Tuesday, August 28, 2012
Saturday, August 25, 2012
Emergency Department clinical experience 8-23-12
In
comparison to processes within some areas of the hospital, the nursing process
within the Emergency Department (ED) is dramatically different and dynamic. It
is ever-changing, and lends itself to needing constant attention and
reevaluating as the flux of patients and orders are relentless and seemingly
never-ending. Our exposure to this process began quiet interestingly while
observing the nurses as they began their shift “huddling” in the break room preparing
for their onslaught against the challenges of the day ahead. As we began our
clinical rotation in the area of the hospital that holds one of the most
compelling and attractive nursing roles, we were privy to the final moments of
this huddle. We listened as team members expressed their concerns and expectations
concerning an item that holds the potential to dramatically improve the
efficiency of their operations and keep them closely connected and accessible.
They were concluding their pre-shift report huddle by discussing their new
individually assigned radios, and some were expressing excitement at the
possibility of “bedazzling” and personalizing their newest “weapons against
ignorance”. With these radios, they apparently anticipated improving their
abilities to stay abreast of events as they unfolded, and of each other’s
whereabouts.
Seriously, my clinical experience within the
ED was almost everything I had hoped it would be. It was not a day of unusual
and extremely interesting case presentations and endless episodes of
once-in-a-lifetime chances; however, it was a grand opportunity to “do anything
they’ll let you do”. My day began in the
best way it could, by being assigned to the ED. In the ED, I was assigned to
shadow Leah, a relatively “new” nurse; a very effective and polite nurse who maintained
a great attitude, demonstrated excellent care for her patients, and presented
herself quite professionally at all times. She managed to offer frequent
instruction and directions without being overbearing or insensitive while
simultaneously attending to her responsibilities and making me feel appreciated
and respected. Leah was one of many
wonderful ED staff members who made us feel welcomed and appreciated.
I began the shift observing the layout of the
unit, and noted some distinct similarities with the ED where I work part-time.
I shared my limited knowledge and instructed my fellow clinical student in the
utilization of the status boards, and how the “tracker” monitors are used to
alert staff in regards to outstanding orders, procedures, and other information
pertinent to the patients.
Throughout
this day, I was awarded numerous opportunities to assist in direct patient care
activities. I provided multiple blood-draws and made one IV attempt (which
incidentally was successful on a “very difficult stick”). I assisted with and observed
repeated external jugular cannulations made by the emergency room physician. I regulated
and monitored intravenous fluid administration, provided a few intramuscular
and Z-track injections, performed some physical assessments of initial and repeat
vital signs, attended one patient transfer to the radiology department for a CT
scan and one to the CCU for admission, and assisted with receptions and movements of
EMS patients.
During
the little downtime there was, I was allowed to interact independently with
patients, and occasionally provided much-appreciated efforts directed towards
positioning, cleansing, comforting, consoling, humoring, and even educating
patients and family members. At times, I reported the patient’s or their
family’s needs or desires as requested, and subsequently followed-up to
determine if their requests had been met. In many of these “nursing process” instances,
I acted as a nurse would, for I was assessing, intervening, and evaluating for the
effectiveness of our treatments and efforts. I even made repeated efforts to
help in the restocking of linen when the need presented itself, and frequently
provided efforts to clean and prepare the rooms and stretchers for awaiting or
upcoming patients.
I
saw and learned a lot during my short clinical exposure in the ED. I observed and
appreciated the effectiveness of three team leaders who each were partially
responsible for a very successful day. Our clinical team leader, Cliff, availed
himself to us often, and provided much welcomed, appreciated, and respected
assistance to us many times during our day. It is no wonder he is a supervisor
at his job, for he seems to possess a natural ability to provide comfort and
strong leadership. The ED’s team leader, or charge nurse, Carolyn, was another
person who inspired me during this clinical. She also seems to have the unique and
rare quality of a leader who is there for all the right reasons. Moreover, of course, I must recognize our
clinical instructor, Ms. Brown-Lucas; without her, our day would have been
incomplete, and would have lacked the icing on the cake. Ms. Brown-Lucas has
complimented our cadre of instructors, and brings a much-welcomed style of
leadership that is truly respected and very much appreciated. I really
appreciate Mrs. Miller’s including her in our team of clinical instructors, and
by all reports, I am not the only one.
Friday, August 24, 2012
15 Years...and one day!
Yesterday I celebrated making the final payment and "owning" a little piece of "heaven on earth". The river-land is paid-off!!! I stopped enroute back from Albany and camped out and visited with Mark. Well, time to try to make up for lost time, for I haven't studied since the day before yesterday. Gotta hit the books...Love Y'all!
