In the past 5 days, Spring has sprung in New York; however, I've been oblivious as I've worked the last five nights. Today, as I walked down the street (in only a semi exhausted fog) I noticed the leaves on the trees and the birds a churping. It's a happy day. So while I've neglected to notice the entrance of spring, here are a few things that I have done the past five days...
1. Worn the same pair of sweatpants to and from work
2. Left my dinner at home, orderd out at work, gotten too busy to eat it, left the ordered dinner at work, brought in the forgotten home meal the next night, only to dicover my ordered food from the night before.
3. Stood at the Kronos macine furiously typing my ID # to punch in, getting annoyed that it wouldn't accept it, only to realize that I was typing in the residnet on call's beeper #
4. Called the pharmacy to complain that they still haven't sent up my patients antibiotics, told them I checked the drawer and patients room and was very frusterated for the delay...they told me to look in the refrigetor, th emedication needs to be kept cold. Whoops, my bad.
5. Not remembered walking home in the morning..autopilot anyone?
6. Tripped on my patients foley bag , leaped through the air, caught myself on the roley chair, and splat....faceplant. *ouch*
7. Answered my cell phone, " Burn Center how can I help you"
8. Showed up to pick up my new glasses at 8am on a Sunday morning, only to realize they aren't open. (In all honesty, can you blame them?)
9. Realized after I was nakey in the shower that I had no towel...thank God the roomate was at work that afternoon.
10. tried to use my license to swipe in the credit card machine
11. Fallen asleep sitting on the bus and missed my stop
12. Gone to bed with wet hair and woken up looking something like Don King
13. Shampood my hair conditioner and conditioned my hair with shampoo
Now, off to take advantge of this lovely weather. Happy Earth Day
Monday, April 21, 2008
Friday, April 18, 2008
Stuff You Didn't Learn in Nutrition Class
Sleep deprivation is killing me. I now spend what should be precious hours of sleep, surfing the net for fun food facts. Just thought I'd share some of them...
Lemons contain more sugar than strawberries
The onion is named after a Latin word meaning large pearl
Half of the world's population live on a staple diet of rice; there are over 44,000 varieties fown world wide
The first breakfast cereal ever produced was Shredded Wheat
There are about 100,000 bacteria in one litre of drinking water
Instant coffee has been in existence since the middle of the eighteenth century
The dish chop-suey does not come from China. It was created by Chinese immigrants in California
The Average Person Eats Almost 1500 Pounds Of Food A Year!
-->On average, that can be thought of as 150 pounds of meat, 290 pounds of milk and cream, 35 pounds of eggs, 48 pounds of chicken, 68 pounds of bread, 125 pounds of potatoes, and 80 pounds of fruit. That should be enough to fill your stomach.
6 out of every 10 apples that get eaten every day in the U.S. were grown in Washington State. The most popular varieties are Red Delicious, Gala, Granny Smith, Golden Delicious and Fuji.
Hawaii is the only state that grows pineppales
A hard boiled egg spins but a soft cooked or raw egg does not.
.007 calories are consumed while licking a stamp.
Buffalo wings have nothing to do with bison. They are spicy chicken wings that originated in Buffalo, New York.
The energy food of bikers and hikers is called Gorp: Good Old Raisins and Peanuts.
According to folklore, pretzels were given to children who knew their prayers. The pretzel shape was supposed to signify arms folded across the chest in prayer.
Mozzarella Cheese was first made in the 7th Century from the milk of the Indian Water Buffalo.
Credit where credit is due, and due, and due
Lemons contain more sugar than strawberries
The onion is named after a Latin word meaning large pearl
Half of the world's population live on a staple diet of rice; there are over 44,000 varieties fown world wide
The first breakfast cereal ever produced was Shredded Wheat
There are about 100,000 bacteria in one litre of drinking water
Instant coffee has been in existence since the middle of the eighteenth century
The dish chop-suey does not come from China. It was created by Chinese immigrants in California
The Average Person Eats Almost 1500 Pounds Of Food A Year!
-->On average, that can be thought of as 150 pounds of meat, 290 pounds of milk and cream, 35 pounds of eggs, 48 pounds of chicken, 68 pounds of bread, 125 pounds of potatoes, and 80 pounds of fruit. That should be enough to fill your stomach.
6 out of every 10 apples that get eaten every day in the U.S. were grown in Washington State. The most popular varieties are Red Delicious, Gala, Granny Smith, Golden Delicious and Fuji.
Hawaii is the only state that grows pineppales
A hard boiled egg spins but a soft cooked or raw egg does not.
.007 calories are consumed while licking a stamp.
Buffalo wings have nothing to do with bison. They are spicy chicken wings that originated in Buffalo, New York.
The energy food of bikers and hikers is called Gorp: Good Old Raisins and Peanuts.
According to folklore, pretzels were given to children who knew their prayers. The pretzel shape was supposed to signify arms folded across the chest in prayer.
Mozzarella Cheese was first made in the 7th Century from the milk of the Indian Water Buffalo.
Credit where credit is due, and due, and due
Wednesday, April 16, 2008
You Guessed It, FFOF
Here are this week’s four questions. If you are inspired to play, go HERE
#1. Cottage cheese. Small curd, large curd, chunk or whipped?
I used to prefer small curd, but my job has pretty much turned me off from all chunky liquid substances, thankyouverymuch. :)
#2. Burgers. Made fresh, preformed fresh or preformed frozen?
It seems that preforned frozen veggie burgers stand up the best. Don't get me wrong, I've tried to make fresh but it was more of a disaster than a success. Anyone have any advice to share?
#3. If you could only buy one kind of salad dressing what would it be?
I usually just stick with pure aged balsamic vinegar, but there is nothing like Poppyseed Dressing, yum!
#4. Share a crockpot or slow cooker recipe.
Bell Peppers Stuffed With Salsa Rice And Beans
Serves: 4 *Use red, green, or yellow bell peppers and hot or mild salsa, according to your preference*
4 large bell peppers
1 1/2 cups cooked or one 15 1/2-ounce can red kidney beans, drained and rinsed
1 cup tomato salsa
3 scallions, chopped
Salt and freshly ground black pepper
One 14.5-ounce can crushed tomatoes
1/2 teaspoon ground cumin
1/4 teaspoon dried oregano
1/2 teaspoon sugar
Cut the tops off the bell peppers and remove and discard the stems, seeds, and membranes. Arrange the peppers upright in a 5- to 6-quart slow cooker.
In a medium bowl, combine the rice, beans, salsa, scallions, and salt and pepper to taste. Mix well. Fill the pepper cavities evenly with the rice mixture, packing lightly. Replace the pepper tops.
In a medium bowl, combine the tomatoes with the cumin, oregano, sugar, and salt and pepper to taste. Pour over and around the peppers in the slow cooker. Cover and cook on low for 4 hours, or until the peppers are tender but still hold their shape.
Excerpted from Fresh from the Vegetarian Slow Cooker by Robin Robertson ©2004, The Harvard Common Press.
#1. Cottage cheese. Small curd, large curd, chunk or whipped?
I used to prefer small curd, but my job has pretty much turned me off from all chunky liquid substances, thankyouverymuch. :)
#2. Burgers. Made fresh, preformed fresh or preformed frozen?
It seems that preforned frozen veggie burgers stand up the best. Don't get me wrong, I've tried to make fresh but it was more of a disaster than a success. Anyone have any advice to share?
#3. If you could only buy one kind of salad dressing what would it be?
I usually just stick with pure aged balsamic vinegar, but there is nothing like Poppyseed Dressing, yum!
#4. Share a crockpot or slow cooker recipe.
Bell Peppers Stuffed With Salsa Rice And Beans
Serves: 4 *Use red, green, or yellow bell peppers and hot or mild salsa, according to your preference*
4 large bell peppers
1 1/2 cups cooked or one 15 1/2-ounce can red kidney beans, drained and rinsed
1 cup tomato salsa
3 scallions, chopped
Salt and freshly ground black pepper
One 14.5-ounce can crushed tomatoes
1/2 teaspoon ground cumin
1/4 teaspoon dried oregano
1/2 teaspoon sugar
Cut the tops off the bell peppers and remove and discard the stems, seeds, and membranes. Arrange the peppers upright in a 5- to 6-quart slow cooker.
In a medium bowl, combine the rice, beans, salsa, scallions, and salt and pepper to taste. Mix well. Fill the pepper cavities evenly with the rice mixture, packing lightly. Replace the pepper tops.
In a medium bowl, combine the tomatoes with the cumin, oregano, sugar, and salt and pepper to taste. Pour over and around the peppers in the slow cooker. Cover and cook on low for 4 hours, or until the peppers are tender but still hold their shape.
Excerpted from Fresh from the Vegetarian Slow Cooker by Robin Robertson ©2004, The Harvard Common Press.
Saturday, April 12, 2008
Why I Love New York
Last night was the first Friday night I've had off, aside from my vacation, since January 1st. I know, great social life, hunh?!?
I wound up on the lower east side at this really homey, eclectic (odd combination, right) Italian place. My friend and I met around 9 and the place was packed. The bar is on the left side of the restaurant and some really narrow tables on the right...the only way to make it to the back was to squeeze through this approximately 18 inch wide opening...thank god I skipped lunch, haha. We made out way to the back, put in our name, were told the wait was 35 minutes. Hey, not bad for a Friday night. We grabbed drinks and sat outside on the patio to wait. 45 minutes later, they called us, literally. This place takes your cell phone number!
We squeezed back through the 18 inch passage way and were taken through this small doorway to another part of the restaurant. Equally crowded, as the open kitchen took up more than 1/2 of the space. looking around, I was ratter bewildered as to where we would be seated, can we say full house? But because this city never ceases to amaze me, out host sat us at the bar/counter looking into the kitchen. Talk about a first class seat! The sights and smells were more than enough to offset that fact that were sharing this amazing view with 2 other people resulting in each of us with about 8 inches of personal space. Food was great, service was great, all in all a good way to spend a Friday night.
Only draw back to the night was our location. It's a haul from the UES to the LES...a 35 minute bus ride or a 20 minute subway ride plus a walk. I took the bus down, and figured I'd take the subway home. I get onto the packed 6 train and hold on for dear life...all the while thinking, AMEN that I have some purell in my purse. After 42nd Street the train cleared out. As I'm sitting there I look straight, to be met by an angry stare from a crazed woman dressed all in white; I look to the left to be glared back at by a thuggish guy all decked out in lots of gold bling; I look to the right and suddenly feel uncomfortable as this Mexican is looking me up and down. That's when I decided that I'd just look down at people's feet. After about 2 minutes of sizing up every one's shoes, I was already bored. And that's when I looked up and started reading all the advertisements: "Phoenix University", "Viagra: The Little Blue Pill", "Learn English in Comforts of your home" (wait, why is that sign written in Enlgihs???), "Depression and Anxiety Study", etc, etc. That's when it hit me. They don't put up all these ads to get a point across, they do it to help people like me feel less awkward. Sweet!
My night was topped off when I walked up to my building behind this guy and girl. They sort of paused outside the door, like they were hesitating. Thinking maybe they lost their keys in a drunken stupor, or that they were looking for a certain apartment to buzz, I asked, "Do you need to be let in?". Then with a straight face the guy looks right at me and says, "Nope, We're just waiting for you tro pass so we can make out for a while." I chuckled and thought, "you're a good man pal, a good man."
