Sunday, October 3, 2010

Meatless Monday: Curried Pumpkin Soup

Meatless Monday: Curried Pumpkin Soup

It's fall y'all! This is the time of year I love to sit with a bowl of soup and savor each spoonful as I watch the leaves falling. I haven't tried this soup yet but The Wizard made dinner for me Thursday evening--Shrimp and Vegetable Curry. He served it over rice. I ate two helpings. I LOVE curry, coconut curry even more. So, I thought what better soup to make to usher in the cool fall days and nights than a pumpkin curry. Hope you try it.

Tuesday, August 24, 2010

Work Schedule

This week I'm starting a new work schedule--self imposed in an attempt to make better use of my time at the facility. Yesterday went fairly well, slow and easy pace. The lady with the labile blood sugars seems to have fared better on the new regimen I started for her--that's a relief.
I am happy to have a job where I have a flexible schedule, what a blessing! Sometimes I do miss working in an office environment where I have my own desk, computer, pictures and set hours. There are office pot lucks, birthdays, drug rep lunches not to mention someone who schedules who I see and when, no hunting around for someone to see because you're worried you won't make your quota for the month. Again, that's where I am fortunate in having a doc that is understanding. He knows you can't just go see a patient because they are sitting in front of you, there must be a medical necessity or it's considered fraud--Medicare fraud. That carries a HEFTY fine and I never want to commit that crime.
I have to mention that yesterday I wrote discharge orders on someone that I never thought I would. He was a patient that had come to our facility after a stroke. He was depressed. He was weak and had essentially given up his will to live. He was to the point that in order to survive he had to be fed liquid nutrition through a tube.
I've seen this done a lot and the outcome has never been good. Well, wonders never cease. He made a 360 and has gained almost 30 pounds, is eating on his own, talking, laughing, a happy man. Truly, he is a success story. It does my soul good to see him and know where he was 2 months ago and see where he is today. Today, he's going home! My best to you Mr.____, you've renewed my faith in PEG tubes!

Monday, August 23, 2010

If I had a dime...

Oh if I had a dime for every time I said I was going to be faithful and make a post daily or weekly I could...what? What would I do with all those dimes? Never mind, here I am again with the best of intentions.
As I looked at the last post with the picture of the broccoli, I saw there were no weeds in the garden. I need to take some pictures to show you just what it looks like now. I have had the best harvest ever, put up a freezer full of summer veggies. We've had lots of heat and rain and I've had little time or interest to weed in the hot humid garden. Ugh!
Yeah, I don't have enough time to fully engage in all my hobby delights and thus the weeds have grown tall, the insects are filling their little bellies on most of what's left in the garden. My friend CS, a.k.a. "The Wizard", has been too busy himself to come help out in the garden. I've even thought of renting out a room upstairs to someone if they would agree to be my "handy man" and help keep the house and garden in order. I sure could use the help.

Friday, May 28, 2010

'Pac Man', that's the name of the variety of broccoli growing in our garden. So, all that activity on Mother's Day is paying off. The garden is growing and thriving except for the eggplant. Ugh! I should consider myself fortunate as the bugs have not chosen to infest any of the other plants--so the eggplants are the sacrificial plants--well, two survived. I moved them down and into the row of parsley. I think I remember hearing that parsley was a natural insect repellent.
Lets see, there are 4 or 5 varieties of tomatoes, bell peppers, watermelon, muskmelon, bush beans, broccoli, red cabbage, okra, blue potatoes, 2 varieties of basil, parsley, yellow squash, zucchini squash, 5 varieties of sunflowers, cucumbers and 2 badly defoliated eggplant plants. I have yet to plant the zinnias. It's supposed to rain this weekend, maybe I'll have enough time to get out and scatter their seeds so we may enjoy fresh bouquets all summer.

Monday, May 10, 2010

Around The House...Bird House, that is!

