Patti Turner

Writer. Nurse. Shutterbug. Maker, MyIntent Project

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Home » Archives for Patti

What You Don’t Expect When You’re Expecting

September 5, 2018 by Patti Leave a Comment

What You Don't ExpectExpecting a baby? Pregnant, or trying? Delivered recently? Know anybody who is pregnant or had a baby? If so, I want to know what you or they didn’t expect.

Background

With more than thirty years experience as a labor and delivery nurse, I can tell you two things:

  1. There are more than 6 million pregnant women in the United States alone at any given time.
  2. Most of them are unprepared for anything other than a normal spontaneous delivery.

What You Don’t Expect

Time and again my patients are surprised by a twist to their fairy tale. For example:

  • High blood pressure? Preeclampsia? “But my pressure is always low!” Cue the seizure, stroke, or both.
  • Diabetes? Carb counting? Insulin? “But I don’t have real diabetes.” Cue the shoulder dystocia, operative delivery, or diabetic ketoacidocis.
  • Low platelets? Thrombocytopenia? HELLP syndrome? Cue the hemorrhage protocol, exclusion from an epidural or spinal anesthesia. “What do you mean I can’t have an epidural?”
  • Fetal distress? Cue the c-section for emergency delivery.

These are just a few examples of the many twists in pregnancy and delivery stories. I have hundreds of examples. Most of my patients were not prepared for the change in plan or the outcomes.

My Answer to the Problem

The solution: educate women. They need to understand complications in pregnancy and how to recognize them before they become deadly. For example, a pregnant woman suddenly complaining of the worst headache of her life – she shouldn’t wait until morning, or her scheduled next afternoon appointment to tell her healthcare provider. She should seek emergency evaluation before she blows a gasket.

Each person learns differently. Some prefer written materials, some prefer visual learning, some need to hear it and some need more than one learning modality. Whatever they need, I want to give it to them.

Why (and How) I Need Your Help

I’m developing an educational website for pregnant and recently delivered women (and possibly their partners). The contents and methods of delivery are in the research stage. I need 250 women to answer a few questions about their pregnancy, labor, delivery, and/or postpartum experience. Please share the link with as many women as you can so I can collect and analyze the data. I am not selling anything – no product at this time, and I promise not to send spam email. Responses are confidential and will not be shared.

CLICK HERE to tell me about your experience.

Website link (site under construction) which also has a link to the questions.

Thank you for your help!

 

 

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Filed Under: Nurse Tagged With: expecting, Labor & Delivery, pregnancy, pregnancy complications, what you don't expect

Honeymoon Salad – A Caribbean Delight

July 11, 2017 by Patti Leave a Comment

Honeymoon SaladA Meatless Mondays Recipe

We call this “Honeymoon Salad” because my husband and I had this dish on our honeymoon in the British Virgin Islands. It’s a delicious Caribbean treat.

The cook on ship rattled off the ingredients but not exact measurements. Adjust to your taste.

Honeymoon Salad (Vegetarian)

Ingredients

2 cups cooked rice (Uncle Ben’s)
1 red apple, chopped (I use honeycrisp)
1 green apple, chopped (Granny Smith)
1 handful peanuts, dry roasted and shelled
1 handful raisins
1 small can pineapple chunks, drained

Dressing

1 Tbs Worchester sauce
1 Tbs soy sauce
1 Tbs curry powder
1/2 tsp mustard powder
2 Tbs mayonaise

Topping

Coconut flakes

Directions

Cook rice according to package directions. Cool.

Meanwhile, chop the apples and shell the peanuts.

Make the dressing: whisk together Worchester sauce, soy sauce, curry powder, mustard powder, and mayonaise until smooth.

dressing

 

 

 

 

 

In a large bowl, mix cooled rice, apples, peanuts, raisins, and pineapple. Toss with dressing. Chill.

ingredients

 

 

 

 

 

Top with coconut flakes.

Serves 6.

Honeymoon Salad

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Filed Under: Vegetarian Tagged With: Caribbean, meatless Mondays, salad, vegetarian

Labor Nurses: Do You Have a List?

May 30, 2017 by Patti 4 Comments

tear drop on leafCalling all labor and delivery nurses: do you have a “list” at your hospital to determine which nurse is “up” for the fetal demise coming to the labor unit? Do you rotate a demise assignment based on seniority, date order of who did it last, or do you assign the patient to somebody you think is good at this sort of thing? Or is it like every other assignment – you get what comes in, regardless of who did what when?

Lists.

