Friday, April 29, 2011

7 Quick Takes Friday



1. First things first. TGIF! I think that statement is sufficient in and of itself.  :)

2. This weekend I am running a race in Big Sur! It will be a 9-miler, training race. I am really excited because this is undoubtedly one of the most beautiful places in the world and I will most definitely try and take a ton of photos along the way. Just as an example for you... a photo I found on flickr of the Big Sur coastline. Gorgeous, right?!

    Big Sur, California, originally uploaded by ` TheDreamSky.

    3.  Two weeks ago I did a 23 mile run. I could probably do an entire post just on that run because it was so. flippin. hard. BUT I will spare you all the torturous details of the 5 1/2 hour endeavor. (Yes, I ran for 5.5 hours) What I will share with you though, are the photos of what happens when you decide to run for 5.5 hours without sunscreen.
    This is right in the middle of the peeling stages. It was so awful I had to sleep with ice packs on my shoulders for days and couldn't lift my arms above my head. I also have lovely burn lines on my calves from the capri pants I was wearing. Not cute. Moral of the story: wear sunscreen.

    4. I might get to meet a fellow blogger next week from one of my favorite blogs Be Still and Know! This will be a first for me and I am very excited. She feels like a bit of a kindred spirit with her journey into becoming a missionary in Africa and it will be awesome to meet her and her husband if it all works out :)

    5. One of the perks of working night shift is that you get to catch things like the royal wedding on TV because I am essentially on Europe time. Even though I am not a wedding person at all, this wedding was actually pretty amazing and fun to watch. Kate was absolutely stunning with such poise and beauty and grace. Didn't expect to care at all but when I watched it I ended up feeling incredibly nostalgic and happy for the two of them. Best part was definitely her dress. Just gorgeous.
     


    6. Next week I will be running 26 miles. It is my last long training before my first marathon. This is essentially a marathon actually since a marathon is just .2 miles longer and I'll probably just end up running the extra .2 miles so I can say "I ran a marathon!" Especially since I have to work the next day and I'm pretty sure I am going to be incredibly miserable and sore.

    7. Funniest thing I heard this week at work. Actually I didn't hear it but someone told me about it and I was dying of laughter. Ok... picture a guy who looks like he came straight out of the 1970's with slightly shaggy hair and a crazy thick mustache who is just in general a pretty goofy/funny guy. This is one of our ICU fellows and during rounds after apologizing for his phone ringing he says, "I take that back. Never apologize for White Snake." hahaha  That is just awesome.


    Happy Friday Friends! Yay for the weekend!!!



    Sunday, April 24, 2011

    Happy Easter!

    This week I have been sick and recovering from a severe sunburn I got during my 23 mile run last week. I only made it to work one day this week because a cold caught me on my first 12 hour shift. The rest of the time I have been miserable at home, attempting to find some position where I am not in pain. It has not gone well. I am totally worn out and I feel drained on every level.
    All of that to say that I have been completely detached from Easter week this year... and my heart is a little broken because of it. At a time when the world is stopping to reflect on the life of a man who means so much to me, I realize that I have been focused so much on the wrong thing... myself. 
    And the truth of the matter is...
    I miss God
    and I want more of Jesus' truth to be in my daily life.
    So here's to having a blessed Easter weekend, full of redemption, truth and hope!

    Friday, April 22, 2011

    13.1 miles of fun!

    
    This past Sunday, one of my favorite co-workers and I ran a half marathon together. This was my third half marathon and her second. We decided to do this race together last year and had promised each other we would train together by going down to the gym on the days we worked the same shift and run the treadmills.

    At first we were really good about it... and then life sorta happened. Things got crazy and busy. I wasn't running much during the week but because I have 3 (yup 3) full marathons on the books I HAD to train on the weekends. B on the other hand kinda fell off the map... unfortunately she got into a terrible car accident recently and has had some of life's lovely curveballs thrown her way. (She's totally fine now... thank God) I also had a 22 mile run scheduled for just 7 days after the 1/2 marathon. So needless to say, we were both very seriously considering ditching this race.... but after much convincing on my part and a decision to make this a slow "fun run" we woke up at an ungodly hour on virtually no sleep and headed over to Santa Cruz beach to do our first half marathon together!
    Let me just say that this was hands down one of the funnest races I have ever run. Having B as my running buddy and deciding to take it easy and make it a fun, goofy run... it made all the difference. We dressed in bright colors and put our hair in pigtails with red, white and blue ribbons tied around them. We laughed and joked and cheered on the runners ahead of us. We even met a few people along the way and made some new friends!


