Monthly Archives: November 2013

Staying Organized During Football Season and Your Average Hospital Shift

Staying Organized During Football Season and Your Average Hospital Shift

Really, there aren’t two topics of more importance, so why not lump them together. Since I’m sort of between teams right now (oh, the heck with it, Go Raiders!!!) it will be fun to work through this flowchart, since I hate thinking for myself!

On another note, I’m attaching the shift routine worksheet I’ve made to keep on track at work, and prevent charting deficiencies. It really helps me remember to order labs when I’ve got patients on protocols (e.g.; K+ replacement, etc.), to identify Core Measures (thanks, Jay-Co and CMS!) and mind my p’s and q’s. I’m attaching it should it be useful to others on the internets.  Here you go:  Shift Routine for Med-Surg

 

Advertisements

Steel Cut Oats – Much Easier than You’d Think!

Different Oatmeal VarietiesSteel Cut Oats – Much Easier than You’d Think!

I’m on a mission to drop my LDL numbers, since the new ACA has me running scared about paying a surcharge on employer-provided health insurance in the future.  Just takes one float to Neuro for me to be convinced that now is the time to do some arterial maintenance.

This easy recipe by Marin Mama Cooks is, well…easy!  For my weaponized fiber, I choose Bob’s Red Mill SCO’s (local NW product). I like to add a little skim milk, some brown sugar, and a whole, sliced banana.  Great before work breakfast (dinner?  lunch? . . .whatever, we night shift folk are all mixed up anyway!).  Enjoy!

Eureka! It Works! It’s Easy! It’s. . .No-Knead Homemade Artisan Bread

No-Knead Homemade Artisan Bread

This was easy! Why pay $4-5 per loaf of pricey artisan bread when this is so simple? I’m pleased to report that this recipe (click on photo to visit the recipe on The Italian Dish blog) worked extremely well. I’ll try a whole wheat version next chance I get.

For my storage container, I used an inexpensive Rubbermaid Take-Along container (the kind that would fit a 1.5 dozen muffins). I didn’t punch a hole in the lid – rather, I just put it on without sealing it. I used a baking stone, but skipped the water step, as the author of this blog stated she suspected that contributed to a cracked oven window.

Happy baking! Meanwhile, time for me to quit procrastinating and start that paper for school. Ugh.

No-Knead Artisan Bread – OK, I’ll Try It!

I love bread.  Nothing matches the smell of bread baking to make a house feel like home.  (Argh, cliche time!)

One problem. . .I am terrible at it.  Precision isn’t my strong suit unless it concerns medication administration (good thing, right?) and grammar (when I feel like it, I’m a tremendous grammar snob).  Good baking, especially of yeast breads, requires some precision.  I just wander off and lose interest, or forget a step, and before you know it?  Flat, heavy, uninteresting loaves of bread emerge from my oven.  It’s just disappointing!

However, I ran across a recipe for no-knead, artisan bread in one of the local fishrags (that’s newspaper to those of you that actually still read one) that intrigued me.  So, I’m giving it a whirl.  If it works, I’ll share the step-by-step, of course giving credit where due to the original recipe.  It’s rising right now. . .I’m hopeful of avoiding disaster.

Speaking of disaster, do you have a plan should one strike?  Visit http://www.ready.gov/make-a-plan for some hints.  And don’t forget to plan for the needs of your pets.  This can be overlooked.

So, if I say no more on the topic of home-baked no-knead artisan bread, you may assume that it didn’t turn out well.  So, stay tuned. . .

 

Nursing Students – Alternate Item Format Got You Down? I Recommend. . .

Strategies for Alternate Item Formats on the NCLEX-RN Exam, by Silvestri and Mojica (ISBN-13: 9781416038412) is the best resource I have found for tackling the dreaded SATA (select all that apply).  You know’em, and you hate’em.  I have never encountered one nursing student (or a nurse, for that matter) who LIKES these types of questions.

And, guess what?  They don’t end with nursing school and the NCLEX.  No siree. . .turns out RN-BSN programs love’em too.  Yay.

So, I present to you a link for purchasing this resource, dirt-cheap at Bookbyte.  Unfortunately pour moi, I am paid nothing for selling their stuff, but frankly, the warm, fuzzy feeling in my heart that will come from knowing that someone listened to me, took my advice, and had a less hellish time in school/NCLEX/RN-BSN program will be enough.  (Yes, I am being unduly dramatic.  And, guess what?  I don’t care.)  Because I bought this book as an impulse buy (much healthier than my usual gazillion-calorie latte as an I-love-me indulgence).  I loved it.

