eric135

Two Movies...

Last week, we saw Red Eye. It was OK. A very good beginning, but it seemed rushed to a conclusion at the end. It also needed a twist at the end; there were no surprises (and we just gotta have those these days).

Today, we saw The Brothers Grimm. I guess Matt Damon just wanted to play a role completely unlike his Jason Bourne character. Oaf-ish and campy, the role just wasn't believable for him. The guys playing the French characters were just awful. The story line could not even be saved by the implausable fact that, in the midst of early 19th century in French-occupied Germany, in a town populated by characters you usually run into in a Monty Python farce, the two heroes would happen to find a Sports Illustrated Swimsuit Model good with a bow-and-arrow.

Flex Magazine

This will probably throw my sis, Karen, into apoplectic fits, but I picked up an issue of Flex magazine at Fry's last night. Yes, I know the mag is basically a platform for nutritional supplement ads, but some of it is sort of motivating. I used to read Muscle & Fitness years (about 10-15) ago, but the articles in Flex seemed more "reasonable" (god, I hope Karen isn't drinking or eating while reading this...) I especially appreciate the heads up on a Vietnamese body builder, Eryk Bui, whose website appears to be pretty level-headed.

My delicious list for fitness (a growing collection, send me links if you have them)...

Plateau (dammit)...

I've stalled at the same weight (about 15 pounds off) for the past week. I'm not worried though, I know how these things go. I can't imagine tightening up any more with my diet (well, ok, there's the margarine I still put on my whole wheat bread, and I do like my occasional peanut butter and jelly sandwiches).

One gimmick I use to keep motivated: I record the number of workouts at LA Fitness on my calendar. For instance, today's workout is workout #45 since day one on June 30. It's motivating watching the number get bigger.

The telling tale, of course, is how I think I look standing naked in front of a full-length mirror. It doesn't matter what the scales say, I can tell I'm losing. [To my family, I apologize for the vividly unsettling image.]

Flash...

I know I keep saying this, but if you are a new nurse or a nursing student, promise me right now that you will seek opportunities to become excellent at starting IVs. Trust me on this one.

Our IV nurse went home at 10pm last night (usually they are there until 2AM). So from 10pm on, I started a lot of IVs. Now I'm getting calls from other floors asking me to start IVs.

There is this moment in time, when you've inserted the IV needle, when you get something called flashback. This occurs in a small chamber behind the needle and IV catheter, where a small amount of blood will fill when the needle has successfully punctured a vein. It means you're in. Yes, you still have to extend the catheter into the vein (and sometimes that doesn't happen), but when I see that flash of blood, it's a rush.

I'm telling you: go forth and seek flash...

Blog subtitle...

Most blogs have some sort of subtitle. Some short little blurb under the main title of the blog that gives you some sense of what the author is all about. Mine is, "Cogitating the possibilities by the sounds of my own keystrokes," as an expression of how my blog helps me analyze and assimilate what happens during my day.

With all of my entries about starting IVs, I'm thinking of this one:

Eric135...
... you're gonna feel a little prick...

Oh come on, you think it's funny...

Multiple Sets

I'm starting to add in a more organized routine of weight lifting into my fitness program. Back on day 1, June 30, I decided to make the aerobic activity the priority. For the first two weeks, I didn't do any kind of weight lifting, instead working on making 30 minutes working out by swimming, or stationary bike, or elipse, something I could get into.

After two weeks, I slowly added some weights using machines. I'd just try to hit the major muscle groups as I remembered them from years ago. One quick set on each machine without any breaks, sort of as an addendum to my aerobics routine.

Then I became more faithful to the weights. I picked out specific machines to work specific muscle groups, but still used only one set. Since I wasn't using a workout diary or notebook, I was not making much progress.

Now I've pulled out my old workout sheets and re-worked them for the machines in my gym. I've started to record how much weight I used, and mark each set with an "L" for "light" -- meaning I need to up the weight, or "H" for "heavy" -- meaning I need to stay at that weight. I also recorded the seat settings so I don't have to spend minutes on each machine getting the adjustments right.

I'm not one for using a pencil at the gym. Every time I've tried it, I end up losing the pencil. So I've organized the sheets so that each exercise has a column where I can check anywhere from 8 to 15 reps. But instead of putting a check in the box, I fold the paper over that box, and make a small tear. I also have columns for the "L" and "H", and if I need to mark a weight as too light or too heavy, I make a small tear there. No pencils.

After my workouts, I take a new sheet, and write any new weights, and place circles where the next progressive set should end (if I did 9 reps last time, I should do at least 10 next time).

Yes, it means I print off a new sheet every workout, but that's not a problem with all of the computers at my disposal.

Every other day with weights. Well, at the very least, I'll sleep well...

A Weekend of Experienced Nurses... a crowd of mourners...

Don't know how I managed it, but this particular weekend is staffed with mostly experienced nurses. Last night was a quiet one, as years of experienced and well-honed instinct prevented most problems long before they manifested themselves. I did make my usual rounds, and I'd come out to the nurses' station and ask about this and that ("did you notice how hard he's breathing," or "any results yet from his chest CT angiogram," or "how's her serial cardiac enzymes?") My queries were never a surprise, no furrowed brows, no shrugging of neophyte shoulders.

