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Peanut Butter Energy Balls: A Tribute to Nurses Week

Thankfully, I am feeling much better at work lately. It is amazing what 2 months can do. It’s still isn’t perfect, but the fact that I am posting a recipe again means that I am cooking again, which must mean that things are at least a little bit better, and I am a little less stressed. Nurses Week just passed. I was hounded by a couple of the ANCCs to write a story for an “anthology” of stories that was going to be published for the event. Naturally I agreed to do it, but only so long as my story was anonymous, and was only published if plenty of other submissions were received as well. As my luck would have it, my story was the ONLY submission received, and it was published alone, on the back of the nursing newsletter, which was distributed at a very public ice cream social. I didn’t find out until after, and I can tell you, without exaggeration, that my cheeks were as bright as my pink scrubs. Oy! But since the whole world has read my story (it seems) I guess you can read it too. But before that, check out these balls.

I made this recipe because I have been SO hungry at work lately! My coworkers joke that I always seem to be eating something…but I just don’t understand how they aren’t eating something, too! I am training for a half marathon and it is inevitable that some of my runs occur before work, even though that means that they precede a 12-hour cardio endurance event in the ER, which makes me feel that I just created a new Olympic event: the Nursing Duathlon. These energy balls are perfect to pop in my mouth between patients…or on a hike in the Catskills, or a long travel day cross-country to Seattle, the possibilities are endless. And it doesn’t hurt that the “energy” balls kind of taste like cookie dough.

Peanut Butter Energy Balls

Adapted from: The Diva Dish

Ingredients:

1/2 C pecans

1/2 C almonds

1/2 C chopped, pitted dates (I bought pre-pitted)

1/4 C carob/chocolate chips

1/2 C unsweetened finely shredded coconut (plus more for rolling your balls)

1/2 C quick oats

1/4 C pure maple syrup

1 tsp vanilla extract

1/4-1/2 C Peanut/Almond Butter (depends on how extreme you want the PB/AB flavor to be)

First gather your ingredients. In a food processor, first pulse together the pecans and almonds until you see chunky crumbs. Then add the dates and chocolate/carob chips and process some more until your mixture looks pretty crumb-y again. Next, mix in the coconut and oats (one at a time) and pulse until they are integrated. Lastly add the wet ingredients: maple syrup, vanilla and peanut/almond butter and process until they are fully incorporated. Scoop the mixture into a bowl (so the blade isn’t in the way), remove your rings 🙂 it is sticky! Start to roll balls. You can leave them “naked” (which I did for Matt, who has an unfathomable aversion to all things coconut) or roll them in a pretty dusting of coconut flakes (for me, who knows what is better) and then store them in the fridge/freezer as a snack for now/later!

Naked Balls

And now for a little post-cooking story time…

I eye the clock with apprehension. 6:52: my shift starts in less than 10 minutes. I pack my pockets with all manner of nursing paraphernalia; arming myself for the onslaught of patients during the 12 hours that lie ahead. A Carpuject, pulse oximeter, handy notebook of nursing diagnoses and interventions and plenty of saline flushes line my pockets, and my stethoscope is looped around my neck. With a deep breath, heart racing, I set off to receive report, wondering what sort of night lay ahead. It’s impossible not to wonder, but also impossible to control: this is life in the ER.

I thought I knew what to expect. I spent eleven eye-opening weeks as a student in the St Luke’s ER. But “Student Nurse” has a much different ring to it than “Staff Nurse.” As a student, I could apologetically shrug my shoulders and say, “I don’t know” to a patient, and come back with an answer later. As a registered nurse there is a much different expectation. Certainly, I can, and do, ask many questions. But I also feel the weight of responsibility in a different way.

Now, 8-months as a nurse, still green in many ways, I can at least look back on my first few months of being a nurse and see how far I have come. In the beginning, it didn’t take much to throw me off my A-game: a missing piece of equipment that I had to go hunting for or back-to-back “notifications” in the trauma room. Anything could do it, and often did, because the role of the ER nurse is to expect the unexpected and be comfortable feeling perennially behind. Every task is urgent
except for the ones that are emergent. My baseline emotion when chaos erupted was low-grade panic, punctuated by spikes sheer terror.

