Wednesday, December 25, 2013

Merry Christmas!

Last year I had to work Christmas Eve and Christmas Day, both 12 hours shifts that turned into about 15 each. 

This year I got a better deal and just had to do Christma Eve.  It was supposed to be a ten hour shift but in true PICU Christmas fashion, it turned into a 14 hour. 

I don't know what it is about the holiday times, but the week or two leading up to it seems so chill.  And I think, "Oh nice, for one year the PICU will be quiet on Christmas!"  And then the holiday hits and it almost knocks you out.

Yesterday was one of the top 3 worst days of my APN career (only in competition with last Christmas Eve in which we had 16 patients with no other APN or fellow to help me out, and a day last November that 3 of my patients died in 12 hours!). 

It's rough having bad days at work.  It's hard not being able to eat, drink or pee for such a long time.  And yet I always have to be reminded of what it is that I'm doing.

I'm working in a PICU that is filled with sick kids, and families that are hurting.  At a time when they would love more than nothing else to be home with their little ones opening presents, drinking hot chocolate, and watching Christmas movies, they are instead in a hospital.  In a PICU nonetheless.

And so it makes my horrible day so much less horrible.  It's all about persceptive.  And it's important to keep that in mind.

So with that, I hope you have a Very Merry Christmas!! And a special thought goes out to my co-workers who are taking care of our precious little ones today in the PICU.  You are truly a light in this world!

Thursday, December 19, 2013

Old PICU Friend, New PICU Role

For the last week I've been taking care of a 4 year old, who I was his primary nurse from the time he was 6 months old!  He was in and out of the hospital (more in than out) from the time he was 6 months until he was 3 years old.  And I absolutely loved taking care of him, watching him grow, and helping him get better each time.

So I was really excited to see him last week when he was admitted to the PICU (although sad he had to be there for health reasons).

And let me tell you, while I have been very aware of the differences between my role as a Nurse Practitioner, and my role as it was as a nurse, this week made those differences even more obvious.

When my boy came in I was able to spend 12 hours at a time with him.  We read a lot of books. We watched a lot of Sponge Bob.  We took walks in the halls.  We just spent a lot of time together.

But now my role is so different.  Even though I may be in the unit for 10 or 12 hours each day that I work, I don't get to spend it exclusively with him.  And some days when other kids are much more sick and need much more of my time, I may spend 20 minutes with him at most!

What a difference!!  While nurse practitioner may share the word "nurse" it truly is a different world than bedside nursing.  And while I do love my job as an APN, there are some things, certain things, just like spending time with this sweet boy, that make me miss being at the bedside.

So on the days that it seems like I'm not able to impact this one boy in the same way that I once was, being able to make him smile and laugh when nobody else could, I have to remind myself that with this new role comes new ways to make impacts. 

And while I'm still trying to figure out what that exactly means, I will continue to enjoy my role as an APN...and squeeze in any extra minute I can to read Dr Suess books with my precious little boy!

Wednesday, December 4, 2013

Customer service at its finest

I love great service. I love giving great service.  And I get even more proud when I see great service at work.

Since I've been working so many 4pm to midnight shifts lately, which typically means I'm leaving the hospital around 1 or 2 am, I've been taking the free shuttle from the hospital to the parking garage.

I work in an inner city hospital and while it's not in a "bad" part of the city, it definitely has its moments of crime there.  So anytime I can not have to walk the 0.6 miles to the parking garage in the middle of the night, the better.

There are several different shuttle drivers that work the night shift.  But lately I have found my favorite.  His name is George, and he is the friendliest, older gentleman.  Not only does he pick me up at the front entrance and drives me to my garage, but he goes above and beyond.

Once we pull up to the garage he always asks what floor I'm parked on (I'm thinking b/c he wants to know approximately how much time to expect me to come out).  He then tells me, every time, that he is going to wait right at the entrance until he sees me pulling out.

And everytime I pull my car out of the garage, there is he waiting...big smile on his face and waving his hand out of the window. 

It's nice to feel taken care of.  It's nice to have your own personal security guard taking you to your car, and making sure you get out safe.  It's just nice to get great service. 

And while great service is what we strive for at my hospital, truly great service is what is being given my George, the shuttle bus driver!!!  Thank you for all you do (this is a general thank you, b/c I'm positive he does not read my blog!).  You are a reminder to us all to not only provide good service, but to go the extra mile, go above and beyond, make a difference, and deliver exceptional service!

Thursday, November 28, 2013

Happy Thanksgiving

Happy Thanksgiving!  There is much to be thankful for this year.  And as I spend the day with family and friends, I will reflect on all that I am grateful for.

I hope that you all have a safe and blessed Thansksgiving, and year to come!

And for all my nursing and Nurse Practitioner friends who are giving of themselves in the PICU (and other units today), thank you! Thank you for your hard work, for your servatutde, and the way you selflessly give to patients and families on holidays like today, and everyday! You are much appreciated!

Monday, November 18, 2013

When PICU Parents Get in the Way

Ever taken care of a patient and you do everything you can for them??? Only to realize that the "everything" list is completely shortened because the parents just keep getting in the way!?

This hasn't happened to me in quite awhile...until last night.

Around midnight (yes, great timing...JUST as I was getting ready to leave!), I get a CAT page.  I think I've talked about our CAT calls before, but just a little refresher:

CAT = Critical Assessment Team

Anytime a physician, APN or nurse on any unit (outside of the PICU) feel that they want a "PICU Consult" or another set of eyes on their patient for recommendations, or perhaps a transfer to the PICU, they call a CAT call. 

Generally APNs in the PICU respond to these calls (although on some days that we are completely slammed, the fellows can step in if they are not swamped as well!).

We go up, evaluate the patient, and either decide that the patient needs to come down to the PICU, or they are stable enough for the floor service but we can give them further recommendations on what to do. 

While I really was terrified and hated these when I first started as an APN, I'm learning to love them more and more.  It really brings out the autonomy and critical thinking out in my practice.  And certainly as I become more knowledgeable, they get a bit easier.

Until last night!

As I said, I got the page right as I was getting ready to leave.  So of course, I wanted to get up there, decide if the patient needed to come down, and get out of there ASAP!

Almost 2 hours later, I was finally ready to leave for home : (

So what took so long for a process that typically takes 15-40 minutes???

The Parents of the Patient! That's what happened!!

The floor team called the CAT because they were concerned about the patient's neurological status that had been waxing and waning over the last 3 hours that the patient had been there.  I was getting the patient's history from the physician which included fevers, headache, neck pain, decreased appetite and overall lethargy for 4 days. 

My next question was what had been done in the ED and on the floor look into this.  The answer? "Weeeeelll.....not much."

I didn't really get it *what do you mean "not much" has been done??* so I re-phrased.  Off the top of my head, in a patient with these symptoms, I would be concerned about several things, but the top of my list would be meningitis.  Have you gotten a head CT, and done the LP?  What about antibiotics??

