In memory of those who died for our freedom...

(Photo taken 12/12/09 in a small roadside cemetery.)

"These heroes are dead. They died for liberty - they died for us. They are at rest. They sleep in the land they made free, under the flag they rendered stainless, under the solemn pines, the sad hemlocks, the tearful willows, and the embracing vines. They sleep beneath the shadows of the clouds, careless alike of sunshine or of storm, each in the windowless Place of Rest. Earth may run red with other wars - they are at peace. In the midst of battle, in the roar of conflict, they found the serenity of death. I have one sentiment for soldiers living and dead: cheers for the living; tears for the dead." ~Robert G. Ingersoll

Empty Nest

Baby robins have grown up and flown away. (Photo taken May 20th, 2010).

First Flight

I'm pretty certain this is one of the young house sparrows who was raised in our blue bird boxes. He can only fly a few dozen feet before having to land and rest.

This weekend I am putting in a concerted effort to get the garden planted. Between having had lots of rain and being away last weekend and feeling very fatigued in general, the garden has been sorely neglected. Other then 2 rows of raspberries, a dozen rhubarb plants, and a handful of kale plants (which the chickens seem to think I planted just for them!), I haven't gotten anything planted yet. I ended up canceling my order for fruit trees and strawberry plants due to the fatigue I have been feeling. I didn't want them to sit and die since I haven't been feeling up to heavy duty work. Hopefully this fall I will get places prepared for them so when I get my order next spring I can just stick them in ground.

The other reason I haven't really touched the garden is because, what energy I have has been used to pull garlic mustard. Our woods are full of that invasive plant. I've always known that it chokes out native wild flowers and isn't something you want to have around, but after reading about it here, my husband I and went into full attack mode on the garlic mustard. We are combing every inch of the woods and pulling every single blooming plant. We have one more section of woods to work on. Hopefully that will be done this week.

It is going to be a battle waged over several years though as there is no way we can pull every tiny seedling this spring. In some places the forest floor is thickly carpeted with the seedlings. Also the seeds can live in the soil for up to 5 years, so even if we don't let a single plant go to seed (which is our goal), we will still be pulling plants for the next five years.

From the MSU website...
Garlic mustard impacts
Sites invaded by garlic mustard tend to have low diversity of plants growing on the forest floor and it is widely believed that garlic mustard infestations displace native plants. Researchers in Ohio experimentally removed garlic mustard from a forest understory and documented subsequent increases in the richness and abundance of annuals and woody perennials including tree seedlings. Garlic mustard out-competes some tree seedlings, including chestnut oak (Quercus prinus), which could affect forest regeneration over time. Several compounds isolated from garlic mustard were shown to depress growth of both grasses and herbs in laboratory experiments. Researchers concluded that release of these compounds from garlic mustard root systems might account for its dominance in forest ecosystems. Others have suggested that such compounds might also disrupt mutually beneficial relationships between plant roots and certain fungi in the soil, known as mycorrhizal associations. Like many of its close relatives, garlic mustard does not establish mycorrhizal associations. These fungi are used by most North American forest ground layer plants and are critical for nutrient and water uptake in many trees.

Garlic mustard appears to alter habitat quality for several species of salamanders and molluscs through changes in forest litter layer depth and composition. Insect communities are also impacted by the presence of garlic mustard. The native woodland butterfly Pieris napi oleraceae, utilizes the native toothworts Cardamine concatenata [Dentaria laciniata] and C. [Dentaria] diphylla, which produce the chemical attractant sinigrin. This compound is also present in garlic mustard. Because garlic mustard grows taller than the native hosts, in mixed stands the butterflies can mistakenly lay their eggs on garlic mustard where their larvae are unable to develop. The impacts of garlic mustard on vertebrates are largely unknown, however, ground foraging birds, amphibians and reptiles may be impacted by changes in habitat quality.

Garlic mustard smells delicious--just like its name. I read that it was brought over as a culinary herb from Europe. I tried cooking with it once, but have to say that is smells a better than it tastes. I found even the very young plants to be very bitter, even with repeated boiling in fresh water. (And I'm someone who love the bitterness of the endive, dandelions, and even yellow rocket.)

Mount Greylock

The highest peak in Massachusetts, as seen from the Vermont border.

Red Eft

I miss red efts. We don't seem to have them in Michigan. They were common in upstate New York where I grew up. This photo was taken in Vermont on Sunday when I was visiting my brothers and sister in law there. They seem to be quite abundant there as well. I saw at least half a dozen of these colorful newts during a hike in the woods.

100 Years Young

My Grandfather, born May 10, 1910, holds his newest three week old great grandson (my newest nephew), born almost 100 years later. Grandpa still lives by himself. His vision and hearing are going, but his mind is as sharp as a tack.

The biggest morel of all!

