I have always liked words. The dictionary was my friend as a kid. I always liked to look up obscure words so I could use them in my spelling sentences....when I had to do them (I got out of this homework frequently through some other endeavors...)
As I finally got a minute last shift to start documenting, I thought about what was really happening and a couple of words came to mind.
While I ran myself hither and yon the first four hours, I really wasn't idle (my first word), but I'd suspect some of the chitchat here and there was. As I'm running around, I don't mind speed chatting or bantering with the patients as I hang all of my patients IVs for the shift. My night--come in, run an IV, stop, flush, run another IV of Vancomycin, stop, flush, hold and run another IV, and so on, like a bad TV commercial. I can't get too in-depth.
Unfortunately, sometimes oncoming report is a little too idle. We have some nurses who will give you the new orders list (we write one as we take things off) and your report the same way every time and it's complete. A couple of our people are new and they still haven't learned how to give report, so they tend to engage in idle chatter and miss the big stuff. Like the blood cultures ordered three hours before end-of-shift that have to be done today or the 102 temp that the patient getting blood just spiked near the end of his transfusion, or the report on the patient who returned from acute. It wasn't a big deal for anyone else, but it was for me, since I was his nurse.
Eventually, the last four hours drifted into the idyll category. Our neighborhood isn't exactly pastoral, but sometimes, it is pretty, just before dark, and this night, it was exceptional. The sky was a pinkish-red that glowed as the sun set. I only noticed it because I had a minute to look out the window when I called my husband. It made me think of that old saying, "Red at night, sailor's delight." My patients, including the returning one, were quiet and happy. They got all their nightly pills and drifted off to sleep. The only thing that broke the idyll was a fever in another patient, which required an all-hands fire drill to get all the labs pulled before the oncoming shift came.
So we left our coworkers with an idle, idyllic moment of their own, with sleeping patients, as we walked out the door into the cool of midnight.
More later...
Friday, July 31, 2009
Wednesday, July 29, 2009
Nuggets for July 29
Yes, we're back with another exciting installment this week. Yours truly is sifting the wheat from the chaff so to speak from all around the internet, and it just keeps getting more interesting.
In the rehab neighborhood
As a rehab nurse, you learn a lot about insurance, whether you want to or not. Insurance dictates just about everything in one way or another in private rehab hospitals. Dr. Ford Vox, a rehab physician in St. Louis, MO discusses the implications of the Obama health plan in this article at http://www.salon.com/. We're not talking politics here, we're talking people and what happens in his state if you get a SCI (or doesn't happen), so check this article out.
Cool nursing stuff
I always enjoy reading LaTonia Denise Wright's Nursing Law and Order because she always has some interesting legal stories or great links. Here's the latest link she posted from the Center for American Nurses about a study on Respect. Read the PDF. It's worth printing!
From the web
I don't think of Forbes as a health magazine, but they did a great review of a recent health book called How To Debunk a Health Myth which is worth a read. The book sounds pretty interesting, so I'll have to get it on my reading list.
When I went to a conference a couple of months ago, I met a great person from the Cleveland Clinic. The Washington Post had a recent article about what President Obama saw there on a recent visit. (Hi Marie!)
Need a cardiac cath soon? You just may care if they have enough technetium-99 soon, according to this recent NY Times article: Radioactive drug for Medical Testing is in Short Supply.
Out in the blogosphere
Here is an excerpt below from an old story I ran into when I went down the list of blogs I've bookmarked on one of my several computers. The story is sad, but the lines below are some of my favorites, because they make you think outside of yourself. Moral of the story: tell people you love while you are alive if you want to be an organ donor.
"A little girl hugged me today. I think maybe I’m on the right path. I’m not sure if I like where the path might lead, but it is a really nice path. Is it possible that we, as a culture, focus too much on the light at the end of the tunnel, the pot of gold at the end of the rainbow. Isn’t it enough to realize you’re standing on a goddamn rainbow."
Enjoy your rainbows wherever you find them. More to come!
In the rehab neighborhood
As a rehab nurse, you learn a lot about insurance, whether you want to or not. Insurance dictates just about everything in one way or another in private rehab hospitals. Dr. Ford Vox, a rehab physician in St. Louis, MO discusses the implications of the Obama health plan in this article at http://www.salon.com/. We're not talking politics here, we're talking people and what happens in his state if you get a SCI (or doesn't happen), so check this article out.
Cool nursing stuff
I always enjoy reading LaTonia Denise Wright's Nursing Law and Order because she always has some interesting legal stories or great links. Here's the latest link she posted from the Center for American Nurses about a study on Respect. Read the PDF. It's worth printing!
From the web
I don't think of Forbes as a health magazine, but they did a great review of a recent health book called How To Debunk a Health Myth which is worth a read. The book sounds pretty interesting, so I'll have to get it on my reading list.
When I went to a conference a couple of months ago, I met a great person from the Cleveland Clinic. The Washington Post had a recent article about what President Obama saw there on a recent visit. (Hi Marie!)
Need a cardiac cath soon? You just may care if they have enough technetium-99 soon, according to this recent NY Times article: Radioactive drug for Medical Testing is in Short Supply.
Out in the blogosphere
Here is an excerpt below from an old story I ran into when I went down the list of blogs I've bookmarked on one of my several computers. The story is sad, but the lines below are some of my favorites, because they make you think outside of yourself. Moral of the story: tell people you love while you are alive if you want to be an organ donor.
"A little girl hugged me today. I think maybe I’m on the right path. I’m not sure if I like where the path might lead, but it is a really nice path. Is it possible that we, as a culture, focus too much on the light at the end of the tunnel, the pot of gold at the end of the rainbow. Isn’t it enough to realize you’re standing on a goddamn rainbow."
Enjoy your rainbows wherever you find them. More to come!
Tuesday, July 28, 2009
The start of something big
Yes, the big ol' week, that is. Thankfully, it's been more entertaining than irritating so far.
It's always nice to come back after a vacation of any sort. I was discussing this with one of my coworkers today and she mentioned it was the first time in months that she would be off a week. I told her my last vacation (of about the same length) was just wonderful. The freedoms of waking up when you want and doing things that need to be done when you want is incredible.