My confidence was (and admittedly still is) easily shattered. I can start IVs, administer medications and blood products, insert catheters and assist with other invasive procedures. I can competently help stabilize a trauma patient or efficiently do a cardiac work-up. And while I may not yet have the grace of far more seasoned nurses, I can feel satisfaction knowing that as I run around looking harried and crazed, I will get the work done.

It is only recently that I feel a small but perceptible transformation. Gradually, I anticipate what the plan of care will be for my patients, and find that I am correct more often than not. I assist my fellow nurses, like they so often help me. I feel a growing sense of familiarity and comfort with the staff, and realize that in knowing each other well, we work together like cogs in a well-oiled machine. But most significantly, I have started truly hearing my patients for more than their medical histories, and remember the real reason behind why I became a nurse.

One night, as I was busily scurrying around the ER, I picked up patient who had tripped and hit his head. When I went to see the patient, I found a man in his mid-80s, quite confused to find himself in the ER in the middle of the night and with a bloody forehead, to boot. I helped get him settled and explained the purpose of doing a CT of his head. With trepidation, he agreed. He miraculously had nearly no past medical history, and was staggered by the tubes of blood I had to draw for labs and bothered by the incessant beeping that came from the monitor whenever he pulled off his leads. Then, we were called to the trauma room and for 30 minutes I didn’t think about anything else besides the new patient in front of us.

When I eventually made it back to my older gentleman patient, he was agitated and disoriented. While his words came out in a tumble, I gathered that he was afraid, tired, annoyed and that he had soiled the bed. He told me that he had called for someone to help him but wasn’t heard and eventually couldn’t wait any longer. He was embarrassed, and rightfully indignant. I felt terribly that I had been holed up in the trauma room for so long, and apologized profusely. I helped change the linens and his wet gown. Now calmer, clean and settled, we spoke the plan for him to be admitted to the hospital, and I also learned about his wife of 60 years at home with whom he was still head-over-heels in love. In the end, I realized that it wasn’t the subdural hematoma that made my patient feel so scared and upset, but the feeling of being neglected. Everyone deserves dignity in their care and I felt reassured that despite my rush, I am still able to find moments in the ER to provide reassurance, listen to touching anecdotes, and care for my patients during their most vulnerable times. In nursing school, you learn about the progression of competence that every nurse makes in their journey to becoming experienced. It is gratifying to move past a near-exclusive focus on the completion of discrete tasks to the ability to view and implement comprehensive patient care based on individual needs.


 

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Craziness and Cookies for Peace

This story does not make me look like an angel. Yesterday, I was severely annoyed by a patient. This patient drove me so crazy that I wanted to pull out my hair, ignore her completely, or worse, make her disappear. It wasn’t that bad from the beginning. While I knew she had a psych history, and had been to multiple ERs with the same complaints, and had same tests done and had been medically cleared any number of times, it’s not in my nature to immediately distrust a patient that I have never met. But with a large load of patients already, and a busy day ahead, it soon became clear to me who was the truly ill and who fell to second (or fifth) priority. And with a steady stream of complaints and demands with seemingly no relief, I soon grew exasperated. Probably more so than I have felt ever before in this setting. It is not a good feeling, and it colored the quality of my care for this patient and tinged my mood for the entire day. I was not at my best. Less than super nurse, to say the least. She was with me all twelve hours, my lovely lesson of the day. She was constantly telling me how sick she was – as if I could forget. She told me again and again that the regular doses of pain and anti-nausea medication that I was giving her had done nothing at all and she would rate her pain as ten out of ten, and later twelve out of ten. When I paid attention to her it was almost worse than when I ignored her. I hate to say it, but I realized that I had to be firm and set limits with her so that I could safely care for my other patients as well. It was a hard lesson, but very necessary. And when she was finally medically cleared (with yet another CT scan, that she demanded) she still wasn’t ready to leave. Multiple physicians tried to use reason, and I did my best as well, but we could not get through to her.

