Christmas tale

This time I will share with you a bit of the wonders I experienced when I came back home in Bulgaria for the holidays.

I arrived in Sofia on the 22nd of December and went shopping with my boyfriend who is now my husband. Yep, I got married this summer. Congratulations to me!!! ūüėÄ

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The day after we went to Winery and Spa Starosel Hotel where we enjoyed hydromassage, sauna, swimming and eating fine Buglarian food. It felt like being in heaven and I really recommend it to anyone who would like to experience the highest quality of Bulgarian hospitality, food, Spa and wine. Have a glimpse in the pictures below:

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On Christmas day I cooked a British inspired roast dinner but with chicken instead of turkey. And for dessert I made Christmas cookies which we decorated together and had lots of fun! Everyone really liked it which made me so happy!P1300932

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This is the first Christmas my husband and I are celebrating as a family and I wish for 2016 to have even more happy moments together like this! Life is so beautiful when you’re in love! ūüôā

Anatomy of the respiratory system

Thanks to the respiratory system our bodies get necessary oxygen and release unwanted carbon dioxide. This would be impossible without the cardiovascular system though.

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The respiratory system consists of nose and nasal cavity, pharynx, larynx, trachea, bronchi and their smaller branches, and lungs.

The nose is the entering point for oxygen and the exit point for carbon dioxide. The nasal cavity is the internal part of the nose where smell (olfactory) receptors and respiratory mucosa, that humidifies and warms air, are located. Furthermore, a sticky mucus is produced from the mucus glands and acts as a barrier for bacteria.

The pharynx is a muscular passageway through which both food and air travel. It is about 5 inches long. The pharynx is connected to the middle ears through the pharyngotympanic tubes which explains why an ear infection may result in a sore throat.

The larynx is responsible for voice but also to navigate food and air into the right passageways.¬†Food enters the oesophagus and travels to¬†the stomach while air enters the trachea¬†and travels to the lungs. The larynx is made of cartilage and muscles. In men the thyroid cartilage¬†is referred to as ‘Adam’s apple’. One of the reasons you can’t take a breath in while swallowing is due to the epiglottis (spoon shaped cartilage) closing the passageway to the trachea. This is essential to prevent aspiration and choking. In patients with Dementia swallowing becomes a problem as the epiglottis weakens and does not always function effectively. This condition is known as dysphagia and may lead to frequent chest infections.

The trachea is about 4 inches long and leads air to the lungs. It is made of hyaline cartilage and divides into main bronchus.

The main bronchi are left and right bronchus. The right one is wider, shorter and straighter compared to the left one which is why foreign objects usually end up in the right bronchus. The bronchi are connected to the lungs through smaller subdivisions (bronchioles and the smallest alveoli) resembling roots of a tree. The alveoli are tiny air sacs where gas (O2, CO2) exchange occurs. Tiny blood vessels then carry oxygen to the rest of the body.

The lungs are soft and spongy. They are located in the thoracic cavity and are surrounded by a protective rib cage. ¬†The right lung has 3 lobes: upper, middle and lower lobe, while the left lung has only 2 lobes: upper and lower lobe due to the heart’s positioning. Each lung is covered by a two-layered membrane¬†called pulmonary pleura. Between the two layers is the pleural cavity where there is vacuum and serous fluid which reduces friction. A condition called pneumothorax occurs when air or gas enters the ¬†pleural cavity. Pleural effusion occurs¬†when liquid enters the pleural cavity, while hemothorax, particularly, is when blood enters the pleural cavity. Pleural effusion¬†may lead to lung failure so a chest drain is inserted to get rid of excess fluid or blood.

The diaphragm is a smooth muscle at the base of the lungs which assists breathing. It is not part of the respiratory system but plays vital function in it.

