Gratitude Challenge Day 6 -- Details

My job is all about the details. The details on how my patient looks, what his/her history is, what meds are being given, what the home meds are, when thing need to be given, what everything sounds like etc....You have to be seriously organized.

And I am not naturally organized.

I love how my nurse friends have made some great organizational 'brains' to help them get through their days/nights. I end up spending too much time trying to plug in what I need to in the slots provided in the various 'brains' out there. I'm more of a let's be free kind of person. (wheeee, picture me in scrubs singing and twirling -- never mind, don't picture that). I also have to have everything on one page to make sure I don't miss anything through the night. I'm not good at continuously flipping through individual sheets for each patient to see if something is due for that patient.  So this is how I organize my night.

 At our hospital we get our assignment sheet and individual information sheets for each patient. I just used blank sheets for my demonstration here -- because you know, HIPPA, they frown on us sharing personal patient information.  So my top page is our assignment sheet, and the bottom sheets are the individual patient information sheets, all folded so if I leave my 'brain' anywhere personal information isn't in plain view. I put the room numbers on each folded patient sheet and if there's something really important to know about a patient I'll add that too - i.e., DNR, or NPO, or a PICC line.

The top sheet is where I put everything I need to do for the night. I organize it out by times. In my job there are some time sensitve action items, and I find this helps me stay on target. Mostly it's when my patients' meds are due. I also give myself a note in case the meds are not in the Pyxis and they are in the patients' med bins, or if it's an IV antibiotic (then I'm queued into making sure I have lines etc to hang it). I'm on a neuro joint spine surgery floor so we need to do neuro checks every four hours. For our safety no falls protocol we also need to check on their toileting needs every four hours and check for pain every four hours if they're on a PCA (NO ONE EVER GETS TO SLEEP IN THE HOSPITAL). Our 730 am meds are kind of a gray area between night and day shift, technically they're a day shift medication, but I try and give them if I can, so I put them on my list (I'm nice that way). I also put down when my patients can get their PRN pain and nausea meds. Because it's a surgical floor with a lot of people with chronic pain people, those PRN pain meds are really important. Like REALLY important.

So on each individual page I put down what I get and what to give in report. What I need to tell the CNA about the patient in my report to them, the patient's assessment, their fluids, their diet, what arm bands they have and if I need to add a band (i.e., if they don't have their fall band, or missing an allergy band) pain, times I do things since I'll be charting later.

And there you go. The detailed way and unorganized person, organizes her day. Because in my job, those details are important.

Day 3 - Dreams - 30 days of Gratitude - in pictures

I had many dreams of what I would be when I was growing up. One was being a decorator. I would even make doll house out of cardboard boxes, creating walls, doorways and windows, making sure the floor plan was usable. I would draw furniture in each of the rooms. My sister would then ask for the finished product so she could play with it with her dolls. Pretty much the only time in our young lives I didn't care she wanted something that was mine (such are the feelings of an older sister). I gladly gave them to her, because the joy was in the designing. I wanted to go to an art school to study interior design, but my father insisted on a four-year liberal arts degree. I would be more marketable he thought.  He died after my first year of college, but I continued with his advice. Because, pleasing a dead man makes so much sense, no? I majored in creative writing and minored in history (completely and totally NOT marketable).   One of my other dreams was to be a writer. The problem was and still is, is that I'm mediocre at best and didn't have the discipline to make writing a career.  But let me tell ya, it was a fun major to have. I got married, worked job to job, not very fulfilled. Then had babies. 