Then suddenly, while I was in the midst of drawing up medications for another patient, an old man appeared at my side. He said he was her father. He looked nearly as tired as me. But with a sweet smile, he asked me if she was medically cleared, and if so, could he take her home? Unanticipated, a huge sigh whooshed out of me. I told him that yes, she had been cleared. Another sad little smile and he said, “If she is clear, then I can take her off your hands.” This small stocky man with the unruly grey Einstein-esque hair and disheveled appearance–sweater pulled taut over a slight paunch–was my knight in shining armor. And after a full day of caring for this patient with no relief or remission of symptoms, arguing with her about her diagnosis (or lack thereof) and just generally sweating over her care, she meekly followed her father out the door. That easy? For me, it was. That was one day for me. One hard day and then I get to wash my hands of it. But guess who doesn’t get to do that? Her kind mother who called earlier in the day to inquire about her status and her sweet father who came to escort her home and ultimately ended the circular game of discharging someone against his/her will, sick or not. Mother and father will never wash their hands of their daughter’s illness and neither will this woman herself, who is clearly sick in a way that the medications in our Pyxis simply cannot treat. I left very sad, and frustrated. Our system isn’t very good at dealing with the mentally ill. In fact, I would even go so far as to say that the system failed this patient, despite our well-intentioned efforts, and that makes it fundamentally flawed. Clearly, I don’t know the whole story. I only saw a small piece of the puzzle. But, I know something different should have occurred to stop the cycle of her using the ER like a revolving door. Should she have received a psych consult even though every complaint she had was physical in nature? The clues of prior visits point to yes, although clearly this is not a means to a permanent end since prior psych consults have not yielded answers or an end to the behavior. And should she have been assessed for an addiction? Perhaps. It is hard to say without knowing more of the story than her singular ER visit.

What I do know is that the very next day, while putting a chart away at the charge nurse’s desk, a little piece of me shriveled up inside when I heard her voice behind me saying, “Oh, Rachel…I’m back. This time I am really sick!” There she was, brought in by EMS…AGAIN…on a stretcher. She told me that she was still feeling terrible, and that “they” had called her back because they had seen something on her CT scan when re-reading it. I have to admit, I held my breath and crossed my fingers that our team wouldn’t be assigned to her care. And it wasn’t. But the Communications nurse later told me that the look on my face was priceless when the patient called out my name, she said she cracked up, and only for that reason was the patient not assigned to our team again Only in blog-land can I admit how grateful I was. After another 12 hours of her in the ER, with so many other patients, I may have quit my job on the spot. Obviously, I need to learn to better outlets to control my frustrations, because not every patient is pleasant or kind. I am working on learning not to let my crazy patients make me crazy as well because then i really can’t help them!

And now, a recipe for peace. Tea and these cookies, combined with a little yoga on the side help me stay externally peaceful in the ER.

simple lemony cookies

Ingredients (I doubled this recipe and kept one log in the freezer for later use at a future tea party date!) From: VodKitchen
  • 9 Tbsp. butter
  • 1/2 cup fine sugar
  • 1 large egg
  • Barely less than 1 cup all-purpose flour
  • 1/4 cup quick cooking oatmeal
  • 1/4 tsp. baking powder
  • 1/2 tsp. salt
  • 2 lemons for zest
Preparation
  1. Put your softened butter into a food processor with the rest of the ingredients (save the lemon zest) and process until smooth.
  2. Finely grate your lemon zest. Stir the zest into the cookie dough and mix together well. Spoon on to a piece of plastic wrap and roll into a sausage shape with a roughly 2 1/2-inch diameter. Chill the dough in the freezer for 30 minutes.
  3. Preheat the oven to 375°. Get your chilled dough out and cut it into 1/4-inch thick slices. Place these on two cookie sheets, making sure you leave a good bit of space between the slices because they’ll spread while cooking. Place the cookie sheets in the middle of your preheated oven and bake for about 10 minutes, until the edges of the cookies are golden brown. Let them cool down slightly before transferring to a wire rack to let cool completely.

Also great made with orange zest instead of lemon, and served with tea, coffee, or hot cocoa!

