Monthly Archives: October 2014

Music

Posted on October 22, 2014 by theowenscrew

About a week ago we ordered some music books for CC. As part of the program the kids learn to play the tin whistle. At first glance it appears to be nothing more than a kids toy. We are very quickly learning that this is not the case. After looking through the books and the complexity of some of the songs, we decided that this is going to be fun to learn more than what our CC manual has to offer. We read about the history of the tin whistle and that the Clark company, started in 1843, has been making tin whistles continuously this whole time. It is a instrument that can drive me nuts at times but also has something catching to it. Also learned that it is not solely an Irish instrument but that Americans used it for music while marching and to announce various times in the day for the army. We are very much looking forward to learning some Christmas songs to play for the family this holiday season.

~Chad

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PALS

Posted on October 21, 2014 by theowenscrew

PALS (pediatric advanced life support) Getting up at 5:00 AM was a treat, with an extra hour of sleep I did feel more rested. I hopped in the shower, dressed, then snuck out of the house. The plan was to go to Starbucks and cram, having to work nearly everyday since getting my book there had been very little quiet time to study. I climbed in the car and double checked to make sure I had the printed off copy of the pretest. I flipped through the book where I had safely tucked it in preparation and it wasn’t there, I flipped through it again, nope. Where did I tuck it? I know I tucked it in the book, but it isn’t there now. Shoot, I turned the flashlight on on the phone and searched the car, then I got out and made my way back in the house where a little one was now up and in the bathroom…I was trying not to wake everyone and searching for a paper all around the house was not helping. At this point I had looked everywhere it could possibly be besides work, it must have fallen out at work. I have to have that paper or they won’t let me in the class, it’s not like I can just print another one. We don’t even have a printer. I felt like crying, the only three hours I had to read and study were being spent looking for a paper I had so carefully tucked in a spot it could not be forgotten accidentally. I woke up Chad to help me then searched the car a second and third time. Then the kids started coming down stairs. I gave up on Starbucks and started warming up some cold oatmeal. We grabbed the laptop and checked Office Depot’s hours (or Office Max I can’t remember) they opened at 8:00AM and my class started at 9:00AM. We resubmitted the pretest to be printed and put on a pot of coffee. I crammed while Chad made a special breakfast for the kids who were now all up an hour early. Then took the laptop as precautionary incase the paper was not printed and they couldn’t find it. I crammed some more in the parking lot while waiting for the clock to strike 8:00AM. They quickly printed the paper for me and I thanked them profusely. The operator at AMC directed me to the correct room for the class and I checked in a whole 30 min. early. I kept my cramming until class started and inside I prepared myself for a day filled with potential most embarrassing moments. I feel so out of my league in these situations. I’m rusty with my rhythm strips and unfamiliar completely with all the recessitation meds other than epi. It is a good thing that that is almost always the first med given in these code situations. Luckily there were no most embarrassing moments and I wasn’t the only rusty one. You gotta just roll up both sleeves and jump in in these situations and not worry what other people think. I love learning and wish it was practical to take many more classes and tests, and it ended up being a nice breather since I’m looking at tomorrow and Wednesday being both super busy shifts. The test was good, although maybe not a true picture of my PALS knowledge since the whole class is taught to the test so if you listened you had been given all the test answers throughout the day. Now what do you think the chances are that I will remember it for two years, maybe three months for ACLS in January? Probably not. Not with out a chance to practice, and I hope to shout we have none of that in OB.
The kids greeted me at the door Eve had no accidents today and her head is looking better.

Hannah had drawn a picture of a Unicorn giving birth to Pegasus’ baby.

this mama could nurse a whole litter of little ones. And We got the new tin whistle books in the mail.

Eve proceeded to have an accident on our bed just before bedtime, it’s a good thing the dryer is quick. Good night all.