The unit's getting more occupants this week. Some are regular suspects, such as the drug addict who's always got problems with his teeth. This time, he just added a couple more problems and most of them were courtesy of non-specialty physicians in his neck of the woods out-of-state. We could have saved him some time and trouble admitting him earlier, but when he's such a handful, no one really wants him back.
We also got a VIP...or at least this patient thinks he/she's one. I'm so happy I got to admit the other character. I was so upset I didn't hear tons of complaints about how "backward" the unit is, either, among the litany of shortcomings said person regaled the admitting nurse over two hours. My response: Hello, please tell someone who can do something about it! We're still waiting for Santa Claus to remodel and get us all the goodies and toys, like wireless internet access, that you're looking for in your accomodation. Besides, you'll only be here a couple of days, so why not just go a couple of miles that way and stay in a hotel with the person who brought you if it's so rotten here? Yes, I'm thinking all of this, as I put on my best, fake, customer service smile, and thanking my lucky stars that those mind-reading things are not on the market right now!
The Slug came back, with somewhat of a Jekyll and Hyde personality going on...one minute, nice, one minute her usual pain in the arse self. Not sure why...but still happy from vacation, so I don't care. One of our new nurses, who's been around the block, had fun teasing her, so we just enjoyed ourselves. This nurse is a breath of fresh air and has been a nurse for a long time. She came to us because of local downsizing, and we're happy we could get her. She doesn't wear a cape, but she does have the skills to do a super job.
Happily, the day rolled along and I actually got out on time. All paperwork complete, people fluffed and buffed and everything done as ordered. Now I get my requisite days to prepare for my long stretch ahead...the something big called working the entire weekend.
Stay tuned...more to come.
It's always nice to come back after a vacation of any sort. I was discussing this with one of my coworkers today and she mentioned it was the first time in months that she would be off a week. I told her my last vacation (of about the same length) was just wonderful. The freedoms of waking up when you want and doing things that need to be done when you want is incredible.
The unit's getting more occupants this week. Some are regular suspects, such as the drug addict who's always got problems with his teeth. This time, he just added a couple more problems and most of them were courtesy of non-specialty physicians in his neck of the woods out-of-state. We could have saved him some time and trouble admitting him earlier, but when he's such a handful, no one really wants him back.
We also got a VIP...or at least this patient thinks he/she's one. I'm so happy I got to admit the other character. I was so upset I didn't hear tons of complaints about how "backward" the unit is, either, among the litany of shortcomings said person regaled the admitting nurse over two hours. My response: Hello, please tell someone who can do something about it! We're still waiting for Santa Claus to remodel and get us all the goodies and toys, like wireless internet access, that you're looking for in your accomodation. Besides, you'll only be here a couple of days, so why not just go a couple of miles that way and stay in a hotel with the person who brought you if it's so rotten here? Yes, I'm thinking all of this, as I put on my best, fake, customer service smile, and thanking my lucky stars that those mind-reading things are not on the market right now!
The Slug came back, with somewhat of a Jekyll and Hyde personality going on...one minute, nice, one minute her usual pain in the arse self. Not sure why...but still happy from vacation, so I don't care. One of our new nurses, who's been around the block, had fun teasing her, so we just enjoyed ourselves. This nurse is a breath of fresh air and has been a nurse for a long time. She came to us because of local downsizing, and we're happy we could get her. She doesn't wear a cape, but she does have the skills to do a super job.
Happily, the day rolled along and I actually got out on time. All paperwork complete, people fluffed and buffed and everything done as ordered. Now I get my requisite days to prepare for my long stretch ahead...the something big called working the entire weekend.
Stay tuned...more to come.
Sunday, July 26, 2009
Sort, shift, shuffle
And that's how I'm ending a pleasant vacation at home. A few major things done, lots of minor things, and lots of assorted miscellany in between. Now I'm sorting school-related paperwork.
Except for a little sinus craziness going on, I feel pretty good. I wish I could do this little three day thing every month. (My boss would kill me, I'm sure!). I am also thankful. In talking with people I haven't talked to in a long time, I realize that I am happy and healthy and I'd just better start to be grateful for that. Many of my friends have their own health issues and lots and lots of caregiver strain issues.
Well, back to paper shuffling...then on to dinner with friends. I can't think of a better way to end vacation.
I'll be back to the old grind tomorrow. Stay tuned...I've got lots of goodies planned next week. Thanks for stopping by everyone! You make my day...now leave a comment if you please! ;->
Except for a little sinus craziness going on, I feel pretty good. I wish I could do this little three day thing every month. (My boss would kill me, I'm sure!). I am also thankful. In talking with people I haven't talked to in a long time, I realize that I am happy and healthy and I'd just better start to be grateful for that. Many of my friends have their own health issues and lots and lots of caregiver strain issues.
Well, back to paper shuffling...then on to dinner with friends. I can't think of a better way to end vacation.
I'll be back to the old grind tomorrow. Stay tuned...I've got lots of goodies planned next week. Thanks for stopping by everyone! You make my day...now leave a comment if you please! ;->
Friday, July 24, 2009
Friday, Friday...
Finally, it's sticking in my head that it's Friday. It should since I was able to do all of the things I enjoy on my occasional Fridays such as the following.
First, Bubba went on his weekly pilgrimage out with me and Dahey for breakfast. I can't remember exactly when we started this, but it's been going on so long, the staff remember when we hauled him in the restaurant in his carrier as a baby.
Next, I went to see my friend Giacomo. He survived vacation which included visiting the multitudes of sisters in his native land near the Erie Canal. Not just one sister, but the entire flock of them, along with mom and the requisite contingent of nieces. He was still reeling from being the lone male around and getting all the "attention." In his family, it's not always good to have attention...
Following that, I also saw some of the coffee people I haven't seen in ages. Dahey told me I need to get a medical file, since most of the oldsters are now answering my "How are you?" with all sort of medical complaints and requests for advice. It's hard to be blunt with them when a) they're old, b) they know your entire family--grandparents, parents, etc., and c) a few of them can tell you about your odd habits when you were younger. (just in case you think you're getting too smart for your britches!) For the most part, they're happy and for now, healthy, and I thank God for that. Besides, a few of them even love my zucchini bread!
