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Out of Stock
Item # TTT0037
Don't worry though, we have a lot more Road Stems in stock than that.View Similar Products
3T ARX Team Alloy Stem $0.00
The 3T ARX Team stem is built to balance competing factors: It needs to be light, it needs to be stiff, and it needs to be immensely durable. Perhaps it's no surprise, then, that Arx is Latin for stronghold. Durability is its greatest quality.
The ARX Team is forged to give its aluminum grain structure optimal strength. The steerer and bar clamp are beefed up but carefully designed to minimize stress on your fork steerer tube and handlebar (whether they're carbon or not). The ARX Team passes the recently re-vamped, made-much-more-demanding DIN and CEN certification tests.
At 120g, 3T keeps it light by outfitting the ARX Team with a titanium bolt package. It's available in 10mm increments between 90mm-130mm. It comes in a +/- 6-degree (aka 84-degree) and in a +/- 17-degree (aka 73-degree). The stack at the steerer clamp is 40mm tall. It comes in a 31.8mm clamp size only.
Tech Specs
View more Road Stems
Reviews & Community
I'm curious if I should use the 90mm or 80mm stem. I currently have a 120mm stem and it's just too long for me. Any suggestions?
Feel free to call or chat in for more help, but it really depends on your particular bike fit. Normally I would recommend 10mm changes in stem length. So a 110mm would be a good jump.
Good light stem
- Familiarity: I've used it once or twice and have initial impressions
Got this stem on special - nice, light, and matches the 3T ergonova bars I have on my bike. I've read up on the issues with the bolts failing - not a problem on the stem I received. I didn't torque the bolts to spec though - just enough for them to grip the bars and steerer securely. The titanium bolts on the stem came with washers on mine - maybe 3T addressed the faulty bolt problem?
The finish on the stem is good, though it doesn't seem as smooth as my 3T pro stem. I removed the red line on it with some acetone and my fingernails - looks great now that it matches the rest of the cockpit.
All in all, great stem, would recommend it, particularly if you're running any 3T handlebars.
Solid Solid
- Familiarity: I've used it several times
First off, love the variety of lengths 3T offers for this stem. From 70mm all the way to 140mm and +/- 6 and 17 degrees, there are just a lot of options to suite your fancy.
Installation wise, found the titanium bolts to be sturdy. 5N is the max, but as Cam mentioned the best fit is at about 85% of the MAX. Secure without issue.
Performance on the bike it's plenty stiff felt great in its response side to side sprints or out of the saddle on a climb.
Simple look and a nice addition to your training or racing rig.
Another great 3T product
- Familiarity: I've put it through the wringer
I've installed 3 of these on different bikes using a torque wrench and unlike the other reviewers have had no problems with the titanium bolts snapping. Even had to remove one stem and re-install when I switched out my bars and still no probs with installation. Torque wrenches do need to be re-calibrated over time so perhaps that could be part of the problem some people have had with the install? Also, 5Nm is the MAX torque the stem can tolerate and I usually tighten to 15-20% below the max torque recommendation. Just add carbon paste with installation (if you have carbon bars like I do) to keep things where you want them without having to max your torque. Stylish, thoughtful design, rock stable, and no probs with durability although I'm a climber, not a sprinter so I don't really torque on the bars much. 4 stars cuz it could be lighter.
Bolts are junk
- Familiarity: I've put it through the wringer
One of the bolt snapped way before reaching the torque value of 5N.m. I stopped there and returned the stem. A friend of mince had 3 bolts snap.
I have the ARX pro on all my bikes and love them but the Ti bolts from 3T are of the lowest quality. Maybe we got a bad batch.
I had bolts snap too- thought my torque wrench was off...
Got a new 3T ARX team stem. This time, I counted how many times I screwed each bolts in and went 1 turn at a time then 1/2 turn then 1/4 turn. No bolt broke.
Morale of the story: these Ti bolt need to be screwed in absolutely straight. I wish 3T would say so.
Boss Stem!
Upgraded to the 3T Arx team alloy stem and was immediately impressed with the improved stiffness it provided on my road bike with my 195 lb weight. Matched the 3T stem with the 3T bars and seatpost. Overall I am extremely satisfied with 3T products and highly recommend them. I have the stem on my mountain bike as well and cannot find any faults.
Any of the Black/Blue Garmin stems left??...
Any of the Black/Blue Garmin stems left?? I see the black, but no option for blue...
Sold out, sorry.


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Video: Brother, Friend Marines Gather to Honor Fallen Comrade
Video by Cpl. Mark Garcia
On a hot sunny, somber Saturday morning more than 100 service members gathered to pay their final respects to Cpl. Daniel L. Linnabary II, a fallen brother during a memorial ceremony in the sweltering Afghanistan sunlight, Sept. 1. Sound Bites include 1st Lt. James Nash, officer in charge of 2nd platoon, Bravo Co., 2nd Tank Bn., Staff Sgt. John Kramer, platoon sergeant for 2nd platoon, Bravo Co., 2nd Tank Bn., Lance Cpl. Nicholas Matareese, tank gunner with 2nd platoon, Bravo Co., 2nd Tank Bn. Also available in high definition
This work, Brother, Friend Marines Gather to Honor Fallen Comrade, by Cpl Mark Garcia, identified by DVIDS, is free of known copyright restrictions under U.S. copyright law.
Date Taken:09.1.2012
Date Posted:09.11.2012 8:47AM
Video ID:154799
Location:CAMP LEATHERNECK, AF

subset: commoncrawl


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Mayor Parks Approves Benefits for Other Cities
DESERT HOT SPRINGS, CA – When does a council member speak for the city without first seeking the formal approval of the city council where they serve? That is a question at the center of a brewing conflict on the Desert Hot Springs City Council.
Continuing down a familiar path, mayor Yvonne Parks recently sent a letter on behalf of the city endorsing enterprise zones in California. A statewide debate is underway over their effectiveness.
Twice the city has taken the position that enterprise zones creates an unfair advantage for communities that compete with Desert Hot Springs' economic development efforts. To put an end to that unfair advantage, the city has twice applied for enterprise zone status, both times being rejected.
Yet despite those formal positions of the city council, a February 6, 2013 letter unilaterally initiated, signed and sent by Yvonne Parks says "The City of Desert Hot Springs formally supports the positive benefits of the Enterprise Zone Program in local communities and on a statewide economic level."
It is a position that never came before the city council for approval.
"Yes I have a problem with the Mayor acting unilaterally without first obtaining council approval," said Councilman Russell Betts. "She did this before when she volunteered our city to be an overnight homeless shelter without authorization and when she voted to support the 1e11 electric parkway [Golf Cart Path] despite a council vote against it."
Russell Betts said he suspects if the matter were to come before the council a majority of the council may well think it is a good idea to support enterprise zones but that he does not support enterprise zones when their benefits do not include the city he was elected to represent.
"If you look at the significant disadvantage our city is placed in by not having an enterprise zone while neighboring areas do, there is a good case to be made why we should not be supporting a statewide initiative on this subject" said Russell Betts.
"The immediate problem, though is not that Yvonne [Mayor Parks] putting other area's interests ahead of our city, it is that she acted on her own without obtaining required council concurrence," said Betts.
The letter from Yvonne Parks was created on city stationary and sent to the Department of Housing and Community Development in Sacramento.
Businesses locating in a state designated enterprise zone receive tax breaks and other favorable advantage. Those advantages lure those businesses to other areas and act as a disincentive to locate in cities like Desert Hot Springs that do not have a enterprise zone designation.
The industrial park in Desert Hot Springs is nearly empty of business while the industrial parks off Bob Hope and on the south north side of the freeway going north all the way to Coachella in the Enterprise Zone are filling up with businesses and associated local jobs.
Spectrum Cabinets, a Desert Hot Springs cabinet manufacturer that is located in the city's industrial park has spoken of relocating to an Enterprise Zone for those advantages. It is harder for a manufacturing company outside of an enterprise zone to compete.
Defending enterprise zones, Parks said "Enterprise zones provide a geographically targeted economic development tool designed to improve poor and blighted communities.
"It looks to me as if Yvonne is doing her best to encourage a local manufacturer and three dozen jobs to say goodbye to Desert Hot Springs," said Russell Betts. "I don't see how this helps us."
Councilman Russell Betts, who has a manufacturing business background, said the city's focus should first be on economic development inside the city where council members are elected to serve.
Sacramento is discussing elimination of enterprise zones as it is unfair to neighbor cities, is a way for certain businesses to avoid paying their fair share of taxes and has been a cash cow for consultants without creating new jobs.
The homeless shelter referenced by Betts deals with an invitation to Coachella Valley cities to use Desert Hot Springs as an overnight shelter for Valley homeless. In 2008, Parks secretly gave the OK to locate the homeless shelter in a residential neighborhood off Mountain View.
Homeless people were bused into the neighborhood from as far away as Indio to the east and as far away as Yucaipa to the west. The homeless from out of town were left wandering the neighborhood after they were bused in for the night.
Both the police chief and city council were not aware of the mayor's actions until the story broke on television news. As a result of a crime spree in the area and neighbors' complaints, the fire marshals and police stepped in to shut it down.
On the golf cart path, the city council voted not to support funding for the path because the project was in competition with the city for funding from the CPV Sentinal power plant. Despite that vote by the council, Parks voted in favor of funding for the Golf Cart Path at a Coachella Valley Association of Governments meeting.
Yvonne Parks Central
Dean M Gray
For over 40 years Dean has been published in a variety of small newspapers and magazines. As publisher he founded an alternative city weekly newspaper in 2008 and published over 200 uninterrupted issues over 4 years to over 20,000 readers via 800 locations (and online) before selling the business. Now online with over 4 million readers worldwide.
Dean is a Master Carpenter and the author of the biography of Hilda M Gray, desert homesteader. He served as Planning Commissioner for the city of Desert Hot Springs from January 2014 to January 2015 when he resigned.
Dean M Gray is a member of the Society of Professional Journalists and Investigative Reporters and Editors and lives in Palm Desert, California.
Latest posts by Dean M Gray (see all)
- Ian Armstrong Demands Palm Springs Marijuana Politics Webpage be Removed - October 7, 2015
- Dmitri Navroska Blows Palm Springs Council Member Ginny Foat Recall - September 26, 2015
- Desert Hot Springs Walmart Building as November 2015 Election Issue - August 1, 2015


