"When you get those rare moments of clarity, those flashes when the universe makes sense, you try desperately to hold on to them. They are the life boats for the darker times, when the vastness of it all, the incomprehensible nature of life is completely illusive. So the question becomes, or should have been all a long... What would you do if you knew you only had one day, or one week, or one month to live. What life boat would you grab on to? What secret would you tell? What band would you see? What person would you declare your love to? What wish would you fulfill? What exotic locale would you fly to for coffee? What book would you write?"
Thursday, November 28, 2013
So my personal tradition annually is to list things I am thankful for each year. Just like my traditional new years resolutions, I don't really do it for others to see, more so for myself to see each year and watch myself grow.
What am I thankful this year? Where do I start?
I am so thankful to have had a very successful first year in my first house! No disasters, no fires, nothing bad so far. Just a couple ghost sightings (friendly!) and lots and lots of house improvements!
I am thankful for having a big-girl job that pays me well enough to be able to afford all of these amazing improvements to my little humble house. Every day I thank my lucky stars that I am decently comfortable.
On that note I am also extremely thankful for a job that although comes with some drawbacks, I am so blessed to be able to have the schedule I do and go into work every weekend and see what I can truly call some pretty awesome friends. My weekend co-workers and I are a true team, we help each other out and don't let anyone drown and that truly makes the difference in hospital nursing, when someone has your back.
I am thankful for my family, all healthy, all loving! My father is absolutely the most helpful father I could ever ask for when it comes to starting up a first year house with lots of necessary home improvements! And my mom is certainly helpful when it comes to critiquing home improvements and help decide on future renovations!
I'm thankful for my healthy grandma that finally got to see my house just a week ago! Although facing severe macular degeneration and hip pains, she strives every day to enjoy life and enjoy time with family.
I am thankful for what is now my year and 3 month boyfriend, Brian. He teaches me and motivates me every day on how to be a better person. He also keeps my house looking amazing and helps with a lot of improvements as well! What more could I ask for?
I'm thankful for my sister, we've been getting to know each other on a more adult-personal level and turns out she's a pretty cool cat, a lot cooler than when we were 5 ;) I think I'll keep her around.
Speaking of cats, I am thankful for my two most adorable kittens in the world, Ms. Lilly and Belle. Although they at times torment my house and my sleep schedule, they make me laugh every single day and are always there to greet me when I come in the door and always know when I need a hug and some love. And they are cuddly :-)
I am thankful for my own kind heart. I've been facing a lot of adversity lately. I've been feeling slightly jaded as a nurse and I hate that, and I've been going through a lot of self reflection lately. And although many in the world believe the only way to survive is to only think and fight for yourself only, I strive to believe that is not the only way. Through all this self reflection and taking a step back to look at myself, I've noticed the things I do that I consider to be very kind, and I do it out of pure reflex, or instinct. I don't do them for any monetary or personal enrichment. I just help people because that's what needs to be done. I'm trying to spread this attitude and I want others to see that if we just sprout more and more kind hearts, that maybe we can overcome the evil in the world. SO many kind hearted people out there are masked with evil actions because they feel that the only way to beat evil is to be evil themselves. I'm thankful for my acceptance that for at least the time being, I refuse to screw someone else over in any way just for my own benefit.
I'm thankful for my new side job, with Premier Designs Jewelry! Although I never would have guessed I'd be an independent business owner for jewelry (I used to hate jewelry), it has truly been a wonderful and interesting experience, and certainly worth my time!
I'm thankful for my vision, as I've seen what my grandma is going through and it makes me so, so thankful for my own. I do wear glasses and my vision is awful without them, but at least I have no tunnel vision or black spots, I have full range of vision and for that I am thankful. Without my vision I couldn't do three of the things I am most thankful for, art, writing, and reading.
I am thankful for my hearing, for without it I would not have music. Music is my therapy, the only way I know how to calm down and focus. Music Is there for me when I've had a nursing shift from hell, music is there for me when I want to just be calm, be by myself and create art. Music is always there for me and it is my love. Music can do so much more for me than any person.
I am thankful for my studio. Although I haven't had time to be a writer this year, I am thankful for my new space that is just for my studio and I have since created multiple pieces of art that I love. I am thankful for that space.
And most of all, I am thankful for this blog! Woot! I have readers from all over the world and over 50,000 views and you guys are seriously awesome for reading what I just think is my regular thoughts every day.
That's all folks,
love you, all. Miss you, all. I'll write soon. :-)
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Wednesday, October 2, 2013
I write this blog today because I've just about exactly hit my "Two Years" Nurse Anniversary. This is a definite bittersweet anniversary/year.
It is sweet because, hell, I've been a nurse for two years! I've SURVIVED! If I can survive this long, chances are I'll survive the entire career. I've made it past that point where I doubt myself every minute of every shift. I've made it past the point where my coworkers doubt me every minute of every shift. (Now only some coworkers do, lol). No really though, in all seriousness, I've been on two very autonomous, heart-wrenching (literal and figurative), fast-paced hospital nursing units now, and I can proudly say I've seen and done a lot in those two years where I legit feel comfortable with my knowledge base now. So much so in fact that I'm craving more knowledge.
This is also the problem, knowledge. Now, roll with me guys. Does it make sense at all, if I tell you that despite what I just said above, hitting the two-year mark also means I'm hitting the "I've been a nurse for two years and I still don't know what the hell I'm doing" mark? I know you're confused but let me (try) to explain. Despite having a wide array of skills and a comfortable knowledge base that has grown in these two years, there is still so much I don't know. And I understand that nurses feel like that after fifty years of nursing, too. There's always going to be something new or confusing. I know enough now where my unit seems to think I'm charge-nurse quality and I'm frequently elected charge nurse to this telemetry unit, where I'm in charge of 2-6 nurses and 14-36 patients at a time. And yet when I am in charge, there are still so many times I run into a new situation that I don't have an answer to. And those times, I have nurses that need those answers from me, like I needed from my superiors back when I first started. And that's batshit crazy.
