Monday, December 20, 2010

Last Minute!!

I am finishing the shopping I need to do Wednesday. Nothing like waiting till the last minute, eh?

It is just a few little things, and it will be fun! Well, as fun as shopping can bed since I really dislike it to begin with. I do plan to take advantage of the after Christmas sales and at least look around.

The greatest gifts are still the simplest:


the things that cannot be bought but only gifted. These are the best gifts.
Happy Holidays.

The First Christmas Without Mom

My mom passed away Sept., 22 as many of you know. This is the first holiday season without her. I am sure it will hit home a little later, but at this time, I just know she is enjoying all the lights and spirit from another perspective.

With her Alzheimer's she, and I mean "her", who she is/was - well, she was gone a long time. The season will be less painful with respect to watching her not be able to follow our family conversation and the sadness and confusion in her eyes of knowing she doesn't know but not really knowing what it is she is not following.

Wierd, I know...

We all miss her, but she is in a better place.

Saturday, November 13, 2010

For Health Care to Work...

There are many levels of change that are required if we really want to change health care. Here are just a few with (hopefully) brief comment.

1-Culture: The idea that "I can do what I want and live the lifestyle I want and when I need to be treated, I should get all the treatment I need regardless if I can pay for it or not."
If you have something like open heart surgery and you continue to smoke, not exercise and refuse to change your life, then you don't get another shot...especially if it was on someone else's dime in the first place. People must decide to make an investment in their own health. There is personal responsibility required. Which brings me to the next thing...

2-Doctors should be able to tell you "no." They should be able to be brutally honest with their patients, and not get sued.

3- Consequently, I think there should be greater education on the "after surgery" part as much as what the surgeon will do when he is operating on you. The recovery is very much the patient's responsibility. But the doctors have to give a realistic picture of what that recovery will entail. I hear people all the time say, "If I knew it would be this hard or like this, I would not have done this."

4- An end to the " I deserve this" mentality. EX: Patient comes in, has smokes in his back pocket, hundreds of dollars of tattoos, the latest, most expensive smart phone, and has expensive clothing and yet tells you he cannot afford the blood pressure medicine. But the patient feels like he deserves your best service, to be fed, and pampered and can be rude to the staff.
WTF??? PRIORITIZE YOUR LIFE. Because now, since the person was too idiotic to spend his dollars in the correct spot (i.e. BP meds), this person has had a stroke from too high blood pressure, his right side no longer works and is now disabled for life. Wow, the blood pressure meds are looking PRETTY inexpensive now.

5-Frivolous lawsuits. Just because something bad happens does not always mean it is someone's fault. Life sucks that way sometimes. We need a screening panel of doctors, nurses, and non-medical people with at least a 4 year degree to review lawsuits to determine if it has merit or is just bullshit.

6- And with reference to #5, doctors need to be trusted. Doctors have to order ever damn test in the world to cover their asses even when their experience tells them the tests are unnecessary. But on the tiny, minuscule chance that something can go wrong, they do everything imaginable to cover their butt. And it's ALL expensive.

7- Tell you doctor the f'ning truth. Don't lie to him because your labs won't lie. "No, I haven't used cocaine in several months." Really? Then why is your toxicology screen positive for cocaine and marijuana AND barbiturates??? Just wondering. Just tell him the truth.

We need to remember something about medicine. The reason its called a Medical Practice is because that is what doctors and nurses are doing...they are practising.

Medical care is not a product - it is not something you buy that is pristine and perfect and if it does not do what you want, you get a refund. Medical care is a service and at times, it is really hard to do. The vast majority of service providers in health care are interested in caring for their patients to the best of their ability. But it is never perfect and never full proof. With honest communication (see #7), it can be a great service.

Lots has to change for health care to get better. That change has to be in the community, in legislation, in how docs get paid and with personal responsibility. So many levels of change...
Wish us luck!!

Saturday, October 23, 2010

Because it's funny...

To Begin Again

I have recently (and finally!!) found a new martial arts program. It is training with people I have trained with before but who are developing a new style.

