That's What Christmas is All About Charlie Brown...

Since all of my students are on Christmas break I have been working a lot more at the hospital. I have to admit that while I do generally enjoy my work, any sort shift in the schedule upsets the extremely delicate balance I have worked so hard to make it that way.
Last Wednesday was my random one day off in a long string and I was looking forward to spending it visiting with some good friends. My friends live about 40 miles south of me so I try to take advantage of making such a long trip by adding in other things I need to do in that direction. That morning it was taking the car in for service.
I left the house early as I had accepted the first appointment of the day. Traffic was a bit heavy so I was late by a few minutes. As I hoped out of the car and started inside I suddenly realized my keys were still in the car and the car was locked! Oy Vey!
Fortunately it was only about an hours walk to World Vision where my mom works. It was a cold morning but the walk gave me time to reflect. Of all of the days this could happen at least I had the time to deal with it today. Was it really that bad, more embarrassing that anything I guess. So I spent part of the morning praying as I walked.
I was able to borrow mom's car to drive all the way to my sister's place to get the key to my house and then to my house to get the spare keys. A few hours later I arrived back at World Vision to deliver mom's car to her. Of course with mom being mom, she didn't want me to walk back to the mechanic. "I get off early at 4 today, you can wait here for me." Ahhh... It was only 1 at that time.
So there I sat in the lobby of World Vision with my laptop half working, half people watching. Then I noticed a family outside looking at the statues of Jesus and the little children. As they entered, the children (a boy and girl about ages 8 and 1l) excitedly ran up to my mom's desk. They wanted to buy farm animals for people in Africa.
Of course mom is the receptionist and switch board operator, not the person who takes the donations. She tried to explain this to the family but the disappointment on the children's faces was just too much. As she called around to find a solution, the kids counted and recounted the precious money they had earned for this specific purpose.
They managed to create a elaborate plan to maximize their gift using every last dollar they had. Mom filled out the papers and gave them each a little receipt which their mom said she would hang on their Christmas tree.
"I hope you are rich when you grow up, you would just give it all away," said the mother to the little girl.
As I thought about that statement I thought about all the different ways we could be rich and all the different ways we could give it away. I'm hoping to take that as a challenge.

Christmas Greetings

Greetings everyone and a Merry Christmas!
The last few years have been full of blessings and new adventures for me.
In May of 2008 I traveled to Rwanda as a part of my master’s thesis to teach a class in basic trauma nursing. I had the pleasure of working with my friend Julie Yerger at Kibogora Mission Hospital. The experience was nothing short of amazing, I am sure I learned much more than I have ever taught.
In June 2008 I successfully defended my thesis and presented the work I did in Rwanda completing my work and officially becoming April Morgenroth RN, MN. It is much more exciting than it sounds however, as all it meant was a change in offices and an increase in responsibility. I suppose I could add to that eligibility for a PhD program, but that of course means many more years of work (and hopefully more trips to Rwanda).
In September 2008 I officially became the Northwest University Medical Surgical clinical instructor at Overlake Hospital in Bellevue. I have truly enjoyed the experience and have been blessed two years in a row with the “Best Clinical Group Ever.” We have had so much fun learning, laughing and growing together and I feel so incredibly blessed by them.
June of 2009 was the first year in 13 that I wasn’t in Mexicali, Mexico on the MOP mission’s trip with the high school students. The trip was canceled this year due to violence in the border cities. I must say there were a lot of disappointed high school students but we’re hoping to resume this year.
Of course I couldn’t let summer go by without any international travels… July found me in Cambodia with a medical team from New Life Foursquare Church. We served the Province of Ratanakiri by setting up a free clinic at a local orphanage. Thirteen practitioners saw over 1600 patients in only three days! We saw everything from Malaria to heart disease and everything in between. The clinic was actually cut short by some political activity but God has His hand on us and everything turned out for the best, even better than we had planned in fact.
Two weeks after returning to the U.S. from Cambodia I left for Mexico City with four students, one nurse and one nurse practitioner. This was part of a pilot program for a summer nursing elective travel course. The class was on trauma nursing and we partnered with the Mexican Red Cross. Fortunately I was able to modify the same curriculum I had developed for Rwanda for the work became a little more manageable.
The trip was amazing and we all made many wonderful new friends. Each team member was also able to bring in an extra suit case packed full of much precious donated medical supplies. An ambulance crew received their very first and only bag valve mask, a clinic was outfitted with a nebulizer machine and oxygen equipment and most of all, everyone was encouraged. The new curriculum has officially been approved by the office of the Provost and we are all looking forward to next summer.
These last few months since the beginning of the school year I have been dividing my time between University of Washington in the intensive care unit and Northwest University with my “9 kids.” The year is going by so quickly, I’m excited to see what the next year will bring.
Merry Christmas Everyone!

A Happy Thanksgiving

This year for Thanksgiving I had four nursing students with me who lived far away and were unable to go home. Two are sisters from India and two are roommates, both from out of state. We started out at my house baking bread and making delicious curry. In the afternoon we headed over to my sister's house to enjoy the Thanksgiving meal with the rest of my family and some other friends.
The food was delicious and everyone seemed to be enjoying themselves and eachother. Lisa and even broke out the Wii. It was a kick in the pants to watch my students play Wii bowling with my mom. Everyone seemed to be getting into it to extent of making sound effects.
After most of the guests had left, we got Priya and Reena to play Guitar Hero; what a hoot! I am so thankful for all the fun loving people in my life!

