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Archive for August, 2008

The summer is over, and I shuffle back to school on Monday. My thirteenth semester in school. Bah. I’ve yet to buy my books, I don’t have all my highlighters in a row and my uniform isn’t pressed. I did resolve my financial aid situation, but it really did take all. fucking. summer. Jeebus.

Work has been so awesome. I didn’t know that you could have a job that you enjoyed doing and didn’t dread going to. I have seriously never had a job that I didn’t loathe. It’s awesome. I can even overlook the terrible clothes I have to wear. Don’t tell anyone, but one of my secret thrills at work is donning the surgical masks and gowns for isolation rooms. I feel really official-looking in my yellow paper gown tied tight around my waist and the mask looped around my ears. I even hold up my gloved hands like doctors do and put on my most serious face, my “doin’ important work, stand back!” face. I hope this giddy feeling never wears off.

Over the summer I lost about 25 pounds; right now I’m at 279. I had a bad week in mid-July where I gained eight pounds and it took three weeks to take it back off, but I’m finally back in the black. I am looking forward to getting into a routine with school and work where I can build in some gym time. I need to build some endurance in my heart and lungs so I can keep up with my long-legged preceptor and stave off any asthma attacks in the winter months ahead. I believe that if I strengthen my lungs my asthma could be completely unmedicated. Right now I use my rescue inhaler up to 3 times a week. I’d love to see that number go down.  I also need to build stronger muscles in my back, adductor, hamstrings and stomach. I have very strong legs (it takes a lot of strength to carry around a big body!) but my back has really atrophied because I have babied it for so long (I have two bulging lumbar discs that have been treated with a string of spinal blocks). I have to protect myself with some preventative strength training so I don’t injure myself on the job. I lifted a patient on Sunday 17 August and hurt myself badly. I scared myself by being able to be injured so deeply. It can’t happen again.

I’m looking forward to an Autumn full of hard work and hopefully some hard play. I’ve realized over the summer that working hard is one thing, but doing things with friends and loved ones is just as important. I want to focus on building friendships with my new coworkers and keeping in touch with my former ones. I plan to reconnect with a lost friend after four years apart, and I have made a promise to myself to go on at least one date this Fall. I have to not only look for love, but follow through and pursue it. If it is in God’s plan to be with someone who makes me happy, then I will accept it with open arms. Come and find me!

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After a long weekend of back-to-back 14 hour shifts, my mom looks forward to dinner on Sunday night. I try to make something comforting, which for our family usually means chicken in a creamy sauce (such as Chicken Marsala or Paprikash). Since I’m trying to cook lighter, I’ve been avoiding my old standby of heavy cream and sour cream and tried Skillet Chicken and Rice with Peas from America’s Test Kitchen:

4 boneless, skinless chicken breasts

Salt and pepper

AP Flour

Vegetable oil

Unsalted butter

1 med. onion, minced

3 cloves garlic, minced

1/8 tsp. Red pepper flake

1 1/2 cups long grain rice

1/2 cup dry white wine

4 1/2 cups chicken broth

1 cup frozen peas

2 tbls lemon juice

5 scallions, sliced thin (optional)

Season the chicken with salt and pepper and dredge in flour. Heat oil in a 12-inch nonstick skillet over medium-high heat until just smoking. Brown the chicken well on one side, about 5 minutes. Transfer the chicken to a plate and set aside. Add the butter to the skillet. Add the onion and 1/2 teaspoon salt, and return to medium-high heat until softened, 2 to 5 minutes. Stir in the garlic and pepper flakes and cook until fragrant, about 30 seconds. Stir in the rice thoroughly and let toast for about 30 seconds. Stir in the wine and let the rice absorb it completely, about 1 minute. Stir in the broth, scraping up any browned bits. Nestle the chicken into the rice, browned side facing up, including any accumulated juices. Cover and cook over medium heat until chicken is cooked through. Transfer the chicken to a clean plate. Gently brush off and discard any rice clinging to the chicken, then tent the chicken with foil and set aside. Return the skillet of rice to medium-low heat, cover, and continue to cook, stirring occasionally, until the liquid is absorbed and the rice is tender, 8 to 12 minutes longer. Add the peas and lemon juice to the rice and let heat through. Season with salt and pepper to taste and serve with the chicken and lemon wedges.

