........suction........bag patient.....suction.......COUGH!! Patient breathing again. Settle patient, reconnect ventilator, monitor vigilantly, send ABG in 30 minutes.
THEN
Patient in room ABC looses A-line (this is a problem as the patent's blood pressure is dependant on dopamine ). Page resident, take cuff pressures every 2 minutes, set up for new A-line. Anticipate that resident will fail miserably at inserting this Aline into this 3rd spacing fluid overloaded patient and page the night fellow. 15 minutes and 2 attempts later, fellow manages to inert a new line.
THEN
Patient in room EFG drops blood pressure and stops urinating. Reassure the bewildered resident, suggest it's time for a fluid bolus!
THEN
Nurse for patient 123 gets into argument with the pharmacy over dispensing a new ativan drip. Get on phone with ~~the devil~~ pharmacy tech and explain that the patient had line changes and all new drips must be hung, so even though a new drip had been hung at 8pmfriday and didn't expire until 8pm on Saturday, we needed a new drip STAT. You can't stop sedating a patient on a ventilator. dumnbass!?!?
THEN
Staffing office calls to tell us they are sending 2 nurses for day shift. We should be overjoycing, right? WRONG. We need at least 16 nurses to "safely" staff the unti, the 2 nurses they're sending us, only puts us at 13.
THEN
The mother of the 34 year old patient in room MNO calls for the 5th time in 7 hours "to check up." OK lady, here's a little insight for you.... your ~~kid~~ 34 year old son burned his peni$ 2 days ago and made it clear at that time that we are not to give our any information over the phone to anyone except for his wife (who we assigned a password to for obtaining info). It's 3am and he's sound asleep. Like we explained before, we don't connect calls into the rooms after 10pm, it's disruptufl. you need to get the # from the patient and call them directly. Please don't send him flowers because flowers aren't allowed on the unit .And lastly, stop trying to bribe me with coffee and a muffin if I'll let you come in before visiting hours begin at 11am. thankyouverymuch
THEN
Receive phone call from the ER attending that there is a 40%er in the ED who needs to be admitted.
THEN
Patient in room QRS shits himself for the 8th time requiring the nurse to change his sterile dressings on his back and legs for the 7th time. Time to make sure that the 3rd CDiff specimen has been sent and then insert a rectal tube. If the devil created diarrhea, then God created the Zassi.

A whole lot more happened that night, but I won't bore you with details. I was in charge again Saturday night and didn't get out of work until 9:30am Sunday morning. I went to bed at 6pm and slept until 11 am today. I'm all recharged and it's a beautiful thing....that is until I go back to work on Wednesday.

dominos

2008-08-01T00:18:00.005-04:00

Last night was my first night back at work, actually taking care of patients, after almost 3 weeks of time off to heal my little injury (which is getting better every day, thankyouverymuch).

My boss had called earlier in the day, as in 8am (like that the heck would I be doing at that time of day? Sleep?!?! Apparently not). He called to ~~make sure that I was coming in because staffing is atrocious~~ "see how I was feeling". I assured him that I'd be in and would see how I felt. I did make one request. I told him that I would prefer one very sick, preferable vented patient, over a few "walkie talkie" step-down patients. Have I ever mentioned that I loathe the call bell and think it was possibly invented for the sole reason of tormenting overworked staff??

I arrived at work early (after a year I still overestimate the amount of time it will take me to walk 5 blocks) and am surprised to find that my assignment is actually a "sickie". Oh wait, he's sick, but he's also a bariatric patient (a mere 206 kilos). Um yeah, so like how am I going to maneuver this man? With help, of course. My coworkers were great with lending a hand (or two, or three, or four) but my adventures didn't end with his size. All those with weak stomachs and/or those who want to eat in the next hour, don't read on. During the course of the night he started to blow snot bubbles-one popped in my face (amen to face shields). He projective vomited (did I mention he also has a tracheostomy), that was delicious. Despite giving pharmacy a 2 hour heads up that I needed a new ativan drip, they were 45 minutes late in supplying me a new one. You know how it goes from here...Patient sedation lessons, patient pulls out NG tube that the attending had placed. While I was replacing the NGT tube, the patients A-line pressure bag malfunctioned and I lost the waveform. After 2 attempts the NGT goes in but the patient just coughed off his trach cap and goo flies everywhere. I attempt to prop him on his side and what to do you know? Oh yes, some of the worst smelling farts ever. Only good thing is that there was none of that brown delight, to accompany the odor. That's when my foot skid on the floor. Oh yes, I had just stepped into a the pile of puke that I missed when cleaning up the vomit with cl0r0x wipes (remind me again why we pay a housekeeping staff?) I squatted down to examine the problem. WHOOPS, OUCH, F@c^! That didn't feel good. Now, stuck in a squat, I just started to laugh and laugh and laugh. What else could I do? I pulled myself up and just started to fix all my messes.