So this is where the story got interesting.  The ED apparently had to convince the parents of this patient (that sometimes woke up, sometimes not so much!) that he was actually sick!  Despite several attending physicians discussing at length with the family, they ultimately refused everything except the head CT (which was normal).

So no LP, no antibiotics, no further testing! Done.  They almost took the patient home, but the ED physicians said they would not allow that b/c their son truly was sick and needed medical attention.

So here I am, about 6 hours later doing a thorough neurological examination and determining that this patient now needs to go down to the PICU, mostly for hourly neuro checks (which is too much for our floor nurses when they have a larger patient load than PICU nurses). Ohhh boy, the parents did NOT like that!

Nor did they appreciate that I stated that he really did need an LP.  And antibiotics.  And once again, they flat out refused.

In their minds, their son was sick, but was something that he would need to fight out on his own.  And they though he truly wasn't that sick.  But he was!!

So it was a very long, very drawn out process to get the patient down to the ICU.  Ultimately, I wrote my CAT note (detailing very thoroughly what I had recommended, and that the parents were refusing most of it along the way), and had to hand off this hot mess to the team that would be there the remainder of the night.

So here are 2 parts of the PICU that can be hard or frustrating:

1.) When things are unfinished, or unresolved, it is so unsatisfying just leaving, and not really knowing the outcome right away.  But for the sake of my sanity, and the fact that I was exhausted, I did leave.

and 2.) When parents get in the way of doing what you know needs to be done medically for the patient.

So while I have no idea what happened today, I look forward to going back tomorrow night seeing what was ultimately decided among the family and the medical team.  That will help to resolve the frustration of #1.

As for frustration #2...unless we take over legal custody because the parents are truly harming the child (which is a much longer and drawn out process than sometimes seems necessary!), parents such as this will continue to be parents just like this.  And while I can't do anything to change them in the short term, I can continue to try my best to help them understand what medically would be best for their child.

And ultimately, I will continue to provide the best care that I possibly can for them.  Doing everything I possibly can to get this patient back to their healthy former self, and out of our PICU!

Tuesday, November 12, 2013

PICU Vices

I laugh at how frequently the topic of being a nurse practitioner and alcohol go hand and hand.

I remember when I was referred to a hematologist almost 2 years ago, I had just finished school and hadn't started as an APN yet.  I saw the heme APN and she asked, "So have you started drinking yet!? Because if you haven't now, you definitely will once you start working."

The question took me a little bit by surprise, so I just laughed. I mean Jon and I have always loved wine. Or an ice cold beer on a hot day.  Or a good dirty martini (see, I'm no stranger to alcohol!).

But then I started working as an APN and it definitely took on a whole new meaning.  The hematologist APN was right!

I also have a friend who is a mother of 2, in her 40s, who is now in the midst of nursing school and she recently posted on facebook a status that read something to the effect of "I don't know how I'd get through these classes without X, Y and Z friends...that and our good friend wine. If nursing school doesn't turn us into alcoholics..."

I laughed as I read it and then commented, "Just wait, if nursing school doesn't turn you into an alcoholic then your first year as a nurse will!"  Laugh, laugh.

And now my co-workers and I laugh at the end of a hard day about whether it was a "one or 2 glass sorta night."  Generally, the super hard days that involve note writing at home are the 2 glasses types of nights!

So it was particularly funny when one of my favorite co-workers called me last night to say that I would be proud of her.  While she was pouring a glass of wine after a long day, it was the first time in 4 or 5 days (yes, we celebrate the small victories!).  I told her that I indeed was impressed, and asked her what she replaced her wine vice with.  Because I KNOW it's not something you just toss to the side without a replacement.

While I was completely joking in asking this question, she sheepishly replied, "Yeah, I've taken up online shopping!"

We both laughed so hard!! Oh boy. 

She then replied, "I think I'm going to stick with the wine, because it's definitely cheaper!"

So I'm not sure what it is about nursing school, nursing in general, grad school or being an APN, but there is a direct correlation with that and wine consumption!  Now there's a smart research study waiting to be done!

Are you a wine drinker??? If not, what is your post-nursing/APN hard day vice???

Friday, November 8, 2013

Goodbye Three Things....

OK, after 2 short weeks, and one of them not even being on time, I've decided 3 Things Thursday is over. 

YUP, this is coming as no surprise to me...remember what I told you my journals and diaries used to look like? I'm telling ya, a ten year span can fit in about the front 1/3 of a very small notebook!

I just realized that I don't have the kind of job that I can guarantee to blog on one particular day of the week! 

So instead, as I come up with them, I can do a 3 things here and there. 

Since I started this blog to document the many fun and crazy things that happen in the PICU I don't want to start feeling stressed or obligated to produce something.  That's definitely not needed!

So Happy Friday instead!  I'm working this weekend and am looking forward to it (as much as you can look forward to working on a weekend!). 

I spent 2 days last week spending time with the Neuro Critical Care APN and the remainder of my last several shifts have been evening/nights so I'm excited just to get back into the regular swing of daytime PICU.

My one true career love...days in the ICU! 

But tonight, it's a date night in with my man.  Nothing can beat that!

What are you doing this weekend???

Friday, November 1, 2013

Happy Halloween!

In leiu of Three Things Thursday today (since it became Three Things Tuesday this week!), I am simply wishing you a very Happy Halloween! 

Since I don't have kiddos of my own yet, it's always a blast to work on Halloween and see the kids of the PICU dress up.  Most kids in the PICU are too sick to participate, but the few that do definitely bring huge smiles to all of us! 

And since I can't post pics of those kids without getting consents and legal stuff, blah blah blah, I will leave you with some pictures of Halloween the Lerma style. 

Horrible lighting, I know...sorry! But we started the night with amazing loaded baked potatoe soup...YUM!
Super excited about carving the pumpkin...and determined not to overcut the top so it falls right in like last year : )

My spooky dollar store skeletons on our kitchen ledge

Ewww. guts, guts, guts! (Sadly, this is the SAME face I've made on halloween for the past 8 years...some things never change apparently!)



Tuesday, October 29, 2013

Three Things Thursday...ahem, Tuesday

3 Things I'm Loving:
1.) Our 3rd annual scary movie and haunted house party went off without a hitch this weekend! We had a blast!  We acutally picked 2 movies perfect for the occasion, which let me tell ya has never happened before (Mama and The Conjuring, in case you were wondering).  And the haunted house we picked was a major winner- it was in a huge arcade and was 19 rooms of horror, PLUS a 3-D haunted experience which was awesome!!  The only downside, I got so wrapped up in the fun I forgot to take a picture of my amazing food and drinks all turned out so creatively and awesomely (and yes, that's now a word!).  Oh well, at least we got a few pics of the friends...and that's what counts, right???

2.) A little bit of arm bling that I got on MAJOR discount (like $3!), plus free overnight shipping. Gotta love a great bargain!  Too bad these aren't very work friendly...I'd likely stab a patient in the eye with the spikes! OK, retract former statement, these DEFINITELY are NOT work friendly!