    We even decided we were going to document this glorious event with a few silly videos (two of which include our pre-race victory dances!)
    video


    video

    video

    The course ended up being absolutely beautiful and I look forward to hopefully running this race again next year...





    And since it started and ended at Santa Cruz beach we got to see the surfers out riding the waves as we came in for the finish line
    The amazing thing about this race was that it was the first time I could actually feel a difference in my running because of my marathon training.
    I did run this race pretty slow for my usual pace. I was about 30 minutes beyond my PR for a half marathon... coming in at 3:01 hours... but I could feel a drastic difference in my recovery time after this race. The course was relatively flat... only a few steep hills to worry about...
    but still... it felt great to wake up the next day with virtually no soreness. I even jumped on the treadmill the next night at work and did a 5K of sprint intervals!
    Now if only I could feel that good after my 22 mile runs too :P
    Definitely one of the best races I have ever done.
    Thanks B for making it so much fun!

    Monday, April 18, 2011

    On Call RN is a year old!

    One year ago today I began my blogging journey and I am so glad I did! I was worried that it wouldn't be something I would stay consistent with but it has been a wonderful outlet in my life. I have "met" some wonderful people through this blogging community and I am just so incredibly thankful for all of you who continue to read! I started this blog because I remember starting my journey as a new grad in the ICU and thinking, "Good Lord I am TERRIFIED about this job!" I was so desperate for any advice that I began googling "new grad ICU blogs" haha... sadly I had no luck and proceeded to enter the world of ICU nursing as green as can be. So... I decided that I would document my journey here for others like me who wanted a tip or a story here and there to help them get through those scary moments. The beautiful thing about this writing process is that this blog has become just that... a way to reach out to others... and yet it is so much more! It is a place to share about and document my life and to grow as I write and photograph my way through these years as a new nurse.
    Again, thank you to all of those who have shared this journey with me! Happy Birthday to On Call RN and I look forward to the next year of writing and sharing with you all!

    Saturday, April 16, 2011

    Lebanon: Post 1

    Marhaba!
    Welcome to the middle east!

    It's been two months now since the day I left for Ireland and Lebanon. It doesn't feel like it was that long ago because I still think of my time there so frequently... but I guess that's what happens when the hum drum of daily life sets in. Time just flies.
    There is something about Lebanon that captured my heart completely and it was done in such a subtle way that I think it will be hard to even verbalize how much I loved this trip. I think a lot of it has to do with the cultural differences... that tug and pull you feel on your comfort zones. The sudden awareness you have of yourself... that internal tension of the world you come from and are familiar with in contrast to the world that surrounds you.


    I think part of it also has to do with the notion in the back of my mind that maybe... just maybe... someday I would end up in Central Asia or the Middle East doing missionary work as a nurse. Because truthfully that is why I wanted to become a nurse in the first place... to treat women and children in a place where they often times do not receive adequate health care... if any health care at all.
    I think the most impacting part of my trip to Lebanon though had to be the people. The reason I chose Ireland and Lebanon as my vacation spots this year was because my two BFF's are living in those countries. My friend Annie has been teaching history in a Lebanese Evangelical school outside of Beirut for almost two years now. It meant the world to me to be able to see what her life has been like there these past two years... to be able to step into her world and see and feel and get an understanding for what she has experienced there... really it was priceless. Not to mention the sheer joy of having a whole week to spend quality time with her, catching up on life, processing through what we have been dealing with on opposite ends of the world. It's hard when people live so far away because quality time together is so rare which is why this trip was so great. It gave me a chance to invest into my friendship with Annie in a way that I haven't been able to for years.

    We truly had an amazing time together in Lebanon and I can't wait to share more of the trip with you all. Don't worry... there are many more pictures posts to come!

    Until next time my friends...
    ma'a as-salaama!

    Tuesday, April 12, 2011

    Green hills and nostalgia

    Road trips always seem to bring out the nostalgic side in me. It's something about the endless miles of road, the music, the people.... or lack thereof, that sends me into a lull of memories. A few weekends ago I was able to take a road trip with my BFF's to see a play that my friend had been the assistant director/stage manager of. It was a quick trip and it was jam packed with visits of friends we rarely get to see. It was great to see them and catch up... even if it was only for a meal or a few minutes at best. It was also really wonderful to be able to see into what my friend had been pouring her heart into these past few months and so glad to know that she is incredibly happy with the work she has done there.

