Thursday, December 10, 2015

The Nursing Process

According to The American Nurses Association,

"The common thread uniting different types of nurses who work in varied areas is the nursing process—the essential core of practice for the registered nurse to deliver holistic, patient-focused care."

The nursing process is composed of the following parts, illustrated by my kids in pictures...


"James, there's seems to be a problem with my car. It's not working." - Reese
"I believe you're right, Reese." - James


"I'd recognize that problem anywhere...obviously you've got a case of Risk for Impaired Mobility r/t improperly functioning vehicle going on." - James


"Based on our assessment and diagnosis, Reese, we'll set some measurable and achievable goals for this situation.  I find that easiest to accomplish when I consult my cat." - James


"Let's try this, Reese!" - James


"Iiiiiii don't know if this is working, James..." - Reese

Plan of care modified, if needed

"That didn't work at all, Reese. Scrap that idea, let's take the sports car instead..." - James
"What a splendid idea!" -Reese

Saturday, November 14, 2015

Reese Is THREE

Today we celebrated Reese's third birthday.

She started the day helping me make breakfast.  Her helpful helpyness included opening the silverware drawer, handling/licking silverware, and returning them to the drawer.  Ew. Ew. Ew.

Later she played outside with James and Memaw and Pawpaw and Daddy.

The fierce is strong in this one.

There was cake and candles.


There were presents, which she loved. That's her new "puppy" that comes with a carrier/purse and a comb.  She then observed birthday nap time.  It is tiring getting older.

During nap time, James played with some of her presents too.


Wednesday, November 4, 2015

Due Date

This day three years ago was my due date with Reese.  My first pregnancy, my child was born on her due date.  My second pregnancy, my child was born on his due date.  As unreasonable as it was, I fully expected my third child to be born on her due date.

Reese wasn't up for that.

November 4th came and went, no baby. On November 5th I cried.  I did NOT appreciate still being pregnant.  I went to a work meeting that I wasn't supposed to be able to go to. (Rex people, think Women's and Children's quarterly meeting.)  Susan, the director, asked when I was due.  I said "Yesterday," sulking. 

Read about her delivery--

Reese finally arrived on November 8th.  And there was much rejoicing!

Now, on the brink of her 3rd birthday, Reese is a joy to be around.  
I feel like this picture captures her personality so well.  And that shirt DEFINITELY describes her.  She's smiling way more than she isn't.  She talks to anyone and everyone who will listen.  Wait...not true.  She'll talk to anyone, whether they are listening or not.  She likes music and singing.  You should hear her sing "Jesus nuffs me" or "You are my shunshine."

This girl loves her some jewelry, especially "becklaces." 
She's lady-like at all times...
One of her favorite activities is coloring.  She holds crayons really well, with either hand.
She is a strong, independent, at times completely exasperating, little girl.  But we're so glad she's ours!

Happy Almost Birthday, Reeseypiece!

Tuesday, November 3, 2015


Scott and I were talking this evening about this crazy month ahead. "It's just going to be an odd month,"  he described aptly.

  • He has two business trips this month.  Back to back weeks.  He has not traveled with this job before, so we are not old pros at him being gone.
  • Our daughter turns 3.
  • I'm starting a new job.
  • His best friend is getting married.  There will be multiple awesomely fun events during the wedding weekend. No lie, this will be fun. We're excited.
  • We're taking a trip to his parents.
Scott definitely quoted these lines from this movie during our conversation:

I'm one of those people that "gets a full plate easily."  It doesn't take a whole lot for me to feel like there's a lot going on.  This isn't a comparison game, I realize.  I know tons of other people have a significant more amount of stuff and things going on in life this month.  But for me, for our family, this will be a full month.

What recommendations have ye?? Organizational tips?  De-stressing techniques?  Mental exercises to do? (Hint: I like maybe journal prompts or something like that?)

Sitting here with tight shoulders and a quickening pulse...
*adding chiropractor appointment to the list of to-dos*

Sunday, November 1, 2015


No. I'm not pregnant.

Can't a female of child-bearing age make a non-pregnancy announcement?? Come on...

On Monday, November 9th, I'm starting a new job.