Celebrating Life's Little Victories

At the end of the long term care rotation I asked my students to write down three goals they hoped to achieve during the acute care rotation. One student (who can sometimes be especially "giggly") stated that she wanted to work on maturity. This goal came from a conversation she had with another nurse about the skills they had learned in skills lab. Apparently she couldn't say she learned about enema administration without laughing.
One day at clinical a nurse asked her to administer a fleets enema to an extremely constipated patient recovering from a hip surgery. With hip precautions a extra person is needed to help turn the patient in such a manner as to protect the joint. I went into the room to help her. In attempt to put the patient at ease we made small talk with her and found out she was from the Olympic Peninsula. We discussed the elk crossing signs in Sequim and the enema was administered without even a smirk! Sometimes it's the little things...

Patient Hand Off to Eternity

Over the last few weeks of teaching I have encountered two repeating themes, patient hand off and end of life issues. The Joint Commission (the accrediting body for hospitals) has put a lot of emphasis on patient hand off recently in an attempt to improve continuity of care for patients during the transition between care providers. I have been thinking of ways to discuss this with my students and provide them opportunities to practice patient reports.
A few weeks ago I found myself standing with a student at the bedside of a patient as he passed. Only days later one of my students found herself caring for an extremely ill developmentally delayed young man who was on deaths door. She did a wonderful job providing competent and compassionate care for the boy but unfortunately he died just a few days later.
I fell asleep Monday night reflecting on the last weeks events and wondering how best to respond to the students difficult questions about death. I awoke at 2:30 am from a very vivid dream. One of my junior students was with me at work in the ICU. We where standing at the foot of that same young man's bed. We had come to the place where we could do no more for this boy. We remained at his bedside as he took his last breath. Then we did something very strange, we clapped. It was a long hard fight coming to a gracious end. As we where clapping the boy took flight right out of the bed. I know; odd, cheesy, disturbing, call it what you will...
After thinking about it for a bit I finally realized what it was all about. As nurses we naturally desire to cure our patients, to make them well. We often take on too much responsibility for them, forgetting that in perspective we really have little offer them. While we must carry out our duties as nurses, we must also remember to daily "hand off" our patients to The Great Physician. Our job is to help help set the stage for God's grace in the forms (likely and unlikely) in which it manifests.

"Called"

The other day one my students asked me if I felt like I was "called" to Rwanda or to Cambodia or to Mexico. Though I genuinely enjoy traveling, cultures and international medicine, I had to admit the answer was 'no'; or at least not specifically. I went to all of those places simply because of open doors.
While I will not deny that God sometimes calls us to specific geographical locations, I believe that more often God is calling us to deeper and deeper places in our faith and in our walk with Him. When our hearts are in the places He calls them, our geographic location matters very little; we cannot help but be a part of His plan.
"Thou wilt keep him in perfect peace, whose mind is stayed on thee: because he trusteth in thee." Isaiah 26:3

I'm Choosing to Feel Loved!

Last year the university enforced a new policy that students may no longer call professors and staff by their first names. With a three syllabal last name, I was often called Professor M. One student, however, decided that even that was too long and he began calling me ProM instead. It wasn't long before almost all the students were calling me ProM. It didn't bother me, I don't think it was ever said rudely and I can think of much worse things to be called.
This year I find myself still being called ProM, only this time by former students, new students, the office ladies and even a few fellow professors. I suppose I should feel loved?
Yesterday I went down to the school to make a few copies and do a little cleaning in my office. I went into the nursing student lounge to put some things in the student mailboxes. As I looked up at the white board, I saw this...

I suppose I should be glad that it didn't say "ProM Sucks!"

Living the Dream

This is written version of the schpeal that I gave in chapel on Friday. Of course I don't really read word for word while I'm giving an address but this is pretty close:

Have you ever had a dream? I’m not talking about the "I showed up late for class one day to everyone pointing and laughing only to find out I was in my underwear” sort of dreams. But have you ever had a time in your life where you know God was saying, "Listen up! There's something important here and I want you to pursue it!"

Each person you see is up here because they had that kind of dream and they went for it! For me this dream started in 1996. I was in Mexico for the first time, meeting my neighbor up close and personal, and God planted a dream that I called "the 3M’s:" Mexico medical missions. In Mexico, God showed me a people that He loved -- a people with an openness, a readiness, a connection, and a need that I felt called to work with.

Dreams are processes, in God's kingdom, and the journey is part of living the dream. One of my favorite memories from this trip was a church service one night, where we were all sharing testimonies. It was awesome to see how God had been shaping each of our ideas and circumstances, for all these years, to bring us to this place. The two weeks you're going to hear about are just the tip of the iceberg.

So what was this trip? Our work began in a village called Aldea, where we set up a clinic below a rock quarry to meet the needs of the surrounding community in partnership with a local church. We covered everything from runny noses, to ear infections, to prenatal care. Some of us even cut hair!