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Women's Gymnastics Plays Host To 12th-ranked Denver
Feb. 14, 2013
CHICAGO – The UIC women's gymnastics team plays host to Denver Saturday at 5:00 p.m. (CT) inside the Physical Education Building.
"We are excited to the No. 12 team in the nation with us here in Chicago," co-head coach Peter Jansson said. "We feel ready to put together a great performance on all four events this weekend and are looking forward to doing this in front of our home crowd."
The Flames are coming from a third-place finish (193.925) against Big Ten teams Iowa (195.875) and Michigan State (194.850) on Feb. 8. Senior Chantel Turk scored a 9.775 on floor to lead the Flames. Turk also scored a 9.800 on vault and placed first in the all-around with a 38.925. Sophomore Gabrielle May scored a 9.800 on bars, while Junior Catherine Dion led UIC on beam (9.800).
The Pioneers enter the meet after beating Southern Utah 196.400 to 195.475 on Feb. 8. Moriah Martin placed first on vault (9.900) and all-around (39.375). Nina McGee scored a 9.875 on bars and beam to place first in both. Kaitlin Moorhead notched a first-place finish on floor with a 9.875.
Be sure to check back to UICFlames.com for final results and a recap of Saturday's meet against the Pioneers.


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True friends answer the phone when you call.
They listen to you cry and say you've realized the only way you'll ever be happy is by becoming a farm hand.
They don't laugh at your new life plan, or suggest you see a therapist.
Well, they're going to suggest you see a therapist.
But in the truly-concerned-about-you way, not the sarcastic-mocking way.
True friends laugh with you.
Even if they don't think your strawberry joke or Eddie Vedder story is funny.
In which case they might be laughing at you.
But it's the laughter that counts.
True friends forgive.
If you're running hours late, or are still working on that Christmas present from 2008, or called their grandmother racist, they forgive you.
Though you shouldn't speak to their grandmother like that. Have some respect.
True friends stop and smile, even if they don't want to, no matter how many times you ask.
I have a reflection addiction,


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Wantering is designed to solve one of the most basic problems in online shopping: how do you find something to buy when you don't know exactly what you want. In order to solve this problem, Wantering has spent the last 18 months building some unique technology.
The first piece is the crawling framework that allows Wantering to gather up-to-date pricing, stock, and other metadata about over 500,000 products in near-real-time. When a product goes on sale across the web, Wantering is the first to know.
The next piece is its proprietary coolhunting algorithm which uses over 100mm social signals to figure out which are the hottest products for any result.
The final piece is a beautiful interface that makes it fast and easy to browse for fashion on your desktop, tablet, or smartphone.
- Website:
- http://www.wantering.com
- Categories:
- Startup
News on Wantering
Wantering today announced the launch of the Wantering Insider Network, an invite-only community of style bloggers. The Wantering Insider Network, known as WIN, integrates the company's product... more
BCBusiness today released its inaugural list of its "30 Under 30" winners. Here's the list: 1. Adam Woodhouse – Art Director, Invoke Media 2. Amy Dopson – Founder, PAC 10... more
This fall the Canadian Trade Commissioner Service's Canadian Technology Accelerator (CTA) program will host eight promising Canadian-based startups at General Assembly's New York... more
At Wantering we've been focused on making shopping online better for the last 18 months. What Canadians would call luxuries—free shipping and returns, next day delivery, and duty-free... more
Wantering has launched a fashion search engine that allows shoppers to discover and buy clothing from handpicked boutiques, flash sales sites, and select major retailers. The... more
Vancouver's Wantering announced late last week the closing of a $470,000 seed round led by Yaletown Ventures. The annonucement was timed with the startup's public launch after completing six... more
Two months ago, Techvibes reported that Vancouver's newest superangel, Mike Edwards, would be taking over the helm of Vancouver accelerator GrowLab. We warned Vancouver's startup community to... more
Vancouver startup Wantering launched their latest project today - Shirtify. And it sounds like a great idea. The basic premise is really simple: you listen to music on your favourite online music... more


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In every direction you look there are back-to-school ads for everything from pencils to iPads. While preschoolers don't need as much, they definitely have their own list. At the top – their first backpack!
When my daughter went off to preschool, we focused on her favorite character. To be honest, she wasn't so sure about this whole school thing. She was pretty content hanging out with Mom and little sis. There was a fair amount of coaxing and convincing required. One tactic I used to sweeten the deal was a Hello Kitty backpack. That sweet little cat would make everything better.
I searched high and low for that thing. Silly me thought we'd walk into Target and see a section filled with them. When I finally found one online, I hit "order" before I could think twice. We were short on time and I needed that baby delivered FAST! When it arrived, I probably made a bigger deal than I should. It was almost ceremonious. We had a camera ready and everything. So imagine how I felt when my itty bitty girl slipped her arms through the straps and what was on her back resembled something more like a moon pack than a backpack. It was HUGE and could have fit her little sister inside!
I totally neglected to look at the size. While we made do, it was all wrong. She carried Hello Kitty with her to school for only a few days. There was no way to fill it since she only needed a few things, plus, if we did, it would be entirely too heavy. My bad. I'm not sure why it didn't occur to me that she'd need a smaller size.
Today, there are loads of options available just for your pre-Kindergarten student. Design is key! Made for little hands, compartments and zippers are perfectly-sized and straps are well padded. Everything is in the right proportion to carry what they need while keeping the weight limit to a minimum.
Did your preschooler get a backpack for school this year?
Photo credit: Skip*Hop


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We Proudly serving Seattle's Best Coffee & Espresso
This classic American latte features rich Henry's Blend espresso infused with silky, light-as-air steamed milk. Guests can customize their lattes by adding their favorite flavored syrups.
Brewed Coffee
Uncommonly Smooth Coffee TM. Our celebrated brewed coffee menu features Henry's Blend, Hazelnut, and Henry's Blend Decaf.
Iced Coffee
Smooth and refreshing iced coffee made with fresh espresso and blended when you order. The flavors are endless or choose one of our popular iced mochas.
Seattle's Best Coffee has long been known for its wonderful mochas. A variety of chocolate sauces is combined with rich espresso and velvety steamed milk to create an irresistible mocha experience.


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Pork-Heavy Restaurants Worry; Zutto Seized
Plus: the "gutter of Tribeca," and Michael Anthony's favorite cheap eats, all in our morning news roundup.
• In the face of swine flu, pork-heavy restaurants like Hill Country and Porchetta are coaching their staffs on how to assuage customers' fears. [Crain's]
• Tribeca's Zutto has been seized for nonpayment of taxes. [Eater]
• Some members of CB1 were concerned about granting a 3 a.m. beer-and-wine license to new pizza spot Dona Bella, lest the late hours put Chambers in the same situation as Murray, which has become "the gutter of Tribeca." [Downtown Express]
• Gramercy Tavern's Michael Anthony's favorite cheap eats include Sushi Seki and 'inoteca. [Feed/TONY]
• Clinton Hill chicken-and-waffle spot Little House on Clinton has shuttered. [Clinton Hill Blog]
• There was a fire near Good Burger and Republic last night. [Always Eating/Twitter]
• Sandra Lee's new Food Network show will focus on money-saving tips, including "eschewing lots of flavors in favor of a McCormick's all-in-one seasoning package." [Urbanite/amNY]


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Li Qingzhao
To the Tune of Mulberry Picking
Who planted the bajiao tree under my windows?
Its shade fills the courtyard;
Its shade fills the courtyard....
Leaf to leaf, heart to heart,
folding and unfolding,
It expresses boundless affection.
Sad and broken-hearted, lying awake on my pillow,
Late into the night
I hear the sound of rain.
It drips and splashes, cool and melancholy;
It drips and splashes, cool and melancholy....
Lonely for my beloved, grief-stricken,
I cannot endure the mournful sound
of rain.
* Ba jiao [pa chiao] belongs to the musa family, grown for
the ornament of their large striking foliage.
tr.by Lucy Chow Ho


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The car doesn't just suffer down the stretch - both Rosberg and Hamilton were under pressure from the get go when they started from pole. The Merc just doesn't seem to be able to handle the high fuel load. At the end of the last race when the fuel had burned down, Hamilton was much faster.


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Get ready for some serious fun at Charlotte Motor Speedway's Dirt Track, Saturday, August 10, as they host Stonecrusher, Brutus, and other monster trucks at the Circle K Back-to-School Monster Truck Bash.
For more information and details about the event, click here.
Our winner will receive a family pack of tickets for admission for 2 adults and 2 children.
Entries must be submitted by 9 am on Friday, August 9, using the tab above. The Observer will randomly choose and notify a winner.