It's just, nurses are required to know the entire body system. Even though I work on a telemetry cardiac-focused care floor, the heart can affect many other organs and I must be prepared to handle anything. And there's so much to know and remember I don't think I'll have it all down by the time I'm retired, but I'll always be trying. I want to be the nurse that knows everything, that can help everyone, my staff and my patients. I want to always have an answer. But as the saying goes, the nurse that knows everything can be the most dangerous. So I have to be patient with myself. I have to accept the fact that it's okay to not know everything. But I'm finally at the point where at least I know a lot of things.
So that's where I am now. But looking towards the future, I'm still at a loss. I don't want to become stagnant In my position, I want to keep growing. I talk to my patients in their 80's that tell me they worked the same job for 50 years and I can't even fathom that. I know that generation workforce is entirely different than the one today. Not only could I not last 50 years in this position, but I feel almost pressured to move on. Like good nurses are supposed to keep growing, keep changing, keep moving to different units so their knowledge base becomes even more diverse and themselves more experienced. Like If I stayed on this unit for 10 years and did nothing else, I would feel like nothing. Like I'm taking my life nowhere, In no direction.
So now that I've hit that two year mark where I feel slightly confident in my skills, I feel that pressure that I need to do something else with those skills. I've recently successfully passed ACLS, which stands for Advanced Cardiovascular Life Support, which is a major step up from only being allowed to do compressions and airway support with just a BLS (Basic Life Support) Certification. Now with ACLS I can direct and lead a code blue in an emergency situation, even without a doctor being present. I can push life-saving medications into a patient during, just before or just after a code. I can participate in advanced airway management techniques now. So this has quenched my thirst for more self-evolution and knowledge, but only temporarily so.
So where does that put me now? Well, I want to go back to school. Not only because I just actually really do like school, but because that's the ticket to advancing my career. The only major problem is, what career? Applying for a masters in nursing is like a senior in high school that is trying to pick a career out of all the choices in the world again. Yes I am trying to advance my career in nursing, but in what route? There are so many choices and routes that I could potentially see myself being successful in, but how do I know which one I actually will be happy in? I can't get a degree in everything (as much as I'd like to), so I have to be sure.
I've debated starting to a local program near me that is for a "Nurse Executive" degree, basically a dual-degree of MSN/MBA. It would take forever and be super expensive but would put me down the road of maybe eventually being very high up in the hospital administration pool one day. But as high-paying, important and as cool as that is, is that really what I want? To leave the patient bedside? To lose what it really is to be a nurse? To hold someone's hand and tell them they are not alone and will be okay? To instead be in an office making and revising policies, firing and hiring people and enforcing rules? Is that what I want? I don't know yet.
I've also been interested in the future of nursing informatics, but I would also completely lose the bedside nursing aspect there, too. With a degree in there I could help formulate programs and design new computer charting for nurses. I've also fantasized about working in epidemiology, where I could easily travel and investigate new diseases around the world and help stop or control them. I'm also very interested in the route of emergency nursing, where that would keep me at the patient bedside, but in a totally different manner. I'm slightly interested in ER nursing, but even more interested in field nursing, but even that has many different routes. I could do pre-hospital nursing (riding with ambulances providing pre-hospital care), or I could go completely crazy and apply to be in a disaster relief system to travel to new disaster areas and help triage (that really is crazy I don't think I'd actually do that). I'd miss my kittens too much. ;-)
But can you see how overwhelming this could be? That is the blessing and the curse of nursing. Just because you're in nursing as your one career, does not make you limited. I can still pretty much do anything I want and that scares the shit out of me.
So that's where I am. I know a lot but am craving to know more. I've been a nurse for two years and don't know where I'll spend the next 30 years. So (too) many options.
I just try and like....meditate, and try and picture myself in the future, what am I doing and am I happy? And I just can't see it. I guess that's because I can't tell the future....makes sense I guess.
Anyway, with love.....
Wednesday, May 22, 2013
This post stems from something that's been brewing in my mind for quite some time in my nursing experience. It is an unrealistic fantasy, but still one I'd like to talk about. Enjoy!
When patients are admitted to the hospital, a lot of things happen. They go to the ER, their problem either gets resolved or it needs further treatment or observation and they get admitted to a floor. When I receive patients, they only have a couple of orders to start out. These being medication orders and nursing task orders. When a patient then gets settled and is being taken care of by day 2-3 ish, these orders are probably bound to change a little based on the patient plan of care. Now, lets say a patient gets a headache- a normal headache that is completely unrelated to the problem admitted with, but instead related to the high amounts of stress from missing work and being away from family and stuck in hospital? So this patient with the headache asks me for a Tylenol. Simple request, right? Something the patient would naturally do if at home with a headache.
Well, I as the nurse, take this request. But if your doctor wasn't nice enough to order you Tylenol as a pain management preventive to begin with, I have to call the doctor for an order for Tylenol. Don't get me wrong, I don't mind doing this at all. But then when he finally calls back, it may be up to 10 minutes already. Then lets say he says yes, he orders it, it goes down to pharmacy and they can take up to 30 minutes for it to be profiled in your orders and in my medication dispense machine. So you as the patient have a headache that's bad enough for you to have reached out for help from me, and it may take me up to 40 minutes, 20 if you're lucky. Maybe up to 3 hours if something else- like CPR or something- takes precedence- if you're unlucky. For a Tylenol.
Don't you think this severely restricts patients freedom? Patient's involvement in their own plan of care? How do you think patients feel when treated like a 5 year old asking for something they can easily buy over the counter and take at home, without a doctors order?