We spent the second half of the trip serving with the Red Cross, focusing on trauma patients. Our team had the opportunity to see life in the streets of Mexico City from a medical perspective. We rode in ambulances, dealt with accident victims, sutured wounds, performed CPR and saw firsthand the needs of the city, which extended far beyond just the physical. Even though we were “living our dream,” the work wasn't easy.

It truly was an amazing adventure, but really it's just part of the ultimate journey. God is at work in each of us, bringing us closer and closer to where he wants us to be – and really, that's The Dream that we should be living every day.

Yay!

It's official, NURS 4910 has been approved for credit and will be in the course catalogue for this upcoming summer! The students are extatic, as they should be, they worked VERY hard for this class. Since we've been back three different professors have asked my students to share about their experiences in their classes. I have a lot of juniors already expressing interest. Here goes something...

Is it OK if I'm Laughing?

August 15th marked the date of a good friends wedding, it was also the day we were to leave for Mexico. Fortunately our flight out of SeaTac wasn't until very late during the night, I had plenty of time to go to the wedding, pack my bags, pack the medical supplies and do last minute checks on paperwork before boarding the plane.
That morning I work up early to finish packing my bags and to run over to my sisters house to feed her cats before heading off to the wedding. I had to be there early as I was slated to work in the kitchen helping to prepare the wedding feast. The wedding was held on a farm in Arlington. The reception hall was a converted barn. The kitchen area was quite small for an event like this but we came prepared with crock pots and the like.
The food was well planned and there was a detailed list and timeline to follow as far as when to add the sauce, boil the noodles, etc... All was going well and I was right on schedule with my salad making duty when suddenly I saw from the corner of my eye flames jumping from the stove top! It seems that one of sauce pots on the stove had boiled over and caught the burner on fire. Two other women and I quickly turned off the stove, removed all the pots and attempted to smother the fire with the lid of a pot. By this time the room (and the reception hall) was filled with smoke. Unfortunately my pot lid idea was unsuccessful in smothering out the fire, we had bust out the fire extinguisher. Fortunately that seemed to take care of the problem very quickly but it also covered a large amount of our prepared food in layer of fine powder. Needless to say we ended up having to throw the food away, keep the guests busy and send somebody on an emergency Costco run.
In the end it all turned out OK but I did end up smelling like smoke for the plane ride to Mexico City. All in all it was quite the funny story; or maybe you had to be there...

I just saw that a friend of mine posted this really cool quote, I'm not sure where she go it from but I thought it suited the subject.
"Fire is the reuniting of matter to oxygen. If one bears that in mind, every blaze may be seen as a reunion, an occasion of chemical joy."

More from Mexico CIty

Greetings from Mexico City! My apologies that we haven’t been able to update you sooner, our schedules have been jam packed with various adventures. Adventures which included a trip to the pyramids, a corn festival, a coffee house, a southern gospel version of “This Little Light of Mine,” stained glass window depicting Spanish Conquistadores wearing Nike and Converse tennis shoes and the list goes on!
The last brigade was held yesterday which was probably a good thing as we ran out of vitamins to distribute to those who came. I believe the last update was written right after the first brigade. I’ll attempt to fill you in starting from that point. Our second brigade was held at a new location, the base of a rock quarry in an area called “Aldea.” Aldea is a very poor area and is apparently notoriously difficult to evangelize (as we were told by our hosts). Worship death and the dead is also prevalent in this area. Overall the day went well, we saw somewhere around 70 patients and had the opportunity to encourage and be encouraged by our host church.
Wednesday was set aside as a “play day.” We visited the ancient Aztec pyramids at Teotihuacan. It was an amazing experience to be able to have team devotions atop the Pyramid of the Sun. As we walked through the ruins of the great Aztec City we were reminded of Isaiah 40. Verse 8 says, “The grass withers, the flower fades, but the Word of our God stands forever.”
Thursday and Friday were spent doing more brigades but this time at Ezekiel and Eva’s church (our housing hosts) here in Chalco. All went well with the clinics and many people were served. Our patients ranged from newborns to the elderly presenting with a wide range of problems from heartburn to the more complex problems including diabetes and glaucoma.
This morning at church three of us were able to share testimonies. Zanna spoke about dreams that God lays on our hearts, Alex spoke about God’s purpose in our lives and I spoke about the vulnerability and about how God wants us to know Him and to be known to Him. I don’t think any of us knew what the other was going to talk about but as it turns out they all fit together perfectly, especially with the message that Carlos (our host) had prepared for the service. Carlos spoke about God’s call for all of us to share our hope with others whether in our own neighborhood or other countries. Some are called to be missionaries near and some are called to faraway lands. The church here is just beginning to send out missionaries to other people groups. They have access and unique connections that could make them effective in this work beyond what many Americans have. It was amazing to be able to encourage them in that. After the message we able to pray for all the young people and encourage them to live out God’s purpose in their lives. What an amazing day!
Tomorrow we begin our work with the Red Cross. The students are excited but a bit nervous. It’s the start of the second leg of our journey full of potential for exciting new adventures. We will keep you updated as time and internet access allows.

