Happy Anniversary

Oh, a few years ago, I was fretting away getting my hair and nails done right about now, just before the wedding.

A few lost in-laws and nine wild years later, here we are...and we're celebrating with the modern anniversary gifts this year! Woo hoo!

Happy Anniversary Dahey!

Up, down and all around

That's been my story lately. A lot of things almost whirling around my head and inside the building. A fly kept buzzing the table as K. and I ate our dinner. I watched it whirl around the room. No matter what I did, it wouldn't land.

Later that evening, K. caught said fly in a weak moment and slapped it dead on the table, and sent a bag of open potato chips all over the floor. Thankfully, one of the nursing assistants found the broom and dustpan (housekeeping usually locks this stuff up) and it was cleaned up quickly.

My patients were reasonably good. Both have my least favorite bug, C-diff. If I only had a dollar for every time I was in their rooms and for every, single, solitary time I had to wash my hands (since that ol' hand sanitizer won't do with C-diff), I would have a whole lot of money. I am so paranoid with C-diff. I go home and disinfect my shoes with bleach spray (since housekeeping hides ours).

School's gonna kick my butt if I'm not careful. My first paper came back yesterday. I talked to the instructor about it because of the grade and we have a resolution. Stay tuned! I have two weeks to resubmit, which I thought was a nice thing for her to do. From her discussion, I suspect she gets a lot of people who would be going to the dean or something if they don't get x grade. Not that I like a not-so-hot grade, but if the instructor's amenable and has a solution, I have no problem working with them. We'll see how it goes. I have a few more ideas and another paper to submit by Monday. This weekend will be busy in a few more ways than one.

Gotta run...an off day means errands and homework! More to come...

Some things change...

And some stay the same.

The unit was pretty much same old, same old last night. Nothing particularly new and exciting.

1. The Slug is still the Slug and wouldn't know his/her backside from a hole in the ground (Dad's favorite saying...only a little spiced up!). He/she obviously didn't look out the window before swearing, "Oh, all these patients are crazy because it's a full moon." Not really, but perhaps on whatever planet he/she's on, it is!

2. Ringing the call light at the change of shift is becoming commonplace whenever I work evenings. One patient decided he needed help in less than the five minutes it would take the ongoing shift to get him situated. So what does he do? He says, "I think I'm having a heart attack. My left arm feels funny." Roommate was oblivious to all the commotion and snoring away.

Here goes the fire drill. Get vitals, get him repositioned, get out the EKG machine and call the doc on call. Nice. Thankfully, the evening charge nurse and I went down with some of the night shifters and got him all situated until the doc arrived. No other classic signs and a "I thought I'd say that so someone would come down here right away." almost merited the famous Dope Slap from the night charge nurse.

3. And finally, some people are still on evening bowel routines on our unit. Some are scarier than others. One of my patients had one which reminded me of a horror movie about tapeworms.

That is all...stay tuned for more excitement.

They tell it like it is...

I really enjoy reading articles about centenarians. Unfortunately, many times there are lots of obits, but I really enjoyed this one from the current world's oldest man in Montana. His advice: don't eat so much.

One of my other recent favorites was the obit for Gertrude Baines, who died earlier this month. Her long-life secret: crispy bacon. As another crispy bacon devotee, I have to agree with her. One of my grannies lived to be 93 and she swore by a nip of schnapps every night. It was the only "medicine" she would ever take.

I don't think I'll be taking up schnapps any time soon, though.

More to come...stay tuned.

Vacate for a vacation

Yes, it's true, I've been enjoying mine for the past week and I have to go back to work tomorrow. However, I can't imagine not having any time to recharge and renew. One or two days in a row is just not enough.

I read an article recently that stated, "According to an Expedia.com survey, 35 percent of Americans don't use all of their vacation days each year." Sure, some places may pay you for saving up your vacation days and cashing them in, and in this day and age, it wouldn't be too bad, but I cannot imagine doing that anymore. I just need my sanity. Sanity involves leaving the premises and not coming back for a few days.

The best thing I read about vacations was this list: Signs that you need a vacation. Reminds me of the Dilbert book I read at the store the other day: What do you call a sociopath in a cubicle?

Another article talked about how vacations can help you with job performance. I totally believe this. While I'm expecting to get the most demanding assignment on the floor when I get back (they like to do that to people returning from any time off on my unit) right now, I feel as if a rest will be helpful in dealing with it. Having memories of quiet time, coffee, good books and bubble baths, even now, makes me feel relaxed. If that doesn't work, a good time-out never hurt anyone!

Nuggets for September 24

Yes, it's been awhile, but since I've been on vacation, I figured I should just stop the early Christmas shopping and get with posting a few of these goodies. Hope you all enjoy!