Nurses have lists for everything. There is a seniority list (for holiday and vacation rights), a pull list for who got sent to another unit when, a list for who gets to go home in a snowstorm and who has to stay. There are sign-up lists for party food, who put money in for lottery tickets, and a list of who wants to order out. And a demise list. I like all those lists but the last one.

I hate that list.

What if you were the patient with a perinatal loss and you heard the staff fighting over which nurse should get the dreaded assigment? I daresay you would be appalled.

We’re nurses. We are caring, compassionate, and trustworthy. Patients and families with perinatal loss trust us to see them through the horror. They trust us to handle the tiny body with respect, photograph it, take footprints, get a lock of hair, measure and weigh it, swaddle it, then stay with them while they say goodbye. We have to support them during one of the most difficult events in their lives.

Nobody likes to go to the morgue and place a baby in the chiller. It’s horrible. It sucks.

Life and death.

Life comes with death. Granted, the death part is a less often in labor and delivery than it is on a medical/surgical floor, emergency room, or one of the intensive care units. Do the nurses in those areas keep track of who had the last patient death and make assignments based on the risk of which patient might kick the bucket this shift? I’ve worked at many hospitals in many specialties, and I’ve never heard of it before. Only in labor and delivery.

We are all going to die one day. I hope the nurses taking care us aren’t fighting over who should get stuck with the assignment.

I’ll do it.

Supporting families experiencing sorrow are some of the highlights in my career. Give me the assignment every time there is a fetal demise or non-viable infant due to deliver. I care about and for all patients and families, in the joyous moments and in the depths of their sorrow. It is why I became a nurse.

I’d rather take all the depressing assignments from now until I retire, lest these patients get stuck with a nurse who doesn’t want to do it, can’t handle it, whatever. Because if I can give even one moment of solace to a family in despair it will be worth it.

Nurses, spill your guts.

Do you have a list where you work? Do you like it? Hate it? I want to know how the rest of you feel.

 

 

 

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Filed Under: Labor and Delivery, Nurse Tagged With: fetal demise, Labor & Delivery, labor nurse, nurse, nurse problems, perinatal loss, RN, the list

April the Giraffe Labor & Delivery Live Cam – Addicted!

March 3, 2017 by Patti Leave a Comment

April the GiraffeeApril the giraffe is due to give birth at any moment. I’m hopelessly addicted to watching the live cam, waiting for the big event to happen. Sure, I could watch the video after the fact, but there’s something about witnessing a live birth as it happens. It must be the labor and delivery nurse in me.

It must be the labor and delivery nurse in me.

Labor and delivery and the birth of a new life fascinates me. Even after 30 years working as a labor and delivery nurse I still tear up and get emotional when a baby is born. Any kind of baby – human, animal, egg hatching, etc.

Addicted.

My name is Patti and I am an addict. I’m addicted to labor, delivery, and birth. I work as a labor and delivery nurse, I watch shows about labor and birth of all kinds of species, and I’m especially addicted to watching live cams. My current addiction is to April the giraffe. She’s due to give birth at any time.

Previously, I watched (was addicted to) Katie the giraffe’s live web cam as she gave birth to Kipenzi in April 2015 at a Dallas zoo. When she was pushing I wanted to shout “Well done! Well done!” in a British accent as the nurse-midwives do in the PBS series Call the Midwife. I watched Katie and her baby for months on the giraffe cam. When baby Kipenzi had an accident and broke her neck, dying instantly, I was devastated.

Before the giraffes there were the eagle cams (eaglets are so cute) and the panda cams. Any impending birth or hatching cam.

I need April the giraffe to birth her baby already so I can get back to my real life!

April the giraffe.

You can join the birth watch of April the giraffe on YouTube – the link can be found at www.aprilthegiraffe.com.

 

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Filed Under: Labor and Delivery Tagged With: addict, April the giraffe, Labor & Delivery, labor nurse, pregnancy, RN

Cheesy Cauliflower Breadsticks – Perfect Low Carb Vegetarian Snack

February 27, 2017 by Patti Leave a Comment

Cheesy Cauliflower BreadsticksA Meatless Mondays Recipe

Cheesy cauliflower breadsticks are an addictive low carb snack. They’re perfect for gluten-free or wheat sensitive people. You can serve them as an appetizer, side, hors d’oeuvre or eat them for lunch. They reheat well, so making them ahead of time for your next party is not a problem.

Many thanks to my friend, Sharon, who made these for me and shared the recipe.