And with that, I entered the building tucked my little self into bed, all the while thinking...this is why I love New York.
I wound up on the lower east side at this really homey, eclectic (odd combination, right) Italian place. My friend and I met around 9 and the place was packed. The bar is on the left side of the restaurant and some really narrow tables on the right...the only way to make it to the back was to squeeze through this approximately 18 inch wide opening...thank god I skipped lunch, haha. We made out way to the back, put in our name, were told the wait was 35 minutes. Hey, not bad for a Friday night. We grabbed drinks and sat outside on the patio to wait. 45 minutes later, they called us, literally. This place takes your cell phone number!
We squeezed back through the 18 inch passage way and were taken through this small doorway to another part of the restaurant. Equally crowded, as the open kitchen took up more than 1/2 of the space. looking around, I was ratter bewildered as to where we would be seated, can we say full house? But because this city never ceases to amaze me, out host sat us at the bar/counter looking into the kitchen. Talk about a first class seat! The sights and smells were more than enough to offset that fact that were sharing this amazing view with 2 other people resulting in each of us with about 8 inches of personal space. Food was great, service was great, all in all a good way to spend a Friday night.
Only draw back to the night was our location. It's a haul from the UES to the LES...a 35 minute bus ride or a 20 minute subway ride plus a walk. I took the bus down, and figured I'd take the subway home. I get onto the packed 6 train and hold on for dear life...all the while thinking, AMEN that I have some purell in my purse. After 42nd Street the train cleared out. As I'm sitting there I look straight, to be met by an angry stare from a crazed woman dressed all in white; I look to the left to be glared back at by a thuggish guy all decked out in lots of gold bling; I look to the right and suddenly feel uncomfortable as this Mexican is looking me up and down. That's when I decided that I'd just look down at people's feet. After about 2 minutes of sizing up every one's shoes, I was already bored. And that's when I looked up and started reading all the advertisements: "Phoenix University", "Viagra: The Little Blue Pill", "Learn English in Comforts of your home" (wait, why is that sign written in Enlgihs???), "Depression and Anxiety Study", etc, etc. That's when it hit me. They don't put up all these ads to get a point across, they do it to help people like me feel less awkward. Sweet!
My night was topped off when I walked up to my building behind this guy and girl. They sort of paused outside the door, like they were hesitating. Thinking maybe they lost their keys in a drunken stupor, or that they were looking for a certain apartment to buzz, I asked, "Do you need to be let in?". Then with a straight face the guy looks right at me and says, "Nope, We're just waiting for you tro pass so we can make out for a while." I chuckled and thought, "you're a good man pal, a good man."
And with that, I entered the building tucked my little self into bed, all the while thinking...this is why I love New York.
Thursday, April 10, 2008
Is this the answer to my want-ad?
I know you are all still on the lookout for me after reading my post/want ad....but now I'm not sure if I should give up now, or fight harder. Let me know what you think after reading this article. (See below)
The Eligible Bachelor
HOW ECONOMICS AND GAME THEORY EXPLAIN THE SHORTAGE OF AVAILABLE, APPEALING MEN.
By Mark Gimein
Posted Wednesday, April 9, 2008, at 4:23 PM ET
It is a truth universally acknowledged that the available, sociable, and genuinely attractive man is a character highly in demand in social settings. Dinner hosts are always looking for the man who fits all the criteria. When they don't find him (often), they throw up their hands and settle for the sociable but unattractive, the attractive but unsociable, and, as a last resort, for the merely available.
The shortage of appealing men is a century-plus-old commonplace of the society melodrama. The shortage—or—more exactly, the perception of a shortage—becomes evident as you hit your late 20s and more acute as you wander into the 30s. Some men explain their social fortune by believing they've become more attractive with age; many women prefer the far likelier explanation that male faults have become easier to overlook.
The problem of the eligible bachelor is one of the great riddles of social life. Shouldn't there be about as many highly eligible and appealing men as there are attractive, eligible women?
Actually, no—and here's why. Consider the classic version of the marriage proposal: A woman makes it known that she is open to a proposal, the man proposes, and the woman chooses to say yes or no. The structure of the proposal is not, "I choose you." It is, "Will you choose me?" A woman chooses to receive the question and chooses again once the question is asked.
The idea of the woman choosing expressed in the proposal is a resilient one. The woman picking among suitors is a rarely reversed archetype of romantic love that you'll find everywhere from Jane Austen to Desperate Housewives. Or take any comic wedding scene: Invariably, it'll have the man standing dazed at the altar, wondering just how it is he got there.
Obviously, this is simplified—in contemporary life, both sides get plenty of chances to be selective. But as a rough-and-ready model, it's not bad, and it contains a solution to the Eligible-Bachelor Paradox.
You can think of this traditional concept of the search for marriage partners as a kind of an auction. In this auction, some women will be more confident of their prospects, others less so. In game-theory terms, you would call the first group "strong bidders" and the second "weak bidders." Your first thought might be that the "strong bidders"—women who (whether because of looks, social ability, or any other reason) are conventionally deemed more of a catch—would consistently win this kind of auction.
But this is not true. In fact, game theory predicts, and empirical studies of auctions bear out, that auctions will often be won by "weak" bidders, who know that they can be outbid and so bid more aggressively, while the "strong" bidders will hold out for a really great deal. You can find a technical discussion of this here. (Be warned: "Bidding Behavior in Asymmetric Auctions" is not for everyone, and I certainly won't claim to have a handle on all the math.) But you can also see how this works intuitively if you just consider that with a lot at stake in getting it right in one shot, it's the women who are confident that they are holding a strong hand who are likely to hold out and wait for the perfect prospect.
This is how you come to the Eligible-Bachelor Paradox, which is no longer so paradoxical. The pool of appealing men shrinks as many are married off and taken out of the game, leaving a disproportionate number of men who are notably imperfect (perhaps they are short, socially awkward, underemployed). And at the same time, you get a pool of women weighted toward the attractive, desirable "strong bidders."
Where have all the most appealing men gone? Married young, most of them—and sometimes to women whose most salient characteristic was not their beauty, or passion, or intellect, but their decisiveness.
Evolutionary psychologists will remind us that there's a long line of writing about "female choosiness" going back to Darwin and the male peacocks competing to get noticed by "choosy" mates with their splendid plumage. But you don't have to buy that kind of reductive biological explanation (I don't) to see the force of the "women choose" model. You only have to accept that for whatever socially constructed reason, the choice of getting married is one in which the woman is usually the key player. It might be the man who's supposed to ask the official, down-on-the-knee question, but it usually comes after a woman has made the central decision. Of course, in this, as in all matters of love, your experience may vary.
There may be those who look at this and try to derive some sort of prescription, about when to "bid," when to hold out, and when (as this Atlantic story urges) to "settle." If you're inclined to do that, approach with care. Game theory deals with how best to win the prize, but it works only when you can decide what's worth winning.
The Eligible Bachelor
HOW ECONOMICS AND GAME THEORY EXPLAIN THE SHORTAGE OF AVAILABLE, APPEALING MEN.
By Mark Gimein
Posted Wednesday, April 9, 2008, at 4:23 PM ET
It is a truth universally acknowledged that the available, sociable, and genuinely attractive man is a character highly in demand in social settings. Dinner hosts are always looking for the man who fits all the criteria. When they don't find him (often), they throw up their hands and settle for the sociable but unattractive, the attractive but unsociable, and, as a last resort, for the merely available.
The shortage of appealing men is a century-plus-old commonplace of the society melodrama. The shortage—or—more exactly, the perception of a shortage—becomes evident as you hit your late 20s and more acute as you wander into the 30s. Some men explain their social fortune by believing they've become more attractive with age; many women prefer the far likelier explanation that male faults have become easier to overlook.
The problem of the eligible bachelor is one of the great riddles of social life. Shouldn't there be about as many highly eligible and appealing men as there are attractive, eligible women?
Actually, no—and here's why. Consider the classic version of the marriage proposal: A woman makes it known that she is open to a proposal, the man proposes, and the woman chooses to say yes or no. The structure of the proposal is not, "I choose you." It is, "Will you choose me?" A woman chooses to receive the question and chooses again once the question is asked.
The idea of the woman choosing expressed in the proposal is a resilient one. The woman picking among suitors is a rarely reversed archetype of romantic love that you'll find everywhere from Jane Austen to Desperate Housewives. Or take any comic wedding scene: Invariably, it'll have the man standing dazed at the altar, wondering just how it is he got there.
Obviously, this is simplified—in contemporary life, both sides get plenty of chances to be selective. But as a rough-and-ready model, it's not bad, and it contains a solution to the Eligible-Bachelor Paradox.
You can think of this traditional concept of the search for marriage partners as a kind of an auction. In this auction, some women will be more confident of their prospects, others less so. In game-theory terms, you would call the first group "strong bidders" and the second "weak bidders." Your first thought might be that the "strong bidders"—women who (whether because of looks, social ability, or any other reason) are conventionally deemed more of a catch—would consistently win this kind of auction.
But this is not true. In fact, game theory predicts, and empirical studies of auctions bear out, that auctions will often be won by "weak" bidders, who know that they can be outbid and so bid more aggressively, while the "strong" bidders will hold out for a really great deal. You can find a technical discussion of this here. (Be warned: "Bidding Behavior in Asymmetric Auctions" is not for everyone, and I certainly won't claim to have a handle on all the math.) But you can also see how this works intuitively if you just consider that with a lot at stake in getting it right in one shot, it's the women who are confident that they are holding a strong hand who are likely to hold out and wait for the perfect prospect.
This is how you come to the Eligible-Bachelor Paradox, which is no longer so paradoxical. The pool of appealing men shrinks as many are married off and taken out of the game, leaving a disproportionate number of men who are notably imperfect (perhaps they are short, socially awkward, underemployed). And at the same time, you get a pool of women weighted toward the attractive, desirable "strong bidders."
Where have all the most appealing men gone? Married young, most of them—and sometimes to women whose most salient characteristic was not their beauty, or passion, or intellect, but their decisiveness.
Evolutionary psychologists will remind us that there's a long line of writing about "female choosiness" going back to Darwin and the male peacocks competing to get noticed by "choosy" mates with their splendid plumage. But you don't have to buy that kind of reductive biological explanation (I don't) to see the force of the "women choose" model. You only have to accept that for whatever socially constructed reason, the choice of getting married is one in which the woman is usually the key player. It might be the man who's supposed to ask the official, down-on-the-knee question, but it usually comes after a woman has made the central decision. Of course, in this, as in all matters of love, your experience may vary.
There may be those who look at this and try to derive some sort of prescription, about when to "bid," when to hold out, and when (as this Atlantic story urges) to "settle." If you're inclined to do that, approach with care. Game theory deals with how best to win the prize, but it works only when you can decide what's worth winning.
What Would Friday Be Without FFOF??
Here are this week’s four questions.
#1. What’s your favorite food smell?
The Fall. If I could bottle up the scent of fresh, crisp air with the hint of newly fallen leaves, and the background undertones of a wood buring chimney....ahh yes, I think Yankee Candle would have a winner!
#2. What’s your favorite kind of apple?
