A Place I call Home

What do these have in common.....

2008-10-09T08:33:00.001-07:00

Do you know what these two photos have in common? Give Up?
They both come in all shapes, sizes, colours and can be almost anything you want them to be.

You might be thinking where is she going with this. Well a couple of places actually. Some of it positive, and some of it not so positive. I have been a nurse for 20 years....I know there are nurses out there that have been in this profession for 30 or 35 years...it was their life long passion to be a nurse. I work with some of these nurses. When I was at work yesterday and looking around me....the varying nurses that were there, the chatter that was going on....the care that was taking place. It sort of struck me that nursing is as varied as knitted socks. Knitted socks can be what ever you want them to be....they can be bold and bright, striped, boot like, cartoon characters...the list is endless. That is how I see nursing.

Nursing has changed. It's not the traditional bedside nurse that most people think of when they think of nursing. Nurses are seen in research, wound and ostomy care, Operating room, Emergency nursing, Nurse administrators, Nursing instructors/educators, Critical care, Paediatric, Neonatal intensive care, Cardiac intensive care, Nurse practitioners the list is endless.

When I went into nursing 20 years ago I originally thought that I wanted to be a paediatric nurse...after my stint in paediatric nursing I realized that it wasn't for me. I then got a passion for Palliative care and then Critical care. Nursing has been an amazing ride. It's a profession where you have an opportunity to enter into someone's life although briefly, but can make a tremendous impact on their recovery or a dignified death.

Knowing that I am going to be on the receiving end of this care, I have been paying close attention to how nurses interact with their patients. The nurses I will come in contact with will be recovery room nurses, critical care nurses and step down care nurses. All will bring varying degree of expertise. What I am hoping will stay constant is their passion for providing the best possible care they care. To be patient and compassionate. Empathetic and Caring. Is that a tall order? I hope not.

As of late, I have observed nurses who's demeanor I wouldn't wish on my worst enemy. I don't know what bee is in their bonnet but I wish if they were feeling that miserable that they get out of the profession or call in sick. As in many walks of life we will come across people who come from a variety of backgrounds and whether they acknowledge it or not it can impact their practise causing them to be biased or judgemental.

Now as a recovery room nurse, I care for patients coming out from a variety of surgeries....many are elective surgeries....and many not. With that each patient comes out of anesthetic differently. There are expected outcomes but some people are just more sensitive to the drugs than others and respond differently. Some have a higher pain tolerance than others. Some cry, some feel sick to their stomachs, others are fearful and yet some even laugh. I find, it is how we as nurses interact with these patients that can make a difference in their recovery process. We are often the first face they see and voice they hear when they come out of the anesthetic. They are not at their best. So for us as nurses to judge them....to say they are too needy, or that they are a "whiner" or have no coping skills is out of line. We all come to the table from different socio economic backgrounds. These backgrounds can most certainly play a role on an individual's coping skills.

So socks and nurses do share some similarities....some give you the warm cozy feeling and others are rough and scratchy. I just hope that when it comes to the day of my surgery and hospital stay, I have nurses who still have a passion for nursing and will just accept me for who I am, and that they are wearing their warm fuzzy socks that day.

Contradictions

2008-10-08T06:46:00.000-07:00

I was reading in a little book I have called Meditations for Women Who Do Too Much by Anne Wilson Schaef, and I found this topic having to do with "Contradictions" it intrigued me....

"So much of our lives are glaring contradictions. We swear that we will never be like our mothers, then find ourselves screeching on the same note. We know we would never manipulate others the way our boss manipulates us, and then we catch ourselves doing it. We seem to see so clearly "out there", while "in here" is a muddle. Relax, it's all part of this addictive disease process. It's called denial. Breaking through the denial about what is really going on in our lives is the first step in recovery."

When I first started reading this I could see certain characteristics in myself....reading further I am not sure that I would agree that is an "addictive disease" but I would agree with the denial......Any thoughts on that?

I see sunshine on a cloudy day..........

2008-10-06T14:49:00.001-07:00

Ok enough already....enough feeling sorry for myself. In my previous post I mentioned that I had made an apron for my daughter.....it's been years since I have sewn....and I sewed this on that $3 sewing machine I told you I picked up at a garage sale....what do ya think?

I opted to do a lining with it to give it more thickness....I incorporated the lining into the pocket..I trimmed the top of the pocket with the same colour as the front....but you know now that I look at it...I think maybe I should have done the pocket in the same colour and then trimmed it with the reverse colour. I just loved the material. It really should have been for Thanksgiving...but seeing as that is this weekend it will just have to do as a fall apron. It's my youngest daughters birthday on the 25th and she is really a Susie homemaker. She loves to bake and cook, she just recently learnt how to bake pies! So I thought as part of her birthday present I would give her this apron, I am going to make up a collection of some of my favourite recipes and put them in a book, I also got her a couple of kitchen utensils. I am hoping she will like it. Of course I will be getting her something off of her birthday list...but I thought this would be a little something especially from me to her.

I love this little clip art of Piglet and Pooh.....it's just so cheery.....how can it not put a smile on your face.

Not feeling so sunny today.....

2008-10-06T05:00:00.000-07:00

It was a relatively quite weekend for me. Saturday I spent the morning searching the Internet and drinking my latte....by early afternoon I decided it was time to do some house chores....hubby had asked me about a recipe I had for some cookies....hint hint.....so I baked some cookies. Saturday evening we spent over at the in laws playing cards...nice peaceful and relaxing. Sunday was pretty mellow as well.....after my morning latte I went out and cleared some brush at the top of the property....hubby was busy cutting down a tree and chopping it for firewood. By early afternoon I found myself cutting out material for an apron I made for my youngest daughter. All in all it was a productive weekend...but my mind was somewhere else.

Since my appointment with the specialist last week I have been a tad preoccupied to say the least, and to top it off I just physically have not been myself.

