Bah Humbug

I’ve grown to hate this time of year. It’s always incredibly stressful for me, and it usually starts in mid November and doesnt end until after New Years. Since I moved to the same town as my mother, into a nice sized home with some space to entertain, I’ve been expected to host all the holiday meals. And in years past, it wasn’t so bad. Everyone would help cook a couple of dishes, and so it was a manageable duty. But this year, I was already responsible for the entiree Thanksgiving meal, and now I am in charge of the entire Christmas meal as well.

Last year, I got a “break” of sorts. I was working at the hospital and I was night shift, so I was in no position to host anything. Would you believe both holidays went ignored because I wasn’t handling it? Yup. No one cooked anything or went anywhere.

This tells me something. The holidays are only important enough to celebrate if they are not in charge of it all. I feel taken advantage of and as if it is now expected of me, regardless of how I feel about it. So what have I been googling tonight? “How to avoid hosting the holidays.” I refuse to do it next year. I will be in my 4th semester of grad school, and intend to use it as an excuse. Someone else can step up, or not. I dont care.

And to make matters worse, my husband decides tonight, Christmas Eve, to invite a friend and his girlfriend over for dinner tomorrow. I abhor these people. Especially the girlfriend. And I will tell you why. Two Christmases ago, they came for dessert and coffee. I have a cat who gets very anxious around company and typically hides. But she also used to being fed at night (so we can sleep peacefully until morning without cries of hunger), and so she came out of hiding to eat. “Girlfriend” wanted to love on my kitty, but my angel wasn’t having any of it, and warned her with a few growls that she didnt appreciate being cornered. I told the girlfriend to be careful, she doesnt like strangers and she doesn’t like being touched. But did she listen? No. So my angel swiped at her. And what did “girlfriend” do? She lashed out at the cat with her foot, motioning to kick her.

And THAT is how she came to be on my shit list. So I am dealing with a husband who doesnt understand why I hate these people so much, and why I dont want them in my house for extended periods of time. Plus I have my own ungrateful family I have to feed and quite frankly, I am over all of it.

If anyone can come up with a practical solution to get me out of hosting the holidays permanently, I’d be forever grateful. I cant use the school excuse forever.

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Catching up…

So, lots of things have happened since my last entry. August 1, at approximately 7:45am, I came home from my last shift at the hospital, and a few weeks after that, I began my journey as a grad student working toward my MSN FNP degree, all mentioned previously.

Now, it’s the end of my first semester, and I earned A’s in all 4 of my classes. I know each coming semester will grow increasingly challenging, but I feel I am starting off on the right foot. Also boosting my confidence is the fact that my Ethics professor asked to take 3 of my essays to use for future students as “examples of excellence.” What a compliment!

I’m enjoying my downtime, which comes to an end January 6. I’ve been Christmas shopping, doing some pleasure reading, taking long soaks in the tub… one of which ended with an all too curious kitty attempting to sniff the draining bathwater and fell into the tub! The mess was worth the hilarity.

But I’ve also been working more on eating right, and I’ve added fasting to my regimen as well. The results have been amazing. I’m following a ketogenic diet, which is high fat, moderate protein, and low carb. I have been tracking my food, and I eat no more than 20 net grams of carbs daily, 50-70g of protein, and I eat fat until I am satiated. I am following the protocol set forth by a Toronto nephrologist, Dr. Jason Fung. Dr. Fung has successfully treated obese people, and has reversed Type 2 Diabetes in his patients. No longer is T2D a progressive disease. His approach is simple and logical, and I encourage anyone curious about ketogenic eating to look up is podcasts, youtube video lectures, or his books. It’s an approach that I intend to bring to my patients, and am considering writing my dissertation on the topic, when the time comes.

As I mentioned, and as Dr. Fung encourages, I have incorporated fasting into my diet. I began with intermittent fasting (IF) on a 16/8 schedule. I would stop eating at 6p at night, and not eat again til 10a the next morning. Then I pushed to an 18/6, then 20/4 eating schedule. I even toyed with a few 24 hour fasts as I felt more comfortable. Currently, I am on my first week of alternate day fasting. I eat one day, fast the next, eat the following day and fast the next. So far, I’m liking this the best. It frees me up from thinking about food more often, my grocery budget is as low as it’s ever been, and I’m dropping weight and feeling better than ever.