Pandemics-R-Us

Since it was on my list of things to do, I got my seasonal flu shot this week.

It's easy to get caught up in the hype, but keep your wits and learn something from the CDC's page on H1N1 flu.

On the subject of flu, my personal favorite in the "when people get carried away" section appeared recently in the NY Times with some great photos and is called City Critic- What not to wear when worrying about the flu. No, Tyveks are not fashionable this year. Big thing to remember: hand hygiene people!

Family fun

The myriad of articles on family dynamics, etc., really surprised me. Here are some I found interesting:

Seven ways your siblings may have shaped you (from Yahoo!Health)

Mama wasn't always right: 9 updated health rules (from cnn.com) Guess I won't get in trouble for reading in low light anymore!

Medical news of note

I am always fascinated by brain stories (I guess in another life I was somewhere in neuro) and this one was really interesting: Brain pacemaker for a rare disorder (from msnbc.com)

The BBC has been having some very interesting articles on health, and here are a couple below.
Antibiotic resistance clue found

And because most of my patients are in the target demographic for this...
'Viagra cream' could prove safer

Tools you can use
And finally, since I've been embarking on a few home improvement projects, check out these nifty health related tools. No batteries required!

The ANA has a new site on Safe Patient Handling. It's got a lot of information you don't want to miss to keep your work environment safe.

I found this one thanks to a nursing newsletter from the ANA. Statistician George Fernandez at the University of Nevada at Reno has devised an even simpler implementation of BMI called MWL or Maximum Weight Limit. The calculation is a breeze, especially if you don't have a calculator handy.

Happy Rehab Week!

Yes, indeed, it's time to give a shout out to all my fellow rehab nurses and all of our friends in other rehab-related specialties, especially the therapy folks.

Want more info? Check out The National Rehabilitation Awareness Foundation for more information.

Lift, load, upload and loaf

Happy Monday from the land of ahhs! Ah! I turned in that paper I was working on this weekend, in between loading up my iTunes on this laptop. I just never got around to it a month ago because school started and I had other technical issues to resolve.

Now I've got a lot of very wonderful stuff from ABBA to Van Halen to Vladimir Horowitz. Dahey has a huge collection of all sorts of stuff, so I'm just loading up, including the Christmas music (can't find any Hannukah or other holiday stuff anywhere right now.)

The loading happened earlier today when I went in the storage area and started taking out all the stuff I triaged and set aside to give to charity. Loaded up the battle wagon twice and got a good chunk done today. Put some big items up for sale, so we'll see how that goes.

The loafing...a nice, uninterrupted bath and a book. It didn't last too long, but it was nice.

More to come...stay tuned!

Decompress

Ah, it's so nice to be done for the weekend...and able to look forward to a week in which I don't have to go to work.

There have been a few surprises. The trainwreck elderly patient I ended up with on my assignment really wasn't bad at all. For a man of few words (can't speak due to a trach issue), he's pretty funny. Lots of flailing gestures and an animated face make it pretty interesting.

My other patient was grounded, too, due to some other health issues, but surprisingly, I found stuff to keep him busy and he was relaxed and happy. I was worried he was going to get wigged out about staying in bed.

Most of the people I work with were pretty good, too. We have a lot of new people floating around the unit, so maybe people were just on their best behavior. The Slug, of course, was not. He/she literally tied up every phone at the nurses' station (with personal calls) and even the boss thought it was funny. It just goes to show you what leadership (or lack thereof) we have. Someone else will have to fight that fight...I just don't care. Put me as far away from that phone as possible, so I don't have to answer it!

We got some new toys on the unit--lifts, stretchers and a new computer. I didn't have anyone to heave around or take anywhere, so I played with the computer. I like working with new stuff, even if some of my collegues recoil around anything new. I'd rather just play with it when things are slow and figure out how it works. We had another department come around with new snappy accessories for the computers, so we had fun with those.

While they won't be doing what they do in Europe, we will be getting tested for MRSA in the nares one of these days. One of my coworkers asked to have her MRSA scheduled for when her kids are out of school if she would have to stay home. Me, too! It would be the only way I'll ever get the summer off without having to go back to school to become a teacher.

Speaking of school, it will keep me busy this weekend. I have to work on several projects and write a paper for my class. When I get done with that, I'll be tackling the house the rest of the week. It should be fun.

More to come...stay tuned!

It's an emergency!

Medic999 is hosting this latest edition of Change of Shift, so head on over stat!

BTW if you want to know what a Geordie is, head on over here.

Fluids, flotsam and jetsam, oh my!

That was the story of one of our shifts.

Need D5 1/2NS, which is one of the more popular fluids on our unit? Gotta run around to find it. Those supply people must have had a bad day because no one at Madison had more than one lonely bag.