My first year after graduating from nursing school, I worked rotating shifts in the Special Care Nursery at Rex Hospital (now NICU woot woot).  Six weeks of day shift followed by six weeks of night shift. WOW WAS THAT FUN.  Said nobody ever.  After that year was up, I was given a choice of a permanent day shift position or a permanent night shift one.  I chose days.  From July of 2009 until November of 2013, I worked day shift.

And then we moved to Columbia, SC.

I had a feeling it wouldn't be too hard to find a new job as a nurse in a new city, but I didn't know if I could find one in my (1) specialty of Neonatal Intensive Care, working (2) part time (3) day shift.  Well, two out of three ain't bad.  I was hired by a magnificent manager for a part time, NICU, night shift position.

When I say I was hired by a magnificent manager, that is not lip-service.  I have never worked for a better supervisor in all my working life thus far.  She was a nurse in this unit before becoming the manager of it and that was a huge selling point for me.  She understands, inside and out, what it's like to be a bedside care nurse in this particular unit.  She is awesome.

Another reason I was excited about taking my current job was my coworkers.  This unit does not have a lot of turnover.  Nurses come here to work and they stay.  For a very long time.  That is a great sign of a positive work environment. The down side of the low turnover is there is a looooong wait to switch to day shift.

I was mildly concerned about working night shift again, but I figured Scott and I could figure it out.  My parents (our amazing childcare providers when I work) were on board with the decision for me to take the night shift job.  I accepted the position and started in January of 2014.

As is the case for a lot of new nurses on a particular unit, I oriented for several weeks on day shift before switching to my regular night shift time frame.  My preceptor was amazing.  She is a kind, knowledgeable, PATIENT woman, thank the Lord.  I was so grateful for her patience with me.  Even though I came to this new job with 5.5 years of experience caring for preemies, I had only dealt, for the most part, with 30 weekers and above.  It's a different world caring for micro-preemies.  At Rex, I could have a vent-baby for a few days, because that's usually all it took before they came off the vent.  At my current hospital, babies can be vented for weeks.  That's just the nature of micro-preemie lungs sometimes.  Also, I had a harder time than I ever would have expected learning a new hospital's way of doing things.  It was easier as a new grad learning how to take care of preemies than it was as a nurse with some experience trying to un-learn what I thought I knew and re-learn a new way.  That's where my preceptor's patience reeeeeally shined.  God bless her. Truly.

Since April or May of 2014, I've been on night shift.  Night shift is both gloriously awesome and horrifically bad all at the same time.  Lemme esplain.  There is too much.  Lemme sum up:

While at work, night shift is so.much.better than day shift.  Come on, hospital workers, admit it.  You know it's true.  The slightly more relaxed atmosphere, the people who work nights being a slightly quirky usually hilarious group, the pace, etc.  It is a magical place in a hospital at night, for the workers at least.  As a patient it is altogether CREEPY.

While away from work, night shift blows.  I find myself hanging out in one of two emotional/physical places:  I'm not sleeping and I should be or I am sleeping and I shouldn't be. The constant battle for getting sleep (after a shift or at night when not working) wreaks havoc on me.  I truly believe that people that manage to do long-term night shift work require less sleep than the average human and certainly less than I do.  Scott would probably tell you that even cats require less sleep than I do.  I need my sleep.  Night shift is not very forgiving in the sleep department.

In early September Scott and I had yet another conversation about me and my job and the struggle I was having with it.  We decided I would start looking for another job.  I applied for four jobs a few days later.  We covered this whole process in prayer.  I knew the Lord knew better than I did what exactly I was looking for and what I needed.  Within a week of my first application, I had an interview.


That was much quicker than I expected!  Over the next few weeks, I interviewed for three of the four jobs for which I applied.  One job stood out to me from the other three as the most desirable.  In the end, that is the job that was offered to me and is the one I accepted.

It is not bedside care.  It's an administrative role.  It's called Nurse Navigator, but may function more like a discharge coordinator.  It's a new position, so I'll have some say in what the role looks like.  It's day shift.  It's part time.  Eventually there will be weekends, but initially, none.  It's no holidays.  I'll start out working three 8 hours shifts.  It's in the same hospital system just a different location about two miles away, so all my benefits should transfer over.

I am ecstatic.