3.) The pickles I wanted to try here...Umm, YES they are AMAZING!! So much so Jon and I have eaten no less than 2 entire jars of them in the last week!  I'd love to say we rationed them over the 7 days, but no...we definitely ate the first jar in one sitting, and the second jar the same way!  Nothing like homegrown cucumbers turned oh so delicious organic pickles!

3 Things I'm Loathing:
1.) Precious little ones passing away. Heaven gained a new little angel yesterday and while I am so grateful that I can be a presence and support to the family, it doesn't make each and every death any easier. My thoughts and prayers are with the family through this incredibly difficult time. 
image via
2.) Open Enrollment Preparation- ohh, my eyes are going blurry just thinking about the chart again!  Wouldn't it be nice if there was just a one sized fits all insurance package that was great for everyone! And I love how every year I've been at this hospital they keep increasing the monthly premiums and decreasing the actual benefits that we actually get.  Or changing the insurance to companies that stink!  So much so that my hospital no longer accepts patients with OUR insurance!! They will let employee's children be seen here, but nobody else with our subpar insurance will be accepted. That's a lovely message to employees, huh!?
3.) The fact that the second installment of Three Things Thursday is being posted on Tuesday.  Yes, I knew this would happen. You should see my journals from high school, college and early married years. There's like 7 entries spaced out over a 2 year span, and then about 200 blank pages.  Oh well! Three Things Tuesday it is this week!

Monday, October 21, 2013

Psychic in the PICU

Lately, I think I'm psychic. 

And I know what you're thinking.  Because I thought it too.  I'd see commercials for psychics and roll my eyes. 

But let me tell you, I'm starting to change some of my habits in the PICU because of this new little trait I've inherited...or honed in on.

You see, it all started a couple of weeks ago.  I was working a night shift, and there was actually a little bit of downtime.  So I decided that I would look up a topic of interest and educate myself a bit. 

We hadn't admitted a patient in DKA (diabetic ketoacidosis) in awhile, so I thought I'd start there. After about 30 minutes of reading, I got a call from the fellow working with me saying we were admitting a patient in the ED. 

The patient was 4 years old, new onset diabetic, in DKA.


Then about a week later, during the day, I was sent several research and educational articles from an attending to read.  I decided that I'd read about status asthmaticus and adjunct therapies used in the PICU. 

Lo and behold, an hour later, guess what type of patient I admitted!?  An 8 year old in status asthmaticus.

Only 3 nights later, I was on call with one of my favorite fellows.  We had a little bit of time to sit down, and I jokingly told her that I WAS NOT going to look up a topic because we would inevitably get that admission a short time later.  She laughed at me and rolled her eyes (just like I did with psychic commercials!). 

So she asked what procedure she would like me to review with her instead, and I said Lumbar Puncture.  I hadn't done one in about 9 months, and felt like I needed a refresher.  So we reviewed the quick procedure.  Then we started talking about LP results and diagnosing meningitis (viral vs bacterial).  So I started looking all that up and refreshing myself on taht information. 

And I'm not even lying...less than 10 minutes later we get a call saying we were admitting a kid from an outside hospital with likely meningitis!

What the what!?!?

So I'm not sure what's going on here! I'm batting 3 for 3.  And really, it's 3 for 3...because we've been so busy lately there's been no other time for reading during my shifts!

You may call me psychic.  You may call me crazy.  You may call me lucky.  

But whatever you call me, I call it...well, I'm not sure what to call it.  But I think the lesson here is to start looking up "colds" or "varicella"...something that will not lead to such a crazy busy shift! 

Or maybe just read about "instant weight loss" or "being a natural at running marathons and enjoying it".  That wouldn't be too shabby of a delivery 10 minutes after reading it, huh!?

What would you read about if you knew it would come to pass shortly after???

Thursday, October 17, 2013

Three Things Thursday

In an effort to improve my consistency in blogging (because I really do enjoy it, and particularly enjoy reading things from a year and 2 years ago!), I have decided to start what I will call:

3 Things Thursday

So every Thursday (or as many as I can remember!) I will present 3 Things that I love from the week, and 3 things that I loathe from the week.  It may or may not pertain to the PICU. Some days there is just nothing to love within the confines of those walls.  And other days there's nothing to loathe (LOVE those days!).

And thats ok because really, a nurse is not just a nurse.  There's a whole other life once she (or he) leaves the doors of that hospital.

So enough introduction.

Here's the first installment of Loving & Loathing 3 Things Thursday!

1.) Peaceful, quiet moments in the morning with my homemade pumpkin lattes, great books, and a chocolate hazelnut candle!

2.) Having the best husband in the world. I mean seriously, who else would do this when you were getting ready to have a minor surgical procedure early on a weekday morning!?!? Kept me laughing the entire time waiting!

3.) The football themed Peanut Butter Cup Chocolate Fudge Brownie triffle I made for our last football tailgate over the weekend! Oh yes, it IS that good.  This was the second time I've made in it the next couple of weeks!!

sorry for the bad picture phone not at its finest!
1.) Waiting in the doctors office for over an hour this morning just to be seen for all of 5 minutes. On the up side, I have now officially "pinned" about a trajillion new recipes to try! (below are the two I am going to do today!)

courtesy of
courtesy of
2.) The cold we weather that came through today and looks like it's here to stay..BRR!  I was SO loving the warmish fall we have been having here. Guess it had to end some time!
*So you can't feel the cold...but can you see it in the grey skies!?*
3.) Politics in's just not my thing. But what's really getting me this week is the exorbitant amount of it that keeps inundating my favorite tv shows and the internet! I know I should be a little more up to date with some of the things going on, but really!? Can't we all get along! Obviously not!

Monday, October 14, 2013

PICU Call Rants #1 and 2

RANT #1:

First of all, let me start this post with saying how much I hate saying "call shifts."  In the PICU, I am not "on call." I am present, for the entire shift.

I am not able to sit at home, on my couch, or sleep in my bed, and simply answer a phone to give a nice quick answer to the nurse calling about a patient.

I am there, in the PICU, generally running around, barely getting to sit down, sometimes not getting dinner, and many times not drinking enough water to produce adequte urine output.

I wish we'd just call it night shift. Because really, that's what it is.  Well, a combination afternoon and night shift.  But either way, that sounds better than "Call shift"....because that's NOT what it is!

Rant 1 over...phew! Although it will lead me into Rant #2....

RANT #2:

The REASON why we don't call it night shift!  I had a manager tell me in the last several months that calling it night shift (AKA: I hate working nights!  Night shift sucks!...sorry that's generally how the phrase comes up from me) referred to bedside nursing.


I was supposed to call it what it "was"- "Call shift."  Why??? Because that's what the medical model called it.

OK, there's some crazy, slightly ironic reasoning if I've ever heard it! 

First of all, I AM a nurse!  I may be an Advanced Practice Nurse, but I am a NURSE!  So calling it a night shift, which could have a nursing connotation would be appropriate! 