Whenever I work evenings, or if I happen to be off, Dahey and I usually go somewhere for lunch. This is a good thing because we get to try new restaurants without having to bring our small restaurant critic along. Today, it was soul food near a place I used to work. This end of town was quite scary when I worked there, but every time I come back now, it's getting better and better. The food was magnificent. I thought I died and went to heaven when I got the smothered pork. The portion was so big, with the mac and cheese and the green beans, that I put half away. It probably won't last too long tomorrow.
I keep looking ahead and try to prepare myself for going back to work. I really understand when some of our older nurses say, "It was really hard for me this time to go back." This little vacation has been wonderful. I have made contacts with people I haven't talked to in years all over the world. I have had lunch with friends who I don't normally see, even though they live within two miles of me. I realize more and more how lucky I am in my life, as crazy as it sometimes can be. It has been a thoroughly amazing time.
Tomorrow I get to do a few more things, then start preparing for the return to work. We'll just keep cruising along...stay tuned!
First, Bubba went on his weekly pilgrimage out with me and Dahey for breakfast. I can't remember exactly when we started this, but it's been going on so long, the staff remember when we hauled him in the restaurant in his carrier as a baby.
Next, I went to see my friend Giacomo. He survived vacation which included visiting the multitudes of sisters in his native land near the Erie Canal. Not just one sister, but the entire flock of them, along with mom and the requisite contingent of nieces. He was still reeling from being the lone male around and getting all the "attention." In his family, it's not always good to have attention...
Following that, I also saw some of the coffee people I haven't seen in ages. Dahey told me I need to get a medical file, since most of the oldsters are now answering my "How are you?" with all sort of medical complaints and requests for advice. It's hard to be blunt with them when a) they're old, b) they know your entire family--grandparents, parents, etc., and c) a few of them can tell you about your odd habits when you were younger. (just in case you think you're getting too smart for your britches!) For the most part, they're happy and for now, healthy, and I thank God for that. Besides, a few of them even love my zucchini bread!
Whenever I work evenings, or if I happen to be off, Dahey and I usually go somewhere for lunch. This is a good thing because we get to try new restaurants without having to bring our small restaurant critic along. Today, it was soul food near a place I used to work. This end of town was quite scary when I worked there, but every time I come back now, it's getting better and better. The food was magnificent. I thought I died and went to heaven when I got the smothered pork. The portion was so big, with the mac and cheese and the green beans, that I put half away. It probably won't last too long tomorrow.
I keep looking ahead and try to prepare myself for going back to work. I really understand when some of our older nurses say, "It was really hard for me this time to go back." This little vacation has been wonderful. I have made contacts with people I haven't talked to in years all over the world. I have had lunch with friends who I don't normally see, even though they live within two miles of me. I realize more and more how lucky I am in my life, as crazy as it sometimes can be. It has been a thoroughly amazing time.
Tomorrow I get to do a few more things, then start preparing for the return to work. We'll just keep cruising along...stay tuned!
Thursday, July 23, 2009
Change of Shift is up in Australia
Head on over and see what Ross has running on his Nurse in Australia blog. Enjoy this installment!
http://www.nurseinaustralia.com/change-of-shift-sunshine-coast-edition/
http://www.nurseinaustralia.com/change-of-shift-sunshine-coast-edition/
Wednesday, July 22, 2009
Nuggets for July 22
Yes, it's back on its regular day. It's gonna be a long post with all the interesting stuff out there, so sit back and enjoy yourself or read in bits if you're working.
I'm really enjoying the heck out of this vacation so in between housework, networking and shopping (the other important "work"), I've been surfing away. Please enjoy as you see fit in your neck of the woods.
The nursing shortage
It's incredible how there is a Dr. Jekyll/Mr. Hyde thing on reporting on the nursing employment. One minute it's dire, the next minute, wonderful, since all those nurses contemplating retirement are staying. I'm just going to chalk it up to American business and the "short term syndrome". Basically, if it's not a problem now, it won't be later, even if demographic trends suggest otherwise.
I'm also crossing my fingers that I don't break my hip in the next 10-20 years, since I'll have to be my own rehab nurse the way things are going.
ACP internist (MD) weighs in on this topic and the glut of nurses.
Kathy Quan (RN) presents the other side: shortage.
Health news of note
Here are a few stories I found very interesting in the health arena. Somebody needs to take me to Greece to complete the one study, though. A long, faraway vacation would be very nice, thank you!
Sex and sleep are just as important as antioxidants (from the 360 blog at www.cnn.com)
This study about people on a Greek island was pretty hopeful in the long-term view.
Want to know if your health habits are making you younger or older? Check out the Longevity Calculator.
Disclosure: I do take an extra vitamin and mineral, but I don't traditionally recommend these as treatments to my patients. This article called Docs and nurses use and recommend diet supplements from www.reuters.com was interesting because it discusses how most doctors and nurses had little education in supplement use.
From the NY Times
This article from the NY Times shows Vets' Mental Health Diagnoses Rising among Iraq and Afghanistan veterans.
Cases-Our Scars Tell the Stories of our Lives made me think about how I look at scars on my patients.
Etc.
Yes, they're released annually, and Madison didn't even make it in as an honorable mention, although some of our system hospitals did show up....way down the list. The US News and Report of America's Best Hospitals even has a couple not far away, if I do need one for specialty care.
Our friends in Canada put a great story in The Globe and Mail recently: Pop culture gives way to peep culture.
Fun!
And last, but not least, who's not going to have fun on vacation? Well, I surely am, and from the looks of some of these goodies, even people at work are having fun and entertaining others, wittingly or unwittingly.
Lost on the Floor just moved, but he is finding some fun in Chart Bloopers.
Braden and many of the ER nurses are always finding great patient complaints. Here's one of his latest patient reasons for visits to the ER at 20 out of 10.
Ahoy! Yes, I'm married to an escaped sailor, so I'm just going to have to order one of these nursey things for my locker, because somedays, I'd really like to raise the Jolly Roger when storming the poop deck on evenings.
I'm really enjoying the heck out of this vacation so in between housework, networking and shopping (the other important "work"), I've been surfing away. Please enjoy as you see fit in your neck of the woods.
