Turnip's 4th Birthday!

At a few months old on her foster mom's couch:
Her adoption picture at 6-7 months and 45 pounds. "She won't get any bigger" they said......


And now she's just a big dork!

Today is the first time....

.....I got truly barfed on. I mean like the really splashy kind, and it was purple for some reason. No spare scrubs in the car either. Maybe there are a few lessons to be learned from this experience.

Also, work is slowly getting a little easier. I no longer panic at every little problem and I can now get stuff done without asking for help. I'm starting to feel more nursey every day! It's a great feeling when someone has a problem and I can fix it. Everything is starting to make a little more sense. Finally. Oh, and I ate lunch for the first time today. I actually did enough time management so that I could eat. Amazing.

Barfed on and eating lunch! Such a memorable day.

And now I have three days off! And I'm getting a new computer! Yeah for me!

Go me!

Today I bribed a man with a cigarette so he would take his medications. I've sunk so low already.......

Well, let's see what happened today at work......

1. The facility is getting a new roof and the roofers were working on my side (read: constant hammering).

2. A roofers' foot went through the ceiling of one in my patients' room.

3. Two rooms became flooded at the same time. Could not find anyone with mopping skills.

4. Cafeteria was able to send a rancid fish smell down my hallway for most of the day.

5. We had a fire drill where we had to clear the hallways and shut every door in the building.

6. We had a second fire drill possibly caused by the roofers messing around with the heating system.

7. A only Spanish speaking Cuban family wanted to know every detail of one of my patients condition.

8. About 11:00 I started getting really dizzy and was seeing spots. I guess I needed some water or something.....

9. State inspector was asking me questions about documentation. I think I was coherent. Can't remember.

10. The payroll person informed me that she didn't have any of my hours recorded for last month.

11. After my 5 hours of passing meds, I was informed that 1) I'm getting a new admission on my unit and 2) I have to attend a one hour inservice about passing meds.

12. After a good cry, I put myself together, completed the inservice and then was subsequently late finishing my charting and loose end tying-up.

13. Ten and a half hour nursing shifts are fun!!!

Yes, we did!

Oh boy, the career has started

I wish I could express my thoughts to you about my first 2 days working as an RN, but I can barely wrap my head around what has just happened to me on my first shifts! The first epiphany I had during the first hour of my shift - throw out everything I learned in clinicals in nursing school. The 5 med rights? Two RN insulin checks? Reliable patient identification? What are these things? The second - nepotism is a huge part of nursing in my geographical area and will be something I will have to learn to manage to make my job not too difficult. I'm sure I'll come up with a whole lot more epiphanies in the months to come.

Basically, at this skilled nursing facility, I have around 30 patients with everything from young adults with cerebral palsy, brain injuries and multiple sclerosis to elderly patients who are living out their last days. There are a lot of psychological issues as well social and medical. My job is to give all these patients their medication (what is that? about 350 pills, powders, shots and syrups?) which takes the first 4-5 hours of my shift. I haven't done it by myself yet, and it will literally take me about 7 hours to give them. The key is to know your patients so that when med time comes, you know exactly how they like it ("Sir, would you like a minute side of applesauce with your digoxin?"). However, I have no time to get to know my patients since I'm getting to know the place and giving meds all day. One of my patients today I didn't even meet until 3pm! My job description should really be "surly medicine cabinet" because that's what it takes to get those med down!

Also, I just read this great book by Echo Heron called Tending Lives which is a compilation of stories from nurses all over the country. If you really want to know what it's like to be a nurse, this would be a great place to start.

(Oh and we have a new family member. I love it!)

Two Mini Vacations

Last week we went to the Santa Cruz County Fair, which is only our second time going in the five years we've lived here. There is so much to look at and do at the fair that it's always a good time. We met my friend Sue and her kids there unexpectedly. Some of our favorites events were the frisbee dogs, giant vegetable competition, feeding carrots to goats, feeding ourselves fried food, homebrew taste-testing and of course, the piglet races:
I'm kinda obsessed with piglets. It's hard to see in this photo, but there are two rows of piglets in which the bottom row is completely obstructed from view by the top row. Unfortunately, I could not hold one.

Sheeps in jackets!


Yesterday Jake and I went up to San Francisco for the afternoon to visit the Chihuly exhibit at the de Young Museum. We've always been big Chihuly fans ever since we saw an installation in the Old City of Jerusalem in 2000. We've also been to an exhibit in Grand Rapids and we see his work pop up all the time (there's even a permanent piece in Kalamazoo). His work is very distinctive. This exhibit didn't have any new works, but we did see some pieces we haven't seen before and it's just always a joy to see his amazing glass work. These pictures were all taken with my iPhone.