I did make a very stupid mistake recently, and that was to go off my progesterone. I figured I was losing weight, and my diet was completely anti-inflammatory now, so why would I need progesterone? I completely forgot that releasing fat means I would be releasing the estrogen stored in those fat cells, and that it would add to my pain levels. And add to them it did.

I was off my progesterone no more than 3 weeks, but my pain levels sky rocketed. I’m back on them now, about a week, and things are already improving. Not great, but it’s getting better.

I’ve done so much healing since my initial diagnosis of Lyme disease. I still can’t believe how far I’ve come. I keep up with blogs of other Lymies, to remind me why I’m pursuing my education. It pains me when I see so many still suffering, not being able to find effective treatment, and wondering what my future place will be in this fight.

I have a busy holiday season ahead. I will be meeting with friends from nursing school, and friends I used to be able to call co-workers. I’m grateful I’m still remembered among them, and get to spend time with them. They have each added so much to my life. Then it will be family for Christmas, and more friends to celebrate the end of the year.

I will be back to the grind soon enough, but for now, I feel full… happy… blessed.

To everything… there is a season

They say the only constant in life is change. And adapting to change is still a skill I work on.

I left my hospital job in August, and have been focusing on my studies ever since. Part of me really regrets having to leave. I loved what I did. I took pride in the uniform I wore, and the care I provided. I didn’t want any skills I had gained to be lost from lack of practice. I also didn’t want to leave my team behind. I felt like I was abandoning them on some level.

Night shift is a quirky bird. I loved it. There is a comradery of sorts. You walk through hell and back together when the proverbial shit hits the fan, and you know you can rely on your team mates during those dark hours. Management isn’t around, which again, is a blessing and a curse, but I believe it brings the night shift team that much closer. You have to know each other’s skill set, and, at least on the floor where I worked, you used all of those skills to give all the patients on the floor the best possible care. Often, the night shift nurses go unrecognized, by management and by patients and families, but they are always there, through the week hours of the night and into the morning, sacrificing their own health and relationships to nurture those of our patients.

So I miss that.

But I also feel called for something else. And so here I sit, a pile of books beside me, typing at my blog when I really need to finish that cardio unit in pathophys.

Things have changed since the beginning of this, my first semester as a grad student. I’m calmer. I have a better handle of the expectations of my professors. And I’m holding my own, grade wise. I’m sure each new semester will bring its own challenges, more changes, and an initial sense of panic as I sort through it all, over and over again. But I feel ready.

My health is much better. I’ve cleaned up my eating even more, eliminating all sources of sugar, all grains, all legumes, and I’m on a low carbohydrate, whole food oriented eating plan. It’s doing wonders for me. I began my new eating plan the day after I came home from my last night shift at the beginning of August, and have so far dropped all twenty pounds that I gained from being on night shift. Inflammation has also improved tremendously. I rarely need to take anything for pain, and my cycle is finally starting to normalize again. Granted, I still have quite a bit more I’d like to lose, but I have faith it will come with time, patience and effort.

And so, here’s to change. I lift my glass to you…

Grad School

I didn’t think I’d be this overwhelmed this soon.

I’m seeing clearly now why they suggest you give up your employment in order to pursue the MSN FNP. (It’s still debatable as to whether I will choose the invitation to complete my DNP – a decision that has to come by the end of the semester.) I am literally at my books 6-7 days a week in some capacity. Sometimes it’s for 4 hours, sometimes it’s as many as 12. And yet, I still feel like I am behind.

Four graduate level classes. Twelve credits. No choice to pursue this degree part time, at least not at this university. It really wouldn’t be as bad if two out of my four classes weren’t so disorganized. Disorganization and lack of clarity and communication issues seem to be part and parcel of nursing programs in general, at least in my area, it seems.

Had a friend check on me last night to make sure I wasn’t getting discouraged so early in the game. I assured him I wasn’t. At this point it’s just frustration, and I know with time things will get sorted out. But in the meantime, I will be putting in a lot of hours till I figure out how this game is played.

I am still very excited about my education, and I have momentary attacks of “SQUEEEEEE!” as I read my books and I can apply it to something I saw in a patient at work, or if the passing thought of “OMG I am really doing this!” pops into my mind. The road is going to be long, and I am already counting down the weeks left till the end of the semester, but I really hope I can remember to enjoy the journey.