I deal with lots of fluids and stuff--urine, sputum, feces, but every nurse has a weakness for one. Mine is vomit. I'm not phobic, mind you, I just don't like being there for it, or dumping it, but I had to do that the other night when one of our people got sick, right before shift change. Patient got his PRN Compazine but was still retching away an hour later. I got to pass him on to the next shift for a fluid order. Too bad he didn't have his PICC anymore...he's a terrible stick.

More to come...stay tuned.

We let go

"When I was a child, I used to speak like a child, think like a child, reason like a child; when I became a man, I did away with childish things." New American Standard Bible (NASB)

We let go of a few things on the last shift. One of our regulars, who was injured years ago and a world away, coded suddenly as we got report. He had been sent to Washington to be monitored, but was going downhill since he left us.

We liked him. He kind of grew on you. He was quiet and unassuming and loved his baseball games. We never worried about not knowing what was going on with any televised baseball because he'd keep us apprised whenever we asked. I always went by his room to ask the score, and while I was there, unwrap his snack and open his milk.

He was someone who was always grateful. Grateful he could still use his arms. Grateful his family was still around. Grateful for friends, who would bring their children to visit him.

As a wounded veteran, he was a brother in arms to the younger guys who were injured. He'd light up when people asked him to help out by talking to a newly injured patient. He was a great listener and was a pro at making people feel at ease.

Though he was modest and generous, we often laughed and called him "the colostomy salesman". He said it was the best thing he ever did after his injury, because it helped him to live independently for so long. He had one so many years, he could tell stories about how it used to be, and how he liked it now.

Overall, we were sad to hear of his passing, but we delight in the fact that he will not suffer anymore. Happily, we let him go, hopefully, to a place where he is free of all pain and suffering, complete with his own field of dreams.

Sore

Flipping people around in beds and chairs can be exhausting as a rehab nurse. You expect muscle strain from that.

You do not expect, however, people to leave large objects in front of walls near swinging doors, so when you open them and push you push into said object and into the wall.

And crunch yourself into the door, and feel the pain of the combo lock hitting you squarely in the chest. Nothing like a little pectoral crunch at night. Now I have some idea of how people feel breaking their ribs.

Guess I just have to move slower! Stay tuned...

Never forget...

That on this day, and at this hour, eight years ago, New York was burning, the Pentagon walls were breached, and multiple heroes on a plane gave their lives in a Pennsylvania field to stop further carnage.

And our little, insulated lives as we knew them changed forever.

Nuggets for September 9, 2009

Yes, it's 09/09/09, and according to some, a lucky day. In light of everything going on the past few weeks and months, I consider every day a lucky day and some better than others.

This week's installment of Nuggets includes the best of my fellow bloggers out there in the blogosphere recently. Please check these stories out and enjoy.

Head Nurse always has some interesting stories. I'm a story person. If you like good nursing stories, you have to read Holes, part two. My favorite line is below, and it sums up how stories can really make your life.

Those who are not here any more eventually, and irreversibly, define what I am.

Keith at Digital Doorway is heading out on the open road and feeling stirrings of nursely guilt. Godspeed, Keith. Enjoy your travels wherever you may roam!

Maha has a great post about alternative medicine and diabetes, which, thankfully, did not have disastrous results.

And while this is not a healthcare blog, I found it via another nursing blog. If you like food and you like funny stuff, check out Cake Wrecks, which is subtitled when professional cakes go horribly, hilariously wrong. It is hysterical!

Shout and Out!

Yes, it's time for a shout out section again thanks to sitemeter, so here goes...

The international section

Yes, to all those folks in France, especially in Paris and aux alentours who keep meandering by...j'arrive...je suis un peu fatiguee a l'instant! Le cours d'info m'echappe!

Hello to all the other folks coming by from India and the Philippines. I have to mention the people getting here from Under the Mosquito Net out of beautiful Bangladesh. Thanks Randall for the link by which they got here!

In the western hemisphere

I'd be remiss if I didn't thank maha from Call Bells Make Me Nervous. So many people lately come by way of your blog. Many, many, many thanks, and if I'm ever in your neck of the woods, I'll have to stop and say hi. Kim at emergiblog also sends lots of people here, so I am very, very grateful. (I'll be jumping up and down when I have 10% of Kim's traffic!)

And all the readers from Kansas City, MO; Atlanta, GA; and all sorts of good folks around Houston, TX, especially at the Health Sciences Center, thanks for coming by.

So now more stuff...