 

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Spring has finally Sprung…today in my kitchen



Can I complain for one hot second? I’ll take a rain check on a verbal/written reply and take the silence as a ‘yes.’ I am fed up with winter. It rained for my sister’s entire outdoor graduation. Sideways rain, and I don’t think you can get more insulting than that. It rained for my graduation too, but I was happy as a clam to be inside a Track & Field stadium (addendum: I would not have found myself quite so content had it been a sunny-side-up day). I am angry at the weather. Angry to be on the East Coast, although, given the recent (and not-so-recent) rash of natural disasters and other not-so-natural disastrous events, I suppose I should feel at least a modicum of gratitude to be right where I am.  But I am not grateful for my location so much as the produce that it produces. Today, it a little market near my train stop I found all three of the above-pictured vegetables. I hadn’t a clue what to do with them, but daydreamed all the way home on the train, and by the time I arrived, I had the scaffolding of a couple of ideas in my head. I rushed home. I dirtied a lot of a pots and pans. I sweated in my kitchen for the first time in many moons. I requested fancy cocktails from my fiance for our guests. He provided them. (they were delicious) I had a mini-meltdown over 2 poorly poached eggs. Then I got the hang of it.

I took one singular picture…it doesn’t do the final dish justice…but if you want to try any/all of the mishmash medley of vegetarian sensations that I created, the lackadaisical recipes are as follows:

Creamy Polenta

6 cups of water with a dash of salt to speed the boiling process

2 cups dry polenta

œ cup cream

2 tbsp butter

Πcup grated romano/pecorino/other fancy cheese

Salt & Pepper to taste

Bring the water to a rollicking boil before mixing in the 2 dry cupfuls of polenta. Lower heat and let bubble and brew at a simmer for 10-15 minutes. Stir in cream and butter, stir well and bring to a simmer again. Lastly, mix in cheese and season with salt and pepper to taste before serving. Best served hot. Makes 6 servings or more


Mizuna Greens

A Japanese green, these tender young’uns have been descried as “piquant, mild peppery flavor…slightly spicy, but less so than arugula.” I tossed them lightly with sesame vinaigrette, toasted sesame seeds and finely grated pecorino.

Caramelized Rutabega

1 large rutabaga (cut into œ-inch cubes)
Πcup butter
2 tbsp. brown sugar
1/8 tsp. pumpkin pie spice
Freshly ground pepper

Cut the ‘bega into small cubes. Boil in salted water until tender-crisp (about 10 minutes). Drain well. Melt butter in pot, add the rutabega, sprinkle brown sugar and mix gently until caramel appears, just a few short minutes. Add pumpkin pie spice and pepper.

Crispy Pan-friend Spring Onions

4-6 young spring onions

3 tbsp butter

salt, pepper, lemon

With a mandolin, slice the onions into rounds. Melt butter in a skillet and turn up the heat. Add onions and flash-fry for 1 minute on each side. Season the onions with salt, pepper and lemon. Drain any excess butter (can be used with the polenta for an additional seasoning flavor).

Poached Eggs

Tips:

  1. Do NOT boil the water. Do not let it simmer. Get the water “excited” with bubbles just barely appearing at the bottom. It is poachable now.
  2. Pour in a splash of vinegar
  3. Prep your eggs in ramekins, do not crack directly into the whirlpool you create.
  4. Make a whirlpool in the water with a spatula in your dominant hand, hold the ramekin containing the egg in the other hand, and gently dump it in the center of the whirlpool at the same moment that you remove the spatula
  5. Do not touch your egg as it swirls and gels. Close your eyes if you have to! Do not touch the egg. Trust it.
  6. Let it cook for at least 90 seconds before nudging it gently with the spatula to make sure it is not sticking to the bottom of the pan. If it is ready, gently scoop it out with a slotted spoon and put in a warm bath of water to await serving time.

I discussed egg poaching in a previous entry and recommended Smitten Kitchen for an excellent tutorial. I still  stand by this method, despite my initial failed attempts. Check it out for detailed instructions and pictures.

Happy happy spring!

 

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Healing Belly: Morning Glory Muffins

Sorry for the lame-O photO today...rushing around this morning and had to use my phone camera for the snapshot.

Mmmm, I made the most delicious and nutritious muffins yesterday. Truly! The word muffin is not usually synonymous with nutritious (even if it poses as nutritive) but this is actually factually a yummy-tasting specimen.  It doesn’t even taste like cardboard, as my mother suspiciously asked me today, point-blank, as I gushed about them. Rightly so, she is suspicious of replacing butter and other deliciously decadent fats with healthier alternatives like applesauce, and for the most part, she is right. Nothing stands up to butter and fat in the taste category. But if you are looking for something that won’t necessarily compete, but simply serve as a humble and healthy alternative, then this is it. And it won’t even make you muffin-top over those nice new pants you just purchased. Unless you eat 20 of them. Bah ha ha.