Another dream -- being a mom. I love love being a mom. I love parenting. As much as I complain about it, I don't mind the numbing-tiredness that parenting can be at times. I love my children with all my heart and love the men they are becoming - metaphorical warts and all. When the kids were older, I needed to think of a career, one that would be fulfilling, one that would tap into the caring person my children taught me to be, one that would give back. I thought about teacher, because how much fun would it be to inspire kids to want to write and read and have wonderful discussion about great works and newly discovered authors. Yeah, I'm an idealist. I also thought about nursing. Nursing won out, I enjoy the science of health, I think the nursing ideal of loving care of those who are in need fits right in with my personality. It was hard, nursing school was hell (seriously, if Dante actually went to nursing school, this would be the closest ring to Satan himself). But it was all worth it.  Nursing was a newer dream, but one of the hardest to achieve and I'm proud of the work I've done to get here. I also get to add teaching back in as I volunteer to precept, speak at nursing schools, mentor and encourage new nurses. I also do a lot of patient teaching....so nursing was a great choice, even if I'm not discussing great works and encouraging writing (although, I do talk to patients about the books they have on their bedside tables and have had great discussions about books and authors).

I haven't given up my dreams on decorating and designing. I just use my own house as my canvas and once in awhile my friends will ask for my advice and I gladly and enthusiastically give it to them, sometimes with swatches. I, and I can't believe I'm admitting this, am starting to write a novel. I'm not sure how good it'll be, or what will come of it....but if I don't try, I'll never know.

That's the thing about dreams, the first step is the hardest, but once you take that first step you are that much closer at achieving whatever it is you dream.

Day 2 Gratitude Challenge

Thirty days of gratitude....yeah yeah, we should all be grateful daily and I am. I just don't announce it to the world because I really believe the world enjoys my whining so much more.  I'm going to do this thirty day gratitude thing (don't worry, I'm sure I'll still whine). It won't always be on my blog...because let's face it, I've been sucking at blogging. Day one was on my FB page -- I just posted a picture of the Front Range and thanked the Lord I live in one of the more beautiful cities in the US (because I really do, I mean how many people get the beautiful view of the Rocky Mountain Range on a daily basis).  Today (as you can see by the nifty challenge graphic below) is laughter.  And I LOOOOVE ME some laughter.  I really do have one of the funniest husbands ever, he makes me laugh all the time -- he sometimes even does it intentionally. I am also always finding amusement in my children, who are both growing up with wonderful senses of humor -- sometimes even appropriate. I love laughing and I love to make people laugh.

 For this post I am thankful that although my sister was full of pain to the point she lost her life to alcohol, drugs, and depression, she had the most contagious laugh of anyone I have ever met. Her smile and laugh would light up a room and you couldn't help but laugh when she was laughing.  We grew up laughing. I am grateful I was able to hear my sister's laugh for over 40 years of my life. My sister and two of my brothers are pictured here laughing.

 After she died, one brother and I went to Florida to be with my mom, step dad and other brother. We spent the weekend crying, fighting (good-naturedly), and laughing. I am grateful for such two awesome, talented, handsome brothers who can do silly like no one's business.

 Look at my hubby's smile...how could you not laugh all the time with this guy, and the youngest -- he is such a lovely sweet boy who says the wildest things, and the teen, who has that typical teen expression, has a dry sly wit that catches you off guard. I am grateful for all of them. I am the luckiest mom and wife in the whole entire world.

And my coffee lady book club neighborhood peeps -- crying, laughing, gossiping, hugging group of women who give me strength -- All have wonderful senses of humor. How can I not be thankful with these lovelies.

One of the best pranks ever played and it still makes me laugh is when a group of my friends added a bunch of extra wives to my sticker-car-family -- a little making fun of my weird obsession with plural marriage (okay, all of us had a little obsession, we got together to watch Big Love every week and we call each other sister-wives).

 My marriage started out in laughter...the best way to begin a life together. My sister and sister-in-law laughing along with me, one of my best friends from high school and my best friend from college joining in (the three of them also came to my sister's funeral, to say good-bye because they too knew my sister, loved her and laughed with her). We have all had our own journeys to live, one with a mother and husband who had cancer (and are still alive and doing well). She and her husband make me laugh all the time. One whose daughter has Down's syndrome with autism, but posts the cutest and funniest pictures of her son and daughters on Facebook, and the third, my sister-in-law has advanced MS and she still is able to laugh and enjoy life.

So, yes, I am grateful for laughter. Without it life would be unbearable.