Mexico City Update

We’re here! We arrived in Mexico City on Sunday morning after a rather uneventful flight. Customs was an adventure as Janell and Sarah were both stopped and our mountains of medical supplies were searched through. In the end all we lost was a few boxes of syringes but hundrends more made it though!
After the customs fiasco, our wonderful hosts Carlos and Carrie,were waiting for us on the other side and we were able to have first meal in Mexico at lovely little café on the way to the church. We are staying with Carlos’ aunt and uncle, Eva and Ezekiel. They pastor a small church in the outlying area of Chalco. What wonderful gracious hosts they are!
Yesterday we began work at or first brigade. Between Mr. Peck and Dr. Luna we got through about 60 patients, most of them children. Janell did a lot of the translating for her dad while working at his clinic station. Julie and Sarah did a lot of vital signs and triage and also worked with Dr. Luna. Alex and Zanna were “flexico in Mexico” and helped out with an unmet need by cutting hair for school children as the school year here in Mexico begins next week.
After the clinic experience we headed to a pharmacy to pick up some medications that wished we would have had at the clinic during the day. While at the pharmacy, 5 more children showed up needing medical certificates for school. (apparently they do this at the pharmacy?) The pharmacist, a friend of Carlos and Carrie’s, “invited” us to help him out with the assessments. So… There we were assessing school children on the side of the street outside the pharmacy window, why not!
While assessing the children at the pharmacy, Carlos got a call from his uncle who hosts a Christian radio show. He was inviting us to be on his show! I wasn’t quite sure how the girls would feel about this but I thought it would be a great opportunity so I said yes; after all, Mexico is flexico. What a hoot, we were on the Mexican equivalent of Focus on the Family being interviewed about missions!
Thank you to all of you who are praying for us at home. God’s hand of protection as truly been upon us and we are so blessed to be a small part of what He is doing here in Mexico.

Greetings from Taipei!

Hellow everybody, I've made it safely to Taipei. We are on a 4 hour layover between here and Cambodia. The flight wasn't bad at all, I got a window seat but nobody in the seat next to me. I got to spread out a bit and get some good sleep and still had some time to relax and read a good book. (In His Image by Paul Brand and Philip Yancey).

Right before I boarded the plane I turned to one of my teammates and said, “What am I doing?” “Following Jesus,” she answered. I must admit that I never really had any special interest to work in Asia. When I was asked to consider going on this trip my first thought was ‘no’. Now I find myself in a foreign airport with a team I don’t know, totally “pumped” for the unknown that lies ahead. How did I get here, well I hope my new friend was right, by following Jesus.

This is going to be a very different sort of trip. Not only is it a new place with a team that I don’t know at all, but I’m not in any way shape or form in charge! I never thought of myself as a control freak but I must admit that it is quite different to be placed in this position. I have a lot to learn and I have a feeling that this whole experience is going to be an exercise in listening and being prompted. Praise the Lord for situations such as these where I have no control, no idea what’s going on, don’t know the language and the only thing I can do is listen, wait upon the Lord and following His prompting.

I'm Leaving on a Jet Plane

Well folks, at this time tomorrow I'll be on plane headed for Cambodia. We'll land in Phnom Penh, spend one night in a guest house, and then head out to our final destination of Rotanakiri. We will be setting up a clinic at an orphanage which will serve the people of the surrounding area. We anticipate seeing 4000 patients during our six clinical days. The team consists of 31 people, 12 of us "practitioners" and 19 support staff.
Last weekend we had a "pill packing" party where 68 suitcases where strategically filled with medications and basic medical supplies. It was a rather huge production which took over 100 people about 7 hours to complete.
Fear not faithful readers, I am happy report that I was able to contribute several boxes of medical supplies from "the stash." Yay for finally sending some stuff out! However, it appears as though the team had way too much of certain other supplies. We ended up pulling off a supply exchange and I came home with more than I had sent out... But in my defense, the stuff I brought home were items that I had very little of that I think would be very useful in Mexico City. I'm not sure if I will have any Internet access at all while I am away, so I might not be able to update until after July 31.

Ratanakiri or Bust!!

A last minute change in plans, I love those. So apparently this last week the leaders the New Life Cambodia Medical Team have found themselves in quite the predicament. It seems that process to get all the permits to set up clinic in Krava, as per the original plan, was taking much longer than anticipated, hefty bribes were also being demanded. We as a team don't have the money to pay the bribes anyway, so it was off to find another site.
On Sunday we received confirmation from a leader in Ratanakiri that we are able to set up clinic there. Ratanakiri is in the northeast corner of Cambodia on the border of Vietnam and Laos. It is the poorest area of all of Cambodia and inhabited by mostly tribal people. This is great news for us as we will be able to serve in the area with the most need. Unfortunately, this also means that we will need to go through 2 interpreters; one will translate English to Khmer, and one to translate Khmer to the local tribal language.
I am told that Ratanakiri is mountainous jungle, unlike the rest of Cambodia which is mostly flat. Scott, our team leader, describes this trip as an Indiana Jones adventure.

The Talking Head

This summer is my first attempt at teaching a class that involves distance education. In attempt to make the material easily accessible to all the course participants, it was suggested that I make a lecture/demonstration video.
Some good friends of mine run a sort of media ministry out of their home that includes radio broadcasting and filming. Last night I went down to their place to film the first of my 5 lecture series. In spite of how much I hate cameras, things were going well and I was nearly 2/3 of the way finished when suddenly the camera man says "cut."
What was the problem, I was on a roll? As it turns out the one day I actually wore color, it just happened to be a long sleeved green shirt. What's wrong with that, you ask? We were filming in front of a green screen, I would be nothing more than a talking head and pair of hands! While that might actually be funny for the first few minutes, we decided that overall it would be way to distracting.
"Take 2!"