Categories: Family Time, Fun, Travel Nursing | 1 Comment

A weird sort of day

Posted on October 20, 2014 by theowenscrew

When I arrived at work and looked at my assignment, I was sure I was missing something. A vaginal delivery who would be discharged by noon and a really easy antepartum, was I supposed to have an induction coming in too? This was very uncharacteristic. So I rounded on my sleeping patients, then stayed in the nursery so the other nurses who had a baby in the nursery could get out and assess their patients. Did some baby assessments, a bottle here and a CCHD screen there. I got out and rounded again and everyone was still sleeping, so I headed back to the nursery and helped a nurse with a heavier assignment by taking her twins out and helping the mom breastfeed. About 9:00 am my patients started coming around, but it didn’t take long to get their stuff done, so soon I was back to helping hang blood and fetching a wheel chair. The assignments were seriously lop sided. Although the one nurse with the heaviest assignment got two of her three patients including the twin babies discharged by noon, I had a triage who in addition to my post partum went home by noon, the two other nurses on discharged pts too, so that we were down to very few patients on the floor. Every one got lunch. Then we admitted an SROM but she was given to someone else, I admitted another antepartum and then the pt we hung blood on was discovered to be bleeding internally so she was whisked down stairs to the main OR. A patient came in in atrial fibrillation (or Vfib, the report was unclear, I’m pretty sure it was Afib they just said Vfib on accident a few times, there is a HUGE difference between the two) either way, No, you can’t cardiovert her on an OB unit we will come to you and monitor the baby! Yikes! Then came in an ethics committee case. I am pretty sure in my 10+ years of nursing that we have never had to call the ethics committee, oh and the police (although I have had to do that a few times). The charge nurse was saying, “why me, these things always happen to me.”
Then in an effort to be helpful another nurse also named Sarah changed bed linens for the patient in the main OR and accidentally sent her new nursing bra down the laundry shoot with everything else so we wondered the halls in the basement of the hospital going up strange back stair cases and taking a freight and shipping elevator wondering if we were going to get lost or locked in somewhere looking for the room where the laundry shoot comes out so we could sort through and find the patients belonging. Security ended up helping us and they weren’t even quite sure but after a while we found it and only had to go through about 7 bags of laundry before we found the missing item. We were so glad that the birth center has different sheets and gowns than the other floors so we could easily identify bags belonging to our floor. We were careful not to let anything touch our clothes I could imagine C. Dif being our fate, so we washed and sanitized really well. The family was so glad to have the item back and we were glad to be headed home before anything else weird happened.

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I so forgot my lunch this morning

Posted on October 19, 2014 by theowenscrew

Working 15 hours yesterday with no lunch break got me home and in bed with enough time to squeeze out six hours of sleep. The alarm came early, but I was showered and down eating breakfast before usual, which gave me enough time to eat my breakfast sitting down, and believe me my stomach was thankful. I got out in good time and didn’t have to scrape my windows. I got to work in good time, and as I climbed our of the car discovered that I had forgotten to grab my lunch out of the refrigerator. I grabbed my debit card in hopes that the cafeteria would have something I could eat if the opportunity arose to eat a lunch.
Two fresh c/s patient and one antenatal, two insulin dependent one with a pump. It was steady. Very steady. I walked some serious miles today, and felt like I took good care of my patients. There was no lull where lunch was possible until after I discharged one antenatal and picked up another one two hours before the end of the shift. I made it down to the cafeteria to discover that at 3:30pm on Saturday the options were sandwiches (no GF bread) pudding, chips, fruit and bottled drinks, so I had a lunch of champions.
My usual lunch consists of a baked sweet potato, an apple, and an orange with a granola bar for dessert, which I do love, but it was so great to eat a whole meal of crappy food. Maybe I shouldn’t have enjoyed it so much. The chocolate pudding was fabulous, with two very small bags of jalapeño chips, then a banana and a bottled Starbucks coffee to follow. I don’t know if it was the chocolate, the coffee, or the jalapeños but it hit the spot and I was uninterrupted for a whole 30 minutes. I made it back up stairs, tied up all my loose ends, left all my patients with no immediate needs, taped report and got out on time. It was such a beautiful thing. One more day before we switch back to nights for a few weeks.
After dinner I headed up stairs to get ready for bed, this is at 7:40pm, when it dawned on me that I had not gone to the bathroom all day since I woke up at 4:15 am. Yep, it was busy, but good. I better drink a liter before bed. Good night.