So here's what I propose. What if we gave patients that meet a certain criteria a packet of OTC medications that they can take at their own will in the hospital? Some things included in these packs would possibly include: Tylenol, Motrin, Colace (stool softener), Benadryl, just for starters.
I realize that this idea comes with a lot of complications and responsibilities. First off, only certain patients would qualify for having the privilege of having this pack. Some qualifications to start might include being in complete stable mental health, no drug abuse history or impulse decision making, and patient must have no dementia-short term or long term, and patient must be 18 or older. Those are just some qualifications I can think of on the top of my head. Also, there are some health qualifications. For example, someone admitted with liver cirrhosis or alcohol abuse shouldn't exactly be taking Tylenol. Or someone receiving a lot of Percocet or additional high strength relief NSAID therapy, shouldn't have access to their own reach of Tylenol or Motrin.
Next complication is cost. It would be very expensive to give each patient a pack, and to replace the supplies and stock of medications in the pack. But would it equal out in the high amount of patient satisfaction? In the press ganey scores? If you remember from my last post, happy patients make happy scores, which makes a lot more insurance reimbursement to hospitals. Plus, giving a patient freedom to lose Tylenol and restocking that has got to be less expensive than constantly giving patients the most powerful narcotics such as Morphine and Dilaudid, right? I know that there will always be that patient population that purposely seeks out those types of narcotics, but for the patients that have minimal amounts of pain that could lead into a more serious amount of pain in the future, maybe having bedside OTC painkillers to start out with might help prevent that pain from exceeding too much in the future, therefore saving having to give the patient an expensive narcotic.
Take the following scenario as an interesting example:
A patient of mine not too long ago was in her 60's. She was admitted with kidney failure and was having a lot of back/kidney pain as a result of a recent stent placed. When I initially assessed her, I asked if she was having pain. She said no, but she was having pain earlier that day. I told her that if that pain crept back, to let me know and I could give her something to help with that. She said OK. Now, the way my hospital is designed is that we can sit in between two patient rooms and chart if we so desire. It's supposed to help with keeping an eye on our patients, but I see it as a peaceful escape from the nurses station sometimes. So it just so happened that I was charting outside this patients room, the one with the kidney pain. It was a couple of hours after my initial assessment, and I overheard the patient talking with her daughter, small talk mostly. The patient must have repositioned herself and winced in pain, because the daughter asked "are you having pain, mom?" The patient must have nodded and the daughter said "Well you gotta tell the nurse, mom", in response the patient said "No I hate to bother those girls, they are busy."
Now I could write a book about that statement right there. I hate it when patients think they can't call because we are too busy. And all it takes is one time, one nurse to really have been too busy with something else - to make the patient feel that way. Other patients think we are too busy because they hear stories from family members or friends that work in healthcare. Others just genuinely don't want to rely on other people and don't like calling for something they need.
So in these examples, these patients could take their bedside pack and take something like Tylenol or Motrin. A lot of times, its enough to do the trick- especially with the elderly.
Something else to worry about in terms of cost is waste. How would healthcare handle leftover medications in these packs that the patient didn't use? For infection control reasons, anything that enters a patients room cannot be used again in another patients room. So we would have to throw good OTC medications away at the end of the patients stay. However this could be reduced with a couple measures: We perhaps can only give these packs to patients that have been declared inpatient status, those that are more likely to be there for longer than 2 days- rather than those on observation status (supposed to leave before 24 hours). Also, we would only stock about 2 doses of each OTC medication in each pack. Also, analytical studies can be done to see which medications patients are using or not using the most in these packs, and we can adjust what we offer.
Another complication is how do we keep track of how much the patient has taken? Easy. Like I said earlier, these packs would be given to patients in sound mind, and would receive an education sheet on these packs AND drug information about all medications in the pack. They would sign a sheet on admission, upon receiving this pack- that they acknowledge the responsibilities of the pack and respect it. They would be given a sheet that would be at bedside, for them to log what medication they took, and what time/date. Now either nurses can collect these sheets at the end of each shift, or every 24 hours (like midnight), depending on what system works best. Now the nurse can log into the computer what the patient has taken at this point, or can log when the patient needs more supplies.
Consider the following example:
The patient has 2 doses of Tylenol in her pack, amongst other OTC meds. She uses her 2 doses of Tylenol within the recommended time frame, every 4-6 hours. Now she needs more doses replenished in her pack. The nurse at this point would look at her log and make sure the patient would not exceed the safe amount of Tylenol per day, and replenish the pack- at the same time completing medication documenting in the computer.
It would be very hard for a patient to lie that they took less than what they said, because missing medication packets would be in the pack. If at any point the nurse feels the patient is using the pack irresponsibly or if the patient outwardly breaks the commitment signed upon admission, the nurse can take it away. Of course this creates confrontation between the nurse and the patient, confrontation that a lot of nurses would feel uncomfortable with. But its the same thing as confronting a patient about hiding cigarettes or unsafe medications or street drugs in their possession in the hospital. We've all been there and it sucks to have to be the bad guy and take it away.
The way I see it is, patients are going to take whatever they want when they go home, regardless of the doctors firm instruction. There aren't cameras watching them at home, and patients are free to make their own choices upon their own judgment. So maybe if we watch them, watch what they are most inclined to do, we can better predict what they will do at home.
I know its a long stretch, and will probably never be adopted as a practice in the hospital. But I do think it would be nice. Maybe in futuristic hospitals. Although we have potential for our hospitals to be even stricter in the future, at the rate we're going now. So thanks for listening to my inventive rambling! Anybody in healthcare have any thoughts? Pros or Cons to this idea? I'd love to hear some other viewpoints!
Anyway, with much love,
Wednesday, May 8, 2013
Anyway, todays post is a nursing post, a somewhat controversial one and I even debated awhile even posting it at all. But, here goes...
