Sunday, February 19, 2006
Wednesday, February 15, 2006
Clinical Ethics
So, I know I’ve been very bad about posting on this blog lately. But between work, class, and clinical there hasn’t been a lot of time. I finally have a few days off this week. Anyway, I thought you might like to see what I’m “learning.” One of the classes I am taking is Clinical Ethics. Yesterday in class we had to discuss the following scenarios. For each one assume you are a doctor/nurse practitioner and ask yourself: What should be done and why?
1) A patient with a family history of colon cancer and other risk factors refuses your best efforts to encourage scheduling a colonoscopy.
2) An 18-year-old woman requests a cesarean delivery for an uncomplicated pregnancy because she fears labor. You are concerned because there are no medical indications for the cesarean delivery, which has more risks. At the same time she requests a prescription for an antibiotic because “this cold is a drag and antibiotics always seem to help.” You believe her “cold” is viral and not bacterial.
3) You are a medical or graduate nursing student working in a clinical setting and your observe one of your peers falsifying patient-related information in a chart note.
4) As a resident, you are ordered to obtain consent for a procedure from a patient whose decision making capacity appears to be adversely affected by medication.
5) You are part of a team caring for a patient who preferences for a Do Not Resuscitate/Do Not Intubate order are ignored by the attending physician. The patient suffer a cardiac arrest.
6) A nursing colleague confesses to you that an unintentional error he made in a patient’s medication may have been responsible for hastening the patient’s death.
7) You overhear a fellow student using derogatory language to describe a patient with HIV.
8) The family of a patient with metastatic, end-stage breast cancer, who is no longer able to communicate her own preferences, demands that she receive treatment that is “futile” in the judgment of her professional care givers. You are one of the patient’s caregivers.
9) The parents of a 13-year-old boy with limited mental capacities, impaired judgment, and new tendencies to act out sexually with girls, demand a vasectomy for their son.
Monday, February 13, 2006
Friday, February 10, 2006
Tuesday, February 07, 2006
Dagens Namn -- 6 Februari 2006
P.S. Megan, tell GG I screwed up. Her name day was Monday, not Sunday. Sorry!
Sunday, February 05, 2006
Roger Clyne and the Peacemakers

I am very very excited, because I just found out that one of my favorite bands, Roger Clyne and the Peacemakers, is going to be coming the Washington DC area in April. I have seen them perform twice before, once in Dallas and once here in Arlington. They will be playing at the State Theatre in Falls Church this time and I'm excited because the venue is much bigger than Iota where I saw them previously. They put on a damn good show and plus I think Roger Clyne is kind of hot! Listen to a few of my favorite RCPM songs: Leaky Little Boat, Sleep Like a Baby and Wanted (courtesy of Nemo's Goodies). [Hey mrshife, what are your favorite RCPM songs??]

Saturday, February 04, 2006
Thursday, February 02, 2006
Tuesday, January 31, 2006
Oscar Nominations
Monday, January 30, 2006
Swedish Royalty in the Big Apple
Whale Vomit
Thursday, January 26, 2006
Tuesday, January 24, 2006
Christian Valdemar Henri John

Monday, January 23, 2006
My schedule is super fun!
1/16 - work 12.5 hours
1/17 - class 4 hours
1/18 - clinical 8.5 hours
1/19 - clinical 8.5 hours
1/20 - work 12.5 hours
1/21 - work 12.5 hours
1/22 - clinical 8.5 hours
1/23 - class 3 hours
1/24 - class 4 hours
1/25 - work 12.5 hours
1/25 - DAY OFF!!!!
This is all by way of trying to explain why I haven't posted anything but the Dagens Namn posts for the past six days.
I have to say that clinical while exhausting has been rather enjoyable. I am certainly learning a lot. On Wednesday I saw 15 patients, on Thursday I saw 13 patients, and on Sunday I saw 11 patients. A significant number of them came in with upper respiratory infections, which you can't really do all that much for. I've gotten to do both some time in both the Family Practice and the Urgent Care settings. You really do get to see an interesting mix of patients. It certainly gives me a better appreciation for practitioners and how busy they can get. It is very easy to get behind in your schedule because every patient thinks they are the most important person there. People are generally appreciative though. I've only had one patient refuse to be seen by a student (which is their right). I try not to take it personally, but at the same time it really annoys me. The only way a practitioner gets to be a good practitioner is by gaining experience. The more people refuse students, the less the students will learn and consequently come out of their program (be it medical or nursing) as weaker practitioners.