These next two photos were glass pieces that were placed above a clear glass ceiling. The room was just glowing from rainbows.

We now really want to go to Tacoma, WA to see Chihuly and his team at work in the studio.

Adorableness

Here's an adorable picture of us that our friend Brian took at his wife's birthday party. I made the cake again because it's her favorite and she waits all year for it. Diana said that it's worth getting older just to eat this cake! Couldn't have had a better compliment.

Oh my god......

......we got iPhones. And they are AMAZING.

Now in addition to the Prius and dog ownership, attempted green lifestyle and Apple worship, we have perfectly molded to the Northern California lifestyle.

(If you didn't get a mass email about our new phone numbers, just email me for the numbers!)

I am an RN!

Yep, it's true! I just got my license number.

Now I just need a job.

Post-Test

Well, that was pretty terrible.

The test was very hard, but not in the "I don't know this information" sort of way. Most of the questions were about teaching, delegating and prioritizing. And then there was the random pharmacology questions about a drug I've never heard of before. And everything was way to vague. Gimme details people! ::cry::

Basically, the NCLEX works like this - you have 6 hours to do anywhere from 75-265 questions. The number of question you get depends on how well you are answering the questions (in an algorithm sort of way). The test shuts off when the test is 95% certain that you have performed above the passing standard. The test will also base the questions they give you based on how you answered the previous question. Confusing? Yes. My test shut off in 75 questions (took an hour) so I either I did very well, or completely failed. And because my test was really hard, my friend Mike said that's a good sign because it means I did well enough for the test to give me more challenging questions. Oh, and they thrown in questions they are testing out for upcoming tests which don't count on our score and we don't know which ones those are. I still have no idea how I did.

I'm fried. Jake's taking me out to dinner.

Turnip's Blog Entry #1

This is how I look after I've thrown up all over the backyard steps:

Boy, I feel much better now!

On the job hunt.

I just applied for the job I really want. Wish me luck!

Look what I found on the internets!

Like the cutest thing ever that isn't Turnip!
The caption reads: "Cinderella, a British piglet, won't walk through mud unless she is wearing her specially adapted Wellington boots. The little piggy lives with owners and pig farmers Debbie and Andrew Keeble."

Here is the website with many other cute baby animals.

Grass Fires and Swimmin' Holes

Here's our local grass fire. All of Bonny Doon was evacuated!

From our house:
From the park:

It was pretty hot today, so Turnip dragged me to her secret swimming hole! Shhhhh....

Pictures

Mike and I. Where's my money necklace??


Dean Apen immediately after I was hooded.
Here's a link to all the photos taken by the professional photographer at graduation. Kim's picture is particularly cute.

Our Mutt

Turnip is so close to becoming a real live "mangey mutt". Her vet described her appearance as "moth-eaten" and tested some of her bald spots for ringworm and mite-type things. (Did you just hear $100 fly by??) I'm now to anoint her bald spots with vitamin E every day.....and to clean up the greasy mess off the carpet, couch, clothes........sheesh.

Send me your pictures from graduation!

I'll post my favorites here for the whole world to enjoy.

Done!

It's been a long busy three weeks at the burn unit and last night was my last shift. Last night was particularly exciting when my vented, semi-sedated and extremely strong patient tried to flip over in bed. We had to call the hospitals Rapid Response Team to bring in the muscle and good drugs to help us manage the situation. Fortunately his tube didn't dislodge and besides us all being sore and extremely sweaty, it turned out fine.

I just wanted to quickly update that my preceptorship went really well and I had a great evaluation from my preceptors. Graduation is on! So right now I'm exhausted, hot and I have to go work my 19 hour shift in an even hotter part of town. Grrrr....

Last night

My first shift at the burn unit went really well. My preceptor is really nice and actually lives really close to me in Santa Cruz. The most exciting thing that happened last night was that I did my first blood draw! It's a pretty routine and mundane thing, but for me it was really exciting and felt very "nursy". My patient's veins were "highways to success" so I wasn't even nervous. Unfortunately, he was quite the joker and delighted in yelling in pain when I stuck that needle in him. Thanks, dude.

I think I have the next couple days off so I can actually do some laundry and cook dinner! Exciting stuff.

Now we can all relax

I passed my final exam - 0.10% away from an A, by the way! My final grade has been bumped up to a B so I'm just thrilled.

I'm exhausted and looking forward to a stress free weekend. I start my preceptorship Monday evening and I'm really excited. I will be studying my chapter on burns tomorrow, but I'm not going to worry too much about trying to know everything my first day.