Gala in the summer, Granny Smith in the spring, and Macintosh the Fall
#3. What veggies do you like in your salad?
Baby spinach, baby arugula, tomatoes, cucumbers, white mushrooms, celery, grilled eggplant, broccoli, grated carrot, sun dried tomatoes, chickpeas. I know, not really "basic" but us vegetarians cannot survive on lettuce alone.
#4. Share a recipe that uses beef.
Stuffed Burgers
*Makes 6*
olive oil
2 cups yellow onion, finely chopped
1 cup green pepper, finely chopped
3 pounds lean ground beef
2 eggs, slightly beaten
3 tablespoons Worcestershire sauce
salt and pepper to taste
1/2 cup ketchup or chili sauce
2 teaspoons minced fresh oregano
6 thick slices of sharp Cheddar
-Heat olive oil in skillet. When hot, add onions and pepper and cook until tender.
-In another bowl, combine beef, eggs, Worcestershire, salt and pepper. Mix lightly and shape into 12 thin patties.
-Spoon onion and pepper mixture onto centers of 6 patties and top each with 2 tablespoons ketchup or chili sauce and some oregano.
-Cover with remaining patties and pinch the sides securely closed; place refrigerator until ready to cook.
When you're ready and the grill is hot, grill burgers about 3 inches from the coals for about 5–8 minutes on each side.
Top with a slice of cheese when you're just about done; cover the grill to melt the cheese.
Enjoy with a big soft bun, summer tomatoes, butter lettuce and the condiments of your choice. These burgers are so moist.
If you are hoping to do more low carb, use two large leaves of Boston lettuce in place of the bun!
#1. What’s your favorite food smell?
The Fall. If I could bottle up the scent of fresh, crisp air with the hint of newly fallen leaves, and the background undertones of a wood buring chimney....ahh yes, I think Yankee Candle would have a winner!
#2. What’s your favorite kind of apple?
Gala in the summer, Granny Smith in the spring, and Macintosh the Fall
#3. What veggies do you like in your salad?
Baby spinach, baby arugula, tomatoes, cucumbers, white mushrooms, celery, grilled eggplant, broccoli, grated carrot, sun dried tomatoes, chickpeas. I know, not really "basic" but us vegetarians cannot survive on lettuce alone.
#4. Share a recipe that uses beef.
Stuffed Burgers
*Makes 6*
olive oil
2 cups yellow onion, finely chopped
1 cup green pepper, finely chopped
3 pounds lean ground beef
2 eggs, slightly beaten
3 tablespoons Worcestershire sauce
salt and pepper to taste
1/2 cup ketchup or chili sauce
2 teaspoons minced fresh oregano
6 thick slices of sharp Cheddar
-Heat olive oil in skillet. When hot, add onions and pepper and cook until tender.
-In another bowl, combine beef, eggs, Worcestershire, salt and pepper. Mix lightly and shape into 12 thin patties.
-Spoon onion and pepper mixture onto centers of 6 patties and top each with 2 tablespoons ketchup or chili sauce and some oregano.
-Cover with remaining patties and pinch the sides securely closed; place refrigerator until ready to cook.
When you're ready and the grill is hot, grill burgers about 3 inches from the coals for about 5–8 minutes on each side.
Top with a slice of cheese when you're just about done; cover the grill to melt the cheese.
Enjoy with a big soft bun, summer tomatoes, butter lettuce and the condiments of your choice. These burgers are so moist.
If you are hoping to do more low carb, use two large leaves of Boston lettuce in place of the bun!
Wednesday, April 09, 2008
Entitlement?
I would like to think that I have not become a hardened bitch and or nurse Ratchet, but tonight there seems to be a whole lot of "WTF" going on.
Explain to me this, if you are going to refuse services, why did you bother coming to the hospital. Why did you seek treatment.
Pt X, 61 year old obese female, admitted s/p flame burns to chest and right upper extremity. Burns noted to be mostly 2nd degree with some 3rd degree around the areola of her R breast. Pt went to the OR 5 days ago for autografting, donor site was the R upper thigh.
Where to begin with this patient...
#1: She's been primarily bed bound due to her bulky splint and dressing for the past 5 days; she's obese.
*She's been refusing her heparin shots.
Yes lady, I know they hurt like hell, but would you rather throw a clot and have a stroke or a heart attack, or both and die?
#2: Her blood sugars have been well over 200.
*She's been refusing her insulin.
Yes lady, I hear you when you say you weren't "diabetic" before you came to the hospital; however, you also do not have a primary care physician, nor were you testing you blood sugar at home. Did I mention that sometimes the stress of a burn injury can induce a temporary rise in your blood glucose level. Do you understand that the tighter we control your sugars, the better you wounds will heal?
#3: She's mal-odorous (I'm being nice here).
*She's been refusing her morning shower.
Lady, you sweat profusely, you have a weeping donor site, you have large breasts and abdominal folds that need to be washed so you don't get a fungal infection that will inevitably spread to your freshly grafted wounds and then you will be here getting IV antifungals that will turn your urine orange and you will pitch a fit because we will have to put in a foley catheter in order to accurately examine your kidney and liver function due to the toxicity of the medications you will be taking. FOR THE LOVE OF GOD, TAKE YOUR DAMN SHOWER!
#4: She complains about the food.
*She's been gobbling up every last morsel we put on her tray and mooches off of others.
*Lady, I'm sorry: that you think the mashed potatoes are too lumpy , that the chicken isn't tender enough, that the tea is a basic blend and not something of the organic variety, that we use smuckers peanut butter instead of jiff, that we serve oatmeal raisin not chocolate chip cookies, that we have Splenda not Equal, that we use white eggs not brown ones, that lunch and dinner are served on plastic trays, and that we supply plastic not metal silverware (it;s not like we are serving fillet Mignon)-wait, let me apologize for that too. Honestly, this isn't a five star restaurant. There are sick people here. Tell you what, if you hate the food that much, lie back and I'll put an NG tube in you. We'll pump you with liquid nutrition, you won;t have to taste anything.
#5: She complaints about the linens.
*She refuses to use hospital linens and/or wear a hospital gown.
Lady, I'll cut you a little slack on this, I agree, I wouldn't really want to lie on sheets that had previously been covered in god knows what, but your complaining about the thread count is out of line. And the issue about the gown, give me a break! The gowns allow for easy access. I have to change your dressings twice a day, It's not fair that I be required to strip you down like someone who's dressed to venture out in a blizzard. Please, for the love of god, and the sake of the patients who are really sick, cut the crap, and wear the gown.
Am I being unreasonable? I get that being hospitalized is stressful. I understand that you have lost control of your environment, that you endure painful procedures, that you experience aggravating delays in care, and that you really want to go home, but please, work with me here. I'm trying my best. Try and make the best of the situation. I want you to heal so you can go home but if you fight me on all the little things, time is going to stand still.
Explain to me this, if you are going to refuse services, why did you bother coming to the hospital. Why did you seek treatment.
Pt X, 61 year old obese female, admitted s/p flame burns to chest and right upper extremity. Burns noted to be mostly 2nd degree with some 3rd degree around the areola of her R breast. Pt went to the OR 5 days ago for autografting, donor site was the R upper thigh.
Where to begin with this patient...
#1: She's been primarily bed bound due to her bulky splint and dressing for the past 5 days; she's obese.
*She's been refusing her heparin shots.
Yes lady, I know they hurt like hell, but would you rather throw a clot and have a stroke or a heart attack, or both and die?
#2: Her blood sugars have been well over 200.
*She's been refusing her insulin.
Yes lady, I hear you when you say you weren't "diabetic" before you came to the hospital; however, you also do not have a primary care physician, nor were you testing you blood sugar at home. Did I mention that sometimes the stress of a burn injury can induce a temporary rise in your blood glucose level. Do you understand that the tighter we control your sugars, the better you wounds will heal?
#3: She's mal-odorous (I'm being nice here).
*She's been refusing her morning shower.
Lady, you sweat profusely, you have a weeping donor site, you have large breasts and abdominal folds that need to be washed so you don't get a fungal infection that will inevitably spread to your freshly grafted wounds and then you will be here getting IV antifungals that will turn your urine orange and you will pitch a fit because we will have to put in a foley catheter in order to accurately examine your kidney and liver function due to the toxicity of the medications you will be taking. FOR THE LOVE OF GOD, TAKE YOUR DAMN SHOWER!
#4: She complains about the food.
*She's been gobbling up every last morsel we put on her tray and mooches off of others.
*Lady, I'm sorry: that you think the mashed potatoes are too lumpy , that the chicken isn't tender enough, that the tea is a basic blend and not something of the organic variety, that we use smuckers peanut butter instead of jiff, that we serve oatmeal raisin not chocolate chip cookies, that we have Splenda not Equal, that we use white eggs not brown ones, that lunch and dinner are served on plastic trays, and that we supply plastic not metal silverware (it;s not like we are serving fillet Mignon)-wait, let me apologize for that too. Honestly, this isn't a five star restaurant. There are sick people here. Tell you what, if you hate the food that much, lie back and I'll put an NG tube in you. We'll pump you with liquid nutrition, you won;t have to taste anything.
#5: She complaints about the linens.
*She refuses to use hospital linens and/or wear a hospital gown.
Lady, I'll cut you a little slack on this, I agree, I wouldn't really want to lie on sheets that had previously been covered in god knows what, but your complaining about the thread count is out of line. And the issue about the gown, give me a break! The gowns allow for easy access. I have to change your dressings twice a day, It's not fair that I be required to strip you down like someone who's dressed to venture out in a blizzard. Please, for the love of god, and the sake of the patients who are really sick, cut the crap, and wear the gown.
Am I being unreasonable? I get that being hospitalized is stressful. I understand that you have lost control of your environment, that you endure painful procedures, that you experience aggravating delays in care, and that you really want to go home, but please, work with me here. I'm trying my best. Try and make the best of the situation. I want you to heal so you can go home but if you fight me on all the little things, time is going to stand still.
Sunday, April 06, 2008
In case you happen to see one of these just hanging around...
Be on the lookout!
Wanted: fairly attractive, normal guy ,with a decent job,and a healthy sense of humor; who is a wine lover, adventerous eater,close with his family, an active and energetic person; who knows how to dress well, that money isn't everything, that sometimes I have to work on nights and weekends, and won't laugh at me we when he learns I can't drive stick shift or use a lighter.
If all else fails (aka reality, haha) , I'll settle for a completely and utterly "yup-tastic" guy. True fo my New England and Ivy League roots: summers on Nantucket, popped collars wtih embroidered shorts from J.Crew, loafers, aviators, and blazers...all make me weak in the knees.
So in case you happen to find someone who meets the above criteria, let me know. k, thanks. :)
Wanted: fairly attractive, normal guy ,with a decent job,and a healthy sense of humor; who is a wine lover, adventerous eater,close with his family, an active and energetic person; who knows how to dress well, that money isn't everything, that sometimes I have to work on nights and weekends, and won't laugh at me we when he learns I can't drive stick shift or use a lighter.
If all else fails (aka reality, haha) , I'll settle for a completely and utterly "yup-tastic" guy. True fo my New England and Ivy League roots: summers on Nantucket, popped collars wtih embroidered shorts from J.Crew, loafers, aviators, and blazers...all make me weak in the knees.