Cheesy Cauliflower Breadsticks (Vegetarian)

Ingredients

Cauliflower (1 large head)
2 eggs
2 cloves garlic, minced
3/4 tsp. dried oregano
3 cups mozzarella cheese (shredded, part-skim)
1/2 cup Parmigiano-Reggiano, grated
Salt
Black pepper, freshly ground
Crushed red pepper flakes
1/4 cup freshly chopped parsley
Marinara (for dipping)

Directions

Preheat oven to 425 degrees.

Line a large baking sheet with parchment paper.

Remove cauliflower florets and place in a food processor. Process until finely ground. Transfer to a large bowl.

Whisk eggs and add to the cauliflower with garlic, oregano, 1 cup mozzarella cheese, and Parmigiano-Reggiano. Season with salt and black pepper. Stir until combined.

Divide the “dough” in half. Turn onto baking sheet, pat down and shape into two rectangular crusts. Bake until dry and golden, about 25 minutes.

Remove from oven. Top with the remaining 2 cups mozzarella. Sprinkle with crushed red pepper flakes and parsely. Return to oven and bake until cheese is melted and golden, about 8-10 minutes.

Slice into sticks with a pizza wheel. Serve with marinara for dipping.

 

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Filed Under: Recipes, Vegetarian Tagged With: meatless Mondays, recipes, vegetarian

The Mood Scale: How Happy Are You?

February 9, 2017 by Patti Leave a Comment

Happiness ScaleHow happy are you? When was the last time you thought about it?

People drift through life, going with the flow, doing what has to be done, with no direction on where they want their lives to go or how they feel about it. We’re so busy with work and family obligations we forget to slow down and live in the moment. How many of us suddenly realize time has passed, with too little time left, leaving our hopes and dreams a distant memory? It’s time to get out of the rut and start living again. So I’m asking…

How happy are you?

What if a question could change your life? What if this question could change your life? It can. It changed mine. So I’m asking you to think about it. Take a few minutes to examine your overall happiness, contentment, and joie de vivre (or lack thereof).

Participate in the poll.

Please participate in the poll. Thinking about your happiness level and clicking the corresponding button is the first step on the road back to a new way of living your life- with joy.

Becoming your happiest self…

Check back for the results of the poll and discussion on becoming your happiest self. Better yet, SUBSCRIBE (upper right corner of every page) to receive email notifications of new posts.

Being happy makes me want to sing!

But I’ll spare you that and offer this instead:

 

 

 

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Filed Under: Words worth repeating, Writer Tagged With: change, dreams, happiness, happiness scale, Happy, joie de vivre, mood, poll, words worth repeating

NaNoWriMo Winner

November 30, 2016 by Patti 2 Comments

NaNoWriMo (National Novel Writing Month) 2016 is over and I’m a winner.

NaNoWriMo is an annual novel writing challenge. To win, you must write 50,000 words of a novel in the 30 days of November (from scratch). That’s 1,667 words per day on average, if you can write every day. If you can’t get to it each day because of other obligations (job, family, etc.) you have to write ahead or try to catch up.

What do you win?

Nothing.

After validating your final word count of 50,000 or more words, you can print out your official winner’s certificate.

NaNoWriMo Winner

 

 

 

 

 

 

And you get the right to wear the NaNoWriMo 2016 winner shirt.

NaNoWriMo

 

 

 

 

 

 

Big deal, right? Hell yeah. It’s a huge deal.

It’s not about “winning”.

It’s about being a winner. It’s about setting a (lofty) goal, making a plan and a making a promise to yourself. It’s about the sense of accomplishment you feel when you achieve your goal. It’s about checking an item off your bucket list. It’s about feeling good when you complete a project.

It means setting priorities and sticking with your plan. It means pushing yourself beyond your comfort zone. It means digging deep to write on when you want to quit. It means learning how to say no when family and friends try to tempt you away from your dream with promises of instant gratification. It means learning to be strong. It means learning to fight the guilt of putting yourself first.

It’s finding out who you are and what you are made of.

But what do you win?

You win the right to say “I did it”. You win the knowledge that you are stronger than you thought and capable of more than you imagined. You win pride in yourself and your ability to accomplish what felt like the impossible.

You win.

And you wrote a novel.

To my fellow participants…

Congratulations! Thank you for your support, encouragement, and virtual companionship. I couldn’t have done it alone. We’re winners!

 

 

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Filed Under: On Writing, Writer Tagged With: #amwriting, NaNoWriMo, winner, write, writer

This Patient is a VIP

November 13, 2016 by Patti Leave a Comment

…Or how to insult a nurse.

VIP patient“This patient is a VIP.”