So I worked Friday through Sunday this past weekend. What started as a slow-ish weekend quickly turned extremely busy (who woulda thought for early May? Weird.) Anyway, Saturday night I thought I had a pretty easy assignment. Most of my patients were in their 50's, the easiest and very nicest age range group in my opinion. This is not to say that they don't have potential to be very sick because by all means- any patient in any age group has potential to be critically sick. But it just so happened that that night my patients were very nice and had what I thought to be easy diagnoses to take care of.
Now, when it comes to customer service in the hospital- patient satisfaction means everything. It's how hospitals get reimbursed from huge insurance companies. It's how we get more patients. You've all heard the term, one patients good experience- they tell one person but if they have a bad experience they tell ten. When something good happens to a patient in the hospital, it makes them smile. But they still feel yucky. They just want to feel better and go home. They *might* go home and remember that they had a good nurse, but probably won't remember your name. But, they may tell other people that your hospital has "good nurses". But all it takes is one bad experience mixed with one grumpy or really sick patient to create a chaotic mess of unhappiness. Suddenly that patient feels wronged, that what has been done to them is unjust- even if all it was was that they had to wait 40 minutes for you to remember to bring a soda back they asked for. What they don't know is that when you leave their room, maybe you had to suddenly help a coworker in a dire situation, or another one of your own patients needed you, or whatever! Patients don't think about that. Realistically, patients do know that they obviously aren't the only patient there on your floor. They know that. But they don't like to think about it.
Think about how you would feel or have felt if you were a patient. You are bored. You're thirsty and all you want is a coke. You ask the aide to bring you some when she comes in for vitals- and she says yes but then keeps going along with vitals and when she's done she forgets. Thirty minutes go by and you ring your call bell and the nurse comes in- you ask her. She says no problem but then gets pulled into another patients room and forgets about your soda. The nurse doesn't even realize how big of an issue to you this is because in our eyes, the nurses, its just a soda in the whole scheme of things. We are worried about your vitals, your health condition, our other patients, etc. But to the patient, they just want the friggen soda and they feel that as if everyone is forgetting about them. Next they go home and tell ten people that your hospital has horrible customer service, even if you provide the best healthcare.
On that note, I always try and do my best possible job when it comes to customer service. I always knock when I enter patient rooms. I always address them properly and then remember how they like to be addressed after that. I smile with them, I listen to everything they have to say and I don't belittle them. I do my best to remember if they asked for something and I get it as soon as I can. I always tell them what shift I'm working and what time they will be under my care until. Before I leave at the end of my shift I make sure to explain that I will be leaving in approximately a half hour and then your next nurse will be in shortly after so that patients know. Patients tend to not like when their nurse just disappears and a new nurse takes over, or when a nurse hasn't been in for over an hour because they were in report or seeing other patients. I always always do my best to explain everything to the patient, even if its just pushing a saline flush into the IV. To us its a simple saline flush, harmless- to them its a large syringe of something that is being pushed into their body.
So despite my best efforts to be attentive to all and provide the best customer service, sometimes its truly impossible. The more patients you have, the harder it gets to be as attentive to all as the patient wants you to be. Take the following story as an example.
I had a young patient, lets call him John Smith. He was in his 50's and his wife was as well, and was staying with him in the hospital, watching and listening to everything. John had just had a heart procedure done with us and was put on a very good blood thinner, now extremely necessary and important for his heart to function. However, John was prone to nosebleeds. In addition to the (very good) blood thinner and the dryness of our hospital, he came down with a nosebleed. When my nurse aide had told me that it had begun, I went in right away to check it out. I told him exactly what to do and told him I'd be back in ten minutes. At that exact same time an admission had just arrived under my care. Now, small blip- patients just admitted to the floor require a lot of customer service. They are scared, probably tired, hungry, they don't know whats going on, they need a lot of answers. They don't like rolling up to your floor on a stretcher and then being left there for 90 minutes before the first person comes in to see them. I always try to greet admissions within ten minutes of their arrival and do my whole admission shebang. So anyway, I told John I'd be back, and I went to go say Hi to my admission. I gave her the downlow on what was going on and completed a quick assessment. I told her the aide would be in soon and we should be able to get her to be able to sleep shortly, as it was 12:30 at night. So back I went to see John, and suddenly realized it wasn't just a nosebleed, it was a water fountain. I tried a couple more tricks and then quickly got my nursing supervisor.
To make a LONG story short, I was basically in that room from 12:30 to 7:00 am, with maybe a 45 minute break (in which I quickly went to the bathroom, got something to eat, and charted like my life depended on it). The nosebleed was so severe that it required my constant attention, constant manual pressure to the nose, and a STAT consult to the ENT MD team, twice.
Okay so point here- In this case, I was able to provide excellent customer service to John. Him and his wife even said at the end of it all, right as I was saying goodbye, how fantastic I was all night and how excellent this entire hospital has been so far. They were pleased, despite John being in a very uncomfortable clinical situation. However, I had a brand new admission that was probably wondering where I was after I gave her the down-low, and I had 4 other patients that needed me as well. One of those four patients began having chest pain while I was with John, and another was yelling that he couldn't breathe. Because it was necessary for me to stay with John, I had to delegate responsibility to handle these new problems to other nurses on the floor.
Now think about this for a second. While I was doing what I had to do and on my end was taking care of the patient by sending another nurse in- this is what the patient feels: Its 2am and you wake up with chest pain. You ring for your nurse who you've had for two nights now and knows your story- but in comes the aide. You tell her you have chest pain. She goes and gets me, who unbeknownst to her- sent in another nurse. Now one of my (very good) friends and coworkers handled the chest pain for me by attending to this patient by explaining that I was tied up in another room. But does the patient want to hear that some other patients problem is more important in my eyes than her chest pain? Probably not.
