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.