Monday Saturdays are the best!

Happy Saturday to me...Happy Monday to all the rest of you! Unless of course you're also a nurse and worked this weekend! Then YEAH for Monday Saturdays!!!

I don't love working weekends. BUT- I do love having days off during the week.

And in all honesty, working weekends can have its advantages (which I'm sure I've mentioned before here...that, or I'm having some weird blogging deja vu). Weekends are MUCH quieter at the hospital, much less people to put up with, and just a more relaxed feel.

And, working weekends is good for my diet. I pack my lunch the night before, and whatever I take to work I eat. Since what I pack is healthy, what I eat is healthy! Pretty simple. It's the other weekends that we have to worry about...ugh!

Anyways, having Monday's off every once in awhile is nice. It makes running errands much quicker. There are certainly way less people at the grocery store on a Monday morning vs a Saturday morning.

Monday Saturdays also allow me to have catch-up coffee dates with other Nurse Practitioner friends which is fun and much needed!

AND Monday's are 25% off my favorite thrift store, so even better!! I went in to get a few (hopefully) dress shirts for work now that I can't wear scrubs anymore...or at least won't be able to once I start...and walked out with all of this:

For just $33!! Holla! That's right...while I only came away with one shirt and one dress for work, I also got a black pair of leggings, a GA Bulldogs comfy baseball tee, 2 summer dresses, pair of board shorts, tank top, 3 belts, 2 necklaces, and a decorative "L" (which I will paint to match our decor!).

Yes, once again I LOVE thrifting. And I love my Monday Saturdays!!

Hope you had a great weekend...and if you're a nurse who worked this weekend, then I hope you enjoy your weekday weekend as much as I am!

A month in Recaps

Where in the world does time go!?!? I'm not in school anymore. I'm not having to spend 40 some hours in the PICU at my job, and 24 hours in a PICU for clinicals...on top of keeping up with the course load of 3 classes or so!

So seriously, WHERE DOES time go!???

I have been scolded three times in the past week for not keeping up with my blog. One out of town friend says the only way that she knows what's going on with me is by my blog. Another co-worker says she misses my funny PICU and poop stories (which let's be real, the poop stuff got so drowned out by all the school stuff for SO long...which I guess school could be classified as "poop!" most times...what a weird "coming full circle" game!). And a third just said she was disappointed in my lack of blogging!

So in efforts to keep my friends and family informed, to throw in some poop (eww...really!?), and to not have co-workers disappointed, here I am presenting my past month in recap form.

It has been a crazy, fun, up and down, tiring, exciting, amazing month.

My last post I talked about Denver. It was not the most pleasant time that I've ever had, but it was fun to be away while the husband was away. What WAS fun about Denver was this:

Who would'a thought I would LOVE skiing!? OK, I knew I

liked skiing! But who woulda

thought Jonny would have loved it so much!? Yet another reason I love

this man!

And then when I got home from Denver, I was offered this:

OK, maybe not ALL of this...but at least a tiny portion of it...

Because I am officially a:

Oh, that's not really clear as to what those people are...well...

I'm officially a Pediatric Nurse Practitioner....with a JOB!...

in the PICU!!!!!

I know! I couldn't drift too far from what I love!! And I guess by "too far" I mean I couldn't drift at all. Because while I am changing positions and titles, I'll be in the exact same hospital.

I am so excited about this for so many reasons!

First, I have a GREAT team of nurse practitioners to work with, to learn from, and to train under! Second, with the grant I was just given for my research project it would be painful to leave that in the hands of someone else to complete! Third, it is scary enough to go from RN to APN...so it'll take some of the "scary" (and downright terrifying, horrifying...OMG I could really kill a kid fear!) out of not having to adjust to a new hospital with new policies, and new people, and new...well, everything really!

There are a ton of other reasons that I am so excited about my new job, but I'll save that for another (probably equally as long!) post!

And then finally, for the past 2 weeks I have been doing this:

That's right, Jon and I escaped to Hawaii for 2 whole weeks...one spent in Maui and one in Kauai. And the above 3 pictures only scrapes the surface of the amazing things we did. We jumped in caves, went to beaches, and took a doors off helicopter tour, yes!

But we also went to secret beaches, hiked through the rain forest, ate fish straight from the ocean, saw whales in their natural environment, took a boat ride with a school of dolphins, watched a sunrise on the top of the mountain, saw more stars in the dark night sky than I could have ever imagined possible, took over a thousand pictures, and made what feels like more than a million memories!

While some of these memories include the both of us getting the flu and knocking us out for 3 days in Maui...and me completely wiping out on top of (and quite close to the edge of) Mount Haleakala and scraping up my entire left shin, hip and arm, only to stand up and shout out to Jon "I'm OK" even though my insides were screaming...and getting sand blasted one day because winds were "under advisory"- yeah, we STILL came way LOVING Kauai! What a great trip, a great time away!