Maybe I over think things. In fact I know I do. But to me, its basic human connection. I've always been extremely aware of peoples emotions around me and I have the extraordinary ability to put myself in others shoes and see how they might be feeling, and then I have the decency to try and fix it. I try to make patients as happy as possible and in situations like that shift, those five other patients probably weren't very happy with me, but John was. So I made one patient happy and sacrificed five. But let's say I had left John to be on his own for his nosebleed- to provide his own manual pressure to his nose for six hours while I tended to five other patients. Sure- I would have made five happy and sacrificed one, but that one sacrifice would turn into a monstrous story if not even a lawsuit. So although I couldn't obey the law of attending to the greater good, I obeyed the law of excellent nursing. Although I may not have made my patients the happiest, I at least knew about their problems and made sure they were taken care of by at least someone. To me that's the best I could have done.
Well thank you for reading today, as always! I love you all,
Friday, May 3, 2013
Anyway, this topic sprouted into my mind a couple days ago. Let me give you a small back story. Lately, my boyfriend and I have come to the inevitable conclusion that its seriously time to lose weight. Neither of us are significantly overweight, but we're both at the point where it definitely couldn't hurt to lose, either. Those happy blissful first years of dating make for a lot of restaurant frequenting and alcohol, neither of which are good for you! :( So we decided to do this together, the whole diet and exercise thing.
Now I overall thought I ate pretty healthy to begin with. As some of you know, I decided about 6 years ago that I was never going to eat or support any fast food franchise ever again. By support I mean I refuse to even take my kids there and give the franchise money even if its not actually being eaten by me. Will that change when I have ten minutes to feed the kids en route from soccer to dance practice? I hope not! Time will tell, but I hope that I can stick true to my beliefs.
So being that I never eat fast food (except for Subway and Panera if you want to count them), I also never drink Soda, never eat Chocolate and don't typically indulge in a lot of sweets, I eat a LOT of fruit and a fair amount of veggies....My only understandable downfall is my love for restaurants and that I probably don't drink enough water. I also have a bad habit of eating late at night. Also, working night shift doesn't help at all. So based on all that, it didn't seem fair or right to me that I was still seemingly gaining weight at a rapid pace. So I had to put a stop to it before it got any harder to lose, and my boyfriend was on board. We thought about a couple programs, including Weight Watchers (a personal favorite of mine) or perhaps trying it on our own, or going to see a nutritionist, or a freelance dieting company, or one of those marketed weight loss pills/shakes or whatever.
But instead of spending money right away, we decided to do it on our own with the help of the program "my fitness pal". It's available online and via apps on a lot of phone carriers. Via phone, you can literally scan bar codes of what you are eating and it calculates everything for you. It's futuristic and awesomely awesome. It sets up a profile for you and makes goals and predicts progress for you based on how your day went. At the end of the day it even gives you pie charts of the breakdown of carbs, protein and fat you ate. It's pretty cool, and all for free. It focuses on calories mostly, but also tracks the remainder of nutrition for each product. Like Weight Watchers, It really teaches you what you were doing wrong and opens your eyes to how much you actually eat during the day and where you can cut back. Just from using the app for three days now I've realized a couple of my hinders to weight loss, some being: Starbucks Green tea frapps with soymilk/no whip (still unhealthy), Thai tea with bubbles, RITAS (I'm a ritaholic), my soy ice cream, and wineeeee. All of those said things I knew to not be extremely healthy per say but I didn't consider them to be *the* reason I wasn't losing weight. Now I treat myself to one of those said things when I have a couple calories to spare.
Anyway, the point of this post- what's wrong with this country?
The other night for dinner, my boyfriend and I picked Saladworks for dinner. For those of you unfamiliar with the franchise, its a lot like a Panera Bread- you can pick soups to eat, salads, sandwiches. What I found to be cool is you can create your own salad. My boyfriend got a Chicken Cesar premade salad, dressing on the side- And I made my own. I got romaine lettuce and added chick peas, carrots, egg whites, wheat noodles, croutons and lite raspberry vinaigrette dressing on the side, and it came with a whole wheat roll. For me, that's 509 calories. Not too bad for what I got (a lot) and the roll is to blame for a lot of that. My boyfriends was 441.
Now before I make my point here, lets think about a meal at McDonalds. Now I went to their dollar menu choices and picked out a theoretical/fake meal for my boyfriend and I.
Two McDouble Cheeseburgers, two medium fries and two sweet teas. This led to 1,840 calories, being 920 each.
So Saladworks: 950 calories for BOTH of us, cost me $19.58.
Mcdonalds: 1,840 calories, would cost me about $6.
I had to pause there for a second because it makes me so angry. So lets think about this. The country of America has a raging epidemic of obesity. We have ads everywhere to lose weight. Take this pill, drink this, eat this, join our program, be high school skinny again! Yet we have endless ads for fast food, too. So Okay lets say someone wants to lose weight but they are on a budget, like 89% of the country is. Lets face it the majority of us aren't swimming in cash. So someone wants to go lose weight so they think, oh hey! Saladworks! I like salad! It's healthy! I'll lose weight! But oh, how much? That's $20!? When I used to spend about $6 dollars on my dinner? I can't afford to lose weight! So they go back to McDonald's, spend less but also eat less matter, but eat more calories, gain more weight. See where I'm headed here? What incentive does the majority of America have to lose weight when it's obviously dramatically more expensive to lose weight. Joining Weight watchers alone will cost an individual about $52/month alone. People go to the fast food because its cheap, its fast and it tastes good. Places like Panera and Saladworks are dramatically more expensive and it takes longer. This.Is.Why.America.is.Overweight.
In an ideal utopian world, well- my utopia- people would have incentive to buy healthier things because its a lot less expensive. Popular fast food chains would become sky rocket prices-the dollar menu would cease to exist and "Value" meals would now cost $20. People on severe budgets would be drawn to healthier food because its cheaper. Think about it, we are digging ourselves a hole right into health care itself.
