Last year I went to school to be a medical assistant. Too easy. Never studied. Got all As. So I went to nursing school to be, obviously, a nurse. (After a several week battle with myself which I do wish I recorded.)

Quick summary of classes that I took for the medical assisting degree. There was a whole class of secretarially  work. I hated that one because the test were very poorly written and poorly taught. Pathophysiology was frustrating because it honestly just gave an overview of what was taught. And we did go into some lab stuff because as medical assistants we can do basic lab and drawing blood, but only a CBC, sed rate (checks for inflammation), blood smears for the lab tech and urine analysis.

So I have a clue about what is going to be going on when I got out of school but not a major clue. I did wonder how it would be after I got out of school and I was working and for some reason that didn’t fully appeal to me. I figured that I once I was working in a peds clinic (I want to work with either children or OB.)  and I got into the back office where I wanted to work, everything would be fine. I would be happy with my work and there would be no problems.

Instead, I switched degrees. So now I’m going to be a nurse in two years. (71 weeks + test, not like anyone is counting)

I was walking to the library today after class and I began thinking. And the thought just popped into my mind.

I can’t wait until I’m done with school and able to work.

I don’t know why. It’s not like we’ve done a lot. And maybe it is because I keep seeing how much the teachers know and I can’t wait until I can know that much. Or maybe it’s because the work actually appeals to me in its entirety. Who knows what it is. But the fact still remains, I cannot wait until I’m done with school and can get out there and start working.

I’m glad. My mom will be glad too when she hears it. I just never thought I would be this excited about learning nursing when I started almost a month ago.

Now I’ve gone and done it, I’ve started a blog. I’ve always thought of a blog as a diary. People writing their daily or lifetime experiences except everyone can read it. I’m not even sure if I will utilize my blog that often. I guess we will see… So here it goes…

I have been married to the love of my life for 16 yrs.. We have been blessed with 2 beautiful children, Joshua, who is 4 1/2 yrs and Mareena who is  2 yrs old . I am a Pediatric nurse at a Childrens Hospital, for 18 yrs! I work  part time and I work my Arbonne business in between the hospital and day-to-day family commitments. I started my Arbonne business about 1 yr ago after using the products for a year and a half. My husband has labeled me an Arbonne addict.  My best friend from the “old school days” is my business partner. She introduced me to the products and I have loved them ever since. Some people are addicted to shoes, purses, shopping, drugs etc. i am addicted to Arbonne products and spreading the word on these awesome products. I love to “drip” Arbonne when I get a chance.

My “WHY” for doing this business is to one day be able to have the hubby stay home as often as he would like or to start a ministry, be able to be debt free, travel with the kids to countries we never seen and give lots to charities that are dear to our hearts. I’m not wanting to be a millionaire,but would just like some financial freedom for our family. Arbonne is the gift to obtain this freedom and I plan to utilize it to my fullest potential. I have seen what Arbonne has done for others and I think someday, yes, someday I could obtain that for our family.

In the meantime, I am a good mom,wife and nurse. Love my hubby to death, I would be lost without him. He is our rock! He is a “Libra”, he is my checks and balances guy. I am the “Pisces”, the emotional dreamer..

I must tend to the kiddies now…..  Oh and the kiddies, one could blog on them for days…..

My website is: www.healthyskincareforall.myarbonne.com

A nurse colleague on twitter asked me for tips on starting IV’s in pudgy toddlers. This tweet was followed by another, stating “I have trouble with pudgy at any age”. Yes, I agree. Even to the most experience infusion nurse, pudgy is always a challenge and usually means no chance of finding veins or easy venipuncture. Here are 10 tips that I find helpful in any situation, pudgy or not, young or elderly, when peripheral veins are hard to find. These are based on my own experience as an infusion nurse for more than 20 years.

1. Dry heat: Use dry heat to the proposed site. Application of dry heat increases blood flow allowing for good venous dilatation, thus improved vein visualization. To me, heat has been a proven technique and now, as I have discussed in a previous blog entry, has been studied. Dry heat was 2.7 times more likely than moist heat to result in successful IV insertion on the first attempt, had significantly lower insertion times, and was more comfortable.

2. Tapping: Apply the tourniquet. Lightly tapping the skin or area where you see veins will help distend the vessel. Avoid “beating” the skin as it might cause venospasms.

3. Stroking: Stroking the vein toward the hand allow for venous refill.

4. Open/Close fist: Open and close fist during vein assessment but keep arm relaxed during venipuncture.

5. Palpation: Apply the tourniquet. Use your index finger to palpate the veins. Press directly on the vein with your index finger, assessing for vein softness and volume. Then release the pressure slowly without lifting your finger and feel the vein bounce back to your index finger. Repeat as often to ensure you found a suitable vein. Don’t stick without palpating the vein!

6. Skin Anchoring: An important step to the success of venipuncture. Prevent the movement of veins during venipuncture.(especially for “rolling veins”). Pull skin downward below the point of insertion with the thumb of the non-dominant hand or pull skin above the point of insertion with forefingers or pull skin from underneath the extremity.

7. Enter at an angle: Select the smallest gauge and shortest length catheter. Position catheter tip bevel up. Approach angle to skin at 10 –15 degree. Deeper veins need greater angle. Superficial require lesser angle. If parallel to the skin surface, will drag the skin as you puncture it. Lower angle once blood return is observed and advance the catheter.

8. Vein Viewer and Ultrasound: There are devices that can help you find veins. The equipment ranges from transillumination to ultrasound. These are expensive equipment and would require training prior to use. There is increasing evidence that the use of ultrasound for venous access is safe and successful. It’s use perhaps will be a common practice soon.

