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Ridiculously Remiss from Spoonful

I have been too long gone. I apologize. I deserted my blog; hook, line, sinker; without even a backward glance. Why? Not because I haven’t been cooking…I had so much to share, and so many cooking conquests and yet not a single one was translated into blog-ese. part of it was that my computer was so darn slow (before I replaced the hard drive which apparently is kind of like computer Botox, takes away many of the visible wrinkles without completely erasing the signs of aging) and I was too impatient to wait for my pictures to upload or for the actual words on the screen to catch up with the speed of my typing (which frankly, isn’t even all that fast). Partially, it was studying for the NCLEX and job-hunting (which I passed AND got a job, hooray!) and part of it was a total dearth of the stories because I was not longer in the ER 3 days a week (soon to be remedied…eek!) And also…it was enjoying the summer weather…soaking up every single drop of sun and basking in its amazing warmth (until the Big Apple became the Baked Apple and I actually COMPLAINED ABOUT THE HEAT…never before has that come from my mouth). At last, I return.  However, my blog has missed many memorable exploits. For example, with the first fruit of the season to arrive in our CSA, I was inspired to try this:

rubies of the early summer

 

 

 

 

 

 

 

 

 

 

And with my lovely sis’ we ventured on even more cook-a-thons (she, holding my hand all the way through, as I rolled my eyes at the outrageous pickiness of the classic macaron recipe, and simultaneously steeled my nerves for my fear of failing) BUT WE SUCCEEDED! Recipe to come shortly, but I simply cannot do it justice today. A sneak preview:

double trouble

And with the increasing CSA bounty, I have had my hands FULL. And therefore, if for no other reason, the blog must come back, because all the awesome green (and other color) creations that I am making need to be recorded so I don’t forget them for next summer! Easy suppers (ie: taco salads, black bean veggie burgers, vegetable & tofu stir fries), crunchy lunches (read: massive salads) and delicious and different breakfasts…like the one I made today!

midsummer CSA love

Huevos Rancheros

“East Coast Style” inspired by Deb at Smitten Kitchen (who is my kitchen guru despite all the other cooking blogs I have found and delighted in…her taste is superb and her writing style is still my fave.)

Combination: Salsa Fresca con Salsa Verde Crudo (tomatillo salsa)

Makes about 2 cups.

2 large fresh ripe tomatoes, finely chopped (set aside)

10 tomatillos, husked and well washed, quartered
1/2 large white onion, peeled and coarsely chopped
3 garlic cloves, peeled and crushed

1 jalapeño pepper, stemmed, seeded and chopped
1/4 cup chopped cilantro leaves
Fresh lime juice or 1 teaspoon red-wine vinegar
Salt and freshly ground pepper, pinch of allspice

  1. Puree all ingredients together (reserve the ripe tomatoes) until smooth, then combine with the tomatoes that were set aside, taste and adjust seasoning as necessary.
  2. Let the flavors marry for 15 minutes or so before serving, but serve within a couple of hours.
Los Huevos
Tortillas (I humbly recommend The Tortilla Factory, white corn, AMAZING if you don’t have a tortilla press)
Eggs
1/2 cup cheddar cheese, finely grated
GOYA black bean soup (this brand is awesome, this is the secret to the ease of this recipe)
Salsa Fresca
Salt/Pepper
Heat tortillas in a lightly greased pan/skillet. Flip over when browned slightly. Top with some of the cheddar cheese. Crack an egg directly on top of the tortilla. Don’t worry if it runs over the edges a bit. It’s about to get way messier; embrace it! Season to taste with salt and pepper. When the egg is about halfway set, slide your spatula under and gentle flip the whole thing over. The yolk may break or it may not, either way, it’s delicious. Sprinkle a bit more cheese on this side. Cook to your preferred level of done-ness. Flip onto a plate and decorate as you desire with the black bean soup concoction, fresh salsa, and grated cheese. YUM
(pics to come)
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Posted by on July 23, 2011 in Breakfast, Snacks

 

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Poaching a Snow Day: Perfecting Egg & Toast

Today’s snow day breakfast was this:

 

Just what the Nurse Practitioner ordered for a head cold on a snow day: poached egg with toast, tea and DayQuil. Yum.