Clean puke: check

Get new pressure bag for A-line: check

Reinsert feeding tube: check

Suction out patients mouth and nose and tube for any residual vomit: check, check, check

Completely change patients linens and bed (2nd time in less than 2 hours): check

Wash patients face: check

Take off gloves; Rremove mask; Wash hands; Sit in chair; Pray that 8am isn't really still 5 hours away

I'm back tonight for #2 of 4. Stay tuned, it's always an adventure when nurse Kelly is around.

Four Foods on Friday: Candy

2008-07-30T10:04:00.003-04:00

Here are this week’s four questions. This week they’re about candy. Hungry now? Check out what others are drooling over here

#1. Candy. Do you prefer sweet or sour candy?
Sweet (all dentists cringe now!)

#2. Gum. Love it? Hate it? What kind is your favorite?
Love it. Peppermint or Sweetmint 0rbit

#3. What is your favorite candy?
Peanut M & M's. Mix of salty sweet

#4. Share a recipe for anything that you can include a piece of candy in.
These are my "Kitchen Sink Cookies". I was trying to clean out my cabinets after holiday entertaining and here is what happened:

1/2 c. brown sugar, packed
1/2 c. white sugar
1 cup flour
1/4 c. instant vanilla pudding mix
1 tsp salt
2 tsp baking powder
1 egg
1/2 c margarine, softened @ room temp (NOT melted!)
1 c. broken pretzel pieces
1 c. chocolate chips
1 c. peanut M&M's
1/2 c old fashioned oats
(can also use 3/4 cup of rice krispies)

Preheat oven to 350
-cream sugars and margerine together, mix in the egg
-combine flour, salt, baking pwdr, pudding mix, and oats- gradually mix into egg mixture. Hand mixing works best with wooden spoon
-add pretzel pieces, choc chips, M&M's
-combine until add-ins are evenly spread throughout dough
-spray a cookie sheet with baking spray: drop 1 TB balls onto cookie sheet, about 12 per sheet: bake for 10-12 minutes, or until dough is starting to "tan"

*it's okay if they aren't perfect balls. The little pretzel bits sticking out the sides, are a perfect sneak peak at what's inside.

When I Grow Up...

2008-07-28T08:19:00.009-04:00

I wanted to be:

A Hairdresser- I'd spent hours doing my friends hair, but wouldn't let a brush/comb touch my curly sue long banana curls. Then I discovered scissors and suddenly my barbies suddenly looked like her . So blame me, I started the trend.
original photo credit: www.chitchatchica.com

A Teacher- My mom used to find me sitting on the toilet, with the shampoo bottles lined up along the tub edge, speaking to them...uttering some sort of academic verbage. Thankfully, I moved on from shampoo bottles to dolls and my friends. I thought it was SO COOL when my dad brought home a giant, school size, chalk board from his office conference room that was being renovated. I was the only kid on the block with a class room necesity mounted on their playroom wall!

A Cashier- I thought cash registers were so cool. After years of cutting up paper (and killing lots of trees to make fake money and receipts), my parents bought me a REAL cash register like one that made receipts and beeped and chimed. Unfortunately, it didn't come with real money, but a girl can dream, right?

An Archaeologist- Digging up the greatest lost treasures of the world.
Unearthing dinosaur bones. Finding the treasure map that would lead to the hidden chest of gold. Getting the glorious tan outside under the dessert sun. Oh wait! WHAT?!?! I might see a snake? Er, no thanks. I guess I'll stick to the history channel.

A Doctor- trauma surgeon, actually. The rush of adrenaline as the gurney wheels in through the ER door. The rapid "lub-dub" of my heart beating as my beeper goes off...what sort of fun next? The satisfaction of closing up a chest after stopping the gushers from a gunshot wound. Comforting and consoling a family when they fall upon hard times. Wearing scrubs to work every day (so budget friendly)!

