Graduation...

Circa June 10, 2012.  Prepare yourselves for a small blog dump over the next few days... All the things I've been meaning to but putting off over the past six months. Today's round: My graduation from the University of Washington with a Bachelor's degree in Nursing.

June 10, 2012 marked the completion of my on year full-time student-ship at the University of Washington on the Bothell campus. It was easy to say that it was just a piece of paper, and it felt like a giant waste of time at times. I'll tell you this, however. I've learned to be a more complete nurse. I've become a more well-rounded person. There was a large emphasis on leadership, diversity, and community nursing. And the bottom line is that an education is never wasted. So while I feel as though my technical writing skills and student-studying and learning new information skills may have lessened over the course of a year, I did learn these things. And I became good friends with a coworker Jen Raymond while I was at it. Driving once a week to and from class in the wee hours will do that to you.  Before I share the pictures though, I'll tell you my favorite part about graduation.  The week before I graduated, my parents and I met in Washington DC and I showed them around the city and around Gettysburg. Then they flew out with me to see me graduate. No matter how much I told my mother that it really didn't mean that much, and that I wasn't even sure if I wanted to go, she insisted that I was going and that my parents were coming to see me. And I'm glad she made me go. It was a big deal.

30 Second Dance Party

This is graphic. Parts will be hard to read. I write it because it's real, and I need to get it out. There are many of you who will understand all too well. Read if you like, I understand if you can't or don't want to. It's okay. Remember a while ago when I talked about the "reset button" after a grueling code in the ER?  This is another of those moments.

There is a patient I had a while back that continues to visit my thoughts on a frequent basis. She was 15 years old. She had been found by a dumpster minimally responsive. She had been left there by a man who had paid for her services and had no further use for her. She was intoxicated and high on several illicit drugs. In the brief time the police officers were on scene they answered three different phone calls from her John inquiring as to when she'd be ready to go out again. She came to the ER alone, unconscious, and cold. Among other life saving treatment, a catheter was used to get a urine sample in order to quickly tell what drugs were in her system. There were over-use injuries noted that are unspeakable. And she was fifteen. And she was drunk and high and homeless and a prostitute and fifteen. Our social worker was put on the task of locating a family member, guardian, or someone responsible for the child. A friend was eventually located who shed some light to the fact that the child had been living this lifestyle for two years, had run away from home, and that her mother was in the same line of employment.  She eventually sobered and warmed up. When she was awake, she wasn't scared. She wasn't upset that she was in the ER alone and hooked up to all sorts of cords and wires. It wasn't her first rodeo. When she was ready to be discharged she was belligerent. And she was fifteen. And there-in lies the true tragedy.

I see hard things. I see people die that shouldn't. I see people be kept alive in ways that I consider tortuous, treated by family members in ways worse than you'd treat a dog. I've saved people that have been stabbed, shot, raped; and I've taken care of people who have not survived these occurrences. I work every day as part of an amazing team, and we've all seen tough things. This one case, more than any I've been a part of stuck with me. It made it really hard for me to go to work for a long time. I kept telling people that I needed to live in a world where 15 year-olds weren't homeless alcoholic strung-out prostitutes. I needed to live in a world where that doesn't exist, where I can blind myself with rose-colored glasses to life's harsh reality.  I thought seriously about finding a new field of nursing to work in. I first thought babies. But I realized when you work in the NICU you sometimes have to deal with parents who don't deserve to be parents, with babies who suffer and will die through no fault of their own. I thought about doing pediatrics, but I know I couldn't handle seeing child abuse cases any more than I already do. I thought about every single avenue of nursing out there, and they all have their downfalls. It was a really bleak way to look at life. But I'm still at it. Still in the emergency department. Do you know why?

Tonight there was a moment on Grey's Anatomy where Meredith was finally able to locate the source of bleeding in a critical patient in surgery. She clamped the blood vessel and asked the interns in the room if anyone knew what to do next. The answer she gave them was "30 second dance party" and there, in the OR, they took 30 seconds to have a little dance party.  That's why I'm still where I am. That's why there's nurses that are still where I am after fifty years. That's why there's nurses that go back to work even after having to carry premature neonates down nine flights of stairs while bagging them during a hurricane-induced power outage and generator failure.  I saw three of those nurses a few days later being interviewed on TV a few days later, and they were asked how they were able to appear so calm in the face of so much chaos. They all three smiled and gave some form of the answer, you do what you have to do. The truth is, that's what we're trained for. That. Is. What. We. Do.

That is why I'm still here. Because of the 30 second dance parties after your septic patient finally has a blood pressure in the 70's. After the pulmonary fibrosis patient is finally able to be intubated on the seventh try because of scarring. After the gun shot wound to the chest and the eviscerated stab wound to the abdomen make it successfully to surgery. After the patient on every medication drip known to pharmacy stabilizes enough to be moved to the ICU. After the patient moves a hand after being given clot-busting medication following a paralyzing stroke. I'm here because of the baby who smiles and blows bubbles at you when they feel better. I'm here for the veteran's thanks for a job well done, when it is I that owe him more thanks than can be expressed. I'm here because sometimes, things go right. And when they do, there is ALWAYS a 30 second happy-dance party. Sometimes physically, but at the very least in my head. I'm here because I'm a member of a team that makes miracles happen. Yes, there are hard days. And there will be many more days, many more patients that will make me question if I have the stamina to do it again. Those patients really do take everything out of you. Everything. But I come back every day, because every day there are victories no matter how small. And no victory is too small for a 30 second dance party.