For the record, last snow day’s breakfast was this:

 

Crepes A La Snow…

Made with this:

 

Uncle Bill's hand-hewn mixing spoon in its innagural batter

Apparently the only things I accomplish on snow days are delicious breakfasts. I haven’t been outside yet to view the (supposed) 19 inches of snow, nor have I cracked a textbook. But I did learn how to make poached eggs. Who knew that all it took was a splash of vinegar in a barely simmering pot of water, swirled into a whirlpool with a spatula? Now you know too.

Nothing much to add to the recipe that I found on Smitten Kitchen, except to comment that is perfect, has an incredible photo montage dedicated to the process (which I am not sure how she accomplished with only two hands), and is only missing red-hot chili flakes it its garnish. The toast fingers are ingenious. Check it out.

The crepes recipe was found in a tiny little cabin in the North Cascades, in an old cookbook. I think it is a pretty darn perfect recipe as well. I copied the recipe on an old sheet of notebook paper, which I now can’t seem to find anywhere. I promise the recipe in a future post, when I alight on the it again…

In the meantime, I will most certainly be making more poached-belly eggs. They are runny and delicious and my boyfriend is missing the “eggs-taste-good” gene, so they are all mine.

In my post-poached egg bliss, I am spending a moment reflecting on my clinical experience yesterday. I have given some more thought to bed pans. They really are dreadful. It was one thing to help my residents use the toilet while working in Assisted Living, but it really is quite a different thing to help a patient scoot a pink plastic oddly-shaped…thing… under his/her bum. From the moment I walked in at 7:30 to take vitals on my first patient, to the 30 minutes I spent before leaving at 2:00pm helping my nurse clean up a patient who had been lying in her own excrement for too long, most of my day was about poo. Again. I can’t seem to escape it. Even as a nursing student, where there are many more “important” things to mull over (like my recent successful IV insertion in the ED last week, or the deodorant container that was found in the rectum of another individual the very same day), poop just seems to follow me, and I really think it’s important to dwell on the un-enchanting topic for the patient’s sake. I think we all can relate. I hate needing to go #2 when I am on a camping trip, or in a public restroom. But sh*t happens, and sometimes you just have to. However, now put yourself in the shoes of your bed-ridden patient. Can’t you see the conundrum? Not only do you have to go #2 IN bed, you need to co-opt someone’s help in order to do it! And if you try to hold it, telling yourself you will be out of bed in just a few days? Oh no, you’ll be much worse off now: the doctors and nurses will note that you haven’t had a recent BM and will give you all sorts of fabulous concoctions to make more BM appear from your rectum than you ever dreamed possible. The bed pan will become a fleeting dream of the past, something you wish you had used gratefully, now knowing that the alternative is soiling your diaper/chuck every 5 minutes and needing to press the call bell for yet another fresh set of sheets.

The underlying theme of all this is the loss of dignity that seems to necessarily occur for hospital inpatients, especially of the bedridden variety. But is it really necessary? While crouched in a position of extreme vulnerability, trying to help a patient attach her diaper from where she was awkwardly standing over me holding onto the bed (don’t ask me how I got in this position), this patient looked down at me and shook her head sadly. She said, “Growing old really is the pits. Everything turns upside down and inside out and you look at the situation and it seems so surreal. I don’t even know how I got here.” From my awkward position and preoccupation with getting the diaper successfully fastened, I could hardly think of the right thing to say. I think I mumbled something comforting, but when I finally got her seated again, I tried to rectify the pacifying words I had said before. I gave her an opportunity to share more, but she seemed past the moment of vulnerable sharing. She smiled at me, held my hand closely and told me my hands were cold. She thanked me gracefully, and I was reminded how powerless yet strong these elderly people can be. What I wish I had said to my patient while crouched on the ground was this:

“You’re right. It can be difficult and frustrating to grow old and lose independence. I can only imagine what you feel like right now. I know that so many other people feel exactly the same way that you do, powerless and a burden on others. But we will all be in your place some day.  We all will need and rely on the kindness of others. I can only hope to age as gracefully and willfully as you. Your warmth and willingness to share helps me see you better for who you are, not just a patient but an individual with a life and an incredible story. Thank you for sharing part of it with me.”

