Friday, January 28, 2011

Why I decided to run 26.2 miles.

"Stillness must begin in the heart. It is a decision, an active choice, to become still, to still your soul. Sometimes, it is as if there is a bunch of monkeys in the tree-which-is-your-mind; and you will not still them by shouting. If you speak quietly and gently- peace will result." ~Celtic Book of Prayers.
I found this quote on one of my favorite blogs recently. Be Still and Know, a mother and physician and soon to be missionary in Africa, writes about her life and daily struggles raising a daughter with non-verbal learning disorder. Truly a brilliant writer... she has a way with words that reaches out and tugs at your heart strings. Check out her blog if you get a chance!

But I digress... 

As I was reading this quote on her post the other day I began thinking about that stillness. That silence is something I have been longing for recently. When I first began running last May, I dove into it head first out of complete desperation. I let go of one of my most feared demons... my addiction to nicotine and if I didn't keep moving I was terrified it would overcome me at any moment. So I ran... I ran to avoid that deafening silence; to avoid my brokenness. I then discovered that when you run... there is nothing but silence. Just you and your thoughts, flowing to the rhythm of your own two feet. It became cathartic and for the first time in a long time, I felt at peace with myself. At peace with the woman I was becoming. I ran my first half marathon and overcame one of my greatest fears. I also immediately decided that one of my life long goals of running a marathon was completely out of the question. 

"NO way in hell will I EVER do that twice in a row!" I thought as I ascended the freeway home.

Two days later I was already researching marathons that I could run in the upcoming year. I was hooked.
I found a training program that included walk breaks. Jeff Galloway became my personal coach and for every 5 minutes of running I included 1 minute walk breaks. I bought all the right gear, CW-X compression pants, garmin watch, interval timer, multiple pairs of running shoes... the whole bit. On June 5th I will be running my first marathon and have already decided to do another one, two weeks later and another one just a month after in SF. Yup... that's three marathons in the span of 90 days. I will officially become a marathon maniac this year! 

Today I ran 12.5 miles and it was incredibly hard... it took me 2.5 hours, my knees hurt, my legs are sore and I can barely descend down the stairs to my parking lot. Nearly three months into training and I am realizing that it is the silence that is the best and worst part of marathon training. Running such a long distance... you get to a point where your entire body begins to wither and your mind is telling you, "Enough Already!"

You become completely exhausted.... broken even and although you feel as if you cannot take a single step further... you keep going... you keep going to prove to yourself that you can. To push through the pain of it all because you know that in the end you will be re-built as a new person and that the discipline will bring you one of the most amazing accomplishments a runner can ever have.

Finishing 26.2 miles.

Today I ran 12.5 miles without the crowds of people cheering me on. Without music because my phone ran out of power. Without someone telling me, "Keep going... you're almost there!" I ran until my legs felt like jello and then I ran some more.

Today I ran 12.5 miles with nothing but silence and even though it was incredibly difficult... and even though I felt pain in every fiber of my body... I had the joy of knowing that despite my brokenness...
 I can overcome.

Now that is something worth running a marathon for.

Monday, January 24, 2011

10 things I've learned being an ICU nurse

In honor of my 100th post I figured I'd write 10 important things I've learned these past two years of ICU nursing. 10 things  I would tell myself as a new-grad... if only I knew then what I know now. I think it'll be fun to do this and see how it might change over the years.

10. When in doubt gown up!
Self explanatory really but if you're interested... Read this post and you'll see just what I mean. Also, since we are on the subject... it never hurts to have an extra pair of scrubs in your locker and this can be applicable to any hospital health care worker.

9. It's all in the details...
Even if its the smallest change or just barely off vital sign, lab value etc... sometimes its the subtleties that add up to a very important diagnosis. Example: A nurse once sent home a pediatric patient with a temperature that was slightly below normal. 96.9 f (normal  is 98.6 f) The child ended up back in the hospital the next day with full blown sepsis and ended up later passing away. The below normal temp. was a sign that the patient was in the "cold" phase of septic shock.

8. Some things just take time.
No matter how much you study or how many classes you attend...some things just come from experience.... and that just takes time. Don't stress about trying to get the "difficult" assignments... they will inevitably come to you and when they do... trust me... you'll miss the days of getting the patient up to the commode 10 times in one shift.

7. A little lot of humility goes a long way.
If there is one thing I've realized about myself and people in general while working in the ICU is that a lot of the time when people are cocky or defensive it is because they have some major insecurities they are trying to compensate for. Consciously having humility will always get you so much further than being domineering or prideful towards others... especially when you are working in a team setting.