An Architect- I must have drafted 20 versions of my dream house. I had grand plans for renovations and additions to my parents house. I'd go on walks through new neighborhoods and browse the real esate section to look at floor plans. I filled 2 sketch books with various homes and designs. One Christmas my parents bought me home design software for the computer. It was my favorite gift that year. we no longer have the computer but under my bed at home is a box filled all my designs and the paint chips of varied color palates and the cut outs of furniture and hardware to outfit my designs.

It's funny how I never dreamt of being a nurse, yet managed to spend $200,000 on an education to become one. At the begging on my junior year in high school, I started to heavily contemplate my future. what did I want to do? What exited me? Where did I see myself? Heavy stuff for a 17 year old. I don't remember when I first considered nursing. But I do know that I got mixed reviews about my choice to attend nursing school.

My guidance counselor, a fabulous mentor, was disappointed. He thought I was settling, "Why not medical school?"

My chemistry teacher, a woman who still inspires me to this day, thought it was great. "Kelly, you are so detail oriented and organized, not to mention your compassion and friendliness, you'll be a wonderful nurse."

My English teacher, the warm and fuzzy grandmother like figure, was thrilled. "Oh good choice Kelly. We know how much you hate grammar and full sentences." (I'll never forget the look on her face. Love you Mrs. B!!)

My friends, people who had seen me at my best and worst, weren't that supportive. "You want to wipe asses all day? Ew, gross."

My aunt and uncle, always jealous over my academic achievements, thought it was just great. Their girls would clearly end up with a better paying job some day.

My best friend S, someone who always called it like she saw it, embraced the idea whole heatedly. She was going to school for OT and we knew that we'd be able to commiserate though biology, chemistry, anatomy and physiology together. She is one of the reasons I made it through.

My parents, my rocks though thick and thin, wanted me to do whatever was going to make me happy. They went to every open house, drove all around the east coast looking at schools, listened to me bitch and moan in fits of indecisiveness, wrote out all those application checks, and didn't think twice about re-mortgaging our house to send me to my top choice school. Without their support I never would have made it though college or even the application process, but when they walked me walk across that stage and receive my diploma they knew all their patience and prayers had paid off. Plus now they had a ~~diploma~~ receipt for their $200,000, even if it was written in Latin and no one knew what the hell it said.

As I approach the one year anniversary at my job and look back, I don't really have any regrets. Being a nurse may not have been what I originally saw myself doing... it's certainly not glamorous, I'm not in it for the money, the hours can be crappy, I deal with a lof of crap (literally)...but at the end of the day I'm learning a lot, meeting great people, making decent money, wearing scrubs to work (take that dry cleaning bills!), and proving to myself that some of life's best adventures aren't the ones you originally saw yourself completing.

Only In New York

2008-07-27T20:11:00.001-04:00

Yesterday in Central Park there was a Transvestite on Roller-skate competition.....absolutely incredible!

Wednesday Night Dinner Club

2008-07-24T16:46:00.003-04:00

I hosted WNDC this week.

On the menu:
*Honey Balsamic Rosemary Chicken
*Herb Roasted Potatoes
*Fresh Green Beans
*Tomato, Mozarella, Basil appetizer
*Chocolate Mouse Cake with fresh berries
and Wine...lots of wine Napa Valley Chardonay, Appellation California Pinot Noir, California Zinfandel, Abruzzi Il Bordo, New Zealand Sauvignon Blanc

Next week: Craig is cooking. I think the theme is Greek. Any suggestions for a nice wine pairing?

Friends in Unexpected Places

2008-07-23T17:24:00.004-04:00

It may or may not come as a surprise to you loyal readers that one of the first things I did when I moved to New York, actually even before I moved to New York, was join the gym. An exercise/endorphin junkie, I was thrilled that my apartment was on the same block as my apartment...I swear I didn't plan it!

I've never been one to think of gym time as socializing time. I go to sweat, clear my head, stay healthy, and (okay, I admit it) scout out ~~cute boys~~ hunky men. However, due to the nature of my job, I'm always there during "old people hours". 5am or 2pm...all those Wall Streeters, construction workers, and men in uniform are there at night, too bad! In any case, I'm used to seeing the same crowd. You get to know them, wave a little hello, flash a little smile. Oh, and if I ever mention to an older man or woman that I'm a nurse, I'm either immediately asked a health question, or told some story about "when they were in the hospital." I'm flattered that they are comfortable opening up to a complete stranger, or maybe I'm weirded out. haha.