I spent most of the night working on various projects. I even got to take a brief walk around the building and watched a helicopter land, dropping off a bloody mess strapped to a rigid backboard, flight EMTs squeezing bags of clear fluid into the veins. I heard she made it.

On my return trip, I stood quietly as a young hispanic mother wailed the hopeless mourning wail of a mother who will never see her 3-year-old daughter make it to grade school. The news freshly broken, she ran out into the street, screaming and crying. Family members poured out of the building behind her, weeping. As I negotiated around the small crowd of a dozen or so, the mother was beating her fists against the chest of (I presume) her husband. The wails.., it sends chills down my spine as I recall them.

I'm back for two more nights.

The Andromeda Strain

One of my favorite sci-fi movies. I have seen it thousands of times, but I think this morning was the first time I had seen it in its original letterbox unedited version. When I first saw the movie as a child, it might have been my first exposure to The Scientific Method even before I was taught the concept.

But for the first time, I noticed that, since there were only three key stations to prevent the nuclear detonation that served as the climax of the movie, and since there were five sections that were sealed when the device is set off (with the hand-wringing five-minute delay), there was a predictable 40% chance (2 key-less sections out of 5) our hero would be trapped in a section without the key station. Poor planning, I think.

Werk

Two days off. I'll hardly feel them. I don't know what it is, but the past week or so, I just haven't felt like working. I don't mean the fact that I occasionally experience the usual werk blues. I'm saying I just don't feel like working for a living. I just don't want to have to go in there and do anything.

It's not that I have anything pressing I want to do. I don't want to leave town on vacation. I don't want to clean (besides, as I've said on numerous occasions, when my bathroom is clean, the kitties think we're moving). 

Laying on the couch in my underwear getting decubitus ulcers while watching Trek episodes seems like a lovely idea.

I'll get over it, I'm sure. I have until 7pm Friday.

PALS

I've been giving serious thought to getting some orientation time and being a relief House Supervisor. I've never worked the position before, and I always have believed that widening your horizons gives you not only more options, but also gives you some sensitivity to what other folks go through.

But in order to do this, I have to get PALS (Pediatric Advanced Life Support) certification. When the supervisor told me this the other night, I balked at the idea. Not only do I really dislike pediatric nursing, but I just can't believe I'd actually have to use PALS in a supervisor role. In all my years working in hospitals, I have yet to see a supervisor doing any direct nursing care. I'm not saying they don't work hard, I just haven't seen them inserting IVs, or NG tubes, or doing wound care.

So at first I rescinded my offer to do relief supervisor hours. But now they're thinking of letting me be relief without being PALS certified.

No idea if I'll still go through with it. I already have a lot on my plate right now with the relatively new charge position. But it's nice to know I'd be welcome.

Multi-Hip Machine

This is definitely my favorite machine in the gym. No, the person in the photo is not me, you goofball. I don't know why, but it feels good to use it. It's called a Multi-Hip Machine. I like it because there seldom is a line for it even at peak hours (not sure why, probably because it takes a bit of tinkering to learn how to set the floor height, the lever distance, the lever angle and the weights.) The big guys apparently consider it A. T. T. N. (A Tad Too Nelly). As seen in the photo, you can use it for leg abductor. Swing the lever higher and you can do adductors. If you turn 90 degrees either direction, with the lever up high, you can swing your leg over it and do a nice smooth exercise ending up with glute work. If I'm lazy, this is where I do all of my leg work. I might try to add the hamstring curl, or the leg press, but these machines are very popular, and folks tend to just sit on them between sets to rest (considered rude).

For upper body, I do the close-grip overhead pull down, a wide grip pulldown, a seated pushdown (hits triceps and some chest), then triceps and biceps. I just try to get to whatever machine is free, I just hate waiting for a free machine, even if it messes up my order.

I'm working for the next two nights. I love going to work these days, as different people who have been off for several days get a load of my change in appearance. Last week, when the day shift crew came in at the end of my shift, I noticed a bunch of them whispering in the corner. Finally, one of them comes up to me and says, "You look different... and we were wondering... if you... got a.... Facelift."

It made me laugh.

Ponds Cold Cream needs a safety label...

I was at work one night, and was mentioning my worsening problem with dry facial skin. The girls at work got a kick out of the fact that I use Oil of Olay moisturizer.

One of the nurses tells me, "You should try washing your face with Ponds Cold Cream."

Sounded like a good idea, and the stuff is a lot cheaper than other facial cleansers. So I buy a jar of it, and when I got home, I threw the jar into my gym bag, since most of my showers happen at the gym.

The next morning, I am standing at the sinks at LA Fitness. To my left is Lou Ferrigno. To my right is Dolphin Boy. I take a gob of that stuff (oh, I'd say about a tablespoon or so) and start smearing that stuff all over my face. When I try to wash it off, it WILL NOT WASH OFF. The water just pushes that stuff all over my face and my hands. It acted a lot like Vaseline petroleum jelly, and water just would not cut through it. Penguins, otters, seals and sea gulls wash up dead on beaches all over the world covered in this same stuff.