My notes:

Last week I had no onions but I had three shallots, so I used those. I browned the chicken as ordered on just one side. I deeply carmelized the shallots, which I thought at the time was a mistake. I used Tilda basmati rice in favor of long-grain domestic rice (Tilda is my rice of choice). Finally, cartons of chicken broth comes in 32 oz. (4 cups) so I used more wine than the recipe called for to come up to an even 5 cups of liquids.  I actually used half white wine and half vermouth, since I didn’t have very much white wine left.

The resulting dish was deeply fragrant and brown. You could smell the carmelized shallots through the whole house. It was so tasty we both gobbled up double portions, fairly licking our plates. We both remarked that we wished for more browned chicken, so I noted that I would brown both sides of the chicken next time.

Tonight I used onions and half vermouth/half maderia. I didn’t carmelize the onions much, since I watched the episode of America’s Test Kitchen that this dish is featured in and it was very blonde. I browned the chicken on both sides and used World Market brand basmati rice, because I had used all my Tilda last week.

The dish was blonde and frankly, insipid. Without the deep carmelization of the aromatics the dish fell flat. The addition of extra lemon juice couldn’t even lift the flavors. The rice was also not as firm and individual as Tilda, which I feel caused the dish to suffer. Finally, the maderia was too sweet for this application.

All in all, I would use my modifications from week one, using Tilda rice, extra dry vermouth and shallots. I would brown the chicken on both sides, and deeply brown the aromatics. I would also use plenty of salt, because the chicken and rice suck up seasoning like crazy. I would make this dish again, because it is comforting, simple and sooo tasty.

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I r serious nurse

I finished my first week of orientation and training at the hospital with a full morning shift on the Surgical unit. I’ll split my time there and Medical on the 4th floor. Surg is on the top floor of the hospital and shares the floor with Telemetry overflow (closed the day I worked), the Sleep study unit and ECC. Both sleep and ECC are closed wings, so the only traffic on Friday was in my unit. There are 18 rooms and one central nurses station. Unlike my mom’s unit, there are no C.O.W. (computer on wheels) cubbie ports every 3-4 rooms and their Pyxis station isn’t in a coded room it’s in the open with a fingerprint lock.

In the morning the Nursing Assistant’s main jobs are baths and bedding. In the evening, when I’ll be working, the main jobs are vitals and I & O (intake and output). It is these things, and other things I observe and execute during the day, that I will chart in CareCast. On Friday, the day started quietly at 7 am. Most of the patients (pts.) were asleep and my preceptor L went down the hall initialling the hourly rounding cards outside each room. She then printed off a page with the pts. names, room and bed number and prognosis that she could use during the day to note the things she would be charting at the end of the shift. She must chart the time when she either gave a complete or assisted bath or observed the pt. bathing him/herself. Eye care, oral care, hearing aides, glasses, foot care, etc. must also be charted where applicable. It’s amazing all the little things you don’t think of that you do to get yourself ready for the day. Whenever L assisted a pt. with something, like assisting to the bathroom or washing a pts. back she had to chart. She also has to chart if she changed a pts. bedding, which has to be done every other day.

Nursing assistants also get to do all the stuff RNs don’t want to do, like bedpans, wound care, walking aid, taking pts down to the queue to leave, and cleaning up any messes that come along. Around 09:30 a pt. projectile vomited all over herself, her bed, the wall and the privacy curtain. Guess who got to clean it up? L. When an obese patient took off down the hall and locked himself in the bathroom, guess who had to wrap his naked ass up in two gowns and get him back in bed? L. It was so crazy, and yet it didn’t really faze me. I was expecting much, much worse. It was so nice to be able to help the pts. to be honest, that all the poo, pee and stank didn’t really bug me that much.  The only thing that really got to me was this one pt. who had a bad wound that he didn’t take very good care of. It smelled so bad and he demanded his heat be turned up and his windows and door shut that the stank got trapped in his dark little room. Uuuugh. I could smell it for hours after I got home….(shudders)

As soon as I got home I stripped my scrubs off and got in a hot shower. The hospital’s unique smell lingers on your skin, and I could smell it. I wanted to smell like me again…soap, shampoo, sunshine, flowers. I dried my hair in the sun while I read a book and drank coffee. Afterward I took a nap. It was a great week but I had had enough.  I slept 11 hours today and took it easy. Went to see a movie tonight after dinner with E. Had a couple of cocktails. Trying to get ready for another week of training!

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