No more fake triplets at work, but I was telling someone the story and they brought up the other end of the spectrum. And by this I mean the women who come in at full term fully dilated and claim they had ABSOLUTELY no idea they were pregnant. I think these people are at least equally if not more deluded than the people who falsely claim they are pregnant. How can you not feeling a living being moving around inside your body and not think there might be something going on? Having never experienced it myself I can't say for sure, but I'm pretty certain that you would feel a full term baby inside you.
Saturday, January 21, 2006
Friday, January 20, 2006
Wednesday, January 18, 2006
"They're Hiding"
About 10 minutes later, the patient (a 350 pound black woman) came flying through the doors on a stretcher with a full entourage of ER and EMS staff (one ER doc, one ER nurse, and four EMTs). The EMTs were helping her breathe through her contractions and holding her hands. Apparently, the patient was apparently 3 days past her due date and her water had broken about 30 minutes prior to her arrival. Oh, and by the way, she was carrying triplets!! First red flag. None of our perinatologists would ever let triplets get past about 35 weeks gestation, yet this patient is apparently past 40 weeks.
All the same, we rushed her to the recovery room next to the OR, because if she was indeed in labor we would need to do a c-section. The NICU was alerted and came running over looking harried. According to the patient, she had gotten her prenatal care with Dr. P. Second reg flag. Dr. P moved her practice to another hospital about a year and a half ago.
The ER doc had done a quick cervical check in the ER just make sure there wasn't a head coming out. This check was confirmed by our OB docs. The ER staff then went back down to the ER. Since there were about 8 people in the room I went back out to the nurses station to keep an eye on all the other patients. A few minutes later the ER nurse called up and said, "You know, I was talking to one of our docs down here. He thinks he remembers that patient and said she's totally crazy. Just so you know, she may not even be pregnant. Call me back when you guys figure out what's going on with her." I promised to give her an update when I heard any news.
About five minutes later the OB resident came out with an exasperated look on her face. After doing both an abdominal and a transvaginal sono, they confirmed that there was absolutely no baby in the patient's uterus, let alone three. To this the patient had responded, "Oh they always have trouble finding them. They're hiding."
After that, the patient was sent back down to the ER, as she was clearly a psych case and not an OB case. I talked to my friend in class the next day who works in the ER. She says they get psych cases all the time claiming to be pregnant. I guess most of them just don't make it to us. Probably they just don't put on quite as much of a show as this woman did. As I said before, she was 350 pounds, with a belly that looked like she easily could have been pregnant with at least one baby. Plus, she really did act like she was having painful contractions. Maybe she was faking it or maybe due to her mental illness she really was feeling psychosomatic pain.
Tuesday, January 17, 2006
Thursday, January 12, 2006
Wednesday, January 11, 2006
Waiter Rant
Monday, January 09, 2006
Sunday, January 08, 2006
Just A Few Things
1) I work on Labor and Delivery. Generally my job is a happy one, but every now and again there are truly sad moments. On Wednesday, I took care of a woman who broke her water way too early and delivered twins prematurely at 22 weeks. Generally 24 weeks gestation is considered viable and this is when the NICU team would be there to whisk the baby away and help it breathe and generally just hang on to life. But at 22 weeks the NICU team doesn’t come and so even if the baby is born alive (i.e., with a heart beat and some respiratory effort) you kind of just have to watch it die. One of the twins from Wednesday was born dead (a stillbirth), but the second one was actually born alive. He weighed just over one pound and lived for almost an hour after he was born. He looked perfect in every way, but he was just too small and his lungs too underdeveloped to sustain life. As the NICU team wasn’t there, I was left to take care of him and comfort his grieving parents. Days like this remind me that no matter how much I may think my life “sucks,” there are other people who are clearly worse off. I wouldn’t wish that kind of grief on my worst enemy.