Because it seemed like a great way to ~~spend thousands of dollars a year~~ get stronger, I hired a personal trainer. We'll call him "G.I. Greg." Greg's sarcastic attitude and humor made my grueling training sessions enjoyable and he helped knock some sense into me..."What are you doing? Is that how we train? Come on, get it together." I started giving him the finger when eh gave me too much shit. He retaliated and every time I raised that middle digits...30 squat jumps. that little finger hasn't waved in the air since December 2007.

We had been training for abbot a month when he showed up to a session with a huge cut from playing football. I gently offered my "professional advice" and he replied, "Why thank you, Nurse Kelly"...and the nick name stuck. G.I. Greg introduced me to Cheryl and we immediately hit it off. She worked in member services and I'd always pop in and say hello or she'd swing through the training area just to say hi.

As the weeks passed, I got to know most all of the other trainers. Or should I say, they all got to know me. I'd be minding my own business,~~getting all buff~~, and they'd wave across the gym and say, "Hey Nurse Kelly." Really? This is too funny. Nick names catch on quickly. I'd always share stories from work (the good, the bad, and the ugly) with G.I. Greg while training and naturally, others would hear them and ask questions. It became standing interaction, for them to ask, "Save any lives today Nurse Kelly?" Other gym members would always turn around, puzzled, and then sort of eaves drop.

In January I decided that I was going to channel my running passion and run a marathon. I began to log more and more miles each week; I was loving it. GI Greg was helping me build my core strength but he kept warning me that I was running too much, or running to fast, and not getting enough rest. I wanted to listen to him, but I couldn't. Running was like a drug, and I as hooked. I wold hop out of bed to lace up my shoes and hit the road, or even treadmill belt! G I Greg wold run with me in the park and he introduced me to other running partners

In April I got the bad news, GI Greg was going to be leaving in July for some classified federal training (yes, he has one of those cool protection jobs). We continued to rain, I trekked on. I started hanging out with Cheryl more and more. Her schedule was less hectic in the summer, as she doesn't work for the dance company. We made it a plan to do dinner on Wednesday nights. The first night was the week GI Greg left. Wait, forgot to mention, once Cheryl and GI greg are dating (it all makes sense now!)

The next week, Cheryl introduced me to her friend Gay Craig (LOVE THIS BOY!). Well had an excellent time at dinner that night, sharing stories, being silly, sharing our love of great food and wine. That night we saw Aline, another one of GI Greg's former clients, and she joined us for a drink. Before we knew it, 4 hours had passed and we were ~~drunk and full~~ done. Cheryl, much like GI Greg calls me Nurse Kelly. However, Craig, after a few glasses of wine decided that he was going to call me Nurse Betty (ya know, from the book and movie?). Aline, on the other hand, insisted on calling me Nurse Kelly.

Craig decided the following week that he wanted to cook on Wednesday night in lieu of going out. We waked over to Cheryl's apartment. We called Aline and she arrived bottle of wine in hand. Without even thinking, we also called Ken-a trainer and friends of GI Greg's, and came over with his wife and their adopale dog phoebe. *Simply a bonus that we all live within 4 blocks of each other* And there you have. The first official meeting of Wednesday Night Dinner Club. Our dynamics are hilarious:
Cheryl- 30 something, dancer/choreographer who works in sales at the gym
Craig- a late 20 something, who proudly makes fun of his Jewish family, works as a stylist by trade and ~~socializes~~ sells memberships at the gym
Aline- late 40 something with a zest and vigor for life who is absolutely crazy with an amazing husband who tolerates her hanging out with us on Wednesday nights while he plays poker
Ken- 30 something trainer and fitness guru who looks like he stepped of the beaches of Malibu, but is actually a native Long Islander
Lori- Ken's wife, who works in real esates and dablbles in calligraphy, and who sort of crashes WNDC...
Phoebe- Ken and Lori's puppy who is 100% cute, 100% wild, with so many allergies that she sneezes non-stop, and the perfect accent to WNDC.
and me- 20 something year old gym rat , somewhat recent college grad, who loves her job as a nurse and saving lives one hospital bed a time

I never would have thought that such a random group of people could have so much fun! But we do and it only goes to show that you really can find friends in unexpected places.

Four Foods on Friday: Baking Style

2008-07-22T10:26:00.000-04:00

Here are this week’s four questions. This week Valmg is asking us about baking.