Over the weekend I uncovered the old bird house that the ivy had overtaken. It was infested with insects and falling apart. No worry, The Wizard went to work and created a brand new one!
In the background, you can just see the edge of the garden. That's were I spent most of the day yesterday, Mother's Day.
Today when The Wizard had put the finishing touches on the new multifamily bird house, he mounted it to the tree pole that was remaining (still in good shape) and had no sooner walked a few steps away from it, when he turned back and saw a potential tenant checking it out. I hope they will like their new digs. I sure do!

Wednesday, May 5, 2010

The 2010 Flood in Nashville

Stayed home Monday due to the flooding. My house was fortunate, a lot of others, not so much. This picture was taken at the end of my driveway. There is a creek that runs under a bridge as you turn into my drive. A big part of that (the bridge) was washed away in the flood.
The picture below was taken after the water receded. As I said, our house was fortunate as there was no actual damage to the house only the driveway suffered. I was able to get out and go in to work yesterday.
As I drove past Nashville it was so surreal--seeing the city where I live and play under water. No, I don't work in Nashville but in an outlying community southeast of Nashville. The town I work in had some flooding too but not as bad as some other areas. Check out this video clip of the Nashville flood--no better song or singer to be the background for some pictures of the devastation. Keep us in your prayers!

Saturday, May 1, 2010

How I became a Nurse Practitioner

I'm a late bloomer, a testament to "it can be done". Due to my stubbornness (and divorce at 37), 3 children and no real work experience, a love of science (biology) and undergraduate major in Biology, I became a nurse practitioner at the age of 41. Since I had a college education the judge decided I should find work. I had been a stay at home mom since I married in 1981. I never worked before I was married. Yes, I was somewhat spoiled by my parents (they were divorced). My mother told me as I went away to college, "You go to college to be well rounded in certain subjects and to meet a husband--not have a career. Women are supposed to stay at home, have children and throw memorable dinner parties for their successful husbands, look at Jackie Kennedy!" My mother was always comparing us to the Kennedy's--? I remember my sister fussing about eating at McDonald's and my mother retorted, "If its good enough for the Kennedy's its good enough for us."
Anyhow...I wasn’t encouraged to pursue my dream of becoming a Marine Biologist or maybe even practicing medicine, instead my dreams turned to homemaking and raising 2 daughters and a son. I was married to a successful and very handsome man who gave me a monthly allowance which I used to buy groceries and whatever else I wanted to buy. I never knew how much the household bills were, my husband took care of all that. He even took care of having all his clothes (with the exception of under garments) dry-cleaned. We lived on an estate sized lot with 5 bedrooms, an in-ground swimming pool, a garage full of cars including a new Suburban and a darling little white BMW 325i convertible—both of which were my cars to drive, we had a boat, 2 SeaDoos, not one but two country club memberships. Needless to say, most would think I had it made. Money can buy a lot, but it cannot buy happiness.
Tried to make it work but it wouldn’t. I will spare you the sordid details. Divorce.
As I think I mentioned earlier, I had never had a job. So, I went back to my Alma Mater for career counseling since I had been told that I would need to get a job to help support myself and the children. The psychologist administered different tests that would give me insight into my personality and which careers would be best suited for me. Number one on the list: Administrative law judge. So, off I went to begin training as a paralegal as I didn’t want to start law school right off the bat. There were other options, Physician, University Professor; they were all requiring no less than a doctoral degree. To find a job with my own major required me working on a doctoral degree. I mean, what’s a degree in biology going to get you—not even teaching? Nope. That requires a minor in education—more school. So, I opted for the paralegal program. It was nine months and they offered job placement.
My first job was with the Attorney General’s Office, Criminal Justice Division. I was on “the Death Team”. It was serious work, the “worst of the worst” crime against another human—murder. Pictures. After a while you get used to it, not so shocked by the photographs of the victims. I remember the point where I knew I was hardened. It was a gruesome photograph where I made the comment, “Oh wow, they’ll never get the blood out of that rug, what a shame.” I remember the rug was exceptionally beautiful, it was needlepoint or something and it was totally ruined. I had not even thought about the victim as another human, a daughter, a mother, a wife, a sister. An emotional defense mechanism—block out the victim?
More money lured me away from the AG’s office. I was moving up. Up the hill to a high rise and to the ultimate demise of my law career—boredom. After about a year of working at “the department”, I was totally bored. I had often daydreamed about a career in medicine. I was a biology major after all. Most of my fellow (and I say fellow because they were mostly guys) biology majors were pre-med. It had crossed my mind but that was about it, remembering what my mother told me about girls and careers. Wish I had not lived a good part of my adult life being totally irresponsible and dependent upon a man (my husband). I was determined that I wasn’t going to be a victim of this. I grabbed my gumption and boot straps and got on-line and checked into a program at a local university where I could “bridge” into the nursing program to become a master’s prepared nurse practitioner in just 6 semesters. A friend of mine had mentioned this to me, she was a nurse and thought this would be a good way for me fulfill my dream of practicing medicine and they had a geriatric program which is the specialty that I wanted to go in to. I found out that I was missing some of the prerequisites to be admitted into the program and that I would have to take the Graduate Record Exam (GRE). I got busy getting into the local state university for the classes I needed, and never thought to take prep courses for the GRE, and signed up to take that also. When I got to the test taking office, so many people were talking about the prep class they took and how hard this was going to be. I said a prayer in my head and thought, if the Lord wants me to do this I will score well enough on the GRE to be accepted into the Bridge Program, if not, He will open a window (if He closes a door, he will open a window).
I graduated the Bridge Program in May of 2002.