Top Ten

A teacher friend of mine is listing her top 10 ten favorite moments of the school year as she counts down to the last day. I thought that was a pretty neat way to end the year. Unfortunately, my school year has already ended, but here are my top ten anyway. (in no particular order)

1. I was once late to my own class, when I arrived I found the students diligently doing clinical paperwork. I apologized profusely and the first response I got was this "Therefore there is now no condemnation..." Wow!
2. On the very last day of clinicals I let the students off early, we went to lunch at Red Robin and then for a walk in the park.
3. During clinical a student ran out of a room to find me in the hall to tell me patient wouldn't wake up. I walked in the room to find the patient nearly in respiratory arrest as she was "over medicated." It wasn't the students fault as she wasn't the one who gave the 2 mg of dilaudid, but we got give narcan! The students then made up a lovely song about it. "Nar-can, you don't have to put on the code light, Nar-can..." It was quite a learning opportunity.
4. A picnic with cheerios and milk at the Kirkland waterfront in the dark after pinning all because we thought the end of year was "anticlimactic."
5. I had my Mexico City students over for fish tacos once to discuss assignments and expectations for the class. One of the students looked her keys in the car and got stuck at my house until 11pm. We ate cheesecake and had some pretty great "rice krispie treat" exchanges.
6. I was rounding the students at clinical one morning and noticed I didn't find one of them on the floor so I asked another student where she was. "Miss M, you just sent her down to the OR about 10 minutes ago." Apparently I asked again a little later that day. Now every time I forget something they just respond with, "Where's Rachael?"
7. The interesting comments the students made during my lecture entitled, "Shock and Awe: Declaring Rapid Dominance Over States of Hypoperfusion"
8. The Christmas party in the skills lab and our clinical evaluations.
9. Hearing, "Miss M., I got the job!"
10. I had spoken in another professors class about my adventures in Rwanda. Later that week I found a bag of coffee from the Bourbon (an amazing coffee house in Rwanda) with a little note, "Ms. M., Just a little to get you by before you go back!"
What an amazing and blessed school year! I will remember it fondly always.

Oh Kitty Where Art Thou

Thursday evening I had a friend over for dinner. Since it was a really hot day we decided to dine on the back deck. Little Kosha insisted on coming with us. I was a little hesitant at first as heard from her previous owner that she has always been an indoor cat. I finally gave in. Afterall, I would be outside to watch her and I have a six foot fence; during the time it would take her to scale the fence I could run over and grab her.
As we sipped our smoothies and chatted, Kosha sniffed around the yard but finally got so hot that she settled under the porch for shade. As I brought her water dish out only minutes later, NO KITTY! There was a small gap under the gate near the edge of the porch which must have been where she got out.
We looked for her for quite some time and I continued my search the next day, still no kitty! I live next to a large wooded area inhabited to coyotes so I was starting to wonder if she had perhaps become dinner. Afterall, only weeks ago a neighbor's cat had befallen that very fortune.
But alas, very early this morning I heard banging on the back side of the house. I thought it was the wind blowing stuff around on the porch but when I looked out the window there was no wind. As I went downstairs I could see a silhouetted figure hanging from the screen of the sliding glass door, there she was. Too bad she can't talk and tell me all about her grand adventure.

Red and Yellow Black and White

Last week at church a friend asked me to help photograph (and wrangle children) for her Sunday School class as the main teacher for that class had gone out of town. The lesson for the week included the parting of the Red Sea as the children of Israel where escaping Egypt. My friend had made a "winding path through the desert" out of masking tape on the carpet. In the middle of the path was a pan of Jell-O. The kids walked their Israelites down the path until they came to the Jell-O. Then a miracle happened that the Jell-O Red Sea parted.
I was sitting at the craft table helping the kids (ages 2-5) color the "Children of Israel." I had quite the conversation with one little boy as he diligently colored his picture.

Boy: "I don't like Jell-O."

Me: "You don't have to eat any then."

Boy: "I want some, can I have some? You're just like me."

Me: Handing the boy a square of Jell-O "Oh really, how so?"

Boy: "I'm black, and so are you."

Me: "Really? How fun!"

I'm not exactly sure how I suddenly became "black" but I did certainly find it amusing.

My Summer Classroom

I have devoted today to an all day curriculathon for our new summer class NURS 4910 and thus far I'm truly enjoying it. I know, curriculathon, sounds nerdy doesn't it? Check out my classroom though! Here I sit sipping lemonade on my newly repaired deck in a lounge chair in the sun with a view of the maple tree and rhodadenderon in my back yard typing away to the sounds of birds chirping. The part I didn't tell you about yet is my retired neighbor wandering around witih his shirt off on the other side of the fence singing to himself. Maybe I should get some headphones...
Most of the class is being conducted online as all of my enrolled students have gone home over the summer and are spred from Chewellah to Medford. They are reading the book "In His Image" by Dr. Paul Brand as part of their assigned readings. They are required to post reflections on the assigned chapters weekly. Thus far I am truly blessed and impressed by their posts. Check out www.bestdaysever.wordpress.com if you feel so inclined.