I think my blah, humdrum rainy day doldrums are taking their toll. My head is whirling with all the possibilities for the outcome of the surgery.....I am telling myself not to worry but in doing so I worry. My brother's wife called me on Saturday expressing her concern for me and really wished I would consider having my surgery sooner rather than later. I explained the rationale for the decision on the date and thanked her for her concern she was truly being very genuine and I was very appreciative of that, but it certainly did not help with my mood.

Part of me keeps saying "chin up" get on with it.....don't waste good energy worrying about something you have no control over. So when I say that, I try and distract myself by keeping busy...hence the sewing...and knitting.

Some times it works....some times it doesn't. There is part of me that just wants to crawl under the covers and come out when it is all over. But that isn't going to happen. Life must go on.....I must continue to be productive and enjoy everything that life puts before me. I just want to scream. I feel like a bundle of contradictions. There is a definite right and left side of me going on. The "don't worry be happy" and the "I am pissed,angry,sad and scared" side of me, and I hurt. I ache all over. Kinda like you feel when you get the flu.....but no fever, no sick stomach, nothing just this constant dull ache throughout my whole body. Like it's feeling it's all worn out.

I keep trying to do.....but Ifind I have to do a lot of self talk....generally this would come natural.....I love to run and be active....not so much right now....it's a struggle to get me onto my stepper...I'm doing it, but not enough.....so then I feel bad....I feel good mentally after I have exercised so I know it is something I should really work at trying to continue to do...but I would be lying if I didn't say it was a struggle.

Maybe I am just in a funk. But I ask you....don't you sometimes feel like you just want to hide till all bad things go away....like the ostrich? Or what about when you just aren't feeling like yourself but those around you think you should just get on with it. I want to smack them....well not really but you know what I mean? Or do you?

Monday is another day...I see my physio in the morning then my GP and in the evening....I am going to bellydancing.....so maybe that will help me with my funk.

Let's Dance...............

2008-10-04T12:01:00.000-07:00

I was looking at that picture I posted yesterday with Fred Astair and Ginger Rogers. Gosh weren't they just an elegant couple....how they just flowed on the dance floor....they made it look so effortless. That photo really put a smile on my face.

I have wanted to take ballroom dancing for some time....initially hubby said he would, but now not so much. I love to dance as does he... I always thought it would be nice to have some professional lessons to learn some new steps. Anyhow, I don't see that happening in the near future..not that I am giving up....oh no....

A couple of the girls I work with are taking belly dancing lessons and asked if I would like to join them. Most people when they think of belly dancing think of the women dressed like this dancing and gyrating around the tables at Greek restaurants......

For me I think about the historic dancers....like these.....and how mystical and hypnotic their dance was...

According to Wikpedia:

Belly dance is a Western term for a traditional Middle Eastern dance form. Some American devotees refer to it simply as "Middle Eastern Dance." In the Arabic language it is known as raqs sharqi ( literally "oriental dance") or sometimes raqs baladi literally "national" or "folk" dance. The term "raqs sharqi" may have originated in Egypt. In Greece and the Balkans, belly dance is called tsiftetelli , çiftetelli in Turkish. The term "belly dance" is a creation of Orientalism, first used in English in 1899, and translating in French to "danse du ventre."

Belly dancing has really become popular with the general public. I took belly dancing lessons about 6 years ago and it was so much fun....it was really awkward at first and I felt very silly, but what a great work out. All sorts of people take belly dancing lessons....as evident by these photos.....

Anyhow, these lessons are a win win.....they are held at a community hall....it's by donation and all proceeds go towards a Christmas party for the less fortunate children in the area. Sounds good to me....I get to learn how to dance and have a great work out at the same time doing something for the community.

So I guess it's time I got up and shook my booty.....Happy Weekend all!

Doing the Friday dance..........

2008-10-02T20:57:00.000-07:00

Well it's Friday and I am doing the happy dance. It's been a long week and the weekend couldn't come soon enough.

Being a shift worker Friday's don't really mean that much to me. But tomorrow is truly a Friday for me and I am looking forward to the weekend.

Not sure why I get excited about the weekend because I usually fill them up with things to do.....but I guess it's a change from the "Having" to get up and get into work. I can do my chores or not.....I don't "Have" to do anything if I don't want to. But being the Type A kinda of gal I am I feel obligated to get the chores done.....Some days I would far rather just sit and read my book or lay in bed past 0700....but I don't I just can't seem to do that. I've always been the type of person that had to get her chores done...and then I could have fun. I think that comes from when I was little, my brothers and sisters and I always had to do our chores before we could have fun. I mean if I went for a sleep over I would have to be up at the crack of dawn and get home to get my chores done. Funny how that carried on into my adult life.

Regardless.....it's Friday.....I do "Have" to go in to work, but it is for an educational day. Then it will be the weekend, and I really do plan on trying to just relax and have some fun.

What about you.....do you look forward to your weekends? Do you make plans? Or do you just go with the flow?

I hope you all find some time for yourself.....Happy Friday all!

Life is like a box of chocolate's.......

2008-10-01T17:37:00.001-07:00

Life is funny sometimes isn't. Just when you think you got all your ducks in a row...somebody or something comes along and ruins the line. I think sometimes I have been guilty of being that someone.

As I nurse I have often had to be on stand by for the patient when the doctor delivers bad news. I want to be there so I know what he/she has said to the patient so if they have any questions I know what has been told to them and how to best explain it. In the hospital setting the specialists often rush into the room give an overall view of what is going on and what the plan is. They often don't take the time to provide the patient with an opportunity to ask questions, or to help alleviate some of the stress the patient may experience based on the information the doctor has given them. I try to put myself in the patients shoes. How would I feel if I was spoken to in that manner, what is it that I need to know to help me understand the information that was just given to me....how would that effect my life?