Morning Glory Muffins

Ingredients

  • 1 cup all-purpose flour
  • 1 cup whole wheat flour
  • 1/2 cup white sugar
  • 1 tablespoon ground cinnamon
  • 2 teaspoons baking powder
  • 1/2 teaspoon baking soda
  • 1/2 teaspoon salt
  • 2 cups grated carrots (about 3 medium-sized)
  • 1 apple – peeled, cored, and chopped
  • 1/2 cup shredded coconut (raw or sweetened, to taste)
  • 1 egg
  • 2 egg whites
  • 3/4 cup applesauce
  • 1/8 cup vegetable oil
  • 1 tablespoon vanilla extract
  • 2 tablespoons chopped walnuts
  • 2 tablespoons toasted wheat germ (if you have it. I didn’t, and didn’t miss it.)

Directions

  1. Preheat oven to 375 degrees F (190 degrees C). Lightly oil 18 muffin cups, or coat with nonstick cooking spray.
  2. For ease and speed: food process your carrots, apple, walnuts and coconut all together, and set aside.
  3. In a medium bowl, whisk together eggs, egg whites, apple sauce, oil and vanilla.
  4. In a large bowl, combine flours, sugar, cinnamon, baking powder, baking soda and salt. Stir in carrots, apples, coconut and walnuts mixture. Stir in wet ingredient mixture until just moistened. Spoon the batter into the prepared muffin cups, filling them about 3/4 full.
  5. Bake at 375 degrees F (190 degrees C) for 15 to 20 minutes, or until the tops are golden and spring back when lightly pressed. (I had to bake them much longer, roughly 25-30 min – test the centers!)

Amount Per Serving  Calories: 194 | Total Fat: 4.2g | Cholesterol: 12mg

 
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Posted by on May 4, 2011 in Breakfast, Snacks

 

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Tempting Tidbits: A Finger Feast

This past weekend’s dinner party was… dare I say, “Wow?” I had many of fabulous sous chefs helping in the kitchen and some seriously expert meal planning assistance from my rockin’ Sister Chef. I have to say though, I am still quite proud of how it all came together. So proud that I feel a little cocky rooster boasting coming on…ahhh, it’s too big to restrain, I can’t quash it…it…oh no, it’s a photo explosion. Sorry, I tried to hold back. I failed. Here it is.

 

For the early bird: Rosemary Twice-Baked Bar Nuts
the bartender’s station. mojitos anyone?

 

snacks

snack station

All the fixins for Vietnamese Fresh Rolls
Asian Sesame Cabbage Coleslaw
Momofuku-inspired deviled eggs
The essential last (or first) course: dessert
Starring: these lovlies, peppermint patties

 

After that delicious food trip down Photo Lane, I truly don’t know what recipe to share first! I loved all the new ones that I tried, and literally the only kitchen snafu that occurred was slight burnage of kale chips. They were still deemed edible by the judges, however. One thing not pictured that I was really excited about (as were the guests, apparently, since not a single crumb remained post-party) were the Sweet Potato & Celery Root Croquettes. I found the recipe for a similar purĂ©e on the NY Times website, and found myself intrigued. Yet, as my sister astutely pointed out, puree is awfully hard to eat as a finger food. She brainstormed up croquettes, and after a little trial and error, a fabulous frying team, and a breadcrumb trail to pave the way, an incredible (if not incredibly photogenic) platter of croquettes materialized:

 

sous chefs protecting one another from oil spatterings

Ugly ducklings

So, even though they were slightly ugly and more than slightly fried, I have to trust my audience, and my boyfriend and rank them as the #1 bestseller. (Plus, you can reserve half of the puree to be eaten as a leftover – a fantastically healthy post-food coma snack!) Here’s the recipe. Since I made up the croquette version on the fly, I don’t have exact measurements. Experiment to the consistency that you like, then mold to your desired size and shape: patty, croquette stick, or melon ball.