MaruDo is the style name and it most resembles a combination of traditional Japanese Karate and Ike Jujitsu. Weapons will be incorporated as well but it will be later. The Ike I knew would take forever to learn, but I still love it. The Karate I knew would be different but I thought might be easier to get on board with.
But, alas, I am wrong.

Having to retrain and unlearn 10+ years of muscle memory is a pain in the butt. It is coming along but a constant vigilance is required in order to learn and unlearn. Not to mention getting all of those muscles back in that kind of shape! Every class leaves me drenched in sweat and sore for a couple days after.
I totally love it.

I really am enjoying this new style because of how it incorporates many different aspects of the many branches of martial arts. The Karate half mandates that the body be a whole piece (very Tai Chi), moving in a continually connected fashion both physically and psychologically. The power you can generate when you “get it” is fantastic, but it is hard to do when 10 years is arguing against you! It feels so fluid and lighting fast, it is just going to take slow, steady practice to get there.

But that’s OK, as I am a patient woman. Anything requiring sweat, personal growth and perseverance matched with continually sore muscles is my cup of tea, and yes, my cup is empty.

How Hard is Too Hard?

One of the docs and I got into a discussion about the future work ethic of the medical field. He is a well experienced MD, and is a little aghast at some of the changes in medicine happening with each passing day. He told me that new MD's have mandated naps and breaks in long 16 hr shifts, don't do surgeries the day after they are on call were a few of the "changes" that administration has put into play in an effort to reduce medical errors. His research indicated that none of these changes had made any difference in error rates over the last few years.

His question was this; when a patient goes south and it's an "inconvenient time" will the new MD's being trained today be able to deal? He sees that the work ethic is just not there. Not to say these newbies aren't driven and determined, but sometimes the only way to be ready is trial by fire. Medical training is supposed to be awful and hard and difficult with sleepless nights because when it goes badly, you need to have walked that path before. Residency is when you are worked to death so you learn how to keep surviving while there is still a safety net.

Twice this week we have had patients crater at really bad times. One had to go to surgery from 12 Am to 4AM - that MD had already put in a 12-13hr day seeing patients. The other was on the unit. That MD had finished open heart surgery 4 hrs before and ended up massaging the person's heart with his hands for an hour and 40 minutes in an effort to save the patient. This had to be done with the bare minimum of resources as it was on the unit and NOT in the OR.

The only way to be able to deal in those situations is to have been forced to do it before.
Some things are supposed to be hard. Otherwise everyone would do them.

Relationships and Caring for People

A co-worked and I talked about how long it takes to develop a relationship with your co-workers and the doctors who are regularly on our unit. Taking care of critically ill people is a game not played alone. When the fecal material hits the rotary machine, it is ALL about the team. None of us could do our job without our co-workers and that includes, our fellow RN's, the MD's and our respiratory therapists.

But these relationship-this trust- takes time to develop. I have been on this unit for 2.5 yrs now and love my co-workers and my MD's. There is one MD I have worked long and hard to develop a relationship with and a few weeks ago, I gave a run down of a patient's condition when he came to assess. Of course, the patient would not do any of the things I said he did for me because I had just given the patient sedation (timing!!). When I went to pause the sedation he said, "That's OK, don't worry, I trust you."
Wow, such powerful words.
It only took 2.5yrs.

We each are responsible for our patient's well being and yet all of us are responsible together. It just takes so much time to know how your fellow teammates work, think and act, especially under pressure. Having worked with one set of MD's longer, I know exactly how each of these docs work. I know what I can do and what I have to call about. That took time, but time I happily invested.

Working in the hospital is not like other jobs, people die, and your actions can and often do improve or make worse a person's situation. It is a huge responsibility, not just the liability; but for the truly vested, it is about your conscience. We really do care.

I still make mistakes every day, I learn and go on, because dwelling on them only leads to more errors. But I know my team believes in me and supports me, just as I do them.
I relationship I gladly nurture.

