Friday, March 23, 2012

moose, moose and more moose!!

i never bore of moose. they are just so dang adorable. this pair was in the bog. still playing catch up with my pictures. took more moose pictures at the dog park today and have the ones i took out at the coastal refuge to load in. happy to be off work for a few days. work was rather enjoyable the last few weeks. one night i could have skipped, but then my tolerance for the parents of chronic care kids wears thin in short order. above is one of blossoms tennis balls that was lost to university lake. no way to retrieve it once it slips under the ice. i'm sure if they ever drain the lake they will find several thousand tennis balls.
but back to the chronic kids. it doesn't happen to every family with chronic kids, but i've decided to name it CPS (chronic parent syndrome) it really should have a place in the psych texts. like i said, it doesn't happen in every case, but when it does it is not an easy thing to deal with as a health care person. i've decided that these people dedicate thier entire lives 24-7 to the care of these extremely delicate and chronically ill kids. if they were to be able to just drop them off at the hospital and have us take just as good a care of them then, what is the point of thier lives and sacrifices. therefore, ergo, they contstantly have to prove how much better they are with this kid, or how bad you are or just control each and every aspect of the kids care. battle of the endotracheal tube. breathing tubes have been known to be removed by patients who awaken just enough to yank it out. most people are chemically restrained with drugs and often physically restrained to prevent this. i am zero for thousands of patients in accidental extubations. i was not thrilled to have a parent who constantly untied his kids restraints and then would forget to retie them. you know who would be to blame. you just have to chose your battles with these parents, as they can be nuts. then you act like they are the most amazing people and they do the most amazing things for thier kids. one night was enough for me. i begged for an assignment next two nights i had super nice families and patients. interesting cases as well! the one kid is so wonderful and compliant. i mean anything i taught him he needed to do to aid in his care he was all over it. patients do have some control over outcome. early ambulation, good coughing and deep breathing are basics that i often can't get adults to do so always amazing to meet a teenager to willing to absorb information and put it to use. families were both hmong. we have an increasing population of hmong in our community. actually for a city of less than 300,000 people we have a huge variety of ethnicities represented. it's actually quite cool. i can't recall exactly but our school district has to deal with over 100 different languages.
many people in the united states are not really aware of the sacrifices the hmong people made during the vietnam war. many lost thier lives in the war often saving lives of our servicemen. for thier sacrifice they have been taken in to our nation. should go read more on this so that i have a better understanding. this guy here was at the dog park. saw three moose there today. a mom and baby were tucked into the woods just off the trail. i mean like 10 feet off the trail. i was able to leisurely walk past them twice in my looping. they did stand a few minutes after i passed. the one had to pee. the dogs and moose are in pretty close proximity and yes a few dogs get kicked here and there. moose will get aggravated if a dog tries to rush them and barks at them. in general, my dogs and i have been able to pass them fairly easily. you do get good at gauging what the moose mood is. i'm guessing moose that hang out at a dog park are pretty accustomed to the interations. a few years back a moose delivered twins at the dog park and then kept them in that area for at least 4-6 weeks. i decided the moose knew she could fend off the dogs and the dogs tend to make the bears stay away. so smart moose i think. so my bog and university lake moose are jumbled up here. above dog park, below bog. have been to the bog a few times this week but haven't had much moose activity.we had a few float nurses from the neonate icu. a pair of travel nurses. we all had a lively discussion about medical ethics and the nicu. always interesting. i love that stuff. as with all areas of medicine the general public doesn't seem to have a realistic expectation when it comes to outcomes. nicu's try to make younger and tinier babies survive. people spend alot of money getting pregnant and they want a baby at any cost. even if it means the baby will have many medical issues and maybe not live a very healthy or happy existence. gods will....we always hear that. i'm thinking more and more that the real test is if people will be selfish or respectful of the life that they have been given. i think god will be asking people why they didn't just cherish the life they were given enough to let them pass with dignity. there is a frightening bill headed to our state. apparently some right to life dude believes that everyone should be given cardiopulmonary resusitation if that is what the family wants even if the patient is totally terminal with no hope of survival. they say you can't beat a dead horse, well you can, but the horse will still be dead at the end of the day. it's so frustrating in medicine now that people who are emotional and have no medical training are telling us when to stop cpr on thier families. we ask them, "is it okay if we stop now, we've done everything we possibly can". with this bill it sounds like cpr can go on for hours. it's pointless. cpr is effective at times, but not as often as people think, unless it's a witnessed event and a team is right there. sadly, even in those situations though we can bring a heart rhythm back that doesn't necessary grant success. my mom required a short burst of cpr during a surgical intervention to get her dialysis catheter working. they broke 8-9 ribs, due to this she had to sleep in a chair and had a great deal of pain. being diabetic this meant that she got stasis ulcers to her lower extremities requiring further care. she passed away within a year of this traumatic event. once she told me she wished they hadn't resuscitated her. a huge proponent of the bill is a woman who's husband had terminal brain cancer. he'd made himself a dnr ( do not resuscitate) but it sounds like when his heart actually stopped she wanted to change her mind and the doctors refused to do cpr as he had a terminal condition, it would have been a total act of futility. at some point reality needs to rule and death should be accepted with some semblence of dignity. we are losing our ability to die with any dignity. i've been in many codes and believe me, there is no dignity in it. cpr is worth doing in some circumstances, but our nation is insane with this right to life stuff and quite crazy with what they all seem to believe god wants. above is a sure sign that you are at the local dog park. the snow is yellow everywhere