Well I have been on the receiving end of news from doctors many times in my life. Yesterday was no exception. I am not sure if I have mentioned this on my blog before or not, but I have a pacemaker. I have had one since I was 23 years old for a condition called Sick Sinus Syndrome. Sick sinus syndrome is a condition where the heart has episodes of tachycardia(going to fast) and bradycardia(going to slow). The heart as a muscle open and closes the valves in a rhythmic method which produces the heart beat. The muscle does this through an electrical pathway which starts in your atrium Sinus Node. So in Sick sinus syndrome the sinus node is literally "Sick" as it is not controlling the electrical impulses the way it should. This is a very elementary explanation of the heart as a pump....if you would like to know more about how the heart works as a pump you can check out this siteHeart for more information.

Getting my pacemaker was the best thing that could have ever happened to me. I was able to have three healthy children, participate in all aspects of life, from sky diving, water/snow skiing, tubing, wake boarding, para sailing, horseback riding, playing ball, golfing...you name it, I let nothing stop me except my own fear of maybe getting hurt.

As much as I would have loved my pacemaker to last my whole life....it didn't and they don't. The average life expectancy of a pacemaker is 7 - 12 years. I have generally required getting my pacemaker changed earlier for a variety of reasons. I am currently on my 4th pacemaker. The pacemaker itself is made up of two components the battery component(generator) and the leads. These leads are attached to the PM(pacemaker) and then directed into your atrium and ventricle. Again if you would like to learn more about Pacemakers why and how they are used you can check out this site here. Like any battery the more you use it the sooner it wears out. This is true with PM's but a little more complex. Life expectancy of PM's as I stated is 7 - 12 years. But this depends on how the PM is set and how often it is used. There are many settings within the PM to help you get the best quality of life for you and to help extend the life of the PM.

As I mentioned the PM(battery component) has a life expectancy so do the leads. When a person first gets a PM they may only get a single lead...then a few years down the road it might be determined they need another lead....hence making the original lead older. As time goes on leads can possibly fracture, wear out or become faulty. In the case of a lead becoming old and requiring replacing the surgeon will often cap the old lead and put in a new lead. Also, like anything mechanical it can be faulty and need replacing...such was the case when I had a lead replaced two years ago. You must appreciate that these leads are going through a very small vessel and can only accommodate so many leads.

After my last PM change and lead replacement I have been uncomfortable. Month after the operation I was back in having another operation as the lead that was capped migrated to the top of my PM. Now two years later I am still uncomfortable and it is affecting my quality of life.

The short version, I spoke with the Surgeon who did my last PM and lead he suggested I see the cardiac surgeon in Vancouver. I saw this specialist yesterday.

He was very relaxed and hence made me feel relaxed. Prior to seeing this doctor I did a lot of research regarding Lead extractions and options. I didn't really think I was a candidate for the procedure. After a very lengthy discussion with him it has been determined that not only does he want to remove my lead he wants to take everything out all three leads and the PM and put a complete new unit in another part of my body. Here's the thing. He believes I have a infection brewing hence the pain and burning I am getting. Because this site has been opened up so many times this site becomes a prime candidate for infection. Lead extraction is major surgery. Because one of my leads is over 23 years old makes it even more complicated and risky. He believes he can get them all out....the problem is that I might require open heart surgery and all of the risks that goes along with that...which I won't even go into right now.

Here is what I know.....if there is an infection I will be on antibiotics for minimum a week but possibly as long as a month...if I have to be on them for a month they have to put a special intravenous line into me so they can get frequent access with out having to poke me all the time...if this happens my stay in the hospital will be longer. If they end up having to do open heart, which would require cracking my sternum I will be in hospital longer and recovery will be 4 - 6 months post discharge from the hospital.

So you can imagine that I have a lot to take in.....lots of things to consider....and getting my ducks all in a row. The surgeon wanted to do it as early as the 15th of this month. I said no. I have my youngest daughters 16th birthday this month and I am planning a big Sweet 16 party for her. They then gave me November but middle daughters birthday is that month and I certainly don't want it in December, to close to Christmas. So I am booked for January 2009. I have lots to do before then....lots of things to get organized.

When things like this happen it really helps you put life into perspective now doesn't it. It makes me think of that song "Live like your were dying". Enjoy everyday, don't sweat the small stuff and it's ok to leave the dishes until tomorrow.

I think this has been my wake up call.......

Did you know.......

2008-09-28T08:38:00.000-07:00

We have a Federal election coming up in a few weeks? If you didn't know news flash we do...October 14th is the date. I am just amazed at how little we are hearing about the election. I find we are still being inundated with the news south of the border regarding the US election.

Well I am sorry, yes I know it is important to know what is going on in the world around us especially with our neighbours to the south being the US, but should that negate us losing or taking interest in what is going on in our own country?

I don't know about you,but I am really not hearing anything from any of the parties about what their political party plans are for the future of this country. I have heard snippets of Layton saying he would scrap the Soft lumber agreement, Dion and his Carbon Tax....and well waxy mortician like Harper is just trying to make us believe he is a family man. Have you seen any of those adds with Harper sitting in his wing backed chair talking about his fond memories of being a dad.....well that's just great Mr. Harper, now would you get on with improving the health of this country.

There are so many issues that aren't even being talked about. Like health care, education, child care, seniors issues and the list goes on. Where is all the public debate I haven't heard of one in my area. Seems like everyone is just keeping a tight lip and not saying anything.....well what good is that. For example I haven't heard a word out of the current Federal incumbent in my area ....I have seen his signs but not a word about his position on any topic or performing public appearances and doing town hall meetings. Nothing, Nada, zilch. I was talking with my husband the other day and saying how I really didn't know anything about this man...I don't know what he has done good or bad.. he is a non entity as far as I am concerned...I honestly can't tell you what he has done for his constituency and I am suppose to vote for him....I don't think so...but then I look at the other candidates and again I don't have a clue as to what their position is on health care for example. That is not like me. I generally know who the candidates are what their position is on certain topics etc....but this time no one is really getting out there and speaking up...and that worries me.