So in case you happen to find someone who meets the above criteria, let me know. k, thanks. :)
Friday, April 04, 2008
"This Is My Confession"
So yeah, definitely stole that headline from Usher, but at least I'm giving him proper credit now.
I have to work tonight, so I tried to have a mellow day. I did laundry, cleaned, organized (compulsive, but I swear I'm working on it), read, ran 10 miles, etc. After all that was done, I found myself bored and reading many of the blogs that I follow. I came across one that was a good read and made me chuckle. Actually, most of her posts make my chuckle; nevertheless, I thought I'd also write about a few of my "secrets". And now.....drum roll please.....my confessions.
*Warning- reading these may seem like TMI. You have two choices: stop reading or read on and don't pass judgment, haha*
1. I wear sports bra's 98% of the time. I counted today, I have 18 of them. I have 4 real bras. Sometimes it's good to have the chest of a teenage boy.
2. I talked my way out of my first (and only) speeding ticket. I didn't cry. Actually, I sort of bribed the cop. When he saw that I was wearing my work uniform "Cridge Crew" and knew that I was coming home after a long night of scooping ice cream cones and that the lines are usually ridiculously long, I was happy to agree to giving him a free sundae and let him cut the line the next time he stopped by "The Ridge".
3. In second grade I stole a package of gum off my teachers desk. Whoops!
4. I am slightly obsessive compulsive about cleaning and organizing. I cannot go to sleep with a dirty kitchen, leave the house with a dirty bathroom, or enjoy doing nothing when my laundry isn't put away. I'm sure this will make me a very good hosuewifey one day, but in the meantime, it just comes off as psychotic.
5. I was pissed that I only graduated 4th in my high school class. That stupid B+ in Calculus I junior year.
6. In high school, my boyfriend's mom, dad, aunt, uncle, grandmother and grandfather walked in on us. Apparently they forgot their house keys after a family dinner outing and had to come in through the garage. We made a conscious effort never to "snuggle" in the basement TV room again.
7. There are some pictures of me wearing a whip cream bikini top from a summer pool party gone very wrong. Thankfully I have the negatives and they will NEVER surface again.
8. I hate chest hair. So with respect to my dating life, "Gorillas need not apply"
9. The summer before my senior year in college I was eh, hooking up with one of the surgical residents who worked on the floor where I was externing. We thought we were sly, funny, most of the staff knew. Note to self, don't mix work and play
10. I'm an awful liar.
11. I have peed my pants as an adult
12. I didn't poo the entire first week of college because I "poop stress" aka the thought of using a public toilet was agony
13. I have body image issues.
14. I would rather wax my eyebrows and get it over in one quick "RIP" than to put myself through agony of the individual "pluck"
15. My freshman year of college, I passed out with my head in a trash barrel in the top bunk of my boyfriends bed.
16. I have the drinking tolerance of a 10 year old. 2 beer queer, if I'm lucky. Hey, it makes me a cheap date!
17. My ankles swell to tree trunks by my 4th 12 hour shift, despite the fact that I wear compression stockings. Sexy, hunh?
18. I've forgotten to take off my surgical cap before leaving work. I looked pretty damn sexy walking down 1st avenue...so that's what the taxi's were honking at
19. I've been locked out my apartment twice.
#1- 8am on a Saturday morning in west Philadelphia. I was wearing a boys lacrosse shorts and white tank top with my crocs. I had to walk 5 blocks to the locksmith. Boy what that a sight!
#2- 6pm on a Friday on the UES of Manhattan. I was wearing a skirt and flip flops. I had to run 12 blocks to the locksmith who had the proper information to make me a new set of keys. Turns out, his methods were faulty, and he really couldn't let me back in. However, the brother gave it his best sho, became my BFF and asked me to his sisters wedding after I had known him all of 25 minutes. For the record, I politely declined.
20. There is nothing like picking a good wedgie.
21. In St. Maarten while out for my morning run, I thought I could clear the chain separating the beach from the street. Nope! Face plant. Still have the bruises on my arm, shin, and hip to prove it.
22. My closet can be separated into J. Crew, Banana Republic, Gap, and Target. Classy, right?
23. I've got other "dirty laundry" but I'm not okay putting it 'out there' on the web.~ thankyouverymuch~
I have to work tonight, so I tried to have a mellow day. I did laundry, cleaned, organized (compulsive, but I swear I'm working on it), read, ran 10 miles, etc. After all that was done, I found myself bored and reading many of the blogs that I follow. I came across one that was a good read and made me chuckle. Actually, most of her posts make my chuckle; nevertheless, I thought I'd also write about a few of my "secrets". And now.....drum roll please.....my confessions.
*Warning- reading these may seem like TMI. You have two choices: stop reading or read on and don't pass judgment, haha*
1. I wear sports bra's 98% of the time. I counted today, I have 18 of them. I have 4 real bras. Sometimes it's good to have the chest of a teenage boy.
2. I talked my way out of my first (and only) speeding ticket. I didn't cry. Actually, I sort of bribed the cop. When he saw that I was wearing my work uniform "Cridge Crew" and knew that I was coming home after a long night of scooping ice cream cones and that the lines are usually ridiculously long, I was happy to agree to giving him a free sundae and let him cut the line the next time he stopped by "The Ridge".
3. In second grade I stole a package of gum off my teachers desk. Whoops!
4. I am slightly obsessive compulsive about cleaning and organizing. I cannot go to sleep with a dirty kitchen, leave the house with a dirty bathroom, or enjoy doing nothing when my laundry isn't put away. I'm sure this will make me a very good hosuewifey one day, but in the meantime, it just comes off as psychotic.
5. I was pissed that I only graduated 4th in my high school class. That stupid B+ in Calculus I junior year.
6. In high school, my boyfriend's mom, dad, aunt, uncle, grandmother and grandfather walked in on us. Apparently they forgot their house keys after a family dinner outing and had to come in through the garage. We made a conscious effort never to "snuggle" in the basement TV room again.
7. There are some pictures of me wearing a whip cream bikini top from a summer pool party gone very wrong. Thankfully I have the negatives and they will NEVER surface again.
8. I hate chest hair. So with respect to my dating life, "Gorillas need not apply"
9. The summer before my senior year in college I was eh, hooking up with one of the surgical residents who worked on the floor where I was externing. We thought we were sly, funny, most of the staff knew. Note to self, don't mix work and play
10. I'm an awful liar.
11. I have peed my pants as an adult
12. I didn't poo the entire first week of college because I "poop stress" aka the thought of using a public toilet was agony
13. I have body image issues.
14. I would rather wax my eyebrows and get it over in one quick "RIP" than to put myself through agony of the individual "pluck"
15. My freshman year of college, I passed out with my head in a trash barrel in the top bunk of my boyfriends bed.
16. I have the drinking tolerance of a 10 year old. 2 beer queer, if I'm lucky. Hey, it makes me a cheap date!
17. My ankles swell to tree trunks by my 4th 12 hour shift, despite the fact that I wear compression stockings. Sexy, hunh?
18. I've forgotten to take off my surgical cap before leaving work. I looked pretty damn sexy walking down 1st avenue...so that's what the taxi's were honking at
19. I've been locked out my apartment twice.
#1- 8am on a Saturday morning in west Philadelphia. I was wearing a boys lacrosse shorts and white tank top with my crocs. I had to walk 5 blocks to the locksmith. Boy what that a sight!
#2- 6pm on a Friday on the UES of Manhattan. I was wearing a skirt and flip flops. I had to run 12 blocks to the locksmith who had the proper information to make me a new set of keys. Turns out, his methods were faulty, and he really couldn't let me back in. However, the brother gave it his best sho, became my BFF and asked me to his sisters wedding after I had known him all of 25 minutes. For the record, I politely declined.
20. There is nothing like picking a good wedgie.
21. In St. Maarten while out for my morning run, I thought I could clear the chain separating the beach from the street. Nope! Face plant. Still have the bruises on my arm, shin, and hip to prove it.
22. My closet can be separated into J. Crew, Banana Republic, Gap, and Target. Classy, right?
23. I've got other "dirty laundry" but I'm not okay putting it 'out there' on the web.~ thankyouverymuch~
Wednesday, April 02, 2008
where did the time go?
Holy cow, I've been a real nurse for 9 months.
It's unbelieveable.
Overnight, (okay, four years, $210,000, numerous lost social hours, and more bed pans than I can count) I became a nurse.
Yup, on July 5th I went from Kelly, student nurse/"wanna be R.N." to Kelly R.N./"scared shitless to enter the real world of nursing because now people's lives actually depend on what I do."
I had a little less than a month after "becoming a nurse" to let it settle in. Before I knew it, I was taking on new challenges as a nurse in the Burn Intensive Care Unit.
And now, for your viewing pleasure, "My Life As a Nurse from A-Z"
a) It's been long, it's been hard, it's been frustrating, it's been rewarding.
b) There have been tears of laughter and those of sorrow.
c) I've been covered in every bodily fluid imaginable.
d) I've successfully resuscitated someone;
e) I've stood by as a family withdrew care and I watched the monitor flatline.
f) I've had patients reinstill in me the reasons I became a nurse;
g) I've had patients who made me question every decision I've made over the last four plus years.
h) I've worked days, I've worked nights, I've worked overtime.
i) I've been awake for 42 hours straight;
j) I've slept for 18 hours straight.
k) I've held a patients hand to let them know I care.
l) I've been karate chopped at by an angry/violent patient crying out for attention.
m) I've sounded idiotic when I've called pharmacy and cannot pronounce the name of the antibiotic that I'm requesting.
n) I've saved a life when I noticed that the antihypertensive agent (hydralazine) was ordered instead of the antihistamine (hydroxyzine).
o) I've gone 14 hours without urinating; I've urinated non stop after 5 beers.
p) I've missed out on parties/dinners/movies/social gatherings becuase of working night shift;
q) I've had 8 days off from work without ever having to take a vacation day.
r) I've been asked out by a patient
s) I've seen some mighty cute doctors roaming the halls.
t) I've passed gas in a patients room
u) I've been covered in every bodily fluid imaginageble (whoops, already said that one).
v) I've seen more male genetalia that all of my "promiscious" friends combined
w)I've sen what gravity does...NONE of us want to age.
x) I've stood in the med room talking to myself about what I need to do
y) I've talked to family and loved ones about death
z) I've come a long way, but my journey is just beginning.
Thanks for all the support along the way. Now hold on tight, this is only the warm-up!
It's Friday! You know what that means!
Here are this week’s four questions.
#1. American cheese. Sliced fresh or prepackaged processed cheese product?
I don't really like cheese, except for goat and The Laughing Cow swiss cubes. However, when I'm going to be serving it (American Cheese) up, it must be fresh sliced. That rubbery processed stuff scares me! Then again, maybe it has a loner shelf life, so I'm sure it works for someone.
#2. What is your favorite cracker?
Reduced Fat Wheat Thins. Oh that salt and crunch, yumm!
#3. What hot breakfast cereal do you like? Think oatmeal, farina, grits, etc.
McCanns Steel Cut Irish Oatmeal. Throw some chopped apples and cinnamon in it, yum!
#4. Share a recipe that uses corn.