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s Neighbourh ood Guide: Things to do in North Loop
The response to the North Loop neighbourhood in Minneapolis has been extraordinary. Over the last year, the neighbourhood's development has exploded, thanks to independent retailers and restaurateurs and an abundance of chic, rehabbed warehouse-style buildings.
The eclecticism of things to do in North Loop (or NOLO) encapsulates all the best things Minneapolis has to offer: stellar, inventive dining, delightful shopping, and just enough quirk to make it Minnesotan. Take, for example, Marvel Bar, a speakeasy-hideaway bar tucked around the back of a brick building – the only signs it exists are a bouncer and a purple door. Inside are some of the city's most creative cocktails. But it's not pretentious – its menu consists of one item: Cheetos. In the shop around the front of the building, Askov Finlayson, you'll find peerless locally made products like collectible Red Wing pottery – perfect for a gift to take home. They also stock men's outerwear, fashion, and gifts, including their own private-label line.
The stores that have established themselves in North Loop ensure pre-eminence in the Minnesota shopping scene. D.NOLO, one of the latest additions, is a gorgeous industrial space filled with pared-back luxury basics and specialty pieces. Soon it will have more than one retailer in its space, offering a wide range of designer and cutting-edge fashion. Arrow, just down the street, stocks a range of collectible fashion as well, including pieces from Steven Alan and Rachel Comey, plus hard-to-find European designers.
For home-décor fanatics, The Foundry Home Goods should fit the bill. Former interior designer and owner Anna Hillegass has artfully filled her shop with simple, elegant pieces that are functional and beautiful, for a lifetime of use. You might just want to live in her shop. MartinPatrick3 is a men's shop, but it draws female shoppers, too. Men's clothing and shoes are just the beginning: a gorgeous apothecary and gift selection hits a home run every time.
Minneapolis is frequently noted for its bicycle culture: usually clocking in at number-one or number-two on best cities to bike in the United States lists. Both One on One, which is a bike/coffee shop run by an ex-racer Gene Oberpriller, and Handsome Cycles, which carries bespoke bikes and lifestyle products, are two reasons our bikers are so supported in the Twin Towns of Minneapolis and St. Paul.
Wetting your whistle is no problem in between all those shops. Cafés like Moose & Sadie's and Janine's Coffeehouse offer tasty treats, beverages, and light lunches. Those looking for a power dinner will find The Bachelor Farmer's Nordic fare a thrill; or head down the street to tuck into an organic, locally sourced dinner at Borough (and have a cocktail at its downstairs specialty bar, Parlour).
If that's not enough, just blocks away is the Jean Nouvel–designed Guthrie Theater and spectacular views of the mighty Mississippi River. You'll leave with a whole new impression of the Midwest!
Header photo: Minneapolis skyline © Steve Glenn/iStock/Thinkstock
Our partnership means you can enjoy our award winning service on Virgin Atlantic flights to New York, Boston, Los Angeles, Washington, Chicago and San Francisco and then travel onwards to 44 North American destinations with Delta Air Lines – earning miles every step of the way.
You'll also be able to book direct flights from London Heathrow to Atlanta, Detroit and Minneapolis. Plus, you can look forward to more frequent flights from Heathrow to New York and Boston, giving you even more choice.
Have you visited North Loop? What are the best stores, bars and restaurants in you found in Minneapolis? Share your thoughts with us in the comments below.
Written by Katie Dohman
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Awesome write up on the North Loop!
Add ons- making a stop at Bar La Grassa to try the soft egg and lobster dish or a number of pastas (James Beard Best Chef Midwest Isaac Becker), draw on some dollar bills at Cuzzy's (hole in the wall bar), get a lobster roll at Smack Shack (if it's warm enough, sit outside on their patio which has an abundance of flowers), if you're in need of a manly meal like steaks/chops visit J.D. Hoyt's, and for late night dancing head to Jetset or Tangiers. Sporty? Target Field for a Twins game.
The Guthrie is in the Mill District, but it deserves a visit no matter what!
ps Marvel bar upped their options to four on the menu, but the Cheetos are the most fun.
About the author: KatieDohmanKatie Dohman
Katie Dohman went into journalism due to her insatiable curiosity and innumerable interests, her tendency to overshare, and her never-ending love for entertaining people with a good story. As a style editor, she's covered fashion, beauty, health and wellness, fitness, home décor, and trends. But she also loves pop culture, parenting relationships,—and, of course, travel. Her favourite trips? Maui to get married (and Kauai to honeymoon), and a three-week criss-cross of Thailand. Find her at @katiedohman


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In order to assist enhance the convenience of the Police in Tumu to enable them give off their best in the service, the Sissala East District Assembly has managed to donate some set of furniture to the Tumu Divisional Police.
The gesture is also in consonance with the strategies and plans set by the NDC government to strengthen the security systems at all levels to ostensibly promote and preserve absolute peace and calmness in the country.
Besides the Assembly has also yearned to extend electricity facility to the Divisional Police at the area which forms part of the energy delivery programme implemented by the government in the local areas.
Hon. Sulemana Alijata Gbentie, new Member of Parliament for the Sissala East constituency in an interaction with Ghanadistricts.com has said that she would assist to wholly promote development in the area across-board in all the sectors.
She pledged her support to the Assembly to advance the "Better Ghana" agenda programme tom inure the benefits of the people living in the area.
Jonathan Adjei/Ghanadistricts.com


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2009 Butler Volleyball
2009 Horizon League Volleyball Championship
Friday, Nov. 20
No. 4 Butler (21-13, 10-6 HL) vs. No. 5 UIC (15-17, 8-8 HL) - 7:30 p.m. - Cleveland, Ohio
Live Stats | Video
Semifinals - Saturday, Nov. 21
Live Stats | Video
Championship Match - Sunday, Nov. 22
Live Stats | Video
Download Printable Butler Volleyball Match Notes
The Butler volleyball team will travel to Cleveland for the Horizon League Volleyball Championship this weekend. The Bulldogs, the No. 4 seed, will take on UIC in the quarterfinal Friday, Nov. 20 at 7:30 p.m. The lowest seed remaining will play regular season champion Cleveland State Saturday at 1 p.m.
This season marks the 1st time league teams have had to play their way into the tournament. The top six teams qualified for the championship, with the top seed serving as host. The Bulldogs spent most of the season in 3rd place, but a pair of losses in Wisconsin brought BU into a tie with Milwaukee at 10-6 in league play. UWM had the tie-breaker and Butler was seeded 4th.
If seeds hold, Butler would advance to play Cleveland State in the semifinal. The championship match is set for Sunday, Nov. 22 at 1 p.m.
Butler and UIC split the season series, with each team winning at home. The Bulldogs recorded a 3-2 home-finale victory over the Flames on November 7, which clinched an undefeated home season for Butler. The Flames set the Bulldogs in Chicago on October 10.
Junior Jessica Wolfe finished the regular season as the league leader in kills per set (3.98) and points per set (4.58). She also finished 3rd in the HL in aces (0.31). Senior Porshia Allen also finished among the league leaders in kills (7th, 3.31) and points (6th, 3.80).
DOGS HIT ON 21: Butler is having one of its best seasons in years, winning more than 20 matches for the 1st time since 1997. 2009 is Sharon Clark's best at BU; her 2003 team went 20-12.
...AND GOT ALL 9 AT HOME: The Bulldogs finished a perfect 9-0 at home, including an 8-0 mark against Horizon League opponents. The Dogs won 27 sets in Hinkle this season while losing just nine.
WOLFE THE TOP DOG IN HL: Outside hitter Jessica Wolfe continues to lead the Horizon League in kills per set (3.98) and points per set (4.61). She also ranks 3rd in aces (0.33). If she can maintain her 3.98 kills rate, it would be the 8th best season of hitting in school history. Wolfe was named all-tournament in three of Butler's four tourneys, and was named Horizon League Offensive Player of the Week on September 7.
BUTLER IN THE NATIONAL RANKINGS: BU is ranked among the national leaders in two categories. The Dogs are 49th in kills (13.68) and 48th in digs (16.41).
BU IN THE LEAGUE TOURNEY: Butler won the league tournament in 1997 and advanced to the final match in 2000 in Sharon Clark's 1st season. Since then, Butler is 3-8 in the tourney and hasn't advanced past the semifinals.
COACHING MILESTONES FOR CLARK: Butler's 3-0 win over Alabama A&M on Homecoming was career victory No. 250 for Sharon Clark. The Bulldogs' head coach, in her 10th season at Butler, now has 156 wins at Butler. The school record for wins at Butler is 169 by Sharon Dingman (1992-99).
DAPRILE KEEPS DIGGING: Junior Katie Daprile ranks 5th in the Horizon league in digs (4.41) and is 3rd in the HL in conference play (4.85). The Bargersville, Ind., native was named Horizon League Defensive Player of the Week on Oct. 19 after picking up 27 digs in a 3-0 win over Youngstown State. She has reached 15+ digs 16 times this season.
VERA SETTING IT UP: The setter on the other end of Butler's attack success is freshman Gina Vera. The Joliet, Ill., native ranks 2nd in the Horizon League with 10.70 assists per set, and she has been in the national assist rankings for the majority of the season. Vera was named all-tournament at IPFW and Kent State.
ALLEN CLIMBING ATTACKS, KILLS CHARTS: Senior Porshia Allen continues to amass impressive career totals. Allen has 4,133 career attacks, good for 6th on Butler's all-time list. She is also 5th in school history with 1,450 kills, 148 swats behind Kali Carter (2001-04).
UP NEXT: With three wins in Cleveland, Butler can advance to the NCAA Volleyball Championship for the 1st time since 1997.


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Fall 2012 Broadway Guide
by Whitney Spaner, 08/28/2012
Courtesy, Jeffrey Richards Associates
The Anarchist
Two-time Tony winner Patti LuPone and three-time Academy Award nominee Debra Winger pair up with Pulitzer Prize–winning playwright David Mamet for what is sure to be an award-winning new play, The Anarchist. In contrast to Mamet's male-focused Glengarry Glen Ross, which also appears on Broadway this season, this new play focuses on the relationship between two women. LuPone plays a longtime prisoner with ties to a political group, and Winger, in her Broadway debut, plays a prison guard whom LuPone is trying to convince to let her out on parole. The pairing of these two powerful actresses in a life-and-death battle of wills is not to be missed.
Lyceum Theatre, 149 W. 45th St. Previews begin on November 13; opens on December 2.


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They are what they are (KR's words). Unless Pirelli were to make bespoke tyres for each team - hardly a feasible option - then the spec/construction should remain as they are for the full season. Changing them would be an unfair action to benefit some teams and compromise others. All the teams had pre-season testing to identify the best way to run them. If a team has an issue, then work to resolve it, not cry "foul".