Thursday, October 21, 2010

Kate Update

My dog Kate has settled in nicely. Her separation anxiety has subsided almost completely and she is learning her obedience dutifully. Her comic streak continues to emerge in hysterical fashion.
My favorites to date are:
-she does not like to walk on fallen leaves and watches closely on walks to avoid stepping on them
-She loves wood floors. When she chases her toy she purposefully pounces on it and slides with all four feet across the floor obviously enjoying.
-To combat her separation anxiety she still raids the laundry hamper to have some clothing with her while she is on her dog bed. (It's always the work-out gear that REEKS!)
The best part is how affectionate she has become.
Actually the best part is I have a regular, always enthusiastic running/walking/biking/hiking partner!!

Another Phase in Life

September 22, 2010 my mother passed away. Her health had declined rapidly over the last two months prior to her passing, but still, it took myself and my four other siblings by surprise.
There was just that call, "I am so sorry, but I have to inform you that your mother passed away earlier today."
In our shock, sometimes are responses can be almost comical as was my brother's, "What, you mean she didn't fall out of her wheelchair??"

I have to wave the flag of gratitude as my siblings and I were all on the same page as to what Mom wanted and what her last wishes were. One task that was largely painless.

There are many feelings I did not anticipate with her being gone. The major one is how much of an orphan I feel like. My father has been dead for many years, 19 to be exact. My mom had mentally been absent for many years what with her late stage dementia. But she's just gone now. It is different in a way a did not anticipate.

Truthfully, my family and I are grateful that her end was quick and without some extended hospital stay. Although her skilled nursing care facility was top-notch and beautifully run, it still was not her own home. We all hated that fact for her and we are certain she did as well.

At any rate, life seems to march on regardless.

Thursday, July 29, 2010

2 Years out

June marked my 2 year anniversary working as an ICU RN. I love what I do.

I am just about ready to go back to school. I would like to start next fall for my masters. If I could get this out of the way, then whenever I am ready I can teach.

The one thing about nursing, that RN allows you to do almost anything. I have so many choices. My 10 years+ of research experience lends me some rather unique opportunities as well. I am so very happy where I am at, it will be a while before I am ready to do anything different on a full-time basis.

As with any job, there are things that are not so fun, but over all it suites me perfectly.
That 05:00 alarm is at the top of the "Bleh" list!

Will Euthanasia ever be Allowed

Not to go all Kevorkian on you, but I have to ask if the right to end one's life by choice, or the life of a family member with some horrible life-ending disease will ever be allowed.
I and my family currently have the responsibility to care for my now severely demented mother. It is a time, emotional and financial responsibility.
Recently, she was in the hospital and upon her return home, this event has proved to be a tipping point of sorts.
She is no longer her; meaning, she has no recollection of how to be her or who she is/was.

As I sat and held her the night she got home, she cried and cried because she did not know where she was. She did not know how the bruises got on her hands. These were from the IV's she kept pulling out. She is in a constant state of fear and unknowing, a constant state of unconnectedness. She cannot care for herself even in the most basic of ways.

How is this living? How is this not suffering? Believe me, I don't want bad things to happen, but I would give anything for "her," her consciousness to come down, observe herself and talk to me.
Would she want to continue on like this?
How would she feel about our upcoming decision of having to have her be in a skilled nursing environment? She cannot live with one of us, she would be dangerous to herself and to the household.
What would she say?

Working in the ICU, I see many people watch in anguish and pain as their loved one approaches the end of their life.
Why do we currently feel like we have to allow people to come to their end, slowly, painfully and without dignity?
I guess really, the question is why are we so afraid of death?
What would the people say who are lying in the bed, if given the opportunity and ability to answer one last question: "If you can end it all right now, do you want to?"

I think this is a question our society will come to face, very, very soon.

Wednesday, June 16, 2010

Kate update

Kate has settled in nicely into our lives. She is a wonderful dog and I am so happy to have her. Her list of "learning experience:"
-broken the front window twice
-has learned to test the electronic collar, when it doesn't beep, she goes over the fence and to John's house.
-discovered my stuffed walrus is NOT hers
-Learned sit, down, shake, speak. Come and stay are in progress and doing well.
-Crate training is not going well.