Second of all, I did not go to medical school. I am not a physician.  So do I really care if I am following the medical model, or using medical terminology (no, not at work, but in situations such as this!)???

I'm realizing more and more lately that being an APN is a weird chasm between two worlds.  We are not quite nurses anymore, but we are not quite physicians either.  I function exactly the same as the fellow physicians in the PICU, and yet I'm not a fellow.  I have nursing in my title, and was a great bedside nurse for 8 years, but no longer function in that way. 

And I take great pride in being a nurse.  Families and patients call me doctor all the time, and I very quickly correct them. Not because I feel I'm not "worthy," but more because I know that patients and families see a big difference between the care that they get from me and my fellow APNs vs some of the residents or other physicians.  And I want them to continue to differentiate the two. 

What a weird chasm to be in- in one world, but a part of another.  But as weird as it in, and as with all things nursing and APN related, I know that I will figure it out.  Figure out how to be an incredible APN in a medical model while still holding tight to the values and traits that are exclusive to nursing. figure out how to continue to differentiate ourselves as APNs from the physicians.

But most importantly, figure out how to get everyone else on board on calling a cat a cat, a dog a dog, and a night shift a night shift!

Thursday, October 10, 2013

Turning PICU dislike into like...or even love!

So apparently I'm a stinky blogger lately.  I really had great intentions to get right back to it, and chronicle all of the adventures lately, but then life just happens.

Ever happened to you??

You know, you create a "To Do" list with expectations that come the end of the week, the month, whatever, and all your items will be checked off.  And then that time period ends, and you have one check mark (if you're lucky)!

Grr, I hate when that happens.

And no, I'm not saying that writing my blog is a burden or even ever on my To Do list.  Although I think if I put it there, I might have an improved writing rate!

Either way, life happens, it gets in the way.  Moving on.

The PICU has been crazy busy lately.  Like CRAZY busy!  We not only have a high census, but we have a higher acuity than we have in a long while.  And this generally happens in the winter with summer time being a bit slower, but it's happened earlier than I remember it in past years.

That translates to staying late for a lot of shifts.  Coming home and wanting to just collapse on the couch only to have notes still to write.  And call shifts that turn 16 hour nights into 18 or more without sitting down, eating much, and barely peeing.  Yeah, that can't be good for ya! 

We've seen a TON of meningitis lately.  I've gotten to do 3 LPs in the last 2 weeks because of it.  It's definitely been a great time to be able to get more procedures for sure.  And I'm liking procedures more and more.

Someone asked me several months ago if I "loved procedures!?!!?"  To which I really had to answer, "Umm, sure, I guess." It's not that I dislike them.  I just couldn't say that I "LOVED" them!

I think it's mostly because we don't get procedures all that often in my institution because there are several APNs on one shift, working with a fellow.  Anytime we're on call or day shifts with first year fellows, they get priority in procedures.  Or if a second or third year "needs" more of whatever procedure, they get priority over us as well.  Plus, we let intervential radiology put in a lot of our central access, so that drastically decreases the amount of lines getting placed in the PICU.

But I've decided that the more procedures I get to do, and the better I get at them, the more I enjoy them. 

I guess that's probably true with many things.  I don't enjoy bowling, but it's b/c I'm pretty lousy.  On the other hand, I love soccer, ping pong, volleyball, etc.  But I'm also pretty good at that. 

So I guess if we're going to be insanely busy in the PICU with crazy sick kids, I'll relish in the fact that its an opportunity for me to get more procedures.  And for me to get much better at them!  Which in turn, will most likely increase how much I enjoy doing them.

Unless its placing chest tubes...b/c I just hate that!!!  Even if I were a chest tube pro...ugh, that's the one thing that just grosses me out.  But that's a different story for a different day.

What's something that you are learning to love, or like a little more, as you get better at it?  Could be in nursing school, as an APN, or just in real life???

Monday, September 9, 2013

July in the PICU

July was a big month for me in regards to my career in the PICU.

I didn't work for 2 whole weeks!! 

And while that sounds counterintuitive as to how that could be huge for my career, it truly was.  Because while I wasn't physically working in the PICU, I was working in Prague, Czech Republic.
That's right...July was the BIG Noise Study Poster Presentation at the Sigma Theta Tau International Nursing Research Conference. I'm not going to say too much about it in this July recap because I will have a whole post on it, but it was an incredible experience!

I was able to meet a lot of great people, from a lot of different countries.  I was able to get my feet wet with poster presenting.  And hello, I was able to go to Prague!

After Prague, Jon and I headed off to Italy where we were able to spend about 2 days in Rome, and a week in Cinque Terre.  We stayed for 3 nights in Vernazza, and 3 nights in Monterosso.  All I have to say about Cinque Terre now is if you haven't been, you MUST go.  It needs to be on everyone's top 3 places to visit before you die list!
Outside of traveling, there were some other highlights of July.  But let's not kid ourselves...nothing that could compare to Prague and Italy!
We started the month by spending a relaxing 4th on a rooftop in the city with some good friends, a once in a lifetime view of fireworks from about 45 towns all at once  (unless of course, we go there next year!), an amazing homemade rubarb pie, and a few glasses of good wine. Now that's a good 4th to me!

I then went on the next week to participate in the 4th Annual Critical Care Bootcamp.  It was my second time participating, and let me tell ya it was about 1000 times better this year!  Myself and one of my co-workers who started about a year before me were initially signed up to learn how to be instructors for upcoming years, but we were signed up too late. So we went as participants.  And while we were both initially dreading it, it was actually a fabulous learning experience.

As uncomfortable as Simulation Labs can be (who wants to pseudo-take care of a manequin that talks to you while the rest of the class is watching you through the one way mirror!), they take you so far outside your comfort zone that you truly remember those lessons! 

And it was also very exciting to see how far I've come in the last year.  I've grown in my confidence, in my knowledge, and in my patient care overall.  Since the rest of the group were brand new APNs and fellows, for the first time ever, I actually felt like I had a bit of a leg up.  It was a short, small...very small, leg, but I'll take it.  That never happens, so yes, I relished in it just a bit : ) 

So there ya have it.  PICU in July.  You know, a little bit of Bootcamp, a little bit of holiday partying, and oh a little trip to Europe!!
What crazy, fun, memory making things did you do in July???

Thursday, September 5, 2013

The PICU in June

I figured since I'm so behind on my blogging, I'd do a few summer recaps on the PICU. And maybe include a few personal things because really that's what keeps a PICU Nurse Practitioner sane...the things outside of work!

So today I invite you to revisit June.  Because really, who doesn't love June!?  It's probably my very favorite month of the year!  It's the first month that truly feels like summer to me (at least where we live).  It's the month I was married in.  It's just a great month!
My mom has been asking for about a year for a picture of me in my lab coat at my there ya go mom!  I absolutely LOVE having my own desk, with my own pictures...and my own phone extension! So much fun!
Highlights of June:
-Jon and I celebrated our 8th Anniversary on June 4th...hello, am I even OLD enough to be married for 8 years!? What!?
Mmm, what better anniversary dinner than
lobster tail, scallops and risotto with great wine!
And what better way to celebrate than in PJs,
no makeup and glasses...classy I tell ya!