My face is now PORCELAIN WHITE and I now take on the appearance of a Geisha Girl celebrating the Chinese New Year. And I cannot get that stuff off.

I finally ended up having to take paper towels and just wipe it off.

Admittedly, my face was as soft as a newborn baby's ass, even if I was a bit of a spectacle.

Whoa, cool pans...

We went grocery shopping early this morning (about 430am). I've been weaning myself off white bread, and bought a loaf of "healthy whole grain" bread (I call it "Colon Blow Bread"). So I get it home, and am looking at the nutritional label. Same number of calories per slice as white bread. Same dietary fiber. Same number of grams of protein. I still think I'm doing better than a short time ago, when I was buying a brand of white bread that had the crust cut off (I'm not kidding, and was probably paying close to 3 bucks a loaf). I still can't resist putting margarine on the bread before I eat it.

I've lost 14 pounds so far. They say you shouldn't lose more than 8 pounds a month or you gain it all back, so I'm pretty much on track, or maybe just a tad ahead of schedule. I've stopped wearing the heart monitor when using the elipse for now, since I haven't had any trouble getting into my target heart rate, and have been trying to max out on intensity for a while.

I got a couple of prescriptions filled while at the grocery store. When I dropped off my scrip for Benicar, the pharmacist looks at it and asks me, "So, you're not on Univasc anymore? Or are you taking both?" It didn't dawn on me until later how strange that was. She has quite an impressive memory, since I was given 8 weeks of samples and so I haven't been at her counter for 2 months. And she didn't refer to a computer or any other kind of records either. Amazing.

Anybody watch Giada DeLaurentiis on the Food Network? She hosts a cooking show called Everyday Italian. It's one of my daily views (and no it isn't just because of her amazingly large head and/or small body either, I really do like her cooking). Anyway, I always get a kick out of her cookware. She has the cutest modern cookware, everything from her measuring cups to her pots and grill pan. I know she has to have nice stuff since it's TV, but the other hosts I watch (Paula Dean, Rachel Ray, and Dave Lieberman, along with the Barefoot Contessa gal) don't have stuff that cool.

Just wondering.

I'm off for three nights. I've been a bit lazy with the blog thing these past several days. I've been coming home and spending the morning watching TiVo. The usual suspects: Star Trek DS9, Star Trek TNG, Star Trek Voyager -- need I go on? I've also been catching up on this season's episodes of Monk, The 4400, and Battlestar Galactica. 4400 and Galactica are excellent, even if the casts are pretty much nothing but Undergear models.

We watched Kung Fu Hustle on DVD. About as far away from an Undergear catalogue as you can get, which is really quite remarkable. Lots of kung fu and the whole Matrix Moves stuff, but the ideas were just so incredibly original. Also, none of the stars were the usual beautiful people. Some of the martial arts stars were very different compared to the classic physical stereotype. Imagine the owner of the local chinese restaurant (if it's a young guy, imagine his father) and put him up as a kung fu master, and that's what you'll see. I know, doesn't sound all that great, but it was.

I sat in the sauna at LA Fitness yesterday. I don't like saunas that much. I really prefer a steam room. It seemed like I put out more sweat than the dry sauna. There was a steam room at the downtown YMCA in Richmond Virginia, and I certainly missed it.

Yes Ma'am...

I'm off for one night. They're short of nurses tonight, but they'll find nurses to work. They always do, and if they have to use agency to fill the positions, that's fine. I recognize that a lot of agency are just nurses from other hospitals getting top dollar, and some of the nurses at my hospital are doing the same thing, filling agency spots at other hospitals. I don't worry about it anymore. I am not indispensable.

We had an episode last night, when things got a bit rude and nasty between a few ER nurses and a few of my nurses. It's always the same stuff -- we don't receive report fast enough. It just got so out of hand with the verbal abuse and sarcastic comments that I called the Supervisor and said I wanted a meeting between me, the ER charge nurse, and the supervisor.

So at the meeting, I ackowledged that the ER is busy, and that little would be gained by the two of us comparing piles. Because my pile is always bigger than yours, and your pile will always be bigger than mine, regardless of what nursing area we are in at the time.

I also told him that, because the flow of patients never occurs from the floor to the ER, that it will always be more perceivable when the floor nurse is not available to listen to report when the ER nurse calls. What he and his nurses don't realize, is that we often do call back, and the ER nurse is not available. Because she's with patients. Just like we're with patients.

Then I told him that, as leaders, we need to get our nurses above all this, and that we should just tell them to stop the nonsense. And, as gentlemen, we agreed to stop it.

And it stopped.

It was still a busy night. I started 7 IVs. One NG tube. Two massive Code Browns (I usually call these Poopey Patrols). Two patients screaming at the tops of their lungs due to Alzheimer's dementia. Two angry patients. One broken laser printer. One patient that disappeared AMA (Against Medical Advice) without being discharged. One nurse with a case of the vomits. One little old lady begging me for enemas. A handful of employees angry with their newly announced work schedules. One patient pulled out his foley with the balloon still inflated.

And the two patients who kept calling me "Ma'am."