My last day on the pediatric floor was the total opposite of the rest of time there.
It sucked.
I was on the verge of tears from most of the shift. I had to deal with a horde of medical students poking my poor nine year old medical mystery, while being totally annoyed with following percautions protocol. If I never see a blue plastic protection gown and mask again, I will die happy. I was nervous about the intense medications being given, including Ativan, Prozac, Depakote, and Risperdal, which I've never even seen used in kids. I watched over her for most the day, because it was possible for her to have a seziure at any moment, but no one taught me what I should do if it actually occured. So I just kept praying it wouldn't happen, figuring I'd just cross that bridge when I got to it (this probably isn't smart). As miserable as I was though, I was able to help out my patient and her mother by capitalizing on a unique gift God has bestowed upon me and I use to spread happiness throughout the world: sticky fingers.
I am very very good at stealing things. I think no one expects me to be stashing tons of things underneathe my white coat all day long, so I float by undetected with all my pilfered goods. I have weighted myself with and without my lab coat on, and there is a ten pound difference because of how much I have shoved in the multiple pockets. My patient's mother told me she was insanely bored, and suddenly Better Home magazines began disappearing from the waiting room. Cookies and coffee went missing from the break room. I totally just claimed a vital signs cart and blood pressure cuff and hid it in a closet, figuring my need of it was probably greater than others without unstable patients. Obviously, I didn't go rob a bank or anything, but I have begun a life of crime.
As it was the last day, I made something decedant for the peds nurses: cheesecake brownies. Brownies are really strange to make, but apparently I have mastered the art of creating them, because I get requests all the time.
Cheesecake Brownies
1/2 cup butter
2-oz chocolate, chopped. Dark is probably best, but I didn't have any so I used 1 oz milk and 1 oz unsweetened
1 cup sugar
2 large eggs
1 tsp vanilla extract I couldn't find my vanilla. Turns out it fell off the spice rack, and I found it later in the back of the pantry. Instead I used 2 tsps of rum. I know this sounds weird, but OI sometimes use it in place of vanilla. It has a much more grown up taste that makes things a little interesting.
2/3 cup flour
2 tbsp cocoa powder
1/4 tsp salt
Cream Cheese Layer:
8-oz cream cheese, room temperature
1/3 cup sugar
1 large egg
1/2 tsp vanilla extract
Preheat oven to 350F. Line an 8×8-inch square baking pan with aluminum foil and lightly grease.In a small, heatproof bowl, melt butter and chocolate together. Stir with a fork until very smooth. Set aside to cool for a few minutes.In a large bowl, whisk together sugar, eggs and vanilla extract. Whisking steadily, pour chocolate mixture into sugar mixture. Stir until smooth. Sift flour, cocoa powder and salt into the bowl and stir until just combined.Pour into prepared pan and prepare cheesecake mixture.In a medium bowl, beat cream cheese, sugar, egg and vanilla extract until smooth. Drop in dollops onto prepared brownie batter. Gently swirl two batters with a butter knife.Bake for 35-40 minutes, until brownies and cheesecake are set.
The brownie layer is thin and SUPER fudgey and the rum made it taste really dense. Overall, I think they came out good and it was a great way to bribe the nurses to let me come back to pedatrics.
Tuesday, February 10, 2009
Thursday, February 5, 2009
Obstetrics Day #1
Today was the first day of my rotation on Labor and Delivery. I woke up in the slight panic and needed to take at least 10 deep relaxing breaths before heading out the door. I was so jazzed up, I was a little concern that I had accidently given myself seretonin syndrome, a bizarre fear I've been harboring for a few weeks now.
Anyways, I wasn't super excited about Delivery. I had loved pediatrics and wanted to stay there. Maternity freaked me out, because I had no previous experience to draw upon and didn't really feel fit to care for anyone's reproductive plumbing. Plus, the word fundus always make me giggle in class, and I didn't want to insult anyone if I burst out laughing when they gave report. Thankfully, my anxiety level started to fall after my third soothing cup of coffee and I found out I had been assigned duty in the nursery. My experience in caring for babies in much more advanced than caring for their mothers, so I felt comfortable swaddling infants for the next 12 hours. However, when I got to the nursery, I found out all the babies were off with their new moms, rendering me utterly useless. After 20 hopefully minutes where I prayed my clinical instructor would just ship me off to some place I could disappear, like the OR, I was assigned a nurse to follow and a patient. She was not postpartum, but had given birth to a little boy a weekend ago before developing preeclampsia. She was also an NP who worked in the ICU at my school.
Preeclampsia sucks. It is high blood pressure greater that 140/90, with protein in the urine, low platletes, terrible headaches and epigastric pain, visual distrubances, and the nasty habit of causing seziures. I have no idea why it happens, and it freaks me out that so much can go wrong so quickly. It is however, diagnostically interesting, at least to me, and the use of mganesium to treat is bizarre because normally levels of over 2 are not great and my patient's was 5.8, which in this case is considered theraputic. Also, preeclampsia was on an episode of House a few weeks ago, which really is the greatest learning tool available.
I had a great day with her. A few hours of chatting and two foot rubs later, I that she was awesome and gave her my email address when I left. Interestingly, I found out that she had been doing "natural family planning" where she monitored her cycles as a method to prevent birth control. She was married April 12. She was prgnant April 18. She told me "I think we need to re-evaluate our methods..."