-I took a couple of days of PTO...just because : ) now that's nice! And it allows time for things like farmers markets, long bike rides, and runs with my hubby who swears he's not a runner...but I'm slowly convincing him otherwise : ) 

-I did my first educational session with a group of nurses at a pediatricians office with one of my old co-workers and great friend.  While I have always known that I love...LOVE...teaching, this just reinforced it!  It was so much fun being able to teach "Pediatric Emergencies" to a group of nurses, through a little bit of lecture and a lot of interactive games, a scavenger hunt, and a cut throat relay! What a great evening!

-I started precepting...again.  This time as a nurse practitioner.  I remember after being a nurse for a year and being asked to precept for the first time, I thought "Are you crazy...I've only been a nurse for ONE year!? I'm not smart enough to precept!!"  And this time around as a nurse practitioner I thought "Boo ya, I got this!'  BA HA HAAAAA...NOT!!!! I actually thought the exact same thing as the first time around! But it turned out to be a good in which the orientee and I both learned a lot! And once again reinforced how much I love teaching.

-And June ended on a very dirty note.  Literally.  At least this time it was dirty mud outside of work...and not the many types of "dirty" that the PICU can (and has!) bring!

A few befores..while we were still clean : )
And after...just a little dirty : ) Stef and I have been besties since I was born.  Meg and I besties since, well highschool...and frenemies for 6 years before that : )  Oh the memories we've made, and are still making! I love it!

So that was my June.   How was yours??

Wednesday, August 28, 2013

ICU Psychosis

ICU Psychosis is a very real thing.  I see patients with it all of the time.

And I think that I've had it the entire summer.  That's why I haven't blogged since May!

OK, that's most likely not the reason I haven't been blogging.  In actuality I think there are a lot of reasons.  My differential diagnosis (if you will : ) includes but is not limited to:

1.) It's summer...who wants to stay inside and stare at a computer when you can be outdoors and enjoy the short lasting sunshine!

2.) The amount of night shifts I'm required to do increased starting at the beginning of summer, and I feel like lately a majority of my job is spent on nights and weekends....YUCK! If I blogged about that, you'd be depressed.  Because it makes me that way. And I may scare away some new grads or students who want to go into the PICU.

3.) There's just a lot going on, both in worklife and real life.  And some has been fun and exciting, and others more emotional and challenging.  And since I'm not one to process emotions very quickly or easily, it's best I figure that out before it spews on a page for the world to see : ) 

But I'm back.  I started this blog as a way to document the many adventures that I had as a nurse, and now as a nurse practitioner.  And I want to continue to do so.  I want to retire one day, and be able to look back at the many fun and sometimes funny memories that life in the PICU brings.  And even the not so fun, or downright sad memories are important because they have helped shape me into the Nurse Practitioner I am today. 

So I enter the (almost) fall with a renewed energy in work, in life, and in blogging.  Thanks for sticking with me during my hiatus.  And to the sweet reader "Anonymous" who commented back in July to make sure I was ok...thank you!  Yes, I'm ok. 

I'm better than ok.  And I have A LOT to catch you all up on.  But rather than cramming it into one blog (because that would really turn into a mini-novel, and nobody wants that!), I will try to get you updated i
n short spurts. 

So as I leave you today, all I can say is buckle up because it has been, and will continue to be, one bumpy, crazy, and most definitely adventure-filled ride on this road I call being a PICU Nurse Practitioner.

Sunday, May 26, 2013

PICU Questions

I've had a majority of the last several weeks off of work and while I'd love to say they were days off spent on vacation, or doing something amazing (or even productive), they weren't.  They were taken off for health reasons, but now I'm back.  Back to work, and back to blogging about work. 

And I must say, I am glad to get back into the swing of things.  I wasn't really looking forward to waking up at 5 am every morning again, or even the stress that the PICU occasionally (ok, frequently) holds, but once I went back to work last Thursday and Friday, I was reminded how much I truly love it.

How much I truly love the patients that I care for.  How much I love my co-workers.  How much I love the feeling of a long day of work being over...and yet how productive and gratifying that long day can be!

And now that I'm back, I've had a few questions on the blog that have gone unswered in my absence. Ironically, as I read through them today, I realized they were some of the same questions that a friend from church who is going into her 3rd year of nursing school asked this morning.

And I love answering these questions.  I love watching the excitement of a nursing student, or brand new nurse.  I remember back to the days that I was in undergrad, still trying to decide what it was exactly that I wanted to do.  Make sure the pediatrics, and the PICU more specifically, was right for me.

So today I'm going to take a bit of time to answer a few of the questions I've missed today.  If I've answered some of these in the past, you can just skip it.  Or, if you've been a nurse for awhile (or a few days!) and want to chime in, feel free. I think the more nurses students can talk to, the more prepared they will feel once done with school entering into the real world!

Q: Why did you pick the PICU?

A: I think to best answer this, I have to start with why I picked pediatrics in general.  In nursing school early on, I narrowed my choices down to Labor and Delivery/Mother Baby, and Pediatrics.  I did an internship after my third year of nursing school and didn't get my first choice Peds, but rather my second choice Mother/Baby with a couple of weeks experience in L&D.  While initially I was disappointed, I am SO glad I had this amazing experience.  It was not my clinical rotation in nursing school that showed me I didn't truly love L&D, it was the internship that did that.  So while I had a great time in Mother/Baby, there were many things that just made it not right for me.
     So that narrowed it down to Peds for me.  And then I applied for a nursing assistant job at the Children's hospital in my town and the position just happened to be in the ICU.  Now let me just say, I didn't necessarily have an interest to work in an ICU setting.  Although I also didn't have a disitnerest.  I just didn't really know much about it.

    So I took the job, liked the people (although hated the nurse assistant job b/c you don't get much hands on with the patients!), and decided, "Yeah I think I'd love this as a nurse."  So once I was done with shool, it was an easy decision.  Why work on a general pediatric floor, or a specialized pediatric floor when I could work in the PICU where I already worked? 

     I have to say looking back onto my nursing journey,  I feel like while there was some decision making, there was a lot that just fell into my lap.  And luckily for me, it has worked out well.  Better than I could have even planned it, I suppose!

Q:  What are the top 3 things that you love about the PICU?

A: 1.) The amazing patients and families that I get to work with, get to know, and spend a lot of time with.  I guess this could fall into "top 3 things I dislike about working in the PICU" if the family is crazy, or the child is a total brat, but for the most part I absolutely love the relationships that are formed in the PICU that cannot compare to any other unit.

2.) The adrenaline, the stress.  Don't get me wrong, there are many days where I think "Why in the world did I not just pick a desk job!?"  But really, I know myself.  And I know that I would be bored out of my mind if I didn't work in an environment that is as exciting, exhillarating, adrenaline filled, which can often translate to stressful, as the PICU. 