Off to the farmer's market on this gorgeous Saturday morning!

I love my garden.

Jake and I baby it everyday! I took a break from studying to take a few update pictures. They probably aren't interesting to anyone but me, but these are my little babies right now!

These little cluster of rogue tomato seeds are from the golden cherry tomatoes from last season. They grow in these cute little papery skins!

Little lettuces.
Swiss chard grows really fast.

I took a test yesterday

which predicted that I have a 99% chance of passing my boards (NCLEX)! That felt good.

If you noticed

I put 'tags' on all my posts so if you're looking for something like, well, dog pictures, you can go to the list on the right and choose 'dog' and see all the posts that have something to do with Turnip.

Oh, and I'm almost at 1000 views on the blog. There's a little counter at the bottom that tells me how many times the page has been brought up. I think everyone can see it, or maybe it's just me. I don't know these things. However, it's a little misleading since I added like 100 counts whilst putting tags on everything....

Where I'll be starting April 28th....

The burn unit! I got my internship there on the evening shift and I'm really excited. I want to start studying for it (reading my chapters on burn physiology and burn care) but I really need to study for my final exam which is next Friday. I didn't do so well on the other two exams and now I just want to pass. I'll be grateful for a C.

And we got strawberries at the farmer's market today! Organic and delicious.

Pictures have been requested

A certain faithful reader of Falling of the Turnip Cart has requested pictures of the garden. And I'm throwing in some pictures of Turnip for good measure, of course.

Front yard. The two new plants are the bushy purple thing in the middle and the gold irises in the front right.

New adorable flower planted in window box:

Baby veggies! Soon I will eat you.


Baby swiss chard. (and a cherry tomato skin from last year)

Such a goober:
But she has a very nice forehead.

Garden Planted!

We took some time today to go to our favorite nursery and buy new plants for the new season. We got some flowering plants for the front yard (going with the purple, yellow and white theme) and some veggies for the back garden. We have peas, cucumbers, tomatoes, tomatillos, basil, swiss chard, eggplant and mixed lettuce. The lettuce is from seed and I'm really inexperienced with that. We'll see what pops up!

During the growing season, I love going outside every morning with my coffee and checking on the progress of my little babies. I'm such a goon.

Semester Countdown

1. 3 clinicals left
2. one paper (geriatric project)
3. 4 exams (2 final exams)
4. one day of phlebotomy instruction
5. 4 days of lecture

This is all in the next 3 weeks, then I start my internship from April 28th to graduation. I don't know where I'll be yet, but I put in a request to work in the Burn unit at Valley Med. I never wrote about my experience in the burn unit, but it was an amazing experience that I would like more of. One of my favorite patients there was a little boy named Julian. I was there the day the reporters were doing a follow up story on him. There is a slideshow link in this article with audio that's pretty interesting. But for those who are a little squeamish, you might just want to listen. I think my forehead is in one of the pictures! (And here is a recent news clip from ABC that is really good.) Even though his situation is incredible depressing and horrific, I was inspired by him and the other patients there who are going through life altering experiences. If I do get my request to work here for the next month, I'm hoping I'll be able to handle it and not run away screaming every day. Another reason why I choose the burn unit was because I'll get to practice all the things I need: starting IVs, IV therapy with PICC lines, changing dressings, wound care, care of naso-gastric tubes, caring for both adults and children, end of life care and family support. I'm also drawn to this unit because a lot of the patients stay there for long periods of time and I'd get to know them and their families well. My second choice for my internship was medical-surgical (what I've been doing for the past two semesters) and my third choice was pediatrics. I'll keep you updated - I should find out in the next couple weeks.

Spring Break was a Bust

Well, I got the flu. I was in denial for days but grandma was right, I was really sick. I was fine until Wednesday night when I became suddenly ill. I finally started feeling better last night after eating a real meal. The constant chills went away and I even slept through the night. I feel pretty good today, except for a little lightheadedness. That didn't stop me from doing a million errands that had to be done today before I have to go back to school tomorrow.

Things that were accomplished on spring break:
1. Weeded the front yard.
2. Studied my EKG strips for my next test.
3. Visited my friend in Richmond (with the cutest little baby! and dog! and parrot!).
4. Completed 2 out of 3 interviews for my geriatric project.
5. Transitioning Turnip to previous diet after two months of chicken and rice hell
6. Became deathly ill (was NOT on my "to-do" list however)

Things that were supposed to be accomplished:
1. Weeding the backyard garden.
2. Buying and planting flowers and veggies.
3. Studying.
4. Starting my paper due next Wednesday.
5. Finishing Marissa's wedding present (almost done I swear!)
6. Make and freeze some food for the rest of the semester.
7. Getting some good sleep.
8. Go to the beach.