The nursing shortage
It's incredible how there is a Dr. Jekyll/Mr. Hyde thing on reporting on the nursing employment. One minute it's dire, the next minute, wonderful, since all those nurses contemplating retirement are staying. I'm just going to chalk it up to American business and the "short term syndrome". Basically, if it's not a problem now, it won't be later, even if demographic trends suggest otherwise.
I'm also crossing my fingers that I don't break my hip in the next 10-20 years, since I'll have to be my own rehab nurse the way things are going.
ACP internist (MD) weighs in on this topic and the glut of nurses.
Kathy Quan (RN) presents the other side: shortage.
Health news of note
Here are a few stories I found very interesting in the health arena. Somebody needs to take me to Greece to complete the one study, though. A long, faraway vacation would be very nice, thank you!
Sex and sleep are just as important as antioxidants (from the 360 blog at www.cnn.com)
This study about people on a Greek island was pretty hopeful in the long-term view.
Want to know if your health habits are making you younger or older? Check out the Longevity Calculator.
Disclosure: I do take an extra vitamin and mineral, but I don't traditionally recommend these as treatments to my patients. This article called Docs and nurses use and recommend diet supplements from www.reuters.com was interesting because it discusses how most doctors and nurses had little education in supplement use.
From the NY Times
This article from the NY Times shows Vets' Mental Health Diagnoses Rising among Iraq and Afghanistan veterans.
Cases-Our Scars Tell the Stories of our Lives made me think about how I look at scars on my patients.
Etc.
Yes, they're released annually, and Madison didn't even make it in as an honorable mention, although some of our system hospitals did show up....way down the list. The US News and Report of America's Best Hospitals even has a couple not far away, if I do need one for specialty care.
Our friends in Canada put a great story in The Globe and Mail recently: Pop culture gives way to peep culture.
Fun!
And last, but not least, who's not going to have fun on vacation? Well, I surely am, and from the looks of some of these goodies, even people at work are having fun and entertaining others, wittingly or unwittingly.
Lost on the Floor just moved, but he is finding some fun in Chart Bloopers.
Braden and many of the ER nurses are always finding great patient complaints. Here's one of his latest patient reasons for visits to the ER at 20 out of 10.
Ahoy! Yes, I'm married to an escaped sailor, so I'm just going to have to order one of these nursey things for my locker, because somedays, I'd really like to raise the Jolly Roger when storming the poop deck on evenings.
Tuesday, July 21, 2009
Shout out
Hooray! Vacation! Vacation! I just thought I'd drop by to share those thoughts. Lots of thoughts actually are whirling around in my head right now. While it's another semi-staycation at home, I'll be putting the fingers to the keyboard reading and writing. I'd like to say hi to all the folks I've been seeing showing up in my sitemeter recently, since I don't get too many comments (that moderation thing must scare off some folks).
To my friends in Picardie, France...
Salut mes potes! Soyez le bienvenue...merci de votre visites hier et aujourd'hui. J'aime la France!
...and in Quebec, la belle province...
Je t'ai envoye mon pote americain pour manger de poutine! Attention!
To my friends in the southern US...
Hey, y'all, thanks for visiting. I gotta find me some grits now that I had a patient from N'awlins talking about them all night last night. Hope y'all come back now!
To all my Aussie friends, especially in Sydney...
Thanks for visiting. One of these days I'm coming your way.
And finally, to all you anonymous people...
Thank you, too, wherever you are.
More to come...
To my friends in Picardie, France...
Salut mes potes! Soyez le bienvenue...merci de votre visites hier et aujourd'hui. J'aime la France!
...and in Quebec, la belle province...
Je t'ai envoye mon pote americain pour manger de poutine! Attention!
To my friends in the southern US...
Hey, y'all, thanks for visiting. I gotta find me some grits now that I had a patient from N'awlins talking about them all night last night. Hope y'all come back now!
To all my Aussie friends, especially in Sydney...
Thanks for visiting. One of these days I'm coming your way.
And finally, to all you anonymous people...
Thank you, too, wherever you are.
More to come...
Sunday, July 19, 2009
Pondering the universe
When it's a slow shift, I often go out looking for stuff. It's just my nature to be busy. Perhaps a little too much of the "idle hands are the tool of the Devil" stuff when I was a kid.
I was surfing away this morning and ran into this post at Reality Rounds. Thankfully, in rehab settings, we don't drop "the bomb" on people too much. That bomb has already exploded by the time we get people, due to accident, illness or other random idiocy, and we're busy picking up pieces and putting things back together for the rest of life.
As a result of too much time, I started looking at labs, and found a high alkaline phosphatase on one of our old timers. We don't diagnose, of course, but when you can historically look at trends, it makes you wonder what's going on with people. I also think it helps me to talk to doctors to see what their take of the situation is with said patient.
Of course, when we have free time, there's always something silly. One nurse buggered up her iPhone and it would not vibrate. We tried to get her to check out www.apple.com to find out what was wrong with it (maybe in the user's guide...hmm?!) but she waited to see what her significant other would say about this problem, since he could fix it since he has the same phone.
Another patient got a generic gadget catalog similar to Harriet Carter. But, he was in for a surprise when he opened one page...they weren't selling any Billy Mays stuff or SlamChops, no they were selling vibrators. He's wondering if the person who gave him the catalog is trying to drop a hint. We shall see, as this becomes yet another inside joke on the unit.
Yes, we have inside jokes everywhere at our place. It's simply a way of coping with time, space and personnel for a lot of our people, who spend an enormous amount of time with us. One guy has his "wife" on our unit. (that's what he calls one of our nurses, who constantly nags him to check his blood sugar).
Finally, a couple of our people said goodbye this week. They went home. One is travelling to a home he's never seen with his long-time fiancee. Another patient is going home, then travelling across the country to live near relatives and meet his online girlfriend. His wife has been gone for a long time and he's finally decided he doesn't want to be alone anymore, after surviving one health issue after another. He is a very smart man, often moody, but frequently nice when he wants to be. With all he's gone through, he deserves whatever happiness he can get.
More later...stay tuned.
