Seattle: day 2!

I know it's taken me forever to update about Seattle but I have a serious aversion to posting pictures that haven't been edited. Plus, I literally took 1200 pictures during the 4 day trip so sifting through them is quite an effort.

First thing we did that day was take the monorail from Westlake Center down to the Space Needle area. This is where the Pacific Science Center and Science Fiction Museum are.

Pictures of the very cool Science Fiction Museum, designed by the famous architect Frank O. Gehry.

Reminded me of the buildings in Spain by Goudi.

The famous Space Needle and the Pacific Science Center.

One of my favorite parts of the day was doing the "Ride the Ducks" tour around downtown Seattle and through Lake Union. The houseboats along lake union were so cute!

The Horizon... one of the crab boats from the TV show Deadliest Catch! (btw, did I mention that I LOVE that show?)

It's kind of hard to see but one of these houses was the "Sleepless in Seattle" house. The blue one, on the left next to all the sail boats.

What I would give to have a summer house on Lake Union...if only I had a few million bucks laying around.

The cheapest place on Lake Union, $800 a month and 200sq ft. or something unbelievably small like that.

Yup, its that tiny little white shack in the middle of the picture. Crazy, huh?

Cool fact: 1% of all tax payer funds for public buildings goes to art....also its completely legal to decorate it as long as it isn't permanent or damaging. Isn't this statue cute?

The Fremont Bridge opening up for a boat to come through.


After the tour we decided to head back down towards Pike's Place Market to take some fun pictures and get our daily Starbucks fix :)





Underneath Pike's Place there are a ton of really fun shops. Across from the magic shop there was a cool mural that I just had to snag some pictures of.

Then we finished off the day with a trip down to the Olympic Sculpture Park. It was so neat! Had a great view of the city and Puget Sound and there were all of these sculptures made to look like everyday objects and pieces of furniture...

Plus the lighting was so great I couldn't help but take a ton of pictures!










One of my favorite sculptures... gotta love the randomness of a dryer and washing machine sitting in the middle of an open field.

Walking along Puget Sound just before sunset.

Joel and Em who were nice enough to come visit us for the day and take us around the park. I just loved these two...such sweet people and I loved these pictures of them laughing it up.

So that was our second day in Seattle... eventually I'll post about the other two and share some tips about visiting the city too :)

Meet "The Girls"

In a few hours I will be heading to one of my favorite places in the entire world; the lovely state of Colorado. It's my home away from home, and although it is a beautiful place in and of itself, the reason I go is not to view the wonderful and majestic Rockies...although that is a definite plus! The reasons I go are because of "my girls."

This is my best friend Ami and two of her daughters, Thea and Petra. I met Ami back in 2003 when I was doing missionary work in South Africa. That was before she got married and now she has three kids!

For those that know me well, when I say, "I miss my girls," they know I am talking about Thea, Petra and Ivy. Most of the time I call them my god-daughters...just because its hard to explain just how important they are to me. "My best friends' kids" just doesn't quite cut it.

This is Petra and I, this past Jan. when I came to visit. I love this kid because she just absolutely cracks me up and melts my heart at the same time. She is so petite and tiny and yet is probably one of the most self assured, feisty little girls I know. She has no problem lettin' you know what's on her mind and still at the same time will be the best little cuddle bug anyone could ask for.

I love this picture of Thea, she's the oldest... just turned 6 on June 30th. She's incredibly intuitive and thoughtful and she feels so deeply that sometimes she is just a ball of emotions. She is truly one of a kind and I always remember as a baby she was and still is, so observant. Nothing gets passed this one.

This is Ivy... the baby of the bunch and actually she has gotten much bigger since I last saw her. These pictures were taken last summer and I can't believe how fast she is growing up! Ivy, like the other women in her family (and her father too) is a force to reckon with. Has a smile and a laugh that will light up a room, but make her mad? ...Well, can't say I didn't warn you. :)


This is Ami with her husband Andrew. Hands down, two of the most persevering, loving, gracious, caring and wonderful people I know. If it weren't for these guys I would most likely not be a nurse today and really it is an understatement to say that I consider them family....to me...they are my family.

Andrew is truly like the best, big brother I never had... and Ami...well she deserves a whole separate post, but all I will say is that she is an incredible woman and I am so lucky to have her as my best friend.