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So this morning I was out riding and feeling pretty good about the ride. it's warm but I'm moving right along. On one particularly long, gradual climb I was actually in a higher gear than I normally use. I'm feeling pretty good about myself when all of a sudden I hear, Hello. And this guy blows by me like Im standing still. Oh well. That pretty much let the air out of my balloon.
BUT I weighed 198 lbs. in December. I was 177 lbs. this morning when I got in from the ride!


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I've lost my hubby to the Masters this weekend. He's the sports director at WBTW and working hard to get great highlights of the event to share with you. (P.S. I'm really jealous of him...I would LOVE to go)! However, I am fortunate enough to cover Monday After the Masters at the Dye Course and I will be bringing some of the highlights to you on the air from 9:30-10 a.m. Monday morning.
Back the real Masters in Augusta, GA...here's what we do know as of Friday morning. Tiger Woods isn't off to a good start. He finished the first day tied for 13th place, and dropped an F-bomb on camera. Oops! Who IS doing great? CCU grad, Dustin Johnson. He finished his first round yesterday with a 67 - placing him in second place after Sergio Garcia and Marc Leishman - who both shot 66 yesterday - and are tied for first. Let's hope DJ can keep it going in round two today. It would be great to see a guy with local ties with a major title to his name. And this is unbelievable, 14-year-old Tianlang Guan from China is the youngest player ever at the Masters. He shot a one-over 73 for his first round. He says he feels great. I bet he does - what an accomplishment!
Return to: Kristine's Blog Blog


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- 8 years ago by Dexie
- 8 Comments »
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I really am a huge fan of the Olympics. I love that adrenaline. I love cheering for the US Team. And last night was one of the most intense cheering I have done thus far. At about 11pm, I was … More
I really am a huge fan of the Olympics. I love that adrenaline. I love cheering for the US Team. And last night was one of the most intense cheering I have done thus far. At about 11pm, I was … More
Hey guys, I'm celebrating my 1 year anniversary at my Women's Bargain Fashion blog, Style It Less and for this week's contest, I'm giving away a $200 Gift Certificate from Twisted-Silver. The latter is a jewelry/accessories store by the way … More
Image details: Tom Hanks And Ron Howard On The Set Of "Angels And Demons" served by picapp.com I know I know, Angels and Demons has nothing to do with Men's fashion but it sure has a lot to do with … More
I bet you at one point you've asked yourself "what is in my wife/gf's purse"?. Women these days love to carry those oversize bags. Like their life is over if they can't fit in another 2 tubes of lipgloss to … More
When I posted a birthday greeting for my husband yesterday, Alicia from Mental Health Notes was surprised to know that b5media has a married blogger duo. Well, Alicia, you'll be even more surprised to know that my husband and I … More
My Hubs is celebrating his 40th ;) birthday today. Nahh, he's not 40, YET, hehehe. 40, 30, 32, who cares. He's a hottie and he's my hottie! Shameless plug for his own b5media blogs. Metalmartyr and Health and Men. … More
If you're a blogger, like everyone online is pretty much, then you have an online outlet to show how romantic you are to your wife/gf on her birthday or your anniversary. So here's a page from my husband's book of … More
So what are you guys doing before or during the ball drops at midnight? Holiday season is usually the time couples move up to the next level of commitment. Any one of you got engaged this past Christmas? Josh Duhamel … More
Men's Health magazine conducted a survey among 215 Women for their November issue regarding the thing called PDA. That's Public Display of Affection for yah. These 215 women rated which actions are very classy way of showing Men's affection and … More
My husband didn't just buy the $15 Starbury sneakers when we stopped at a Steve and Barry's store from our road trip vacation. He also found some other goodies for himself like novelty shirts and one pair of chino shorts. … More
Prison Break star Wentworth Miller wearing a white long sleeves dress shirt which he decided to roll up and cuff for about 3/4 sleeves, light wash denim jeans and THE athletic shoes to have, the classic blue Chuck Taylor's. Wenty, … More
Giving flowers to the woman you love shouldn't just be limited during Valentine's Day, her birthday, or an anniversary. Surprise her with flowers any day, no occasion necessary, just because. That's exactly what my husband did for me last Friday. … More
My husband and I are equally picky when it comes to perfumes. It's got to be really nice, subtle and not too over powering. We're always doing the "sniff" test on the packet samples usually found in magazines. We had … More
I have a confession. I prefer Men's watches over Women's watches. I love the masculinity of 'em. I don't like delicate skinny straps nor do I like the frilly designs. I love the no-fuss style of Men's watches. The straps … More


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Brand Strategy // Brand Identity // Website Design // Content Strategy // 2014
Silverock Group is a private investment company that knows how to create big returns for their clients. They needed a corporate identity that spoke to safe, secure investments, but would also play well in the world of ultra-luxury real estate and hospitality—their key investment areas.
Naming // Brand Strategy // Brand Identity // 2014
The Modani is an ultra-luxury spa resort and wellness center in Israel—or rather the vision for one. I'm the lead Brand Strategist on the project, working closely with the project principals, interior designers, and marketing team to ensure that the brand we build will keep the guests coming.
Brand Identity // Website Design // 2013
Sarah Jackson's growing private yoga business needed an Identity to keep up with it. A simple mark, bright pops of color, and some playful pattern fit just right.
Logomark // 2013
As I was getting ready for class at Sonic one day, a flier caught my eye: a competition for an icon to complement their typographic logo in exchange for a year of free class. Although I didn't win the competition, I ended up with some design work I was pretty happy with.
Brand Identity // Website Design // 2012
Private yoga instructor Sarah Ireland came to me with a goal: reflect her personal teaching style in her Brand Identity. We got to work practicing yoga and design, and together we created a system that represents her warm, bright teaching style.
Brand Identity // Package Design // 2008-2014
Hooper 206 is a small batch winemaker with a big mission: make wine that's so delicious it speaks completely for itself. And while they have no budget for marketing, this pro bono work definitely pays off: more delicious, handmade wine than I know what to do with.
Brand Identity // Package Design // 2012
When Andrew Horowitz started making music outside of his band, Tally Hall, he chose to go by the name Edu. He had a great start—a unique, whimsical sound and a loyal following. To complete the picture, we built an Identity to give him a look that was all his own.
Brand Identity // 2009
The Galilee Experience is a tourist attraction in the historic city of Galilee, Israel. While working at Propoza, my team was given the opportunity to rebrand their logo and aspects of their physical site. The designs on this page are work I did for our bid.
Brand Identity // 2009
Univiews is an IT consulting and training company. When my team at Propoza was hired to give them an Identity, we got right to work developing a system that offers as much clarity and organization as their work gives their clients.
Book Design // 2007
I took on this passion project during my last semester of college. While the final assignment for my "Music of the Beatles" class was to simply compile the written responses kept throughout the class, I decided to design and bind a book instead. (Anecdotal extra: I was so embarrassed to be seen as a teacher's pet that I turned in the project during office hours.)
Book Design // 2007
I designed this book to fulfill my senior seminar (thesis) assignment. I researched and edited all of the written content, created original illustrations, and laid out the many visuals that helped tell the story of this interesting—and at times controversial—garment.
Fine Art // 2007
At the heart of my passion for design is my desire to visually create. Before I ever touched a mouse (and for as long as I remember) I drew, painted, and made things with my hands. I created this piece in a printmaking elective using woodcut and other printmaking techniques.


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Register with us or sign in
From 0 ratings
Plant type
Half-hardy annual
Flower colour
Skill level
This is a particularly interesting tobacco plant from Brazil. It has delightful sprays of nodding, bell-like flowers in an unusual apple-green colour. The leaves are very sticky. Plants are tall, with branching stems, and create a real focal point in the flower border. They are half-hardy annuals, which can be grown from seed indoors, with heat, and planted out after the last frosts, in late spring or early summer.
Family: Solanaceae
Genus: Nicotiana
Species: langsdorffii
Plant type: Half-hardy annual
Flower colour: Green
Foliage colour: Mid-green
Feature: Flowers
Sun exposure: Full sun, Partial shade
Soil: Well-drained/light, Boggy
Hardiness: Tender
Skill level: Beginner
Height: 150cm
Spread: 35cm
Time to plant seeds: March to April
Flowering period: July to September
Be the first reader to review the Nicotiana langsdorffii Tobacco plant!


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A series starring a "Sopranos" star (and member of the E Street Band) is back for season two, and has added to its cast.
Netflix's "Lilyhammer's" second season is currently filming in Oslo and Lillehammer.
Steven van Zandt, who also exec produces, is there on break from his touring schedule with Bruce Springsteen.
Paul Kaye ("Game Of Thrones"), Erik Madsen ("Da Vinci's Demons"), Amy Beth Hayes ("Mr. Selfridge") and Jakob Oftebro ("Kon-Tiki") have all been added to the cast.
'Lilyhammer' premiered in Norway in January 2012, and drew record numbers for network NRK1. It was the first original series to launch on Netflix when it debuted via the streaming service in the U.S., Canada and Latin America last February.
In season two Frank Tagliano (van Zandt's mob fixer) is still in witness protection and juggling fatherhood and running his criminal operation. This season a group of English soccer hooligans; a bank robbery that threatens to reveal Tagliano's identity; and a ferocious new female sheriff will have to be dealt with.
Eilif Skodvin and Anne Bjornstad are the showrunners; Anders Tangen is a producer;.and Lasse Halberg executive produces with van Zandt. Season two filing runs through April, at which time van Zandt goes back on tour.