    The drive was incredibly beautiful and it lit a small fire to the travel bug that has been quietly put to rest since I came home from Lebanon. I love seeing new places... or old ones in a new light. Truly, California is a place that is so diverse it is hard not to see its beauty in new ways each time you drive through the countryside. The entire trip down I just kept saying, "This is basically what Ireland was like! I can't get over how green this is!!".... lush and stunning from every corner. I'm pretty sure by the end of the trip everyone got the point. haha



    This is my BFF TK and one of his multiple attempts (and only successfulone at that) to jump into my pictures. haha definitely a keeper. I heart my friends. :)

    It's funny how the randomest things can spark a memory. A good portion of the trip we were listening to Jason Mraz's first album... "Live at Java Joe's" and I was instantly thrown back to my first year of college. I had a CD player (yes a CD player... the days before iPods ) that I would carry in my back pack, headphones threaded through the top with that album playing non-stop for basically an entire year.... I rode my bike everywhere and would listen to it the entire ride to school and then to work and then home later that night. Listening to those songs I can picture the exact rode and the exact bike I was riding. The feeling of hope and fear of entering into an adult world where nothing was set out for you like it was in highschool. The naive spirit I had coupled with the feeling that I had to do anything I could to make it through... even if it meant working insane hours to support myself through college. The excitement in knowing that I had so much ahead of me and the feeling that I could do anything if I just worked hard enough....
    and it got me thinking... about the dreams and hopes of that 18 year old girl I once knew. I wonder what I would think if I took a snapshot of my life now and showed it to myself 8 years ago and said, "So... this is your life.... is it all you'd hoped it would be?"
    I think in many ways I would be incredibly proud and relieved to be out from under a lot of the turmoil I used to live under. In so many ways I am still shocked at how seriously blessed I am... and how far I have come. Just today at work I had to stop for a minute and think to myself, "Yes, Andi.... you really are a nurse...working in the ICU for almost 2 years now! You actually did it!" I can't believe it sometimes. God has had his hand in my life... no doubt about it. Still... there is a part of me that thinks I would look at my life and be really surprised at where I've ended up. Not in a bad way... just a surprised way. At that point in my life I don't think I had any clue where I was supposed to be... I was planning on being an art therapist but really.... I just knew I wanted to help people... and I knew I wanted to travel. There is still a part of me that feels that pull towards other cultures and people and I just wonder.... 8 years from now... who knows where I'll end up?
    Kind of an exciting thought, huh?
    What about you friends? What kinds of things make you nostalgic?

    Friday, April 8, 2011

    7 Quick Takes Friday!

    1. I finally finished editing Lebanon photos! Yay! There will be a Lebanon post (or two... or three) coming up in the next week or so. Stay tuned!:)
    2. Is it a full moon or is it just me? The way this night has been going I swear more than half the patients on our unit are completely off their rocker. Seriously, what is up with all the crazies man?! It's starting to make me go a little nutty myself! I just keep telling myself... "one more night... just make it through one more night."
    3. This week I almost had a complete melt down while cleaning out my fridge. Ok... I am an ICU nurse and I know I come in contact with all kinds of disgusting germs all the time but I can't help it... I am a complete germaphobic neat freak. ESPECIALLY when it comes to my kitchen and bathroom. Earlier this week, I pulled out a whole chicken I had in the freezer and moved it to the fridge to de-frost.... only to come back the next day to find an ENTIRE shelf covered in bloody, disgusting, chicken juice. All of the food on that shelf was covered and I was so mortified I basically threw out everything on that shelf and proceeded to freak out as I vigorously scrubbed down my entire fridge. Few things scares me more than bacteria from raw meat. Yuck. Yuck. Yuck.
    4. I am running my third half marathon this weekend! Technically I'm only supposed to be running 6 miles for my training so I plan on taking this suuuuuuper easy... mainly because I have a 22-23 mile run next weekend but it will be a pretty course along the coast so hopefully I'll get some fun pictures.
    5. I AM SO OVER MARATHON TRAINING. I cannot emphasize this enough. I am not physically overtrained because I am doing hardly any running these days but I am so SO mentally drained. I'm pretty much down to only doing my long runs on the weekend with an occasional mid-week run because I know that it would be a disaster and a half to skip those long runs but seriously what I used to love about running has some how vanished. I think after I am done with my marathons this summer I will take a break from races. I'm signed up for one or two, half marathons this fall but those are nothing compared to marathon training. I also think I need to get back to trail running... just hitting the trail and running until I get tired and calling it a day. No running for distance or speed.... just running to feel good.
    6. This week I got training to do CVVH or Continuous Veno-Venous Hemodialysis. It was pretty cool. These patients are usually pretty sick and since they are so unstable and cannot tolerate regular dialysis we put them on a machine like this one pictured and we dialize them continuously for a small yet steady effect. It definitely felt good to be challenged in my work again. :)   
        