The shift starts out with with a “higher up” going over the staffing sheet with the charge nurse. They whisper but I know what it means. They’re trying to decide which nurse should take care of the VIP (very important patient). You should be flattered if asked – it means they think you’re the best nurse on the shift for the job. But I’m not flattered. I’m insulted.

Who is a VIP?

From movie stars to the CEO of the hospital, physicians to nurse managers of other units, sports figures to musicians, financial donors to the neighbor of a “higher up”, they are considered VIPs in various contexts. Their importance (social status, politics, occupation, fame, position, donor status, etc.) has the potential to influence clinical judgement or behavior.

What is VIP treatment?

It’s assumed that VIP treatment results in superior care and service. However, this can backfire and compromise patient safety and service.

We need to keep the VIP happy at all times, so rules are bent or broken. Clinical protocols are not followed. Steps are taken to please the VIP but this often results in sub-standard care and inferior service. Decisions are made to please the patient. Decisions should be made according to clinical guidelines.

One possible scenario:

To afford privacy, a VIP is given a room at the end of the wing. All other rooms and the hallway are blocked. Security checks IDs and if a person is not on the list, they can’t get access to the hallway. The patient has pain. Physicians associated with the VIP case prescribe narcotics. If the VIP still complains of pain additional medication is given, ignoring the rules of clinical response, dosing protocols, and setting reasonable pain management goals with the patient. The patient stops breathing due to an overdose of narcotics. The code blue team is called for respiratory arrest leading to cardiac arrest. Team members names are not on the approved access list and can’t enter the hallway. The VIP dies because life-saving personnel could not get to the patient in time.

A few more scenarios:

  • A nurse is assigned to cater to the VIP. There are many other high acuity patients on the unit, but they have to wait for care while the rest of the staff divvies up the patient load and works short.
  • The approved visitors list, made by administration to restrict access to the VIP patient, inadvertently omits close family members. The patient is unaware of the VIP status (designated so for the spouse or parent of a physician or administrator, a neighbor of a “higher up”, etc.) and family is unwittingly denied access.
  • Clinical tests (x-ray, ultrasounds, etc.) are done at the bedside with portable machines so the VIP doesn’t have to travel to the radiology department where others may identify him/her. Other necessary tests (MRI, CAT scan) are not ordered because there is no bedside equivalent.
  • Restricted diet orders (diabetic, cardiac, renal) aren’t strictly enforced when the family brings food. Everybody wants the VIP to be happy regardless of the consequences.

Why are we bending any rules to make the VIP happy?

Because we want to please them? Because we want the VIP to tell others about their great experience at our facility?  Is it really about excellence in healthcare, or is it about the expectations of the patient?

Did I mention HIPAA and privacy?

While caring for the VIP patient, a number of physicians and administratiors call for updates or visit the unit to ask the nurse. Wait – is this a trick? Because I’m certain HIPAA rules prevent me from discussing care, progress or anything else unless it is on a need-to-know basis. And they don’t need to know. They want to know.

I’m insulted.

I give excellent care and service to all of my patients. Calling ahead to warn of a VIP or even designating the person as such implies that I need to give better care to the VIP than my regular patients. Not possible. I give everybody the same quality of care (excellent) and therefore to imply otherwise is insulting to me as a nurse. I won’t tell you anything, either, because all patients deserve to have their privacy protected.

Please don’t assign the VIP to me.

*Note: No HIPPA laws were violated in writing this posting.

 

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Filed Under: Nurse Tagged With: HIPAA, nurse, nurse problems, patient, RN, VIP patient

Mourning the Loss of My Best Friend

September 23, 2016 by Patti 3 Comments

Mourning the loss of my best friendToday I am mourning the loss of my best friend. She died nine years ago. I spent the day looking at old photos and reliving our time together. In between, I cried, as I do every year on September 23rd.

We shared 31 of the most important years of our lives. It isn’t the length of time we had that I mourn, but the timing of those years. I met her when we were almost 19 years old, and lost her when we were 50.

She’s the only one who knew me before – before husbands, kids, divorces, remarriages, and a host of other life events. We were the…

Keepers of the secrets.

Best friends share confidences not fit for outside ears. They trust each other with those secrets for eternity. I still keep her secrets. But there is nobody left on Earth who knows mine. They died with her.

We shared the time in our lives when we were dating, looking for love, finding love, getting our hearts broken, finding love again, and finally marrying. We whispered about marriage and relationships. We shared recipes and tips on being a housewife, and plotted careers. We supported each other during pregnancy, motherhood, and parenting. Later, we chatted about failed marriages, getting back out there, finding love again, second marriages, blended families, and our adult children. In between, we confided our secrets. Ultimately, we spent time together while she battled ovarian cancer and I spent long days with her in her final stage at a hospice.