3.) I love working with kids of all ages, from neonates to young 20s (and ocassionally we do see some older) with all kinds of diagnoses. I love coming into work knowing a little bit about a lot of topics (although hopefully as I get more experience, it will turn into knowing a lot about a lot of topics!).  I love that my job focuses on the body as a whole, and not just focusing on one organ.  I love that no two days look alike in the PICU.  So I guess to sum it up, I love the diversity that the patients and diagnoses bring into the PICU.

Q: What are the top 3 things that you dislike about the PICU?

A: 1.) Death.  I hate seeing kids die. Sometimes it is bittersweet because the kid has been suffering for so long.  But in the end of it all, I hate watching parents watch their child die.  But it's a part of working in the PICU.  And if I can be a light, provide support, or just a presence to the families of these little angels, than I consider myself one lucky person to be able to have a job that has such a high calling and responsibility.

2.) Night shift.  I hated working nights as a nurse, and I hate it as an APN.  I would love to say, "Yeah, I kinda sorta dislike nights" but really that's an outright lie.  I hate them. HATE them!  I hate staying up past midnight on any given day...New Years is a stretch for me!  I hate the way that I feel at 3 am after already having been up for 20 hours.  I hate even more how I feel at 9 am when the bed is calling my name and I'm not yet home, after being up for 26 hours. But that too is a part of the PICU.  The PICU will never close down just because it's late. Or a weekend. Or a holiday.  The PICU will always need excellent nurses, regardless of the shift. 

3.) The stress.  Yes, I know that this also fell into my favorite things category, but I couldn't come up with another 3rd thing.  And thinking about it, while stress can be very beneficial, drive people to do great things, and to overcome fears, there are also negative things that can follow stress.  So it's for the negative reasons that this also is falling into my 3rd thing I dislike category.

Q: Have you ever work in, or floated to a different unit? How does it compare to the PICU?

A:  No, I have never worked as a nurse in another unit.  And as an APN, we don't "float" in my hospital.  But, when working as a bedside nurse I did float to several other units.  And they were all VERY different.  I worked in the NICU most of the time that I floated, and let me tell you while the two units share 3 letters, it's the first one that truly separates them into two totally different worlds.  Teeny, tiny babies, that don't look much like babies, are just not my cup of tea.  But most NICU nurses absolutely love their jobs.  To each their own!

I also floated to the Hematology/Oncology floor twice and highly disliked it.  I can't imagine being surrounded by kids with cancer all day.  Yes we see terrible things in the PICU.  But we see a vast variety of terrible.  Cancer all day, not my thing.

And then I floated to several other floors that specialize in various other things such as Pediatric Surgyer, Endocrine, Neurology, etc.  And while I didn't mind working on these floors for the day, I just didn't like the environment that a non-ICU floor holds.  I guess I like taking care of the sickest of the sick.  I like being able to give all my care and attention to one or two kids and really getting to know them, rather than being spread thin and caring for 5 or 6 patients.

So how's that for a "Welcome Back" party!?!?  Just a long-winded hello!

But I hope for the nursing students out there, or the nurses who are in an area that they are not completely happy with and are considering the PICU, thanks for sticking it out to the very end.  And I hope that I've helped you to see that the PICU is where it's at!!

Yes, there will be bad days.  But if being a part of a team that heals the sickest of the sick kids is something that excites you, the PICU is the place for you. 

I know without a doubt, despite having 3 (and sometimes 33!) things that I dislike about the PICU, it truly is the right place for me!

Monday, May 6, 2013

Funny Orders

There are some days that seem mundane, and then you just happen to stumble on orders like the following:

NURSING COMMUNICATION: "No oral fluid by mouth"

And then the rest of your day is spent laughing it up with the co-workers and poking fun at the APN that wrote it (who in her defense was febrile and throwing up...yes, shortly after we found this out we sent her home!).

Oh, and the best part was having a contest to see who could come up with the wittiest remark or finishing that sentence.  

Do you think you would win??? Let's hear your best.  And I may just tell you some of our funniest!

Tuesday, April 30, 2013

Nursing Interviews

As mentioned in my last post, today's topic is interviewing.

Now it doesn't matter if you are interviewing for your very first nursing job straight out of undergrad, your first APN job after already having been a nurse, or even your 20th interview as a medical professional, interviewing can be tough.

Without the right amount of preparation, good intentions can really go south in the interview room.

So here is a list of 5 things that I have done, or read about, or seen as I have interviewed others, in order to best prepare you for that big interview and get you that job!

1.) Know Your Stuff: Know the company that you are wanting to work for- what is their mission and vision? What are some of their values? What is the culture like?  Most of this information can be found on a hospital's website and will be valuable as you go throughout your interview.  When your professional mission, your vision, your values and goals align with the business, this is very attractive.

2.) Dress Professionally:  This is just my personal opinion, but I think that whether you are interviewing for a nursing position or APN position, you should dress to impress.  And this generally means a suit.  Some people will say it's ok for nurses to wear dress pants and a "nice shirt" but I think if you really want to make an impression, the full suit will make you stand out.

For one of my interviews I wore a pencil skirt with a button down shirt, and suit jacket.  Another intverview I wore the same jacket with a different shift underneath, and black dress pants.   And let me further tell you, just because you have an interview and need to dress professionally, does not mean spending a ton of money before you are even making it.  That pencil skirt and suit jacket that I wore above cost me $12 at a thrift store in my area.  There are deals all just have to find them!

3.) Make an Impression: You only get one chance to make a great first impression.  That's part of my reasoning for dressing in a suit.  But the other parts of making a great impression include making eye contact from the very first greeting, shaking hands with a firm handshake (really, who likes shaking a limp noodle!?), smile, breathe and relax.

The more relaxed you are, the better you will be able to listen, and since you will be so prepared for the questions (we'll get to that in a minute), you will come across as confident.  Who doesn't want to hire someone who is dressed professionally, has a firm handshake, smiles a lot, makes great eye contact, and throughout the interview breathes easy, appears relaxed and attentive, and answers each question confidently??? Oh yeah, you are so getting this job!

4.) Prepare for Questioning:  One of the nice things about interviewing is that many of the same, or similar questions are asked.  This is not to say that a curve ball can't be thrown at you, but with preparation of common questions, if a new one does pop up, you will be prepared for it.  And one of the best ways to be prepared for answering these questions is to practice.  Practice by yourself out loud, practice in front of the mirror, and practice in front of family and friends who can give you some feedback.

So what are questions to be prepared for???
     *"Tell me about yourself"- this is a common opener.  The interviewer wants to see how you will handle a very open ended discussion.  This is not the time to tell your entire life story.  Rather, keep your answer concise, but include information about your education, your pertinent work experience, career goals, and a little bit about your personality.  It is essentially like doing a quick run through of your CV/resume.

     *"Why did you go into nursing?"- this is your time to be honest and give a good story. Certainly "for the $" is never an appropriate response, nor is that the truth...if you think you'll be a baller you may want to turn back now! Let them know why nursing is your calling, because truly this is the case for nurses.