Of course I didn’t say all this. But I hope she got the gist of what I wanted to share with her just with my presence. Her response to my fumbling care was kind and comforting, while another patient’s was jarring but just as understandable. At 7:30am, while I made rounds on my patients and taking vitals, I walked in to a patient’s room and greeted him, so as not to startle him out of his sleep. He didn’t look up from his cocoon of sheets. I gently pulled back the covers, as I do with many patients, and attempted to place the blood pressure cuff on his upper arm without disturbing him. Quick as lightning, his arm snaked out and grabbed my wrist and said a harsh, “NO!” Totally startled, I dropped the cuff and backed up quickly. I meekly mumbled that I was just a nursing student, there to take his morning vitals, and  that I was sorry to bother him. But already he was shaking his head. “No, no, no you cannot take my vitals. I don’t care what you are here to do. You all take my DIGNITY. Yes, my dignity, it is a good word for what you do, and I can’t take it anymore.”

His string of words made no sense to me in the moment, but I knew that they must connect to some event that I wasn’t involved in, although I felt personally wounded by them. I tried one more time to explain myself, but his refusal was clear as he pulled the sheet back over his head. Not wanting to risk another violent encounter, I left the room, shaken. I informed my nurse preceptor of the events, and she shook her head, confused as well. Since it was a new shift, we had both just arrived. However, she told me that this particular patient usually had a sunny disposition and had been singing to her just the other day. Later on, we discovered the source of his injury. Apparently, towards the end of the night shift, he had rung his call bell incessantly, to no avail. He needed to use the bed pan, and for whatever reason, no one responded. Unable to get it himself, he immediately felt stripped of power and independence. But his dignity was not lost, he said, until someone finally came in and put him on a bed pan and then left. That person, whoever it was, then went home, probably forgetting entirely that he/she had placed a patient on a bed pan and forgot to inform the responsible party in shift change. From my vantage, I could see how the mistake had occurred, but the patient suffered as a result. I know that one day I will make a similar mistake. It is impossible for a nurse or nursing assistant to remember everything, all the time. Mistakes are bound to happen. I don’t blame the nurse/tech who made the error, but I hope that when I make my mistake, I will have the opportunity to rectify it with the patient myself. It feels so bad to let someone down, especially someone who is so dependent on you. In this instance, I was able to listen to the patient and let him vent. He let out a torrent of emotion and feeling, and by the afternoon, he was singing again. It was a good outcome, and an important lesson for me. These wounds can be healed, and mistakes forgiven, but we have to listen to our patients.

 
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Posted by on January 27, 2011 in Breakfast, Healing Spoonful

 

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Inglorious Bast-turds

Turd is a 4-letter word that I much prefer over test. I promise, I am not talking about wiping bums today, but I do not feel ashamed in at least mentioning it. I would far prefer to clean up after someone who passed their bowels than take a pharmacology/physiology/issues of nursing test…ANY DAY.

I am a bit worn out on exam-taking today. This week. This month.

If there was a pie chart of my life, studying for exams would be disproportionately representative. I know that I need to learn this material in order to be a safe and effective nurse, but this method of tricky multiple choice testing day-in-and-day-out really takes a toll. That’s why going to the hospital this week was such welcome relief. Patience may be a virtue, but I am sadly lacking it when it comes to waiting for competence in nursing practice. Yesterday, however, reminded me why it is worth working for.