    7. Last but not least a sneak peak of Lebanon photos for you...
    Happy Friday Friends!!

    Sunday, April 3, 2011

    It never gets easier.


    For some reason this year I have had quite a few patients pass away. Working in the ICU you expect to see death but surprisingly enough it isn't extremely common. A lot of our nurses will make it through an entire year without having a patient die on them.... AND yet for some reason this year I have had my fair share of comfort care experiences.
    Growing up I was always terrified of death... it would keep me up sometimes at night... my mind reeling from all of the awful things that could happen to me or a loved one.... all of the things I would miss in this life if I was to die young. I think if I worked with pediatrics my perspective on death would be much different... but I don't. I work with predominantly older adults and so death is a natural part of the life process. 
    This week I have seen another side of death though.... a member in Chris' family passed away a few days ago and it was incredibly sad to be on the other side of things this time. Even though I didn't know him... it was so different seeing the effect of it all. The vigil at his bedside. The smile he gave when he saw the little ones wave to him. The tears and stories and heart felt questions.... "Why now?" 
    It reminded me of my first death in the ICU. I cried the entire way home listening to the Death Cab for Cutie song "What Sarah Said" ..... The lyrics "love is watching someone die" ringing in my ears... and I just couldn't get over it.... this person had a life.... a family... memories... a legacy left behind and now... well now they're gone... just like that. 
    Gone.
    I know that he is undoubtetdly in a better place... a place where cancer does not exist and pain has no hold. I have been praying for the H. family this week and today as they say their final goodbyes as well. I hope they feel the love that I see and feel in their family. It is a gift to have so many people surround you as you leave this world and it is so very clear that even if Uncle M. is not here anymore... his love and legacy still remain in the people he has left behind.



    Friday, April 1, 2011

    Joy

    Waiting for a particular turn of events is a good way to head yourself into disappointment. Depending on anyone to make you happy, make you feel good or lift your spirit is a sure way to place yourself in isolation. When your joy is dependent on people and conditions, it is restricted. Joy must spring forth from you before it can surround you. Joy must be the way you walk and the way you speak to those who come into your realm. Joy is knowing you are doing what you can, the best you can, and you are feeling good about it. Joy is knowing time is on your side and wherever you are, you are the joy. Joy is taking a moment to say thank you, a day to do for self and an energy of sharing what you have. Joy is not what happens to you; it is what comes through you when you are conscious of the blessing you are.
     -Iyanla Vanzant-
     I read this quote on Yolanda Holder's blog this week. She is the "walking diva" and currently is the Guinness world record holder for "most marathons run by a woman in a calendar year." I believe she actually even tied with the male record and did 104 last year. One of which I did a 5 mile run during!
    She is incredible and inspiring and I just love that she posted this Iyanla Vanzant quote on her blog. Iyanla Vanzant is one of my favorite authors as well... gotta love such women of strength, wisdom and grace!

    This week I have been feeling strange. Oddly detached from everything and just kind of feeling a little emotionally lost or lack luster in a sort of way. Not particularly sad or upset or worn out.... just kind of floating through the motions. You know what I mean? 

    This quote came at such a perfect time. I want to have joy. I want to be joy. In my line of work joy is a commodity. I have some co-workers who are those types of people... they exude joy in everything they do... even when they are completely livid or frustrated or exhausted.. they always have a smile to share or a hug to give. I want to be like that more often. 
    Joyful.

    Earlier this week I read an update on caringbridge.com from one of my old nursing instructors who is battling cancer. She wrote a simple story that stuck with me...

