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Tuesday, November 30, 2010

those who sleep in our house sleep well

My friend Ange said to me the other day, "Are we the only people in the world whose 3 and 6-year-olds still get up in the night?"

Not very helpfully, I told her I think we are.

Ella has been increasingly scared to go to bed at night. I know this is all very developmentally appropriate but it is still heart wrenching and downright frustrating when you spend 30 minutes reading, soothing, relaxing and snuggling a child for slumber and then have them freak out the moment you go to leave the room.  The easier softer way?  Stay with them until they fall asleep.  Problematic?  You betcha.

The next easiest, hopefully less damaging, more manageable path we have been taking?

"You can come in our room in the night if you are scared."

Sure, no sweat.  Maybe once or twice a week such an event would occur and to have a snuggly warm body scooch in between her favorite people on earth and sigh with deep contentment was really pretty sweet. 

But now I think Ella sets an alarm so that she doesn't miss her nightly scamper across the hall.

Her entrance is more noticeable, her requests more demanding, her failure to bring her own pillow and be sent back for it more disruptive, the kicking and perpendicular position in the bed more maddening.

But can you imagine (or remember?) how comforting your parent's bed, especially with them asleep on either side of you would be??  It is this imagining that has me allowing it night after night.  Plus I want my sleep and this seems the best way to get it.

For her part, Maya can be persuaded not to wake at 4:30 or 5:00 AM if you lay in her bed with her.  I literally tell her to lay down, that it isn't time to go wak up yet and I think she must be too asleep for her will to set in because she DOES IT.  Lately she has been sleeping until 6:30 or 7 AM.  This makes for a better night and day for all involved.

But can you picture it?  Awakened at 2 AM for Ella's entrance and bedding down and then Maya's a mere 2 to 3 hours later?  And then to get myself dressed and settled in Maya's bed and get back to sleep... I think, what is this mad version of musical beds we've got going on here???

Sometimes when Ella comes in I just go right into Maya's bed so I don't have to be woken twice.  Good grief I'm so glad Sandi lobbied for the top of the line pillow top mattresses for the girls.  Maya and I may be squished on that twin but at least I'm comfy.  And there is something about a warm little body curled into your belly that is irreplaceable.

 I tell myself they won't be little like this forever...and if I don't sleep they won't live to get big enough to outgrow our bed or me theirs.

But then you come along this sight in the middle of the day and you can't help but burn with resentment.

6 going on 14

Belatedly...some pictures of Ella's actual birthday which started with a visit from Skyler and Belgian waffles (how can you not like ice cream for breakfast?).


After school (and a little cupcake celebration there) she came home to open some presents and have pizza and cake with some of her favorite people (the Smith's, of course).  She had asked for a "purse- pink with large flowers on it."  I found this Vera Bradly bag on clearance and thought it fit the bill.  Tricia saw it and said, "VERA BRADLY?!?!?!  I WANT THAT PURSE!" 

And around her neck, to celebrate the spirit of the beloved "Annie", we bought her a real silver locket with her name engraved on it.  She had picked out a super cheapo one at a mall store and she had asked for it for her birthday but we decided at six it was time for some real jewelry.  It has pictures of Mommy and Momma on one side and Ella and Maya on the other.  As a result, Maya runs around the house after her asking, "Can I see the family in your necklace???"

Cake time:  Brady trying to get Ella to smile, Maya just being a wacko.
Time for candles and a wish...
I wonder what you wish for when you turn six...

Wednesday, November 24, 2010

pahr-tay

We had the girls third and sixth birthday parties at the Maine Discovery Museum this year.  With birthdays only 3 weeks apart, this strategy has worked for us thus far but I wouldn't be surprised if this is the last year. As Ella said at Halloween, "Do I HAVE to match Maya again next year?"

The thing is it just makes good sense to have one big party since all the same people would come to both, 3 weeks apart.  But I get the whole individual identity thing and very soon more self-choosen school friends so I guess I should budget for two parties next year.  The truth is, I love parties.  I love throwing parties.  Kid parties?  They make me break out in a cold sweat. This two-fer has been a saving grace- a party on steroids but 3 hours later, it's all done.