Lemon Artichoke Pasta

We like to have a vegetarian meals a couple times a week. It cuts costs and in theory can be healthy. Found a yummy recipe on the Pioneer Woman Blog and who doesn't just love her recipes? They've become our family staples -- especially her restaurant style salsa. Anyhow...I made this lemon pasta awhile back and it was yummy -- but, I always have to fiddle and so adjusted some things and came up with the following:

Lemon Artichoke Pasta

16-17 oz of whole wheat spaghetti – olive oil

6 tbs butter

1-2 tbs minced garlic

3 lemons, zest and juice and ¼ cup of extra lemon juice

5 cups Fage Greek yogurt plain

2 cups shredded Parmesan and another cup for topping

2 cans of quartered artichoke hearts drained

Italian parsley chopped

Boil pasta in salted water to al dente, drain and toss with olive oil

In skillet melt butter and sauté garlic. Add lemon rind, Greek yogurt, artichoke hearts,  Parmesan (2cups), and lemon juice, stir until warmed through and blended. Toss with pasta.

Place pasta mixture into 9x13 baker

Top with 1 cup of Parmesan and parsley

Cook covered for 15 minutes, then another five minutes uncovered.

Serves 8-10 people

And it’s freakin’ yummy

Linking up Here

Home Stories A to Z

Follow Your Dreams, Just Don’t Write About Them

I've been blogging, just not here on Zimmerhouse.  Here's why -- I've been nagging my husband about the lack of social media in his company this past summer and to shut me up he's letting me help them out -- for free -- wait, what? Free? Whatever, it's been fun. Here's one of the posts I wrote there. Because we all know how much fun I have making fun of myself:

One of the first lectures in my first Creative Writing class in college was to never write about your dreams. Well at least if you do write about them, don’t turn them into the class for a critique and certainly don’t send it as a story to the college literary magazine for possible publication.

Why?

Well, the professor said because we don’t always know what our dreams mean, or are aware of the symbolism because we’re so close to the dream.

I heard, blah blah blah. Because I was barely 20 years old and I knew everything (sigh, I wish I was still knew everything).

Here’s how I learned this particular lesson because I was too arrogant to actually listen to my professor.

I had a story due and had no idea what to write. I decided to sleep on it. I had this great dream that seemed to me like some awesome mysterious fable and I knew when I woke up this story was going to rock the world of my class (I know, I know, keep in mind, I was 20 at the time). I was pumped, I was energized and I wrote my heart out. It was a story about secret passages leading to a hidden cavern. The heroin died by drowning and every time someone entered the secret passage by canoe she haunted the cavern with her eerie moans. I’m sure you can see where this is going.

I turn it in. No one says anything. Seriously, the lack of a response was disturbing. The professor did reiterate that it is a bad idea to write out our dreams so literally. I do believe she sighed afterwards.

They just didn't get it, but surely the crew at the literary magazine would, so I sent it to them.

When I didn't hear anything, I just assumed they didn’t get it either.

Because it couldn't have been my story...my brilliant story.

A few months later I was at a writing conference and saw a fellow student who also happened to be on the literary magazine committee. I asked him what was up about my story.

And he asks, “the one with the sexual imagery?”

A flood of images clouded my mind turning my cheeks bright red and I realized I just wrote surreal porn and shared it with my teacher, my fellow students, and the entire committee of the school’s literary magazine – truly a Freudian nightmare. In this case a canoe was -- well -- NOT just a canoe.

Not my proudest moment.

Dream journaling can be inspiring; can help you work things out; and can help you with images as dreams can be amazingly vivid. Dreams can help in writing and I would never discourage anyone from writing about them in.your.own.private.journals. But, like my very experienced and insightful professor from 20 plus years ago, I suggest that’s all you do and don’t write the dream out verbatim as a story.

The link to my post on BookFuel's blog: https://www.bookfuel.com/blog/2014/08/dreams-great-journal-not-good-your-story

Social Media in Nursing

As most of my loyal followers (all three of you) know I am in school to get my post-master’s teaching certification for nursing (I don’t know why, I suspect I may be insane). My assignment this week can be an APA style paper (yawn), a PowerPoint presentation (call me a geek, but I really do love my PowerPoints), or a blog post (Whee, a blog post).  I can so do that (even though, I haven’t been doing that lately). Because my subject is about social media in nursing, I thought the blog post option would be the best (and okay the most fun).