Moving on…

My first year anniversary as a nurse passed two days ago. I spent my first year at a hospital on their intermediate care unit. A step down unit. This August, I begin my education as an NP.

Too soon? Not enough experience as an RN? Maybe. But I started this journey because an MD who has been treating me for Lyme disease asked me to finish my education as an NP and join her primary care practice. Because I didn’t have an RN license at the time, I needed to get that first. So far, she’s been waiting 3 years. And she’ll have two more yeas to wait.

I may not have as much experience as I’d like, or is ideal, but I have a solid foundation. I saw a lot. I did a lot. And it truly is time to leave. Things are getting.. hairy… at the facility.

Nurses are leaving in droves. Sometimes it’s because of better pay at other facilities, sometimes it’s because there has been a change in management that just didnt sit well. The hospital, at this point, is hemorrhaging nurses. The hospital has been in a code red situation more than once (critically low staffing) and nurses are being forced to take more patients than is safe.

There will be a sentinel event. It’s coming. I dont want to be around for when it does. I worked hard to earn my license, I intend to keep it. Because eventually, the people that will pay the ultimate price for this will be the patients, and the nurses.

I refuse to clean up your mess

Management, you saw this coming. You watched as nurses left in droves from every floor, every department. And now we’re critically low in staffing numbers. I heard you hired 2 ppl to replace the 4 RNs and 2 techs that left our floor. But the new hires haven’t even passed boards yet. You failed to hire more, already trained nurses. Nurses who would just need some orientation to the unit before they could hit the ground running and start helping.

And now you want to make it our problem. The nurses who are already suffering burnout. The nurses who already carry a heavier load than they should. These are the next nurses who will be tempted to leave.

Where are you, management? Why aren’t you on the floor helping with patient care? Or are you all above that now? Pushing papers around trying to keep administrators happy so you can keep your job, but not really supporting the people in the trenches.

So no. I will not come in.

I, and so many others I know, also suffer with chronic illnesses of our own. Chronic pain, chronic fatigue and despite it we dedicate our lives to serving others in their crises. I and my cohorts need time to recover. We need time to heal between shifts so we can do it all over again when we have to. We have families that also need us. Cooking and cleaning and laundry and the like still need to get done.

So no. I will not come in. My time off is precious, and I need it. My peers need it. So to management and administrators I say: Come down from your ivory towers and get your hands dirty. And take a good look into why folks are leaving, how to replace them efficiently, and how to keep them.

Open Apology to my Day Shift Counterparts

Night shift is short staffed. This is just how it’s going to be for awhile, and I need to come to grips with that. If we have a tech, we’re lucky, because usually charge nurse ends up doing tech duties in addition to her own, and once in awhile is forced to take a patient.

This means that often I need to provide total care for my patients. This also means that I don’t get to dig around in the charts and get the details day shift invariably asks about them when I hand them over. Vascular signed off? Sorry. I didn’t have time to read through charts, and it wasn’t given to me in report, so I apologize for not changing that dressing, because I thought the Vascular doc would be in around 7am to tear it off and look at the wound. But I did change the PICC line dressing. I hope that helps.

I do what I can. I also prioritize not just my patients’ care but the care of my teammates’ patients. That means I am in rooms answering call bells of my fellow nurses, toileting those patients, and even hanging IV meds when my team member is stuck in an isolation gown trying to give meds down a PG tube to a patient who has MRSA in an amputated BKA stump.

I need to find a succinct way to tell oncoming day shift staff that I’m not being lazy because I dont have details they want. Instead I have spent my night doing my work, the work of our often non existent techs, and sometimes the work of my fellow nurses who have a crappier assignment than mine, and are behind schedule because of it. And I want to make it clear that dont resent or regret helping my team members one single bit. I know that I am also on the receiving end of that crappy assignment from time to time, and they are the ones that will settle in my new admit when I’m behind in my work.

I’m told management hired two nurses. But we are still lacking techs for the night shift. The few that remain can’t cover the entire week of shifts on their own. And the nurses they hired are actually still in school, hopefully graduating this May, possibly taking boards this June, and if all goes well, will come off orientation in October. That’s a long time to be short staffed.

So, I apologize to my day shift team members, that I don’t often know the nitty gritty of the patients I am handing off to you. But I got all the patients through the night, and no one died.