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Many companies who are interested in social media think that they will run out of things to blog about after the first week or so….Here is a poster that I use to help them think about blogging for business and indeed any other social marketing initiative
Whether it be a song, a film, a book….remakes can be even more popular than the original content.
Social media is about exploring your area of expertise from many angles, which I often describe as the social diamond approach. Just as a diamond shines because of the angles, so your social media can 'dazzle' by taking viewpoints to your sector or industry
- What do you customers ask in relation to your business – take the customer as the starting point?
- What is your story, passion…who are you? – blog from your angle
- What are the key influencers in your industry thinking, reasearch? – take a look at the business sector as a whole and add your commentary.
- What are the trends in general which will affect your consumers world – take a look at the long term angle?
- What are the changes that have happened in society? – take a look at societal angle for your business.
When social marketing is done best, it is a remake yes of your subject area…but like all great director's you put your twist on it….you change the context of the story. Your story stays constant to help build the brand equity, however you look outside of your business to change contexts which resonate with your consumers.
If you did a movie poster of your blog what would it say?


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Disney takes its characters to housing projects
Aug 27 2013
Disney India has signed up licensing agreements with four property developers in the four metro cities, who would develop Disney themed residential projects. In October last year, it signed the first such agreement with Suntek Group in Mumbai. Early this year, it signed up with Supertek in Delhi and Taurus Group in Kolkata.
On Tuesday, it announced the association with real estate developer Akshaya for a project in Chennai. The project in a 47-acre plot at Sembakkam, off Chennai, would have 3,372 homes in the first phase. Apart from the residential units, commercial space, retail space, school, hospital, recreational facilities and senior citizen homes in the "Youniverse' township would be characterised by Disney characters.
Under the four-year license, Akshaya could use any of the 8,000 characters of Disney, including those of the Marvel brand. Disney India would also work with Akshaya in creating home themes using these characters. "The Disney-inspired homes targets the families with children by providing dream-like fairy tale experience not just in their rooms or homes, but right from the gate of the complex to each and every corner of the township," said T Chitty Babu, chairman and CEO of Akshaya. The project hopes to accommodate more than 20,000 people.
"Brand licensing in the real estate space is something that the Indian office of Disney has taken up. We are looking at more tie-ups in the sector for different cities. In each city we will look for the right developer who can recreate the brand in the right way," said Roshni Bakshi, managing director, consumer products, retail and publishing, Disney UTV.
Disney products are available over 100,000 retail touch points in India and the brand has over 140 licenses across different categories.


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Hi folks,
It'd be nice if the address auto-completion feature while composing message also works for GAL.
Hi folks,
It'd be nice if the address auto-completion feature while composing message also works for GAL.
Last edited by graffiti; 12-03-2005 at 10:22 AM.
Yes this is on the list. Technically it's easier for local contacts since they are all cached. At the moment we don't cache the entire GAL in the web client since for some orgs it may be very large. Either way it's on our list for the future.
Looking for new beta users -> Co-Founder of Acompli. Previously worked at Zimbra (and Yahoo! & VMware) since 2005.
Hi Kevin,
Thanks for your info.
Some other RFEs:
1. it'd be nice to share my calendar to multiple users by just specifying all of their addresses in the "Share with" textbox (each seperated by a colon). ATM, if I want to share my calendar for 3 users, I must repeat the same procedure (right click on my calendar==>Share Calendar==>type in user in "Share with" textbox and finally click Submit) 3 times.
2. it'd be nice if "Share with" is a button like "Attendees" in creating appointment which allows me to search and import address from Personal Contact List or GAL.


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S.S. Canonesa
The Canonesa, together with the other ships of Houlder Brothers and Furness-Houlder Argentine Lines, operated on the River Plate run, with a seasonal trip on the Patagonian lamb run. During the first year of the war she had completed three return transatlantic passage ; from Liverpool to Buenos Aires to Southampton (September-December 1939); Southampton to River Plate to Victoria Docks, London (January-March 1940); and Victoria Docks to River Plate to Victoria Docks (April-July 1940).2
On the last of these, her penultimate voyage, she sailed to the Falkland Isles then across the Straits of Magellan, loading lamb from a series of small ports along the Patagonian coast. Dennis Johnzon, a member of the Canonesa's crew at the time, remembers that on approaching the Thames estuary the 59-ship convoy, with Canonesa taking up the rear, was dive-bombed and machine-gunned by enemy aircraft. As the rear ship she was singled out for special attention, but no bombs found their target, partly thanks to Spitfires eventually driving off the enemy. Machine-gun bullet holes were, however, very evident.3 Peter Tingey, an apprentice on board, also recalls this incident :
"I was on deck as we approached the Thames estuary when intense anti-aircraft fire broke out all around both on shore and from ships as I looked up and actually saw the bombs leaving the high level German dive bombers. Like lightning I made my way to the midship saloon and dived under a dining table. Bombs exploded near but without a direct hit and I also heard a sustained rattle which could have been from the German machine-gun fire. The immediate danger passed as our Spitfires had ploughed a swathe of doom among the air raiders."4
Eleven ships owned by Houlder Brothers & Co., and a further four managed by the company, were lost during the war. The Canonesa was the fourth casualty. Ten ships were torpedoed, two mined, one sunk by a surface raider, one captured and later sunk by a surface raider, and one bombed. Just five ships in service when the war began were still afloat when hostilities ceased. In all 114 men died whilst in the company's service.5
[The Canonesa's last voyage and her sinking are described on the next page.]
You can view more pictures of the Canonesa at the Gallery.
See Battle of the Atlantic Bookstore for fuller


