Day On, Day Off...

Working as a registered nurse has always been interesting, to say the least. Probably the hardest thing for others to accept is our work schedule. Day on, day off, three on, four off, two on, two off, etc. It's all quite confusing to most people, apparently.

I was Lead Nurse this past weekend, and had the opportunity to speak to a staff nurse on the cardiac step down unit at Podunk General. He sent orders for home health to evaluate a patient who was discharged from the hospital. I asked him why he had not called me to let me know he was faxing orders. His answer was simple: he thought we worked “Monday through Friday”...

Hmmmm.....

I always tell people: “there are no holidays in nursing....” and it is so true. I have worked every shift, every holiday, and sometimes didn't even realize that it was a holiday. I have gone home on Christmas morning, after working all night, to see my children's faces light up when I pulled in the driveway.

I have watched the Fourth of July fireworks from the fourth floor of Podunk General, celebrated a New Year with patients, and had variable days off from work for as long as I can remember. The beauty of having to work a weekend is having days off during the week.

And now, after working the weekend, I have a Monday off from work. My schedule for the current week is one on, one off, four on, one off. The only hard part would be the four straight shifts after only one day off. Especially since the paperwork takes time well into the evening....

There was a voice mail waiting for me when I got home from running errands this afternoon. It seems that one of my co-workers was hoping I would trade a shift with her. She needs Saturday off, and is willing to work Thursday or Friday for me, if I will work Saturday for her.

That would change this week to: one on, one off, three on, one off, and then one on. Not my idea of a great week since it means another set of split days off. Should I do it? Or should I say no?

Hmmmm.....

And then it hit me: I had a lovely time on my vacation to Chicago. I remember an especially nice lunch at Miller's Pub, in Chicago, on a Friday at the end of January. I was able to be there, and enjoy it, because this very same co-worker worked my shift for me on that day.

What goes around, comes around....

The Crowning Glory....

Sometimes, it's hard to be brave. Even bravado escapes me.

I think back on some of the first “life and death” situations I was thrown into as a nurse. An understanding, kindly Nursing Supervisor took me aside after my first “code” and made me talk about it. I was feeling shaky, and unsure of my actions. She showed me that, regardless of the outcome, I did the right things.

And for the record, the patient made it. I have been in countless code situations since then, but I don't think I will ever forget the first one. It was the hardest one. And many, or most, of them have been quite hard.

But that's not my point. The point is that sometimes we have to fake it until we make it. And nursing is no exception. Not that I would do something wrong, or without knowing the right thing to do, but just that I would “fake” being comfortable with what I was doing.

No patient wants to hear that the nurse hasn't done what she is doing before...

And that is true in so many places in life. Knowing that I haven't done it before doesn't make it any easier. But, again, it doesn't happen that often, after thirty-three years as a registered nurse. I find that I rarely run into a situation that I haven't dealt with before. And that is comforting.

Being in my comfort zone is always reassuring. But it is also limiting. I can't learn by doing the same things over and over again. And so, I have to stretch, and learn new things, and grow as a person and as a nurse.

Fortunately, that's not hard. I truly think there is a conspiracy out there. As soon as I learn a new IV pump, or feeding pump, or the latest nuances of our computer software, it gets changed. Or the drugs. Practically none of the drugs I learned as a nursing student are still in use. Or, if still in use, they are no longer the drug of choice in most cases.

The same is true in my personal life. Things stay the same just long enough for me to get complacent, and then BAM! Something changes. Something breaks, or needs adjustment, or has to be replaced. And I am off to the races again, trying to figure out what to do, and/or how to do it.

But then, things are never boring that way. There is no need to take things for granted, or wonder what will happen, either. Just wake up in the morning, do the best I can do, try to learn from it, and then put it behind me. And the funny thing is, I keep stacking up successes. Things that shouldn't turn out, do. Things that seemed difficult were, but still were done.

And sometimes, things that seemed like they should have mattered, didn't.

At the end of the day, I have the pleasure of recalling my days positively. Not just the things that happened, and how I handled them, but the negative things, too. Sometimes, knowing that I was able to turn a negative around is sufficient reward for having to deal with it. Finding that being brave made something more palatable, or doable, truly becomes the crowning glory of my day.

Kind of like a glorious sunset....

Magical Moments...

They happen at the most unexpected times. Something quite mundane is suddenly transformed into something quite special and unforgettable.

Magical moments...

All the planning in the world can't insure that they will happen. Bringing all the right ingredients together might help, but it's no guarantee.

Magical moments...

I have had many in my life, as have most people my age. The secret is to be open to them. Not to expect them, or be disappointed if they don't occur, but just remain patiently aware of their ability to occur when they are least expected.