So in exactly 8 hours, I will be on a plane, heading towards a wonderful 4 day visit with these guys and I cannot wait.

I can't wait to see my girls and give them a big hug and hang out with them at home and read stories and play and just chill.

I'm excited to catch up with Ami and Andrew because life has just been too busy to do that recently...being states away and all....

but most of all I'm just excited to go "home." I've been in a strange funk recently... feeling really out of place with everything in my life and I can't think of a better way to get rooted again than to have a visit with family. :)

And when I get back I'll (hopefully) have a ton of great pictures and funny little kid stories to share!

Happy Thursday Everyone! :)

Rite of Passage

This week has been monumental for me in my nursing life. I think I can fairly say "new grad" is no longer a term I can call myself anymore. This post explained just a tiny snippet of what I experienced during this crazy week....particularly one specific day.

I had a horrendous assignment... two intubated patients. One on multiple drips (5 to be exact) that needed to be titrated at least every hour if not more frequently. He was agitated, confused and labile, having PVC's...trigeminy and bigeminy... jumping out of bed and being combative. My second patient was an admit from the OR. Rolled in around 3am. General surgery...an abdominal case, ex-lap turned open for ischemic bowel. Intubated and not sedated, hypotensive, vomiting around her ET tube, massive amounts of the same GI fluid coming through her nasogastric tube simultaneously.

Like I said...a horrendous, awful assignment.

It was completely unmanageable and to top it off, I was not getting the support I needed. People were coming in and out trying to offer help, but in the end, I was in charge of them both and I ultimately was responsible for taking care of them and keeping them stable.

I was angry and frustrated and overwhelmed. I was irritated by the way the doctors sat around and had no sense of urgency when my patient literally had a blood pressure of 69/40.

A few times I flat out said, "I can't do this!" to my charge nurse and resource.

I left work in tears and laid in bed for hours replaying my awful morning... Stewing over how unfair and unmanageable it was. Angry that I felt defeated, but more than anything....

I felt unheard.

When I went back to work that night and ran into my manager, she told me she had sent me a note about what had happened.

"Next time, if you don't like the way your patient is being managed by the ICU team, go above them. Page the fellow, page the attending."

I explained my situation and my frustration. How I had hardly any help and no one was listening to me and how my charge nurse and resource who were way more experienced than I, didn't think to go above our doctors. How I felt totally unsupported and that it was completely unreasonable for someone who is as new as me to take on an assignment like that.

Well...you know what she said?

When code bed is part of your assignment, anything can roll through those doors and we have to be able to handle anything that we get. Getting an assignment like that is a rite of passage...everyone goes through it. Now, you know what to do....now you know how to handle it.

Basically... in summary...

suck it up...this is the ICU.

I couldn't believe it... here I was, angry as all get out and frustrated to the hilt...
I thought surely...when I explain the situation people will take my side, they'll tell me I shouldn't have had to do that... They'll tell me that was a completely horrendous assignment and yes, even our very experienced, and one of our strongest nurses that day could not manage that assignment alone. The assignment had to be split up within minutes of the day shift starting.

It was wrong and it was unfair... end of story.

I heard that from some people... a few people came up to me and validated how I felt, agreed that it was insane and that I did the best I could.... still I couldn't get what my manager said out of my head and I realize now that what she said to me was incredibly valuable and in many ways much more impacting for me as a nurse.

Why?

Because, now I know. Now I know how to speak up and not be a victim. Now I know that I need to trust my instincts. Now I know that getting frustrated won't change a damn thing if I don't learn how to communicate to people with authority. If I don't like what is going on and I am yelling for help with no response.... I will yell louder.

Well my friends.... lesson learned.

This morning I was resource nurse and around 7am, I hear...
"CODE BLUE, 3RD FLOOR, ICU"

I run to the patient's room it was called on and ended up being apart of the code along with the patient's bedside nurse and the whole slew of other people who responded to the blaring announcement over the loud speaker.

And instantly...something changed in me.

I was no longer a scared new grad who didn't trust herself. I was no longer the nurse who did not have a voice. My hands didn't shake like they normally do in codes. I wasn't afraid to jump in and do chest compressions. I wasn't afraid to push people out of the way when I needed to get through and I sure as hell wasn't afraid to ask for what I needed, when I needed it.