Someone on severe budget---> Eats fast food----> Becomes severely overweight----> A lot of health problems arise (diabetes, high cholesterol, high blood pressure, muscle/bone issues, etc)----->they don't go to the doctor because they don't have the money----->they wait and wait and those problems now become---->Strokes, heart attacks, knee replacements, gastric bypass, lifelong rehab, or even death.----they can't pay for that either.
Those second problems are so much more hard to take care of, not only on the demand to healthcare workers but to our economy! Treating someone for a FIRST heart attack that they can't pay for could cost the economy tens of thousands of dollars- and that's if its remotely uncomplicated!
It just gets me so angry. I am blessed enough to be able to afford the higher prices that come with losing weight. But a single mom with 3 kids trying to feed herself and her kids? Perhaps not so much. Yes I over exaggerated, yes I picked out dollar menu items as an example from McDonald's to make my point. Perhaps a more in depth meal at McDonald's would cost up to $15, but can you imagine how many calories that could be? Not only that, but my boyfriend and I were very full after our meal at Saladworks, and we felt great. If I ate $10 worth of food at McDonald's- Not only would I probably feel like complete crap, but it wouldn't be able to keep me full. I'd be craving more fat and sweets within an hour or two and then the cycle repeats.
Okay so I'm done now. I could probably talk for hours and hours about the Nutrition problems with our country, but I can't keep my audience forever. You're probably hungry by now. Just kidding. No I'm actually pretty hungry, I shall make myself some strawberries perhaps....yumm.
I'm sure some people won't agree with me, and that's totally cool- that's ALSO what America is all about- freedom of speech. Amen to that!
Wednesday, May 1, 2013
|Some of my bookshelf on the left with my CRAZY cat|
|my pathway, the beginning stages...|
|She loves to hide|
|the vet said she's weird because she likes her belly rubbed...|
|She thinks shes the queen of England.|
|the day she got home, when she was a weeee bitty kitten!|
|taken tonight, she loves me, 80% of the time|
|Sitting on "her" window|
|she sleeps a LOT|
Thursday, January 31, 2013
- spackeling (sp?)
- cutting things
- staining wood
- applying stained wood to wall (well actually my dad did this- I'm not allowed to hold big machines that nail things to walls)
- Cleaning some more
- making to do lists
- moving furniture
- cleaning said furniture
- taping painters tape
- untaping painters tape
- cleaning things I've already cleaned, again
- applying floor tiles
- buying a lot of crap
- making a lot of friends at Lowe's
- buying a lot of magic erasers
- cleaning some more with those erasers
- making a lot of decisions
- painting second coats
...And it goes on and on. Getting up early and staying up late, every day has been full! But FUN!
I know that these are the days I will cherish and look back on in ten years. I will marvel at how far I've come in comparison, and cherish the memories I'm making with my dad and my boyfriend as we renovate. It's been hilarious, fun, and a tremendous learning experience.
For example, here are some small, some big, all useful things I've learned in this whole experience:
- It's not that hard to buy a house, especially if you're a first time buyer like me. A lot of the stress comes from selling a house. Buying a house isn't terrible once you've picked it out and have the money to do the down payment. The rest is thousands of phone calls and a shitton of paperwork and deadlines, more paperwork and a lot of signatures. But its no big.
- It's not as hard as I thought to paint. But everything needs a second coat.
- I'm not a good enough painter to not use a drop cloth. *sigh*
- Almost anything in your home can be fixed with the right amount of money and sweet talking with employees at Lowe's and Home Depot. And asking nicely.
- Always sample colors before you buy in the gallon size. But I've noticed the samples are sometimes just a twad different from the real thing so be prepared.
- I learned how to stain wood!
- Always let the stain DRY before you try and touch something with it on, and try not to let it get on your bare skin, its really not fun to get off.
- Make sure your ladder is definitely sturdy before getting on and off it a million times. Like don't use the one you found in the garage that was there when you bought the house.
- Keep track of how much improvement money you are putting into the house.
- If you think a room is small, just put on and take off painters tape around the perimeter of the room, on the ceiling and floor. Your perspective will change.
- Make getting blinds a first priority!
- Rome wasn't built in a day.
- It takes 24 hours for spackle to dry.
- Don't take painters tape off until you're certain whoever painted what they painted definitely did their second coat.
- LABEL BOXES when you pack, it will make it SO MUCH easier to unpack and maybe your box with the silverware won't end up under 20 boxes in your office or bedroom.
- ITs your house, don't be afraid to be daring and create your own ideas/designs. Think outside the box!
- If you hear a noise, go check it out. Make peace. Learn about your house.
- When you hire any time of professional, follow them around and learn about your house and what they are doing. That way you know more about your house and you know how to do what they did. Ask questions!
- If you think you may have a ghost, make friends with it on day one. I got mine some pumpkin seeds and she loves it. I'm only partially kidding.
-Almost anything can be cleaned with a magic clean eraser.
- Its not the end of the world if you get paint on the molding, trim, ceiling, etc. Either it wiples off easily, or you can go back with touch up paint.
- Just give in and get the MyLowes card. Preferably not on your last visit to buy paint...
Anyway, I'll probably add some learning experiences as I continue to work on the house. We're still not done painting, we need 40% of our furniture yet, and still so much CLEANING. I honestly never thought I had it in me to clean this much, but I guess you grow up a lot when you have your own house. I first noticed myself caring about cleanliness when I had my very first dorm room in college. I had a single, so it was all up to me to keep it clean. If I didn't, I always was mortified when friends stopped by and saw my messes. So I finally understood why my mom was always so adamant about cleaning the house when company came over. But then by the time I was a senior in my single dorm, I really didn't care about my rooms appearance. I would *maybe*
But anyway, 2013 will be a huge year for me. I've got to learn how to start cutting coupons and paying attention to sales. I've got a friggen mortgage now, which is scarier than anything. I've always been the kind of girl that's afraid of commitment, and having a 30 year commitment to anything is nerve wracking to me. But I'm ready for it. This feels right. I fell in love with the house when I first saw it, and I plan to put a lot of love into it.