Patrick's Wedding

A few weeks ago my step-brother Patrick got married in the most unusual ceremony; it took place on separate continents! The story goes something like this:
Patrick goes on a missions trip to Brazil and meets a beautiful young woman. They become friends and stay in contact even after Patrick returns to the US. A year goes by and once again Patrick returns to Brazil on another missions trip. Friendship turns to a deeper interest and the two fall in love. Patrick goes to Brazil again and this time stays for 6 months living with the girl's brother. While in Brazil he proposes, she says yes... Unfortunately he made his proposal on some of his final days in Brazil before his visa expired. Brazilian law requires a person to be outside the country at least 6 months before they can even apply for a new visa, there is also a longer waiting period for marriage certificates.
Oh drat!! What to do now? Well... Here's what happened. Before leaving Brazil Patrick gave his then future mother-in-law power of attorney to sign the marriage certificate for him; marriage by proxy! Patrick came home and everyone waited. Finally Eliza (his new bride) called to say they had secured a court date. The marriage would happen April 18th at 6 am our time. They were married in a bilingual (Portuguese and English) wedding via webcam.
After the wedding Patrick took a trip to Hawaii with his brother Tyler and his mom. So... Patrick's wife married her mother and Patrick went on his honeymoon with his brother. I always knew they were a little "different."
Patrick leaves for Brazil to be with is new bride this Thursday. Congratulations Patrick and Eliza!

Cambodia and Curriculathons

Hello all, sorry it's been a while since I last posted. How do I sum up the last several weeks? May 8th marked the official end of the school year. I got to wear my regalia at the pinning for the first time. Who knew there was so much involved with putting that stuff on?
After the pinning it was decided that year had come to a sort of abrupt end so Janel and I decided that a twilight picnic at the waterfront with Cheerios and milk was in order. What a perfect way to end the year, it was amazing.
A few days later three of us went hiking at Mt. Si (Little Si). We managed to miss the rain and actually ended up having a great view from the top. On the way back down we ended up encountering some unaccompanied dogs. Long story short they followed us all the way down. One of the then ran off but we walked around the neighborhood trying to see anyone recognized the other. We ended up taking her to a 24 hour vet (it was late by this time) who took her in for the night. I must admit I seriously thought of adopting her if she hadn't have found her home.
The last few paragraphs make it sound like I've been doing nothing but playing since school has been out. Nope, I'm still working at UW; and when I'm not there I can be found either in my office at school or on my couch engaging in more curriculathons. Mexico City is now officially NURS 4910 and has four registered students! I've been working on curriculum maps, grading rubrics, syllubi, international travel policies and like ever since (and before) it's official approval.
Oh yeah... And I offered some of my abundant medical supplies to a medical team going to Cambodia in July. They roped me into going... More details to follow!

Purpose

Last week at work I was caring for an African-American woman in her mid 40s who had congestive heart failure, a recent MI and left sided paralysis from a stroke. This woman, Sue (not her real name), has been in the hospital since November and her prognosis is poor. She is in dire need of a heart transplant but sadly her left hemiparesis makes her ineligible. The severity of her heart condition has made her balloon pump-dependant, yet she refuses to give up and does not want to be put on hospice. Most of the staff are starting to get tired of working with her as she can be a little particular about her care and also suffers from chronic pain.

It had been a busy day, and we were in the process of admitting a patient to the room next to hers. The new patient was a woman in her mid 60s who had come to ICU from the oncology floor where they could no longer manage her low blood pressure. The woman was confused and frightened, crying out loudly and attempting to get out of bed.

When I went back into Sue’s room to assess her balloon pump, we could still hear the woman in the next room crying and retching. Sue’s first response was,

“I hope that lady is OK over there. Dear Jesus, I just want to pray for that lady that you will put your healing hand on her and give her and her family peace and comfort, and for the doctors and nurses that You would give them wisdom to take care of her.”

When she finished her prayer I asked, “Have you been our prayer warrior the whole time you have been here?”

“Praying for people is just something that God has put on my heart, and what better thing to do in a hospital while I’m lying here in bed?” she replied.

“Sue, maybe that’s why God has you here right now.”

A few days later I found myself taking care of Sue again. Sue’s neighbor has gotten progressively worse and it was feared she would die that day. That afternoon I could hear music coming from Sue’s room. It was Sue and her family and friends singing gospel songs. “We’re having a praise fest in here, come on and join in,” yelled her mom over the accompaniment CD. Only moments later, Sue’s neighbor passed away. They had sung her into eternity.

Mexico City or Bust!

The president and provost have spoken, Mexico City is a go! I will take with me 4 of the junior nursing students and this trip will serve as a pilot program to explore more opportunities for future such nursing courses. I sent out applications last week and this next week we will be making some decisions. I'm still potentially looking for other RNs who might be interested in going as part of our group.
Now it's on to more long curriculathons! YAY!

