Monthly Archives: October 2013

It’s Monday in My World, and that Means Soup. . .

Once again, I work tonight.  Can I sleep? Nope.  So, I thought I’d whip up a batch of my favorite workweek survival soup, Zuppa Toscana.

This Olive Garden knock-off recipe, courtesy of blogger The Girl Who Ate Everything, is absolutely yum-tastic and is just as good (if not better) a few days later zapped in the microwave as it is freshly born.  So, enjoy, and don’t hold back on the kale (unless you’re taking warfarin/have an artificial heart valve – basically the same thing, right?).

Cook’s Notes:

Sausage – Jimmy Dean regular is perfectly fine.  Nothing fancy needed.

Red Peppers – Don’t buy a jar if you’re never going to use it.  Just save those packets that come with your pizza!  (Or remember to swipe them from the hospital cafeteria like I do.  Sucks, though, when you reach in your pocket for an alcohol wipe and all you can find is these.  Oopsie!) Two will do it for this recipe.

Kale – two kale leaves is about right, chopped finely (stemmy inside parts removed – yuk!).  Let the soup “cook” the kale so that it softens and has a chance to swap flavors.

*Kale, by the way, is the queen of the winter garden – its flavor only improves with frost!

Hate measuring?  Buy one box broth (4 cups) and add one can broth.  Close enough.

Bacon – be lazy.  Chop the six pieces, then microwave between towels on a plate (6-9 minutes depending on your zapper) until crispy – and ta da! already crumbled bacon.  Crumbling bacon is for people who have time (not me).

Be sure to put the potato peelings, onion leavin’s and kale stems in the composter.  Saving the planet, the lazy way!

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Recipe Link

 

Personality – as Perceived by Self and Others

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Urgh, I just can’t eat anything else made of pumpkin, and I think my skin is turning orange (yes, this can be achieved without the use of certain self-tanning lotions).  So, time to turn to my studies, which I neglected shockingly over the last week.

As part of my RN-BSN curriculum, I participated in an activity designed to help me compare my perception of my personality traits (known, I think) with the manner in which I am perceived by others (unknown).  Hence, the entrance of the Johari Window into my existence.

So, should you wish to construct your own Johari Window and seek input from those you know to find out how you are perceived, here is a link to a build-it-yourself, invite your friends (and frenemies, for that matter) to assess your personality(ies):  Interactive Johari Window

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One Can of Pumpkin, Three Possibilities

So, in rummaging through the pantry (actually, I’m giving it airs, it’s a kitchen bookcase, garden-variety cupboards and a plastic tub that holds up my recycling bin.  Sorry to shatter your image of my kitchen) I discovered a can of pumpkin puree.  Hmmm, I thought, what can haz the internets have in the way of a recipe or three to help me increase my beta-carotene intake?  To follow are today’s attempts, notes and links to said recipes.

#1 on the Husband of DisorderlyCNA list – Pumpkin Cranberry Pecan Muffins

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The other half likes to heat one of these up with butter and raspberry preserves (clearly he is a genius, and not just for marrying me).  I suppose you could use raisins if you didn’t have cranberries on hand.  Recipe Link

#2 Pumpkin-Bacon Baked Mac’N’Cheese

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Dear Heart looked at me suspiciously when presented with this (ahem) three-cheese pasta dish.  I maaaaay have stretched the truth a bit in that the three cheeses are parmesan, pumpkin and egg yolks.  Probably going to hell for this, but whatever, it’s healthier than the normal version featuring two cups of cheese.  It’s tasty and would be even healthier made with whole-wheat macaroni.  Recipe Link

#3 Pumpkin Soup

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“I HOPE YOU’RE OUT OF PUMPKIN!!!!” (It is possible I carried things a bit far with this gourd craze today.)  I thought this was yummy and filling while being easy to make.  Do not omit the sweetener, it makes all the difference.  I laid on the ginger a bit harder than the recipe specifies, and added black pepper.  In keeping with my “damned if I’m leaving the house on my day off theme,” I didn’t have any dry white whine (haha) so I used some very fine screw-top-bottle sherry instead (a spirit that gets along well with onion and cream in creamed onions).  Seemed tasty even so.  The soup is garnished with parmesan in the photo above.  Recipe Link

So, dear readers, enjoy these tummy-warming fall recipes!