6. Never, ever say things like, "I'm bored." "Man, it's slow." or "It sure is quiet around here these days!"
Phrases like that are certifiably going to buy you at least one nasty code blue or a few gnarly admissions in the middle of the night... if it's quiet just enjoy it while it lasts!

5. If you are unsure about something STOP and double check before you proceed.
Probably one of the hardest lessons I have learned since becoming an ICU nurse. Even if it is in the middle of a code... even if people are rushing you or yelling at you... even if you are afraid of looking dumb... if you feel unsure about a drug you are giving or a procedure or a protocol... stop and ask! Trust me... it is always worth taking the extra minute or so to double check or to ask for help. It takes only a few seconds to make a fatal mistake and only a few seconds more to prevent one from happening. It's always worth the extra time and people will trust you and respect you more if you know when to ask for help.

4. A good report sheet and a checklist can keep you sane.
The thing that I love most about ICU work is the detail of it all. As ICU nurses we care for our patients from head to toe. Most of the time our patients rely on us for everything large and small... from oral care to breathing. No task is insignificant and sometimes remembering it all... even if you have only 1 or 2 patients... can be daunting. Having a thorough report sheet and a checklist of things to be done can be a complete lifesaver when things get crazy.

3. Choose to be happy.
The ICU is often times a really difficult place to work and if you aren't intentional about being happy in the midst of that... sometimes it can really bring you down. I think sometimes we have to make a conscious effort to smile, laugh and be happy because usually... the people around us are really sick and scared and are often times in the worst physical state they have ever been in their entire lives... it never hurts to try and bring some joy into the ICU.

2. Leave work at work.
When I first started I used to always bring work, home with me. I think its only natural to do this to a certain extent but it has to be in moderation. It's a good thing to maybe re-hash your day on the drive home a bit... maybe there is something you forgot that you need to communicate to the nurse who followed you.... or maybe something went wrong and it's good to think about how to do it better next time. But seriously... learn to just let it go. Take a deep breathe, go for a run, read a book, take a hot bath... do something to re-center your mind or the stress of working in the ICU will have you on the burn out list before you can say "help!"

1. Follow your intuition!
Because most of the time you are completely right on and it may be that the "hunch" you have can be the clue that can save a person's life. I can guarantee that you will never regret bringing up the small things to the physician even if they seem silly... however if you ignore what your intuition is trying to tell you, and it means you miss something huge later on... well that will be something you will definitely regret.

Saturday, January 22, 2011

The joy's of the ICU

This past weekend I was unlucky enough to have one patient plus the admit bed.... which means I am "open for a hit" as we say in ICU terms. If there is a patient that decompensates in the hospital or comes in from the ER and needs to be admitted to the ICU, I am the one to receive that patient. Sometimes its a simple admission... someone we just have to monitor overnight and sometimes it can be a complete train wreck and I spend the entire shift catching up and getting the patient stable and settled in. Well, as luck would have it I ended up getting an admit that night. (I am definitely known to be a black cloud at work) 

It wasn't completely awful but it was busy and it was my least favorite type of patient... neuro. yuck I hate neuro... ok, I don't hate neurology patients... I just don't feel as comfortable with them as I do say... cardiac or CT surgery patients. Every subtle change in an assessment of a neuro patient can mean something very drastic clinically speaking... so you have to do frequent neuro checks... every hour at least. 

Pupils, motor function, sensory, symmetry, alertness and orientation... its exhausting and when you don't get them often it can be a little intimidating. The patient I had was a rapid reponse call from the surgical floor. He had an evacuation of a subdural hematoma (brain bleed) and was now starting to show signs of a change in neuro status. Couldn't talk, wouldn't follow commands... not good stuff and his CT scan showed signs of a re-bleed and a mid-line shift in his brain. 

Long story short... this guy was probably gonna head back to surgery within the next 24 hours. So... it was my job to watch him very carefully for any further changes and then we were to take him back to CT scan at 2:00am to make sure there hadn't been any worsening of the new bleed. Bummer.

So... we call the radiology attending and schedule for the on call tech to come in to do the scan at 2:00am. As I come back from break at 1:45am and I'm prepping the patient to go down to the scanner I hear my friend P. on the phone with the tech... it wasn't a friendly conversation... I could tell she was frustrated by something. Turns out this particular tech who works on call gives everyone a really hard time if you aren't at the scanner EXACTLY when he wants you there... doesn't matter if its 15 minutes before the appointment... in fact doesn't matter if the patient you have is coding and unstable... this guy does not like to be inconvenienced and he will let you know... for sure.