#1. When you need to serve desserts, do you buy them or make them?
Depends on the size of the party. I can make a few cookies, cakes, pies, etc....but when it comes to entertaining the masses, I might need to hire a little "help"

#2. When baking do you use butter, margarine or something else?
Depends. Butter for things that need to crisp or flaky and margarine for anything soft and chewy. I never cook with shortening.

#3. What meats or veggies do you cook in the oven?
Potatoes. It's the only way to get that soft center and crispy outside. yumm!

#4. Share a recipe for anything that is cooked in an oven.
Maple Roasted Fennel a WH0LE F00DS creation
this makes an excellent starter, or to cleanse the palate. Added bonus is the fragrance of these items marrying in the oven

8 fennel bulbs, trimmed and rinsed, outside layers removed
1/3 cup maple syrup
1 tablespoon water
sea salt, to taste
ground pepper, to taste

Preheat oven to 350°F. Halve fennel bulbs through the root. Slice halves thinly through the root to hold the slices together. Arrange slices on a parchment-lined rimmed baking sheet without overcrowding them. You may need to do these in batches or use several baking sheets.

Combine maple syrup and water in a small bowl. Lightly brush each fennel slice with this mixture and season with salt and pepper. Turn each slice and repeat brushing and seasoning on other side. Bake for 8 to 10 minutes, until fennel is lightly browned. Remove from oven and turn all slices. Bake 8 to 10 minutes longer, until fennel is tender. Remove and serve immediately.

criteria for the "+1"

2008-07-21T17:29:00.005-04:00

Did you ever have a conversation that by the end left you thinking, "What? How did we up on this topic?" Last night was one of those nights. I went out last night with G, our friend-his fraternity brother J, and their other frat brother M, who just got engaged to E. last week; They've been dating for seven years. Earlier in the day, they had all been at the Y@nkees game and were too tired and sweaty to go out to a fancy dinner, so we settled on a local bar for beers and appetizers. Maybe it was the heat, maybe it was that I hadn't eaten all day but my beer was do delicious, I finished it before the boys. But that's not the point.

Back to my story.

Okay, so M &E are getting married. By some serendipitous fluke, both of their parents have the same wedding anniversary, so that date in September is the obvious choice. However, they are looking at 2009, so they've got a good 14 months. Before we left for the bar, I thoroughly enjoyed sitting by and watching G & J giggle and smile with excitement as they talked about the ~~bachelor party~~ wedding. And then we got onto the topic of dates, ya know the special "+1" that comes on the invites.

The group was giving J a lot of shit and jokingly told him that he has 14 months to find the +1. We suggested that he begin his hunt "tonight." And with that he looked down at his shorts and said. "Does this mean I shouldn't 'mesh it' to the bar". Simultaneously we all said, "Yeah. You might want to change out of the mesh gym shorts." J goes into his room and comes out, trying to put on a belt; however, we notice that he's missing a button on the shorts. He told us, "Well the other day I ate some chicken wings, sat down, and POP...off it came." He then patted his belly in a oh so maternal kind of way and turned to reach for another pair of shorts in his closet. But what do you know! 2 more pairs, without buttons. So either J needs to go on a diet, or find a girl who sews. Speaking of finding a girl, once we were at the bar, and all had a few drinks in us, we asked J to make a list of deal breakers when it comes to a girl. Brace yourself, here we go:
1. non-smoker
2. Piercing: only ears and belly button
3. Tattoos: preferably not, but a tasteful, discretely placed would be okay
4. Must love meat
5. Must be willing to "rub his belly" (apparently its okay if this doesn't occur on date #1)
6. Not skinny, he likes a little "something to grab"
7. Jewish, ideally, although he did say he'd take a normal non Jew, to an ugly Jew
8. Must have 2 boobs, uniboob won't do. Really? haha
9. brunette, then blonde. Guess, there are too many red headed Jews?
10. Likes Loves Beer
11. Can cook
12. Likes to spoon AND have sex
13. in relationship to #13, he's willing to wait a while
14. Would want to go to a Mets/Yankees game with him, but if he got tickets to a Sox/Yankees game she'd tell him to go with friends
15.Willing to hang with the guys

and there you have it. J's criteria for his "+1". So if you know any female ages 20-24, that fit the above criteria, and are free in September 2009...be sure they inquire. haha

To Fill In My Past

2008-07-19T10:30:00.004-04:00

Looking back over my blog entries, I noticed a trend...I really haven't written much about boys and dating (or lack there of). There are a few scattered posts, but nothing significant. When I started this blog, 2 years ago, it was a way for me to chronicle my adventures through senior year of college and recollect fond memories from the previous three years. I've half-heartedly stuck to my plan; however, now this blog is more of a personal diary, if you consider "personal" that which is read by people who I don't know and maybe never will.