Mardi Gras Jicama Slaw
1 1/2 pounds jicama
3/4 cup low fat sour cream or 0% Greek Yogurt
1/2 cup chopped scallions
1/2 cup frozen corn kernels, thawed, or 1 ear of fresh corn, shucked, kernels removed
1/2 cup (cooked) black beans, rinsed and drained
1/2 cup chopped parsley
1/8 cup rice vinegar
2 teaspoons cayenne pepper
1 teaspoon sea salt
Peel and shred the jicama with a cheese grater, using the largest holes or the julienne blade of a food processor, and place in a bowl. Blend in the sour cream, scallions, corn, black beans, parsley, rice vinegar, cayenne pepper, and salt.
I know you want to join, check it out here
#1. American cheese. Sliced fresh or prepackaged processed cheese product?
I don't really like cheese, except for goat and The Laughing Cow swiss cubes. However, when I'm going to be serving it (American Cheese) up, it must be fresh sliced. That rubbery processed stuff scares me! Then again, maybe it has a loner shelf life, so I'm sure it works for someone.
#2. What is your favorite cracker?
Reduced Fat Wheat Thins. Oh that salt and crunch, yumm!
#3. What hot breakfast cereal do you like? Think oatmeal, farina, grits, etc.
McCanns Steel Cut Irish Oatmeal. Throw some chopped apples and cinnamon in it, yum!
#4. Share a recipe that uses corn.
Mardi Gras Jicama Slaw
1 1/2 pounds jicama
3/4 cup low fat sour cream or 0% Greek Yogurt
1/2 cup chopped scallions
1/2 cup frozen corn kernels, thawed, or 1 ear of fresh corn, shucked, kernels removed
1/2 cup (cooked) black beans, rinsed and drained
1/2 cup chopped parsley
1/8 cup rice vinegar
2 teaspoons cayenne pepper
1 teaspoon sea salt
Peel and shred the jicama with a cheese grater, using the largest holes or the julienne blade of a food processor, and place in a bowl. Blend in the sour cream, scallions, corn, black beans, parsley, rice vinegar, cayenne pepper, and salt.
I know you want to join, check it out here
Friday, March 28, 2008
Full Moon
My last 4 night stretch was insane. A little recap for your reading pleasure...
Night # 1: 95%er, see this post
Night #2: Freshly extubated patient goes into respiratory distress, with sustained tachycardia and hypertension, spiking fevers, and one nasty tunneling pressure ulcer from an unclosed section of autograft, and pooping gallons of poo. (oh the glory that is my job)
Night #3:
-Upon return from the hyperbaric chamber, a smoke inhalation admission (Pt A) from night #2 drops her BP to 60/30, her heart rate beats at 185, her troponin 0.7....can we say having a massive heart attack?
-While pt A is having her heart attack, the fellow sees a lab result from another new smoke inhalation patient and realizes that the patient needs to have a STAT arterial blood gas drawn...respiratory distress, here she comes!.
-A float nurse, taking care of pt C, decides that because he isn't familiar with burns and just wont do wound care...umm., that didn't fly with the us nurses. The above metnined nurse also revealed that he doesn't know how to use an A-line...uh, okay. maybe you should have told us that before you got report, now the assignment has to be changed at 2am.
-Then arrives incareratedpt E and his chain gang guards. No one can get blood from him...nurse Kelly to the rescue...guess I was feeling like a vampire, got it on the first stick.
-Pt F, thinks it's a good time to have runs of PVC's and then go into V-tach.
-About this time the central lab calls to inform Nurse M that patient E's blood sugar is 44. Did I mention that Nurse M is also taking care of patient F? So I venture in to give some D50, but what do you know?...the patient has pulled out her IV! Okay, IV dextrose out, oral glucose gel in! I
'm sure more was going on during this time but my head really couldn't do much more.
Night #4:
-Pt A has another cardiac episode.
-2 admissions from the ER...why do people let their kids play with matches?!?!?
-Mr. A's (not to be confused with Pt A) trach balloon popped thus severely diminishing the ability for the ventilator to deliver his oxygen. What to do?!? Yup, replace it STAT at the bedside. Oh yeah, that's right, there is ah hospital wide shortage on #8 trach sets...quick, run, to another room and see if they have an extra set. Found one! Thank God it's still in the box and plastic wrap, so much for isolation precautions. Uh, nothing a little bleach wipe can't fix!
-Back to pt A. She's maxed out on pressors, we are having to doppler her pulses every 30 minutes. Uh oh, we just lost the pulses in the right lower extremity. Call the on call fellow STAT. Oh wait, don't get excited, there just wasn't enough gel on the probe. Pulse is still there, weak-but there.
-On to pt E. Her NG tube is clogged. Can't auscultate it in the stomach, can't flush it. Out it comes. In goes a new one, we think. Nope, it's in her mouth. Try again. Nope, can't hear it in the stomach. Try it again. Nope, can't flush it. Enough! Text page the resident. His response: "No way, you're kidding, right? We couldn't get one in her the other night, she has some really funky nasopharygneal anatomy. Try it one more time, then let me know." Result? By some miracles of God, I got it in. All pt E had to do was tip her head back and continuously swallow....easier said than done.
-Did I mention that while all this was going on, our tube system (just like the ones at the drive up window at the bank) was down meaning we had to call escort to deliver all of our labs and/or send a nurse down to pharmacy to sign for meds and narcotics.
Again, I'm sure more was going on, but let's face it...we were already dealing with enough.
I wish I could say that I went home to bed, but I did not. Instead I hauled my tush across town to catch a 9:30 train to Philly to hang out with my favorite 2 and 4 year olds (R & J) for the week. Naps just weren't in the cards for R& J on Monday (who could blame them, Nurse Miss Kelly was in town!), so neither was a nap for me; however, when I finally crawled into bed at 8:45 pm after 32 hours of being awake, I was asleep in less than a minute, and it was pure bliss.
Back to work tonight. Wish me luck.
Night # 1: 95%er, see this post
Night #2: Freshly extubated patient goes into respiratory distress, with sustained tachycardia and hypertension, spiking fevers, and one nasty tunneling pressure ulcer from an unclosed section of autograft, and pooping gallons of poo. (oh the glory that is my job)
Night #3:
-Upon return from the hyperbaric chamber, a smoke inhalation admission (Pt A) from night #2 drops her BP to 60/30, her heart rate beats at 185, her troponin 0.7....can we say having a massive heart attack?
-While pt A is having her heart attack, the fellow sees a lab result from another new smoke inhalation patient and realizes that the patient needs to have a STAT arterial blood gas drawn...respiratory distress, here she comes!.
-A float nurse, taking care of pt C, decides that because he isn't familiar with burns and just wont do wound care...umm., that didn't fly with the us nurses. The above metnined nurse also revealed that he doesn't know how to use an A-line...uh, okay. maybe you should have told us that before you got report, now the assignment has to be changed at 2am.
-Then arrives incareratedpt E and his chain gang guards. No one can get blood from him...nurse Kelly to the rescue...guess I was feeling like a vampire, got it on the first stick.
-Pt F, thinks it's a good time to have runs of PVC's and then go into V-tach.
-About this time the central lab calls to inform Nurse M that patient E's blood sugar is 44. Did I mention that Nurse M is also taking care of patient F? So I venture in to give some D50, but what do you know?...the patient has pulled out her IV! Okay, IV dextrose out, oral glucose gel in! I
'm sure more was going on during this time but my head really couldn't do much more.
Night #4:
-Pt A has another cardiac episode.
-2 admissions from the ER...why do people let their kids play with matches?!?!?
-Mr. A's (not to be confused with Pt A) trach balloon popped thus severely diminishing the ability for the ventilator to deliver his oxygen. What to do?!? Yup, replace it STAT at the bedside. Oh yeah, that's right, there is ah hospital wide shortage on #8 trach sets...quick, run, to another room and see if they have an extra set. Found one! Thank God it's still in the box and plastic wrap, so much for isolation precautions. Uh, nothing a little bleach wipe can't fix!
-Back to pt A. She's maxed out on pressors, we are having to doppler her pulses every 30 minutes. Uh oh, we just lost the pulses in the right lower extremity. Call the on call fellow STAT. Oh wait, don't get excited, there just wasn't enough gel on the probe. Pulse is still there, weak-but there.
-On to pt E. Her NG tube is clogged. Can't auscultate it in the stomach, can't flush it. Out it comes. In goes a new one, we think. Nope, it's in her mouth. Try again. Nope, can't hear it in the stomach. Try it again. Nope, can't flush it. Enough! Text page the resident. His response: "No way, you're kidding, right? We couldn't get one in her the other night, she has some really funky nasopharygneal anatomy. Try it one more time, then let me know." Result? By some miracles of God, I got it in. All pt E had to do was tip her head back and continuously swallow....easier said than done.
-Did I mention that while all this was going on, our tube system (just like the ones at the drive up window at the bank) was down meaning we had to call escort to deliver all of our labs and/or send a nurse down to pharmacy to sign for meds and narcotics.
Again, I'm sure more was going on, but let's face it...we were already dealing with enough.
I wish I could say that I went home to bed, but I did not. Instead I hauled my tush across town to catch a 9:30 train to Philly to hang out with my favorite 2 and 4 year olds (R & J) for the week. Naps just weren't in the cards for R& J on Monday (who could blame them, Nurse Miss Kelly was in town!), so neither was a nap for me; however, when I finally crawled into bed at 8:45 pm after 32 hours of being awake, I was asleep in less than a minute, and it was pure bliss.
Back to work tonight. Wish me luck.
Wednesday, March 26, 2008
4foodsONfriday
#1. What’s your favorite form of potatoes?
Sweet potatoes. I shared a recipe for their yummy delight a few weeks ago
#2. Pie crust. Premade or from scratch?
From scratch. Yup, typical type A over-acheiver.
#3. Vegetables. Fresh, frozen or canned?
Fresh always/as much as possible, oh how I love the farmers market;
Frozen for things like Trader Joe's white corn;
Canned never. Too much salt, too much mush.
#4. What one dish do you wish you could prepare better?
Brownies. No, I'm serious. Mine are always runny or burt to a crisp and look like little turds. Doesn't matter if they are boxed or from scratch, they always have some issue. Hmm...maybe it's my oven?
CLick on over to Valmg's blog if you want to join in the fun!
Sweet potatoes. I shared a recipe for their yummy delight a few weeks ago
#2. Pie crust. Premade or from scratch?
From scratch. Yup, typical type A over-acheiver.
#3. Vegetables. Fresh, frozen or canned?
Fresh always/as much as possible, oh how I love the farmers market;
Frozen for things like Trader Joe's white corn;
Canned never. Too much salt, too much mush.
#4. What one dish do you wish you could prepare better?
Brownies. No, I'm serious. Mine are always runny or burt to a crisp and look like little turds. Doesn't matter if they are boxed or from scratch, they always have some issue. Hmm...maybe it's my oven?
CLick on over to Valmg's blog if you want to join in the fun!
Friday, March 21, 2008
ready-set-go
I was on vacation from work for 15 days. IT WAS HEAVEN. But all good things must come to and end, right? Um, yeah, they do.
Last night was my first night back. As I got off the elevator the familiar, "welcoming" smell of cauterized flesh, charred skin, and topical antimicrobicals wafted under my nose. Sigh...