I was surfing away this morning and ran into this post at Reality Rounds. Thankfully, in rehab settings, we don't drop "the bomb" on people too much. That bomb has already exploded by the time we get people, due to accident, illness or other random idiocy, and we're busy picking up pieces and putting things back together for the rest of life.
As a result of too much time, I started looking at labs, and found a high alkaline phosphatase on one of our old timers. We don't diagnose, of course, but when you can historically look at trends, it makes you wonder what's going on with people. I also think it helps me to talk to doctors to see what their take of the situation is with said patient.
Of course, when we have free time, there's always something silly. One nurse buggered up her iPhone and it would not vibrate. We tried to get her to check out www.apple.com to find out what was wrong with it (maybe in the user's guide...hmm?!) but she waited to see what her significant other would say about this problem, since he could fix it since he has the same phone.
Another patient got a generic gadget catalog similar to Harriet Carter. But, he was in for a surprise when he opened one page...they weren't selling any Billy Mays stuff or SlamChops, no they were selling vibrators. He's wondering if the person who gave him the catalog is trying to drop a hint. We shall see, as this becomes yet another inside joke on the unit.
Yes, we have inside jokes everywhere at our place. It's simply a way of coping with time, space and personnel for a lot of our people, who spend an enormous amount of time with us. One guy has his "wife" on our unit. (that's what he calls one of our nurses, who constantly nags him to check his blood sugar).
Finally, a couple of our people said goodbye this week. They went home. One is travelling to a home he's never seen with his long-time fiancee. Another patient is going home, then travelling across the country to live near relatives and meet his online girlfriend. His wife has been gone for a long time and he's finally decided he doesn't want to be alone anymore, after surviving one health issue after another. He is a very smart man, often moody, but frequently nice when he wants to be. With all he's gone through, he deserves whatever happiness he can get.
More later...stay tuned.
Saturday, July 18, 2009
Nursing practices and current trends
It surely sounds like I'm ready to go into an infomercial, doesn't it? No, I just got out of my state's "What's new in nursing" continuing education class recently.
The first part of it was, "Here's what YourStateNursingAssociation is doing in the Legislature", which is often very dry. When they started going over how a bill turns into law which turns into nursing practice, I had to imbibe in my highly caffeinated soda, since I got sleepy. Thankfully, we got a break right after this part.
After the break, we had the biggest, most rousing part of the seminar--the use of Propofol and nursing section. I almost felt like I was in the new Harry Potter movie, since the presenter and some others referenced "the recent case" (about Michael Jackson), but they never said any names. This issue is a big deal, not just for nurses, but also for physicians who use this drug. Just reading the package insert opens up a whole new world of liability if CRNA is not after your name in the right setting. Lots of ERs in our state are using this for small procedures, like dislocated shoulders, bone setting and stabilization, etc.
We also had fun stuff, too. A collegue of one of my mentors in nursing school gave a presentation on electronic records which was really cool, especially the one that compared drug prices for patients in our area. The disparity was glaring. Atenolol 20mg in one county was $3 for 30 days and in another section of the same county, $30. There were a couple of glitches in the presentation, as happens with just about anything technical. It would have been even more interesting if all of the government websites she referenced were actually working. I guess those pesky hackers are still loose!
Outside of that, I'm still taming the paperwork monster. I'm starting to view our paperwork queen for scholarships as Dr. Jeckyl and Mr. Hyde. One day, it's one thing, the next day another. I'm not sure why Paperwork queen wants all this stuff now, when I was told to wait for a cold day in the hereafter mere weeks ago, but I'm pushing the paper back and forth as fast as I can. They must have unearthed some money somewhere, somehow...and I'm not questioning it.
And school starts in a few weeks....and I already have homework. I'm so glad vacation is coming soon.
More later...
The first part of it was, "Here's what YourStateNursingAssociation is doing in the Legislature", which is often very dry. When they started going over how a bill turns into law which turns into nursing practice, I had to imbibe in my highly caffeinated soda, since I got sleepy. Thankfully, we got a break right after this part.
After the break, we had the biggest, most rousing part of the seminar--the use of Propofol and nursing section. I almost felt like I was in the new Harry Potter movie, since the presenter and some others referenced "the recent case" (about Michael Jackson), but they never said any names. This issue is a big deal, not just for nurses, but also for physicians who use this drug. Just reading the package insert opens up a whole new world of liability if CRNA is not after your name in the right setting. Lots of ERs in our state are using this for small procedures, like dislocated shoulders, bone setting and stabilization, etc.
We also had fun stuff, too. A collegue of one of my mentors in nursing school gave a presentation on electronic records which was really cool, especially the one that compared drug prices for patients in our area. The disparity was glaring. Atenolol 20mg in one county was $3 for 30 days and in another section of the same county, $30. There were a couple of glitches in the presentation, as happens with just about anything technical. It would have been even more interesting if all of the government websites she referenced were actually working. I guess those pesky hackers are still loose!
Outside of that, I'm still taming the paperwork monster. I'm starting to view our paperwork queen for scholarships as Dr. Jeckyl and Mr. Hyde. One day, it's one thing, the next day another. I'm not sure why Paperwork queen wants all this stuff now, when I was told to wait for a cold day in the hereafter mere weeks ago, but I'm pushing the paper back and forth as fast as I can. They must have unearthed some money somewhere, somehow...and I'm not questioning it.
And school starts in a few weeks....and I already have homework. I'm so glad vacation is coming soon.
More later...
Thursday, July 16, 2009
Bad!
And I'm not talking Michael Jackson, folks!
The housework is done, I'm sitting at the computer relaxing and the fun just rolls in via e-mail.
First, no grant money is available for these researchers due to the economy.
Second, these nurses lost their jobs for doing their jobs.
And if those two didn't seem bad enough, and you have the time, read this Peter Singer article about Why we must ration health care (from www.nytimes.com)
Enough! I'm escaping...more later.
The housework is done, I'm sitting at the computer relaxing and the fun just rolls in via e-mail.
First, no grant money is available for these researchers due to the economy.
Second, these nurses lost their jobs for doing their jobs.
And if those two didn't seem bad enough, and you have the time, read this Peter Singer article about Why we must ration health care (from www.nytimes.com)
Enough! I'm escaping...more later.
