A free upgrade from bronchitis to atypical pneumonia and why Zoomcare is still awesome....

Today I have been working on mandatory education for work from my computer. My throat is still raw, I sound like I have been smoking for 40+ years, and my lungs are tired of cough-cough-coughing. The upside is my rib cage muscles will be buff and my abs are getting an extra workout.

Low and behold the nurse from Zoomcare called me to check up on how I was doing. First off I have never ever had this happen with primary care. Obviously they are concerned that their patients get better after they leave.  The nurse was concerned that my symptoms had not improved much since Sunday and said she would have the MD call me.

An hour later I chatted with the MD and explained that some of my symptoms had changed, but not improved per se. She said it sounded like I was dealing with atypical pneumonia, not bronchitis, and that she was calling in a prescription to my pharmacy right away for azithromycin. And that she will be calling me back on Friday to see how I am doing.

I am so pleased at the care I have received!

Zoomcare: An unwanted adventure in really great primary health care

I have been battling bronchitis x10 days. I officially lost my voice at the beginning of my three days of work this week. It made for a frustrating 3 days of work since I talk ALL the time. I fortunately was able to not cough during those 12 hour shifts due to antitussives and decongestant meds and continued to wash my hands incessantly but I barely slept last night as it all caught up to me and I turned into a phlegm monster.

I popped online Sunday morning around 0445 to figure out just where I could go on a Sunday to have an MD confirm the fact that I have an infection and whether it was viral or bacterial. My hospital does have employee health and an urgent care clinic. Both are closed on Sundays. Not helpful!

I happened to notice a few weeks ago a Zoomcare in downtown Boise. I booked an appointment online from my cell phone in bed . It's a one time flat fee for service. No hassle or haggling with insurance. And I'm not going to ER for something minor and clogging up the system meant for traumas, severed limbs, and septic shock.

Overall, the experience was incredibly satisfying and the service was superb and I am serious when I say every town in America should have an urgent care clinic like Zoomcare. I walked in for my appointment at 11:00am and I saw the PA at 11:05am. No waiting. Although I was totally disappointed that my bronchitis is viral (meaning that I will be miserable for another 2-3 weeks) they were helpful in giving me an albuterol inhaler to help with the shortness of breath I have been experiencing. So now I'm on the road to recovery and can breath again.

So far so good...

This week marks my third week of orientation. It has been a very challenging but enjoyable process. I have encountered very complicated patients and worked diligently to heal and comfort side by side with my preceptors.

A few things that have been of interest in the last 3 weeks:

• Although I am in a medical ICU we are apparently referred to as the CCU (coronary care unit). Why this is no one seems to know. And our surgical ICU is referred to as just the ICU.
• I worked with my first balloon pump. Although I will not have a balloon pump patient for probably 2-3 years (they require specialized training)this was a very interesting experience. We literally did not leave the bedside for 12 hours at a time because it is such a delicate and dangerous piece of equipment.
• I worked with a  Swan Ganz catheter, though not a common piece of equipment anymore, it is still seen in critical care occasionally. This is also a delicate and potentially dangerous piece of equipment, but one that I could be working with in the future. I took my first PAWP (that stands for pulmonary artery wedge pressure), where a balloon on the Swan Ganz cathether is inflated inside the pulmonary artery (the artery with deoxygenated blood that travels from the heart to the lungs to pick up oxygen) to capture the approximate pressure inside the L atrium of the heart. This was a terrifying/thrilling moment in my life crystallized by the fact that I had an audience that included not just my preceptor but a handful of nurses from the unit that wanted to come see a Swan Ganz cath.
• We are the only nurses that get floated outside of the hospital. Apparently if the Meridian St. Luke's is short staffed we can be sent over to help. This is quite different from floating to another unit in the SAME hospital and unfortunately requires a car.
• I completed my second telemetry course. This time it was partially online with the American Heart Association and partially done with a real human being. It was excellent, but also provided a sense of accomplishment because I had real life examples to base my questions on. I also realized that all those squiggly lines have become somewhat second nature to me and the class did not feel overwhelming like the first time.
• I started the ECCO (electronic critical care online) program through the American Association of Critical Care Nurse (AACN). This has been a challenging and rigorous course, but completely applicable to my work. I feel like I am in nursing school again, but at least I get a paycheck with it and a lot less tears ;)
• We are officially moved into our new home! I'm a mile from the hospital, 2 blocks from hiking trails, and 1 mile from downtown. On Saturday I went paddle boarding on the river with a coworker from the SICU and her husband and we finished the day at Boise Fry Company (the yummiest fries I have ever eaten). It felt like a "typical Portland day" and I slept the best sleep I've had in half a year. It was awesome.

Off to unpack some more boxes...

Relocation: Boise!

It's officially started: Tomorrow is the start of general orientation at my new hospital (same hospital organization, but new city and bigger hospital). I am soooo incredibly excited and I have big dragon sized butterflies in my stomach all at the same time!

I have my note book ready, my business casual outfit set out for 2 days of boring hospital admin stuff, and then scrubs for 3 days of nurse orientation with simulation! After that who knows what my schedule will bring. Hopefully I'll be moved into our new house by the end of the month too!