The Lord heard my prayer and he provided in a huge way. Within two months of making a decision to look for other jobs, I am starting a new one.  That is crazy to me.  That kind of fast timeline, from the interview process to my current manager working with me on giving notice, that can only be the Lord in his grace and mercy providing for me.  I am so very grateful.

There are always positives and negatives to change.

  • I've never done a non-bedside-care-kind-of-nursing-job.  I'm supposed to wear business casual clothes. Wha?!?  I don't even own that kind of stuff.  
  • Our childcare burden will increase for my parents by at least one day/week. 
  • Telling current coworkers I'm leaving is terrible.  I learned from my military childhood that leaving is always easier than being left.  Yes, I'm on the easier end of this equation.  But I'm an empathetic person and I understand the "what's wrong with us?? why are you leaving??" sentiment. My coworkers are incredible.  I would recommend this unit to anybody looking to work in a NICU.  The people and the manager (did I mention the awesome manager??) are stellar.  They just are.  At the risk of sounding like a horrible break up, "It's not you [guys].  It's me." Nights are killing me.
So there ya have it.

I have three more night shifts left this week before I transition to the new job.

Here we go!!

Thursday, October 1, 2015


I have been donating to my gym for about 4-5 months now. Donating, in this context, means giving money monthly to a gym establishment of which I never, ever make use of.

Today I decided to change that.  Both kids went to preschool (yay for healthy enough kids to go to school) and I had about two+ hours to call my own.  I wore my bathing suit under my clothes to preschool drop-off.  I was prepared to go straight from there to the gym.

While driving away from the preschool I realized I don't have any goggles for to swim wiff.  Quick pit-stop at Target required.  No problem as there is one between the preschool and the gym.  While walking into Target I realize I have no towel.  Great.  Procured swim goggles and towel at Target.  Off to the gym I go.

When the lady took my keys with my gym bar-code-card attached and scanned it, she did a double take at the computer screen.  I'm not sure exactly what that screen said, but it was probably something along the lines of "OMG...CONGRATULATE THIS GYM MEMBER FOR FINALLY COMING BACK!"

Let's back up...a little swimming history first.  I know how to swim. (hooray!) I was on the swim team in high school.  I wasn't exactly the biggest asset to the team, but they didn't really make cuts, so even I MADE THE TEAM! Woohoo!  Since high school, I haven't chosen swimming as my go-to exercise mode.  I usually default to running.  The older I get, the more painful it is to my back and other parts of me to re-start running.  Thus my brilliant idea to try swimming.  No impact, aerobic, good times.  What could go wrong?!

I'll tell what can go wrong:  THERE IS NO AIR IN THE WATER.


I got in, pushed off the wall and began freestyling my way down the lane.  After two pulls my lungs were screaming "WHY DID WE THINK THIS WAS A GOOD IDEA?!"  I ended up breathing after every other stroke.  Gasping is more like it.

I wasn't moving very fast, but I sure was breathing like I was swimming like this:

I had to laugh at myself.  The logic of switching to swimming from running as a get-in-shape exercise seemed so solid.  Until I realized I can only breathe about half the time while swimming, unlike ALL the time during running.  Minor oversight...

I switched to breaststroke and backstroke a whole lot during this first round of swammin'.  More access to oxygen in those strokes.

Of the 45 minute swam-tastic event, I walked, yes WALKED, about 10-15 minutes.  Pretty sure the other pool/gym goers were probably like " she walking in the pool?? Doesn't she know there are treadmills for that?  And she doesn't need a bathing suit?  Bless her heart." It is the south after all.

There were three swimming lanes total. An older lady in the lane beside me totally kicked my butt the whole time.  The older gentleman in the lane beside her also kicked my butt.

Maybe that's my problem?  I'm just too YOUNG to swim....

Tuesday, September 29, 2015

What is UP with James??

1)  James (4 years old) has been having some issues since May 2015 with vomiting and dehydration, requiring three hospitalizations in five months. In May, his CO2 was 11 on the admission BMP after 24 hours of vomiting.  In August, it was 9.  In September, after only 4 hours of symptoms, it was 16 (surprisingly low for how short-lived his symptoms were.)