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Barbara Allen, 5ET
Bill Banusiewicz, 7WT
Deborah Baron, ECC
Jackie Bland, 7WT
Teressa Ferguson, 6ET
Dawn Oder, Simulation Lab
Robyn Pomykala, Home Care
Barbara Ritchie, Mother Baby
Tina Sweeny, Ortho
Mary Vijayan, 7WT
Joann Deserio, RN
Neonatal Transport Team
Winner of the First Annual NAUTILUS AWARD
When I tried to think of a "caring story", several sharing moments came into mind. They are as fresh in my mind as if they happened just yesterday. And all had an interesting common thread, they all involved thinking "outside of the box" and doing something unusual and intuitive that would never be done under normal circumstances.
There was a time that I was caring for one of our "graduates", a twin, who returned one month post discharge with overwhelming beta strep sepsis. We came to a point where our skills were not going to be able to save this baby boy. His parents consented to withdrawal of life support but wanted to hold him in his last moments of life. They were trying to decide who should hold him. I had a bed brought into our NICU so both parents could get into the bed and lie with their dying baby together as a family, loving and supporting each other and their son. At his funeral they expressed how much that really meant to them. THAT was their memory of his short stay with us.
And there was the time that I was caring for another terminally ill baby who was the son of a single dad. His dad was always by his side, and had to face the difficult decision of letting his son die a natural death. He told me his only regret, one that he could never get used to, was that his son never got to breathe outside of a hospital, never felt the warmth of the sun. He had only experienced breathing through tubes and the artificial heat of our machines. I thought about what he said and came up with a plan. I begged the neonatologists to go along with me because it would not change the outcome and I promised I would stay with the baby. I talked with the dad and he started to cry. We disconnected his son from every device, leaving the endotracheal tube for last. I scooped up the baby, and with dad following right behind, I ran out the back NICU door, down the stairs, and outside to a picnic bench across the street. Then I placed the baby in dad's arms and he sat for a half hour or so talking to his son and describing the world to him. That is a memory that dad would have forever.
And lastly, is my main story, of a sweet deformed baby that his mom did not want because he was not perfect and reminded her of a part of her life she was unable to face. He had a lower limb deformity that cased malformation and fusion of the limbs. He was a DNR at delivery, but survived and I brought him back to be admitted to the NICU. His mom could not deal with his birth, survival and existence. She did not want to see what her past had resulted in. She would not be taking him home. I asked that she be brought to his bedside because he may not live. She came, and I helped her "say hello" to her son, gradually introducing them and ending with her actually holding him and giving him a name. In four days, when we knew he would survive for a while, he left us to go for specialized care he would now need. Mom put him up for adoption, but for a brief time, he was held and loved by his mom, and she had a chance to give love and a name to her son. These events were observed by a peer and were put in a poem, given to me a special and wonderful gift.
We expected the call
but did not want it
NICU needed in LDR9
That's the DNR someone whispers.
I see Joann volunteer to go
She knows her compassion is needed
and they dress her in the
Strictly Business Gown,
mask, gloves,
She dons her Strictly Business Face.
They don't take The Box,
him being a DNR
and I find myself praying
she doesn't have to suffer
It is a quiet wait.
she might return
hands to her side.
Joann returns,
the bundle only half the size
it should be
cradled to her breast.
He keeps looking at me
she says.
I call the chaplain
for her sake, mostly
and she asks if he can have
a temporary name,
Michael, she says,
like the archangel.
He might live
Joann says
and he might not
would you please go get his mother?
The Mother Who Couldn't Do This comes.
I wish I could take him home
she says.
I will name him Kevin Michael.
I can not hold him
she says
but I will look.
And not at his legs.
Joann's eyes tell me the Michael part is her reward.
Joann changes the Michael-Child's diaper
slightly revealing little deformed legs
growing the wrong way
so his mom can see only a little bit
because she is Not Ready To See.
The diaper is not wet
I know.
Joann tells her it's okay
you don't have to hold him
she says
and he is slipped into his mother's arms
in sixty seconds flat.
Very slick, Joann
my heart feels very warm.
With great patience Joann the nurse
introduces Kevin Michael to his mom
a little bit at a time
and they bond.
He may live
she says to me
You know he keeps looking at me.
I will take care of him tomorrow.
And she does.
Third day
the Mother Who Couldn't Do This
never comes back
but we know their time together was good
Joann made it good.
He has decided to live,
she reports with confidence
we're sending him away
to where he can get
multidisciplinary care
he can't get here.
He keeps looking at me
She says.
So powerful is her love,
for a moment the child in me
maybe if they'd leave him here
with Joann
his legs would turn around
and grow the right way.
I go home
and fall asleep
thinking of the Michael-Child
searching Joann's soul with his dark eyes.
Fourth day
his bed is empty
she smiles professionally
and says with pride
They fell in love with him up there, too.
The nurses think he is beautiful.
And I wonder how she can share him.
I guess correctly
she took him there herself
Transport Nurse.
Jumped at the chance to ride
I smile.
The little Michael-Child
left with a piece
of this nurse's heart
She gave it freely
the nurse who volunteered
to go to the delivery
knowing her compassion
was needed.
(Written by Laura Stutzman to honor Joann Deserio)
Pam Mason, RN
Comprehensive Rehab Unit
As nurses, we are very fortunate to have many people cross our paths, and relationships grow. Co-workers, patients, their families, their friends and so on. In February, 2007, those relationships collided.
Working on a TCU unit we had a large turnover in staff. For me it was great opportunity to meet many nurses: Some traveling, some just getting experience and others, like myself, enjoyed working on a Transitional Care Unit. In September 2005, a new nurse arrived-Ann-a fairly new graduate. She had worked at a local smaller hospital so this was an adjustment for her. I was more than willing to help make the transition pleasant. I discovered she lived in my town, and we shared some common interests. We started taking occasional walks on the beach, lunch dates, carpooling to work and always sharing stories about our kids. I always felt as if there was some connection between us. Her dream in nursing was to work on an OB unit. Not long after she came to us, she was given that opportunity and left to follow her dream job. Shortly after, my unit merged with the Comprehensive Rehab Unit. After those changes occurred, our schedules were not conducive to sharing time with each other. We still kept in touch.
On February 12, I was making my local supermarket run and usually passed her house en route. It was early evening and I noticed her house was dark, which was unusually for a home with 3 teenagers. That was the moment that "connection" kicked in. I returned home, and spoke to my husband about it. I made a phone call to her house, and left a message on the answering machine. I didn't receive a call back by the next day. I started to call mutual friends and no one knew of anything unusual. Again I called and left a message. Two days later at 10:30 at night, I received a call from Ann. I can still hear her on the line. Her older son John had a terrible accident and she was apologizing for not calling sooner. They were in the hospital in Gainesville. The long-term prognosis did not look good. He had a serious brain injury. His injuries would require long term therapy, and being three hours from the family was not an option. I talked to her about transferring him to our facility for rehab. They had considered the move but were not sure how to go about it. I asked her permission to help, and with that, set the wheels in motion, making phone calls to case managers, and spoke to our medical director. On February 18, he was transferred to CRU.
I arrived to work on Monday. The charge nurse approached me and said the family had requested I be John's nurse that day. Emotionally I didn't know if I was ready for that. It would be the first time I would see Ann since the accident. We hugged and cried. I knew at that point I was gong to get John and his family through this. In two and a half week he made amazing progress with the support of his family, friend, and the rehab staff of CRU.
It's been about a year and a half now and John is working at an engineering firm and doing very well. Our schedules still don't allow us to spend much time together but we always manage a quick hello and hug in the elevator at work and an occasional long phone conversation. I am thankful every day for the wonderful recovery John made and my relationship with Ann as a nurse and a friend.
Connie Caban, RN
Mother-Baby Unit
I have a story to share-it doesn't relate to any one patient but to a group. I used to be a float nurse and have now been based on MBU for a year and a half. I am bilingual in Spanish but not what I consider fluent. It seemed obvious to me that we were missing an opportunity for teaching an entire population of our patients. Some Hispanic moms register for prenatal classes but I'm told as time goes on, fewer attend in the end. We send our moms home with discharge instructions and a Spanish booklet after they view their video. However, there was no plan of care for them explaining what to expect from us while they were hospitalized. I developed, with the help of Eva Valenzuela, RN, MBU, some Spanish communication tools for bedside use by patients and staff in the hope of enhancing communication, teaching a standard plan of care for vaginal and cesarean deliveries, and improving patient outcomes. Feedback so far seems to be good. It feels good to contribute to the unit. My hope is that both staff and patients benefit as a result.
Sandy Goguen, RN
8 Waldemere
Here is my story of caring! While working on an oncology floor I was very fortunate to meet a wonderful lady, Mrs. S and her 3 daughters. Mrs. S was diagnosed with untreatable cancer and was going to stay with us as a hospice patient. I worked the night shift and am very open with my patients and spend a great deal of time sharing of my family and encouraged them to do the same with theirs. Mrs. S asked many questions about my wife and I and she learned of our being pregnant and soon to be born child. She was very excited for us and every shift would ask how my wife was doing and such.
One day on my schedule days off, I received a call from my floor asking me and my wife to come in as Mrs. S was not doing well and she had asked to see us together. My wife Lynn and I went directly to the hospital to see Mrs. S and her daughters. Upon entering the room, I could tell Mrs. S was very weak and not doing well. How her face lit up when Lynn and I came into the room! She explained she had wanted to meet the woman who her favorite nurse was married to. She was then handed a package from one of her daughters which she presented to my wife and explained that this was a small token of friendship for the special treatment that I had given her (same as I treat all my patients I hope). When Lynn had opened the package, inside was a beautifully handmade crocheted baby blanket that Mrs. S and her daughters had made. Needless to say, my wife and I were both teary eyed at that beautiful and thoughtful gift. All the nurses on the floor were aware of the gift and had kept it a secret!
It was not long after that, that Mrs. S passed away-not knowing if we had a boy or a girl. Once we had our daughter, Sarah, we wrapped her in that blanket and took some photos and hand delivered them to the oldest daughter. Again, our daughter was wrapped in the blanket they had made for her. Once again, the tears flowed and Mrs. S's daughter could not thank us enough for taking the time to remember a past patient and her family.
My family has been very fortunate to have met many of my patients over my career. It is the small things that make nursing my career choice: the "thank you's" the "I'm so glad you are on for the next three shifts," "your co-workers have said so many nice things about you. I'm looking forward to you being my nurse," but every now and then a special friendship or bond occurs and you can tell you have made a difference in someone's life.
Elizabeth Cardinale, RN, BSN
I have always viewed nursing as a team effort, and my view has proven correct on numerous occasions. One particular event that sticks out in my mind occurred during my first year as a nurse as I was caring for a patient suffering from a rare complication following a routine orthopedic operation.
I have worked on the orthopedic unit since graduating nursing school in 2006 and have cared for countless spinal surgical patients and knee and hip replacements patients. At this time, I was a brand new nurse which meant that any high risk patients or patients with high acuity were assigned to the experienced nurses and charge nurses. If at any time I had questions or concerns or wanted another nurse to verify my assessment, all I had to was request so.
The day that this practice-changing event occurred, a nurse was working overtime on our unit from 7am until 3pm. Since we work twelve-hour shifts, every staff nurse had to pitch in to take the nurse's assignment for the remaining four hours of the shift. I can remember sitting down at the nurses' station with a report sheet taking report on a 46-year-old woman status post an Anterior Cervical Diskectomy, a common neck surgery where the surgeon repairs the neck vertebrae by making the incision in front of the neck. She had only been on our unit for 2 hours at 3pm.
"OK, Mrs. Smith (name changed to protect the patient's identity). She is a very needy patient. She has been complaining of discomfort since the minute she arrived. She acts as though everything is an emergency." The nurse reported to me.