I went to the scrubex, got my scrubs, punched in, and headed into the locker room. I almost forgot my combination, but it soon came to me. I chatted with my fellow coworkers who were interested in hearing about my vacation and then I ventured out to "face my doom." To my surprise, staffing was okay, I had two relatively stable patients, well minus the ventilator and erratic junctional rhythm that plagued my patients on top of their burns. I no sooner finished getting report, when the charge nurse hung up the phone and paged me. "Don't get report, Kelly. We're changing the assignment, We've on 80%er." Eeks. Although I love the adrenaline rush of big, fresh, juicy burn, the anticipation can be overwhelming. I tried to get more of the history, but we didn't have a lot of information. the patient was being seen by the fellow and resident down in the ER, the ER nurse was going to be calling up report, but I needed to move fast and set up for a long night ahead.
As that thought crossed my mind, my stomach gave me a little rumble. Guess I should have eaten those eggs I hard boiled at home.
I set off to the supply room in a fury..gathering all my supplies, setting up central lines, prepping for an arterial line, anticipating the needs for a salem sump nasogastic tube insertion, finding all of the supplies to do burn care, paging respiratory to bring me a ventilator, etc. My hands were full, my heart beat was quick, my steps rapid. Game on folks!
I no sooner had everything set up, when the ER called up. I took report. 88 year old female with 95% TBSA (total body surface area) 3rd degree burns-yikes, worse than I thought. Pt was intubated in the ER and currently having an A-line placed. Vitals signs, not so stable; Respiratory status, shitty;core body temperature, 31.1 (that's88 degree Fahrenheit); chance of survival, less than 2 percent. She'd be arriving on the floor in 15 minutes.
Exactly 15 minutes later (shocker, I know! ER time estimates are never accurate) my patient arrived via stretcher being bagged by the respiratory therapist, attached to the portable cardiac monitor, and accompanied by one of our burn fellows. Hmm, gotta love that smell. Charred flesh, and lots of it. Immediately, we transferred her to the bed, hooked up all her lines, started a versed drip, continued to pump her with her Parkland Burn Formula fluid requirements (22Liters in 24 hours. Her temperature 31 degrees. With each degree that her body temperature dropped, so does her chance of survival. WE ran all her fluids though the fluid warmer, placed her under the heat shield and bair hugger. Building engineering increased the temperature of her room to 80 degrees....thank god I remembered my deodorant!
This poor woman was a mess. Her extremities were like icicles to the the touch, her skin beginning to swell as we pump her massively vasodilated circulatory system with fluids, her blood pressure remained low, her heart rate high...all signs pointing to being intravascularly depleted and dry. We couldn't do burn care, she was too cold.
The woman had no family, but her power of attorney was on her way in from New Jersey with the patients living will. Until then, we just had to wait. I ran around hanging fluids, pushing meds, sending of arterial blood gases and blood work, but she wasn't warming up. I sent off her blood to get a metabolic profile with all her electrolytes, but she was so cold and vasoconstricted that the blood kept hemolyzing and we couldn't get a reading. I thought attempt #4 would be my lucky shot, but I no sooner sent off her labs, than I got a phone call from the lab that the top popped off and the sample was lost. What the hell?!?! I can't keep drawing blood off this patient, she's not stable enough for the circus. I gave it one more shot, finally success.
As I was finishing the priest came to administer last rites, the patients last request before she was intubated. Yes, that's right. She was awake and alert for almost 2 1/2 hours. As the priest prayer with/over the now sedated and vented patient, I felt calmed, like if the woman was to die (on this Good Friday) that she would be at a spiritual peace. After the priest left, 3 different neighbors came to pray the Rosary over her. I was touched.
At 1am the health care proxy/power of attorney arrived, looking shaken and upset. I went with the fellow and we gently talked with the woman outside the room. After calling the administrator on call and the attending, the patient was made DNR with no escalation of care. I sat with the HCP (turns out she's the patients god-daughter) and let her know that I would continue to remain available to them if she had questions or needs over night. She thanked me and left.
By 4am, the woman had only put out 4 cc's of black turbid "urine". Quick little bit of math for you: 15 Liters (15,000cc) of fluid in, 4cc out, = 14996net. Kidneys have shut down.
Around 5am her respiratory status really started to decline. Her lungs were filling with fluid and her circumferential chest burns weren't allowing her lungs and chest wall to expand. Aside from changing a few settings on the vent to force some of the alveloi open, there wasn't much we could go. The waiting game began.
Soon to follow, her blood pressure took a hit and her heart rate continued to rise. She wasn't perfusing her extremities. She was loosing body heat again.My heart sank. I stood there and said a quick prayer.
By change of shift, her prognosis was grim and it was torture giving report to the say nurse. It was futile. I felt like I was handing over a corpse. As I walked off the unit Friday morning, I wondered what the day would bring for my dear patient. I went home exhausted. I realized that I hadn't been to the bathroom in 13 hours, but then again I hadn't drank anything either...and that's why my urine was almost the color of tea. Sorry if that's TMI.
Despite the exhaustion, I couldn't sleep. I tossed and turned. Around 1:30 I got up and went running. It was good to clear my head, I needed that.
As I walked back onto the floor Friday night, I heard the overhead page. "Nurse taking care of pt in room XXX please indicate. Transport is here."
And so it happened. She died. The day nurse reported to me that the family decided to withdraw care and remove the patient from the ventilator around 4:XXp.m. She died 8 minutes later.
I'm not sure if it was because this is Holy Week, or because it was my first night back after a glorious vacation, but I do know that Thursday night affected me. We need to cherish each and every day because the only guarantee in life is that there are no guarantees.
Last night was my first night back. As I got off the elevator the familiar, "welcoming" smell of cauterized flesh, charred skin, and topical antimicrobicals wafted under my nose. Sigh...
I went to the scrubex, got my scrubs, punched in, and headed into the locker room. I almost forgot my combination, but it soon came to me. I chatted with my fellow coworkers who were interested in hearing about my vacation and then I ventured out to "face my doom." To my surprise, staffing was okay, I had two relatively stable patients, well minus the ventilator and erratic junctional rhythm that plagued my patients on top of their burns. I no sooner finished getting report, when the charge nurse hung up the phone and paged me. "Don't get report, Kelly. We're changing the assignment, We've on 80%er." Eeks. Although I love the adrenaline rush of big, fresh, juicy burn, the anticipation can be overwhelming. I tried to get more of the history, but we didn't have a lot of information. the patient was being seen by the fellow and resident down in the ER, the ER nurse was going to be calling up report, but I needed to move fast and set up for a long night ahead.
As that thought crossed my mind, my stomach gave me a little rumble. Guess I should have eaten those eggs I hard boiled at home.
I set off to the supply room in a fury..gathering all my supplies, setting up central lines, prepping for an arterial line, anticipating the needs for a salem sump nasogastic tube insertion, finding all of the supplies to do burn care, paging respiratory to bring me a ventilator, etc. My hands were full, my heart beat was quick, my steps rapid. Game on folks!
I no sooner had everything set up, when the ER called up. I took report. 88 year old female with 95% TBSA (total body surface area) 3rd degree burns-yikes, worse than I thought. Pt was intubated in the ER and currently having an A-line placed. Vitals signs, not so stable; Respiratory status, shitty;core body temperature, 31.1 (that's88 degree Fahrenheit); chance of survival, less than 2 percent. She'd be arriving on the floor in 15 minutes.
Exactly 15 minutes later (shocker, I know! ER time estimates are never accurate) my patient arrived via stretcher being bagged by the respiratory therapist, attached to the portable cardiac monitor, and accompanied by one of our burn fellows. Hmm, gotta love that smell. Charred flesh, and lots of it. Immediately, we transferred her to the bed, hooked up all her lines, started a versed drip, continued to pump her with her Parkland Burn Formula fluid requirements (22Liters in 24 hours. Her temperature 31 degrees. With each degree that her body temperature dropped, so does her chance of survival. WE ran all her fluids though the fluid warmer, placed her under the heat shield and bair hugger. Building engineering increased the temperature of her room to 80 degrees....thank god I remembered my deodorant!
This poor woman was a mess. Her extremities were like icicles to the the touch, her skin beginning to swell as we pump her massively vasodilated circulatory system with fluids, her blood pressure remained low, her heart rate high...all signs pointing to being intravascularly depleted and dry. We couldn't do burn care, she was too cold.
The woman had no family, but her power of attorney was on her way in from New Jersey with the patients living will. Until then, we just had to wait. I ran around hanging fluids, pushing meds, sending of arterial blood gases and blood work, but she wasn't warming up. I sent off her blood to get a metabolic profile with all her electrolytes, but she was so cold and vasoconstricted that the blood kept hemolyzing and we couldn't get a reading. I thought attempt #4 would be my lucky shot, but I no sooner sent off her labs, than I got a phone call from the lab that the top popped off and the sample was lost. What the hell?!?! I can't keep drawing blood off this patient, she's not stable enough for the circus. I gave it one more shot, finally success.
As I was finishing the priest came to administer last rites, the patients last request before she was intubated. Yes, that's right. She was awake and alert for almost 2 1/2 hours. As the priest prayer with/over the now sedated and vented patient, I felt calmed, like if the woman was to die (on this Good Friday) that she would be at a spiritual peace. After the priest left, 3 different neighbors came to pray the Rosary over her. I was touched.
At 1am the health care proxy/power of attorney arrived, looking shaken and upset. I went with the fellow and we gently talked with the woman outside the room. After calling the administrator on call and the attending, the patient was made DNR with no escalation of care. I sat with the HCP (turns out she's the patients god-daughter) and let her know that I would continue to remain available to them if she had questions or needs over night. She thanked me and left.
By 4am, the woman had only put out 4 cc's of black turbid "urine". Quick little bit of math for you: 15 Liters (15,000cc) of fluid in, 4cc out, = 14996net. Kidneys have shut down.
Around 5am her respiratory status really started to decline. Her lungs were filling with fluid and her circumferential chest burns weren't allowing her lungs and chest wall to expand. Aside from changing a few settings on the vent to force some of the alveloi open, there wasn't much we could go. The waiting game began.
Soon to follow, her blood pressure took a hit and her heart rate continued to rise. She wasn't perfusing her extremities. She was loosing body heat again.My heart sank. I stood there and said a quick prayer.
By change of shift, her prognosis was grim and it was torture giving report to the say nurse. It was futile. I felt like I was handing over a corpse. As I walked off the unit Friday morning, I wondered what the day would bring for my dear patient. I went home exhausted. I realized that I hadn't been to the bathroom in 13 hours, but then again I hadn't drank anything either...and that's why my urine was almost the color of tea. Sorry if that's TMI.
Despite the exhaustion, I couldn't sleep. I tossed and turned. Around 1:30 I got up and went running. It was good to clear my head, I needed that.
As I walked back onto the floor Friday night, I heard the overhead page. "Nurse taking care of pt in room XXX please indicate. Transport is here."
And so it happened. She died. The day nurse reported to me that the family decided to withdraw care and remove the patient from the ventilator around 4:XXp.m. She died 8 minutes later.
I'm not sure if it was because this is Holy Week, or because it was my first night back after a glorious vacation, but I do know that Thursday night affected me. We need to cherish each and every day because the only guarantee in life is that there are no guarantees.