2) On to a happier note…I went to see a concert at Iota Club and Café in Arlington on Thursday. The main band was Full Minute of Mercury (official webpage, Myspace page) and the two opening bands were Chrysalis (official webpage, Myspace page) and Run Silent Run Deep (official webpage, Myspace page). I went expressly to see Full Minute, as their singer is also the one of the singers in the Legwarmers (whom I saw on New Year’s Eve). I had never seen them perform live before, but had listened to a good deal of their songs on the internet and such. They put on a pretty good show. They know how to perform their songs rather than just sing them. As far as the opening bands were concerned, I enjoyed Chrysalis more than I thought I would. Somehow they were better live than what I had heard of them on the internet. I kind of wish I had had earplugs for the Run Silent Run Deep set though. This was because their music was really just too loud, as opposed to their songs being bad or their singer singing off key. This loudness factor wasn’t an issue I had with either of the other bands that night. All in all it was a good night and I was glad that I finally got to see Full Minute live. Hopefully I will get to see them again soon if they have a show that doesn’t coincide with my hectic work/school/clinical schedule.
3) Friday I had dinner at this place in Arlington called Ruffino’s Spaghetti House. Even though I have lived in Arlington almost my whole life and this restaurant has been around for a while, I have never actually eaten there. My verdict on the place is that it is a quaint unpretentious Italian restaurant that serves good food at decent prices. Check it out if you are ever in the neighborhood (4763 Lee Hwy, Arlington, VA 22207).
4) I got to spend most of Saturday with my cute little triplet friends. As per usual, I took tons of pictures. They never cease to amaze me at how they grow and change. Now they truly laugh at things, instead of just giggling every once in a while. They are also interacting more with each other. The two girls were sitting off in a corner by themselves and all of a sudden your hear them laughing hysterically. One or the other must have done something that they both thought was funny, because there was nothing else around to provoke that kind of laughter. Later on they were playing this kind of peek-a-boo/hide-and-seek game with their mom, where she was sitting on the floor and they were kind of walking around her. She would pretend not to see them and ask aloud if anyone knew where they were. Then all of a sudden she would pretend to “find” them. This got them to laugh hysterically. She did it like ten times in a row and they found it equally funny each time. Kids crack me up!
5) Today I went to see “The Chronicles of Narnia” with my family. I have to say I found it just okay. It was certainly better than the older version that I remember seeing on PBS, but somehow I don’t remember it being quite so “dorky” (this is using dorky in my mother’s sense of it). I’m going to reread the book and see if it is just that the story really is like that or if the movie just didn’t do the original story justice.
Friday, January 06, 2006
Thursday, January 05, 2006
Wednesday, January 04, 2006
Tuesday, January 03, 2006
DC Restaurant Week
Happy New Year…Just A Few Things
Happy New Year to you all!!!
1) I had a great time on New Year’s Eve this year. For the past three years I’ve just gone to bars and it wasn’t really too fun. This year I went to a Legwarmers concert at the State Theater. The Legwarmers always put on a good show and as always the place was packed because every show they put on sells out. I even got to meet a couple Legwarmers and a Leghorn. That’s what happens when you know people who know people. With a few free drinks thrown in the deal was pretty sweet.
2) I’m not quite sure that I believe in New Year’s resolutions. It doesn’t really seem like they are ever maintained for any respectable amount of time. All the same, my New Year’s resolution this year is to get my butt back into the gym. Between work, classes and clinical, I didn’t really make it into the gym so much last fall. But every month my credit card bill comes and there’s that charge from Gold’s Gym. I got such a good deal when I signed up and if I cancelled my membership I certainly wouldn’t exercise more. I’m going to try starting out with committing to one day per week and then work upwards as my schedule allows.
3) According to the 2006 Cosmopolitan Bedside Astrologer, February 16 th, July 7 th, and October 1 st will be my hottest days of the year. Mark those days on your calendar and stay tuned! The online version will give you your horoscope for the current month, but you have to buy the current print issue to get the whole year. Check out my horoscope for January and follow the links to find out your own.