(I'm leaving this morning for the East Coast to celebrate my Grandfather's 100th birthday. Looking forward to seeing family again in New Jersey,then the hills of upstate New York where I grew up, and last of all, my newest nephew in Vermont. I'll catch up with the blogging again when I get back.)

This giant morel was the reward for hours of pulling garlic mustard out of our woods.

Crane Family

The sandhill cranes that were nesting in the pond hatched out one adorable little crane-ling. I was privileged to be driving by just at the moment the parents decided it was time to leave the nest and take the little one for his first adventure out to the wide open corn fields. They literally danced from the pond across the road right in front of my car, constantly bending and turning to make sure the baby was right there with them.

(My little camera doesn't do the family justice...)

Dewy Morning

Dandelion puffball.

Evening Lychnis.

Poplar seedling.

British soldiers. (I think the hairy plant is hawkweed--have to wait for it bloom to be sure.)


Dog violet-tiny violets that grow in the mossy infertile corner of our property.

Apple Blossoms

(photo taken 4/25/10)

Nursing Diagnoses

If you are a home care nurse you take lots of verbal orders--we can't put on a band aide or tell a patient to take colace or tylenol without getting an okay from a doctor. (We rarely ever talk to the actual doctor though, it is the doctor's nurse or medical assistant who gives us the orders.) Each home care agency has a very specific policy on how the orders have to be written.

Where I worked before it was pretty straight forward. Patient has a headache, asks me if it is okay to take Tylenol. Tylenol isn't on patient's official med list. After confirming with the patient that he or she doesn't have liver problems, I call patient's doctor and talk to the nurse at the office. "Hey, Mrs. White has a headache, is it okay with Dr. Smith if she takes Tylenol for it?"
Nurse replies, "Oh, yes, that is fine."

So I write my order. "Patient to take tylenol 325 to 650 mg every 4 to 6 hrs by mouth, as needed for headache. Not to exceed 3000 mg in 24 hour period. Order effective 5/14/10." I sign it and put it in the bin to be faxed to Dr. Smith for his signature and tell my patient she can take tylenol as needed for her headache, as long as she doesn't overdose on it.

Or if one of my patients were to fall I would call the doctor's office and get an okay to send out a physical therapist. I would write an order that simply said, "Physical therapist to eval and treat patient for instability and gait disturbances. Order effective week of May 17, 2010".

Where I currently work, writing an order is a major headache, and I find myself poring out a long list of official nursing diagnoses trying to figure out how to write my order. The order has to include a problem, which is supposed to worded as an official nursing diagnoses, an intervention (what you are going to do, like tell the patient to take tylenol), and an achievable goal (Pt will be relieved of headache).

Nursing diagnoses are kind of like a secret code that nurses communicate in. An example of one, if a patient's problems are mostly related to being overweight, we would give him the diagnoses of "Altered nutrition, greater then body requirements" instead of saying that he is obese. For a list of official nursing diagnoses, click here.

An order I have written several times using this format is one where a patient is taking medication to prevent blood clots and needs frequent lab draws to monitor the effectiveness of the therapy:

Problem: Ineffective anticoagulation therapy.
Intervention: Skilled nurse to draw PT/INR in one week. Results to be called to Dr. Smith.
Goal: Labs will be within therapeutic range.

Today I was talking to a sweet elderly patient who is currently living with her grandson and his wife. She reluctantly confided to me, that she feels like they think she is a burden to them, even though she is pretty independent. She feels like they have been cold to her and are ignoring her most of the time and thinks they want her out of the house, even though she says they would never say that out right. I asked if she would be interested in talking to a social worker to explore the options for assisted living or other types of appropriate housing.

She said yes, and looked very relieved that there might be some hope for getting her own place. I called the doctor office and spoke with the nurse. Our conversation was literally:

Me: Hi, this is Kateri, one of the RN's at (insert agency name). I'm calling to see if it is okay with Dr. Jone's if I send out one of our social worker to talk to Anne Brown about options for assisted living."
Nurse: "Oh, that sounds great. Go ahead and do it."
Me: "Thanks so much. I will write up the order and we will fax it to for Dr. Jones to sign. Can you give me your name?"
"It"s Debbie."
"Thanks so much, Debbie."

Great. I have my order. Except now I have to figure out a nursing diagnoses that fits the problem of "my family seems like they are sick of having me around." (Especially since there doesn't seem to be one that fits "I'd like to move into assisted living.")

Hmmm...how about...

Caregiver role strain? That doesn't seem right.
Risk for caregiver role strain? No not that one either.

Compromised family coping?
Readiness for enhanced family coping? Don't think I will go with either of those.

Dysfunctional family processes? That sounds a little harsh. And I'm not sure that the family is really dysfunctional.

How about something not related to to family or caregivers, such as...

Readiness for enhanced decision making? Okay that sounds really pompous.

Risk for compromised human dignity? No...

