Real Live Farm-is-ville

I’m Farm-sitting again in Farmersville...No, no not the online Facebook version but with real-live animals!
I actually had someone ask me if I sat and did farmville on facebook all weekend....crazy.

It is so peaceful out here, just some bugs and an occasional bark from the dogs...Very nice. I am taking care of their 5 horses, and four dogs and have my own dog out here with me. Everyone is actually getting along fine. Since it isn’t supposed to rain like crazy, I may even ride some this weekend. That’ll be a twist! Even though I grew up on a horse, I haven’t ridden for a while now. I’ll let you know how it goes.

Right now, I’m just enjoying the quiet.

ANOTHER ugly standardized test!!

Wish me luck!! I have signed up for my CCRN or Critical Care Registered Nurse test. It is quite the “feather in my hat” and I hope I pass the first time!! I don’t want to take it again OR pay for it again.... It’s pricey! Work does reimburse once you pass. Keep your fingers crossed for me!!

A new adventure

I have had an over-powering urge to try rowing, or, sculling as I think it is most appropriately called. I have read some about it, and think it is right up my alley. I have been trying to get into the martial arts they way I need to in order to satisfy my need for physical exertion and it just isn’t doing it for me right now. I haven’t really taken a break from it in about 12 years, so this seems fitting. Sculling is supposed to do the same thing; be a total body workout and be super hard, sweat your butt off and exhaust you. Sounds perfect. The start up memberships and all are a little pricey, but still cheaper in the long run than my martial arts is. I will go give it a try and see. Maybe this will be my next 10 year obsession...

My Civic Duty

I had Jury Duty today. Yeah.
I was one of 65 people who went in to answer that lengthy questionnaire regarding the case we were being considered as jurors.

This was different: It started with a power point presentation. It started with a synopsis of legal definitions and the differences in the world of legal vs the world of...well, just the rest of the world. I must admit, the whole experience was interesting as it gave a brief, slightly structured view of the legal world. I was interested. Law is a very interesting field just one I don't think is my cup of tea. I do not know if I will be called back to serve, and actually I hope not simply based on the time I would miss work. If I could avoid missing work, I would be interested to go and be part of the process.

Our system at work!

First Snow

It isn't just the first snow of the new year, it is the first of our winter. I have never been really crazy about holidays, but I love this time of year. I feel as though this time of year is almost a required "slow down" time, a "hunker down and recover" time. The snow is the perfect clue to rest up. I hope this new year brings less stress and more of a relaxed way of going. I have had my fair share of stress for a while.
Best new year wished for everyone. May it be filled with health, happiness and the love of friends and family.

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:

Laughter
Love
Health
Friends
Family

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.

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!!

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.

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.

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.

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!!

Motorcycling...

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.