Throw in some fertility stuff that we've been dealing with, and there ya have my last month in recap. I think it's perfectly fair to say that we fully covered the "crazy, fun, up and down, tiring, exciting, amazing" month!

What have you been up to this past month!? Please, catch me up!!

All Snowed In...or at least that's what I'm telling myself!

It's snowing here in Denver. As I look out our hotel window, I see the beautiful snow capped mountains and a whirlwind of blizzarding snow! Beautiful!

OK- not really! That's what I'm imagining! What I really see is the hotel parking lot in front of the highway...and some snow flurries!

But I'm telling myself that with the way the snow is coming down, there's no way I can venture outside! Which means my running shoes won't see the light of day...and hey, maybe my "real clothes" won't either!

I'm just feeling like it's one of those stay in comfy clothes-drink an extra cup of coffee-catch up on reading and tv kinda day!

It's probably b/c I'm tired, and probably because despite being away from work, I still have "work" to do. The Noise Study I told you about yesterday is a seemingly never ending project!

But, a few hours yesterday, a few today, and a few tomorrow and the bad boy should be absolutely complete and ready for submission to the Nursing Research Council and IRB. And then we'll get it back and have to spend another 10 hours or so on editing from their recommendations.

So yeah....never-ending! Just 'cuz we got the $$ doesn't mean the process is over...ugh!

And speaking of the grant that I got, I learned yesterday that the study was one of only 4 chosen...out of 25 applicants!

I was excited about my accomplishment before...but that was when I assumed that there were 4 applicants and we all got chosen! So this made it even more awesome! And what's more, my co-principle investigator told me that we were BY FAR the youngest investigators to get approved...everyone else was well into their upper 40's-50s.

So there! Just b/c we're young doesn't mean we're not smart! I'm not sure who says that, or why I feel the need to defend it, but hey, it doesn't hurt, right!?

But enough about work. I'm going to go back to my extra cup of coffee, turning on the tv, and flipping through my magazines...all while staying in my comfy pants. I mean, with the blizzard going on outside, what other option do I have!? : )

Hope you have a wonderful pseudo- snowed-in kind of Tuesday as well!

Not Missing what I'm Missing

For the past few months, I have been working my booty off to complete a 50 or so page application to obtain a grant for a research study I've been wanting to do in the PICU.

Whew, that sentence was even exhausting!

A few years back, I did a quick study on noise levels in our lovely PICU. The results??? We are WAY too noisy! As are most other PICUs across the US...and most other hospital units in general.

Seeing as noise is our number 1 complaint on our satisfaction surveys, I wanted to do a better research study on this...and attempt to improve it!

But I certainly couldn't do this study without funding. This is where the Shaw grant came in. So I recruited a friend who is way more versed in research than I am, and we became co-investigators in the PICU noise study.

After a few months of preparing the Shaw Grant and figuring out all the details of our study, we turned in our 52 page application. This was after 2 meetings with the research head who gave us less than ideal feedback.

So we basically were not super hopeful that we would get approved...and if we did, weren't sure they would give us ALL the money we were asking for!

But, about 2 weeks ago, I got the call that we were accepted!!!!

And ALL of our requested money was approved!

Holla...to the tune of almost $15,000!!!!

So the Grant reception is today. All of the recipients of this award get to go up on stage (isn't this everyones dream!?) and receive a certificate and flower. Except I don't get to go.

I'm missing my carnation and certificate ceremony for this great accomplishment!

But I'm not disappointed!

BECAUSE....I'm in Denver!! And since Denver is not home, that means I'm on vacation. It was a very last minute thing, but Jon's company sent him on a business training here for the week. And I decided that I definitely needed to tag along.

So I have a bunch of magazines to catch up on, my new fancy schmancy camera that I got for Christmas that I so don't know how to use but am going to learn this week, and my running shoes that will get put to great use on this beautiful mountainous/hilly terrain!

Yeah, so I'm not missing what I'm missing back home! I'll be perfectly content to enjoy all of the beauty and food that Denver has to offer!

Gotta love last minute vacation surprises!

And I know that when I get back, the grant money will be a welcome home prize good enough for me. I never really did care for flowers anyways!

The Waiting Room

Waiting rooms are an interesting thing. I tend to forget what waiting rooms are really like because we certainly don't have them in the PICU. That's what the ER is for (ooh, my ER friends are really cringing at that one...sorry!).

When I do find myself in the waiting room of a doctors office though, it's always an interesting experience. And today was no exception.