Well... having that in mind... when we get down to CT... I see the tech and I smile and say hello. His response "YOU'RE LATE! I called 20 minutes ago to tell you I was ready! I'm supposed to be scanning the patient at TWO!" 

Wow... ok buddy... you're being a jerk but I'm still gonna be professional and explain that we are here at 2am because that's when the appointment was. He continues to berate P and I about it as we're putting the patient on the scan table... being incredibly unprofessional and rude in front of the patient. At this point I'm starting to get really annoyed too... this guy was rude to my co-worker and is apparently always rude to them and on top of that this guy is getting paid a TON to be an on call tech. I'm thinkin'... if you don't wanna be on call then don't sign up for the job.

Ok whatever... is all I could think to myself.... let's just get this done with right?

Oh no.. this guy had to take it to another level. As we are walking out of the scanner and he passes through the super heavy doors that block out the radiation from everyone else... he SLAMS them in our faces. Hits the automatic shut button and tries to lock us in the scanner!

Oh HAIL no!!! You did NOT just do that?! My buttons were officially pushed and this over-protective, ICU nurse decided she had enough of this guy being rude to her co-worker and friend and especially her patient! For the next 3 minutes of the scan I proceeded to spew an entire monologue about how incredibly rude he was and how it was  "2:06AM and the patient is on the table getting scanned!"

"If 5 minutes is SUCH an inconvenience for you and you cant handle working with an ICU schedule than you are in the wrong profession! It is NOT about you! It's about the patient and I don't care if we are 30 minutes late! If we have a patient that is unstable you WAIT until we can bring them down or you don't be an on call CT tech! I don't care if it's an inconvenience for you... this is about some one's LIFE here!"

Phew... totally did not see that coming. See... I know I can be feisty and all but I don't usually say what I'm thinking to the person... I usually just think it in my head and then go vent about it to a co-worker or friend. Ohhh no... not this time though... this guy made me MAD.

The entire trip back up to the third floor I went off about how that guy was ridiculous and how someone needs to write him up... blah, blah, blah. The best part of the story comes next though. 

By the time we get back to the room and we're getting my patient settled... I'm finally calmed down and P is sharing with everyone how I told off the mean CT tech (not gonna lie I got some props for that one even though I might not have been the most professional about it myself :/ )

Finally I look down at my patient... this man who has not said an entire word or responded to an entire thing I've said the WHOLE night.... I look down at him and say, "Mr. H. have you just been sitting here listening to me complain about this CT tech the entire time?"
The man looks at me and smiles... nods his head and with a slight giggle goes, "haha.. yeah"

P and I instantly broke into laughter.

Friday, January 21, 2011

7 Quick Takes Friday

1. Having the flu sucks but whats even worse is waking up a week later with a sore throat and a possible relapse around the corner. Yuck :( I will be spending most of my day off in bed probably.

2. This week at work was absolutely insane! Apparently, I underestiamted the craziness that a full moon brings around here. The unit is the busiest its been in months... which I guess is good because we've been dealing with major budget cuts and all of our nurses have been floating to other floors... even the med-surg floors which really stinks. Definitely no nursing shortage here.

3. We have had no Internet or TV in our house for over a week now and its been pretty strange. I feel very disconnected from the world. As a matter of fact I've had about 4 blog posts I've started writing but haven't been able to finish because I have no Internet. When our roommate Katie moved out the cable/Internet was under her name and it just got canceled this week. The TV won't be coming back but we will definitely have to get Internet replaced very soon.

4. I got my hair straightened yesterday! Took 5 hours and I had to stay up after work to get it done = up for over 24 hours :( but it was totally worth it. Pictures of that will soon come hopefully. The before/after pictures are kind of amazing. Hopefully I can find a good example of my before  Hermione Granger-esque hair.

5. In less than 20 days I will be leaving for Ireland and Lebanon to visit two of my BFF's!!! I AM SO EXCITED! It's been years since I've been out of the country and I miss them both a ton. Plus I can't wait to get some seriously amazing photos of both countries. :D

6. Chris got to meet my mom yesterday and it was really great actually. My mom and I have had our issues in the past but I could tell she was incredibly happy for me and she really liked Chris a lot. It definitely made my heart smile to realize how much he is becoming such an important part of my life and also to know how much he wants to be.