Tuesday, July 14, 2009
Did you ever think....
You'd be happy to see a letter from your employer? You would be if that letter tells you your lost lunch time was not in vain. The letter has a bunch of legal mumbo jumbo, but I may get enough to buy a few new uniforms...or put it in my grad school fund.
Stay tuned!
Stay tuned!
Monday, July 13, 2009
Forget your troubles...
come on get happy!*
Yes, this blog has been named to the 50 Happy Nursing Blogs list.
Stay tuned...gotta run!
*from this Judy Garland song.
Yes, this blog has been named to the 50 Happy Nursing Blogs list.
Stay tuned...gotta run!
*from this Judy Garland song.
Nuggets for July 13
There are just too many exciting things going on outside in July. So when it gets hot, this nurse heads inside and surfs away. Here are a few of the interesting tidbits I've run into lately.
Enjoy wherever you are!
More Big Brother?
Someone is always talking about new accessibility tools in rehab. If you can't move a finger, there's a tool somewhere for you. Now, as these tools become more advanced, there are new issues. The next hacking frontier: your brain? (from www.cnn.com) talks about hacking and security for new neural tools.
Supporting nurses
As you know, a lot of nurses work to improve their practice by getting certified in their specialty. This article discusses the importance of support in nurse certification: Study Finds Work Satisfaction Tied to Certification Support (from www.nurse.com).
From the blogosphere...
I have to confess. I really love ImpactEDnurse. Those stories from the ED are just too funny. Here are a couple of my recent favorites:
What men really want in a hospital urinal
The well flocked swab
Maha at Call Bells Make Me Nervous has this great post about the q word (I'm not saying it!)
Psych Doc from Serenity Hospital has a great post about life in the clinic in Clinic Fun.
Enjoy wherever you are!
More Big Brother?
Someone is always talking about new accessibility tools in rehab. If you can't move a finger, there's a tool somewhere for you. Now, as these tools become more advanced, there are new issues. The next hacking frontier: your brain? (from www.cnn.com) talks about hacking and security for new neural tools.
Supporting nurses
As you know, a lot of nurses work to improve their practice by getting certified in their specialty. This article discusses the importance of support in nurse certification: Study Finds Work Satisfaction Tied to Certification Support (from www.nurse.com).
From the blogosphere...
I have to confess. I really love ImpactEDnurse. Those stories from the ED are just too funny. Here are a couple of my recent favorites:
What men really want in a hospital urinal
The well flocked swab
Maha at Call Bells Make Me Nervous has this great post about the q word (I'm not saying it!)
Psych Doc from Serenity Hospital has a great post about life in the clinic in Clinic Fun.
Friday, July 10, 2009
Sweet end to the week
I didn't have to get angry at anyone today. I keep reminding myself that frowning will cause wrinkles, and just being happy for the heck of it will irritate the people who drive you nuts.
My people were pretty good. One was up and one in bed, but the census has been low, so I can round on them, and do lots of other stuff without issue. I even helped out another nurse who was busy with his/her heavy (literally and figuratively) patient. Family education is a big part of what we do, so I had to verify that this family could do what they say they can do. Besides, I like the patient. He's a very nice guy. It's not hard to help him.
I actually had time to get into lots of interesting discussions today: about lazy coworkers (one of whom was chewed out by the boss for his/her lack of diligence), family education and dynamics between spouses when one has a debilitating disease or condition, previous lives and packing boxes.
One of my coworkers may trade me her schedule for part of next week, so we'll see if the boss lets me do it. I hardly think it will be an issue, but you never know. With our pre-JCAHO inspection, who knows what will happen.
I'll ponder it all this weekend...while I rest and relax. Stay tuned!
My people were pretty good. One was up and one in bed, but the census has been low, so I can round on them, and do lots of other stuff without issue. I even helped out another nurse who was busy with his/her heavy (literally and figuratively) patient. Family education is a big part of what we do, so I had to verify that this family could do what they say they can do. Besides, I like the patient. He's a very nice guy. It's not hard to help him.
I actually had time to get into lots of interesting discussions today: about lazy coworkers (one of whom was chewed out by the boss for his/her lack of diligence), family education and dynamics between spouses when one has a debilitating disease or condition, previous lives and packing boxes.
One of my coworkers may trade me her schedule for part of next week, so we'll see if the boss lets me do it. I hardly think it will be an issue, but you never know. With our pre-JCAHO inspection, who knows what will happen.
I'll ponder it all this weekend...while I rest and relax. Stay tuned!
Thursday, July 9, 2009
Is it psycho Thursday again?
That was my question this morning. Oh, why, oh, why do some people insist on being complete idiots?!
Psycho #1: The crazy patient who threatened everyone earlier in his stay was getting antsy when his pain meds were wearing off. So he asked for Tylenol. Which I didn't have an order for. Which required pulling (or finding) a doctor who was rounding willing to give me a verbal.
Got that, so all is good, right? Until...
Psycho #2: One of my coworkers made a mistake and started cleaning up one of my people. All this right after I had told him, "Go back to sleep and we'll get you cleaned up at 1030ish."
For some odd reason, the Slug decided she needed to yell at me and demand that I clean up another patient of mistaken employee. "No, I'm busy. (since I was still working on the order for Psycho #1 and I had my own other patient, in addition to med delivery). You're not the charge nurse. Go tell him/her if you have a problem." The Slug just kept getting in the way. Somehow, I managed to get everything done.
Psycho #3: The dreaded patient came in, and thankfully, left without issue. Said patient provokes PTSD in some of our nurses from the abuse on his/her last visit. Many people were really, really happy they didn't have to deal with that admission at this time.
To top it all off, we got the news that JC folks are on the prowl and should be visiting our hospital soon. If I wasn't having nightmares before, I'm sure they'll start now.
Less psychosis and more fun to come...stay tuned!
Psycho #1: The crazy patient who threatened everyone earlier in his stay was getting antsy when his pain meds were wearing off. So he asked for Tylenol. Which I didn't have an order for. Which required pulling (or finding) a doctor who was rounding willing to give me a verbal.
Got that, so all is good, right? Until...