I have never liked the idea of a report starting this way because it sets the oncoming nurse up for a false impression of a patient that is unknown to me. But, I listened to the report and shortly after, went in to assess my new patient.
"Hello Mrs. Smith. My name is Elizabeth and I will be taking care of you for he next four hours", I said. I immediately began to experience that "gut feeling" that something was not right with this patient which is the same gut feeling that my professors would always talk about.
"I can't breathe", she cried. In my assessment, I saw that her oxygen saturations were 100% on 2 liters of oxygen, she was swallowing ice chips well, her skin was warm and dry, her blood pressure was a little on the high side, and her heart rate was in a regular rhythm at a normal rate. Her neck dressing was clean, dry, and intact. Her assessment appeared normal but because of her statement, I reassured her and immediately, but calmly as not to worry the patient, left the room to call a respiratory therapist. I could not even make an educated guess as to what my patient was experiencing, but, from day one you were always told to listen to your patients and mine was complaining that she was unable to breathe.
"Respiratory. I was paged."
"Hello. This is Elizabeth on ortho. Can you please come and look at my patient in 340B?" I explained the situation briefly. The therapist stated he would come up as soon as possible but did not think the situation was emergent. He suggested to administer pain medication or anti-anxiety medication to bring her pain/anxiety down until he was able to assess her.
Without thinking or planning, I went directly back to my patient's bedside to see if there were any changes. Her blood pressure has continued to rise along with her heart rate. She was now slightly sweaty and still complaining of an inability to breathe. Still, all I could do was reassure, raise the head of the bed all the way up to help her breathing, and search for someone to help me.
I placed a call to the surgeon over the hospital's overhead paging system. After a few minutes of no response, I paged again and called the office even though I was sure he was not there as he had just finished a case. At this point, I am beginning to feel overwhelmed and nervous about my patient's outcome. I called my manager and nurse educator who promptly came to my assistance. The intensity was rising so quickly that every nurse on the floor knew what was going on. And, ever worse, my patient's roommate was beginning to feel nervous because in her eyes, nothing was being done about a serious situation.
As soon as my manager and educator arrived, we called a Rapid Response.
The surgeon's office called back and provided my with his cell phone. I had apparently called when he was in route from the hospital to the office. The surgeon picked up the call after the second ring and after explaining the situation, without hesitation, stated he was on his way back to the hospital as he was afraid that the patient was suffering from an anterior cervical hematoma.
The rapid response team was now at the bedside. The patient's demeanor proved that she was going into shock. Her dressing was taut, her skin was clammy, her heart rate was high, and blood pressure declining. My manager encouraged intubation because she knew the outcome if the patient was experiencing a hematoma. At this point, I was so caught up in the moment and nervous that I do not even remember if the patient was intubated on the floor. It seems as though the minute I turned around, the surgeon was there. He immediately said, "Let's prep her for surgery." Then, my nurse manager and the surgeon himself took the patient to surgery.
My educator described to me a few days after how critical our nursing team's interventions really were. The surgeon evacuated a 150cc hematoma. The patient was taken to the ICU on a ventilator for about 2 days before returning to the orthopedic unit. Apparently, she was minutes away from coding but our tight knit nursing staff saved her life. My educator described the situation as "uncommon, but not that uncommon". Strangely, that made sense to me.
Had I ignored my gut feeling, the patient would have definitely suffered fatal consequences. It was my nursing assessment skills that activated a strong team effort that eventually lead to a 46 year old woman walking out of the hospital healthy and strong. I have never felt so proud and accomplished towards my career.
I could not have described a cervical hematoma prior to this but now, I feel as though I can handle many life-threatening emergencies even if the pathophysiology could not be described. I strongly believe that instinct has a lot to do with it. This was my first critical situation as a nurse. Since, I cared for patients who experienced severe hypotension, respiratory distress, severe respiratory depression, and a myocardial infarction. I have a new found sense of confidence and my usual nervous feeling that I had always had before going into work, has disappeared.
Amanda Miller, RN, BSN, CCRC
Clinical Research Center
A Special July Celebration
We all recognize the minute a patient walks through the door into the hospital he or she is already looking forward to going home. There is huge trust that the physical body will be safeguarded, and one will leave either cured or with the opportunity to heal. Our duty as professional nurses is to provide a supportive environment for the individual and the family unit, focused the whole being rather than on the disease or pathology. It can be a challenge to balance the science with the art of nursing but sometimes one really gets it' a recognition that there is a connection with another spirit and an opportunity to transcend the tasks and create a lifelong memory. Close to my heart are two special moments among many, shared with a unique patient who I'll call, "Sam."
Sam was in his 80's, a retired Colonel of the U.S. military. He was the epitome of a proud, dignified leader. I was sure he maintained very high standards for himself and others. Sam was admitted for redo' open heart surgery. His surgeon had explained the risks of complications and mortality was much higher with this second surgery. I met them when the surgeon referred him as a potential candidate for a clinical trial. Surrounding Sam were his two daughters. He greeted me with a big smile but the daughters' expressions revealed their deep fear and dread of the unknown. I immediately felt my presence and purpose was adding to their stress and discomfort. After spending over an hour contemplating the pros and cons of being a research subject and getting an experimental valve implanted, Sam decided to go ahead and participate.
One thing was puzzling me, though. I noticed he had been clutching a piece of paper in his hand during our entire encounter. I didn't inquire as to what it was but knew it must be very important to him. As the morning went on, Sam was engaged in a lot of preparation for his surgery. I spent this time with his daughters, answering research questions as well as other concerns. The fear in their eyes had lessened and they seemed comforted knowing someone they now knew would be with their father through the entire procedure. Having worked in Open Heart Surgery for many years, it was easy for me to reassure them I was going to be his guardian from start to finish. One daughter asked me if I would do a favor for Sam. "Of course, "I said and out came that little piece of paper. On it was a Bible passage from Luke. The passage reflected the strength and power of belief that one is never alone. She asked if I would read it to Sam as he fell asleep in the operating room. I smiled and was honored to do so even though my spiritual beliefs differed quite a bit. The next thing we knew, Sam, the OR nurse and I were off to the surgical suite. The once reluctant daughters hugged me and appeared to have gained a new level of confidence in Sam's care and outcome.
Beeps, clangs, cold patches and a small cool narrow table surrounded Sam. The only slightly familiar thing was me! I never left his side and held tight to his hand, keeping eye contact with his big blues.' When it came time for anesthesia, I asked Sam if he was ready for his scripture reading, and with a huge smile he said, yes.' I leaned down to his ear and read the verse over and over and over at least ten times until I knew for sure he was under deep anesthesia. Then, softly under my mask, I centered myself and blessed Sam with my own mantra. After the procedure, I greeted the daughters who, though tired, now were all smiles. I returned Sam's paper to their grateful hands. They were so happy to know I had followed through with my promise. Though Sam does not remember my reading the scripture, he knows in his heart that his spirit was as cared for as his body.
The second magical moment with Sam occurred in his post-op phase. He was recovering well but slowly, and his stay was being extended. Sam would be spending the 4th of July in the hospital. I thought, What a shame, a retired Colonel not being able to enjoy the fireworks on such an important national holiday! What can I do? Hmmm
.." While visiting Sam on July 3rd, we talked about the holiday and what it meant to him. He had two friends with him and we all shared our stories. I felt sad he was going to miss out on the festivities but assured him I would light a sparkler in his honor. Sam very much enjoyed the idea and I did too; he seemed to actually glow at the thought.
My niece and I lit many sparklers for Sam the next day and we even took pictures. I presented one of the best photos to him. It was titled, "A Fourth of July, honoring our special Colonel!" Sam did fully recover after a very long convalescence. I like to think and hope he experienced not only nurturing of his physical body during the hospitalization but also sincere nursing of his mind and spirit because of our caring connection. Everyday we touch people's lives, but I must admit this is one more time a patient has touched mine.
Diane McMahon, RN, MSN, ARNP-C
Director of Nursing,Bayside Center for Behavioral Health
I was going to Vienna Austria on vacation, flying on Lufthansa Airlines. We were half way across the Atlantic Ocean when a flight attendant asked over the speaker if there were any medical personnel on board. There was: an ENT MD and me. The attendant approached me and said there was a male passenger in distress. Could I see him? He was experiencing chest pain and had fainted at one point. The man was seated next to his wife. He was obese and appeared to be having trouble breathing. The ENT MD stood next to me but did not say anything while I asked questions for a brief history. I learned that 13 weeks prior, this man had a double mastectomy for breast cancer. He was also diabetic, grossly overweight and had been immobile for over 4 hours on the plane. I suspected he had thrown a clot.
The attendants helped me evacuate seats in the center portion of the plane, relocating passengers, so I could establish a small medical bay area to further examine my patient. Seat arms were raised to create a "bed" for him using airline pillows and blankets. I discovered, while this was being done, that there was little in the way of medical equipment on board. A small tank of oxygen had no regulator so I had to control the use by experience of the O2 flow. When I questioned the crew about who knew CPR all of them just starred at me. None of them did.
I did a physical examination of my patient as best I could with my limited equipment. When I auscultated for heart sounds, there were none! How could this be? He was clearly alive and speaking to me. It was only later that I figured out that body posture effected hearing through a stethoscope midair. If I stood akimbo with no part of my body touching any of the aircraft or seat, other than feet on the floor, I could hear the sounds. Otherwise I could not.
I was taken to the cabin to talk with the Captain and reported that I thought our patient had to get to the nearest hospital as soon as possible, that I suspect myocardial infarction. From inside the cabin with my patient, I observed the plane's speed escalate as we headed for an emergency landing in the Canary Islands. This was still over two hours away. I managed to find aspirin onboard with another passenger and, after ascertaining that my patient was not allergic and it was not contraindicated with his other medications, I gave it to him. As time went by, his condition was stable enough for me to be pretty sure that we could continue to Vienna where better medical treatment was available. It was not that much further than the Canary Islands. We landed at the airport in Vienna with me in the cockpit with the pilot and copilot. An ambulance awaited on the runway. The passengers remained on board while an emergency exit was made. The wife did not speak English and I did not speak German but she hugged me with tears running down her face as she disembarked with her husband.
I later learned that my differential diagnosis with little equipment had been correct and that the patient had survived a heart attack. I also learned that the crew, English speaking Germans, did not call CPR the same thing we do. The ENT at one point said to me "You did a great job. I never would have known to ask those questions!"
Some pretty important lessons learned in the air that I needed another time in my career while on a plane.
Kathy Gustafson, RNC
NICU Family Case Coordinator
I have many stories (having worked in the NICU for 23 years) about families and how we have touched their lives as they have touched ours. I do have one story that stands out in my mind and one that I will never forget. We had this baby born around 23-24 weeks gestation 15 years ago. This baby was truly around 23 weeks at birth. Her eyes were fused shut; her skin was so fragile that touching her made her skin peel off. She was bruised from the delivery and her weight was about a pound. This baby had a mom who was young (18 or 19) and no father involved. Mom had a great support with her family. I took care of this baby and bonded instantly with the mom. The baby was not going to make it and lived about 2 weeks, but during that time this mom held on to hope and that a miracle would happen for her little angel.
We all had a very hard time trying to take care of this baby when we knew that hope was slipping away but mom held fast until one day she asked the staff to call me at home to see if I would come in and be with her while her baby was disconnected from ventilator and be able to hold baby while she passed away. I was shocked to get that call that morning but hurried to come in to be with this mom. I sat silently while she held her baby and that baby slipped away to heaven and I kept thinking how privileged I was to be able to experience this moment with this mother. She sat rocking the baby that day for several hours and I was with her when she made her daughters funeral arrangements.