9. Patience: Take the time to find and assess veins. Some veins are located deep in the superficial fascia and the extra “fatty deposits” doesn’t help. Veins won’t change position just because you are in a hurry.

10. Take a deep breath: Both you and the patient! Let the patient know when you are ready to stick and tell them take a deep breath and blow it out slowly. This will distract them from the stick and help the tension in their arm.

Last night I was at an event where it was mostly natural minded moms, hippie moms if you will.  An hour into our get together one of the infants got hungry and as we all usually do the mom sat down and plopped out the boob to nurse her child.  Another baby got jealous and wanted some boobs too, so that mom sat down to nurse except when she did she pulled out a blanket to cover herself.

I have to admit that I just sat and stared. I wouldnt have stared if she has just popped out the boob because to me this is normal… but covering one’s self with a blanket? That is NOT normal in my book. I asked a friend of mine who says that she covers up occassionally why she did it and her answer was that she thought that church was appropriate so that she was not a distraction to those at church.

I guess my question now is, how is a mother feeding her child a distraction?

There is a huge constant debate as to whether breastfeeding in public is lewd or not… on whether it should be legal or even protected. The most common things that are said to breastfeeding mothers are “Can you please cover up” and “Can you please go to the bathroom”.

Hooter hiders, or other covers are really just sending out the message that breastfeeding should be hidden and is somehow indecent. Who can blame people for thinking that?  Even people like Barbara Walters are more than happy to say how breastfeeding makes them uncomfortable and how wierd it is.

Who can forget last year when Barbara Walters relayed a derogatory anecdote about witnessing a woman breast-feeding on an airplane? “It made me very nervous,” Walters said on the May 17, 2005 airing of the ABC talk show, “The View.” “She didn’t cover the baby with a blanket. It made us uncomfortable.” Co-host Elisabeth Hasselbeck, who was nursing her daughter at the time, went even further adding she was “uncomfortable breast-feeding in general.”

Why are we asked to cover up or hide? Mostly it is because of the children. People do not want their children exposed to our bear luscious breasts because their eyes might explode into their brains or something. So I say that we start our own campaign to hide bottle feeding.

Bottles are a part of our culture so much that most dolls come with them.  At baby showers some of the most popular decorations are bottles and pacifiers. One of the most popular gifts for new mothers apart from diapers… are bottles. We are inundated with propaganda about bottlefeeding on a regular basis. When do you see a baby breastfeeding on tv? in a movie? in a magazine ad? It is as often as you see bottlefeeding? How about at all? I am personally offended by being surrounded by bottles. I do not want my children to grow up thinking that you are supposed to feed a baby with a bottle unless it is completely necessary. Who can I go to when I see a bottle feeding mother to complain? Of course all of this is said with tongue placed firmly in cheek, but my main point stands. Breastfeeding is just that… feeding… with a breast.  If bottle feeding does not get harassment, breastfeeding should not either.

This is why people use cover ups for nursing. Eventhough some people might say that they are for breastfeeding and that they are for families the sight of a woman nursing her child is too much for many and as a result mothers react by hiding. I think we need to make breastfeeding the norm. There was an excellent article on Mothering called “Breastfeeding in the Lang of Ghengis Kahn” that really struck a chord with me when I read it.  In this culture they would never think of having a law to protect breastfeeding because it would not even be necessary. While I am glad that we have laws to protect us… I am sad that they were needed.

This week is the date of the Breastfeeding Challenge. We will be having it at the BIRTH Fair this Saturday and I am helping with organizing it. I think that things like this are necessary until we get to a point where breastfeeding in our culture is the norm. Where mothers are not harrassed and where motheres are not being told or being made to feel like they should hide or cover up when nursing their child.

Title: NHS continuing healthcare and NHS-funded nursing care: public information booklet

The Skinny: Summary of information for the public on NHS continuing healthcare and NHS-funded nursing care, including details of what an individual should do if they think they may be eligible.

Publisher: DH

Size of Publication: 12p

Published: 29/09/2009

Title: NHS-funded nursing care practice guide (revised) 2009

The Skinny: Sets out the process for determining the eligibility for NHS-funded Nursing Care under the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. It has been revised in line with the revised National Framework.

Publisher: DH

Size of Publication: 34p

Published: 29/09/2009

I’ve been skipping meals during duty because I can’t manage my time properly.  My routine gets messed up when I have to do referrals to doctors.  It takes up so much time waiting for my turn to use the unit cellphone, for the doctor to reply or to answer my call, and for the patients’ charts to show up (because they keep on disappearing!  argh).  Even trying to find out which doctor under which doctor I should be referring to can be so so so… grrr.  There has to be an easier way.  I’m having trouble working with the system.

What’s more, as a nurse I feel like I am being stifled; I have so little decisive power.  I get surprised that I have to wait for some of the simple things to be officially ordered by the physician, and unfortunately there are some things that just can’t wait.

I hate stat medications because they are ones that must be given immediately but aren’t readily available.  It takes time to charge it to the patient, and only after charging can the pharmacy aid to bring the medication to the unit, or for the nursing aid to retrieve it from the pharmacy. Charging medications and other items is an unnecessarily long process, and it’s definitely not what you’d call “a click away.”

Lack of materials is another thing.  Medicine trays, BP apparatuses, thermometers.  Waiting around for my turn to use them is another time-waster.

I’m sure there’s more than just what I mentioned above, but the most important, and biggest flaw of all is ME, because I don’t know how to manage my time wisely.

And.. and… I have more to say but that’s just going to take up more of my time.

Title: The National Health Service (Nursing Care in Residential Accommodation) (Amendment) (England) Directions 2009

The Skinny: Amendment to current regulations relating to nursing care in residential accommodation.

Publisher: DH

Size of Publication: 2p

Published: 29/09/2009