My hope is that she will be able to be in and out of the house eventually. Right now she has to be outside when I am not home. The window replacement is a pain.

The Prep for Stugis

Our annual driving trip this year is to Sturgis, South Dakota. This is where the largest motorcycle rally is held every year. This year is the 70th anniversary. We both know this will be, um, "outside the box," but life is a buffet, right? Meant to be tasted, watched, smelled, touched and sampled. I can't WAIT for the pictures. John is of course going with full camera gear.

We are hauling the bikes up and then will be riding all over the place. On the "must do" list is Mt Rushmore and general riding in the black hills. I can't wait to see it all. The weather should be ideal, which is important as we are camping. We are currently trying to settle the trailer issue and have a good lead thanks to a good friend. Wish us luck!!

Monday, May 03, 2010


This past weekend we went for a nice long ride with another couple who are also motorcyclists. The weather was ideal, the company superb.

I found myself laughing on numerous accounts at how much you can communicate with a helmet on, the sound of motorcycle engines and, in my case, earplugs. I was reminded about the communication signals used while diving...

At any rate, here is a synopsis:
-pointing at the tank = "I need gas"
-fingers and hand drawn across your throat = "It's dead"
-open hands thrown to the side = "What is wrong? It won't ____"
-Open hand to the front of your full face helmet = "Blowing you a kiss."

It was fabulous riding and great laughs!
Life is good...

The Pendulum Swings Back...

My friend KP mentioned something that I feel I have to comment on. She said she thinks the era of convenience is on its way out.
I think she is on to something.
We have found, as a society, that fast and easy is not always good. It, actually, is seldom good.

Fast food has given us record obesity and a shorter lifespan for our children.

Paying someone else to raise our children has proven to be a bad choice as well. More and more couples are deciding one of the parents needs to stay home.

I think society is finally figuring out that quality needs to trump quantity-or fast-or easy.

Sunday, March 28, 2010

Dog vs Armadillo

We were at the farm this weekend in Oklahoma. John's family has farmed for generations and we were out walking some of the land that borders the river. Kate was of course along for the weekend and she needed some exercise to more relaxed while in doors.

Lots of romping through the shrubs flushed an armadillo. A real live, not-run-over armadillo.
The chase was on!!

Kate chased the armadillo into a burrow and by this time we were all in pursuit as well. As Kate lost interest in the armadillo's boring burrow, she walked away when to everyone's surprise the armadillo came back out!

The chase was on again and with some barking this time.
It was fine entertainment!!
Armadillo vs Kate = DRAW!

Sunday, March 21, 2010

Cutting health care costs

If you want an excellent example of why our health care is so expensive, please watch the youtube video below.

As crazy as this link is, it is completely true.

Reducing health care costs could start in a few simple places:

1-No family member (nor anyone for that matter) should have the ability to revoke a DNR. The only person who should be able to revoke a DNR is the person who make the decision in the first place. We see this all the time: The 91 year old person who has been a DNR for a few years, goes unresponsive (hello...he is dying...!) and the family says, "Oh no, do everything you can!!" When the patient wanted to let nature take its course....So we tube him, put him on gobs of expensive meds, so we can prolong his death until his family deals with their unfinished emotional business.

2-Allow doctors to be doctors. Many end of life decisions should be removed from the control of the family. I know that is a sore subject, but it is true.

3- Change in attitudes: Health care is so expensive because our culture believes it should be a 5-star hotel. People have the attitude that they should get what the want, all of what they want, all the time. The attitude of "You owe me," must change. An attitude currently rampant in many other areas of our culture.

4- Protect doctors. Someone died, because they were very, very sick, yet it has to be someone's fault. This is crap. Bad things happen but it is not always someone's fault. Yes, when health professionals make egregious errors (read cut off the wrong leg), these errors must be dealt with, and yes, some people should lose a license over it. Sometimes it just goes badly and no one made a huge error.
We have to get away from the attitude that every bad thing is someone's fault.
It's not. We also have to end stupid, ludicrous lawsuits.