I attended the funeral several days later and all the family knew who I was and thanked me for being part of this mom and baby's life. That was such an amazing point in my career and it made me realize that nursing was for me and that this mom and baby changed my life as well.
Spence Hudon, RN
Clinical Manager: Cardiac Acute, Heart Failure Unit and Remote Telemetry
Rather than my story, I would like to share with you a story of a caring moment in the nursing career of my colleague, Eric Minkin, RN. First I want to introduce you to Eric, so you can fully appreciate what he did for his patient.
Eric grew up playing sports. In high school and at Davidson College he excelled in basketball. He played with injuries in his senior year at Davidson. His stats were less than stellar because of the injury, but he was still named a First Team Jewish All-American, the best at his position in the United States. He accepted a contract offer in 1972 to play professionally in Israel. He signed with the basketball team and arrived in Israel just two weeks after the Munich Massacre of the Jewish Olympic Team. Eric played under strict security with the Israeli team. At one time, he played in a gym surrounded by 500 sharpshooters, in place to guarantee the safety of his team. In 1977 he was a part of the Israeli team that played the Russian Red Army Team for the first time in Israel's existence. They defeated the Russians and were greeted on coming home by 1,000,000 Israeli's, one third of the country. They went on that year to become the European Champions. His experiences while playing in a beleaguered Israel led him to be fiercely Jewish.
After his basketball career was over, Eric returned to the states and got a job selling cars, but found it emotionally dissatisfying. He says he wanted to do something he could be proud of, so he decided to become an RN. He felt it was an honorable profession that gave him an opportunity to help people.
And that leads to the day that Eric was caring for a patient on Cardiac Acute. His patient had not been very religious in his life, but was facing life threatening surgery and felt a need to have the support that prayer and faith can offer. Eric, in talking to him, realized that he had never been baptized and that the lack of that symbolic act was distressing to the patient. Eric asked if he would like to be baptized here, in the hospital, and the patient was enthusiastic about the possibility. Eric contacted the physician, who agreed the patient was well enough to be baptized. Then he contacted the hospital Chaplain on call and they discussed how they could get this done. It was decided that Eric would call rehab and ask about using one of their whirlpools. They readily agreed. Eric went with his patient to rehab and witnessed the baptism in a whirlpool. The patient gained peace and confidence and went on to do well in surgery and was discharged home.
So it was that two cultures touched and a Jewish basketball player who wished to join an honorable profession met his patient's need and fulfilled his own wish to help people in a way that would make him proud.
Kim Sondey, RN
Intensive Care Unit
When I was a young nurse many moons ago, I had a patient that I think of her till this day. I worked on an ICU and ICU step-down unit and our staff was a very young staff on evenings. We were all in our twenties, so when a young patient of twenty nine was admitted to the ICU from labor and delivery, it hit very close to all our hearts. During labor, Geraldine's blood pressure started to rise and she started to become increasingly more lethargic. At first it was attributed to her long labor, but after delivery, she became unresponsive. She was sent for a CT scan and to the ICU with a cerebral bleed. Her family was devastated and even more so when the neurologist and neurosurgeon gave them the prognosis. The neuro- surgeon, gave her a 1% chance of making it out of the OR and no chance at all if he didn't take her to surgery.
She was taken to the OR and the bleed was identified as a ruptured aneurysm and was clipped. She made it through the night and a few days later, she woke up to all our delights. At first she had some major deficits. She was in the ICU for weeks, but we saw a steady improvement over time. The staff was so attached to her and her lovely family that most went above and beyond the norm. When Geraldine was finally sent to the step down unit, we were thrilled and her progress continued.
About two months into her stay, the family decided that it was time to christen the baby. One Saturday evening the nurses emptied and cleaned our locker room, cooked and baked and watched as the baby was christened over a hospital basin. We all went into the med room then and cried our eyes out, because we were all younger than her and you never know. Geraldine eventually went home with her son. She still had left sided weakness but could be independent. She did need help with the baby. The nurses from the floor were all invited to his first birthday, which we were all happy to attend and she kept us updated on there progress for years to come. As we all moved on to other jobs, we lost track of her , but there are a few of the other staff members that I still keep in touch with and we still talk about her and wonder how she is doing. Her son should be in college by now. There have been other patients and other families that I have connected with over the years, but I don't think anyone hit as close to home as Geraldine.
Dawn Oder-Colletti, RN
Center for Advanced Surgery
Taken too soon
She was one of my patient's the first year I was a nurse in the Medical ICU. My patient was a 20 year old girl who had been diagnosed with terminal breast cancer. She was in the unit for complications from her treatment and had been weaned off the ventilator. She had a 2 year old daughter. Her mother had been by her side the whole time when she wasn't taking care of her granddaughter. About a day after she was weaned off the vent, her mother came in to present her daughter with legal papers to give custody of my patient's daughter upon her death. The family was requesting that I help coordinate this with the support of their pastor. Apparently my patient had been in an abusive relationship with the child's father, and it would not be in the best interest of the child to be left with him. This was expressed by the patient; and she was scared about what would happen to her daughter. The importance of having this document was apparent, but as we talked to her, with her raspy voice from intubation and tears streaming down her face she demanded that she didn't want anyone to take care of her daughter, SHE wanted to take care of her. That statement hit me like a brick wall. I was pregnant with my daughter and could not imagine leaving her at such a young age to be taken care of by others, even though it would be family.
I left the room trembling, and went into the nourishment room. I broke down and just cried. I was crying for her pain, for the unfairness of her situation, and for her daughter who would not remember her Mom and how much she loved her. A couple of the nurses working with me that day came in to support me and let me cry. But, I knew I had an obligation to my patient to try to get through this difficult day with her. I pulled myself together and went back in the room with the clipboard that held the documents that needed to be signed. I can't remember all that I said to her, but I spoke to her as a Mom, knowing we do what is best for our children no matter what the circumstances. This being the worst I could imagine. I told her that what she is going through is not fair, and we were all hurting with her. I also told her I knew in my heart, as well, that her Mom would love and nurture her daughter; and do everything in her power to never let her daughter forget her Mommy that was taken away too early. Her daughter would have an angel always watching over her. With both of our hands trembling as I held the clipboard and she held the pen, she signed those papers. Two days later her Mom came to tell me she was gone.
I was glad we were able to get things in order for her. For several years, I would see her daughter and Mother at church, or around town. They would always come to see me and the Grandmother would thank me again. I watched her daughter grow into a beautiful little girl. I wished my patient was here to see her daughter's smile.
Deborah Barron, RN, BSN
The story or "caritas" that I am about to tell is significant for me because it encompasses many areas and aspects of nursing and because it occurred here, at Sarasota Memorial Hospital, where I work in the Emergency Care Center.
My assignment in the Emergency Care Center (ECC) when I arrived for my 7am shift was room #'s 401-404. The nurses have 4 rooms each and, as you can imagine, things get very busy very quickly. Any extra time we can give to our patients is often a luxury. In room 402 I received a female patient in her mid to late sixties with chest discomfort. She was very attractive and I could see at once that she was independent, intelligent and appeared to take care of herself very well. We introduced ourselves and made a connection right away. I learned that she had a history of atrial fibrillation and she was under the care of a primary physician, a cardiologist and that she was going to have a routine diagnostic colonoscopy the following day. Her chest discomfort was about a 4/10 and had started in the late morning. She described it not as chest pain or even chest pressure, but "just something there".
Over the years I have heard these typical descriptions of "something is just not right" or "something is there" when they refer to chest discomfort. Of course, I proceeded to put my patient on the cardiac monitor and oxygen, start an IV and draw blood, and perform an EKG; all the while we were talking and I was assessing her. She had gone out for a light breakfast with her friends in the morning and then she gone to the local YMCA (which I had just recently joined) for a pool exercise class. Towards the end of the class she had felt the chest discomfort and decided to drive herself to the ECC. We talked about diet and exercise and medications and how her lifestyle had begun due to the aging process and atrial fibrillation. She told me that she stopped coumadin 4 days earlier in preparation for the colonoscopy and asked me if that had something to do with the chest discomfort she was experiencing. She also shared that one month ago she had stopped the coumadin for the same reason but the colonoscopy had been cancelled and she restarted the coumadin, only to stop it again 4 days ago. We discussed some possibilities and I encouraged her to wait for the test results and then discuss things with our ECC physician. She asked me please, not to speak to her daughters about anything so as not to worry them and of course I complied with her wishes.
The test results came back and her cardiologist decided it would be best, based on the results and the clinical presentation of his patient, that she be admitted overnight as an "observation" admission, for further blood tests and evaluation. My patient was visibly upset about this, mostly because of the colonoscopy scheduled for the next day.
She asked me what I would do if I were in her place. I could not answer the question, and instead I asked to consider the admission as a small event in time that might be helpful and we could monitor her heart, cardiac enzymes and other lab values. My patient did not want to stay. I suggested that she speak to her cardiologist and to this she agreed. I called him and explained the situation and he was happy to talk to her. I arranged the phone call and witnessed it. My patient was discharged with instructions to go home, continue the prep for the colonoscopy and see the cardiologist the day after. She was very pleased with this plan and satisfied and pleased with all the care I had given her. I was still concerned for her and told her not to hesitate for a moment to return to the ECC for any chest discomfort.
I walked her to her car, which was parked in front of the ECC triage area, and we hugged each other.
Two days later, I was working in triage when I received a phone call from a woman asking me if I had cared for her mother, Mrs
..? I replied, "Oh, yes, I did take care of her", as I recognized the name. "Well, can you tell me what happened to her in the hospital?" "I'm her daughter". I responded that I was not at liberty to discuss the patient's care as that would be a breach of patient confidentiality but she cut me off and blurted out, "She's dead!" I felt like I had been kicked in the stomach. I was silent then I practically stuttered: "I, I'm so sorry. Your mother was a patient here a couple of days ago but she was discharged after talking to her doctor." The woman said I see
" then silence. I continued, "If you have power of attorney or you are next of kin, you may access the medical record and surely you can talk to her physician. Can you tell me any thing?" She seemed a little more comfortable and told me that it appeared that her mom had died in her sleep in her bed. There was no evidence of a break in or foul play. She never made it to the colonoscopy appointment. They just didn't expect it. It was a shock. I was still stunned too. I did say that her mom had asked me not to discuss anything with her daughters because she did not want to cause them concern. The daughter replied that "Yes, mom was a very private person, very independent". I offered that her mother seemed in good spirits, had had a nice morning with her friends and exercise class and that she was satisfied with her plan of care when she left the hospital. She thanked me for my time and I thanked her for letting me know about her mother. I wished her well.
About a week later I received a short, hand written note of thanks from my patient's daughters. A week after that, the two daughters came to the ECC to thank me personally for caring for their mother. I was overwhelmed by that gesture and by their kind note of thanks. Again, I offered condolences and told them how much I enjoyed their mom, how I thought she had enjoyed her life because she shared so much of herself with me.