Overcoming Blood Part 2

This week has been the long awaited "IV week" at school. We finally were able to get the materials we needed for the students to learn IV starts. Never has there been a more anticipated yet feared skills lab in all of nursing school history. Do you think the fact the students practice on eachother might have something to do with it?
I asked for a volunteer to demonstrate and IV start on and to my surprize obtained one without difficulty. Only later did I find out that this particular student isn't overly fond of needles. She could have fooled me, she did just fine!
Though I know that this skill can be very difficult for many of the students, there is one who seemed to have a little more apprehension about it than the others. After one of the practice sessions I kicked out my other students and kept this one... First we worked on putting on the tourniquet, then palpating the viens, then drawing blood and finally starting an actual patent IV. She performed the skills beautifuly and left my arm "hematoma free." I'm not sure why but for some reason the most difficult part was touching the veins. But... She was determined and willing to work hard to overcome this and she did! I know it sounds a little strange but I came away so inspired by this!
Just two days later I found myself in a situation that was difficult for me, one that I despirately wanted to overcome. I thought about how she had overcome. I decided to pray and to tell myself "I can overcome because it has already been overcome for me by the blood of lamb."
Throughout this past week I have seen many of the students "overcome blood" but the overcoming blood... Another "happy teacher moment!"
John 16:31
"I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world."

Overcoming Blood

I was reading a book by one of my favorite authors Paul Brand and came across something very fascinating. The chapter was describing the development of the smallpox vaccination and an expedition sent out by the king of Spain to vaccinate Bogota Columbia in the midst of a smallpox outbreak. They had now to way to preserve the live vaccine during the long voyage so they created a human chain to incubate the vaccine during the months it took to reach Bogota.
The chapter went on to describe how the body's immune system creates antibodies specific to invaders that it has been exposed to. This is how a vaccine works, either by exposing the body to a weakened form of the invader allowing the body to create it's own antibodies or, in the case of immune globulin, by directly giving the body antibodies to protect against a given threat.
The next point Dr. Brand made was what blew my mind... We have a saviour who came to live among us in human form. He was despised and rejected, temped and ultimately killed all so that we could have eternal life. He overcame these things for us so that by his overcoming blood, we too can be overcomers! This brings a whole new meaning to "this is my blood which shed for you and body which was broken for you." We truly are saved by the blood of the lamb.
I took the opportunity to discuss this with my students this week. We ended up having a little Passover Seder in post clinical conference. There truly is power in the blood!

Foleys for the Philippines!

A few months ago I received a donation of some 700 Foley catheters from a pharmacy in Bellevue. Some of the catheters went to the nursing lab for the students to learn and practice procedures on, the several hundred others have been sitting on shelves in my office awaiting shipment.
Picture this, used urinary catheters washed being washed and hung up to dry on bushes. That's the reality in many places around the world. Studies show that in the US alone approx. 25% of hospitalized patients with indwelling urinary catheters develop bladder infections, 30% of those go on to develop a systemic infection. How imagine what these numbers might be like in places where the catheters don't come out of sterile packages.
A friend of mine from work had been a nurse in the Philippines for several years before coming to settle in the United states with her husband and children. She still keeps in contact with those she worked with and sends several packages a year to friends and family still living in the area. Long story short, we have found a home for our Foleys and developed an unofficial "Foleys for the Philippines" program. We're hoping to be able to start shipping the Foleys in May.
Kind of funny the things you get excited about when you're a nurse... :)

Fruit Salad

A week ago today was my last day with my first (official) very own clinical group. We've enjoyed some great times over the last several months and they have been pure joy to work with. I'm proud of their accomplishments and how far they have come. All of the nurses we have worked with sing their praises. I truly was blessed with some fantastic students. I think I have learned more from them then they have learned from me.
On our last morning together I made them breakfast, cinnamon rolls and fruit salad...
I gave each student a different fruit and also assigned them one of the fruits of the spirit that I thought he/she was especially gifted in. As each student added their fruit to the bowl and read the Bible verse I had given them I told them the story of how they earned that fruit. The other students were invited to share how they have been blessed and encouraged my their classmate as well. We decorated photo mugs with pictures we had taken during our time together and the verses I had printed for each one. It turned out to be a wonderful time.
However, at the end of the salad they noticed that "faith" had not been added, our group had only 7 students and we all know that God is love. They then did something I didn't expect, they gave me faith! "You had faith in us. We have seen your faith in how you prayed for us and how you have been sensitive and responsive to God's leading with us. We are blessed by witnessing you live your faith." WOW!!!

Presidents and Provosts

Last week I encountered the dean of the school of nursing while in the copy room. He tends be somewhat elusive at times so I took the opportunity to ask him a few questions. The top question of course was regarding being able to invite students on a medical mission to Mexico City.
The response I got wasn't really what I expected, it was much more... "Perhaps we make it some sort of pilot class that could satisfy the upper division elective." Of course this sounds like something I would interested in so we set up a meeting. The meeting went very well and our gracious hosts Carlos and Carrie have already begun to set some things up for us. But there is always a however...
The proposal is now waiting on approval from the provosts. This apparently requires some rather intense communication between my dean and the president and provost, all of whom are busy people.
My email inbox is now stuffed with CC'ed messages to and from presidents and provosts. It's hard to be CC'ed on conversations between people like this, I have a difficult time not emailing back. So for now I wait, my summer plans hinging on the decisions of presidents and provosts.

All Growed Up!