A little information about Boise itself for those who are unfamiliar with the area:

• Population: roughly 210,000....the largest city between Portland, Oregon and Salt Lake City, Utah
• Climate: semi-arid climate with 4 distinct seasons....today's weather: high of 94F and low of 64F. 
• Pronunciation: Boy-see....the locals will slap you for saying Boy-zee
• Activities: Boise Downtown (BoDo), Idaho Shakespeare festival (outdoor ampitheater that has plays all summer long), the Boise River for floating/kayaking/rafting, the Boise Foothills for hiking/biking (considered the "foothills of the Rocky Mountains," and Bogus Basin for skiing/snow shoeing

Sage brush sunrise

I live a blessed life where I see both sunrises and sunsets every day that I work because I am awake for both. My last night at work this week was crazy busy and I came off my 12 hour shift with a big dose of adrenaline, so on my drive home I stopped and snapped some photos along the way.

sunrise in the side view

sunshine in color, review mirror

sage brush sunrise


"Keep your face always towards the sunshine- and shadows will fall behind you"
-Walt Whitman

How I now feel about birds.

This is also part of my 4 night stretch adventures. 

The small birds outside my window drove me absolutely crazy. 

This scene with Zooey Deschannel captures my sentiment precisely!!!

After 4 nights on....

I will sleep anywhere!!!

The Goldilocks' shift and 2 pairs of Danskos (eeek!)

Friday night was awesome. My biggest complaint on night shift has been that it has been too slow. I realize that I sound a bit like Goldilocks- day shift was too crazy busy and night shifts have tended to be too boringly slow. Friday night was my Goldilocks night where everything was just right.

I had 3 patients. I transferred one upstairs, admitted one from the ER, and worked side by side with my favorite doctor who was admittedly looking a lot like a zombie from lack of sleep. My coworkers were a set of ladies I had not worked very much with yet and discovered that together we made a formidable team in the IMCU helping one another out all night. It was great to feel both supported and to know that I was helping my coworkers out equally.

By the time I looked at the clock it was already 0430 and I rushed to finish interpreting cardiac strips, download vital signs, finish noting orders, and be in time for my 0600 meds. By the time I finished giving report and clocked out at 0730 I was running on adrenaline that even after my drive home I was feeling great. The sunshine, that has previously missing from my life for the last 3 months (I didn't see it on day shift either), was glowing in a blue blue sky. We had pumpkin waffles at my in-law's for breakfast and then my darling suggested we drive to Boise for the day to spend our Xmas gift cards.

Much to my delight I got 2 pairs of Danskos - one orange with leaf prints and one dark cherry red (both sparkling). Interestingly enough I found them at two different farming stores. Shopping for Danskos in the middle of cowboy boots is pretty entertaining, but makes sense in the fact that they are all made of leather and last forever. My orange ones were from a little store, Flynn's Saddle Shop of Boise (gift certificate location #1 and they carry the shoes at much lower cost than anywhere else). The staff was super sweet and got me all the size 38s they had available in their small selection. Since Danskos are hand stitched even though the sizes are the same, the fit is not always equal. So after much deliberation I found my 'Cinderella slipper.' Since none of the other 38s fit quite right it was then onto D&B supply to use gift card #2 where I found the dark cherry red pair that remind me of the Wizard of Oz. Although I'll keep my black Danskos on hand, it's nice to feel like I have outgrown them for work!

We ended the delightful day of shopping (don't worry- my hubby got to do his very own shoe shopping with his REI gift card for hiking boots) with dinner with hubby's brother and sister in law and our nieces and drove back under the stars. It was so great to spend time with family, get out of the house, see some sunshine, and then sleep a well deserved 12 hours when I got home.

Happy New 2013: car payments and moving!

Yesterday was spent test driving cars. My honey and I have happily lived with only 1 car for the last 5 years. However, since we no longer both work in the same town that was bicycle friendly (like we did in Moscow, Idaho) and we no longer have access to public transportation (like we did in Portland, Oregon), we have come to face the harsh reality of considering a new car purchase. Since I get the commuter car to go the hospital in the next town over this leaves my hubby without a vehicle. This is an issue on weekends especially where he would rather go skiing at Bogus or Brundage while I'm working my 12 hours shifts.

It was snowing and twenty degrees all day yesterday, which meant it the most excellent day to test out the small SUVs that we have in mind. What was even better was that each car salesman was happy to point us in the direction of an especially icy road to show off how great their vehicles handled the snow and ice even without studs on! Having never gone car shopping, this was actually pretty fun! Thanks to consumer reports we narrowed our search down to 6 vehicles to take out for a spin yesterday. This gave us plenty to think about in the coming month as we figure out finances for a new car payment. Ugh!

Meanwhile, we have decided to stay in Buhl. This means we will be moving into a nearby duplex soon once all the repairs are done. I have been so thankful to live with my in-laws, however, I know I become an absolute monster when I switch to night shifts as I demand absolute silence when I sleep during the day. I flip at the end of this month (yessss- no more 5am alarms to get up!) and hoping that we can have our new place arranged and homey by then.

As for today - it's a day to play and enjoy the winter time as we reflect on the year behind us and the year starting.

P.S. For your enjoyment here is a photo of Brisbane enjoying his winter holiday in McCall. He's in a dingo snow hole here.