I wonder how many of my blogging friends south of the border even know that Canada has a Federal election coming up in just 2 weeks.....not many I suspect. I bet you more Canadians know about all of the nuances about the American candidates than they do about the candidates in their own riding. I mean look how we are being flooded with news about Pallin and her bizarre background and her pregnant daughter and McCain and his forgetfulness and will Obama has been in the limelight for over a year now...goodness....I bet more Canadians know more about American politics than they do of their own. Could you imagine the Americans having an election for the President in under a 2 month period.....never....dear god it took them over a year to determine who was going to be the leader of a party and now the race for presidency is on...which is really anti climatic if you ask me.

This brings me to another topic. How is it that the Canadian government can announce and hold a Federal election under 6 weeks! Yes the announcement for the Federal election came on September 7th and the election will be October 14th! This doesn't leave us much time to really find out much and or challenge the candidates on issues. What the politicians are saying is so vague....it really doesn't make them accountable for anything...now isn't that convenient. If you are at all interested here is a little news clip regarding the announcement of the Federal election and a very brief synopsis of what the leaders of each party are saying they will do for this country of ours....Canada election-call .

Saturday Scavenger Photo Hunt

2008-09-27T00:54:00.001-07:00

This weeks theme is "View". The first thing that came to my mind was the movie "Window with a view"....which then gave me my idea for portraying the theme this week. Here are some photos of a bit of the wild life I have seen through my kitchen windows over the past year.

This is a view I see out of one of my kitchen windows (early spring)

Or the California Quail, male(the one with the tuff), female and baby....see from another on of my kitchen windows.

Or this lovely Pinesiskin just sitting in the tree just outside my kitchen window......yes I do feel fortunate to have such a room with a view.

If you would like to join in on the fun please check out tnchick for all of the instructions.....Happy Hunting all!

Nursing stuff......

2008-09-26T18:50:00.000-07:00

Well it would appear that my blog has gained a little notoriety. Apparently it has been included in a post from RNCentral.com for nursing students....it's "100 Best Blogs for Nursing Students"
I found this to be quite an honour as included in this list is one of my all time favourite nursing bloggers Nurse Ratched. I am very honoured that my blog has been recognized by RNCentral, and I truly hope I can bring something to the table for our future nurses.

I have also been approached to review a book entitled "Reflections on Doctors: Nurses' Stories about Physicians and Surgeons" by Terry Ratner a Registered Nurse and Freelance writer. He says that "Reflections" is an anthology of stories by nurses across the US and talks about their experiences working with physicians and surgeons. He says the book provides situations and issues rarely discussed that arise in medicine and how the role of "nurse" has changed. It sounds like it would be a good read. I thought it would be appropriate to post it here as it seems to tie in with above. So if nursing students are going to check out my blog they may as well check out Terry and his book. So if you are interested in getting more information on his book you can get more information at: remy@mediamuscle.com

Something Shocking.....

2008-09-26T06:02:00.000-07:00

As health care practitioners we are faced with many challenges and diversities. In previous posts I have spoken about Ethics and it's impact on health care. As as RN's we are often put in positions in assisting or caring for patients who are undergoing treatments or procedures that ethically and morally push some of our personal boundaries.

Case in point. I remember when I was a nursing student and my instructor told me how tired she was of treating people who came in to the Emergency department for attempted suicide. I will never forget what she said to me one day. She said that some days she gets so frustrated that if they really wanted to kill themselves she would show them the correct way to do it. This really took me aback, but it opened up dialogue with my classmates to discuss situations that we would all be faced with in our nursing careers that will push our personal boundaries. In our discussion some students expressed that they might have problems nursing patients who are drug addicts or alcoholics, others expressed concern about dealing with patients who had or were seeking information on termination of an unwanted pregnancy. I remember asking the instructor if we had a right to refuse to work with a particular patient if it really went against our morals....she basically told me no. She said we had to treat all patients with the same care we would treat any patient. If we really had difficulties we could ask a colleague if they wouldn't mind trading assignments but basically it was our duty and responsibility to treat all patients with the same respect and dignity and professionalism. That has always stuck with me.

I to get frustrated at times with some patients who I see using the health care system as a revolving door. Not taking responsibility for their health issues. This of course happens for a variety of reasons. Often it is basically that they don't have the tools to make healthy life choices. This is often due to their socio-economic situation or their mental health.

This brings me to my current challenge. One of my duty as a recovery nurse it to care for patients who have had Electroconvulsive Therapy(ECT). Electroconvulsive therapy (ECT) is a procedure used to treat severe depression. It may be used in people with symptoms such as delusions, hallucinations, or suicidal thoughts or when other treatments such as psychotherapy and antidepressant medications have not worked. It is also used for other psychiatric and neurological conditions, such as schizophrenia and Parkinson’s disease.

Before ECT, you are given anesthesia to put you in a sleep like state and medications to relax your muscles. Then an electrical current is briefly sent to the brain through electrodes placed on the temples or elsewhere on the head, depending on the condition and type of ECT. The electrical stimulation, which lasts up to 8 seconds, produces a short seizure. Because of anesthesia, the seizure activity related to ECT does not cause the body to convulse.
It is not known exactly how this brain stimulation helps treat depression, so why do it I ask. They believe that ECT probably works by altering brain chemicals (similarly to medications), including neurotransmitters like serotonin, natural pain relievers called endorphins, and catecholamines such as adrenalin.

ECT treatments are usually done 2 to 3 times a week for 2 to 3 weeks. Maintenance treatments may be done one time each week, tapering down to one time each month. They may continue for several months to a year, to reduce the risk of relapse. ECT is usually given in combination with medication, psychotherapy, family therapy, and behavioural therapy.