I was in the fertility specialists office again early this morning and just found myself laughing. Laughing at how different it is to be a patient rather than the nurse. And then just laughing at all of the other people in the waiting room with me!

First of all, if there is better birth control out there than the following scenario, developing it will allow you to become a millionaire! This couple, who obviously wants to have another child (unbeknownst why to me!) brings in their toddler terror...I mean precious baby boy. This kid is running around the entire office waiting room, screaming, jumping off the couches, and throwing the magazines everywhere!

This is in between him having the nastiest cough and runny nose which of course he is wiping away with his hands and then touching everything in the office...tables, chairs, magazines, doors, the weird little plaster 3-D pictures they have of naked women on the walls...everything! (sidenote: the plaster naked women freak me out a bit!).

Remind me never, ever, to read doctors office magazines again! Or touch their doorknobs for that matter (wow, does that sound a little nurse-germ-OCD or what!?).

So yeah, thinking about having kids? Come to this office with this kid, and it might make you think, "ummm, not so sure about that!" Or it may just make you think about disciplining your kids. Either way!

And then there's the couple that thinks they are the only couple in the entire waiting room. Except there are 6 other couples there. But they are talking about their week, what they want for dinner, and job stuff loud enough for us all to participate in the conversation.

What really made me laugh (and almost chime in on their oh-so-sweet conversation) was when the husband was flipping through a local restaurant magazine and commented that he wanted to take his wife there for their upcoming anniversary. Aww, cute right. She got these sparkly eyes and was about to go on about how she would be so excited when he interrupted her. Apparently while she was swooning, he was reading the fine print which said it would be $110 per person for this 6 course meal (like how I seriously heard EVERY single detail?...I'm telling ya...he was LOUD!). Then he says, "Wow, we should just buy blinds for the house instead!"

Oh there's a romantic for ya!

And then there's the lady who is obviously SO over not getting pregnant that she makes it known to the entire office. This lady is also the only one without her husband, or a significant other in there with her...which I'm thinking may have helped to diffuse some of her anger.

But, she would pick up a magazine, see a pregnant lady and then throw it back down on the table. Pick up another maganize, see a pregnant celebrity and throw it down. This time with a little growl! Then she starts flipping through ALL the magazines on the table, trying to decipher which one may not have a pregnant lady or pictures of baby nurseries in it. Except there were no "Plumbers Weekly" or "Accountants Digest" magazines in the mix. So she just flops back on her chair and starts grumbling to herself.

Oh I told ya that the fertility waiting room is one cool place to be! OK, not really, but at least there is some comic relief if you do have to be there!

And I must say that while I don't love that I have to be a patient there, I am certainly glad that I'm not a nurse there! I definitely wouldn't want my job to be centered around one lady part...enough said!

But more than that, I truly love taking care of kiddos. I love the chaotic, adrenaline rushing atmosphere that is known as the PICU. And I love being able to nurse a super sick, trying to die little one back to the terror that I saw in the waiting room...healthy, vibrant, and crazy!

Now how's that for coming full circle!

The Most Glorious Words

Yesterday I heard the most glorious words from a doctor at work.

Our morning started out with several conversations like this:

1.) PICU Nurse: The patient has been in this position for a really long time. I know that he doesn't really tolerate turning well, but I'd like to take him off the oscillator, suction him, and try to reposition him- it's been awhile since all that has happened. I can get a few other nurses and a respiratory therapist in here to help out. What do you think?

Dr Red (he doesn't wear red, doesn't have red hair, I don't know...just the first thing to come to mind!): Well, I think we should hold off. I'm not sure that we should suction him today. Maybe tomorrow.

PICU Nurse: Well, if he has more desaturations, I'd like to re-consider it.

Dr Red: Umm, ok

*And yes, the "umm ok" was REAL convincing!

2.) a few hours later:

PICU Nurse: The patient's blood pressure is really low. I know that we ordered dopamine for him, but that may take a bit to get from pharmacy. Do you want me to give a little bolus?

Dr Red: Well, I don't think we should give fluid. He's on a lasix drip and may be fluid overloaded.

*The attending physician was standing by overhearing our conversation. She then replied "Nope, we definitely need to give this kid a bolus. Get those pressures up!"

3.) about 45 minutes later I page the doc-

PICU Nurse: My vanco trough just came back really high at 47. I currently have the vanco running. Do you want me to stop the dose and repeat a trough in a few hours?

Dr Red: No, usually pharmacy wants us to complete the dose given immediately after the trough is drawn. We can just re-check a level tonight.

**3 minutes later Dr Red calls PICU Nurse

Dr Red: OK, so I just talked with pharmacy and they want you to stop the vanco. And if you could re-check a trough in two hours, that would be great.