4) This past Friday was possibly one of the most ridiculous days I have worked at my job in the recent past. We only had five nurses for a patient load that ideally would have required about eight nurses. We did seven deliveries in our twelve hour shift, which is the amount we normally do in twenty-four hours. We did four c-sections, including a set of triplets. This number doesn’t even account for the other patients on the floor that didn’t actually deliver, but still required our care and attention. Also, once the babies are born they don’t go to the nursery like at other hospitals (unless they are preterm of course); they also become our patients who require care and attention. I hesitate to say it, but at moments during the day it was even a little unsafe by nursing staffing standards. Now I know there are those of you who don’t quite understand what it is that nurses do, but trust me, we are responsible for a HELL of a lot more than just emptying a few bedpans here and there. Obstetrics is one of the most litigious areas of medicine and I am thankful to say that we made it through the day without any major disasters. Thanks so much to my four colleagues who worked their butts off, barely sat down the whole day, and certainly didn’t get their prescribed 30 minute lunch break (try NO lunch break).
5) I was introduced to a new blog by one of my coworkers today: Duh & Nuh-uhh. Julie has a great writing style and I look forward to reading more of her posts.
Monday, January 02, 2006
Saturday, December 31, 2005
Wednesday, December 28, 2005
Slombhaugen
Just a few things
First off, I didn't have to work. Last year I worked nights (BOO!!!) This year, in fact, I had five whole days off (24th - 28th).
Second, I got to spend some time with my family. I actually stayed over at my parents' house on the 24th and 25th. We had the previously mentioned traditional Swedish smorgåsbord on Saturday night. On Sunday, my sister and I made breakfast between opening stocking presents and opening under the tree presents. The menu was from a 30 Minute Meals episode and consisted of gingerbread waffles, chicken sausage patties, mulled maple syrup, and toffee hot chocolate. As Rachel Ray would say, "Yummo!" After presents we worked on a puzzle most of the rest of the day.
I got some great presents including many little uncomplicated but essential gadgets for my kitchen. My favorite present, however, was a book on CD. The book is a Swedish children's classic called "Vi På Saltkråkan," which roughly translates to "We On Seacrow Island." It is written by Astrid Lindgren of Pippi Longstocking fame. The book is about a family that rents a summer home on an island (Saltkråkan) in the Stockholm archipelago. The book was actually first written for television and then as a novel. I would love to have the DVD of the television series, but unfortunately US and Sweden are in different DVD zones, and so far I have only been able to find the DVD for the Swedish zone.
Yesterday day night we had a "fancy dinner." This event was initially created for the fact that I had these two really pretty cocktail dresses and nowhere to wear them. (I need to find some friends that have or go to fancy cocktail parties.) Then it just seemed fun to plan a fun "fancy" menu. We ended up with salad of mixed greens, pears and parmesan cheese; parslied rack of lamb; potato and goat cheese gratin; green beans with applewood smoked bacon, brown sugar and caramelized shallots; and, chocolate mousse. Drinks included Prince of Norway cocktails before dinner, 2005 Beaujolais Nouveau with dinner, and Bonny Doon Muscat Vin de Glacier with dessert. Quite tasty! And we all felt so dignified and civilized in our "fancy" clothes.
Today I went shopping. I got a bunch of cheap (but classic) DVDs at Target. Then I went to Pentagon City. I spent a good deal of time milling around there, not finding much that I liked. I did, however (as sort of a Christmas present to myself), buy a new cashmere wool coat. It was on sale for 50% off, plus I got an extra 20% off by paying with my Macy's charge. Pretty good deal if you ask me. See below for a picture of said coat.
Tuesday, December 27, 2005
Nerds in the Hood, Stars on the Web
Dagens Namn -- 25 December 2005
Friday, December 23, 2005
Thursday, December 22, 2005
Just a few things
1) Got my grades back for the semester…two A’s and a B plus. Not too bad. Of course it would have been nice to have three A’s, but I’ll get over it.
2) I always like to read the Yahoo New! Odd News. Recently they posted a story summarizing some of the strangest stories of the year. Check it out!
3) Apparently some woman in Oklahoma just recently delivered (luckily by c-section) a 14 pound 3 ounce baby. Can you say gestational diabetes? Although from her picture the mother appears quite large herself. Some time last year at work, we delivered a 13 pound 2 ounce baby. That baby was delivered vaginally. Granted it was the woman’s fourth or fifth delivery. But still, I don’t think I’d be all too proud of something that large coming out of me without too much complication. Apparently the biggest baby ever born, was born in Brazil and weighed 17 pounds!