2) This earned us an appointment with a metabolic geneticist (wha??) to see if he has some sort of metabolic disorder to explain his frequent bouts of vomiting.

3) Today we had that appointment with Dr. Schroer of Greenwood Genetics in Charleston.  What a great man.  He was kind, thorough,  and interacted with James at his level.

4) The result of our appointment today: no new diagnosis. He shared several things that they've ruled out, the names of which I cannot tell you because I've never heard them before and couldn't begin to spell/say them now.

5) What I do remember Dr. Schroer saying:  Each time he has been admitted to the hospital, James has had ketones in his urine.  His lactic acid levels in his blood have also been slightly elevated.  These things could be correlated or might not be.

6)  Dr. Schroer is running a few more tests on the blood still available from James' last hospital admission (9/14/15).  He is also checking for ketones and other things in a urine sample from today (9/29/15).

7)  Dr. Schroer is supposed to be mailing us a typed up version of everything he told us today. *phew* He will also call us in a week or so with the rest of the results.

8) James did great during this appointment.  Although he 4-year-old-whisper-asked "Can we leave now?" about five minutes into the appointment, he hung in there for the duration.  Thankfully, there were no "booboos" (no blood drawn).  Only a urine sample, which he thinks is fun to provide.  Yay for peeing in a cup!

9) Scott and I had plenty of opportunity to ask questions, but weren't entirely sure what to ask...

10) Scott googled some of James' symptoms before we went to Charleston today.  WebMD told him James has Cyclic Vomiting Syndrome.  Dr. Schroer mentioned this to us as a possibility as well.  (Dr.) Scott now feels completely validated in his google-diagnostic abilities and is accepting new patients.  CHEAP.

11)  No, none of the doctors involved in James' care to this point have mentioned anything about allergies.  He never has any skin issues with his vomiting (hives, rashes, etc).  He doesn't have diarrhea with the vomiting.  Each doctor has said "never say never," but that he is not presenting like a traditional allergy case.

12)  Yesterday and today James has had a low grade fever.  No vomiting, thank goodness.  Yesterday he wouldn't eat for most of the day, which stressed me out.  I was waiting for him to throw up once and then we'd be off to the doctor/probably hospital.

13)  That's all I know for now.  Making this post a numbered format gave the illusion of organized information.  I apologize for the false advertising.

14)  Thank you to each and every one of you who prayed for us today.  I felt notably stressed prior to today.  During the appointment I noticed my body language:  leaned back in my chair, arms draped on the arms of the chair, hands unclenched.  In a word: relaxed.  Not tense.  I completely credit the Lord himself for easing my nerves and helping me be present, attentive and not anxious.  Thank you praying folks for your time today.  (Scott doesn't know how to be anxious, so this wasn't an issue for him. He's so laid back...)

15)  After the doctor's office, we had some fun.  We headed over to the USS Yorktown air craft carrier.

James felt right at home sitting in a cockpit. 


Scott briefed us on our mission.  James approved. Momma on the other hand got a wee bit claustrophobic during our briefing and had to jet-set on outta there to the flight deck so she could BREATHE.

Anyhow...we'll keep everyone posted on what we know...whenever we know it!

Sunday, August 2, 2015

Nags Head, NC Beach Trip 2015

We just got home from a beach vacation.  It was super fun.  It was incredibly exhausting.  Good times were had.  I love that prior to going on vacation, I am SO VERY EXCITED to go...

And then when it's time to come home, I can't wait to get there and sleep in my own bed...

This trip was a conglomeration of Davidsons and Acuffs and was only possible thanks to the participation of all!  The first half of the week was mostly Davidsons.

Popsicle and Reese

Reese loves it when people read to her.  If by "read" you mean "skip several pages at a time and basically flip through the book."

Aunt Julie

Gram catching some Reese snuggles.

We played on the beach.  We got sand EV.ERY.WHERE.

We avoided sharks by staying out of the water.  But we stayed ever-vigilant...

The only shark-sighting, thankfully.

The second half of the week was Acuff-filled.
The Colonel

The Memaw

Scott and Betty Anne

John and Nikki

We found perfectly good toddlers washed up on the beach.

We took obligatory sunset photos.

We laughed.

We cried.  

We took #pinterestfail photos.

Good, good times...