Nurses can be afraid of social media, mostly because of media coverage about nurses getting fired for inappropriate postings, or postings during work which may have been a safety matter. Stokowski, (2011) reports one nurse was fired for posting on Facebook while dispensing medications, another nurse was fired for posting a picture of one nurse removing a splinter from another nurse’s foot in an operating room. The excuse for firing the first nurse was patient safety and for the second scenario was because the hospital claimed it was an unfavorable representation of their hospital (Stokowski, 2011).  There was one case where a nurse posted a picture of a placenta. She was fired and then took the hospital to court. The court found in her favor as she had permission and there was no way to identify the patient (Shah 2011, Stokowski, 2011). The court maintained the court case created more coverage of the picture than the original Facebook posting; even though the nurse took the picture down the news showed it and it was picked up various internet sites (Shah 2011, Stokowski, 2011). Both Shah (2011) and Stokowski (2011) maintain social media does not have to be scary and can be used for many ways, such as nursing education, patient education, networking, and for nurse venting (and if anyone needs to vent, it’s nurses). It is important for the nurse posting information about work to be very careful that she or he does not reveal any patient information, or any information where a reader could discern who the patient is. It is also a good idea to keep from posting any disparaging remarks about your place of employment. Shah (2011) mentions that nurses who are very familiar with social media forget whatever is posted on the internet is not private, even if their intention was to share with only their friends. It is important to remember whenever you post something on a social media site, your boss or future employers could find it and read it.

On a personal note I do post on Facebook about experiences at work but when I do it’s for a specific reason and I always protect the identity of our patients and speak of my employers with respect. I will share with you some of my own posts as an example of what types of posts are appropriate and professional for a nurse.

The other day I took care of a patient who was dying of cancer. It was very sad. I posted:

Very sad night with my patient. It’s a reminder for all of us to see our doctors regularly and do our screenings. I made my appointment for my mammogram this morning.

This is my version of a public service announcement. I also reposted a picture of the nurses in our department from the hospital Facebook page to let my friends know about the kudos our department received. Mostly, I write posts about my family, our personal activities, repost funny cartoons or I make fun of myself. Such as:

Most people who wake up with a numb arm and a headache reposition themselves because most likely it was positional -- I wake up with a numb arm and a head ache and think stroke. Glad I repositioned myself before I called 9-1-1

We’ve established social media does not have to be scary for the nurse if used appropriately – remember don’t write anything your boss or future boss would find inappropriate. But what can social media do for nursing or patient education. Not only can it help spread information, it can open up a dialogue between nurses and between patients and health care providers. Social media can help with marketing, networking, and maintaining friendships.

            Fraser (2012) states social media can have an impact of modifiable health behaviors such as medication compliance and provides an opportunity for interactive communication with patients. Health promotion is another area where social media can be used by posting health-promoting messages on Twitter or Facebook (Fraser, 2012). When I was the Bariatric Coordinator I set up a blog, Facebook page and Twitter accounts for the surgeon. I wrote blog entries about diet, exercise, emotional eating, and information about the different surgeries offered and what to do for self care after surgery. I also wrote informative and motivational posts for Facebook and Twitter. These were avenues to give patients information about healthy eating as well as helping patients stay motivated. Often patients would ask questions on our Facebook page and it gave us an opportunity to have a discussion where others could learn or contribute.