As I looked through pictures this evening, from my recent trip to Chicago, I found the photo I took when I had a magical moment....

As we walked outside to catch the “el” that would take us to the restaurant, there were flakes of snow falling from the sky. Although the ground was damp, the snow was melting before it hit the sidewalk. It was soft and cold as it hit my cheeks. It was unexpected, definitely a new experience for me and very, very cold

By the time we were walking back to the hotel after dinner, there was a little bit of snow on the ground, too. The city lights were golden and little white lights twinkled in tree branches and around windows. The city was alive with lights and people.

Walking across a bridge, I looked out toward the river. Twinkling lights reflected in the shiny, black water. The beauty was duplicated, perfectly, in the icy waters of the Chicago River. I have never seen anything more beautiful. Even though it was bitterly cold, I had to stop and just enjoy the sight.

So many magical moments: any Christmas tree; Disneyland, the first time I saw it; any of my babies when they were born; my daughter in her wedding dress; any sunset; most sunrises.......the list is endless. The joys are overwhelming. The opportunities occur daily. The awareness is key. They can't happen if I am not paying attention.

And I was.

Rewriting History...

About a dozen years ago, I went to a seminar in Las Vegas. My hospital sent three of us to learn more about the then-current trends in nursing management. It was held over a four-day period in the middle of June.

Most of my expenses were paid: hotel accommodations, seminar fee, and plane flight. All I had to do was buy what food I ate. Staying at the MGM Grand, for three nights, an airline ticket, and the seminar fee amounted to a sizable sum of money.

I wasn't the only person sent from Podunk General Hospital; there were two other nurses with me. And both of them were accompanied by their spouses. I was the only one traveling alone. Each evening, after the day's sessions, I would go to the McDonald's in the hotel, buy my supper, and take it to my room to eat.

A friend of mine, at work, suggested that I go to the Rainforest Cafe, in the MGM Grand. So, one night, tired of having hamburgers and fries, I decided to check it out. The line waiting for a table was clear out into the lobby. The last couple in the line told me that they had been told it would be at least forty-five minutes until they would be seated.

In short order, my nerve was gone. I no longer felt that I wanted to wait in line to sit by myself and eat supper, no matter how much fun the restaurant might be. And so, another Happy Meal happened. I felt defeated but, I thought I put it away and didn't let it eat at me.

As it turns out, all these years, I have harbored a niggling thought about that time, so long ago. I was alone. No one else was alone, in my mind, and it made the whole trip more difficult. I had a spouse, at the time, and I had asked him to accompany me. He said he didn't like Las Vegas. I think it was me he didn't like.

And all these years later, it still bothered me.

While I was in Chicago, I saw another Rainforest Cafe, near our hotel. It brought back thoughts of that time, long ago. Unfortunately, there wasn't time to squeeze a meal there into the time I would be in Chicago. And, at that point, it wasn't decided yet if I would even be passing through Las Vegas on my way back to Podunk.

Well, I did.....pass through Las Vegas.

And this past Wednesday night, about an hour after arriving in Las Vegas, I was in the Rainforest Cafe, with a friend, enjoying a delicious meal and all the sights and sounds that make that place so special. Screeching monkeys, roaring tigers, trumpeting elephants, slithering snakes and shooting stars kept me amused and delighted.

The food was delicious, Logan was an attentive server, and the company was superb. Was it the best restaurant I have ever been in? Was it the best food? Was it all that I hoped it would be? No. No. And yes.

It was a sweet victory: the former memories have been overwritten by new, much better ones.

Little Star....

It was a busy day at work. I had not seen any of my patients scheduled for the day. After being on vacation last week, I was revisiting patients who were admitted to home health services by other nurses.

Usually, it takes longer to prepare for my visits when I don't really know the patients yet. And I have to find their homes, since I haven't been there before. In addition, I had a nursing student with me for the day.

It's always interesting to have a student: they see things differently than I do, many times. I have been doing this for so long that I don't even think about some of the skills I use until the student asks about them. Of course, teaching students is an important part of my job.

And so is learning from others.

As we arrived at the first patient's house, the student was somewhat surprised. It was a very modest home, and in a not-so-nice neighborhood. As the door was opened for us, it was evident that the house was in a state of disrepair.

The patient was sitting, a little bent over, in a wheelchair. Having suffered a stroke, his affected arm and hand were propped up on a pillow. He was eating hot cereal without any problems as it was fed to him by the speech therapist. His wife looked on worriedly, then smiled when he swallowed it easily.