I was a certified, no nonsense, ICU nurse...

and you know what? It felt good. If anything it toughened me up and at the very least I have gained a voice that I did not have before.

Rite of Passage?

Yes, indeed.

Lesson Learned and Happy 4th!

The 4th of July is one of those holidays that tends to be last on people's list of favorites. It definitely is not one I have ever made a point of asking off of work for. I think though, 4th of July is actually creeping up to the top of my list.



See, most holidays revolve around family and family is something I don't have a whole lot of. I have my mom (who is actually my aunt that adopted me years ago) and I have my grandparents and my little sister, but unfortunately none of us talk very often... it's complicated and sadly, very dysfunctional.



Needless to say, every holiday season has ended up in some huge dramatic fiasco and so for the most part I prefer to work Christmas and Thanksgiving. Mainly because all of my friends (the people I'd much rather spend the holidays with) are off with their families while I am either A) sitting at home, alone and feeling like an orphan or B) am at work because everyone else has families to be with and wants those days off. Both are kind of lame options.



Well, that is why I am starting to favor 4th of July more and more every year. It's not such a serious holiday that everyone has to be with their families and its just fun to find a good place to BBQ or picnic and go watch some beautiful fireworks. Last year, I lived in a place that had the BEST fireworks ever. In fact all of these pictures were taken at last years show on the 4th, right down the street from my house. I will miss being walking distance to them... that's for sure.


So, all that to say that from now on I think I am going to request 4th of July off. This year I will be at work. yuck

At least I'll be on the 3rd floor and will hopefully get a good view of some of the shows in the area... and if not... well there is always next year. :)

Happy 4th of July everyone!

Note to Self

As an addendum to my last post... I've learned a great lesson.

When you work in a teaching hospital... take all of your vacation in the month of July....

It's right after medical school ends.

It's the beginning of the year...

This means that the interns were medical students last year,
The residents were interns... you get my drift right?

Basically, learn to go straight to the fellow or attending when you aren't getting the answer you want (for two hours might I ad)...

OR just be smart and go on a nice long vacation for the month of July

Sounds like a plan to me. :)

Question...

When your patient has a blood pressure of 69/30 with a MAP of 49 and you've given 3 liters of LR to no avail.....

Time to try something new?

Maybe... just a suggestion.

Apparently the new team of residents we've got didn't agree, so I stood there with an absolutely awful, compelety unmanageable, horrendous assignment with two sick, intubated, unstable patients and watched as my patient was on the verge of coding.....
thank God she was being completely 100% paced.

My redemption?

Our wonderful attending...ugh can't say enough great things about this man...
comes in and notices how flustered and angry and frustrated I am and asks me ever so gently...

"Are we doing anything for her blood pressure?"

I smiled...that, "im-not-happy-with-this" smile

"Yes, we are on our 3rd liter of LR"

(this woman is so small that her lungs are probably already backed up with fluid at this point)

"How long has the blood pressure been like this?" Dr. M is looking concerned now.

"Oh about two hours, I've been asking them to start some type of pressor but they want to continue to give fluid." I continue to smile.

He looks at me and gives me that nod that says everything I needed to hear without words...

"We will take care of this in just a few seconds here." Dr. M gives me a quick pat on the back and heads off to round up the docs.

"Thank you!"

I just need to acknowledge how thankful I am for doctors who listen. How thankful I am for doctors who treat nurses like they are an integral part of the medical team and who don't treat us like we became nurses because we were too stupid to go to medical school.

Don't treat me like I'm an idiot and I won't give you attitude... capisce?

I've been finding myself really frustrated with a lot of our docs recently.... product of being in a teaching hospital I guess... but I have to step back and just say out loud (or to the internet) that I do have some really incredible physicians in my hospital. Interns to attendings... there are good ones all along the ranks and for the most part every single one of our attendings are wonderful.... our surgeons are amazing and I feel honored to work with them.

Its days like this that I have to stop and remember that... not all of them are bad, in fact many if not most are great.... and for the times where it seems like there are only the bad ones around... well that's where the Dr. M's come in. :)