I like this one: Readiness for enhanced power.
But I'm sure if I use that one, the doctor will take one look at it and think, what the heck is this nurse talking about?

I finally give up on nursing diagnoses and write my order in plain English:

Problem: Patient states she would like to explore options for assisted living.
Intervention: MSW to eval for alternative housing and other community resources.
Goal: Pt will find a living arrangement that meets her needs.

(For some reason you don't have to put the effective date on orders for this agency. The effective date was the huge sticking point for the company I worked for previously.)

If my supervisor wants to scrap my order and rewrite it the proper way with proper nursing diagnoses, that is fine with me. I would just really like to know which one she decides on.

(Names and circumstances changed to protect patient privacy.)

Fallen

(The fallen phoebe nest, woven of soft horse hair and pine needles and covered with green moss.)

We had strong winds and pounding rains on this weekend. Sadly the wind blew down the phoebe nest in the little barn and the 4 babies died of exposure before I found them.

On top of that, a raccoon strong armed his way into the upstairs of the chicken coop Saturday night and decapitated every one the Ameracauna chicks. Very disappointing and an upsetting way to start Sunday morning. Terry and I are both kicking ourselves because we were confident the coop was secure. We have had it for for two years and this has been the first problem with it. It looked like the coon actually pried on the door until the plywood snapped then wedged his way in, leaving plenty of fur on the wood. We are fortunate that we had blocked off the opening to the downstairs, to give the Ameracuanas some privacy, otherwise the adult chickens might all be dead too. Normally the adult chickens would roost up there at night.


Terry really liked these chicks and I was looking forward to pretty colored eggs. We may try to get some more. The worst part is they were from someone Terry works with and he is raising the other half of the batch as pets.

(Right now I really hate raccoons--someone remind me what purpose they serve other then to eat Nemo's food and kill our chickens?)

At the rate I loose chicks, I should start some kind of chicken memorial. In 2008 I lost 4 three week old Black Astrolourps to a raccoon. In 2009 it was 5 Buckeyes between one day old to 6 weeks old to natural and unknown causes. This year it is the Ameracauanas at 4 weeks old to another raccoon. In fact, the only chicks that have survived into adulthood are the California whites.

More Robin Pictures

Taken today. The robins are 6 days old. They grow so fast--now they look like birds, instead of little alien creatures.

Just hours old. Amazing how fragile and helpless they are.

(The pictures in yesterday's post were taken the day after they hatched.)

Naked Babies

Two out of the four robin eggs hatched a few days ago. No sign of the two missing eggs.

In all Seriousness

The Ameraucanas seem to be very well adjusted chicks. We have them separated from the big chickens in the upper part of the coop (I blocked off the opening from the inside so the California whites couldn't get upstairs). When I get home from work I let both flocks of chickens out to free range. The first thing the little chicks do is go take over the lower portion of the coop--eating the grownups' food, and generally acting like they own the place. I was expecting a lot more pecking and meanness from the big hens, since they are usually not at all pleased to have strangers in the coop, but they have been taking the invasion pretty much in stride.

Deer on a Misty Morning

Who needs a lawn mower when you have a herd of deer munching on your lawn every morning?

The stuff dreams are made of....

A woods full of trilliums as far as eye can see....with a few jack-in-the-pulpit, wild geraniums, violets, and Solomon's seal through in for good measure....

...and with nary a plant of garlic mustard or poisen ivy to be seen.

(Photo taken in a woods a few mile from where I live. Some day my woods may look like this. I just need to get rid of the garlic mustard, wild roses, and poison ivy first--check back in 30 years or so for the results. :)

Easter Eggers

The newest additions to our family--three week old Ameraucana chicks. (The chickens that lay pretty colored eggs.)

In the Little Barn....

I spent a good part of yesterday cleaning out the little barn and organizing one of side of it into a potting shed while we are waiting for farm animals to fill it with. Though we don't have any farm animals yet, it is filled with life, none the less. A pair of phoebes built a nest on top the hanging light and their young are hatching. (The mother was going crazy while I was looking in the nest so I took one blurry photo and then left them alone. There are three babies and two eggs. Funny, I grew up with phoebes' nesting outside my bedroom window for years and I never noticed that their eggs are white.)


A little mouse with big ears had made a nest in a wheel barrel full of trash. (No babies, I checked!). Good thing Nemo wasn't around to eat him.


A butterfly stopped to watch me work for a while. Butterflies where out in full force yesterday. I spent a lot of time chasing them around wishing they would sit still long enough for photos. This was the only one that sat still long enough for me to snap a few photos. I wish I knew my butterflies better. I saw at least five different kinds of butterflies yesterday, from tiny white ones to a big swallowtail.

Run Away Umbrella

Emerald Raindrop

I went looking for a rain drop of my own to photograph after seeing this picture. My raindrop was nestled in the new leaves of a columbine plant.