National Nurse Practitioner Week

Since I am a nurse practitioner, it has not escaped my attention that this week is National Nurse Practitioner Week. I know, I know. It seems like there is a day or a week or a month for everything. But since this is kinda my thing I'm actually paying attention to this one.


For those of you who actually use nurse practitioners (NPs) for your health care you probably know how aweseom they are. Of course everyhing depends on the person, but for the most part NPs are wonderful, they answer questions, take their time with you and are generally very patient-centered. I talked a lot about NPs in this post so I won't go to into it but I wanted to share with you what the US government and the American Academy of Nurse Practitioners (AANP) had to say about their growing (and important) role in health-care. The following is from the AANP's website.

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The United States House of Representatives recently honored the American Academy of Nurse Practitioners (AANP) and National Nurse Practitioner Week.

"It is a great honor for nurse practitioners to be recognized by the United States Congress. As the number of nurse practitioners increases, so does public awareness of the significant contributions made by this group of dedicated healthcare professionals," said Dr. Judith Dempster, executive director of AANP. "Nurse practitioners have differentiated themselves from other clinicians by focusing on the whole person when treating specific health problems, as well as educating the patient on the effects those problems will have on them.

More and more consumers are choosing nurse practitioners as their partner in health because, in addition to providing high-quality primary, acute and specialty healthcare, nurse practitioners empower patients to maintain and improve their health by providing individualized and comprehensive health education and counseling. Nurse practitioners focus on promoting health and preventing disease, which can reduce healthcare cost for patients.

"Nurse practitioners fill a vital role in American's healthcare system. There are over 106,000 nurse practitioners providing high-quality care around the nation, and they are especially important in rural and underserved areas," said Congressman Burgess, a physician practicing in Lewisville, Tx. "I have worked with nurse practitioners and certainly I learned a great deal more from them than I was ever able to teach them."

AANP continually advocates for the active role of nurse practitioners as providers of high-quality, cost-effective, personalized healthcare. Use this occasion to celebrate the vital role that NPs play in bringing high-quality, cost-effective, comprehensive, patient-centered, personalized primary care to all populations of the United States. The shortage of primary care providers is a hot topic in the healthcare reform debate. NP Week is a good opportunity to showcase the many ways that NPs are the primary care providers of choice for many patients and to let others in your community know about the value of NP-delivered primary care.

~Layne

Raina Vlogs

Okay, so I forgot to mention one pretty cute, crazy and hysterical thing that Raina does. Well, Brad and I think it's funny . . .

To explain this vlog here is some background: Raina loves going outside. We have to keep her on the leash at first so that she will focus on going potty rather than all the other wonderful distractions that the outdoors brings. But once she has potty'd and is at last granted freedom, she is in absolute doggy heaven. She romps and runs around, weaves in, out and around the bushes, barks at squirrel, birds, leaves and (her favorite) she hunts.

We aren't really sure what she is hunting but it certainly lives in the bushes and shrubs. And this hunting mostly consists of her diving , yes DIVING head-first into the bushes in search of her prey? Our best guess is that she's going after the lizards that scurry in every direction at her approach. What she will do with them when she catches one is anyone's guess. In fact I'm not sure even she knows. It's pretty funny to watch this hunt and probably the cutest part is how fast her little tail (nub) wags as she digs around into the bushes. You can just tell how exciting it all is for her. I guess it's nice to have a hobby! :-)

This isn't a particularly great example of her hunting prowess but it's the only video we've managed to capture.

Enjoy!
~Layne

Introducing . .

So I know this is random but there is someone who is a big part of my life and I think it's about time we've had a proper introduction, don't you? Her name is Raina and she is the miniature pinscher (aka Min Pin) that I adopted almost 6 years ago.

I was told Raina was "about 1 year old" when I adopted her so I just decided to make her birthday the day I picked her up, December 13th. I have had her almost 6 years now and I can't imagine life without her. She is can drive me crazy but I love her to death.

Without further ado, here are some fun facts about Raina:

She loves, loves, loves to sit on the back of the furniture. Usually she does this so that she can look out the window which is another favorite past-time of hers (trust me, she will find any window to peer out of). But even if she's not interested in looking out the window, her favorite seat is the back of our chair in the living room and she will happily curl up there to take a nap.


Another of her favorites, besides napping, which she does often throughout the day, is burrowing. She loves being covered up and if you don't offer to cover her up with something, she will go off and find something to crawl under. She often gets caught being in places and under things that she's not supposed to be!



Believe it or not, she loves to dress up. At first I just bought her sweaters to wear in the winter. No, it doesn't get very cold here in Florida but she's a little dog without a whole lot of fat so she does get chilly in the winter. So eventually she caught on and whenever we would say the word "sweater" she knew what it meant and got really excited. In time it morphed into everything from Gator shirts to Halloween costumes (those she's not as big of a fan of). Brad thinks I'm nuts but, hey, it's fun.



