How is it that my scale says I weigh 178, and the last time I weighed at the Langley Y it said I was 188 (while my scale said 178) and today I weighed at the downtown Y and it says I weigh 195 (and my scale still says 178)?  I was very upset by this today.  I'm not sure how my scale went from being off by about 8-9 lbs to 17 lbs.  I think it's time to trash the scale and get a new one.

I rarely talk about what I do, other than I am a nurse, I work in critical care...it is who I am, it is what I do. The kinds of patients I care for are the sickest ones in the hospital, not only do the require the most care, they require a lot of thinking, and sometimes they require a lot of your emotions. Today was such a day. I have grown "accustomed" to death. It is a part of what I do. Do I cry when someone dies? Almost always. Is it hard to see someone die? Sometimes it is, sometimes you know it is best, sometimes you are almost glad that it's over...especially when you see suffering. Sometimes, especially in the area I work, you see humor in almost everything that happens...today I didn't smile much.

I spend a lot of time with patients and families. Like I said...that's just what I do, it's my job. Most of the times I can keep myself disconnected in such a way that I don't get too attached. I find it easier now that I only work 3 days and have 4 days off. (I used to work 6-7 in a row, and have 6-7 off). I am able to do what I need to, but as time passes, a lot of times I can keep my emotions in check. Today I could not.

All weekend I cared for the same two patients. Two people with very sad situations, both expected to die soon. I left work last night knowing that one was certainly going to die before I got back to work this morning. He did not. I spent all weekend watching his wife being tormented watching him die. I could see so much love in her face. I don't always see that. It felt good to be in her presence, it felt good to be in the presence of their children. She struggled this morning wanting to do what was right, but wondering why he would not leave. Wanting to know why was he staying, what was he waiting for? She thought that maybe he didn't want her to see him die, so she was going to go home for a little while. I told her that whatever she decided, it was OK, and that I would call her immediately if his condition changed. I left the room so she could say goodbye. I walked away for a minute and came back and she had pressed the call light. I went in and he was gone. What followed next really got to me. This man had been essentially unresponsive all weekend. Barely responding to any kind of stimulus. She told me she told him that she was going to leave, that she understood if he didn't want her to be there and she asked him one last time, do you want me to go. He opened his eyes, looked right at her, and then he passed. How amazing that she was able to see his eyes, his eyes filled with the same love she had for him, just that one last time. I got to spend a lot of time with her today as she told me all about him. I also spent a lot of time with tears in my eyes. How amazing for me that she shared that moment with me.

It wasn't but about an hour and a half after his death that the doctor and palliative care nurse talked with my other patient. She had an accident and it is believed that she would be dependent on machines for life. We took her sedation off and had to discuss with her, her diagnosis and her long term prognosis and what her wishes were. She adamantly denied she wanted to be kept alive by machines. Later, the family came in and we had the same discussion with them alone. It breaks my heart to see a grown man cry. The one you thought was the strongest in the family, was the one who seemed to take the news the hardest. They all knew her prognosis and what her life was going to be like, but they were hoping that she would choose to live by artificial means. They were also respectful of their mother and wanted to do whatever it was that she wished for. We all went back in the room and talked with the patient and family together. She was able to express to them that she didn't want any of this anymore. What got to me was when they asked her if she was ready to go home to Jesus and she nodded with such conviction. I lost it then.

After they spent their time with her, they told me they were ready. As the day progressed and I was checking in on them to make sure she wasn't in any distress, I saw one of her children sketching. She had drawn the most amazing, most beautiful picture I've ever seen. It was a picture of her mother's hand on the blanket, with every detail...her armband, her IV's, tubing, wires, call bells, wrinkles in the blanket. It was perfect. I told her later that I had seen her sketching and how beautiful I thought it was. They then told me my patient was also an artist and shared her sketches she had drawn...and not only that, they shared many things about her that I had not known. I wish I had been able to know the woman they knew...I think she was probably a pretty amazing lady.

You can tell when a parent has done a good job. I saw two perfect examples this weekend. Two separate families, yet two families who were so respectful of the staff, but mostly respectful of their loved ones. And with both families, you could see and feel the love in the rooms. I hope when I die I am surrounded by that much love.

I am absolutely mentally exhausted. Today really took it's toll on me. Like I said, most days it doesn't. But today I was really touched. I am thankful for my next four days off.

For the longest time, tomato based sauces weren't sitting well with me, so I just avoided them.  Recently, I've tried some thin crust pizza and it went down OK, no problems  Eggface (from the main board) always seems to have some nummy looking food/recipes posted, so I just did my own variation for pizza.  So this is what I had:

1 flour tortilla layered with:
puttanesca sauce, fresh pineapple, Tyson chicken strips, ricotta cheese and some shredded cheese (co-jack blend).

Put in 350 deg oven until all is melted and warm/hot.  (I think next time I will try at 400 deg just to make the crust crispier.)

It was absolutely delicious.  I didn't measure everything out, but based on the recipe calculator I used it was approx. 280 cal and had about 17 gms of protein and 10 gm of protein.  Of course, that could be adjusted based on how many toppings you put on.  Next time I may actually measure ingredients so I can get a more accurate idea of the real calorie count.  

It was soooo nummy and very filling.  Now if only I could have a diet coke with it.