Tuesday, March 16, 2010

I'm Back...I think.

Yesterday I hit the ground running. Nurse J met me at the door and said, "I need you to come up here and see about Ms. G, she is talking out of her head." Just as I rounded the corner at the South Nurses Station, nurse P says, "Hey, you need to see about her, as she pointed to Ms. L, she's got a cough and then go down and take a look at Mr. F, his eye, well, go down there and you'll see." Then nurse J reports another case I need to see as the family is concerned. Then another nurse from the 400 hall reports that, "Ms. C is not doing well. She's more congested and is getting anxious because she's having a hard time breathing and the granddaughter (who is a hospice nurse) is requesting that we increase the frequency of her Roxanol dosing."

Roxanol--it's immediate release morphine generally used in end-of-life to keep the patient relatively free of pain or help calm them when they are struggling with breathing. "Air hunger" is what we sometimes call it.

After I see all the "acute" cases the nurses have told me about or written a note to me in my book (a spiral notebook just for nurses to communicate problems or potential problems to me), I go back up to the nurses station and pull out the charts (hooray!! they are all here!!--that's another story) and begin my progress note and write the accompanying orders. Before that's done nurse J comes up and says, "Oh, did you see the UAs yet?". So, I pull out Dr. H's folder and pull out the labs and unsigned orders. It's enough to make your head spin sometimes but I begin sorting it all out and before I know it, the patients on this side of the building have been seen, the orders have been written and it's time for me to move to the other side and start the process over again. You see, there is a North and a South Nurses Station. This is what I do daily. Every day presents a new challenge and that's what I love. Monday is my "like a box of chocolates" day--I never know what I'm gonna walk through the door and get. Over the weekend "stuff" happens. Residents get sent out to the hospital because of an acute illness, or a fall, or they start developing symptoms of a problem and need to be seen so that the potential problem may be "nipped in the bud". Tuesday is "lab day" and blood work drawn in the early morning usually returns with some abnormal results that need to be addressed, and Wednesday is "day off", Thursday is "catch up" day for all that may have happened on Wednesday when I wasn't there, and Friday is "Regulatory and lab" day. I usually perform my required visits per medicare guidelines, that is every patient or resident of the facility is seen at least one time a month for management of chronic health problems such as hypertension (HTN), diabetes (DM either I or II), kidney disease (CKD), chronic obstructive pulmonary disease (COPD) and others. It entails a physical assessment of the patient, reviewing their labs, medications, vitals, weights, bowel and bladder, and activities of daily living and determining if their current medical regimen is working to keep them healthy. In addition to the monthly visits, I also see the "acute" problems that pop up. Like the ones mentioned above where the nursing staff is reporting that a resident is "talking out of their head" or having "burning" when they urinate. Some acute problems are fairly easy to figure out, others not so much.