Requested Recipes

At the request of a dear friend of mine, I've decided to share a few of my new healthy-me eating plans. Quite honestly I hesitate to do so, becuase what has been healthy and helpful for me and my food issues certainly wouldn't work for everyone. And the most important part of being healthy and whole is to know yourself, and abide by what you know.   Few basic rules.  No dairy, no added sugar, no added salt, no cooking with oils, nothing processed.  Next up was the schedule. One of my issues was that I would get too busy or bored or just flat out forget to eat. It was not uncommon for me to not eat anything the entire day then get home from a grueling 12 hour shift at the ER and gorge on whatever comfort or processed food I could round up in my food depleted house. So the first thing I had to do was start grocery shopping, and then eating. For me, the strictly regimented schedule of eating something at least every two hours, and never going longer than three was great. It's a pretty basic pattern, a serving of protein, carb, and vegetable for breakfast and lunch with snacks of fruit and fat in between, then a protein and vegetable for dinner. I'm just not a morning person, so the thought of cooking --say an egg white and spinich onlette with a whole grain english muffin is just not going to happen in the morning, so I substituted a low-glycemic meal replacement shake.  But it's that simple. A serving of protein, vegetable, and carb for breakfast. two to three hours later I have a serving of fruit and healthy fat.  My favorite so far is a peach cut up and warmed in a small frying pan with cinammon and crunched up pecans. Any combination of fruit and nuts, or avacado will work.  Two hours later is lunch, another carb vegetable and protein. Two hours later, more fruit and fat, and then for dinner a vegetable and a protein. 

The portions are also key. The amount of calories your body needs in a day is dependant on your currant weight. And it took me at least the first two weeks to get used to actually eating so much food. But I could definitely feel a difference when my body got used to being fueled properly, and my natural metabolism kicked back in.  To find the portion guidelines and eating schedule I used go to the Advocare website and look up the 24-day challenge.  The meal plan and even a recipe book can be downloaded for free. I did the whole shebang with the herbal cleanse and all the vitamins and everything for the 24 days, but I've continued it to be my lifestyle. I just felt too good not to. The difference is I only take my regular multivitamin and fish oil supplements now. Back on track... so check out the serving size of each food category for your weight class. Follow it. It's amazing.  The thing I've found so great and sustainable about this way of living is that it's reasonable. You still eat carbs. You still eat fats, you still eat everything! Check out the website to get the list of healthy carbs...there's plenty of them. Just remember no instant rice and nothing processed. Take the time to do it the right way for yourself. You're worth the time.  Another important tool to remember is season!!! Just because it's healthy doesn't mean it has to be bland! Do you know how many spices there are besides salt?! And they're all better. Use every spice you like and as much of it as you like, you DON'T need salt, I promise you won't even miss it!!

Here's a couple of the recipes I've tried and loved so far. I have one day a week where I make all my food for the week, that way all I have to do is portion out what I need and I'm set. It takes no more than 15 minutes to throw my healthy food together for the day. Perfect!!

Slow Cooker Chicken Burritos:
4 Boeless-skinless chicken breasts trimmed of fat
8oz no-sugar added tomato sauce
1/2 c salsa
1pkg low sodium taco seasoning
1t chili pwd
1t cumin
2 cloves minced garlic

Put all ingredients in slow cooker and cook on low for 6 hours. I like to shred the chicken then put it on a fresh salad with a cut up fresh tomato and low sodium rinsed black beans. No salad dressing needed, it's delish all on its own!

Lemon-Dill Baked Tilapia
8 Tilapia fillets, thawed
1/4 c low sodium chicken broth
1 lemon
Fresh dill sprigs

Line the bottom of a casserole dish with the tilapia fillets. Pour the chicken broth over the fish to prevent burning/sticking to the bottom of the pan. Cover the fish with a thin layer of fresh dill sprigs. Cover the dill with thin slices of fresh lemon. Bake at 450 degrees for 20 minutes. Remove the lemon slices and dill before serving/storing.

Pepper-Basted Grilled Chicken/Turkey

6T olive oil mayo
1T lemon juice
1T vinegar
1T pepper
1t sea-salt

Shake all ingredients together in a small jar/bottle. Baste a thin layey on chicken/turkey just before removing it from the frill. Store remaining baste in the fridge until next time!

Slow Cooker Chicken Azteca

4 boneless skinless chicken breasts
1/2 c low sodium chicken broth
1 c no sugar added salsa
1 can low sodium black beans (rinsed and drained)
2 cloves minced garlic
1t cumin

Cook over low for 6-7 hours. This is another one where I like to shred the chicken in the slow cooker and eat it over a bowl of salad with fresh tomatoes. The chicken is good warm or cold over a salad.

That's it so far... it carries pretty far if you're just cooking for one :)  This week I'm making a slow-cooker Country Captain Chicken and a slow-cooker Marmalade Curry Chicken. I'll let you know how they turn out next Sunday. Perphaps along with next week's recipes of Hungarian Chicken, and Applesauce Chicken.  Happy healthiness my friends!!!