I guess the good thing is that I got my sickness out of the way for the next two months. I feel like I'm on the home stretch with the next month (until April 25th) probably being the hardest yet. I know I always say that, but there is so much to finish up before I start my preceptorship (I still don't know what unit I'll be working on).

By the way

I love when you leave comments...hint hint.

I guess I just want to know if anyone is reading this besides Grandma.......

Taking a day off

I told my instructor that I need a "mental health day" tomorrow as one of my two sick days days for the semester. I've just been stressed and overwhelmed and I don't think I would practice safe and competent nursing care tomorrow. It's a little lame that I'm taking a day off right before spring break, but I really think I need it to get through the rest of the week. When I told my friends this, they couldn't believe I was overwhelmed because I always look so confident and focused. And I've never even taken an acting class!

For my clinical today I got to go to the ER, which I love. There were so many minor traumas coming in by ambulance that I lost count. All but two were motor vehicle accidents (MVA). Apparently, this is very common around daylight savings time because people aren't as alert when they have to be up an hour earlier. I totally understand. This has been one of my hardest spring forwards I've had to deal with them. I've never liked them, but it's really hard when you have to wake up at 4:30 am knowing it's actually 3:30 am. I also got to do a lot of patient teaching (signs and symptoms of heart attacks in women) and practice my cardiac assessments. I called family members to tell them their loved ones were in the ER and talked to the families that were waiting in the lobby. I pushed lots of IV pain meds and watched my nurse start a lot of IVs. Soon I will be able to do that! Anyone want to volunteer their nice juicy veins?

Overwhelming.....

Sorry I've been out of contact for awhile. I bet you can guess why! School is completely overwhelming right now. The lectures are difficult (currently studying cardiac disorders and learning about EKG strips), the tests are really hard (can't get above a C), and my patients are incredibly sick. Even though all this is all really hard, I got a great evaluation from my instructor on Tuesday. When we're evaluated mid-semester and at the end, we fill out this form and we give ourselves a 1-5 score on many different categories. 5 is the best and I give myself a few 3's, a lot of 4's, and a few 5's. My instructor gave me mostly 4's because she said that I need some room for improvement for the end of the semester! I thought that was a pretty good complement. Lately organization has been what I'm trying to focus on for clinical. From 7am to 10am there is so much to do - first check on everyone to make sure they are alive (no one wants to start off a shift with a dead patient), deal with any immediate problems like beeping IV pumps and pain management, do head to toe assessments on each patient, take blood sugar readings for the diabetic clients, give insulin (which takes 2 RN's to check, very time consuming) when the meal trays arrive, give 8am and 9am medications, then chart everything. This doesn't account for other problems that take up lots of time such as missing medications, extra meds for nausea or pain, meds that have to be given through a naso-gastric tube, hanging IV bags....the list is endless. And as a student, we have to have our instructor or nurse around to get meds and to administer IV meds - which sometimes they can be hard to find. My instructor is a nurse at this hospital and she was telling us the other day that when she was working on Friday, one of our floor nurses saw her and asked her where the students were because it is hard for them to get all their work done without us! I'm glad the nurses see us as helping instead of annoying students who can't do anything.

So that's school stuff. Otherwise it's the same - Jake's busy and Turnip's annoying. I have spring break starting the 17th. I already have a million things I need to catch up on during the break. Some school stuff, but I also want to do some major gardening and visit a friend in the east bay who will have had a baby by then.

I hope this all made sense. I needed to type fast so I can get to my work!

By the way, our home phone is not working for a few days due to some internet thingy I'll never understand. Cell phones are fine.

Oh, and here's a cute puppy:

I'm at the coffee shop

...and I just read my horoscope out of the local paper:

"This week and month everything should be about you. You should be tended and cared for, loved and cherished, listened to and drawn out from the depths of concern and worry. As the future unfolds you will be more aware of your purpose and direction. A new sense of self-esteem will evolve along with compassion."

Now I don't usually read or care about my horoscope, but this one is creepily spot on. Especially the last 2 sentences. Shivers!

Just when I start missing Michigan....

Santa Cruz starts pumping out 70 degree weather with the smell of freshly cut grass in the air! I am so happy to be here right now instead of the -10 degree weather with 45 mph winds like Pat was telling me about. No thank you.