Look for more updates on the house, more to come! Maybe I'll tell you my ghost story.
- With love,
Thursday, January 10, 2013
So in case you don't know my nursing history, I was an aide for five years until I graduated nursing school and was hired, at the same hospital as an R.N. For awhile I struggled accepting the differences between being a nurse aide and a registered nurse. I couldn't grasp the fact that now I had to delegate tasks to my coworkers that used to be the same position as me, but now they were beneath me. I knew how busy they were because I had been in their exact shoes. So I became determined to always try and do everything myself and only ask for help from the aides when my patients safety depends on it.
Then this year I came over to a new hospital, where it was a little easier to accept the boundaries between being an RN and the aide. I respect my new aides very much and still always try to help them out, even with patients that are not my own. I try and only ask for help when either I cannot do it or another patient needs me more or I just need an extra hand in the room.
But recently, my patients (like I said, 5-6 different patients within the past week) have done something peculiar.
I go into the room to do my nursing assessment, or perhaps give them a medication of some kind. This one patient asked me the other day, "Do you have CNAs (nurse aides) or something?" I said "Yes, we do." She said, "Can you please send one in when you have a chance, I need some ice water." I looked perplexed, I said back- "well I can certainly get you some ice water, I'll be right back." and she quickly said, "No no, you're the RN, you have much more important things to do. Send a CNA in." This was the first time I had ever heard something like this. I assured her I had the time to do it and I wanted to get her ice water and that I did.
A couple of other patients have done the same thing, and its only been recently. A male patient I had last night spilled a drink of water and needed a new set of napkins, and a towel to clean up the water. I said "sure, I'll be right back" and when I got back, he said, "you didn't have to do that, that is dirty work, i know you have more important things to do."
I looked up at him , almost incredulously- as this was the 5th or 6th this same instance had happened with other patients, and I assured him that helping him and making him feel better in any way was just as important to me as anything else. I don't mind doing anything, that is my job-regardless or not if it can also be the aides job. In fact I think I think it's even in my hospitals nursing policy that we do not leave any room without making sure the patient has everything they need and they are happy. If they aren't happy, we need to find a person with different capabilities that can make them happy. I don't know why my patients have gotten it in their head that the RNs are "better" than the aides. We aren't better. We just can do different things for our patients. Just like I don't necessarily consider doctors "better" than RNs, they just do different things. Sure, I respect the doctors I work with and they are obviously a vital part of health care. But so are nurses. And so are aides. Ok I've gone off on a tangent.
Anyway, my boyfriend has puppy eyes and is staring at me over top my computer screen waiting for me to finish, so I'm wrapping this up. Sorry for the short blog, I just wanted to write about it since its happened so many times recently....and it just doesn't fly in my world.
With Love, WNB
Tuesday, January 1, 2013
I hope everyone is having a good 2013 so far! I have a really good feeling that 2013 is going to be a life-altering year, in a really good way. I can just feel it.
I got a call this morning from my job offering me a deal to come in for day shift hours and I would be allowed to leave at 11pm , instead of 7 am, so that is awesome and totally is what I needed. I ended up getting out at 11:45 and got to hear the radio dance party on my local station. It was awesome being able to bop along to my favorite 2012 songs, even if I was in scrubs, in the car, and not at a party or anything. It was such an unexpected treat to even be able to listen to it in the first place since I was supposed to be at work. Anyway, so when the radio DJ count-downed( is that a word?) to midnight, and there it is just seconds after midnight and fireworks are going off in the distance as I travel down the road, and I finally felt it. I was euphoric. And what was this, was I actually crying?? Yea. I have *never* cried tears of happiness, ever. Never ever. Which made me cry even more because I was so shocked I was crying happy tears. I was just so happy that I wasn't at work, I survived hell week (between xmas and new years in healthcare) and did a really good job, my boss told me I was a really good nurse....and my favorite songs were playing. I couldn't stop smiling.
So THAT my friends is how I know 2013 is going to be a good year. Because after so long of my emotions being shut down, guarded from heartbreak, I can finally feel euphoria again. I cannot wait.
Anyway, my yearly tradition of resolutions! If you're new to my blog, every year I go through my prior years resolutions and comment on how I did. After that I write new ones. Unfortunately, I read through last years and not much has changed. But its tradition! The italicized are last years, the normal font is me commenting on it. Following the whole set are 2013's.
1) Have at LEAST half of my book #1 completely written by 2013. Part of me wants to say write the whole book by 2013, but....I'd rather be proud of myself for accomplishing a resolution than to not because I set the standard too high. So, yeah. Half the book. I think this is definitely possible.
Haha. That didn't happen. But I have a good excuse. Last year when I wrote this, I was working night shift on a 12 bed unit, and although we had our fair share of insane nights, most nights I had time to write a little when all my work was done and my patients were sleeping. Well, then the summer got really busy, and then I got transferred, and at this new place- I barely have time to pee. My home life has been pretty busy as well :(
2) I need to learn how to go with the flow....I'm 23, I have to stop trying to PLAN everything. Stop trying to overanalyze everything and just......be. Just do. Accept new challenges. Accept new people in my life. Do new things. Play new sports.
I did a good job with this one! I joined racquetball! I stayed with it! I didn't quit! I joined tennis lessons! I got out and did things I was afraid of this year. I took a leap of faith with my new boyfriend this year. I screwed the logical planning of every single step of my life. I like my life a lot better this way.