Technically I've been an adult for over a decade now, at least by age anyway. Last Friday I had one of those days where I really actually felt "all growed up." I got up at the crack of dawn to teach clinicals at the hospital. After I released my students I headed over to Rainier Title to sign on my refinance for my house.
As I was walking through downtown Bellevue with my wool Pea Coat and black document folder on a blustery day listening to a church bell ring.
After my document signing on my way back to my care I treated myself to a cup of coffee. Then back to the hospital I wen to do some chart audits... I suppose it's kind of bittersweet.

Shalom Y'all

Howdy y'all from the Mississippi Gulf Coast. So here I am taking full advantage of spring break and visiting some great friends after way too long. I flew into New Orleans arriving on Sunday night after several hours of delays and sitting stationary on tarmacs due to weather and de-icing issues. Once of the plane however, my experience got much better. So far my trip has included dinner at the infamous Waffle House, good coffee with great friends, two burly happy dogs, "Seattle style" weather, a trip to Wal-Mart, a trip with Winn Dixie, theological discussions regarding the "Holy Ghost Weenie Roast" and making the largest loaf of challah I've ever baked. It doesn't get much more southern than that!
I've really been enjoying my time here visiting Jon and Shara, now if I can only convince them to move back. Good times, good times...

Keeping Kosh

This last Wednesday night while at I was grading papers in my office I found myself to be a recipient of a rather unusual delivery. What was it, you ask; nothing other than a "kitty to go."
A family friend, who incidentally had 5 cats, suddently found herself in a pickle when she recently found out about a medical diagnosis on top of other major life changes including having to urgently move from her home. That leaves 5 homeless kitties. My grandma took two of them in while we found homes for two others. The fifth one, well...that's where the "kitty to go" comes in.
My sister called me Wednesday afternoon asking if I would like "a ministry opportunity." Suddenly I find myself the foster parent of a rather affectionate three year old female cat. I took her home and she hasn't stopped following me since. I'm trying to tell myself it's only temporary, that she's annoying and I don't have to keep her. I did however, make the mistake of calling her "Kosha" which means "kitty" in Russian; "Kosh" for short. I hear that once you name the thing it's all over, they're yours forever. It looks like I might be keeping Kosh.

Laughter is the Best Medicine

For the last two weeks my students have been taking care of an elderly lady with a recent amputation of the left leg. As I'm sure you can imagine, she has a difficult time getting in and out of bed. Last week my one and only male student came in the room to help her get back into bed from her chair. She was very grateful for his help and apparently hasn't forgotten it...
This week I went in her room to help the students change the dressing on her stump. The male student also came in to help. As soon as she saw him she said, "I remember you, you are so easy to get in bed with!" He immediately turned beet red and the rest of just couldn't stop laughing. It took her a few seconds to realize what she had just said but when she did, she couldn't stop laughing either.
It turned out to be "the best dressing change she'd ever had, and it didn't even hurt." They say that laughter is the best medicine!

Rice Krispie Bricks

If you know me well or if you have ever read the very first entry of this blog then you might already know what this about; if not I'll attempt to fill you in.
Several years ago in sleep deprived state I asked my friend Angela, "What are your rice crispies saying to you?" It became code for, "What's God doing in your life?" We've been sharing little tidbits of encouragement/testimonies even since and others have joined in! On day I came home to a package on my doorstep, inside... a giant rice crispie brick from a friend in Oklahoma! ;)
This last week I found myself once again the recipient of a rice crispie brick, only figuratively this time... I was blessed to indirectly be a part of something awesome, a gift that blessed and fulfilled the desire of a wonderful dear lady's heart.
I read her message in response to the gift on a day that was especially exhausting. I had worked all night at the hospital and then taught class in the morning and was getting ready to work night shift at the hospital again... As I was on the bus on my way to work that night I remember thinking, "I have no idea how I'm going to make it through tonight. This is almost (but only almost) an emergency." As I was walking up the stairs my unit on the the fifth floor I remembered what was said in the message from my friend, "God cares about the desires the of our hearts, He knows exactly what we need and is faithful to provide it." I prayed a little a prayer, "God I know that you will get me through this shift somehow." When I opened the door to my unit and saw the charge nurse at the desk the first thing she said was, "Would you like to go home on standby?" Praise the Lord!!!
My switch to day shift comes in March but with it I will also lose my shift differential and a significant chunk of my income. With raises being held and the economy what it is, I must say this makes me a little nervous. However, I think it's the right thing to do for health and sanity in general. Once again I was met with a rice crispie brick. My sister called with "exciting news about mortgage rates" and I was able to refinance the house at a much lower interest rate and save several hundred dollars a month. God is so good!

I'm Back!!!

Hello dear readers, I'm back. Ever since the heavy snow fall around Christmastime I've had trouble with my internet connection. After several weeks of trying just about everything, my sister finally fixed my connnection by disconnecting my wireless router completely and connecting my computer with a 50 foot ethernet cable.
Here's the update:
I put in request to change to day shift at the hospital after 10 years of working nights. It was granted! I will now rotate between working days and nights with the option of working mostly days. Hmm... I wonder how this will impact life in general.
I heard back from my friends Carlos and Carrie in Mexico City. They said that the Mexican Red Cross as well as other groups we have been working with have invited us back. Carlos and Carrie have volunteered to host us again! The hope is to take and alumni/nurse group this summer and deliver some of the medical supplies I've got stored up at the same time. Mexico City here we come!