     *What would your previous boss/co-workers/peers say about you? How do people describe you?- This is a time to discuss your positive traits that will make you an asset for their team.  Things like team player, hard-worker, dedicated, loyal all reflect well.  But only discuss things that truly are reflective of your personality.

     *Describe a difficult situation and how you handled it?- this one should be rather easy...if you've gone through nursing school you've most likely had a difficult family member, nursing mentor, preceptor, etc. Just describe the situation, but most importantly show how well you handled it using team work, honesty, great communication, etc (whatever is appropriate for the situation).

     *Describe a situation in which you had conflict with a co-worker and how you handled it?- and really, who hasn't had a co-worker who hasn't given you problems.  BUT- if you haven't, you can always describe a situation in which great communication was required to work things out.  Employers love to hear and see an employee who knows how to handle themselves with grace, and has great communication.

     *What are your biggest weaknesses?- Now is definitely not the time to pretend to be don't want the interviewer to add "Liar" to your list after you've stated nothing!  Everybody has flaws, and the interviewer is trying to understand what yours are and more importantly how you respond to them.  However, you can present the flaw, or weakness, as a positive.

Eg: At times, I can be a "people-pleaser" which doesn't always translate in me standing up for myself, however it allows me to focus on providing great service to my patients. (for those of you that know me, I'm certainly not a people pleaser, but this is just an example).

Another example: I have a type A, perfectionistic personality which can come across as intimidating to peers, and I tend to hold others to the same high standard, but  I get the job done excellently.

*How would you handle a parent of a patient who is not happy with the care received?
*How would you handle a patient who constantly complains of pain?
*What are your career goals?
*How do you handle stress?
*What is the most rewarding about being a nurse? The least rewarding?
*Describe your ideal job and work environment.

There are going to be a lot of questions thrown your way.  Again, preparation is the key here.  Just make sure to listen to each question, take a deep breath, and answer confidently.

5.) Leave a lasting impression- not only do you need to make a great first impression, but you need to make a lasting one. This includes asking great questions at the end of the interview, continuing to make eye contact, staying positive throughout the entire interview, and ending with another smile and firm handshake.  Then, its a great idea to send a thank you. In today's age of technology, a simple email after the interview to thank them for their time, and remind them how you would be the perfect candidate for the job is appropriate.  However, this is only the first step.  A hand written note 3 or so days after the interview will make a big statement.  Again, it's all about making yourself stand out from the rest, and leaving that lasting impression.

So there it 5 tips on acing your nursing or APN interview.  I'd love to hear from you if you've recently gone through this. What were the things that helped you the most? Anything you'd do differently??

Monday, April 22, 2013

PICU Job Interview

I am going to say something that if a co-worker of mine read would make them freak here's to hoping that none of my co-workers actually read this...or, rather, for the ones that do, make sure you read til the end!

Let me preface this with saying, I am not looking for a new job.  I love what I do.  I absolutely love the PICU.  And I love my co-workers.  Repeat, I am not looking for a new job!

Now that that is out of the way, I had a phone interview last week for a brand new, very exciting PICU APN position.  This new position is at a brand new, state of the art facility.

The benefits package literally made my jaw drop- it not only included a $30,000 pay raise, but two round trip airline tickets to anywhere in the world per year, great medical and dental insurance, a housing stipend that would cover rent in full each month, a transportation allowance covering all monthly costs, and a small food stipend each month!

It would be a job working alongside some of the worlds greatest intensivists, researchers, and faculty out there.

At this point, I'm sure you're thinking "Why in the world is she not blogging about accepting this new, amazing position!?!?"

Oh wait, I guess I didn't mention WHERE this new job was.


Never heard of it?  I hadn't before a couple weeks ago when I saw a House Hunters International episode on it.

But prior to that, nope, never heard of it.

Qatar is a small peninsula in western Asia, bordered to the south with Saudia Arabia.  It's one of the richest areas in all of Asia, and despite what I might have pre-judged, is one of the safest areas of the world, with extremely low crime rates.

While I have always wanted to go to a third world county (although this is most definitely first world) to work for a year or so, Qatar was not what I had in mind.

If I were at a different point in my life, if we weren't where we were at in our fertility journey, then perhaps this offer would have me on a jet plane across the world in just 7 short months time.

But, I ultimately am saying no to this position...have said no!

So why the interview then, you ask?

Well, I got the initial call with some basic info that wooed me.  It piqued my curiosity.  And then I realized I have gone through so few interview processes in my life, that perhaps I would benefit from a few more.

I interviewed for my job at my current hospital in the PICU as a nursing assistant which was barely an interview- it was about 4 questions and they mostly consisted of "You in school for nursing?- yes; You sure you want to work here? yes."

After that, I had my foot in the PICU door, and my RN interview was just as short, and mostly spent discussing thoughts of transitioning roles.  Not a real interview.

And then for my current position, I had 6 interviews with various APNs and physicians which lasted all day, but really only 1 of them actually asked me true interview questions. One interview was spent with the attending telling me stories about his four kids.  Another interview was spent with the attending telling me how many mice he killed during his residency research project, and all the joys of that research.

So I really have not had an interview process in a professional manner.  And not that I'm looking for a new job (just wanted to reiterate that again!), I think it was something that I should go through. Even if on the phone.  Interviewing for a dream like job in a not so dream like place.

Seeing as I am going to Prague to present my research in just a few months, and will certainly be put on the spot then with tons of questions, so this would serve as a warm-up.

And it certainly did.

I started this post with the intent on discussing interviews.  And look at the *long* turn that it has taken. So rather than get into the nitty gritty of the actual interview now, I'll save that for the next post.

But I am very aware of the anxiety that can be felt surrounding formal, professional interviews.  There is so much unknown.

Whether you are in nursing school and looking to interview for an internship.  Or you are a new graduate nurse looking for that first job.  Or, you just finished grad school, and are starting all over as an APN.

Whatever the case may be, interviews are a big deal.  And you should most definitely be prepared for them. There are many ways to do that, and many ways to help relieve the anxiety.

So while that was what I initially set out to discuss on this post, I clearly got side tracked.  So I am leaving you in anticipation until my Interview Part II discussion (to be coming soon).  But if you have specific questions regarding interview specifics, let me know and I will make sure to include them!

Tuesday, April 16, 2013

Noise Study Presentation

As the PICU noise study is complete, and I am preparing for the big poster presentation in Prague this summer, I figured it would be a good idea to have a few practice runs in the presentation department.

If you missed the noise study stuff and Prague, you can read about it here.

So this week my co-principle investigator and I did a 20 minute power point presentation at APN grand rounds.  APN grand rounds is held once a month, and is comprised of all the APNs at our hospital, and a few surrounding or partnering hospitals.

I usually love speaking to groups.  While most of my friends dreaded the power point presentation part of our graduate project, I dreaded the 30 page paper that came with it.  So I thought speaking to this group was actually a lot of fun.