Celery Root, Sweet Potato and Apple Puree

1 lb Yukon gold potatoes, peeled and cut into large pieces (I used half and half Yukon gold and sweet potato)

2 large celery roots, about 2 pounds, peeled and cut into large pieces

1 large or 2 small tart apples, such as a Granny Smith, peeled, cored and quartered

1/2 cup, approximately, warm milk or broth from the celery root

2 tablespoons butter or walnut oil (or a combination)

Salt and freshly ground pepper to taste

1. Place the potatoes in one saucepan and the celery root and apples in another. Add salt to taste to each, about 1/2 teaspoon. Bring to a boil, reduce the heat and simmer until tender, 15 to 20 minutes.

2. Drain the potatoes, and return to the pot. Cover tightly, and allow to sit for five minutes to steam and dry out. Drain the celery root and apples through a strainer set over a bowl. Purée all of the produce using a food mill or a potato ricer. Stir together, and whisk in the milk or the broth until the mixture is fluffy. Add the butter or walnut oil to the hot purée, stir until the butter melts, and season to taste with salt and pepper.

3. If you are dying for croquettes, let the puree cool first. Then mix in 2 eggs, 1/2 cup of Parmesan cheese, and a rounded cupful of plain bread crumbs. Add more breadcrumbs as needed to reach desired molding consistency. You can also dredge the croquettes in bread crumbs for a more delectable exterior. Lastly, cook the croquettes in a deep skillet on medium high until browned on both sides. The best thing about these babies is that they taste just as good served at room temperature as they do hot (if they last that long).

 

 
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Posted by on February 7, 2011 in Snacks, Vegetables and Sides

 

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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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Spoonful of Beans

 

beans, beans the magical fruit...rinse them well and you won't toot!

YUM. Every time I go over to a certain friend’s house, she has the most delicious beans simmering on the stove.  The mouth-watering aroma fills her house. However, I never get to see how the process begins. It appears to be a seamless cooking process with no definitive start or finish. A dash of this and that, simmer for a few hours, maybe more, and then taste test. Sprinkle in a bit more of this and a lot more of that, then ¡voila! there are amazing beans to eat. Put them in a taco, mix them with stir fried kale and sausage for a nontraditional breakfast, or eat them solo, piping hot. Finally, after craving them for eons, I emailed her for the recipe. (By “eons” I really mean the extent of this freezing cold on the East Coast that they call winter, instead of appropriately titling it “Arctic Chill.”) Alas, my friend admitted that there was no official “recipe” but gave me a list of suggested ingredients and vague instructions. Trying not to get my hopes up, I went for it, infusing my own sprinkling style into the mix. No measuring spoons or cups used, just instinct. So that’s how the following recipe looks, laundry list style. I won’t be able to recreate exactly what I made today, but I have faith that I (and you) can create delightfully unique but equally delicious Bean Surprise.

Ingredient List

Beans (I use the 17-bean mix from TJ’s. Amazing mix at an unbeatable value)

A few yellow onions, finely chopped

Cloves of garlic, minced

Carrots

Apple or dried apricots

Cumin

Paprika

Cinnamon

Red chili flakes (or anything you desire for some heat)

Few teaspoons apple cider vinegar

Splash of wine

Worcestershire sauce

Chopped chipotle peppers from can (with sauce)

Tomatoes (fire-roasted can version, or a small container of tomato-ey salsa)

Brown sugar and salt, to taste

1) Soak beans overnight, or “quick soak” (soak them for an hour and then boil until slightly softened). Set aside.

2) In a large pan, sauté onions and garlic with a little olive oil and all the spices. Mix in carrots/apples/apricots.  Let these ingredients simmer together for a couple of minutes.

3) Add beans, (keeping some but not all of the liquid that you boiled/soaked them in) to the onion mixture.

4) In no particular, combine with apple cider vinegar, wine, Worcestershire, and tomatoes.

5) Cover and simmer gently over a stove for 1-2 hours, letting the flavors meld. This does not need to be tended often, just tasted occasionally and seasoned to taste. I added a small teaspoon of brown sugar and a dash of salt towards the end.

6) Let the mixture cook down until there is very little liquid left and it is a thick stew-like concoction. Enjoy served over toast, quinoa, eggs, in tacos, or any other delicious vehicle you can come up with.

 
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Posted by on January 9, 2011 in Legumes, Main Dishes, Snacks

 

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