Wednesday, August 22, 2012
Tuesday, July 24, 2012
We're Jammin
Hello. My name is Eric Simpson, and I look forward to sharing with you
today my first canning experience as I prepare pepper jam. Pepper jam can be
used in everything from dips to meat. My arm had to be twisted a little the
first time I ever tried pepper jam, but once I tried it, I was hooked. Not only
is this my first canning experience, it is also one of my first cooking
experiences beyond heating something up in the microwave. My goal today is to
share with you the steps to making and preserving pepper jam using fruits grown
in my garden. As I knew nothing about canning or making jam, I went to the Ball
Canning website to research the canning process because they are one of the
oldest and most well-known canning resources. Many of the steps that I will
demonstrate in the canning process could be applied to the preserving of any
fruit or vegetable.
The basic process for making jam is fairly simple. I began my research
for this assignment by looking for the perfect recipe. My first goal was to
locate a recipe that utilized the peppers I had growing in my garden, and was
also easy enough for me to learn how to prepare pepper jam. After researching
several sites, I located the recipe I wanted to use and a list of supplies I
would use at Cooks.com, and I chose the process I would follow from the
directions found on the Ball Canning website. During my research, I was a
little surprised to learn that peppers are a fruit and not a vegetable as I had
thought. In researching the types of peppers that I had growing, I also learned
from The Nibble – Great Food Finds that the heat, or the pungency level, is
produced by the capsaicin found in peppers. A website called Miss Vickie’s
Pressure Cooker Recipes outlined the Scoville Scale. It is the scale by which
the heat or intensity of peppers is rated. The greater the number of Scoville
Heat Units, the hotter the pepper. In my garden I had four varieties of peppers;
bells, bananas, jalapenos, and cayennes. On the Scoville Heat Units Scale, the
bell pepper ranks a very low of zero heat units, the jalapeno scores 5,000 to
8,000 Scoville Heat Units, The bananas is scored at 5-10,000 Scoville Heat
Units, and the hottest of my four peppers is the cayenne, which is typically
rated from 30,00 to 50,000 Scoville Heat Units. I gathered fresh, vine-ripened
fruit from the garden, and then washed them in preparation for making my jam. Along
with pictures of the peppers that I used, here are some pictures of my garden
that I took prior to making the pepper jam.
Once
I had gathered my fruit, I began the process of washing and preparing the
peppers. First, I had to dice and prepare the fruit. Removing the seeds and
ribs of the peppers is required before placing the peppers into the food
processor. The recipe from Cooks.com instructs that peppers are to be processed
until they are “finely diced”. The Nibble – Great Food Finds site cautioned
that handling hot peppers is best done with gloves on so the capsaicin contained
in the ribs and seeds of the pepper is not absorbed by the skin and cause pain.
Here is a picture I took of my peppers once they had been diced in the food
processor and mixed with the ingredients.
Now that the fruit has been prepared, the glass jars sterilized, and the
supplies gathered, it was time to begin the cooking process. Using my recipe from Cooks.com, I cooked all
of my ingredients until they reach a “bull boil”, which is a hard rolling boil
that can not be stirred down. The Ball
Canning website explained the critical importance of adding pectin so that your
jam will “set”. When shopping for this assignment, I found both a powdered and
liquid variety of pectin. I selected liquid over powdered pectin based on the
recommendation of the recipe from Cooks.com. The pectin is added at the point
that the bull boil is reached. I was unable to take pictures of my jam as it
reached its boiling stage because I was preparing to add my pectin. My
Cooks.com recipe advised to continue the boil for a full 60 seconds after the
last package of pectin was added. I
never imagined that one of the side benefits to this assignment would be clear
sinuses! The smell of all of those
peppers and apple cider vinegar sure cleansed my nasal passages and filled the
whole house with the unmistakable aroma of freshly cooked peppers.
Now that I have followed the recipe, it is time to ladle the jam into
the sterile, previously prepared canning jars. Preparation of the canning jars
was completed based on the directions found at the Ball Canning website. Per the Ball Canning website, in order for
the rubber gasket to make a complete seal around the perimeter of the jar, it
is critically important to ensure that the rims of the jars are free of jam and
are clean. I used a canning funnel to
reduce any spills while ladling my jam into the jars, and then placed the lids
and bands on the canning jars. I photographed the ladling of the jam and the
jars with the lids and bands.
Now that the jam is in the jars, it is time to clean up and prepare the
jars for the water bath which will ensure they are sealed. According the Ball
Canning website, placing your jars in a water bath is the final step to
ensuring a complete seal which will preserve your jam and ensure the safety of
your consumers. Bacteria, including Botulism, can form in your jam if your jars
are not properly sealed. Step by step instructions on this process can be found
on the Ball Canning website. Pictures of
my dirty dishes ready for clean-up, along with pictures of my finished pepper
jam both in canning jars and served on cream cheese were taken to share the
finished product with the audience.
I would like to conclude my demonstration today by sharing that I have
learned a great deal about peppers and the process of making jam through my
research for this presentation. My goal today was to share with you the steps
to making and preserving pepper jam using fruit grown in my garden. I hope this
presentation has been interesting enough for you to try pepper jam, or at least
to try making a jam out of your favorite fruit.
I hope that you have enjoyed “Jammin” with me, and that you feel your “hot pepper” juices flowing. Thank
you! I appreciate your time, and hope I have raised your interest in “Jammin”.
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