 This is Ella with Allie and Brady.  The three of them were some sort of possee in the 3-4 year-old class at Highland Preschool 2 years ago. (And yes, it felt as bizarre to write that as it did to read it.)
It was a zoo trying to make sure 14 kids were supervised (many parents were there but we did have our first drop offs!), kids weren't excluded, feelings weren't hurt and Maya wasn't in holed up in the pretend doctor's office performing illegal strep tests with lightbright sticks.  Many times I commented that I felt like I needed to go home and have a beer (we did.)  Near the end, my sister looked at me and said, "You look like you need a drink."  (I did.)

In truth, some unusual things happened at the party.

First, new talent was discovered.



Already demonstrated talent took a bigger stage.

(If anyone has been burning with curiosity about what I looked like when I was a child, look below.  Headband, microphone, singing.  All that is missing are the fishnets and legwarmers.  So in other words, only the fishnets.)
We had a baby driving a Vespa,
a 2-year-old driving a mac truck,
and a seven-year-old captaining a freightliner.
Reedo somehow got wind that we would be serving lobster at the party and he was going to have some come hell or high water.
Skyler got stuck in a wire bird nest...
and Superman made an appearance!

Sandi's co-worker Jess made this amazing cake. (If she had a website I would insert it here.)  It was beautiful and tasted just as good as it looks.

Who would expect anything less from Maya?























And then, all sugared-up on to some more fun...


There are a lot of things to be grateful for in life: having a roof over your head, food to eat (especially if that food is Sandi's homemade cheesecake or popovers hot from the oven), amazing friends, exceptional wine (especially if it is Ange's homemade wine), a kick-ass run, a cozy fire, healthy, capable bodies, someone else unloading the dishwasher, first snowfalls, dinner made for you, holiday music, pain medication, hot showers, the perfect cup of tea, sisters, a kiss from your beloved after a long day, the smell of your child's hair when you pull them in tight for a nightime snuggle, a really good sale on running clothes, new shoes, hearing your favorite song, REMEMBERING a funny joke long enough to tell it, having flowers delivered to you, sleeping in (till 7 am), the push of the first spring crocus...you get the idea.

New on my list:  a successful DUAL birthday party.  Phew!

Monday, November 22, 2010

STRIKE

As most of you know, Sandi is a critical care nurse at Eastern Maine Medical Center. Things at EMMC are in pretty dire straights right now as nursing contract negotiations (which began in July) have hit a stalemate and, as a result, the nurses are on strike today.

I'm not a nurse but I have the honor of watching one of the world's best nurses get toasted from over extension in a job that already requires massive amounts of giving.  I have had the privilege to be cared for in the hospital by some stellar nurses who went above and beyond just completing tasks of care and instead actually took "care" of me.


EMMC decided it wouldn't be worth their while to replace nurses for a single day and so they locked them out this past Saturday and Sunday.  Nurses were considered trespassers if they showed up on hospital grounds and were written up as such. Guards stood at the door to escort the last of the nurses out in preparation for the lock out.

Those nurses are dangerous indeed.  Hard telling what a bunch of super smart caregivers will do when they want safer working conditions (i.e. more nurses) to care for sicker and sicker patients, and reasonable health insurance from an institution whose business is health care.  Hard telling.

Sandi, in addition to losing pay from the lock out, has been really frustrated with the whole situation, feeling that both sides are asking for too much.  It has been difficult, hostile and insulting to pick up the newspaper and read some of the ads the hospital has paid for misrepresenting the nurses.  While there is much community support for the nurses, as a result of EMMC's spin on the situation, many community members are attacking the nurses for being selfish and greedy.

Yes, those greedy nurses who want more staff. What will they want next, pedicures at lunch time?  Oh, wait!  They barely get to eat lunch, or pee, or sit down in 12 hours...

Sandi wrote a letter to both the hospital administration and the nurses union.  She has sent it wherever it would be read, hoping that both sides will realize the need for a middle ground. Here is an excerpt:



I won’t pretend to understand what each aspect of healthcare costs these days.  Nor do I grasp the magnitude of effort it must take to ascertain balance regarding income vs. expense, necessary vs. unnecessary, “employees” vs. “owners.”  I am an owner.  This is my hospital.  These people are my family.  These patients are people I love and care for.  I understand healthcare at the patient-care level.   And that is from where I speak.