The changes that need to happen to make health care more financially agreeable will mean less of what everyone refers to now as "customer service." It will be less control for the patient and the patient's family. It's a hospital, we are trying to save lives. Quality of life has to be a major factor in the equation, not unfinished emotional business or worse yet, no one wants to let him die because he is worth a lot of money - this last thing sickens me.

In the words of one of my fellow nurses:

"I can't prolong your life, but I can prolong your death."

True in ways you would be frightened to see....

Sunday, March 14, 2010

Kate Update

Kate is settling in nicely. She is calming down, her separation anxiety becoming less and less an issue. Her obedience training is coming alone. Sit, Stay, and Down are starting to be executed readily, although she is a bit stubborn.

Exercise is required, as she is a high energy dog. When walked and exercised, she is wonderful.

Yeah! New doggy!


Thieves suck!!!

Last week my iphone was stolen at the gym. Sadly, I am now well versed on all the software and options for protecting your data and inactivating your phone.
This sucks!!

My whole life was on that phone. Now, I am trying to wait for my upgrade option time, (2 months) and decide if I want to purchase the MobileMe option that lets you remotely wipe the phone.

So frustrating!!

Monday, February 15, 2010

Our trials can be others' gifts.

I have a friend who is battling cancer for the second time. She has a wonderful husband and two small boys. It is just unthinkable that she would be battling this AGAIN at such a young age and at the prime of her life.

Her attitude and the support of her family speak volumes of who she is and what we should all aspire to become. I can only imagine what this type a struggle is like, but I know from watching her progress and reading her posts, I am thankful for her healing and her heart.

That's how I think it goes sometimes. One person's struggle can teach you so much. Simple because you root for them so intensely. I want nothing more than for her to be healthy, cancer free and watch her two young boys graduate college and have kids of their own one day for her to spoil.

Just knowing I feel that for her, makes me realize how much her battle has taught me. How much it has taught me to be thankful people like her are in this world.
And I want her to stay.
A really long time.\
Go Debbie!!

Kate and John snuggling!

Kate snuggled right up to John, melting into his lap and being oh so comfortable! She is starting to respond to her name and doing pretty well. We have a few challenges, but she will be all worth it!

Meet Kate!

Here is Kate! I adopted her on Sunday! She is settling in well and very smart!

Tuesday, January 26, 2010

How Will We Change an Attitude?

Edmund Burke

“ The only thing to allow for evil to triumph is for good men to do nothing.”

How do you teach people to forgive and not to hate? I just finished watching Tears of The Sun starring Bruce Willis. The story line is of a navy seal unit assigned to extract an American doctor from Nigeria since the rebel dictator murdered the democratically elected president and took over. She, of course, will not leave without some of the people she is caring for.

Watching the movie, I could not help but think of our own in Iraq and Afghanistan, apartheid from years past, even our own, on going battle with racism.

I think we have proven beyond any standard deviation that one nation, one culture, cannot transplant an ideal to another culture.

A culture can only come to a new way of doing things in their own time.

We cannot transplant democracy to Iraq.

We cannot walk in and tell people to stop hating another person because they are of a different religious faith, a different skin color, or a different language.

No amount of ammunition or force can change those things.

So, how is it that one person, or one nation can offer support to those ideals most conducive to peaceful, beneficial existence?

What do we offer for support for a people to protect themselves and their family, much less something as lofty as ideas?

Do we sell them weapons?

Give them weapons?

Do we educate them?

How do we teach them to grow beyond what they already are? To grow beyond where they are?

How does a culture change within itself?

What is that process?

It is a difficult question with no answer that is universal. Some of these things, we here in the US still struggle with intensely.

I do not think going in and solving problems for others really solves anything. People must learn to be self-sufficient. It is the same when raising a child, a pet, or a nation. Everyone has to have ownership of a culture, of a life.

Not to harken back to Biblical scripture, but, give a man a fish and feed him for a day. Teach a man to fish and you feed him for a lifetime.

Even still, I think the man must be willing to learn.

Friday, January 22, 2010

Fresh Veggies!