She also loves to sit in the sun. She will find any patch of direct sunlight (indoors or outdoors) and lay in it for hours. She will move every now and then to cool down but always goes back for more!



And finally she is a great snuggler. When she is not spending her time dressing up, guarding the house, laying in the sun or finding something to burrow under she will (sometimes) grace Brad and I with her presence.




I know there are a lot of bloggers and DOC-ers who have furry friends who find their way into the blog from time to time. So I thought it was about time that Raina made her appearance. Hope you enjoyed getting to know her better!

~Layne

D-blog day

Having not been a part of the DOC for very long I didn't even know D-blog day existed until, well, today! Truth be told, I almost feel like a faker. I mean, I want to be a part of the DOC. And I am qualified, seeing that I am actually diabetic. But my blog isn't always about my diabetes. In fact, it's not even mostly about my diabetes.

It's just about me. Saying what I want to say about my life and what I'm feeling at the moment. It's mostly a place for me to vent about frustrations or shout happy thoughts. Sometimes the thing I need to get out is about diabetes but sometimes it's not. So is that good enough?

That's probably a big reason that I don't have a lot of traffic. I don't really stick to a subject. But that's okay I don't do this for the traffic. I do it for myself. And the few people I have met and connected with over the blogosphere have been wonderful. I would love to meet more but the folks on the DOC all seem to be in the New England area. I haven't met anyone anywhere near my neck of the woods (Florida). But if there is ever a meet-up in Florida, you best believe I'll be there!

For me, the DOC is a place I can go where I know, without a doubt, that people get it. It's so funny to me to read things that a complete stranger writes that is something I've tried to tell my husband, my mom, my best friend for years and years. And then there is this stranger who I've never even met who gets it. Who thinks the things I have thought for 18 years. It's so weird but it's also so great.

And you know what else? It doesn't really bother me that my blog isn't always about diabetes. Because I'm not just my diabetes. I'm a lot of things and one of them is diabetes. And depending on the day, the diabetes part can be big or it can be small. So my blog takes after me. As it should.

So happy D-blog day from this part-time DOC-er!

~Layne

My day at work

Today (and yesterday for that matter) I took care of a very sick little boy who was dying. His family is going to withdraw life support tomorrow. Most people look at this as a horrific part of my job and I won't lie, it is awful. But whether I chose to work in the NICU or not, awful things will still happen. Even to wonderful families like this one.

Because I have this job, I went to work and spent all day Saturday and Sunday helping this family through what will be their last weekend with their son/brother/grandson/nephew. This little boy has spent every day of his life since he was born hooked to machines, lying undressed in a warmer, looking more like a "patient" than a baby. Knowing what was coming on Monday, this weekend I was determined to give the family back their baby boy.

I helped him have his first cuddle with his teddy bear, wrapped him in his first non-hospital blanket and today I surprised his family by having him dressed in a very cute onesie that a coworker helped me find. So when the family came to visit, they found their little boy dressed in his first outfit (that helped to hide all the wires and tubes), laying on sheets that were not hospital sheets and sleeping with his bear. I got two tearful hugs from two tearful Grandmas in thanks for the simple kindness of dressing their grandson. That is why I do this. That is why I love my job. How many people can really say they make a difference in the lives of others? How many can say they had the opportunity to help a family through the saddest of times in hopes of being able to make it the tiniest bit more bearable? How could I not be so incredibly honored and humbled to have that job?

Today I placed a grandson in the arms of his grandmother for the first and (probably) last time. I got to watch her rock her grandson, read him a letter she wrote to him and say a painful goodbye. And I cried right along with her. Those things that I did for that little boy today were tiny in the grand scheme of things. And they certainly won't change what will happen to him tomorrow. But it was my honor and privilege to take care of this baby boy and I can't imagine doing anything else with my life. Is this the fun part of my job? No. Did my heart break for this family? Yes. Did I spend most of my day shedding tears right alongside them? Of course.

But like I said these things will happen whether I do this job or not. My hope is that by choosing to do this I get the opportunity try and make horrible situations like these a little bit . . . What? I don't know. I can't say "better" because there is nothing good about it. But if I could give these people a few sweet memories of this boy. Take pictures, create a few special moments for them to remember, a chance to say goodbye in a way that may (hopefully) give them peace. . . I don't know what else to say. My job has the highest highs and the lowest lows. But even after days like today, I'm thankful for it.

Excuse me while I go hug the crap out of Brad and Raina and tell them I love them. Then I'm going to go to bed and have a good cry before I pass out, cause I'm freaking exhausted.