I understand that it is unfair to ask for staffing ratios that are different than what they are.  I do not believe that is the answer.  The way things operate are adequate from a numbers, paper and pencil viewpoint.  But at the bedside, they are not adequate.  The nurses are right in voicing concern.  Most of the time, we as a hospital, can get through a day, appearing successful.  It is not safe, adequate, or “patient-first” in any way when floors are so overwhelmed that their resource and charge nurses are pulled to take assignments.  Acuity fluctuates, census fluctuates, nursing availability and expertise fluctuates.  Access to resources fluctuates.   And we are adaptable, but we cannot expand to be more than what we are in numbers.  We don’t have enough resource at times to expand to what is required.

When I am in charge or acting as resource, it is not uncommon for a “floor” patient’s health to take a downward turn… and for them to spiral quickly if not attended to promptly.  The resource nurse covers the ENTIRE hospital and is often tied up in tests, other RRTs, or with a critical patient in the unit.  If a critical care bed is not readily available, then the patient on the floor stays on the floor.  And if that floor happens to have pulled its resource and its charge to take an assignment, someone’s or several someone’s care is compromised.  And I see the floors.  They are overwhelmed with tasks and documentation.

In my opinion, a nurse’s best assessment skill in forboding illness is instinct.  And a nurse has to have a pulse on the situation prior to any instinct kicking in.  Assess, assess, assess…  and then assess some more.  That’s how I was taught.  On a “normal” day, the floor nurses likely have time to do this.  But on more days than should be happening, the nurses are overwhelmed and expected to expand beyond what they should be.   When a resource nurse on the floor gets pulled, the charge nurse is the fallback.  When the charge nurse has an assignment, the housewide resource is burdened that much more when he/she is responsible for the entire hospital.  That’s when patients don’t get lasix in time and come to the ICU in respiratory failure.  That’s when patients turn septic and instead of being treated in “warm,” compensated shock, they are on their way downward into uncompensated territory, on pressors, and destroying organ tissue.  That’s when peminic reports are filed because unnecessary med errors and falls take place because there isn’t enough time to get to everyone’s needs.

I know it must have been budget driven to change our numbers the way it happened last year.  And likewise, the switch from 8 and 9-hour shifts to 12’s must also have been related to money.  I understand that.  But what I don’t understand is that when nurses say, “this is unsafe,” how is it possible that nobody is listening?  And if anyone is listening, does anyone believe it?


I, personally, have worked week after week of extra and overtime.  I have been in charge when we’ve been scheduled short the next shift and spent hours calling on the same people over and over to find someone who will work extra to fill in the void.  We will stay hours into the next shift to cover patients who would otherwise not have proper coverage.  Our fallback is our department head nurse, who will reliably come in and bail us out by working the ICU or PICU.   It should not be her responsibility to work above and beyond her hours on a consistent basis.

We need a bigger pool of resource from which to draw in unsafe situations.  Charge nurses need to step up and say when situations are unsafe.  Department heads and administration need to know when this is happening.  Attention needs to be placed on patients primarily and on tasks/documentation second.  Nurses need to eat.  They need to breathe fully.  They need to be relaxed enough to make safe assessments and decisions.  It has become far too common for nurses to work through lunch, barely look up during the day, and then go home sore and exhausted- physically, emotionally and spiritually.   We, as nurses, have accommodated the downsize, in shift to shift expenditure, in extra time and overtime.  We have accommodated census fluctuation in pulling from every last resource available.  But it is not safe or healthy.    Ratios are not the answer -acuity changes too much.  The resources available need to be there.  I personally don’t want to float to other units.  However, if we are going to be paid for the time, I would rather be on call to help a unit that is barely afloat than sit at home oblivious.  I don’t know the pool nurse situation floor to floor, but in my opinion, there need to be more available pool nurses when necessary.

A whole is greater than the sum of its parts.  Our parts are operating more independently than they should.  No, a pediatric nurse should not be expected to assess a full assignment of post-op heart patients, but that pediatric nurse can be of help as a resource or with low acuity patients.  I am asked to help in the ER in overwhelming or extraordinary circumstances.  I don’t know the ER or its world, but I am a nurse, and I can offer help of some sort.  The nurses need to give a bit in this arena.