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Beautiful Delivery

Posted on October 18, 2014 by theowenscrew

I did not want a labor this morning, I was less excited when I found out it was a first time mommy, even less when the night shift nurse hinted at back labor.

Can I just say that was the most beautiful birth I have seen in a long time, and one rock star mommy. So refreshing.

Chad tells me that Eve did great with potty training, and made it to the bathroom for everything today. Two things to celebrate.

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Preparing for our one week in Salem

Posted on October 16, 2014 by theowenscrew

The kids were done with their school work including CC review, 5 pages of math, writing their history sentence three times and reading by 10:00 AM. It was a very good thing, with the car being tied up taking me to work for the next six days, we had some errands to run. We had to pick up some documents that we had printed at Office Depot then on to Appleton Medical Center to pay for my PALS class and pick up a book. I’m so glad that they are letting me borrow one because I wasn’t going to be able to get one in the mail quick enough. Then we found a McDs (it is the easiest way to access internet here.) Chad was able to download the CC cycle three app. I retook the PALS pretest, because the test repetition helps me to learn easier than with just reading the book. We were also able to use the time to make Dr. appointments. An appointment for Eve up at Doernbecher, well child checks and Salem Pediatric Clinic for all three kids, and a call to the dentist to see what we can work out there. We were able to do some more research on the hospitals sent to me for consideration for our next assignment, and believe me we checked C/S rates and deliveries/month because I don’t feel like managers are overly honest about those numbers in the telephone interviews. We are also starting the wheels turning on a Christmas project. We are hoping to get shoes to Uganda hopefully we can save up enough to send over 50 pairs. the shoe that grows

Well I don’t at all feel rested enough or prepared for the next six days. I am reminded that God is more concerned about my obedience than my happiness (although I’m sure he is delighted to see me happy. As a parent he wants me to see the big picture and not be so focused on myself). (And the good news is I am happy and have so much to be thankful for) I was reading back through my sermon notes from Farmington, and was especially struck with how God’s word meets us exactly where we are at when I stumbled on this. (These are notes so it’s going to be fragmented)
• In this world you will have trouble but take heart for I have overcome the world.
• God does not explain the why’s and how’s
• Character is built in the valleys
• Not my will but yours be done
• He is good and faithful and just to forgive
• Be still and know that I am God. Psalm 46:10
• Be not wise in your own eyes
• God will not overlook the fact that we have failed to trust in him, he will not overlook that we are doing what we choose to do over his plans for us.
• Break the pattern of trusting in our selves

Hebrews 12:1-2New International Version (NIV)

12 Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, 2 fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before him he endured the cross, scorning its shame, and sat down at the right hand of the throne of God.

These things have been on my mind, strangely, and although they do not make me feel more rested they do assure me that I’m where I am supposed to be, doing what I’m supposed to do, and God will do the rest. He doesn’t ask me to have all the right answers or to be perfect, just to be willing and obedient.
This afternoon when we finally got back to our apartment there was a card in the mail from a friend with this verse.

1 Corinthians 15:58New International Version (NIV)

58 Therefore, my dear brothers and sisters, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you know that your labor in the Lord is not in vain.

This verse and a chance to talk to my favorite MIL may have been just what I needed.

Categories: bible, new mexico | Tags: bible | Leave a comment

TIA or Seizure?

Posted on October 15, 2014 by theowenscrew

I am ok with never ever again seeing expressive emphasia in a childbearing age women especially coupled with her indicating that there is something majorly wrong with her right arm. A few scary moments today resulted in a healthy mom and baby after a visit from the Rapid Response team, CT, and a C/S.

Other news, the kids dug into math before breakfast and were completely done with their school work by lunch. Potty training with Eve was only so so (this is all second hand), and Eve fell off the stairs onto the concrete floor of the basement and has a goose egg that I haven’t yet seen. As the kids were all in bed already by the time I made it home from work.

Now with full rolling headache I’m going to crash. Good night all.