His daughter was visiting from San Jose, helping her elderly mother take care of her father. She brought her daughter, Celeste, with her. Little Celestina, barely two years old, has long, curly brown hair, pulled back in barrettes. Her big, brown eyes are bright with curiosity. Of course, the first thing I noticed about her was that she was wearing a cute, pink coat.

Diminutive, and very feminine, she watched, intently, everything that was going on. According to her mother, she had not been very receptive to the nurse who did the admission visit. It seems that that nurse was wearing a white uniform and little Celestina was afraid of her. Fortunately, she didn't seem afraid of me at all.

At one point, she walked toward my nursing bag and, although her mother told her not to, she stuck out a chubby little index finger and touched my bag. That's all: she just touched it. And then she walked back to stand at her mother's side.

As I talked to the patient's wife, with his daughter interpreting for us, the patient let out a loud noise that was something like an 'aaaargh....” that a pirate might say. It was deep, and guttural, and just about all he could say. He had drooled and it was dripping off his chin. His wife reached down and gently wiped his chin with a tissue.

We continued to talk and the patient let out another loud groan. Little Celestina walked over to the wheelchair, stood on her tippy toes, and gently wiped Grandpa's chin again. It was one of the most touching moments I have ever seen. To see someone so young and so little, demonstrate such compassion was a joy.

Lessons learned, from a Little Star....

Snow......

I have seen a lot more of this country in the last few days. Schools attended by friends, homes lived in during childhood, places I have only read about online or in books. I have eaten wonderful meals and hopefully, walked them off, too!

Seeing things up close and personal is always better than reading about them or seeing them on television or in a movie. So many things are just better when they are experienced in person. And one of those things is snow.

Now, mind you, I have never been fond of snow. At least, not in person. And now I have figured out why: it's too cold. And I have never had the right clothes or shoes to wear, either. This time, though, I was ready: I have my turtlenecks, my sweaters, my jacket, and my UGGS! And a cap and mittens, too.

Friday night, after a wonderful meal at Harry Caray's in Chicago, we decided to walk back to the hotel. Well, not completely true: we were one quarter shy of the needed toll for the CTA. I was so stuffed from eating dinner that I suggested that we walk, instead. And so, we did.

It was snowing, very lightly, when we took the "el" to the restaurant. After eating, there was a little dusting on the ground, and more falling as we walked. The snow was fairly dry, and melted on contact. It was cold, momentarily, as it landed on my cheeks.

Chicago was like a fairyland: lit up with lights in trees, around windows, and in the sky. We walked across a bridge on the Chicago River and looked at all the lights reflected in the icy water. It was truly magical. I took tons of pictures but, I don't have the cord for the camera, to transfer the pictures to the laptop. I'll have to do that when I get home.

There has been snow since Friday, every place I have gone. Today, I drove in it. It was not nearly as magical as it had been on Friday night: it was more like a flurry and it was falling fast and furious as I rolled west on I-80, behind a truck. The windshield wipers were criss-crossing the windshield fast and furiously, and still unable to keep up with the snow.

Having traveled west since Friday, the weather is much warmer, in the twenties and thirties. Snow is piled in drifts every time I stop for gas. At least, it was in Iowa, and a little bit in Nebraska and Colorado. Now, tonight, in Denver, there is ice on the ground, but no snow.

In Iowa and Nebraska, empty corn fields are blanketed in snow. In Wisconsin, drifts of snow still dot parking lots. Many people still have their Christmas decorations up: they won't bring them down until it is warmer, in April or May.

It is amazing, to me, to see the differences in the way winter happens in different places. Occasionally, the temperature will dip below freezing back home in Podunk, but not regularly. And we have fog sometimes, but not the diminished visibility of a snow flurry.

It's almost nine o'clock at night, here, and my feet are finally warm again. Maybe snow is better enjoyed on television or in movies, after all.

Blogging.....In the Sky...

Turbulence. As in “we are experiencing some turbulence....” Not my idea of fun, when flying the not-so-friendly skies in a big silver bird. Hmmmm....

So, my dear friend, Tom, picked me up this morning to go to the airport. Not Podunk International Airport. We did pass it on our way to the 99 on ramp, but we didn't stop there. We went north on 99 to the nearest real airport, an hour away.

It was fun to spend time with Tom. He is one of my dearest friends. We had a chance to catch up on what is going on in each of our lives. He is my friend who's a guy, and I am his friend who's a girl. It is nice to have such a good friend of the opposite sex. No romantic notions to interfere with our friendship.

But, back to the turbulence. I am not fond of flying at all, and turbulence does not enhance the experience for me. By the time the pilot announced that we were having it, we all knew already. So, a bumpy ride into PHX. That's Sky Harbor, in Phoenix, for the uninitiated.