I don’t know the solution, as I don’t know what kind of financial commitment is involved in hiring more nurses.  But I do know that we are the second largest hospital in this state.  We are a level II trauma center.  The people who arrive and stay in our institution are sicker than they used to be.   With the complex nature of the human system and ever advancing practice of medicine, we cannot expect to do more with less when it comes to the nurse. 


 (I love you, babe.  You'll always be my favorite nurse. I'm super proud of you for standing up for what you believe.)

Sunday, November 21, 2010

apple (suz)

To try my hand at canning again, I decided on a food we all love.  A mom must capitalize on a universally loved dish that pleases the whole family, is yummy with a meal, as a snack, packable for lunch, and can even augment dessert.

Nothing less than good 'ol fashion applesauce.
I bought 1/2 peck of apples (how you can resist buying something that is sold in pecks?) from the nearby apple orchard.  It is WAY cheaper to buy "drops", the apples that have already fallen from the tree, when you want to cook with them which is exactly what I was planning to do with these cuties.

The girls and I got an early start to the day and so we got right to it.  Using our "apple peeler-corer-slicer" (which does all the above) from LLBean (I think the name was changed to "Apple Thingamagiger" after the other was too big a mouthful) we got the apples ready for their steamy bath.

Apparently wearing a tiara makes for better applesauce.
Next step: boil.
Then puree and boil some more.  Get it so hot that boiling spatters of applesauce are endangering your eyeballs.

Then jar and hot water canner according to strict methods from the Ball Blue Book (see below).  You may need an Ativan or a stiff drink so that the stress of the exactness doesn't get to you.  I recommend having another adult around so keep children related distractions to a minimum.

San came up with the corny name (I love it) and the labels (I love them too.)

pickled

I decided that this year (in addition to being able to do 5 pull ups- a goal I likely won't fulfill) I would learn how to hot water can.

I can can, I told myself.

After some haphazard trying with just a collection of information in my head and some desperate, in the moment texting to my friend Chris for boiling times and clearance amounts, that it was time to purchase the Ball Blue Book- guide to preserving.  Alternate title: The Bust Your Balls Book.

I imagine this book written a gaggle of no-nonsense early 1900's grandmotherly housewives sporting gray buns (of the face-lift nature), glasses atop their noses with beaded chains dangling down and making sharp tsking noises when ever one of them stepped out of line (such as suggesting it would would more healthful NOT to add 6 cups of sugar to a batch of jam.)

To give you an idea of the tone of the book these are some of the words and phrases used throughout:
"never","accurately","must","required", "followed exactly", "not recommended", "not interchangeable", "not reliable", "must be avoided", "check all equipment a day ahead of time", "carefully", "use only", "cannot be properly fitted", "inadequate", "failure rate is very high", "essential", "follow recipe guidelines as stated" "do not make substitutions or changes to the recipe or method", "must be followed exactly." These ladies take rule following and botulism SERIOUSLY.

I FINALLY learned the difference between jam (made by cooking crushed fruits with sugar- firm, but spreadable) and jelly (juice strained from fruit and then thickened) and marmalade (soft jelly with pieces of fruit suspended throughout.)  Don't you too now feel some part of your life is complete with this knowledge?

Well, I don't know about you, but I LOVE to be told what I am doing when I cook.

Nevertheless, I embarked with my little old ladies in an attempt to make bread and butter pickles.  They would have disapproved heartily of my willy-nilly approach.   I could hear the heavy sighing and tongue clucking of my imaginary critics but I persevered.

First, you cook a batch of pickles on the stove, heat it to boiling (on a thermometer, not just bubbling- turns out that boiling can be a good 10 minutes after bubbling), funnel pickles into hot waiting jars to 1/4 inch clearance, push out air bubbles, cover with heated tops to make rubber seal stick, screw on lids and drop into waiting boiling canner.  Boil for 20 minutes and try not to end up being Lifeflighted out of your kitchen with 3rd degree burns as you extract the cans from the boiling water.

I don't think I did too badly.  They tasted good.  We heard the POP! as they cooled which confirms a vacuum seal.








I guess we will find out this winter when we eat them if we will die of botulism!