Lately, I almost feel like doing a gutteral scream and yelling, "Out!" Out to the dog who goes from sleeping to sick...all over carpets and flooring. Out to kid who says, "Mom, can we change the channel to the Kid channel?" about 40 times at once. Out to all the stuff I have stuffed around the house that I really need to get rid of, once and for all. Out to all of the computer demons who have been inhabiting two of my oldest computers. Not viruses, mind you, just plain old out-of-resources, maxed-out memory craziness.

Recently, I really wanted to tell a patient, "Out!" Said patient is getting ready to discharge yet again after the latest of said patient's plastic surgeries. Multiple issues I really can't discuss abound, but as usual, patient likes to have fun with the nurses by causing psychosocial issues. One minute, patient makes you look great in front of providers. Next minute, patient is telling you how his/her legs were moved incorrectly during transfer and that popped the colostomy bag.

To save time and patient satisfaction scores, I excused myself and took a time out. I got some labs that were needed and said patient talked on the phone. By the time I got back, I was accused of not listening, but I got patient out of bed and out of the room. Thankfully, patient took self off the unit outside, which got rid of some of my angst.

I have a plan, folks. It shall be implemented fully any day now. It's called vacation. I'm not going anywhere, but I will be doing something. Homework in multiple senses of the word. I've got my assignments, now I just have to produce the papers.

Finally, since it's 09/09/09, I'll just twist and shout over to the record store. Today is remastered Beatles release day.

More to come...

Happy Labor Day weekend

As one of the few, the proud, the folks who are off this Labor Day weekend, I celebrate by doing my homework for class and all sort of other stuff I wouldn't normally do while working.

I found this Labor Day quote below by H.L. Mencken here:

The only liberty an inferior man really cherishes is the liberty to quit work, stretch out in the sun, and scratch himself. ~H.L. Mencken

Enjoy your weekend wherever you are, whatever you choose to do!

United front

These two little words can mean a lot of things, and they're coming in to play at work.

Case in point: veterans want one display in the building. Big cheese says no way and removes military display. Many, many people pissed off on this laundry list: veterans who are our customers, veterans who are our employees, spouses of veterans and spouses of employees who are veterans and visitors who hear the story. Air Force veterans, Navy veterans, Marine veterans, and most of all, since there are so many...the Army veterans.

A whole lot of wailing and nashing of teeth. Can we get the boss to believe he/she is wrong?

Stay tuned...this may take an Act of Congress.

Yes, it's crazy...

But don't miss the latest edition of Change of Shift up at Crazy Miracle Called Life.

Psychosocial Insecurity

Our little unit is an open-door haven that former patients visit regularly. Even when they're visiting other folks in our building, they tend to wander by the unit, to see the staff and to see if they know anyone who's staying with us. It may seem unusual to some, but not to us.

Then again, some of the people who stay with us a long time (and they probably make up at least half of the unit) don't want to leave. They enjoy the security of knowing they'll have help whenever they need it, or twenty-four seven room service we like to call it.

Right now, we have a couple of folks ready to leave us and they are suddenly getting jitters. "Oh, I feel sick." "Oh, I can't do this (or that.)" "I don't have any help lined up yet." Surprise, surprise. If we got out our Carpenitos for nursing diagnoses, we'd surely have a lot of these psychosocial diagnoses: Ineffective coping, relocation stress syndrome and my personal favorite, ineffective denial.

Despite the best intentions of getting sick at the last moment to postpone discharge, our first discharge guy left. He not only left, he waited all day to do it. He couldn't rush, because his help wouldn't be there right away. As when many people leave, some people count down to the next time we'll have someone back...as a long-term customer again. Those maudlin thoughts just creep up, even if office pools are forbidden.

One guy keeps leaving and coming back, because we keep discharging him for medical issues too acute to be handled on a rehab floor. I wonder how long it will take before he doesn't bounce back again. Age and infirmity can do that to a person. While I was off this weekend, he was back for one day and returned to acute. He didn't even make it 24 hours on our unit. I guess our idea of stable is a little different than the acute hospital's idea of stable. Not breathing and cyanosis just are not good things.

If the internal excitement is not enough, we have prowlers looking for privacy violators. Yes, it's all because of the good ol' JC. They're on the loose so this is practice...just like those quarterly fire drills. The boss just about had a fit when I gave a chart to a doctor. I had to prove I saw his badge and look him up in the computer. Good thing he's a psychiatrist with a sense of humor!

All this and H1N1, too. It's going to be a rocking end of this year. I'm just crossing my fingers!

More to come...

Bubbling...

Not frothing, mind you, bubbling, like a nice pudding cooking on the stove.

There's a post in my mind that I just can't get out. I'm hoping my writer's block is not contagious, nor long-lasting. Grad school started for me yesterday and the assignment list is pretty long.

Off to clean and cook on today's day off...more to come, so come on back a little later.