7) I had lunch the other day with my friend the Serpent Lord. We were discussing how Christmas Day and the first night of Hanukkah fall on the same day this year. He said he usually spends the first night of Hanukkah with his family and he would therefore be missing a very cool concert at the 9:30 Club. The artist is a Lubavitch Hasidic Jewish guy name Matisyahu. His style/genre is reggae/hip hop/rock. At the Serpent Lord’s suggestion, I check out his official website and MySpace page. The guy seems pretty awesome. Check him out!!
8) On Saturday night my family will be having a big traditional Swedish Christmas Eve smorgasbord. My dad started the preparations the other night by beginning the gravlax. For those of you who don’t know, gravalx is raw salmon, cured in a salt-sugar-dill mixture. It's sliced paper thin and served on dark bread as an appetizer, often accompanied by dill-mustard sauce. Other things on the smorgasbord will include: Swedish meatballs, various kinds of sill (herring), Sillsallad (“salad” made with herring and beets), ham , Janssons Frestelse (Jansson’s temptation, a gratin with potatoes, onions, cream, and anchovies), and various breads and cheeses. Dessert will be ostkaka with strawberry or lingonberry preserves. YUMMY!!
Tuesday, December 20, 2005
Sunday, December 18, 2005
Friday, December 16, 2005
Master Bedroom
Wednesday, December 14, 2005
Bound for Glory
Congratulations
2) To my friend and coworker Gemma who got engaged to her boyfriend Paul on December 5th in the snow at the monuments. Ah young love!
3) To my friend and coworker Molly who was finally able to buy her own condo. Can't wait for that wine and cheese housewarming party!
Tuesday, December 13, 2005
Dagens Namn -- 13 December 2005
In Scandinavia, December 13th is always celebrated as St. Lucia day. See this Wikipedia article for more info. See below for a picture of me as St. Lucia.
The Dash
I read of a man who stood to speak
at the funeral of a friend.
He referred to the dates on her tombstone
from the beginning...to the end.
He noted that first came the date of her birth
and spoke of the following date with tears,
But he said what mattered most of all
was the dash between the years.
For that dash represents all the time
that she spent alive on earth...
And now only those who loved her
know what that little line is worth.
For it matters not, how much we own;
The cars..the house...the cash.
What matters is how we live and love
and how we spend our dash.
So think about this long and hard...
are there things you want to change?
For you never know how much time is left.
(You could be at "dash mid-range")
If we could just slow down enough
to consider what's the true and real,
and try to understand
the way other people feel.
And be less quick to anger,
and show appreciation more
and love the people in our lives
like we've never loved before.
If we treat each other with respect
and more often wear a smile...
remembering that this special dash
might only last a little while.
So, when your eulogy's being read
with your life's actions to rehash...
will you be proud of the things they say
about how you spent your dash?
Unknown
Monday, December 12, 2005
Saturday, December 10, 2005
Quote for the way I feel today
Most human beings have an almost infinite capacity for taking things for granted.
English critic & novelist
(1894 - 1963)
Friday, December 09, 2005
The Ninth Beatitude
Blessed is he who expects nothing, for he shall never be disappointed.
Alexander Pope, Letter to Gay, October 6, 1727
English poet & satirist (1688 - 1744)
Make A Flake
Dagens Namn -- 9 December 2005
Thursday, December 08, 2005
Dagens Namn -- 7 December 2005
Tuesday, December 06, 2005
Dagens Namn -- 6 December 2005
The Dutch are big on celebrating the feast of Saint Nicholas, or Sinterklaas. This is one of the very popular children's songs sung on the day, that my sister and I always like to sing.
Sinterklaas kaopoentje,
gooi wat in minj schoenthe,
gooi wat in mij laarsje,
dank u, Sinterklaasje
See this website for a little history of the holiday as celebrated by the Dutch. Sinterklaas is actually the basis for our American Santa Claus, so all the Santa lover/haters can thank/blame the Dutch I guess.
Monday, December 05, 2005
Dagens Namn -- 5 December 2005
Sunday, December 04, 2005
Favorite new snack

Ok, so my patient today introduced me to my new favorite snack. Greek yoghurt with honey! Yummy yummy yummy! I have seen it at Fresh Fields before, but I only tried it for the first time today. It is made by a Greek company called Fage. Check out their website!