I can remember as a nursing students when I was doing my psych rotation at a very old psychiatric hospital where they did the ECT's down in the basement of the building....I found it distressing....the patients were like cattle lined up outside the door...taken into a dark dingy room...treatment performed and then they were moved into this open room where they were drooling and noticeably out of it....they would be observed for a short period of time and then sent back to their wards. I didn't think this was a very good experience for my first time seeing ECT's.

Now here I am now caring for patients who are still having these treatments.....I do question the validity for some of them....I mean we have this one patient that we have to use restraints on because when they come out of the sedation they are extremely violent. I understand the rationale for the treatment but it doesn't mean I have to like it.

Nursing, is a wonderful profession and provides us as individuals so many opportunities to experience and explore healthcare on so many different levels.

Sunday Meme

2008-09-20T10:07:00.000-07:00

I like this meme....it provides me with an opportunity to show off some of the glorious sunrises and sunsets I see here in my Smalltown. These photos were taken in July on a evening we had just been out to pick up prawn traps it was a wonderful evening and the sunset set was spectacular and great ending to a day......
If you would like to join in on the fun please check out
Sunrise-Sunset meme for all of the instructions.

Saturday Scavenger Photo Hunt

2008-09-19T21:53:00.001-07:00

This weeks theme is "Road".....when I hear that I think of the song..." the long and winding road".....and then I think of the many "road trips" I have taken with my hubby......here is a view of what I saw on one of our everyday road trips....

So we are driving down the road and what do I see to the right of me but this....

I behold this spectacular Glacier....in actual fact this is an every day view for the folks living in this town....but I just work here....hubby and thought that we would like to take a plane trip up there to see the Glacier from a different vantage point, but we haven't done that yet. Many people make the weekend trek to the Glacier....it is truly something special....

If you would like to join in on the fun check out tnchick for all of the instructions.

Happy Hunting all!

The Learning Curve.....

2008-09-17T20:20:00.001-07:00

They say that learning should be a life long experience, that we should strive to learn something new everyday, whether it be technical or simply a new way of doing something you have done before.

As most of you know I started my new job in PAR(Post Anesthetic Recovery)in August. My new employer has provided me with an excellent orientation, however the learning curve has been steep. I have never been a PAR nurse and that wasn't a requirement for the job. They wanted someone with Critical Care background and ACLS(Advanced Cardiac Life Support) training, all of which I have. I gather they thought I could learn what I needed to know on the job. Oh my gosh, there is so much to learn.

I don't know if you have ever heard the saying " A nurses is a nurse". I couldn't disagree more. Yes we all have the fundamental training....but that is where it stops. Saying a nurse is a nurse to me is like saying a neuro surgeon is cardiologist Let me tell you if I have a brain aneurysm I want the neuro surgeon operating on me and not the cardiologist. Well that is about how I feel in nursing. Nursing has become so specialized, and yes you must always remember your ABC's regardless of the field of nursing you are in. But nursing has changed and continues to change.

In years past, nurses would float from one ward to another. In one shift they could go from assisting in delivering a baby to defibrilating a patient in cardiac arrest. In remote areas this still holds true, the nurses have just become more specialized in their field.

I have worn many hats in my nursing career. I have been a student, teacher and student again. I have worked in the areas of Medical/Surgical,Palliative,ICU/Cardiac care and now PAR. The one thing that has stayed constant is that I find I am always the student. There is always something new to learn. It seems as soon as you get a grasp on something they come along and change it. Currently, not only am I learning a new form of nursing but a new way of delivering nursing care. In attempts to make health care more efficient we are being faced with new technology. New computers, and computer systems, out goes hand written nurses notes and incomes computerized nursing notes, slowly but surely they are eliminating the paper trail. I can't believe the changes I have seen in my career. I think about my colleagues who have been in the profession for 25 or 35 years and all the changes they have seen. Some for them good....some not so good. I digress.

I mentioned my learning curve. I am not a PAR nurse I never claimed to be one....I had the qualifications they asked for and I am eager to learn. I had no idea how much I didn't know. That is scary. I find myself after coming home from my shifts going on the computer researching surgeries why they are done, looking up answers to anatomy and physiology questions that have come to me....drugs and anesthetic agents that are used and what to expect....my head hurts, my eyes are heavy. I want to know.....I feel like I should know.....but I don't....and so the pressure is on....not so much by staff...as they have been really good with me...but with myself. I figure I should know it....but how can I...I can't expect to know all of those surgeries and treatments and anesthetic agents...not yet anyhow, hopefully with time I will have a better grasp. Today, was a very busy day, the OR slates were full I was on my feet my whole shift except for my lunch and coffee break(for which I was thankful). I am stressed. I wish things came to me easier. I seem to struggle...somethings I grasp faster than others...somethings....like programing machine to deliver a medication took me longer than I thought it should partially because I let my stress take over and my common sense went out the window. I know more than I give myself credit...I want to show them that I can do this and that I do bring something to the table and make a good team player. But right now, my nerves take over and I don't believe in myself and I know that causes me to block things that normally would come easily to me.

Anyhow, I feel like I am forever learning, my grey matter is over flowing and it hurts.

Sunday Meme

2008-09-14T08:15:00.000-07:00

This my first time joining in on this meme....but being a lover of both Sunrise and Sunsets this seemed a likely meme for me to participate in.

These two photos where taken from my back porch, a wonderful sunrise in the spring

One of the many beautiful sunsets we see in my smalltown.

If you would like to play along please check out
Sunrise-Sunset meme

for all of the instructions.....Happy Sunday all!

Saturday Scavenger Photo Hunt

2008-09-12T19:07:00.001-07:00

This weeks theme is "Wild" so I thought I would share some of the wild birds that I have seen on my property over the last year.....