~Layne

Feeling Low

So I don't tend to wake up at night with low blood sugars all that often. But for some reason this week I seem to be going for a record. Multiple times I've woken up with low sugars and last night was the worst.

Before I go into any details let me first tell you about a very strange symptom I get at night with my lows. Most diabetics I know have trouble waking up to their lows at night. I never have, which is a good thing I guess. Instead my night time lows cause this weird version of insomnia. I do have the usual waking-up-shaky-and-drenched-in-sweat kind of lows but starting right after college, I found myself randomly waking up in the middle of the night, wide-awake, for absolutely no reason, no symptoms. I obviously wasn't well-rested because I'd only been asleep 3 or 4 hours. But there I was wide awake and unable to fall back asleep no matter how hard I tried. Eventually I got the bright idea to check my blood-sugar and lo and behold it was low. No familiar low symptoms, but I was still low. So I treated, my sugar came back up and I fell back asleep. I will say it's a very annoying way to find out I'm low because even though I am aware of it, it still usually takes me a while of tossing and turning to think to test my sugar. Again, because I don't feel low.

Okay, so yesterday I had been fighting off lows most of the day, mostly because I just didn't have much of an appetite. Before bed I felt that faint "butterfly" feeling in my stomach that I get at the beginning of a low and not at all tired. So I tested and I'm 84. I thought, ok, I'm awesome. My blood sugar is on it's way down and I caught it early, I'll treat and have an otherwise restful night.

Wrong! I went to bed at 11pm and tossed and turned for an hour and a half before I gave up and tried checking my sugar again. 48?!? So I guess whatever I did to the 84 just made it angry. I get up, drink the last dregs of milk out of the carton (for the protein) and then some OJ (for the raw sugar power). I go back to bed think, "Take that!"

And it worked. . . for about 4 hours. I'm up again at 4:45am but absolutely refuse to get out of bed. I don't really know why but I'd already felt cheated out of a restful night and treating the same low for a 3rd time just seemed like admitting defeat. So I tossed and turned until my alarm went off at 6am. And of course I checked before I left the house and my blood sugar was 62.

So I had the low that wouldn't die last night and tonight I'm freakin' beat. I really hope I can get some good sleep tonight to make up for it. Has anyone else out there found themselves fighting the same low off all night long? How do you handle it? Do you get angry and hide under the covers refusing to come out? Or do you act like a mature adult and get out of bed, test and treat? Just curious. ;-)

~Layne

Intro to Vlog

So this is my first official vlog. I made it weeks (months?) ago and never actually got around to posting it. Why, you ask? Probably the same reason I hardly ever post anything. Big ideas, good intentions, bad follow-through.

No more! That's what NaBloPoMo is all about. Changing bad habits, right? Right! In some ways I guess it's good that my follow-through sucks because it means I have a bunch of draft-posts to work with all through November. Procrastination (at it's finest) finally pays off!

Anywhoooo . . . this is from way-back-when all the DOC-ers were doing the purse-diving vlog. I absolutely loved watching everyone's vlog. Maybe it's the inner voyeur in me or maybe it's because I saw so many similarities between other purse-carrying diabetics and myself. But in addition to the similarities I saw the little differences in how others do things. It put me to shame, really, because I felt like I was way less prepared than the average bear, uh, diabetic.

So, without further delay (except for the usual disclaimer about incessant rambling and please disregard the fact that I sound like I'm 12 yrs old), I present to you my first vlog. Enjoy.

~Layne

Eye doctor

In honor of National Diabetes Month, I went to the eye doctor today. That's not really true, I always go this time of year but it sounds good, right? Anyway, the appointment was not too exciting, which is always a good thing. Still no signs of retinopathy. Yay! And it's funny because I had Lasik surgery back in December of 2004 and since then every time someone checks my eyes they comment about how great they look, that they almost can't even see the scar and what a nice job the surgeon did. Personally, I pat myself on the back a little for that one because who'd a thought a diabetic could heal so well?!?

The one little downer though is that even though I had 20/15 vision right after the Lasik surgery, it has slid a little in the last 18 months or so. My left eye is now about 20/25 and my right is about 20/50. (Keep in mind before the surgery my vision was about 20/450. Yep, folks, I was legally blind without my contacts!) The right one is the one that drives me a little crazy but I'm still going fine without corrective lenses. I keep a pair of glasses in the car in case things get blurry on the road at night but I hardly ever wear them. In the long run, I'm still very happy with my vision and my eye health.

Well, that's the most exciting news from my day. Hope you had a good one!

~Layne

It's Over!

