Happy Halloween!

 Happy Halloween!  My Little Mermaid and little US Army soldier had a blast!  Ben had planned on being Spiderman for a couple of months but after we discovered a hand me down costume of cousin Sam's Ben changed his mind.  I didn't realize that the camo on Ben's costume would really camouflage him into the background but it did! The leaves had fallen and when Ben would stand in the grass I could only see his cute little face. I will make sure he wears something brighter next year!

Little soldier!

We went trick o' treating with our friends Layne, Adam and their three children Liam, Eli and baby Moira:

Cute little Moira!

Adam and Layne

 Anna is still my  little bug girl. She brought me our "new pet" a couple of days ago. I just prefer not to have things with long crawly, skinny legs hanging out around the house! Luckily I was able to convince Anna that if she really loved the bug she would let it live outside =).

 

 Yesterday was a beautiful fall day here. It was nippy in the morning at 32 degrees but it warmed up to the high 50's/low 60's. The kids and I spent two hours at the park and we were the only folks there! Kentuckians must have thin skin when it comes to the cold weather. Maybe our Scandinavian heritage makes us tough =)

The kids and I went out to dinner with Anna's "very best friend" Sofia and her mom on Friday.  I am so happy that Anna has a friend that she loves and that it is mutual! Sofia's parents told me that Anna is all that she talks about. Sofia's parents are from Puerto Rico and have lived here for the past 10 years. 

Here are a few pics from today after church:

Yes, she is quite the fashionista. I had nothing to do with this ensemble =)

I have survived 6 weeks at my new nursing job! It feels like I have been there a lot longer! This job is A LOT different than my job at UC Davis. In some ways it's better and in other ways I miss my old job.  I have flexibility with this job which is great. If I have a doctor's appointment or want to be at the school for something I can arrange for that.  I have a lot of autonomy which again is good and bad!  I am the case manager for about 26 patients which is a lot of responsibility.  At my hospital job my work stayed there. When I clocked out I was finished and didn't have to worry about much until my next shift. With this job I can be called at anytime of the day about a patient and I am ultimately responsible for their care from the day we admit them until discharge.  

Photo I took in front of a patient's house.

In the hospital the environment was controlled. The patient was surrounded by the sterility of the hospital. Everything I needed was at my fingertips. With this job the patient is in their own home environment and the only supplies I have are what I have in my trunk.   All of our patients have Medicare, which is for anyone 65 years of age or older. My patients vary ranging from black, white, rich or poor.  Some very wealthy people pay for their own private duty care so I don't typically see "the rich of the rich" but I see everyone else.

My territory includes Lexington and three of the surrounding counties. My favorite place to go is out in the country on the farms. The people there are just different than in the city. They wake up early, work hard, and typically do a lot better with  their care. It takes a little while to drive to them but I have met some incredible people and have seen some beautiful farms.  

I have had the opportunity to learn what "the holler" is. One day I was told I was seeing a patient "out in the holler" and I didn't know what that meant ... haha! I learned that you drive through hills until your cell phone service doesn't work nor your GPS! My patient there had three dead deer heads on his porch -- lovely =).  

There is of course a lot of poverty in some parts out here.  I guess one shouldn't expect to have such beautiful countryside without a counterpart -- everything in life just seems to. There are people who live their lives with no running water, no teeth, cockroaches running amok and when I meet them seem like happy campers.  

I won't lie, I wanted to quit my first week. I wasn't comfortable going to some places and I just felt vulnerable being all by myself without another nurse around to help me. I decided to wait it out a few weeks to see if things would get any better. Well, the patients haven't changed but the job has grown on me:).

During my first week of visiting patients my worst fear came true when I was out in the country visiting a patient that became very sick while I was with her. I was all alone out in the country about 45 minutes from Lexington. This person lived alone and didn't even have a phone plugged in. Her heart rate was only 19 and she was barely responsive. I called 9-1-1 but it took 20 minutes for the paramedics to arrive and things didn't get a whole lot better when they did.  Well, she survived! It took myself, two paramedics and even putting one of her loved one's to work but she made it.  My patient spent two weeks in the ICU but she is home now. She sent me a card that said "You are the love of my life and very best friend". I don't think I've ever had a patient tell me that before!

 I think in any stressful environment joking and laughter is key to getting through stressful times. So, for that very reason the other nurses and I came up with a way to categorize where the patients live not using zip codes:  "Lexington, out in the country, the sticks, the holler and Deliverance  (remember the scary move???)".  All kidding aside, we love them all the same.