The American Golden Finch and Pinesiskin....

The Purple finch(male)

Downy Woodpecker

Varied Thrush

The Stellar Jay

The Northern Flicker(part of the woodpecker family)

So there you have it my take of the theme for this week...if you would like to join in on the fun, please check out tnchick for all of the instruction.

Happy Hunting all!!!

A sweet find....and my talented hubby....

2008-09-12T09:10:00.000-07:00

Well it is TGIF day....not that Friday really means anything to me...I mean being a shift worker and all. But today is Friday and I have it off and my girls are coming to visit for the weekend. Yipee! So with that being said I have many chores to get on with.

We are hoping to get out on the boat on the weekend. Hubby has been busily making sure everything is operational. Cosmetically he has been working on it as well. He decided some time back that he wanted to get a new canopy for his boat. He went out and got pricing but the best price he could get was around $800 or more. WOW! So he thought that maybe he could do it.

So he went and priced out material on Ebay and got the material. Then he needed a sewing machine. Something heavy duty that could manage the heaviness of the material and could hand the task. Hmmm. Now that could be pricey. So we started looking in the Buy and Sell and on the web for used machines....even used were very pricey. One day I was out and about and came across this garage sale, so I thought I would just stop and see what they had. Looking around (and believe me there was a LOT of stuff) I was at this one table when I notice down on the ground this old sewing machine box. I opened it up and this is what I found :

It looked like it was in pretty good condition.........they had these as well.......

I love the box.....so vintage....and look at all the accessories it still had in it....almost like new.....I could believe it....I asked her how much.....hold your breath......$3......Yup, I couldn't believe it. Do any of you know that Ikea commercial where the woman leaves rushing from the store yelling at her husband to get the car.....she was so excited about the deal that she got she figured they must have made a mistake and wanted to get out of there before she thought they would change their mind. Well that is how I felt about this ....such a bargain. The one down side is that it weights a ton....very very solid machine. The other was it didn't have the instructions...but with a little tweaking and oil...this machine ROCKS!

So the other day when I was doing all my canning, hubby was cutting and measuring and sewing.....

He actually finished that canopy in a day! I couldn't believe it....his sewing skills put mine to shame....I told him he was making the Halloween costumes.......LOL! I need to get a photo of the finished project.....

Thursday Humour

2008-09-11T09:22:00.000-07:00

Well I haven't done this in awhile so I thought let's keep things light and easy today........
The first one's are on a baby theme......

And Now some Nursing humour:

Two doctors in practice in a small country clinic had to hire a new nurse when the one they had won the lottery and quit. They interviewed Nurse Nancy and decided to hire her. She had only worked two days when one doctor called the other to his office and said that they would have to let Nurse Nancy go. "Why, we just hired her?""Well, I think she is dyslexic and gets things backwards. I told her to give Mr. Smith two shots of morphine every 24 four hour, but she gave him 24 shots in two hours and it almost killed him. I told her to give Mrs. Jones an enema every twelve hours and she gave her twelve in one hour."The doctor had barely finished his reasons when the other doctor rushed out of the room. "Where are you going in such a hurry?" the doctor asked. "To see Nancy, I just instructed her to prick Mr. Hill's Boil!"

Hope you all have a fantastic day!!!! Keep on smilin, they'll wonder what your up to.....

A Bountiful Harvest.....

2008-09-08T05:00:00.000-07:00

Well I know it is not officially fall yet...and believe me I don't want to rush the seasons or anything like that. The sun was shining it was a lovely 20 Celsius that's about 72 F yesterday. And today feels like it is going to be another nice one. It truly does feel like fall. The leaves have already started to turn and fall. The blackberries are ripe and ready for the picking. Yes harvest time is upon us, and with that for those of you who like canning or preserving things for a later date to be used as gifts or simply for household consumption the time is right.

I have spent the past two days canning. I am not an avid canner, sometimes I wonder what the heck am I doing in the kitchen...who am I fooling. But lo and behold I did manage to can a few things with more to come. Yesterday I was busy canning beets, yes I know not everyone's favorite but my girls and I just love them. Mother in law gave me a huge baskets of apples from her tree. Originally I was going to make apple sauce or pies and freeze them. I opted to do neither. I made Apple Conserve instead(apple pie filling). I have never made it before so I am hoping it will turn out, it sure smelt good.

Yesterday, I set off early to the market to see if I could get some baby cucumbers to make pickles....no such luck. But what I did come home with was a couple of bags of beans and more beets. So I cut and cleaned the beans...I have pickled them as well. I think they might end up spicy as I added a red pepper to each jar that I had grown and dried and a clove of garlic....I am hoping they will be good to use as a condiment at gatherings or used for Cesar's...hmmm. So after the beets and the beans, I decided to make some pumpkin bread. I just love pumpkin bread. I have a recipe that makes five loaves. So that is what I did, once cooled I wrap them and freeze them and often give them away as gifts as well.

I bought a case of peaches, but I just ran out of steam(no pun intended). Hubby tells me he loves canned peaches so that is what I will do next. Canned peaches and blackberry jam. The tomatoes in my garden are bountiful so I might be making some tomato sauce as well.

I feel like a pregnant woman who is nesting, getting everything ready for the arrival of her baby. It's crazy. I've been cooking up a storm, cleaning, and now canning...gosh whats' up with that...Actually, I know this may sound strange but I find it very soothing and comforting.

Here are a few photos of my labour of love......

I am off to work this afternoon so I won't be doing much of anything except maybe using my stepper.

There's something else I have been working on. A couple of weeks ago I decided to start knitting. Again, I am not an avid knitter but I like to give it the old college try. I decided I wanted to knit an Afghan. Big aspirations I know....but because I like to keep things simple I went on the Internet and looked up ideas for Afghans. I found the simplest idea....just knit a square and crochet them together. Yes I can do this I said to myself. Last year mother in law gave me this huge bag of wool . I made a couple of styles of scarves but that was about it. So I thought you know Christmas is coming I could make something for a gift.