She’s gone. When she died, part of my heart died with her.

But I was just the friend.

In death, the friend is nobody. There are protocols for wakes, funerals, a repast (repass), receiving lines, paying respects, etc. When you’re just the friend, there is nobody there for you. We are all there for the family. The friend grieves silently and alone. Today, on this ninth anniversay of my loss, I am breaking the silence.

I am mourning the loss of my best friend.

It sucks. It hurts. I’m in mourning. I’m crying as I write this. I miss her every single day. I can’t “get over it”. I don’t want to forget. She was important to me, an important part of my life, and I still want to talk about her. She’s still in my heart and my head and that will never, ever, change.

We should be continuing our conversations. We both have grandchildren now, but I will never be able to live and share this wonderful part of life with you.

What I would tell her if I could.

Your daughters have grown to be awesome women. You have beautiful grandchildren you never had a chance to meet. Life has moved on, but you are still in the hearts of everybody who knew you. You were loved. You are still loved.

To my friends and family…

I love you all. Not more or less than this friend, just differently. We share a relationship, role, or time in our lives that is different from the time I write about here. In no way are you less important to me.

To everybody…

Love, not hate. Tell your friends and family how you feel in the here and now. Don’t wait until you can’t.

Live life, don’t exist. If you hate what you’re doing, stop. If you’re not with the right person, leave. If you aren’t doing what makes you happy, start now. Because life truly is too short to wait.

In Memoriam

DebbieRest in peace, my friend. Don’t forget we have a date in the future at the big tea shop in the sky. We have a lot of catching up to do!

Debbie
May 18, 1957 – September 23 ,2007.

 

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Filed Under: Words worth repeating Tagged With: best friend, grief, loss, mourning

3 Words A Nurse Should Never Have To Say to A Doctor

September 2, 2016 by Patti 13 Comments

Clean Hands Save Lives!…Or to any health care worker

Wash your hands!

Hand hygiene is a given, ingrained in us from the time we are small, at home and in school. Healthcare facilities have training for all employees on hand hygiene. The Joint Commission mandates compliance. The Centers for Disease Control requires it and provides educational resources. The World Health Organization has guidelines on hand hygiene. The largest health care insurer, the Centers for Medicare & Medicaid Services, imposes reimbursement penalties for hospital acquired infections. We all know that good hand hygiene prevents the spread of infection. It protects our patients, and it protects us. We’ve known that since Florence Nightingale wrote about it in 1860. We’ve all taken microbiology – and know what grows on our hands.

So why do I have to say…

Wash your hands!

These are 3 words a nurse should never have to say to a doctor or to any health care worker. Patients have a right to safe care . We have a responsibility to our patients, to our coworkers, and to ourselves to prevent the spread of infection.

I’ve witnessed doctors enter a patient’s room (no initial hand washing or use of hand sanitizer), don a pair of sterile gloves, perform a vaginal exam, discard the gloves, leave the room without performing hand hygience measures, and proceed to use the computer keyboard to type a progress note. Meanwhile, they’ve touched the markers to write on the white board, used the eraser, and touched the phone, desk, and chair. Sometimes they cough or sneeze into their hands (sneeze into the sleeve and cough into the cloth, people!). And then they may leave to see a patient in the emergency room, oncology floor, or a post-op patient, with their germs hitching a ride.

This is disgusting behavior, from professionals who know better.

It is not my job to monitor what the rest of the hospital staff does. But it is my job to advocate for the safe care of my patients. It is my responsibility. The American Nurses Association’s (ANA’s) “Code of Ethics for Nurses”  states “The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.”

Heed my warning!

If you are a physician or any other health care worker and you don’t perform hand hygiene before and after you attend my patients, I will point it out. I will not allow your risky practice to endanger the welfare of my patients and their families, my coworkers, or myself. I will ask you, in the presence of my patient, to please wash your hands. Clean hands save lives. Protect patients, protect yourself, protect your coworkers.

If you are a patient reading this blog, I’m telling you how it is. It is your right to see your health care provider wash their hands or use hand sanitizer upon entering and leaving your room. If you don’t see it, speak up! Clean hands save lives. And it might be yours.

And did I mention?

Wash your hands. Clean hands save lives.

 

 

 

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Filed Under: Nurse Tagged With: clean hands save lives, hand hygiene, health, nurse, nurse problems, RN

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Welcome!

I'm Patti Turner, labor & delivery nurse by day and writer by night. I enjoy writing fiction, reading, cooking vegetarian food, traveling the world, and photographing everything. Read More…

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