Categories: Family Time, Fun, Homeschool, new mexico | 2 Comments

Tin Whistle

Posted on October 14, 2014 by theowenscrew

We started tin Whistles today, oh joy! It was actually quite fun, and Chad ordered a few extra tin whistle books. It should be fun.

Chad has the video of all of us playing Tin Whistle “Mary Had A Little Lamb,” “Jingle Bells,” and “Twinkle Twinkle Little Star.”

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Sunday, Sunday…I love that day!

Posted on October 13, 2014 by theowenscrew

We are going to the 11o’clock service here in Neenah and so Sunday mornings are slower paced and relaxing. We got up late, everyone got a shower, we girls had time to get all pretty, and even put on some perfume left over from my trip to Europe in 2000. It’s amazing that it still smells good, but it does.

The sermon was on Ecclesiastes and was an amazing message that had me re reading it after dinner, so I could take better notes and really understand the whole thing. After church we went out to Indian food. Mmmmm so yummy.

After lunch we headed home and changed our clothes then talked to the land lord and his wife as they were cleaning the neighboring apartment to get it ready for the next tenants. They are tearing out the cabinets and linoleum, and the wife said that the demolition is the best part. She was elbow deep in her project, and all smiles, and she kind of reminded me of my mother. We then headed to the library to get our books for this next week of school, and the Walmart for groceries. When we got home and everything was put away, Caleb washed all of the dishes, Hannah and I folded the clothes and straitened the Living room, and Chad and Eve cleaned the kid’s room and straitened the upstairs. When we were all done with our job the kids fended for themselves for dinner, which looked like tacos and grapes. We watched a missionary movie about Papua New Guinea that was pretty interesting, and took us until 7:01pm, bed time. Chad watched J. A. G. while I did my reading and took Myra for a walk. Then we crashed at 9:00pm. Pretty restful day in a nutshell.

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And Then There Were 20

Posted on October 12, 2014 by theowenscrew

Two great shifts in a row seem like an amazing gift from above, and as I drove to work I half thought to myself, half prayed for antepartums. Low and behold that is exactly what I got three high risk antepartums…mag, twins, high blood pressure…the whole bit. These patients are pretty fun for the most part, as they are often board and chatty and you really get to know them well, even having them only one shift. Then, if you by chance get them back another time (they can be there for weeks) it is that much more fun. Keeping up with charting all day, and not having to play catch up was an added bonus, and taking a lunch break plus an additional 15 min. break later on in the shift was the icing on the cake. Really. I feel rehabbed, like I can do another twenty. Thank you Lord for caring for me, loving me, and for not giving me more than I can handle, but enough that I am being pushed to grow.
I had time to make a list of the things I have experienced and learned here.
1. How to set up the epidural pump myself.
2. Caring for high risk antepartum moms, with all kinds if diagnoses, down to 18 weeks gestation.
3. Betamethasone- steroids for fetal lung maturity.
4. Transcutaneous Bilirubin (TCB) so much nicer than poking every baby, now if we could only do the metabolic screen with out a poke.
5. Amnisure- a swab test for the presence of amniotic fluid in the vaginal vault.
6. Epic is a frequently used program for computer charting in healthcare systems. A lot of job postings require epic experience, and now I have it!
7. Post-op GYN patients…ok, I have had some experience with this in my med/surge/Ortho days but that was 10 years ago now, and minimal at best (only when I floated to the surgical floor from my Ortho home unit).
8. Being shared between two hospitals, it’s nice to feel wanted.
9. My first tiny patient with a testicular torsion.
10. My first tiny pt with the urethral opening going from the top of the glands all the way down the front to where the foreskin is attached. AMC joked that they were only going to give me baby girls from here on out. In this process I learned why you don’t circumcise the penis when there is an irregularity…they use the foreskin to make the needed repairs.
11. I learned first hand why rhogam and the antibody screen are so important when my very yellow 20 hour old baby had a bilirubin of 24.6 which I believe ended up needing a transfusion….I was so thankful for the NICU that day.
12. Patient on Methadone that only had half the doses she would need to get her through her hospital stay and the hospital protocols on that (being the go-between between the physician, pharmacy, and the methadone clinic.

I have twenty more shifts, let’s see what else I can learn.

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