Our preceptor placed us with telemetry/cardiac monitor patients this week. In the RICU, this may seem like a step down in terms of hands-on learning since our patients weren’t dealing with tracheostomies and ventilators, but in terms of gleaning knowledge from our patients about their present illness, it was profoundly educational and emotional. This was my first patient that could actually speak to me!  More than speaking to me, she entertained me to no end.* Breathing was difficult, her energy was low, but her wit abounded. She was a total trip. She told a doctor that she was going to kick, ahem, his little “behind” if he didn’t get her off the drug that was causing her anxiety. While she was consulting with a palliative care doctor about possible treatments, her son was telling me all about her career working for the police department and before that, traveling with the army for close to 20 years. In a break from talking with the physician, her son asked, “Hey mom, what’s your favorite gun?” Without missing a beat (quite a feat on a 50%-O2 saturation partial face mask) she responded, “M-16 and M-19,” then she turned back to the doctor and continued conversing about her treatment. I was momentarily shocked that this little tiny lady had not only handled a gun, but that the names of her personal “favorites” had tumbled from her lips as easy as 1,2,3. Previously, we had spoken about salsa dancing and I had pegged her as a dancer in her former life, but that clearly wasn’t all… She is quite a character. Unfortunately, her condition doesn’t promise a quick recovery: sigmoid colon cancer, pancreatic cancer that quickly metastasized to the liver, bones and lungs. For this reason, my day with her was quite bittersweet. I was able to talk to her about her life and illness, take my time in giving a bed bath which she and I both thoroughly enjoyed, and also meet one of her incredible children who moved here from different state barely a week ago to be with her in the hospital. I was able to understand her condition (an achievement in itself) but this also opened my eyes to the possibility (or reality) that she will most likely not be leaving the hospital with her son. This is a hard pill to swallow.

When I left the hospital yesterday, though, I wasn’t sad. Maybe my residents helped me understand death and dying a little better. There was a part of me that was sad for her and her family. But I was able to compartmentalize that sentiment and also recognize another emotion: elation. At 6am that morning, I left the house as a Negative Nelly, feeling down-in-the-dumps over another upcoming test, compounded by a serious sleep deficit. But at 3:30pm, as I left the hospital even more weary, I had a completely different outlook. Again, my patient reminded me why I am here. It made me so excited to learn more, even if it means test-anxiety, some more sleepless nights, and even the monotony of studying on a Friday night. It’s only a few more weeks until August, and then it’s three weeks OFF!

In honor of my impending cooking-fest, I will post a recipe that I found the time to make the other day and ADORED.

Eggs Nesting In Tomatoes On Toast

Adapted slightly from A Cozy Kitchen

Serves 4 (maybe…)

  • 4-5 eggs (separated, reserving 2 of the whites for another use)
  • 1/8-1/4 cup extra virgin olive oil
  • 2 cloves of garlic (minced)
  • ½-1 tsp red pepper flakes
  • 1/2 tsp of dried oregano
  • 1 24-oz can of whole tomatoes (San Marzano highly recommended)
  • 1/2 tsp of salt
  • 2 Tbsp of chopped fresh basil (I’m growing mine on my fire escape!)
  • 4 slices bread–whatever you have on hand, toasted

In a cold medium skillet, combine the oil, garlic, red pepper flakes, and oregano.  Turn on the heat and warm over medium heat until the garlic begins to become fragrant (without browning), about 2 minutes.

Raise the heat to high, then use your hands to “crush” each tomato into the pan. (I used a fork/finger to pierce them because the squirt-factor was out of control. Beware of your cute t-shirt, it is in danger!) Season with salt and pepper.  Fry the tomatoes, continuing to break them up with a fork. Cook until they concentrate and no longer look watery (5-7 minutes).

Lower the heat to medium and stir in the egg whites.  Cook until the whites become opaque and firm, thickening the tomato sauce, about 1 minute.

Turn off the heat. Using the back of a spoon, make 4 indentations in the sauce, allowing a few inches around each.  Nestle an egg yolk into each indent.  Pull the sauce in from the edges of the pan so that it cradles each of the yolks.  Cover the skillet and leave it on the stove, heat off, until the yolks are just warmed through and beginning to set, about 3 minutes for runny yolks.

Gently spoon some sauce and a yolk onto each piece of toast and serve immediately. Use a large spoon, perhaps lightly oiled, to pick up a nestled yolk without breaking it. Enjoy for breakfast, lunch, snack, or dinner. Or another special occasion time (plucking your eyebrows??)

*information changed & withheld to protect patient identity

 

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