My tomatoes and broccoli are sprouting! the garlic is crazy already!

I planted three varieties of tomatoes and one of broccoli in my indoor seedling starter kit. They seem to be doing well so far. Little green sprouts are coming up. I will have to leave the top of the little greenhouse box off soon.

Keep on growing!

Already Mid-January 2010

Wow, it's already mid January in the new year! I always have this vain hope the new year will pass a little more slowly than the previous.
Alas, I guess not.

Is it that the ratio of lifetime to one year gets more skewed as you age? Is this why time seems to fly by at an ever quickening clip?

I can remember as a child, awaiting the beginning of a new school year feeling as though summer would NEVER end. I was one of those kids that loved school....

Now I think, it is December again, already?? How did that happen?

Is the pace of time perception quickened by our state of busy? Or our endless responsibilities?
And yet, that watched pot still does not boil....

The questions of perception fascinate me.
I guess I can just try to stop and smell the roses!

Wednesday, January 20, 2010

Favorite Side Effects

Below are a few of the best "side effects" patients have listed as to why they do not want a particular drug.
  1. Ambien: "It makes me drowsy" (Isn't that the purpose??)
  2. Morphine: "I see my dead relatives and it creeps me out." (This is valid...)
  3. Zofran (an anti-nausea med that does not make your loopy like phenergen): "It doesn't do to me what I want." -> These people always want the phenergen....

Some of side effects listed that are funny, but I don't remember the drug associated:

  1. "That makes my teeth hurt."
  2. "I felt like someone was holding me down." (I did not ask whether there were restraints involved.)
  3. It gave me anal leakage. (yeah...)

There are a few gems for your enjoyment.

Thursday, January 14, 2010

Breckenridge 2010

Our ski trip is again great fun! We all wish for more snow, but the slopes are groomed and the icy, slide-E parts are avoidable. I have done a great blue-black this trip and will continue skiing this trip. I won't say no to snowboarding in the future, but it has been great fun being able to hang with everyone and ski together. Never would have happened had I boarded.

I have not wiped out too badly either, falling only a very few times. However, I have had this crazy time of falling while getting off the lift. I have done this three times, at varying degrees of hysterical. The best was was my basically getting behind my skis and sitting on my skis while sliding on my palm all the while removing myself from the lift line. Janell pulled me up and they did not have to slow the lift. It is hard to get up while laughing hysterically.

The wrong turn by one of the group was also film quality distress. My choices for skiing were: mogels, grass, rocks, or ice.

Needless to say there was much falling down the slope. We made the mental note to never, NEVER do that run again. It was truly funny though.
Like I said, one of my goals this year was to laugh more....
Mostly at myself.

Thursday, January 07, 2010

Car Maintenance

I took the Subaru in for its 105K maintenance. Not as expensive as I thought it would be but pricey enough.

I intend to drive the car until it throws its wheels up into the air and cries "Mercy!" No car payment is dreamy and I don't want another one. My goal is to save up now and pay cash or lots of cash for the next one.
I see no reason to ever buy new again. You can get that "new car" smell in a bottle if you so desire, and for a lot less money.

I have decided my next auto purchase will be a medium sized truck. So many times I have needed the functionality of a truck! John promises to let me drive his sports car at least once a week if I buy a truck, so the deal was made! We will see how long the Subaru lasts, but I think, short of an accident, it will last for some time.

It drives much better now too. I don't fear dogging it at this time either! I will try very hard to avoid speeding tickets!!

Ski Time Yet Again!

Saturday we leave for Breckenridge, CO. Ski-time is here again! This is unofficially mine and John's anniversary trip as this is where we got to know each other three years ago. Although I would not want to live in solid snow for 5 months out of the year, I love to visit, play in the snow, and ski.
Yes, just ski.
I believe I have, for one of the few times in my life, admitted defeat.
I have decided unless you live there and started snowboarding at a younger (read immortal here) age, snow boarding is just too hard to do once a year. I mean, I'm on vacation....

Skiing is great fun and I get a little better every year.

It is always a great time!
I do, however, have to get some diving in this year!!