there. i'm hoping for a fresh coat of snow tonight just to clear up the joint. of course, when i suggested this to a few regulars at the park, they weren't too keen on the more snow idea. not sure why. haha!!caught this moose in a compromising situation...she's peeing. she kinda looks pissed, probably shouldn't post pictures of moose peeing, but what a great face!here she is just a few feet of the trail. below is a tennis ball that has been horribly violated. will be sending this to the PETTB (puppies for ethical treatment of tennis balls) headquarters and perhaps things will change soon for tennis balls everywhere. i make myself laugh even if others don't find me humorous at all. laundry day. has to go switch em out. do love sleeping on the clean sheets. still impossible to make the bed without blossom deciding to help.meltage below in the driveway. of course at nights it's still dropping down to 0F so chilly mornings getting off work. another court case of interest i read about. a man was diagnosed with esohpogeal cancer shortly after marrying. they opted to put some sperm in a bank in case he was made sterile by treatments. at some point he improved and they had one kid the old fashioned way. the guy passed away at some point and after his death the widow became impregnated via the sperm bank sperm they had. the first child was entitled to the deceased man's social security benefits but in the end the supreme court ruled the twins born almost 2 years after his death were not entitled to the same benefits. above is from my drive home this morning. just thought the sky looked pretty!not sure what lena and amy were up to over on thier side of the unit...but it did look suspicious. we had a great crew last night. i love a no drama group! another night i was informed that someone was bitching about me out on the floor. i find it's best to just confront people. i'm all into the confrontation bit. i think i just said something like, i hear i got your feathers ruffled and you out here talking smack about me. best to just get shit out there and over with. usually it's been made larger than it needs to be and i think we all need a little reminder that the stuff we say is heard and can get back at people. you have to be careful who you rant to. some bird activity in the bog. funny as i was looking at a norway blog i like to check she had a very similar picture. norway seems to have many similarities to the life here. anyway, there is no use getting your panties in a bind when you find out someone has been talking about you behind your back. i mean we all do it from time to time. for me though, i find that if i'm saying it to someone else, you've already heard it from me. no surprises that way. i wouldn't bother confronting someone if i didn't actually like and respect them. though i did make a few comments to another person who i know was ranting about me one night i was off about my schedule and the fact that i go between the two units. it soon became clear that she is upset that i do all my required weekends in the adult unit and not the peds unit...but the fact is for years she's been able to not really do any weekends at all so really she wanted to screw up my life in hopes that she could stay weekend free. the funny part is that i never really pay attention to what others do but since she made the big stink about me it became clear to everyone that she doesn't even work any weekends. so i saw her with the schedule and i of course made a few comments. just wanted to let her know i knew about her ranting and also knew that she doesn't work her weekends. rio has such a huge, floppy neck. usually when she is out and i take pictures of her she has her collar on and when she is at home and i take pictures she's sleeping and you can't see her neck.anytime you work closely with others stuff comes up. i've been on the bad side of the nastiness enough to have learned that the best way to deal with it is to not be afraid to confront and nip the stuff in the bud. i think when you are not afraid to confront it makes people think twice before talking to just anyone about you. we all have to bitch and i know i tick people off and they tick me off, but you have to have friends you trust to bitch to. i'd really rather not hurt peoples feelings. the bottom line in this case was i had said something that ticked off the other person. i'm not perfect, but i do prefer people just confront me, rather than make something trivial a deal. of course, i'm rambing on...enough of that!!blossom often climbs under a tree, snaps off the little twigs at the base and makes herself a little fort. she is so cute!haven't done much social of late. will have to make some actual plans for my days off with actual humans. not that the dogs aren't good company, they are. since i'm makin up songs for them it may be time to interact with the other humans.wait, here is proof of human interations! maddie and tanya joined me on a walk over spring break. i think maddie only did it for the cupcakes i'd made. she loves that i make cookies and cupcakes and stuff with actual sugar in it. she's all cute and colour coordinated!!been in a boggle mood. need to sync my phone and get the earthquake app on there. we get tons of quakes up here. you can set it up to let you know zone to report and to report over a 3 or 4 or whatever you desire. everyone here seems to have the aurora app. always looking for a cool new app. the games are so awesome for if you are stuck in line or have to wait anywhere. you just no longer care. wish the batteries lasted longer. i'm sure the games use up loads though.alicia joined me for the monday walk over spring break. she is a new travel nurse in peds icu. great to get to know her. she's lots of fun. i think she is enjoying her time up here. hope she extends.blossom goes deep to recover a tennis ball that sunk into the deep snow.they found a body out somewhere. everyone is looking for a girl who was taken from a coffee shack. she hasn't been found yet. often bodies turn up after the melt, but more often they just don't turn up. the body was that of a man though. not sure what happened, finding the body does help an investigation though so hopefully, whoever killed him gets thier justice. just before i moved to anchorage from ketchikan we had a travel nurse in ketchikan i worked with. i saw him a day or so before he left ketchikan. we were both out hiking. we chatted and he was telling me how excited he was for his next assignment. i think it was bethel or nome or something. he never showed up. they never found his body. that was back in 2001. so sad. doesn't look like we will ever know what happened to tom, but it looks like foul play. i do find myself wondering whenever they find some bones out there. there are enough wild animals in this state that bodies that are ditched out in the wilderness get scattered and devoured pretty rapidly making for lots of unsolved cases. this place is huge and people disappear. well, on that lovely positive note i shall head to my fresh sheets for a night of slumber.

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