As most of you know I volunteer. One of the groups I volunteer with is the Community based Mental Health. I have a client that I go and do home visits with. She is really a very sweet lady but pretty much house bound. The only time she really gets out is when I take her to appointments or call her and ask her if she is feeling up to going out for a coffee. I know she likes the visits. Along with her mental health she has physical health issues...I think it's one of those situations which came first the chicken or the egg . Regardless, she lives alone and because of her medications shouldn't drive...so she doesn't and some days it takes all of her energy to get up off of the couch.

So as I was knitting it dawned on me. I could make this for her for Christmas....now I am on a mission. It's now given my knitting some purpose.

Then I got another idea. I know bloggers are such a generous group, I wondered how they would feel about knitting a basic square. I thought if I could get enough squares I could make maybe another afghan or maybe even two and then donate them to the Mental Health Society.

So what do you think. Are any of you interested in knitting a simple 8x8 plain old garter stitch square that I could make up into an Afghan? Please don't feel pressured I just thought, there are a lot of generous bloggers out there that might want to help out a cause. So if anyone is interested just let me know here or email me and I will contact you giving you the details(which will be pretty basic). I would love to be able to give the Mental health group a couple of Afghans for Christmas to hand out as they see fit.....and or if I get a real skookum response and am able to make up something a little more elaborate maybe they could use it as a raffle to raise some money for a project or something. Just thinking out loud here. Anyhow, I leave it with you my blogging friends.

To assure you all that I will do something with the squares I will take photos and have some letter of acknowldegment from the organization.

Just sharing the blogger love.......thanks all....have a fantastic day!!

Schools back and so are the germs.....

2008-09-06T13:20:00.000-07:00

I made this post for the Wetcoast Womens blog and then I thought it might be useful here as well....so for those of you who have read this post there please excuse the duplicaiton.

Our little darlings are back in school….yay for some boo hoo for others. But with the joys of beginning another school year comes the increased risk for our little precious ones being exposed to many more germs.

The common cold for one. You know our little munchkins sneeze….and rather than use a Kleenex they wipe that snotty little nose with their hand or the sleeve of their shirts. Never intending of course to pass the germs along but they do. Think of all the items they touch just after sneezing….their desk….the teachers desk….the building blocks….the books….the door handles the list goes on.

So what can we as parents do to help minimize the spread of these germs. First and foremost we can teach our children the basics of good hand-washing and why it is so important. I know this may sound so elementary to most but a lot of children don’t understand why it is we nag at them about washing their hands, not just when they finish in the bathroom, but when they come in from outdoor play, or sneeze. Most classrooms have a sink and towels encourage them to use it. Now days you can buy those small antibacterial soaps that they could keep in their desks…..or better yet insist that your child’s school installs the hand cleanser dispenser outside the classroom door and in the class room.

There is study after study proving how simple hand washing eliminates many of the common germs, and decreases the risk of spreading germs and other diseases dramatically. So why aren’t we insisting that the hand dispensers are provided for every classroom? If it only costs a couple of bucks to provide one for your child or have the school install(more dollars I know)isn’t it worth it? Think about all the lost days of school that happen because children are passing the cold or flu bug around? Thousands of instructional hours are lost. And what about the poor teacher who has to deal with the sniffles of every other student in the class.

This brings me to another topic….Immunization. What is wrong with people who don’t keep their child’s immunizations up to date? What are they thinking? I was shocked when I heard about the Mumps outbreak in Abbotsford. That should never happen…..people have gotten lacked when it comes to immunization. They were initiated because immunization do save lives. I know there are groups that don’t believe in them….part of me thinks that’s because they have never experienced it…and why is that…..because the rest of the population has dutifully ensured their child’s immunization are kept up to date. Believe me you don’t want to see your child get the mumps….or what about Polio….something that was totally eradicated as a result of the immunization…..do we want to go back to those days? I don’t think so.

And while I’m on the topic…..please please please don’t use the school as your babysitter. If your child is sick…keep them at home…no one needs them coughing or sneezing all over them, and they will recover much faster at home rather than sitting in a stuffy not well ventilated classroom. Here are some statistics about the common cold:

“From the time a cold virus enters the nose, it takes 8-12 hours for the viral reproductive cycle to be completed and for new cold virus to be released in nasal secretions. (13) This interval is called the incubation period.

Cold symptoms can also begin shortly after virus is first produced in the nose (10-12 hours). (13) The time from the beginning of the infection to the peak of symptoms is typically 36-72 hours. (1, 2)” So what does that mean…that means we need to keep our little darlings at home during that time….don’t you think it is worth it in the long run?

You can get more information about the common cold here: http://www.commoncold.org/undrstn3.htm

Anyhow, that is my rant. Let’s try and make this a cold and flu bug free year for our little munchkins.

Good health to you all and your little darlings….

Well if you like contests and are interested in winning a little something jenn At my kids are the world to me has a September give away....who doesn't like free stuff...please go check it out.

Have a great day all!

Saturday Scavenger Photo Hunt

2008-09-06T05:00:00.000-07:00

I haven't plays this for awhile but it's Saturday Photo hunt...and this weeks theme is "String(s)".....so here are my pics.....

The wool(string) used to knit...my daughter and her first attempt at knitting......

String used to help keep things covered during the rain......And finally the string(ok rope) used on the mast of this sailing ship....

If you would like to play along please check out....tnchick

Happy hunting!!!!

Tell me what you think....

2008-09-05T20:10:00.000-07:00

I am struggling with something and your input would be appreciated.

In this day and age of technology there are many ways to stay in touch and to find old friends. One such venue is Facebook. I primarily use facebook to stay in touch with family and friends that I have worked with. Personally I have not attempted to contact anyone from my college or high school days. No desire really. But there are those who really have a need to reach out and find people from their past for whatever reason.