God, I'm off topic again. Yes, back to dating. I figured that I'd start to fill in some of the gaps. This way it's on record for me and you can be entertained, maybe.

When this blog was born, a rather interesting summer had just ended. Let me take you back there…

At the end of my junior year I was seeing a boy in the med school. I thought all was great, especially seeing as I was staying in Philly over the summer to work at CHOP. What I failed to recognize was that he was essentially in school all summer going back and fourth to clinical sites, just like I had been all school year. We spent some great time together, conversation was incredible, and let's just say that he was a good host in the few days when I was homeless in between apartment leases. However, then he went out to , PA and we were apart for a few weeks. I was working at the hospital, so it was common for us to play phone tag. At first, the calls still came, but then they were less and less. On July 2nd, I actually managed to get a hold of him on the phone. He asked me my plans for the 4th and I said that I was planning on heading down to the fireworks and street fair with some friends. I asked him the same question. He mumbled something about meeting up with friends for a bbq later in the day. I could sense a distance in his voice, but he told me was just exhausted. He asked if I wanted to meet up for brunch on the morning of the 4th. Odd? I thought, but agreed.

I had that feeling in the pit of my stomach that something was up, but I tried to let it go.

I got up early on the 4th and went for a long run...yes, in the 90 degree heat. I needed to de-stress. He arrived at my apartment around 11 and came to the back door. I welcomed him in, offered him a drink, and a seat. He sort of looked nervous, hands in pockets, rocking back and forth in his shoes and quickly suggested that we go grab some food. We walked up the block to M@rathon and were quickly seated… next to 2 of his friends. I got the sense he wanted to move our seats, but the restaurant was busy. He was sort of an a$$. He said hi to his friends and gabbed for a minute. He didn't introduce me. I introduced myself, "Hi, I'm Kelly." He followed with, "Oh, yeah, um...my fri...she's in the nursing school."
Smooth, real smooth.

We ordered our food and made small talk, a huge change from the great conversation usually shared between us. I thought I was going to be sick. I knew where this was going and I just wanted it to be done. SAY IT ALREADY!

Then the bill came. Don't get me wrong, chivalry has a time and place, but this is modern day and I have no problem paying for my own food. I always offer. However, he had never let me pay before, so it did surprise me when I pulled out my money and he said, "Well, can you leave $15?" Uh, okay.

We got up and walked out. No hand holding, barely a door hold. We walked back, briskly, to my apartment and, again, I invited him inside. We sat on my futon and conversation seemed painful. And then he turned to me and said, "Soo...I'm not sure how you feel, but I've done a lot of thinking, especially since I was away..."
Wait, are we defining this 'relationship' or ending it?
"And what I realized is that, I don't have the time to give you....that you deserve...for this relationship"
I swallowed hard, "Uh, hunh."
"I think you're great, but we are at different points in our life. We're both just so busy, ya know?"
So now he's deciding that I'm too busy? Okay, whatever. But wait, did he just do that? He actually defined and ended the 'relationship’ in the same breath. Never heard that one before.
He looked at me and said, "This is okay with you, right?"
Erg, how do you respond to that? I'm assuming it's more of a rhetorical question.
"I understand. We've each got our own stuff going on…” I took a deep breath.
"Really? Great!"

He then attempted to go on and make normal conversation. I was hurt and really just wanted to ask him to leave. I could only hold back the tears for so long and swallow the lump in the throat so many times.
After a seemingly eternal five minutes, he got up and left. No hug, no hand shake, just the head nod (yes, the head buck forward that seems almost gangsta).

He left, I closed the door, curled up in bed, and cried. Why I was upset. It's not like we were dating, or that it had been clearly established. But as I let the tears roll, I realized I was upset because I was sad. I had every right to be sad. I lost a friend and felt like the above transpired events were one sided. Maybe I wished I could have spoken my mind, maybe not.

I've always been a quiet person. Not emotionless, but quiet. I’m a thinker and listener. I take it all in and analyze it…then I speak my mind. I'd forgo an argument if it seemed pointless. I believe we are all entitled to our own opinions and why argue over a minute point if you know you'll never change their mind, that they will see your lips move but be mute to the sound. I kept wondering, should I have said something? Would I have felt better?