I’ve been reading Florence Nightingale’ s work, Notes on Nursing: What it is, and What it is not.  It’s interesting how relevant this text is to the work of nursing, especially concerning how much we should hover over those who receive nursing care,  and the role of the nurse in running interference between the patient and well-meaning folks who put their concern for the patient before his/her well-being, if you understand what I mean. 

This work is available free from Amazon if you have a Kindle.  If you don’t, here’s a link to Notes on Nursing – Nightingale (free).

Read it, I assure you, it’s a good use of your time, and while the content may seem obvious to us now, remember that Pasteur’ s germ theory wasn’t yet widely accepted during her time.  Hence, why her work is so amazing. 

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Enchiladas, ACLS and CIWA

Verde Chicken Enchiladas Tillamook

enchiladas

In tonight’s episode of “disorderlyCNA is too lazy to go out,” I submit for your consideration an enchilada recipe that takes 10 minutes to assemble and 30 minutes to bake. . .serves 3-4 comfortably. I make this when I am totally uninspired and need to clean out the pantry. Plus, it’s quite good left over.

28-oz can verde enchilada sauce (I like Las Palmas, although La Victoria would get the job done also)
7-oz can fire roasted diced green chiles
two 12.5-oz cans Kirkland canned chicken (although you could probably also use a rotisserie chicken – unfortunately for me that would involve leaving the house. Fail.)
*Oregano
*Cilantro
*Ground cumin
*Tillamook extra-sharp cheddar
*Tillamook extra sharp vintage white cheddar
6 tortillas (burrito size, please)

Preheat oven to 375 (350 convection)

In large saucepan, combine all the canned stuff (drain the chicken before adding) and spices to taste. Mash the chicken into the sauce with the back of a slotted spoon. Subject mixture to medium heat until bubbling. Remove from heat.

Next, shred generous amounts of the cheeses, then mix together (I suggest an amount that yields at least 3/4 cup when in its final shredded form).

Microwave the tortillas on a plate for 1 minute on high (10 seconds per tortilla). To assemble enchiladas – lay one tortilla on another plate, and, using slotted spoon, remove 1/6 chicken/chile/spice mixture, place in a line along the center of the enchilada. Add some of the shredded cheese, then roll tightly and place in 13 x 9 pan (I suggest a heavy pan, such as a Corning ware). Repeat until you are out of tortillas, chicken filling and all but 1 cup of the cheese. Pour the green sauce over the tortillas, being sure to “paint” all of the top surfaces. There will be a lot of sauce in the pan. This is not a reason to panic, but rather to rejoice. Add the remaining cheese to the top, then bake for 30 minutes. Cheese adequacy is important here – don’t skimp!

I have to take ACLS this month.  I’m looking forward to yet another opportunity to freeze up in a mock code situation.  Real codes, no problem. . .but there’s something about skills lab that makes me freeze!  It’s all good, though, if I can just memorize those pesky algorithms and the meds, I should be OK.  At least the CPR part is familiar!

One last pro tip and I’m out for the night.  Nurslings, when you care for your first patient who is withdrawing from alcohol, you may well follow the CIWA protocol for monitoring and medicating your patient so’s they don’t climb out of bed/seize/wind up in the ICU/die on you.  Key tip – it’s great to assess the patient while you’re in the room. . .but don’t forget to step out for a few moments, then sneak back in to see if they are pulling at their covers, gown, or otherwise acting withdraw-y.  Could mean the difference between an appropriate Ativan dose or one that is inadequate and results in your patient hitting a score in the 20’s and scaring you.  **Whew!**

Well, that’s all my cooking/medicating hints for today!  To your health!