After lunch, to my surprise, I found out I was still considered the nursery room nurse and there was a baby I needed to care for. I walked into a room and quickly realized that my new patient hadn't been born yet, but was apparently coming soon. The nurse, pedatrician, and I set up suction, tubes, and blankets while the mom pushed, and I whispered to the doctor, "Um... this is my first day..." and he was like "um.... really? Wow, intense first day huh?"
The birth was what you would logically expect. A watermelon sized head was attempting to fit through something much much smaller. I watched the fetal monitoring strip that reported the baby's heart rate, and thought "Oh this is total shit" as it declined to dangerous levels. The doctor was forced to quickly cut an episotomy and pull out a baby that we grabbed. About a billion things suddenly happened at once, and I started adding up the APGAR score in my brain, while I tried not to cry/puke/pass out. After, I took a "bathroom break" where I just sat in the stall clutching my cellphone, our generations comfort item.
I've decided I love labor and delivery.
I brought 10 grain muffins, because I had a bag of 10 grain cereal in the pantry, and I really hated it, so I figured I'd bake it up. They were a total hit with the nurses, who requested the recipe a million time. I was relieved, because I really thought they were crappy muffins, but they enjoyed them. Here is the recipe:
INGREDIENTS:
1 large Egg
1/2 cup Sugar
1/3 cup Margarine
1 cup whole wheat flour
1 tsp Salt
1 tsp Baking Powder
1 tsp Baking Soda
1 cup 10-Grain Cereal
1-1/4 cup sour Milk or Buttermilk
Mix 10 Grain Cereal and milk; allow to stand for 10 minutes while preheating oven and assembling other ingredients; cream sugar, margarine, and egg together. Add dry ingredients and milk mixture. Stir only until mixed. Spoon into greased muffin pan. Bake at 400°F for 15 minutes. Makes 12 muffins.
I added blueberries and almonds to mine, which gave it nice color and a good crunch. I also ended up with 13 instead of a dozen.
Anyways, I wasn't super excited about Delivery. I had loved pediatrics and wanted to stay there. Maternity freaked me out, because I had no previous experience to draw upon and didn't really feel fit to care for anyone's reproductive plumbing. Plus, the word fundus always make me giggle in class, and I didn't want to insult anyone if I burst out laughing when they gave report. Thankfully, my anxiety level started to fall after my third soothing cup of coffee and I found out I had been assigned duty in the nursery. My experience in caring for babies in much more advanced than caring for their mothers, so I felt comfortable swaddling infants for the next 12 hours. However, when I got to the nursery, I found out all the babies were off with their new moms, rendering me utterly useless. After 20 hopefully minutes where I prayed my clinical instructor would just ship me off to some place I could disappear, like the OR, I was assigned a nurse to follow and a patient. She was not postpartum, but had given birth to a little boy a weekend ago before developing preeclampsia. She was also an NP who worked in the ICU at my school.
Preeclampsia sucks. It is high blood pressure greater that 140/90, with protein in the urine, low platletes, terrible headaches and epigastric pain, visual distrubances, and the nasty habit of causing seziures. I have no idea why it happens, and it freaks me out that so much can go wrong so quickly. It is however, diagnostically interesting, at least to me, and the use of mganesium to treat is bizarre because normally levels of over 2 are not great and my patient's was 5.8, which in this case is considered theraputic. Also, preeclampsia was on an episode of House a few weeks ago, which really is the greatest learning tool available.
I had a great day with her. A few hours of chatting and two foot rubs later, I that she was awesome and gave her my email address when I left. Interestingly, I found out that she had been doing "natural family planning" where she monitored her cycles as a method to prevent birth control. She was married April 12. She was prgnant April 18. She told me "I think we need to re-evaluate our methods..."
After lunch, to my surprise, I found out I was still considered the nursery room nurse and there was a baby I needed to care for. I walked into a room and quickly realized that my new patient hadn't been born yet, but was apparently coming soon. The nurse, pedatrician, and I set up suction, tubes, and blankets while the mom pushed, and I whispered to the doctor, "Um... this is my first day..." and he was like "um.... really? Wow, intense first day huh?"
The birth was what you would logically expect. A watermelon sized head was attempting to fit through something much much smaller. I watched the fetal monitoring strip that reported the baby's heart rate, and thought "Oh this is total shit" as it declined to dangerous levels. The doctor was forced to quickly cut an episotomy and pull out a baby that we grabbed. About a billion things suddenly happened at once, and I started adding up the APGAR score in my brain, while I tried not to cry/puke/pass out. After, I took a "bathroom break" where I just sat in the stall clutching my cellphone, our generations comfort item.
I've decided I love labor and delivery.
I brought 10 grain muffins, because I had a bag of 10 grain cereal in the pantry, and I really hated it, so I figured I'd bake it up. They were a total hit with the nurses, who requested the recipe a million time. I was relieved, because I really thought they were crappy muffins, but they enjoyed them. Here is the recipe:
INGREDIENTS:
1 large Egg
1/2 cup Sugar
1/3 cup Margarine
1 cup whole wheat flour
1 tsp Salt
1 tsp Baking Powder
1 tsp Baking Soda
1 cup 10-Grain Cereal
1-1/4 cup sour Milk or Buttermilk
Mix 10 Grain Cereal and milk; allow to stand for 10 minutes while preheating oven and assembling other ingredients; cream sugar, margarine, and egg together. Add dry ingredients and milk mixture. Stir only until mixed. Spoon into greased muffin pan. Bake at 400°F for 15 minutes. Makes 12 muffins.
I added blueberries and almonds to mine, which gave it nice color and a good crunch. I also ended up with 13 instead of a dozen.
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