Psycho #2: One of my coworkers made a mistake and started cleaning up one of my people. All this right after I had told him, "Go back to sleep and we'll get you cleaned up at 1030ish."
For some odd reason, the Slug decided she needed to yell at me and demand that I clean up another patient of mistaken employee. "No, I'm busy. (since I was still working on the order for Psycho #1 and I had my own other patient, in addition to med delivery). You're not the charge nurse. Go tell him/her if you have a problem." The Slug just kept getting in the way. Somehow, I managed to get everything done.
Psycho #3: The dreaded patient came in, and thankfully, left without issue. Said patient provokes PTSD in some of our nurses from the abuse on his/her last visit. Many people were really, really happy they didn't have to deal with that admission at this time.
To top it all off, we got the news that JC folks are on the prowl and should be visiting our hospital soon. If I wasn't having nightmares before, I'm sure they'll start now.
Less psychosis and more fun to come...stay tuned!
Happy Birthday CoS!
It's the birthday edition over at Change of Shift, hosted this week by Kim at emergiblog. Go check it out!
Wednesday, July 8, 2009
Fantasy becomes reality
Lots of good and potentially not so good stuff going on today, so some fantasies readily become reality and some we wish would just go away.
First, one of our patients who was very depressed during his/her stay came to us in a very good mood. Said patient has a goal--to go hunting this fall. All patient needs is a letter from us so patient can get a special permit from our nearby state to participate in a special program. We wished patient well and hopefully, this fall, we'll see some venison sausage and lots of smiles. If only we could convince more of our patients to participate in the Wheelchair Games!
Second, lots of things were discussed recently with our team, which includes the nurses. One of the worst patients the place has ever seen may be returning to the unit. Said patient is so abusive and mean to staff that some long-serving nurses have threatened to quit if said patient is brought back. It's all about policy and paperwork, so we'll see what happens.
Third, my patient who's been wanting to get out of bed for days got his wish. His bowel problems resolved enough that I was able to get him out of bed for his allotted hours. He went to therapy and worked his arms so much he was tired by the time he got back, so I put him to bed.
Finally, our facility is cutting more costs. Our own "Chainsaw Al" is willing to burn and pillage to make a name. We can only wait to see what happens next, as I pretty much kiss any hope of anything extra for school or certification goodbye.
Maybe that lottery fantasy comes true, so while I wait, I'm still filling out scholarship forms. It's a long shot, but at least, most scholarships have better odds than the lottery.
More later...
First, one of our patients who was very depressed during his/her stay came to us in a very good mood. Said patient has a goal--to go hunting this fall. All patient needs is a letter from us so patient can get a special permit from our nearby state to participate in a special program. We wished patient well and hopefully, this fall, we'll see some venison sausage and lots of smiles. If only we could convince more of our patients to participate in the Wheelchair Games!
Second, lots of things were discussed recently with our team, which includes the nurses. One of the worst patients the place has ever seen may be returning to the unit. Said patient is so abusive and mean to staff that some long-serving nurses have threatened to quit if said patient is brought back. It's all about policy and paperwork, so we'll see what happens.
Third, my patient who's been wanting to get out of bed for days got his wish. His bowel problems resolved enough that I was able to get him out of bed for his allotted hours. He went to therapy and worked his arms so much he was tired by the time he got back, so I put him to bed.
Finally, our facility is cutting more costs. Our own "Chainsaw Al" is willing to burn and pillage to make a name. We can only wait to see what happens next, as I pretty much kiss any hope of anything extra for school or certification goodbye.
Maybe that lottery fantasy comes true, so while I wait, I'm still filling out scholarship forms. It's a long shot, but at least, most scholarships have better odds than the lottery.
More later...
RehabRN book club - Summer 09 edition
Yes, I finally am taking the time to write about what I've been reading outside of nursing-related material.
Here are a some of the interesting reads of late. Enjoy!
First on the list, David Whyte's The Three Marriages: Reimagining Work, Self and Relationship. Sure, this looked like a deep read from the title, but actually, it's a pretty manageable book that's a) short (only 323 pages) and b) discusses the interrelationship of your life at work, in partnerships, such as marriage and your self. Lots of interesting poetry tidbits throughout and overall, a nice relaxing book.
Next, I read Mating Rituals of the North American WASP by Lauren Lipton. I don't normally read fiction, but I enjoyed this novel set in rural Connecticut and New York about a woman who marries a man while drunk in Las Vegas.
Finally, I enjoy learning something new, and since I can't find my Strunk and White Elements of Style anywhere, I picked up Booher's Rules of Business Grammar. It has, as the subtitle notes, "101 Fast and Easy Ways to Correct the Most Common Errors." I consider writing well an important part of communicating on my job. The structure makes short reads very productive. If you're so inclined, check out your grammar IQ at http://www.booherrules.com/.
Hope you enjoyed this edition of the RehabRN book club. Stay tuned for more updates!
Here are a some of the interesting reads of late. Enjoy!
First on the list, David Whyte's The Three Marriages: Reimagining Work, Self and Relationship. Sure, this looked like a deep read from the title, but actually, it's a pretty manageable book that's a) short (only 323 pages) and b) discusses the interrelationship of your life at work, in partnerships, such as marriage and your self. Lots of interesting poetry tidbits throughout and overall, a nice relaxing book.
Next, I read Mating Rituals of the North American WASP by Lauren Lipton. I don't normally read fiction, but I enjoyed this novel set in rural Connecticut and New York about a woman who marries a man while drunk in Las Vegas.
Finally, I enjoy learning something new, and since I can't find my Strunk and White Elements of Style anywhere, I picked up Booher's Rules of Business Grammar. It has, as the subtitle notes, "101 Fast and Easy Ways to Correct the Most Common Errors." I consider writing well an important part of communicating on my job. The structure makes short reads very productive. If you're so inclined, check out your grammar IQ at http://www.booherrules.com/.
Hope you enjoyed this edition of the RehabRN book club. Stay tuned for more updates!
Tuesday, July 7, 2009
Taming the monsters
Yes, the full moon is coming, so you always know things will get exciting...crabby patients and even the occasional homicidal one. Well, at least the docs will enjoy talking about that this week.