Wednesday, March 19, 2008
Mail Call
I'll admit it. I've bought into the "Go Green" rah-rah commotion. Actually, I know this sounds dorky, but it's so satisfying to recycle. Growing up in the suburbs, we always recycled. In fact, if I sorted the cans and bottles, and helped bring them to the redemption center, my parents used to let me keep the money. Hey, when you are a kid, $5 is "a lotta" money.
A few weeks ago, I went out an bought these two super cute tall rattan baskets with tops...one for paper, one for plastic. Now that I don't drink soda, and avoid high sodium canned food, rarely is there any aluminum in our apartment. Since purchasing the baskets, we have much less garbage. Maybe 1 bag every 5 days-and that's only after we combine the bathroom and our bedroom trash cans. Go us!
Where was I going with this? Oh yeah. In college, where I became an email/computer/facebook slut, I started doing all my banking and bill paying online. It greatly reduced the amount of mail I received. I also stopped requesting catalogues and would strictly look at the goods online. Seems like a good idea, right? However, the one thing that never seemed to cease was the credit card offers. I cannot tell you how many mailings I would get weekly offering me the "best APR" around, 0% financing, "No fees for 1 year". It's insanity people. Did I mention that the offers come addressed to the most ludicrous names? Kessy Seller-Kelley Seffler-Kally Sesfler, come on people! If you are going to tempt me, at least get my name correct! I only have 1 credit card, thankyouverymuch, and I am quite content with it. I pay my bill each month, never carry a balance, and get pretty decent rewards with it. Wait, I'm getting off topic again. Sorry.
Back on track. Again. Okay, ready, set, go! Junk mail. I thought I was being so smart and taking advantage of the online options, but suddenly I find my email inbox filled with unsolicited emails, clearly my address was just sold and spammed out over the net. For a while I was replying to the "Unsubscribe" feature, but useless, the spam kept coming, even through my spam filter. It's not so much that I mind the occasional junk offer, but I'm contemplating going wireless with a blackberry (gasp! she's becoming a true "New Yorker") and I don't want to get all riled up with new emails only to be let down realizing it's another "Free sample of Viage" email.
I decided to end this email nonsense today. Especially after returning from my vacation to over 250 emails, most of which were SPAM-A-LISCIOUS. After a trusty google search, I came across this website, Direct Marketing Association. It gives plenty of suggestion for how to cut down on junk mail/emails . Click here to join DMA’s eMail Preference Service (eMPS that ) allows consumers to indicate their wish to reduce the amount of unsolicited commercial email they receive. I joined, and if you like, you should too!
Feeling satisfied with my accomplishments, I sought out some more information on recycling and "Going Green" in New York. I was happily surprised to come across the New York "Wastele$$" website. Check it out, it has some really useful tips, even if you don't live in NY.
I guess I can get off my soapbox now, I feel satisfied. The end.
A few weeks ago, I went out an bought these two super cute tall rattan baskets with tops...one for paper, one for plastic. Now that I don't drink soda, and avoid high sodium canned food, rarely is there any aluminum in our apartment. Since purchasing the baskets, we have much less garbage. Maybe 1 bag every 5 days-and that's only after we combine the bathroom and our bedroom trash cans. Go us!
Where was I going with this? Oh yeah. In college, where I became an email/computer/facebook slut, I started doing all my banking and bill paying online. It greatly reduced the amount of mail I received. I also stopped requesting catalogues and would strictly look at the goods online. Seems like a good idea, right? However, the one thing that never seemed to cease was the credit card offers. I cannot tell you how many mailings I would get weekly offering me the "best APR" around, 0% financing, "No fees for 1 year". It's insanity people. Did I mention that the offers come addressed to the most ludicrous names? Kessy Seller-Kelley Seffler-Kally Sesfler, come on people! If you are going to tempt me, at least get my name correct! I only have 1 credit card, thankyouverymuch, and I am quite content with it. I pay my bill each month, never carry a balance, and get pretty decent rewards with it. Wait, I'm getting off topic again. Sorry.
Back on track. Again. Okay, ready, set, go! Junk mail. I thought I was being so smart and taking advantage of the online options, but suddenly I find my email inbox filled with unsolicited emails, clearly my address was just sold and spammed out over the net. For a while I was replying to the "Unsubscribe" feature, but useless, the spam kept coming, even through my spam filter. It's not so much that I mind the occasional junk offer, but I'm contemplating going wireless with a blackberry (gasp! she's becoming a true "New Yorker") and I don't want to get all riled up with new emails only to be let down realizing it's another "Free sample of Viage" email.
I decided to end this email nonsense today. Especially after returning from my vacation to over 250 emails, most of which were SPAM-A-LISCIOUS. After a trusty google search, I came across this website, Direct Marketing Association. It gives plenty of suggestion for how to cut down on junk mail/emails . Click here to join DMA’s eMail Preference Service (eMPS that ) allows consumers to indicate their wish to reduce the amount of unsolicited commercial email they receive. I joined, and if you like, you should too!
Feeling satisfied with my accomplishments, I sought out some more information on recycling and "Going Green" in New York. I was happily surprised to come across the New York "Wastele$$" website. Check it out, it has some really useful tips, even if you don't live in NY.
I guess I can get off my soapbox now, I feel satisfied. The end.
Tuesday, March 18, 2008
Late But Not Lost
Even though I was away in Paradise (sigh....) here's my FFOF entry for last week....
#1. What’s your favorite fruit and how do you like to eat it?
Summer- Watermelon, cold and cubed
Winter-Oranges, much needed vitamin C
Spring- Grapes, juicy and sweet
Fall- Apples! I'll always be a New Eng lander at heart
#2. What is the one spice in your kitchen you use more than any other?
Garlic. Good for your cholesterol, even better for date night, haha!
#3. Pudding. Instant, stove top or premade?
Hmmm, I guess a twist on instant. I add plain yogurt. I'd add my "milk", but the box specifically says, "DO NOT USE SOY MILK". I tried ignoring this warning once, mission failed.
#4. Share a recipe using potatoes.
I make these whenever having a dinner party...there are never any leftovers!
3 Russet Potatoes
1/2 cup Parmesan Cheese
2 TB garlic salt
1 TB Black Pepper
1TB dried rosemary (use less if using ground)
1 1/2 TB dried minced onion
1/4 cup extra virgin olive oil
Preheat oven to 450
Wash outside of potatoes
Chop and cube (1/2 inch)
Mix garlic, pepper. onion in small bowl, set aside
Place cubes in large bowl, drizzle just EVOO over top and lightly coat (may not need all the oil); toss with fingers; sprinkle salt mixture over cubes; toss again
Spread cubes over 2 baking sheets
Sprinkle 1/4 of Parmesan cheese over cubes
Place in oven; check in 15 minutes-flip, sprinkle more cheese; check in 10 minutes, flip, sprinkle; place back in oven until golden brown.
Upon removal, coat with remainder of cheese.
Serve warm!
As always, to join the meme, check out Valmg's blog
#1. What’s your favorite fruit and how do you like to eat it?
Summer- Watermelon, cold and cubed
Winter-Oranges, much needed vitamin C
Spring- Grapes, juicy and sweet
Fall- Apples! I'll always be a New Eng lander at heart
#2. What is the one spice in your kitchen you use more than any other?
Garlic. Good for your cholesterol, even better for date night, haha!
#3. Pudding. Instant, stove top or premade?
Hmmm, I guess a twist on instant. I add plain yogurt. I'd add my "milk", but the box specifically says, "DO NOT USE SOY MILK". I tried ignoring this warning once, mission failed.
#4. Share a recipe using potatoes.
I make these whenever having a dinner party...there are never any leftovers!
3 Russet Potatoes
1/2 cup Parmesan Cheese
2 TB garlic salt
1 TB Black Pepper
1TB dried rosemary (use less if using ground)
1 1/2 TB dried minced onion
1/4 cup extra virgin olive oil
Preheat oven to 450
Wash outside of potatoes
Chop and cube (1/2 inch)
Mix garlic, pepper. onion in small bowl, set aside
Place cubes in large bowl, drizzle just EVOO over top and lightly coat (may not need all the oil); toss with fingers; sprinkle salt mixture over cubes; toss again
Spread cubes over 2 baking sheets
Sprinkle 1/4 of Parmesan cheese over cubes
Place in oven; check in 15 minutes-flip, sprinkle more cheese; check in 10 minutes, flip, sprinkle; place back in oven until golden brown.
Upon removal, coat with remainder of cheese.
Serve warm!
As always, to join the meme, check out Valmg's blog
Monday, March 17, 2008
I'm back!!!!
Just in case you all were wondering, I'm back. Fully refreshed and recharged! Ready to work (well, maybe). I've got a post coming with all the details of my 8 days in paradise, so bear with me. On a different note, Happy Saint Patrick's Day!
Thursday, March 06, 2008
Four Foods on Friday; Sensing the trend?
Here are this week’s four questions.
#1. What type of m&m is your favorite?
Peanut Butter. If you are going to be bad, why not indulge?
#2. Peanut butter. Smooth, chunky, creamy. How do you like it?
All natural and extra chunky; Teddy Brand
#3. Do you usually drink out of glass, acrylic, Tupperware type or paper cups?
Tacky plastic souvenir cups at home; my nalgene (acrylic?) water bottle at the gym and work.
#4. Share a chicken recipe. I cooked this for my gramps one day last summer...he still asks about it. It's from the whole foods recipe series
Balsamic Marinated Chicken served with Grilled Peaches, Sweet Onions & Rosemary
Skinless chicken breasts, marinated in balsamic vinegar and maple syrup, are grilled along with sweet onions and halved peaches, all crowned with fresh rosemary. Delicious.
Serves 6
3 whole skinless, boneless chicken breasts, split
2 tablespoons balsamic vinegar
1 tablespoon maple syrup
4 tablespoons olive oil
1 teaspoon salt
1/4 teaspoon ground black pepper
6 ripe, firm peaches, cut in half, pit removed
2 large sweet onions, cut into 1/4-inch thick rings
4 tablespoons orange juice
2 tablespoons olive oil
2 tablespoons finely chopped fresh rosemary plus 6 sprigs for garnish
salt to taste
Rinse and pat chicken breasts dry. Place in a large mixing bowl. Combine the balsamic vinegar, maple syrup, olive oil, salt and pepper and pour over chicken. Turn pieces of chicken to coat thoroughly with marinade. Cover tightly and refrigerate for at least 2 hours or overnight. Turn chicken several times.
Prepare a charcoal grill or heat a gas grill to medium-high heat. Toss peaches and onion rings with orange juice, olive oil and rosemary. Season with salt to taste. Remove chicken from marinade and grill about 5 minutes per side, until cooked through. Grill peaches and onions until tender and slightly charred. Serve chicken with peach halves and generously top with grilled onions. Garnish each portion with fresh rosemary sprig.
If you want to join, go here! The more the merrier :)
#1. What type of m&m is your favorite?
Peanut Butter. If you are going to be bad, why not indulge?
#2. Peanut butter. Smooth, chunky, creamy. How do you like it?
All natural and extra chunky; Teddy Brand
#3. Do you usually drink out of glass, acrylic, Tupperware type or paper cups?
Tacky plastic souvenir cups at home; my nalgene (acrylic?) water bottle at the gym and work.