My hilarious classmate (loved the way he would say, during study sessions in the library – “Damn you, (insert nursing instructor’s name here) I hate your questions!  This is shit!” (imagine Russian accent) at the top of his lungs – well, he loved this book too.  Another classmate who failed NCLEX the first time around and then slayed it – partially, she said, due to this book – loved it.  Now the book lives on, humbly serving this year’s second-year nursing students who suffer after us.  I’m sure it will continue to be passed on.  You need this book, nursling.

If you don’t heed my advice?  I’d better not catch you complaining about SATA questions (except to say that, darnit, there were not NEARLY enough SATA questions for me when I took the NCLEX).  Said no nursing student, ever.

Image

 

A Few Lessons Learned this Week

A Few Lessons Learned this Week

It was an interesting week for this newbie float pool nurse. Here are the primary lessons learned this week:

1. Saving hundreds of dollars by replacing cable with Netflix will be partially cancelled out by Mr. DisorderlyCNA watching the show My Cat From Hell and deciding that our well-behaved Russian Blue needed an 8′ cat tree (costing more than I used to gross in a week as a CNA). Oh well, the cat’s happy.

2. If you run piperacillin-tazobactam (running at 12.5 mL/hr) as a primary line and “Y” the patient’s maintenance fluids into said ABX line, you are a bad, bad person. No, I didn’t do this, but I was the lucky nurse who got to completely re-route this disaster someone left for me. I guess my infusion skills can always benefit from practice, but , seriously!!! Zosyn run at a very slow rate and NOT piggybacked into some NS set to run at 21 mL/hr leaves you with air in your line, which is miserably difficult to clear (and will definitely wake up your poor, sleeping patient).

3.  Not used to working with psych patients?  Well, reflective communication and therapeutic silence are your best bets!  Otherwise known as stall, stall, stall until someone who usually works with the patient shows up and saves your bacon!

4. People with health conditions should/must wear medic alert tags or bracelets. There really is no excuse, and, in an emergency, even the most composed person can miss an important detail when giving a history to the medics.  Don’t settle for the cheapie kind that let you put a label or labels with the person’s condition on the tag, go ahead and get an engraved one like this.

5. When making a new muffin recipe for the first time, bake just five (one in each corner of your muffin pan and one in the center) to gauge the success of the recipe and/or make adjustments before using the vast majority of your batter and having to to start over.  Waste not, want not!

So, with that, here is a lovely recipe for Orange (ahem, Grapefruit) Glazed Poppyseed Muffins!  (Adapted from this recipe.)

Cook’s notes:

1. This recipe could be lightened substantially by going halvesies with the oil and some applesauce. These are not for the faint of heart, and one muffin goes a long way.  Probably could reduce the sugar to 1.75 cups and be just fine, as well.

2. Do not, do not, do not underbake these babies! Or you will wind up with your muffins doing a Jim Breuer imitation (early career).

3.  No orange juice?  Raid Mr. DisorderlyCNA’s secret stash of ruby-red grapefruit juice!  Or apple juice would work, I suppose.

4. A colored dishtowel makes a lovely backdrop for a photo of your baked goodies. Thank you, Costco!

INGREDIENTS:

Muffins:
3 eggs
2 1/2 cups white sugar
1 1/8 cups vegetable oil (or half oil, half applesauce for a lighter muffin)
1 1/2 cups milk (you can actually skip this if you don’t want it – I forgot to add this and the muffins were still bomb!)
1 1/2 teaspoons salt
1 1/2 teaspoons baking powder
1 1/2 tablespoons poppy seeds
1 1/2 teaspoons vanilla extract
1 1/2 teaspoons almond extract
3 cups all-purpose flour
Glaze:
3/4 cup white sugar
1/4 cup orange juice
1/2 teaspoon vanilla extract
1/2 teaspoon almond extract
2 teaspoons butter, melted
DIRECTIONS:
1. Beat together the eggs, 2 1/2 cups white sugar and vegetable oil (and/or applesauce if using). Add in milk (or not!), salt, baking powder, poppy seeds, vanilla, almond flavoring, and flour. Mix well.
2. Bake in paper lined muffin cups filled 3/4 full at 350 degrees F (175 degrees C) do not adjust temperature if using a convection oven for 20-25 minutes. The tops should be browned and a toothpick inserted in the center should come out clean.
3. Remove muffins as soon as you can while still warm/hot and cool to just warm before dunking tops into glaze. Turn right side up and cool on a cookie rack (with a cookie sheet under it or you’ll have a hella fun mess to clean up).
4. To Make Glaze: In a saucepan over low heat, combine 3/4 cup sugar, orange juice, 1/2 teaspoon vanilla, 1/2 teaspoon almond flavoring and 2 teaspoons melted butter. Warm in pan until the sugar is dissolved. Dunk muffin tops into glaze when cooled to room temperature. (Omit the glaze altogether if you don’t like the mess, but you’ll have to live with yourself for being such a chicken!)