Ooooo, my password still works!

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....

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...

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

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)

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

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

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)

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

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

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 winelaugh. 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

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

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

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!

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

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

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

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

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

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

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!!!