7. Finally getting back into some serious marathon training and it feels great! (minus the soreness and the fact that I realize how much the holidays hurt my training) Did 3 days of running this week.. two of which included sprint intervals for up to 30 minutes! Also finally added in some upper body strength training. Next up is my 11 mile run on Sunday! :D

Happy Friday Friends! What do you all have planned for the weekend?!

Sunday, January 16, 2011

And my soul settles...

The other day I was reading an email from my bff Helena... she recently moved away from the area... still in the same state but far enough to make me painfully miss her daily. So... we write emails back and forth, updating each other on the minutia of everyday life. The details of the places, people and things we experience. We write to each other and we process life simultaneously.

In the email she was describing the people she had recently connected with and she described it as her "soul settling" with them. The fact that they respected her more intense, internal self... how she can just exist with them. It got me thinking about the people and places in my life where my soul settles. I have some amazing people in my life who relate to the world in a similar way that I do... people who are deeply thoughtful people... people who live in an internally focused world and yet in a people oriented way... people who have an affinity for understanding the human condition... and I love that about them...
I also live in a chaotic world called the ICU... a place where adrenaline is always pumping and people are always needing you... where any little misstep can cost someone their life... and it got me thinking.... 

 Where does my soul settle?

(If only I could see this everyday... how could your soul not settle here?)

I can honestly say that the moments when I am most at peace... most settled... moments where I can just exist and feel that deep still water rest in my soul... are the moments when I am alone with my own thoughts... the moments where I can step outside on a run... out on the trails with nothing but music in my ears and the sounds of my feet pounding the ground... a rhythm that lulls me into a sort of trance. Moments where I can go for hours without saying a word to a single person. Moments where I don't have to interact with the world... but I can sit back and soak it all in... the sounds, the smells and the beauty of what is around me. Moments where I am quiet and calm and alone.

I wish I could find a way to turn inward in the midst of chaos and find that settling peace I have when I am by myself. It is the plight of an introvert in many ways.... it is hard for me to feel connected with myself and with the world around me unless I am able to withdraw from everything and everyone... quite a dichotomy I must admit...
but life cannot be lived in such a solitary place... relationships aren't built that way and we cannot exist in the confines of such a detached way of being. I think this is why mediation has become such an integral practice for so many people. I used to meditate daily and I think it is something I need to look into more intentionally. Clearing your mind and purposefully quieting your thoughts... letting the silence wash over you and letting your soul settle in that... tuning into what your mind and body and soul is saying to you... sounds nice.

I used to think that mediation was some strange, new age thing that only weird, "hippy" people did.... until one day, in highschool, my grandfather brought me to a class on meditation from his church. The instructor guided us into a deep silent trance... encouraging us to turn inward as our thoughts effortlessly floated by... one by one... counting our breaths... one by one. After the hour was up, I felt like a new person. Centered, balanced and incredibly calm.... more peaceful than I had felt in ages.
I was officially a believer of guided meditation.
So... I think I am going to make an effort to include mediation... quiet times... in my everyday life. 
How about you?
Where does your soul settle friends? Have you tried any form of daily meditation? If so, please share!

Wednesday, January 12, 2011

Lucky me!

I was the recipient of a blog award recently! Thank you to one of my favorite fellow bloggers, In My Tennis Shoes for the award!

- share 7 things about yourself
  • I am a complete neat freak. For example... at work I will spend a good 20 minutes cleaning up my patient rooms and organizing them a certain way... I also have a particular way for doing pretty much everything like loading the dishwasher, folding laundry... hence my drawers looking like this
  • I LOVE Hello Kitty everything... I have a hello kitty badge holder for work and my work bag is also hello kitty... amongst many other things I own :)

  •  I have the best boyfriend in the world. I have been seriously sick with the flu this week and he was kind enough to brave the germs and bring me Jamba Juice and meds and some much needed TLC. So not used to being the one taken care of but I'm so thankful for it. I <3 him.
  • I have 3 tattoos. The one on my back says Redemption, Hope, Truth in Hebrew and the writing on my wrist means "to heal" in Greek. :)
  • I love trashy TV shows like teen mom, 16 and pregnant and sometimes admittedly I watch the bachelor/bachelorette.... I have no excuse other than its pure entertainment.
  • There are few things in this life that make me feel more alive than running... it is one of the best things I have ever done for myself... becoming a runner. 
  • A few years ago I colored my hair bright pink... sometimes I really miss it.
Thanks for the award! Hope you all are having a great week (and are staying away from this season's flu virus... it's a yucky one!)