PICU Nurse: OK, no problem.

*Just as I was getting ready to hang up the phone, Dr Red adds "Ohh, and I guess I'm done saying no and second guessing you. Everything I've shot down from you today has been the right call. So whatever else you think would benefit this patient, just let me know."

Oh yes! The most glorious words ever!!

No more second guessing and just trusting us bedside nurses!

Score for PICU nurse!

I think it not only validated that I am a good bedside nurse, but that I am ready to move onto being an APN (aghh, did I just say that...scary!). That I can think about the "tasky" things as a nurse, and that I can think about the direction that we should go in.

So it was a good day. A day that I was able to be the bedside nurse that I know to be, and also step up a bit and help coordinate care more.

But what was most glorious about this, was that it was validated. By Dr Red, by the attending physician overhearing our conversation, and by the entire team.

And this just goes to show you that there truly IS power in words. Glorious, glorious words!

Love/Hate Relationship

Know what I love??? My Job

Know what else I love??? Days off from my job!

Know what I hate? Chopping an entire bushel of onions.

But I guess if I'm chopping an "entire bushel" (do they even still say that word!?) of onions, then I guess that means I have a day off. And I'm making some amazing white chili (recipe from here) which I guess then brings me back to....

Know what I love??? days off that allow me time to chop an entire bushel of onions!

Days off are awesome. They allow me to do things like semi-sleep in. I say "semi" b/c I just can't seem to sleep in like I used to. Waking up at 8 am is a successful sleep-in type morning for me!

But days off also allow me to work out, to get a massage, to open a bottle of wine and sip while I cook an amazing dinner. Yeah, told ya...I LOVE days off!

And if you've ever cooked a dinner where your husband has stopped 3 times to say just how amazing it is, you especially know what I'm talking about!

But days off also allow me to reflect on the 3 days that I've already worked this week. And I've thoroughly enjoyed the patient that I've cared for over the last 6 shifts.

While extremely busy at work, I've thought about 22 times what a great blog post this patient or the situation that I've been in would make a great blog post. And about 21....make that 22...times, I've come home SO exhausted, that the blog post never happened!

So as I sit on my day off (night, now), I am trying to decide whether or not to compile all those thoughts, all those "remember when THAT happened!?" moments into one blog....

OR just keep enjoying the evening with my incredible grateful-for-cooking-an-amazing-meal husband...

Easy choice! The husband!

But I will leave you with one little nugget!

This little guy I've been taking care of (to the size of a 9 month old) is VERY sick. We have him on continuous medications to keep him both sedated and paralyzed. And he's decided that since many of his organs are failing and his liver and spleen have grown to the size of my head, that he only likes to lay "prone" (AKA: on his belly)...except we put a big roll under his groin and his chest to keep his belly and lungs from being squashed onto the bed.

So, in this position, and when on the oscillator (AKA: mack-daddy of ventilators...and yes, I said "mack-daddy!"), we really can't move our patients. But, I'm very concerned about this little guys skin, and especially the areas under the roll with lots of tension.

Enter little 9 mo old penis....with a foley in it. Talk about skin breakdown risk! And what an area! The parents are very aware of this risk. But when it comes to saving his airway...his life!...vs his future manhood, airway is always gonna win!

But, in the interim, step in PICU nurse to consistently check on the said "baby package". And just as I have a respiratory therapist in the room to help me lift, I find a perfect opportunity to thoroughly inspect the skin around said sacred area.

The respiratory therapist helps me gently and ever so slightly lift the bottom half of my patient off the bed. To which I try to inspect the area. Except, when on the oscillator you can't really move the patient at all...so I can't REALLY see the area.

Until I am bent over in the weirdest way possible, with my head in a compromising position on the bed.

And then enter a manager of the unit just happening to be walking by. As she walks by, she just happens to hear me say "Wow, that looks good.....really good!"

And given my positioning, she just busts out laughing in the hallway!

Because truly she understands that as a PICU nurse, I'm not only concerned about the life, and the airway of my patient, but also the little things such as skin integrity. And yet, at the position, and with my apparent word choice, it leaves no other option than to laugh at it all.

And so we set him down the entire 2 inches we have him lifted, and I remove my head from the bed. And then we all just laugh.

But I can laugh and know that yes, this is a great time at work. But I can also confidently laugh knowing that I am providing excellent, holistic, save your life AND your skin...and perhaps man organs...type care.

And that is a good day at work.

And the good days at work lead to better days off.

Which is where I'm at now.

So I leave you- happy, full of wonderful white chili, and grateful for my days off. But also happy for the days of work ahead. Because I love taking care of those that are super sick. I love my job. I love being a PICU nurse.