#4. Share a chicken recipe. I cooked this for my gramps one day last summer...he still asks about it. It's from the whole foods recipe series
Balsamic Marinated Chicken served with Grilled Peaches, Sweet Onions & Rosemary
Skinless chicken breasts, marinated in balsamic vinegar and maple syrup, are grilled along with sweet onions and halved peaches, all crowned with fresh rosemary. Delicious.
Serves 6
3 whole skinless, boneless chicken breasts, split
2 tablespoons balsamic vinegar
1 tablespoon maple syrup
4 tablespoons olive oil
1 teaspoon salt
1/4 teaspoon ground black pepper
6 ripe, firm peaches, cut in half, pit removed
2 large sweet onions, cut into 1/4-inch thick rings
4 tablespoons orange juice
2 tablespoons olive oil
2 tablespoons finely chopped fresh rosemary plus 6 sprigs for garnish
salt to taste
Rinse and pat chicken breasts dry. Place in a large mixing bowl. Combine the balsamic vinegar, maple syrup, olive oil, salt and pepper and pour over chicken. Turn pieces of chicken to coat thoroughly with marinade. Cover tightly and refrigerate for at least 2 hours or overnight. Turn chicken several times.
Prepare a charcoal grill or heat a gas grill to medium-high heat. Toss peaches and onion rings with orange juice, olive oil and rosemary. Season with salt to taste. Remove chicken from marinade and grill about 5 minutes per side, until cooked through. Grill peaches and onions until tender and slightly charred. Serve chicken with peach halves and generously top with grilled onions. Garnish each portion with fresh rosemary sprig.
If you want to join, go here! The more the merrier :)
Tuesday, March 04, 2008
watch what you write
In the medical world, charting and documentation dominates.
From a legal standpoint, proper charting could save your but if you go to get sued, improper/sloppy/half asses charting pretty much asks the plaintiff" How much is this going to cost me?"
From a medical standpoint, the entire point of charting is to be communicative and objective to the rest of the medical team, i.e. make sure everyone is on the same page with access to the same information to make informed decisisons regarding patient care.
We are all guilty of some type of "bad charting" (oh God, I am the QUEEN of spelling errors), but here are a few examples of what you don't want to be caught charting (unless, that is, you enjoy being laughed at by your co-workers/everyone who reads this blog entry/anyone who read the original posting....
*ACTUAL SENTENCES FOUND IN PATIENTS HOSPITAL CHARTS*
1. She has no rigors or shaking chills , but her husband states she
was very hot in bed last night.
2. Patient has chest pain if she lies on her left side for over a year.
3. On the second day the knee was better, and on the third day it disappeared.
4. The patient is tearful and crying constantly. She also appears to be depressed.
5. The patient has been depressed since she began seeing me in 1993.
6. Discharge status: Alive but without my permission.
7. Healthy appearing decrepit 69 year old male, mentally alert but forgetful.
8. The patient refused autopsy.
9. The patient has no previous history of suicides.
10. Patient has left white blood cells at another hospital.
11. Patent's medical history has been remarkably insignificant with only a 40 pound
weight gain in the past three days.
12. Patient had waffles for breakfast and anorexia for lunch.
13. Between you and me, we ought to be able to get this lady pregnant.
14. Since she can't get pregnant with her husband, I thought you might like to
work her up.
15. She is numb from her toes down.
16. While in ER, she was examined, X-rated and sent home.
17. The skin was moist and dry.
18. Occasional, constant infrequent headaches.
19. Patient was alert and unresponsive.
20. Rectal examination revealed a normal size thyroid.
21. She stated that she had been constipated for most of her life, until she got
a divorce.
22. I saw your patient today, who is still under our car for physical therapy.
23. Both breasts are equal and reactive to light and accommodation.
24. Examination of genitalia reveals that he is circus sized.
25. The lab test indicated abnormal lover function.
26. The patient was to have a bowel resection. However, he took a job as a stock
broker instead.
27. Skin: somewhat pale but present.
28. The pelvic exam will be done later on the floor.
29. Patient was seen in consultation by Dr. Blank, who felt we should sit on the
abdomen and I agree.
30. Large brown stool ambulating in the hall.
31. Patient has two teenage children, but no other abnormalities.
Hope this made you smile. Now, type on fellow bloggers, type on! (utilizing spell check of course!)
From a legal standpoint, proper charting could save your but if you go to get sued, improper/sloppy/half asses charting pretty much asks the plaintiff" How much is this going to cost me?"
From a medical standpoint, the entire point of charting is to be communicative and objective to the rest of the medical team, i.e. make sure everyone is on the same page with access to the same information to make informed decisisons regarding patient care.
We are all guilty of some type of "bad charting" (oh God, I am the QUEEN of spelling errors), but here are a few examples of what you don't want to be caught charting (unless, that is, you enjoy being laughed at by your co-workers/everyone who reads this blog entry/anyone who read the original posting....
*ACTUAL SENTENCES FOUND IN PATIENTS HOSPITAL CHARTS*
1. She has no rigors or shaking chills , but her husband states she
was very hot in bed last night.
2. Patient has chest pain if she lies on her left side for over a year.
3. On the second day the knee was better, and on the third day it disappeared.
4. The patient is tearful and crying constantly. She also appears to be depressed.
5. The patient has been depressed since she began seeing me in 1993.
6. Discharge status: Alive but without my permission.
7. Healthy appearing decrepit 69 year old male, mentally alert but forgetful.
8. The patient refused autopsy.
9. The patient has no previous history of suicides.
10. Patient has left white blood cells at another hospital.
11. Patent's medical history has been remarkably insignificant with only a 40 pound
weight gain in the past three days.
12. Patient had waffles for breakfast and anorexia for lunch.
13. Between you and me, we ought to be able to get this lady pregnant.
14. Since she can't get pregnant with her husband, I thought you might like to
work her up.
15. She is numb from her toes down.
16. While in ER, she was examined, X-rated and sent home.
17. The skin was moist and dry.
18. Occasional, constant infrequent headaches.
19. Patient was alert and unresponsive.
20. Rectal examination revealed a normal size thyroid.
21. She stated that she had been constipated for most of her life, until she got
a divorce.
22. I saw your patient today, who is still under our car for physical therapy.
23. Both breasts are equal and reactive to light and accommodation.
24. Examination of genitalia reveals that he is circus sized.
25. The lab test indicated abnormal lover function.
26. The patient was to have a bowel resection. However, he took a job as a stock
broker instead.
27. Skin: somewhat pale but present.
28. The pelvic exam will be done later on the floor.
29. Patient was seen in consultation by Dr. Blank, who felt we should sit on the
abdomen and I agree.
30. Large brown stool ambulating in the hall.
31. Patient has two teenage children, but no other abnormalities.
Hope this made you smile. Now, type on fellow bloggers, type on! (utilizing spell check of course!)
Saturday, March 01, 2008
Never a Dull Moment
Get to work 15 minutes early to do some paperwork...office is locked.
Go to scrub dispenser...out of smalls...I'm sporting the Jared from Subway "after" look tonight
Get report on my patients...hear the assignment was changed...get new report...assignment changed back...I'm utterly confused
Begin dressing changes and burn care...finish...begin charting
Charting interrupted by on call resident...I'm getting an admission...set up the room
ER calls up to give report, hangs up before I come to the phone, I call back, they tell me they are too busy to give report....right! and I've got nothing but time?!?!
Go back to finish charting..."Terminal System Error"...all my charting, GONE! POOF! Bye-Bye!
ER calls, gives me report, chews me out for delaying the transfer....uhhh, weren't you the one too busy to take my phone call?
Pt arrives on the floor, parents refusing NG tube and enteral supplements, mom whips out breast and tells me, "THIS is what MY kid will eat"
Initial wound management, skin removal, debridement, etc....
30 Minute discussion (calm and collected) about the inflammatory response and hyper metabolic state s/p burn injuries...father finally agrees to supplements...Mom and dad apologize for being edgy
Back to the lost charting...30 minutes on the phone with IT...they are useless I tell ya!
Charting..."Quick! somebody help me! Now, come soon!"...L and I leap from our seats and see the crazy (no, she is actually certifiable) lady in room *** naked, half out of bed, with all her pumps alarming and chining, tubing disconnected, her wounded extremity thrown over the side of the bed, and urine everywhere...babbling nonsensically...IV Haldol? Yup, think that's just what the doctor ordered!
But wait! What's that noise? Oh yes, the fire alarm. All doors need to closed, pt's and/or their family members sticking their heads out the doors, asking us to turn off the noise...sorry folks, I know a 4am fire alarm isn't really convenient for your sleep, but think about the poor buggers it's actually affecting...oh wait, they just announced, someone was smoking on the 12th floor. Hey pal, thanks, no really- thanks. Jerk!
"Cardiac Team 5 North, Cardiac Team 5 North"...nothing like a 4am code. Thank God we run our own codes (one of the many joys of being an ICU nurse).
Uh-oh, lady is getting naked again...lights still flashing from the "fire" on the 12th floor...pumps beeping...pants falling down...charting mounting...patients coding....
All in a day's (I mean night's) work, right?
Go to scrub dispenser...out of smalls...I'm sporting the Jared from Subway "after" look tonight
Get report on my patients...hear the assignment was changed...get new report...assignment changed back...I'm utterly confused
Begin dressing changes and burn care...finish...begin charting
Charting interrupted by on call resident...I'm getting an admission...set up the room
ER calls up to give report, hangs up before I come to the phone, I call back, they tell me they are too busy to give report....right! and I've got nothing but time?!?!
Go back to finish charting..."Terminal System Error"...all my charting, GONE! POOF! Bye-Bye!
ER calls, gives me report, chews me out for delaying the transfer....uhhh, weren't you the one too busy to take my phone call?
Pt arrives on the floor, parents refusing NG tube and enteral supplements, mom whips out breast and tells me, "THIS is what MY kid will eat"
Initial wound management, skin removal, debridement, etc....
30 Minute discussion (calm and collected) about the inflammatory response and hyper metabolic state s/p burn injuries...father finally agrees to supplements...Mom and dad apologize for being edgy
Back to the lost charting...30 minutes on the phone with IT...they are useless I tell ya!
Charting..."Quick! somebody help me! Now, come soon!"...L and I leap from our seats and see the crazy (no, she is actually certifiable) lady in room *** naked, half out of bed, with all her pumps alarming and chining, tubing disconnected, her wounded extremity thrown over the side of the bed, and urine everywhere...babbling nonsensically...IV Haldol? Yup, think that's just what the doctor ordered!
But wait! What's that noise? Oh yes, the fire alarm. All doors need to closed, pt's and/or their family members sticking their heads out the doors, asking us to turn off the noise...sorry folks, I know a 4am fire alarm isn't really convenient for your sleep, but think about the poor buggers it's actually affecting...oh wait, they just announced, someone was smoking on the 12th floor. Hey pal, thanks, no really- thanks. Jerk!
"Cardiac Team 5 North, Cardiac Team 5 North"...nothing like a 4am code. Thank God we run our own codes (one of the many joys of being an ICU nurse).
Uh-oh, lady is getting naked again...lights still flashing from the "fire" on the 12th floor...pumps beeping...pants falling down...charting mounting...patients coding....
All in a day's (I mean night's) work, right?
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