Tuesday, November 16, 2010

eradicating morning stress (trying to anyway)

This is Ella with her new chart.  It's called "Are you ready to go Ella?"   It seems overly simple but it totally works.  The idea is that she checks the boxes to indicate completion of each task but the chart serves double duty- we no longer have to nag at her and tell her which step to do next. 

(I have to say that this was my idea in response to a conversation Sandi and I had about morning stress and nagging.  Then I saw it on the Today Show as a suggestion to cure morning madness.  I asked Sandi if she would do it and she made Ella the perfect chart- exactly how I had imagined it.)


There are a lot of steps to get ready for Kindergarten!  Now if we can just train Maya to do as we say we will be ALL set. (So in other words, we will never be set.)

Sunday, November 14, 2010

things that make you go hmmmmmm

Skyler is a super creative girl. She loves to cut, color, collage, stamp, staple, paint and probably has even done some stenciling and made a couple Martha Stewart Christmas ornaments.

That being said, it still caught me off guard when she discarded this piece of paper as a failed attempt to cut out a butterfly.

Now, we don't see a whole lot of this sort of thing in our house but I'm fairly sure I know what this looks like.

We never saw this coming...

In addition to eating turkey sandwiches with chopsticks and demanding "It's a Hard Knock Life" while it is already playing, Maya now dresses in this dress (Ella's) and dances around the living room to "Together at Last" from Annie.




Saturday, November 13, 2010

artsy

In a momentary lapse in synaptic firing, I failed to post this photo Sandi fixed up of our flapper get ups.


We might not travel to Italy but we can pretend.

Wednesday, November 10, 2010

Maine Coast Half Marathon: ending the running season on a high

I'm not entirely sure why I am so in love with the York all women's half- marathon.

(Okay, never mind.  I just figured it out.)

There are parts of the course that are utterly breathtaking, 3 loops which is a nice way to break down a run, nice spectator support along the beach and then there is the all women (and one lucky guy) part.

Ella wasn't so convinced.  We had an iffy 2 1/2 hour ride down at 6 am and when the bitching and moaning started from the back seat (the popcorn had run out, the movie was over and the car sickness started) we had to question our judgement.

A snapshot of Ella's frame of mind:


The course is centered around York beach, a gorgeous spread of sandy beach.  The tide was higher than normal and the surf intense making the waves crash up onto the course and sometimes onto the runners. It added a whole adventure element to the already blustery 40 degree day.
Pre-race meeting.  This being the last race of the season, new matching shirts were in order.  I LOVE this Asasics shirt and am actually wearing it as I write this.  This was one of a handful of runs where my clothing choice was perfect and I was comfortable in my clothes the entire time.



The spectator section:


Susan set her sights high on a sub 2 hour race and she (essentially) pulled it off by running and amazing 2:01. Good work Susan!
  I had a really strong race. I felt good almost the whole time, smiling at the spectators and feeling so very PRIVILEGED to get to run in a race like this.  After having some really crummy runs in the past month, I was just to relieved to feel happy as I ran.  I have learned that a happy race = a good race.  My want is always to run for the JOY of it.  

I had unintentionally lost everyone at the start and ended up running the race alone but it was a good day for it.  I had great music, a stellar frame of mind and a body that felt light and able despite the nasty cough rattling my respiratory system.

I think one of my favorite things about this race is that because it is all women the course is lined with a ton of male support and often dads holding babies and little kids with signs "GO Mommy GO!

Mindy looking strong and happy!

Jen, Amy, Emilie and Christine having a running party.  Emilie had been sick for a week and was no where near good health and she ran the whole race in the same time she had last year when she was healthy.   Gritty, I tell you, gritty.
Check out the waves crashing behind Christine!
This picture has a one-word caption: ironic.

What we are all looking to see:
At the finish:
I had a PR of 2:13 and shaved a minute plus off my time from last year's race.
It's easy to smile when you can see the finish line!


The kids were mostly tired and cold and there was so much complaining we agreed they earned themselves a ticket to a grandparent's house.  But who can blame them?  Last year it was 70 degrees and sunny and they played on the beach. 
Here's to a great season girls!  What'll it be next year??
(Naomi: 1,000 thank yous to you.  I did it for the love of it.)