Of course, I had an hour layover, and planned to find something to eat. What I didn't realize was that my arrival gate, and the next departure gate, were at opposite ends of two adjoining terminals. In other words, quite a hike.

And the terminals were crowded, too. It was mid afternoon in Arizona. My stomach was telling me it was lunch time in Podunk, CA. Alas, I was unwilling to take a chance on missing my plane in order to stand in line for pizza or some other gourmet treat. Besides, I spent my standing in line time waiting to get into the ladies' room.

I am getting smarter at this flying thing: stand close to the boarding doors, even before they start calling for passengers to board. Sure, the infirm, children, and First Class get to go first but guess what?? If you are close, and quick, you can get on the plane as soon as they call for Zone 3 (as this airlines calls it) and if you are lucky, you can stow your carry-on somewhere in the vicinity of your assigned seat.

On the connector flight into Phoenix, I was the lone passenger on my row, on my side of the plane. I had plenty of room to spread out and relax. I heard that the flight to Chicago was full, so that wouldn't happen again, I was sure.

Well, as they were getting ready to close the door and taxi out for takeoff, there was just me, at the window, and a gentleman in the aisle seat. As the Flight Attendant went by, he asked her if he could move to a vacant window seat, and she said he could. So, once again, I was the solo passenger in my row of three seats, on my side of the plane!

I did have someone to talk to, sorta. There was a young couple in the seats in front of me, and they had their ten-month-old baby girl with them. She and I played peek-a-boo until we both decided to take a nap....

And then, since I hadn't eaten all day, I purchased the World Famous “Snack Box” for a mere six dollars. I got chips and salsa, crackers and Gouda cheese, chocolate chip cookies, trail mix and a Toblerone chocolate bar. I saved the candy bar and the trail mix....they'll come in handy later, I'm sure.

So now, as I look at the time on my laptop, I am confused. I know we are landing at 8:30 in Chicago. And I know that Chicago is on Central Time.....so.....I guess it's 7:00, and I have another hour and a half until we reach O'Hare. This is a first for me: writing a blog 35.000+ feet in the sky!

That baby in the row in front of me is still sleeping, so there's nobody to play peek-a-boo with, so I guess I'll listen to my iPod.

Don't tell Jon that I'm still listening to his music, K?

"My Kind of Town...."

Sometimes, I have a hard time deciding which is more fun: planning and thinking about a vacation, or actually going away to where my dreams take me. It always makes work easier, knowing that some time off is just around the corner.

I like to go places I have never been before and see things that I have never seen. Having new experiences and writing down my thoughts about them in a journal, or my blog, is fun, too. Taking pictures and recording the beautiful sights preserves them for me.

And sometimes, I like to stay home when I have vacation time. Just being able to sleep when I'm tired, eat when I 'm hungry and spend the day doing things of my choosing is as much of a holiday as going somewhere. Instead of rushing out the door, off to where I am supposed to be, doing what I am supposed to be doing, I can just be a homebody.....

I guess it is the combination of adventure and homebodiness, in fairly equal proportions, that makes my leisure time so valuable. Not always going somewhere, physically, but being home, truly home, is as much of a treat as seeing the Grand Canyon, or Nantucket.

And what makes a vacation perfect, to me, is to have just the right amount of time off from work, so that I am ready to go back, when it is time. It reminds me that I do enjoy my work, and the people I work with, and especially, my patients.

Each time I visit one of my patients, I like to discuss when my next visit will be. If they have doctor's appointments, I schedule my visits for a different day. So, when I leave, they know when to expect to see me again. I have been preparing them for my vacation for the past week.

And today, each visit ended with good wishes from my patients, telling me to have a good time while I am gone. One patient even told me not to forget him, as if I could.

I took all my paperwork in to the office this afternoon, too. I saw my boss and she told me to have a wonderful time and “don't worry: we'll take good care of your patients!” I know they will, and it makes it easier to leave.

So I'm off, tomorrow morning, on another Great Adventure! I have never been to the Midwest, although I flew over it on my way to New England in 2008. I am looking forward to seeing new things and meeting new people. I will cover about 4000 miles in a little over one week.

And yes, this adventure involves another trip in the big silver bird that I so don't like. But I am getting that over with tomorrow, and then, it's terra firma for the rest of the trip. And I'm not really worried. I know that the trip will be a lot of fun.....

Just as soon as those landing gear gently touch down on the tarmac.....at O'Hare.

A Cinderella Win...

After the first few moments, it seemed like the Saints didn't have a chance.

Already behind 10-0, a Colts' victory was looming large on the horizon.

But no, they kept trying, Brees kept throwing, and in the end, the Saints, formerly known as the ”Ain'ts”, became Super Bowl champs!


Never, ever give up....