So I present this to you. A few months ago an old girlfriend of my husband contacted him. She found him via Facebook. They connected there and then exchanged MSN addresses and IM and eventually she sent him her telephone number.

She made the initial contact.....I know he was excited to talk to her...as he says she was not only his girlfriend but a good friend....I can accept that. What I am having difficulties with is her continued need/desire to contact him. It's one thing to catch up on things...it's another to make regular contact. As of late a mutual friend of theirs past away unexpectedly, she contacted my hubby to let him know...she went as far as calling his dad in an attempt to get a hold of my husband. They connected. He got the information about their mutual friend......and sent his condolences to the family. The family were appreciative of his letter and called to tell him so. That was a very touching moment, and I am glad that he was able to connect.

So there, Facebook was good for that....but now what? She continues to make contact....in one of her IM's she actually said...."Your hot"....now how am I to take that? Why would she say that....I asked my hubby about it...he said she always talks like that....hmmmm.

Personally I just find it all very odd. Why would a women who is supposedly in a relationship make continued contact with my husband, telling him he is hot and asking him when he is coming out east, if she wasn't interested in him? Am I being paranoid? Does anyone else find this odd?

I have asked my husband to just acknowledge how this all makes me feel. His response is....that he doesn't respond to her IM's anymore because he knows how it makes me feel. Well that is all well and good. But that is not acknowledging my feelings. Anyone who has taken any conflict course will know what I mean by that. Rather than saying what he said.....if he truly was acknowledging he would say something along the lines....".....I know how that must make you feel"...or " I know that must be hurtful to you and because of that I don't want to talk to her"...but rather he says....I don't talk to her out of respect for you.....so what...if I wasn't around he would? I don't know...maybe I am making a mountain out of a mole hill, but it has upset me. All I want him to do is acknowledge that I am upset....that's it...nothing more......

Personally, I'd like to dim her lights but I know that would be frowned upon. I have asked him...if the shoe were on the other foot how would you feel? He never gives me a straight answer...but I know he would not like it. I can't help but wonder what is her motivation for all of this. Is it that she just wanted to connect with a friend from the past? Albeit a lover. I don't know. All I know is that it hurts me, and I don't like it. If she knows he's married which he says she does...then why doesn't she talk to both of us...why just him...why exclude me?

I am thankful that he has a bit more class and has opted not to respond to her advances.

I really would appreciate hearing your take on this....I have broad shoulders tell it as it is...if I am a nut ball and off of my rocker for being upset about this...then tell me...I can handle it....personally I just want to put it to rest....but it's hard when she continues to make contact via MSN.....I want to reach through the screen and give her a shake and tell her to leave us alone. But that won't happen....so here I am....left trying to deal with the silly emotions. I know my husband loves me....I truly believe that....and I trust him....it's her and her motivations I don't trust.....

Health care and ethics......

2008-09-03T20:41:00.000-07:00

In all my years of nursing there is one thing that I have found to be constant. Ethics. Health care practitioners are faced with ethical dilemmas on a regular basis.

Look at the ethical issues around stem cell or egg harvesting. Those are some of the more controversial topics but ethical all the same.

As an RN I have been witness to many situations that I questioned the validity of treatment or lack of treatment. It's such a hard call sometimes. I mean do we replace the hip of a 95 year old who has fallen? The questions that are posed from that are: What was their quality of life prior to the fall? What was their level of function will a new hip improve their quality of life?.....my answer would be yes....but then we have to ask ourselves what are the risks of surgery.....what was their health prior to the accident, do they have lung problems? Heart issues? Are they diabetics? What is their cognitive state? Those are all things that should and must be considered prior to surgery.

I had a situation the other day....a young male came in for dental surgery. His teeth were in such bad shape that if they weren't dealt with they could cause him much worse problems in the future. Unfortunately, he had mental health issues as a result of a previous head injury. The young man did not want the surgery,his parents thought it best that he have the surgery. He was belligerent prior to the surgery. He refused to undress I don't know how they managed to sedate him for the procedure but they did. He arrived in the recovery room and I knew we were in trouble. He was semi awake and already calling out and being verbally abusive. We anticipate and accept a certain amount of obscenity post op as often it is the drugs that are used during surgery that cause people to respond in a certain way.

When this young man started coming around....he didn't want to have anything to do with being in the hospital...he started pulling off his oxygen mask, the monitoring equipment... we attempted to calm him and eventually he would settle down, although briefly.....the unfortunate thing with this person is that he stopped breathing a couple of times and had what we thought were seizures......it was all very strange...the anesthestist was called and we ended up helping him with his breathing. He came around .....and again he was aggressive and did not want to be there......he was a big person and very strong......we ended up calling a code white on him(aggressive patient) and hoped that security would arrive in time to give assistance....this didn't happen....he pulled out his IV....jumped off the end of the bed.....left the recovery room.....punching holes into the wall. The patients mother was there......she asked people to back off.....she assisted him to the car and left.

Here's the dilemma......was he a candidate for the surgery? Yes....did he want the surgery.....NO....was he in a right state of mind to make that decision for surgery......Questionable.....should we have insisted he stay in the hospital and recover fully before leaving the hospital....my gut told me yes..... should we have restrained him until he was fully recovered......possibly.

I don't know if there are any clear cut answers to this. I know my colleague and I were very upset by what transpired. The anesthetist and the doctor came and spoke with us....explained that it wasn't the drugs that were given during surgery...that those drugs would have worn off by the time he arrived in the recovery room. So what was it, what caused this person to behave and act out that way and should they have performed the surgery?

I don't know that I have the answers to these questions....all I know is that sometimes I am faced with situations that push the ethical boundaries for providing care and treatment.

What do you think?