            Social media can be used in nursing classrooms as well as with patient education. Linked In, Blogging, Facebook, and Twitter are the most common social media sites, but for classroom work there are presentation sites such as Prezi, Slidesrocket, or Vimeo (Schmitt, Sims-Giddens, & Booth, 2012).  When using social media in the classroom it is important to consider the following: everything posted is public, understand your audience, will your post add or detract from the discussion, keep professional boundaries, and always keep patient information private (Schmitt, Sims-Giddens, & Booth, 2012). American Sentinel (2014) gives suggestions on nursing sites via blogs, Pinterest, Twitter and Linked In to help nurses and nursing students find information needed for their positions. Following certain nursing blogs, or nursing websites can help nurses sift through information and hone in on their own specialty or interest (American Sentinel, 2014). If I find I don’t have time to read an article, or want to keep an online article handy for future reference I will “pin” it to my nursing board on my Pinterest page so that I can access it later. Linked In is not only valuable for networking; something important for new graduate nurses as well as veteran nurses (Doksai, 2012). The last semester nursing student can network by joining nursing organizations on Linked In in order to see what is current in the industry as well as reading professional tips such as resume writing. Linked In doesn’t just help directly but can help indirectly as well. I was recruited on Linked In for a home health job, while I did not want the position I contacted a new grad and was able to get the two together and she found a nursing job.

            Social media does not have to be scary and can be quite beneficial to the nurse and nursing student.  Be careful when using social media. Always protect patient’s privacy (you may have noticed this theme running through this post), protect the reputation of your institution, and be aware of your audience. It is a wonderful way to exchange information for both the nurse and nursing student. It can be a way to network for new positions. The advantages far outweigh the disadvantages and those disadvantages can be minimized with careful planning. Most importantly, have fun with it – it’s not like it’s an APA formal paper.

References:

American Sentinel. (2014). Nursing Together. Retrieved from http://www.nursetogether.com/use-social-media-for-professional-developme

Docksai, R.  (2012).  Working and Networking – your way to a job in nursing using social media & available tools. Nursing Licensure. Retrieved from http://www.nursinglicensure.org/articles/nursing-jobs-using-social-media.html

Fraser, R. (2012). Overview and Summary: Social Media and Communication Technology: New "Friends" in Healthcare. Online Journal Of Issues In Nursing, 17(3), 1. doi:10.3912/OJIN.Vol17No03ManOS

Schmitt, T., Sims-Giddens, S., & Booth, R. (2012). Social media use in nursing education. Online Journal Of Issues In Nursing, 17(3), 2.

Shah, A., (2011). Don’t be afraid of HIPAA, say nurse bloggers. Reporting on Health. USC Annenberg. Retrieved from http://www.reportingonhealth.org/blogs/2011/11/11/dont-be-afraid-hipaa-say-nurse-bloggers

Stokowski, L., (2011) Social Media and Nurses: Promising or Perilous? Medscape. Retrieved from http://www.medscape.com/viewarticle/753317_3

Images:

Social media “Like” from http://www.consumeraffairs.com/news04/2012/10/study-checking-your-social-media-pages-is-as-addictive-as-sex-and-nicotine.html

Spinach Pie

I made a spinach salad the other day but stupidly bought my spinach at Costco -- I don't know what the heck I was thinking --  who NEEDS that much spinach. I hadn't made spinach pie in a long time so figured I'd make it with that spinach before it went bad (I'm trying to be better at stuff like that - not letting produce going bad). Any how, it's a super easy and yummy and thought I'd share.

Ingredients (2 pies - one to eat, one to freeze or give away):
2 packages of Pepperidge Farms Pastry Sheets
1 red pepper, chopped
1 sweet yellow onion, chopped
1 Tbs crushed/minced garlic
2 bags of fresh spinach
oregano and basil to taste
2 cups of crumbled feta
3/4 bag of Monterey Jack cheese
6 eggs, half a cup of milk
1 beaten egg to brush pastry

 Saute peppers, onions, & garlic in olive oil, stil browned and soft

 Sweat Spinach

  Put in mixing bowl and add cheeses and spices, mix together.

So lost a couple of pictures...weird, anyhow, place a pastry sheet in bottom of baking dish, and repeat with second baking dish. Place spinach/cheese mixture in bottom of each dish. Beat together milk and eggs and pour half of mixture into each dish.

 Place remaining pastry sheets on top and cut away edges. Brush with egg. Bake at 400 for 20 minutes until golden brown and flaky.

 And serve and enjoy!