In the end, it all worked out for the best. I was lucky enough to be surrounded by a great group of friends that night who didn't let me sulk in solitude. They dragged me out and we had a fantastic night watching the fireworks, rain showers and all.

After a few days, the sting subsided, and I went about my life. Good friends, great memories, and fear not, a few other boys came along that summer. A few months into senior year, I bumped into the boy and we had a great conversation. We decided to meet for lunch the next day. (Am I a glutton for punishment? Maybe.) We talked about the rest of the summer, his clinical rotations, my clinical rotations, his thoughts on residency, my thoughts on moving to the Big Apple and passing my boards. He seemed happy and secure, as was I. And at that moment, I knew I had made the right choice months before. He hadn't ended our fling to spite me, he did it for himself, and I'm okay with that. In this world that we live in, sometimes you just have to do what's right for you, because you know yourself best. He needed to take the time to get his plans figured out and didn’t want to deal with splitting his time. Note* I may have better perspective now on why we broke it off, but he could still use a few tips on how to let someone down in a more precise and less drawn out manner.

It's Friday! And This Is My Four Foods Post

2008-07-18T12:01:00.004-04:00

According to Valmg, "If you’ve got a working sniffer you can play". So why don't you hop on over to her blog and check out this meme!
#1. Fruits and veggies. Do you prefer them peeled or not?
Unpeeled, but they need to be thoroughtly washed. I use this fruit and veggie wash.

#2. What’s your favorite fresh fruit or vegetable smell?
It's a tie between pineapple and oragnes

#3. What’s the worst food smell you’ve ever smelled?
Olives. I love shopping in the gourmet/specialty food shops, but I have to run through the fresh olive section. Makes me want to heave.

#4. Share the recipe for the dish that you love to smell cooking in your oven.
Dutch Apple Cake: inspired by an allrecipes.com recpe

3 apples - peeled, cored and cut into thin wedges
3 tablespoons white sugar
2tablespoons brown sugar
2 teaspoons ground cinnamon
1/2 cup raisins

3 cups all-purpose flour
3 teaspoons baking powder
2 cups white sugar
4 eggs
1 cup vegetable oil
2 1/2 teaspoons vanilla extract
2/3 cup fresh orange juice

DIRECTIONS
Preheat oven to 350 degrees F. Grease and flour a 10 inch Bundt pan. In a medium bowl, combine the apples, raisins, 5 tablespoons sugar and cinnamon. Set aside.

Sift together the flour and baking powder; set aside. In a large bowl, mix together the eggs and sugar. Stir in the oil, vanilla and orange juice, mixing until blended. Make a well in the center of the dry ingredients and pour in the orange juice mixture. Stir just until combined.

Layer batter and apple mixture in the prepared pan, beginning and ending with the batter. Bake in the preheated oven for 70 minutes, or until a toothpick inserted into the center of the cake comes out clean. Allow to cool.

The Diagnosis Is... (the grammatically correct version)

2008-07-12T17:14:00.006-04:00

I know you have all been dying in suspense (oh no wait, that was me) but on Thursday I finally found out what's wrong with me. Like I mentioned in this post, the doctor was 99% sure that I had stress fracture in the neck of femur aka a hip fracture. I had the MRI and then had to wait 2 weeks to get the results.

My appointment was for 9:30 am Thursday morning. All day Wednesday my mind was in a fog and I couldn't focus. I guess I didn't make the best choice by going out and getting a bit tipsy that night, but I thought it would help me sleep. Erg, WRONG. I fell asleep immediately upon crawling into bed, but was wide awake 3 hours later with my mind running a thousand miles an hour.

I think I managed to dose off around 6:30 a.m., only to be waken by my alarm at 8:15. I jumped out of bed, took a quick shower, and got dressed. I felt like a bipolar person. MY mind was all over the place, vacillating from good to bad back to good and then to awful. At 9, I walked out the door and made the 4 block walk to the doctors office. Within minutes I was called into the room and I sat there-on the crisp white paper- in the cotton hospital shorts, my legs so white they blended in with the paper, my heart racing. Dr. M knocked on the door and came in. He heartily shook my hand and asked how I was feeling. I told that I was feeling slightly better, but that the pain was still there.

Silence....God I hate that!

He logged into the computer and pulled up my MRI. He spent a minute trying to orient me to my anatomy but all I heard was "blah blah blah blah....bone should be black....blah blah blah....all this is white, that's inflammation"
Okay, now I needed to focus. I put my best listening ears on (ouy, I've been babysitting too much lately, haha) and then he said, "So much to my surprise your femur is okay...."