A day in the life of a 2nd year Nursing student (Adult)

wsdrfgCurrently I am doing a placement in the community and visit patients in their homes. My mentor is a case manager (Band 6) and the majority of the patients are elderly with long-term (chronic) conditions, such as: heart failure, COPD (Chronic obstructive pulmonary disease), diabetes, cancer, stroke, depression, dementia and more. What I truly enjoy about this placement is that I get the opportunity to communicate with patients and listen to what they have to say! It’s great to get to know them better and support them in their homes.

Typical day would be something like this:

* 9:00 arrive and start reading through patients’ records to familiarise myself with their past medical history, current conditions and aim of visits for the day
*10:15-10:30 travel to a patient’s home

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*10:30 visit a patient with heart failure, 5¬†min to introduce self, role, explain aim of visit and gain consent for any procedures, 10 min conversation about how the patient is feeling using a holistic approach, 5 min perform hand hygiene, ¬†5¬†min record vital signs and write them¬†on patient’s record, 20 min perform care plan while engaging the patient in a conversation, 10 min record keeping on System One software, 5 min¬†answer questions the patient may have. Total (60¬†min)
* 11:30 – 11:45 travel to next patient

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*11:45 visit a patient with type 2 diabetes, obese and suffering from irritable bowel syndrome, 5 min introduce self, role, aim of visit and gain consent for any procedures, 10 min conversation about how the patient is feeling and needs that need to be addressed, 5 min perform hand hygiene, 5¬†min record vital signs and write them¬†on patient’s record, 20 min to perform care plan while engaging the patient in a conversation, 10 min record keeping on computer and make dietitian referral, 5 min¬†answer questions the patient may have. Total (60 min)
*12:45 – 13:00 travel back to office
*13:00 – 13:30 lunch break and practice measuring manual blood pressure
*13:30 – 13:45 travel to next visit
* 13:45 visit a patient with depression following a traumatic experience in ITU (Intensive care unit) 2 years ago when the patient was in coma, 5 min introduce self, role, aim of visit and gain consent for any procedures, 10 min conversation about how the patient is feeling and needs that need to be addressed, 5 min perform hand hygiene, 10 min record vital signs and write them¬†on patient’s record, 20 min to perform care plan and depression screening assessment while engaging the patient in a conversation, 5 min record keeping, 5 min answer questions the patient may have. Total (60 min)
*14:45-15:00 travel to next visit

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* 15:00 visit a patient with an exacerbation of COPD and review wellbeing,¬†5 min introduce self, role, aim of visit and gain consent for any procedures, 10 min conversation about how the patient is feeling and needs that need to be addressed, 5 min perform hand hygiene, 10 min record vital signs and write them¬†on patient’s record, 20 min to perform care plan while engaging the patient in a conversation. Total (55 min)
* 16:00 – 16:15 travel back to office
* 16:15 Р16:55  study independently while mentor is taking phone calls and finishing paperwork
* 16:55-17:00 complete study-related paperwork

To sum up, the work day is from 9am to 5pm and consists of approximately 4 hours face to face contact with patients, 1 hour and 30 min travel time, 30 min lunch break, 2 hours spent in office doing preparation work, phone calls, writing notes,referrals etc. Some professionals manage to visit as much as 12 people per day, however, each visit might not last longer than 20 min depending on the aim of the visit. Giving an insulin injection takes only 5 min but discussing with a patient their end of life care and final wishes can take hours.

 

Christmas spirit

Hello there! It’s that time of the year when everything is focused around Christmas day and the winter holidays. Recently I made a video on how to decorate your Christmas pudding – a dessert¬†traditionally served in Britain on Christmas day.

The history of the Christmas pudding dates back since¬†medieval times. A recipe can be found here, although, there are different variations in each household. I just simply bought a ready pudding from the local supermarket and it was still delicious. The most basic pudding consists of dried fruits, nuts, breadcrumbs, eggs and some alcohol. The pudding¬†is dried for a period from a few hours up to a few months and even one year. So if you have some pudding leftover from this Christmas you can perfectly keep it until next Christmas. ūüėÄ Good luck in the kitchen!