    A blind boy sat on the steps of a building with a hat by his feet. He held up a sign that said: "I am blind, please help." There were only a few coins in the hat.
    A man was walking by. He took a few coins from his pocket and dropped them into the hat. He then took the sign, turned it around, and wrote some words. He put the sign back so that everyone who walked by would see the new words. 
    Soon the hat began to fill up. A lot more people were giving money to the blind boy. That afternoon the man who had changed the sign came to see how things were. 
    The boy recognized his footsteps and asked, "Were you the one who changed my sign this morning? What did you write?"
    The man said, "I only wrote the truth. I said what you said but in a different way. I wrote: 'Today is a beautiful day; but I cannot see it.'"

     My assignment this week was a tough one... a patient with severe necrotizing fasciitis (trust me you don't want to know more... it's a bacterial infection that eats away at your skin, muscles and bones and causes painful, awful looking wounds.)
    Another patient with a severe poly-substance and alcohol abuse history and 3-4 different mental health disorders to boot. Came from our blind rehab unit as a code blue from a narcotic overdose. Now I get him a week after he assaulted about five of our nurses, (including an attempt to kick me in the face while I held him down so that our charge nurse could give him ativan) sending one of our nurses down to the ER after he kicked her square in the chest.

    Yeah... not fun. 
    So, two days in a row I am buried in dressing changes and drip titrations, hoping to eventually wean this guy off sedation for possible extubation in the morning. The man is on enough sedation to knock an elephant out (7mg versed, 250mcg fentanyl and 0.4 of dexmedetomidine) and is still awake, restrained and agitated... attempting to talk around his ET tube and thrashing all over the place.
    Magically, by the end of the first night he mellows out and we end up spending the morning rocking out to Journey and Pink Flloyd on the classic rock station. I am pretty shameless about singing while I work. I grew up in choir and I miss singing so I love it when I have a chance to sing with/for my patients and luckily it didn't bother him at all. The day was busy but it ended well.
    The next night it was the same thing all over again.... dressing change.... drip titrations... argue with the interns about getting something other than fluid for my patient's bottoming blood pressure and begging for  basically every. single. thing. I needed to make my patient stable and comfortable.

    He was still agitated and nervous... suffering from paranoia and anxiety most of the night.
    But then again.... morning rolls around and he is starting to mellow out. I sat at his bedside, holding his hand in an attempt to offer some comfort and he motioned for me to sing for him.... pointing at me and then pointing at his ear... waving his hand in the air like a conductor. I had the song "Landslide" by Stevie Nicks stuck in my head that whole night and knowing he was a classic rock type of guy I figured I'd just sing that. So, I pulled up a chair and began to quietly sing...
    "Well I've been afraid of changin' cause I've built my life around you... 
    And if you see my reflection in the snow covered hills
    Well maybe.... well maybe...
    The landslide will bring you down"

    It's almost 6:00am now and I can see the sun start to peer over the hills... I finish the song and he motions for me to sing it again. I look at the clock and despite being behind on charting I figure I can spend an extra few minutes here... hoping he'll fall asleep for a little while.

    And suddenly something changes... his grip on my hand relaxes and he closes his eyes. Tears are falling down his cheeks and I can see he is in a bittersweet moment. Pain and peace and fear, all wrapped into the same space. 
    6:20am now and I look out the window again... this time being greeted with one of the most stunning sunrises I have ever seen. I immediately stood up and snapped a picture with my iPhone... hoping I could show it to my patient since his bed was facing away from the window.
    "You have to see this! The sunrise is absolutely gorgeous!" I hold my phone up to his face and instantly realized what I had done....
    how could I forget? 

    He cannot see it.
    This man is blind.
    He tries to smile around the ET tube and motions for me to hold the phone closer.... he has a tiny amount of residual sight in his right eye. My heart sank as he squinted and pulled the picture about an inch away from his face. 
    "Can you see any of it? Can you at least make out the colors?"
    He turns towards me and shrugs with a slight nod and a small smile.
    In that moment... that story became so incredibly real to me.
    'Today is a beautiful day; but I cannot see it.'
    I wanted to cry... I wanted to crawl into a hole and hide from the world, I felt so awful for being so insensitive to my patient... but instead I decided to have joy... I decided to be joy. I described the sky in detail to him and then proceeded to sing to him once more. I sat next to my patient... his hand in mind and I soaked up that sunrise for every minute it had left. I silently prayed... thanking God for the ability to see such a beautiful day.
    It is one I definitely will never forget.