These morning clinicals are killing me. It's so hard to get up at 4:45 am and then be coherent enough to drive 20 miles along a treacherous highway, stumble up to the fourth floor of a large hospital, figure out which patients I'll take care of for the day, do my head to toe assessments on 3 patients and give loads of pills to the correct patient - all by 10am. By that time my charting still isn't done and I'm about to faint from low blood sugar and dehydration. The rest of the day always gets better with gangrenous feet inspections and tangled chemotherapy IV lines. However, it's all worth it when my patient cries because I'm leaving and says I'll make the best nurse ever when I graduate.

*weird coincidence - I might be related to this patient because her aunt married a man with the last name Graziano who is from Pennsylvania!

So once I come home I have a roaring headache and then I have to walk the dog (the weather made that worth it today), wash my uniform, feed the dog, assemble some random things in the fridge to call dinner and finish some paperwork I have to do for my instructor. I'm pretty much out by 9pm and have to start the whole thing over again on Wednesday. Jake has evening classes this semester which is making this pretty hard, but it would be much worse if neither of us were home to take care of the T.

Anyway, tomorrow I get a "break" with an observational experience at the burn unit. With my luck I'll probably be thrown into the pediatric burn unit. I'm not really looking forward to this, but Valley Medical has a world renowned burn center and have even flown people in from India to be treated there. I thought I should see it at least once. Fortunately, I get to sleep in an extra 45 minutes........

Quick Update

Sorry about not updating! I'm very busy the next few days and I know I owe a lot of you phone calls! I will get to you at some point.

Anyway...
1. Birthday weekend in SF - rainy but still fun
2. First week of school - daunting
3. Dog - upbeat
4. Jake - good
5. Can't believe I'm 28.....

That's all I have time for!

Lab Results

Turnip had a big lab panel done yesterday and the results were given to us this morning. She has extremely low levels of thyroid hormone which would explain her lethargy, weight gain and heat-seeking behavior. It may also explain her aggressive side and GI problems too, but we'll have to see if that changes with the medication. She was prescribed 0.8mg of thyroxine twice a day and she'll be on this the rest of her life. She also had a very high cholesterol level, but that is a side affect of the low thyroid hormones (I have to look into why that is - sounds like something I should know). For her GI problems, she has been put on metronidazole (temporarily), digestive enzymes, probiotics and a very low fat diet of chicken and rice and the once a day homemade spelt cookie. We're not thrilled that we have to cook all her food now, but putting her on this bland diet for 6 weeks will tell us if her GI problems are diet related. She's going crazy without her peanut butter. It's so sad to watch her pine for it!

In non-dog news, I'm getting ready for school by taking care of things like taxes that can be done early. I've got to go to San Jose later this week and get my parking permit and see which books I need for my ethics class. I've also been putting together a resume that I would like to keep with me when I'm at clinicals - just in case anybody asks! I think I've decided that I would like to get a job at Valley Medical (in San Jose where I've been doing clinicals) because I'm familiar with the hospital and I don't really know anything about working for the local hospital in Santa Cruz. I'll have to make peace with the fact that I'll be commuting if I work at Valley, but it won't be for too long since we're not planning on living here after Jake graduates.

We're planning a two-night trip to San Francisco from February 1-3 for my birthday and so far we've only decided where we're eating - sure sounds like us, huh? We'll probably go to some museums and do some shopping at Ameoba Music, the bestest and hugest CD/record store ever. This time we're staying in a hotel that actually has a bathroom in the room, NOT the European style I'm not so fond of (like last year). I can't wait for our trip, it's been so long since Jake and I went somewhere by ourselves (sans doggie)!

Turnip has reached 100!

Today we saw a new vet, Hannah Good, to get a fresh perspective on T.'s GI problems. She weighed in at 100 pounds which is up 6 pounds from two weeks ago. She's been on a diet and no matter what we do, she keeps gaining weight. This might indicate that she has hypothyroidism, but we have to do a $129 panel to be sure.
We choose Dr. Good because of her reputation for integrating alternative medicine into her practice. She recommended that Turnip start acidophilus and digestive enzymes (Prozyme), continue with her bland diet and eliminate fat intake. No peanut butter makes a very sad dog! An interesting perspective that she brought up is that Turnip's history with parvo virus (pre-adoption) could have resulted in an decreased amount of villi in the intestine which would radically alter her food absorption. After we get some tests done she'll be able to tell us a little more about the reasons for Turnip's problems. Who knew that treating diarrhea would cost thousands of dollars!!!

I need to add to Turnip's list of accomplishments

Napping in her new sleeping bag:

What Turnip is doing on her vacation

Testing out new sleeping positions:

Destroying Christmas gifts:

Cuddling her boyfriend on lazy Saturday afternoons:

Inspecting the aftermath of the storm:
And her favorite, napping on fresh, unfolded laundry (check out those major elbow wrinkles!):