Wahwhoooooo! Horray! Yes, sweet! Oh yeah baby!

"But see this here..."

wait, is he still talking? was that a "but"

"That's your pubic ramus and that's a mighty big fracture."

My stomach came up my throat and my heart sank.

"What this tell us is that you are one tough cookie. Most people with this injury can barely walk, let alone continue to train."

I had to compose myself and fight back tears. The conversation that followed left me so upset. Basically I'm on activity restriction for another 4 weeks, my September marathon is out, and this upcoming week I have to go have a DEXA scan done.

This battle is just beginning. Now that we have a diagnosis, we need to figure out why it happened. My PT evaluation already revealed a substantially weakened left side, but it's more a chicken or the egg question. Is it weak because it's injured, or did the weakness lead to the injury. The bone scan will show the condition of my bones, yet another test I'm dreading. Once I get those results, I'll have a better idea of where I stand.

However, it's odd that I find myself in this predicament. I've known for over 7 years that I have low bone density. One of the treatments for LBD is weight bearing activity (strength training and impact activities) but I already do those. I also take a calcium supplement. I'm sure you have all seen the commercials for the osteoporosis medications like Act0nel, B0niva, F0smax, but they aren't approved for women of childbearing age because they have uncertain teratogenic effect on fetuses.

And let's be honest, I don't want to decide, at the ripe old age of 23, that I want to forgo having kid for the sake of a medication that could be obsolete in 10 years.

So where does that leave me? I don't know.

What I do know is that my PT regimen is grueling. I hurt so much afterwards, I want to cry. I also know that this injury has forced me back into the pool, something that I never though would happen. I swam competitively for 12 years but gave it up college; I haven't set foot in lane lined pool since high school. My reasons for leaving swimming behind are for another post, but I found myself in tears yesterday when I went to the store to buy a cap and goggles.

Today I made the emotional plunge back into the pool. After PT I made my way to the locker room, suited up, walked out onto the deck, and then stood at the edge of the pool. I grabbed a kick board, pull buoy, paddles, and fins. I jumped in and just started to swim. After less than 25 yards, it felt like I had never left the pool. My upper body still carried my stoke, I still preferred breathing to my left side, I still stroked with my left hand right preceding a flip turn...

My body didn't ache like when I'd be out of swimming shape in between seasons, but I felt sore, from using different muscles. I swam for about an hour and by the end I was tired; however, I didn't want to stop. Something in me wanted to keep going, keep pushing. I was tired and sore, but not in agony. Wait, something is wrong with that mentality. I'm never going to get better if I keep pushing to injury. I'm an addict, an endorphin junkie. Working out, the endorphin high, and the stress release is like crack to an addict.

Sigh....

Now, off to work, and let the waiting begin (again)

Four Foods on Friday: Party Edition

2008-07-11T09:21:00.002-04:00

Want to see how everyone else entertains? Go on over to Valmg's blog and check out Four Foods on Friday week # 30!

#1. Cake. Buttercream, whipped cream or ice cream?
Buttercream frosting is classic in my house.

#2. When entertaining do you use real, paper, plastic or styrofoam dishes?
Real dishes (a few too many accidents with disposable dishwear breaking!)

#3. When hosting a party do you cook, have it catered or go to a restaurant?
99% of the time I cook. Sometimes I'll cheat and have a few dishes made and serve them along with the homemade stuff!

#4. Share a recipe that you frequently serve when having a party.
Spinach Stuffed Portabella Mushroms

Ingredients:
2 cups Parsley
2 teaspoons Garlic
.5 cup choppd Onion
3.5 servings Leaf Spinach, Frozen
2 tablespoons Olive Oil
2 tablespoons Butter
6 Portabello Mushroom Raw
1 egg
.5 cups Breadcrumbs
1/3 cup Parmesan, Grated Cheese
1/3 cup goat cheese

Instructions:
Portabello mushrooms sauteed in olive oil and butter and placed aside.
Onion cooked until translucent.
Mix the thawed/drained spinach, breadcrumbs, egg, onion, parlsely, cheese, and garlic.
Stuff the Mushrooms stuffed with spinach mixture.
Melt the butter, and lightly drizzle atop the mushroom caps.
Srpinkle goat cheese on top of caps.
Put in 350 degree oven for 40 minutes.
Remove, let cool for 5 minutes, enjoy!