Dutch Apple Cake

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Maybe it’s that I’m no longer being actively tortured by nursing school (online BSN program is keeping me busy, but I no longer lose 5-10 hours/week driving to/from campus and/or clinical) – I’m rediscovering my love for baking, particularly recipes I haven’t made since, oh, MTV was cool.  Here’s one of my favorites:

Dutch Apple Cake – recipe cheerfully liberated when I was a teenager from my mother’s ancient Better Homes and Gardens cookbook. (Reading under the covers with a flashlight so I wouldn’t get caught with it. You’re welcome.)

Preheat oven to 400 (375 convection)

1 cup flour
1.5 tsp baking powder (I use Calumet)
0.25 tsp salt
*sugar (as sweet as 0730, or 1930, depending on what shift you work)
*butter (you can use margarine, but I detest that stuff)
0.25 cup raisins (grapes that spent a wee bit too much time on the tanning bed)
1 egg, well beaten (like my spirit after nursing school)
0.25 milk (just regular milk, not the milk of human kindness-save that for work)
0.5 tsp cinnamon (do not inhale. this is bad. you might die.)
0.25 tsp nutmeg (couldn’t find mine today, not exactly a crisis)
3 cups peeled apple slices (although I think one could leave them peeled and be just as happy. In fact, research indicates one’s gut flora would prefer it, so they can party with it)

Mix flour, baking powder, salt and 2 tbsp sugar. Cut in 1/3 cup butter (Whoops, looks like I “accidentally” doubled that today. Was delicious, not sorry.) Add raisins and combined egg and milk, blend well. Spread in buttered (because you can never have too much butter) 10 x 6 x 2 (or 9″ round, or 9×9 or 8×8) pan. Arrange apple wedges fancily on batter (sneakily gobbling down any extraneous wedges while the dog watches, drooling). Brush with 2 tbsp melted butter, then sprinkle with spices mixed w/2 tbsp sugar. Bake at for 30-40 minutes. Cut in squares and serve warm. Yum!

Prospective Nursing Students – Some Articles of Interest

Nursing shortage?
Nursing shortage?

My baseline personality type is Golden Retriever/Optimist, so please keep that in mind when referencing the articles linked below.  But gosh-darn-it, I’m pretty grateful to have my acute care new grad position; not all graduates, particularly on the West Coast, are so fortunate (I hesitate to use the word lucky as I worked full-time as a hospital CNA and bypassed things like sleep, family, exercise and gardening to survive nursing school and get my proverbial foot in the proverbial door).

New graduates need to be aware that the nursing shortage doesn’t necessarily equate to a shortage of new graduate nurses, but rather experienced nurses, particularly those with a sexy specialty, such as OR, ICU, ED, L&D, etc.  New graduates are expensive to train. . .I estimate about $20,000-$50,000 per nurse (considering the new nurses compensation/benefits during the orientation period, compensation/benefits cost for preceptors, whether the hospital offers an RN residency program, hospital-based training classes, educator cost, etc. etc.).  *Note:  I have done zero research about this cost. . .just a good educated guess on my part.  Maybe it costs less, maybe more. . .your comments/references are welcome.

So, with that in mind, please read each and every one of the attached articles, prospective nursing students.  These are not meant to discourage you, just to allow you to enter into this adventure with your eyes open and living/lifestyle costs calculated, particularly if you are contemplating leaving an established, successful, remunerative career for nursing.  Obtaining a position is not automatic, no matter what your school’s recruiters tell you! It’s not that the schools are being dishonest, it’s just that they themselves are not actively looking for new grad RN positions, and they may not be surveying their graduates 4-6 months after graduation to find out what sort of nursing employment has been obtained.

Recalculating: The “Nursing Shortage” Needs New Direction

In Debt and Misled: New Graduate Voices on the “Nursing Shortage” (I wonder to what extent for-profit nursing schools and the push for the BSN play into this?)

Realities of the Current Job Market (What you, the nursing student and soon-to-be new grad can do to enhance your employment prospects. Like, be a CNA!)

Lastly, I recommend looking at the National Student Nurses Association website, which has information for current and prospective nursing students.

Sorry to be such a Debbie Downer, but I encountered these article links at the end of the new grad RN survey sent to me by NSNA, and I thought they were relevant.