My particular monster is the paperwork monster. Last week, I finally filled out my loan benefit forms, so we'll see if the almighty out-of-state (OOS) office approves of them. I calmed down my own homocidal tendencies re: this, since different person is in charge of submissions for this benefit. New person told me OOS office aware of idiot who caused all the work in the first place, so I will be crossing my fingers.
I'm finishing the rest of the grad paperwork and checking out more financial resources. At least, all my computer time is not in vain if I can get some funding somewhere. One large resource site with a huge chunk of cash will have submissions in August. Hooray!
Besides the paperwork, work has been interesting. The first night we got to send out one of our regulars due to possible MI. My other patients were really pretty easy, even if one or two was slightly demented. You know it will be an interesting evening when your patient rings the call light, then says, "I forgot why I called." Repeat 25 times and you have my shift the other day. Thankfully, I figured a way around that. I made sure I rounded on someone very regularly and got him/her comfy while I was in the room each time. The next shift...hardly any calls.
In my free time, I started looking at the CRRN material again. Happily, this exam is in December, so I have some time to study before it. It's not a requirement for employment at my job, but since I started in rehab nursing, it's been my goal. It also helps that work wants more certified people, particularly to maintain our CARF certification and to eventually get Magnet status for our hospital.
So since I have some free time coming up, I'm going to get some work done around here. More to come...
My particular monster is the paperwork monster. Last week, I finally filled out my loan benefit forms, so we'll see if the almighty out-of-state (OOS) office approves of them. I calmed down my own homocidal tendencies re: this, since different person is in charge of submissions for this benefit. New person told me OOS office aware of idiot who caused all the work in the first place, so I will be crossing my fingers.
I'm finishing the rest of the grad paperwork and checking out more financial resources. At least, all my computer time is not in vain if I can get some funding somewhere. One large resource site with a huge chunk of cash will have submissions in August. Hooray!
Besides the paperwork, work has been interesting. The first night we got to send out one of our regulars due to possible MI. My other patients were really pretty easy, even if one or two was slightly demented. You know it will be an interesting evening when your patient rings the call light, then says, "I forgot why I called." Repeat 25 times and you have my shift the other day. Thankfully, I figured a way around that. I made sure I rounded on someone very regularly and got him/her comfy while I was in the room each time. The next shift...hardly any calls.
In my free time, I started looking at the CRRN material again. Happily, this exam is in December, so I have some time to study before it. It's not a requirement for employment at my job, but since I started in rehab nursing, it's been my goal. It also helps that work wants more certified people, particularly to maintain our CARF certification and to eventually get Magnet status for our hospital.
So since I have some free time coming up, I'm going to get some work done around here. More to come...
Friday, July 3, 2009
Rolling into the holiday...
And you guessed it, yours truly will be at Madison working when the sun goes down. It may rain in our neck of the woods, so we'll see if there are any fireworks. Thankfully, this year, there isn't anyone with really active PTSD that we have to worry about (sometimes fireworks trigger flashbacks).
For your browsing pleasure, I've found a couple of interesting articles. They're not about fireworks or the holiday, but are interesting nevertheless.
My personal favorite, since I've always wondered about this one: Q: What is the role of probiotics in the the treatment of acute Clostridium difficile-associated diarrhea? from the Cleveland Clinic Journal of Medicine. It's short, sweet and to the point.
FDA advisers vote to take Vicodin, Percocet off the market.
Will this really happen: Oh, this will be really interesting on our unit. (from www.cnn.com)
Finally, there was a character taking photos of our buildings and grounds recently, but I doubt we will make this list: 20 Most Beautiful Hospitals. I must say, however, that our location and neighborhood is very picturesque, even if our building's not so pretty.
Happy 4th of July to all wherever you are! More to come...stay tuned!
For your browsing pleasure, I've found a couple of interesting articles. They're not about fireworks or the holiday, but are interesting nevertheless.
My personal favorite, since I've always wondered about this one: Q: What is the role of probiotics in the the treatment of acute Clostridium difficile-associated diarrhea? from the Cleveland Clinic Journal of Medicine. It's short, sweet and to the point.
FDA advisers vote to take Vicodin, Percocet off the market.
Will this really happen: Oh, this will be really interesting on our unit. (from www.cnn.com)
Finally, there was a character taking photos of our buildings and grounds recently, but I doubt we will make this list: 20 Most Beautiful Hospitals. I must say, however, that our location and neighborhood is very picturesque, even if our building's not so pretty.
Happy 4th of July to all wherever you are! More to come...stay tuned!
Thursday, July 2, 2009
Deep Thoughts, part 76
Ah, it's fun when random things enter your world....here's the latest installment of unusual and the usual...
1. Dahey asked recently why a coworker had unusual colored stool. My only guess is that strange things happen among workers at construction sites....port-a-potty chemicals perhaps?
2. Why, oh, why can't everything have online billing? I just don't like writing and mailing checks anymore.
3. I just loved this comment I saw recently on the NY Times Well blog article discussing nurse stereotypes. I'd really love to work with this doc!
A postoperative patient became incensed during morning rounds, when the little woman kept responding to the questions he was directing at the big man. He wanted answers from the doctor, not some “dumb nurse.” The ICU nurse–a former Big Ten offensive lineman–politely introduced the man to the cardiothoracic surgeon who had saved his life the night before. The doctor, in turn, introduced him to the “dumb nurse” who “will be keeping you alive.”
— Michigan M.D.
1. Dahey asked recently why a coworker had unusual colored stool. My only guess is that strange things happen among workers at construction sites....port-a-potty chemicals perhaps?
2. Why, oh, why can't everything have online billing? I just don't like writing and mailing checks anymore.
3. I just loved this comment I saw recently on the NY Times Well blog article discussing nurse stereotypes. I'd really love to work with this doc!
A postoperative patient became incensed during morning rounds, when the little woman kept responding to the questions he was directing at the big man. He wanted answers from the doctor, not some “dumb nurse.” The ICU nurse–a former Big Ten offensive lineman–politely introduced the man to the cardiothoracic surgeon who had saved his life the night before. The doctor, in turn, introduced him to the “dumb nurse” who “will be keeping you alive.”
— Michigan M.D.
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