    Friday, January 7, 2011


    For those of you who aren't familiar with The Sartorialist you should check out his blog. It's a photo blog... a fashion blog... full of amazing pictures of eye catching people and clothes and the little details of New York, Milan, Paris...

    Recently, he was the subject of a short documentary and in the film he said something that spoke to me... he described taking photos like "going out and allowing yourself to fall in love a little bit.." I have felt that way about photography so many times. When I have my camera with me... I see the world in a different light. I see the shadows and highlights. The lines and geometry of objects. I see the composition of places and the beauty in the mundane. The details of every day life become vivid and more prominent. 
    The crisp sounds of winter and the earthy colors of fall.
    The details of a barn door stop me and the rustic features capture my eye.
    Moments that capture a feeling... a sense that you are taken into a different world. When I take photos I am able to narrow an entire world... an entire scene down to one image... I am able to say "Hey... this is what I want you to see!" It is a wonderful thing and every time I take photos I realize that I am falling in love with the world I am in just that much more.

    Could not have been put in better words... I think I might allow myself to go out and fall in love a little bit today. :)

    Tuesday, January 4, 2011

    Peace, Balance, Contentment

    I am reflecting today on my new years theme: Peace.
    Such a broad term... really in many ways I see it as being balanced and content.
    The holidays are always difficult for me because my family is in many ways disconnected. The busy schedules and massive amounts of baked goods and fattening foods do so much more damage to my health than they are worth. I thought this year would be different too... "I'm training for a marathon!" I thought to myself.... how in the world can someone train for a marathon and gain weight over the holidays, right?! Well my friends... if any girl was gonna make it possible... it would be me. I have gained back almost half of the weight I have lost since I started running last May. 


    Not only that but I was somewhat lax on my running schedule during December... still continuing my weekend long runs but skimping on my shorter weekly runs... and I think it was hurting me more than I realized.
    I noticed my stress level increasing... I also noticed my cravings to want to smoke come back with a vengeance... and I have been tired and run down. It wasn't good and so I decided I must do something about it! Time to get back into a routine...

    Peace.... that is my goal.... contentment and balance. I need to remember to schedule in time to run because I am such a happier person when I do... to schedule in time to eat healthy because it makes me feel better and to schedule in time for me because I need that space to refresh and regain the energy that is lost through the day. My life feels so hectic sometimes... my job is stressful and sometimes I feel like I just can't be needed by anyone else or I'll implode!

    So... the other day I decided that it has been way too long since I have taken pictures... my creative side was dying inside and my right brain was beginning to atrophy. I needed to just stop what I was doing and make time for me... to breathe and go step into that life of balance... even if it meant sacrificing my run for the day and taking my camera out onto the trails for some good ol' Andi time.

    It was wonderful and refreshing and it made me realize that I am just one of those people who needs.... I mean desperately needs alone time.  I hope it will be the beginning of a very healthy, balanced and peaceful year. Do you ever feel that way? Like you just have to stop the world's noise for a moment long enough to hear your own voice?
    Well that's where I've been recently and I am vowing to be more intentional about taking care of myself better... emotionally, mentally and physically.
    What kind of things do you do to take care of yourself? How do you find peace in your life?
    Here's to having a year full of many more quiet moments where my voice is louder than the rest of the world's.... moments full of peace, balance and contentment. :)

    Sunday, January 2, 2011

    New Beginnings

    The holidays are over and I feel like I can take a deep sigh of relief. The stress of shopping and presents and events to go to is over and I can finally settle back into the routine of every day life. I hope you all had a wonderful Christmas with family and friends!
    2010 was a year of extreme growth for me. I made a point of actively sorting and sifting through a lot of really difficult issues. I quit smoking and started running. I traveled to places I have never been and also went back to a place I consider to be my home away from home. I have ventured into the world of being a couple and have learned so much already about what being in a relationship really means. I was able to survive my first bout of nursing burn out and have experienced so much as an ICU nurse.
    I've never been a big fan of resolutions. I feel like they end up being too ambiguous, obnoxiously specific or completely idealistic, so I like to choose themes for the year... a word that will be the foundation for the next 365 days. I have decided that for this upcoming year... 2011 will be defined by the word peace. I think over the next few days I will have to decide what that looks like for me. I think it will have a lot to do with having balance in my relationships, work, and mental, emotional and physical health... having a contentment that runs deeper than my circumstances and a sort of "come what may" attitude towards life. I'm excited to see what 2011 brings.
     Happy New Year Friends!
    What resolutions have you made for yourself this year?
    What would your 2011 word be?