That's all I could think as I drove home today from my interview. Well, I'm using the word "think" here very loosely because at the end of a long day that started at 6am with a 2 hour drive, consisted of meeting 20 million people, asking and being asked 50 kazillion questions and walking all over the two hospitals I was a little, uh, fried . . . to say the least. So I vegged out the first 20 minutes or so of the drive.

But then I got to thinking about today's interview and I also thought back on my previous interview two weeks ago. I had so much floating around in my head, comparisons, facts, people, place. . . I thought my brain might actually ooze out of my ears and onto Interstate 4 as I drove back home. Before I went on this interview I had really thought my decision clear but today the waters became very murky. I have two great institutions to choose from. Two great Level 3 NICU's that I have to choose between. (That is, if I am lucky enough to get an offer from both. But I do have to say I think I did really well on both interviews.)

So this looming decision weighed on me. How was I going to choose? Would I make the right choice? Then I thought of the past 2 years . . . had it really been that long? December marks 2 years since I graduated, full of hope and ambition. But that two years had brought some really rough times. An fruitless job hunt in Orlando, months spent in an NP position that ended up being completely unfulfilling and infuriating, the highs and lows of interviewing at my one hope at a position in Orlando and then getting turned down and then stepping down to a RN position just to regain my sanity. When it comes to my career, the last 2 years have been emotionally and physically draining to say the least.

And then it dawned on me. . . what a wonderful problem to have. And at that second I thanked God for the opportunity to experience this problem. A choice between two Level 3 NICUs were I can persue my passion and really learn. These are exactly the kinds of places I have been looking for. Sure, it's a commute. But this is something I have been wanting (and missing out on) for so long. And I am so, SO grateful that I am finally in a place where I can work in a place that fits me. A place where I can make a difference, do what I love and learn new things about a field I am truly passionate about every day.

And that's what I thought for the rest of my ride home. It's over. The search. The stress. The greif. The uncertainty. It's over.

Thank God.
~Layne

PS: A diabetes related note: Wouldn't you freaking know that I got low twice! On each interview!! Luckily I brought snacks that I stowed in my purse to be ready for this exact situation, but seriously?!? Some days I really think having diabetes is like taking a toddler with you everywhere you go. There are those important days where you just pray it will, sit down, shut up and just behave and not embarrass you. Oh well. ;-)

Nervous Nelly

So, the above title isn't quite true. I'm not all that nervous. More like anxious. But why don't I tell you what all this is about before I start dissecting my feelings. I have an interview tomorrow with a hospital a little less than 2 hours away from my house. (I guess we'll see what the actual driving time is tomorrow, huh?) It's an all-day interview which is pretty typical in my field. And I'm excited to meet the team and see the hospital but I'm also wary becaue I'm beat from my two days in a row of sun-up to sun-down shifts and I have to get up at the butt-crack of dawn to arrive to my interview on time.

This is my second interview in two weeks. Since I went to the NANN conference back in September and caught up with old colleagues and brushed up on the latest research I've found myself yearning more and more to get back into the NNP role. I know, I know. I said I was happy as a nurse . . . and doubly happy with my 15 minute commute. And I am. But it's hard not to miss being in the NNP role. It's what I trained for, it's what I'm passionate about and it's why I have all these school loans, for crying out loud!

However, there is one (very big) problem with this: There are no openings in Orlando. Zero. Zilch. Nada. And it doesn't look like there will be any for at least 2 years. Maybe more. So I developed a strategy. I networked like crazy at the conference and met a few recruiters and a few hospitals, with openings in Florida, all expressing interest. My criteria was this: the hospital had to be within 2 hours of Orlando and it had to offer long shifts (long = 16 to 24 hours). I compromised with myself in order to find a job. It sucks to have to drive 2 hours to a job so I only looked at places with long shifts so that the number of times I had to drive back and forth to work would be drastically decreased. For example, I interviewed somewhere that primarily does 24-hour shifts. So I would do 3 24-hour shifts in 2 weeks, give or take. How sweet is that?!?

I also decided not to entertain any more of this Level 2 business. If I'm driving that far I would only look at Level 3 NICU's. These are the NICU's that keep the sickest babies, house more specialties, perform surgeries, etc. This is the kind of place I want to be in, where I can really learn my stuff. If the hospital was a teaching institution or in a university setting, all the better.

I narrowed the field down to the 2 strongest contenders. And that's where we are now. I've gone on one interview and tomorrow is my second. These interviews are exciting, for sure, but also nerve-wracking and exhausting. Throw in a 4 hour round trip and who knows what shape I'm going to be in tomorrow. Hopefully I'll remember to post! :-)

So I should go now and prepare (aka write up my questions, print out directions, pick out an outfit, etc). Wish me luck and pray that my diabetes stays in check all day!!

TTFN!
~Layne