My partner in crime however did not.  She hates speaking in front of people. She doesn't even like doing bedside inservices to several nurses at a time on our unit.

But I'm proud of her, because she got up there, and despite having a slightly petrified look of seriousness on her face the entire time, she spoke clearly and eloquently.  We can work on the facial expressions for the next presentation!

After it was all done, we got some great feedback via anonymous surveys.  The only negative comment we received was "It was too long."  Well, we were given a 20 minute time requirement, and we spoke for 20 minutes and 30 sec.  So I'm not taking that one too seriously.

I thought the presentation on nutrition felt too long, but that was only 18 minutes.  So I guess that comment is more representative of that person not liking our topic.  Oh well!

So presentation #1 went great!  Presentation #2 is in a couple of weeks.  We will be presenting to the Pebbles Project group which is a nationally recognized organization that is comprised of hospital administrators, architects and anyone involved in new hospital development.

So this group is eager to hear if the new facility was built in a way that improved noise levels.  Unfortunately, it was not.  But we will break the news to them gently!

Friday, April 12, 2013

Chief Complaint: ???

Once a week we go to Firm Rounds with all the nurse practitioners and physicians in the hospital that can attend.  Each week a different "interesting case" is presented.

I don't work every Firm Rounds day, so I don't go to every single one of these. But, when I am working I almost always go. And it's usually a great learning experience.

Until yesterday.

I walked in, sat down in the back and looked up at the power point projected on the large white screen.

Chief Complaint:
Vaginal Flatulence

What!?!?  Really?? We are going to talk about a teenage girl with vaginal flatulence for an entire hour?

No thanks! My first thought was to out of there very fast.  My second thought was to text the other APN I was working with to tell him the exciting topic.

He almost immediately text me back: "That sounds horrific. I'm definitely not coming. In fact, I threw up in my mouth just now."

Ha! And so there I sat, the lone PICU representative, through the entire hour listening to this crazy case.

And I'd love to say that I learned something incredible.  Or even just something.  But, really, I just came away laughing.

Mostly because the only thing that I can really remember (I must have blocked out a lot!) is the moderator...a male doctor in his upper 60s or 70s...who said, "I was told the other day by the head of surgery that everyone has vaginal flatulence.  Everyone.  It's very common."

Then there were snickers around the entire room.  And then he turned a bright shade of pink as he realized what he said, and responded, "I mean, I don't have it.  It is still very common...just common for anyone who has a vagina."

And yes, there were definitely more snickers from around the room.

So I guess vaginal flatulence made for a very interesting, if not entertaining chief complaint.  At any rate, next week can only go up from here!

Wednesday, April 3, 2013


There are some patients that I just fall in love with.  There are some that steal your heart from the minute you say hello.  There are the ones that make you smile, and the ones that make you laugh.

And then there are the ones that despite being quite the snarky little 3 year old, are JUST.SO.CUTE!

The latter is the case for my patient who I've taken care of the last 2 days.  He was quite the sassy little three year old who when being polite was so much fun to be around.  And when his dad made him mad, he said things like "Shut Up Dummy."

Yea, that takes away from the cuteness.

So on day one of taking care of him, he was admitted to the PICU after a failed sleep study.  Day two he had his tonsils and adenoids removed.

Being in a lot of pain after his surgery, he was much more reserved, and really just wanted hugs and cuddles from his family.  He didn't have the spunk or energy to give the sass.

But he still had the energy to give me a compliment.  As I was leaving the room, he was saying something that I couldn't understand.  He was changing his voice and kind of mumbling, I think because his throat hurt so bad.

So I asked him to repeat it.  About 3 times.  He was getting frustrated that I couldn't understand what he was saying.  He said it several times, louder and louder each time.

And then finally, there it was.


I couldn't help but laugh. Really hard actually! Because the truth is, I've always disliked my eyebrows.

They are about 10 shades darker than the hair on my head.  They don't seem to match my skin tone. They can be a bit unruly. In high school, I (accidentally) shaved an entire half of one eyebrow right off...just when you think things can't get worse!  And I can't even quote Dumb and Dumber, because no, taking half an eyebrow off does not redeem an already bad eyebrow.

And now that we've taken a turn in this post I'm sure you were very much NOT prepared for, let's reign it back in!

So here was this 3 year old, who could have given any compliment he wanted, or none at all, and "I like your eyebrows" was what he chose!

That was the highlight of my day.  And that just may be the cute patient highlight for awhile.

Every time I look in the mirror and think "Ugh, those eyebrows" I know I'll smile thinking there's someone out there who genuinely, truly loves them : )

Saturday, March 23, 2013

Caribbean Vacation Recap

Yes, it's true. The vacation came and went.  And I've been at works for 2 weeks now!

I think that somewhere deep down I believe that if I don't blog about work, then I'm not truly doing it.  But the weekends and nights that I've put in since I've been back would beg to differ.

I must say, vacation was awesome.  Amazing, actually!

Not only did I have 18 glorious days off, I spent 13 of those in some gorgeous, amazing places with my best friend (that would be my hubby!).

Jonny and I spent a day in Miami before our cruise, and a day in Hollywood, FL the day after our cruise.  The 11 days in between those were spent on a cruise boat going to islands in the Caribbean.  Yeah, not a bad life!

We did a lot of walking and architecture viewing in Cartagena Colombia.

We spent a day lounging on the white sand and floating in the crystal clear waters of Aruba.

We took a ferry out of St Thomas and spent a relaxing day on one of the most popular beaches in St John (so did about 1000 other tourists, so that was the only downfall, but the beach was seriously gorgeous!)
*For some reason the pics from here mysteriously have disappeared momentarily...gotta have my IT man recover the mystery place I uploaded them to!

We took a speedboat tour in St Martin in which we went to several amazing snorkel spots and a few great beaches.

And we tried Stand Up Paddleboarding in Curacao paddling our way through the ocean and into the Caribbean.  This was my favorite island of them all (although St Martin came a close second). The people were so friendly, the water so crystal clear, the ice cold beer so refreshing!

I actually loved Curacao so much I kept a look out for hospitals there...just seeing if they needed any APN help.  Good thing we never spotted one because Jon would have literally had to drag me off that island!
This is what I call "Rock Star Paddle Boarding"- oh yea, I made an entire new sport out of it : )
And of course, we enjoyed our nights back on the boat, taking in a few sunsets, and eating some great food!

Ahhh, those pictures take me to a happy place!  I love looking at them because it takes me right back to the scents of coconut,  the sight of crystal clear waters, the feel of soft sand beneath my feet, and the taste of a tropical drink (or rather beer, because lets face it, while "tropical drink" sets the scene better, I don't really like them all that much. What can I say...I'm a simple gal!).

There is no place like vacation.  Unless you love your bed as much as I do.  And then there's no place like home to come home to after an amazing vacation!

I'm going to revel in these pictures, and the memories, for one more night.  And then it will be back to blogging about PICU at its finest!