3) I want to really focus this year on becoming a much better nurse. I want to do a lot of research on my practice, and really better myself in unique abilities. My hospital is offering the position of a "wound care champion" that I might look into. It would be nice to be exceptionally good at at least one thing among the amazing nurses I work with.
I did end up becoming a wound care champion at my old hospital! It was pretty sweet to be good at something, and to my new job I therefore brought the knowledge of how to dress a wound pretty awesomely. Sweet. Also, being on a cardiology floor has taught me SO MUCH in so little time and I can't wait to be a proficient cardiac nurse.
4) Along with number 3, in general (in nursing and in life), I need to learn to be more confident in my abilities. In my self. In my knowledge. In my instincts. This is really hard. I need to trust myself.
I have serious self esteem issues and I don't think I will ever learn to be completely confident in myself. I always question myself. I just hate to do things wrong. I still have to work on this.
5) I need to learn how to COOK! Not just any cooking, but I need to learn how to cook in general and cook for lactose intolerance specifically. So, I really need to get on this because right now my food groups consist of: Rice, beans, chicken, chinese food, fish & chips, vegetables, chicken tenders, fries, and smoothies. So, More variety needed? Yess.
Okay. This was hard. Thats still pretty much my entire food group, except I eat less chinese food now, less fries, less tenders, and less fish and chips. So I basically eat: Fruit, veggies, BREAD (so bad), Thai food, chicken, rice and lactose intolerant specially made products. Sooooooo, yeah. HOWEVER, I have a lot of influential people in my life that have been teaching me how to cook real things. I've dated two people this past year that loved to cook and worked with my allergies and taught me how to make some good meals. My grandma is a great cook and did the same for me. My aunt has also been guiding me through some really dumb questions online! With buying a new house soon, I'm going to have a full kitchen to myself that I need to use! Goal: next year, I'm making thanksgiving dinner all by myself :)
6) I need to learn how to love again. But at the same time, I need to learn how to just be ok with me. I need to get to know myself better before I let myself attach to anyone else at this point. I feel like right now, when I "attach" to someone, or see someone, they are dating an empty vessel of a girl that needs to figure out a lot right now. I am in here, I promise. Just need to work on my firewall right now, let people in. Its a new year. New beginnings. Let our endings go. Forever, and ever, and hit the ground runnin! Woo.
I did this! I so did this! I'm doing it! I dated a couple young gentleman in 2012 but there was always something that was off. After a couple bad experiences, I decided it was impossible to meet new people working night shift and the only other thing I did was go to Barnes & Noble, the gym and out with my family and girlfriends. Plus, strangers don't meet and start dating anymore nowadays. And my friends tried setting me up and it just wasn't working out. So I threw in the towel and joined the ever so promising eHarmony. And within three weeks of my membership (and a lot of conversations), I met my amazing boyfriend. He lives in the town right next to mine, yay! We had talked online and through texting for about two weeks, until we decided to have our first date on a Wednesday. By that Friday, we were boyfriend and girlfriend. So it went really fast but everything just felt right. Which is huge for me, because I'm very picky. He is one of the main reasons I think my heart is opening back up to feel emotions. I held true to myself and am comfortable with myself, I know myself pretty well and I am strong. I don't believe in 1/2 and 1/2 makes 1 when it comes to partners. I believe in 1 + 1 makes 2. We do not complete each other, nor should we. Nor should anyone, because then what are you without them? We are each our own unique person, our own soul, our own complete set of strengths and weaknesses, and together we bring that to the same table and combine from there.
7) I already am doing this, but I want to draw a LOT more. I already have drawn so much since school let out and I love it. I also want to do more with my photography this year. Like sell it. Big time. :-) On that note, look for a photography post sooN! I am WAY overdue!
I drew a LOT this year. I got a drawing desk!!!! Its the best!!!!!! I've been on a drawing hiatus because I've been so busy but I plan to go back full force this spring. My new house has room for my own studio :) Oh, and I still owe ya'll that photography post...ha
Alright so here's what I've got for 2013. I haven't thought about my resolutions until literally right now. Usually I think about this blog for like a week. Soooooo, here goes.
1) No more sugar. This is something I've been trying to do for a couple of months now, but it's so HARD. What I mean by no sugar is no OBVIOUS sugar. I still plan to eat fruit. What my problem has been, is raspberry friggen Iced tea. That stuff is packed tight with sugar and I've become addicted to it. I've also gained like ten pounds. I also eat more bread than..........Peeta Mellark. I seriously love bread. Its bad. I don't want to eat any obvious sugar. It will be hard, but I can do it. At least cut out 80% of it?
2)Lose weight. I am uncomfortable with my body and have to change. I come from a past of not being good enough for those I loved. My boyfriend now tells me he loves just the way I am and that makes me so happy but I can't stand the way I feel, the extra jiggles and lovemuffins. I hate the mirror. So, by 2014 I plan to be holding steady under 130lbs. I'm 145 now. I can do that!
3) Budget- Budget- BUDGET. Buying a new house, its not like an apartment. There is no escape plan this time. If I couldn't handle the rent at any point, I could have left at anytime. Not with a mortgage. I have to cut coupons. And actually pay attention to sales. I have to think twice about buying 6 books that will sit on my bookshelf. I can do it.
4) Keep my damn car and room clean. WHY IS THIS SO HARD. I have the cutest little sports car, which looks awesome from a distance and then people get in it and realize its not suitable to non-julie human survival. Sad.
5) Join a badminton team . Join a swimming team.
6) Be smarter. Although I AM a LOT smarter as a nurse now than I was last year, there is still so much I don't know. I so badly want to be the nurse that the new graduate comes and gets and says "can you help me?" and I can just come in and teach and finally know everything and put it to good use. I want to maybe start school this Fall for my nursing MSN. I want to research more about my patients conditions.
7) WRITE MY GODD*** BOOK!
Thats it, folks!! Love you all!
Make a difference. Make it your own.