From the mouths of patients

"I really took a lot of money from that insurance company."  Mr. X

Mr. X, said this when he saw a commercial for a particular company on TV one day.  Not really picking up on what he meant, I asked him, and as fried as some of his memories are for normal, short-term stuff, he proceeded to tell me he "knew what to say" to make his drunken driving escapades look like reasonable accidents and not get caught.

Consequently, I told him he was lucky no one ever figured him out, or he would have gone to jail for insurance fraud.

"I like your shoes. They go with that top." Mr. N.

I guess Mr. Backwoods, who shoots birds from his deck if they get too close, has been watching the Style network again. Funny how some male patients notice any changes in hair style, color, scrubs and shoes before any of your coworkers say anything.

"We miss you in the SU." Mr. J.

Mr. J. is a big, burly character who sees Sue and the Doc in the SU. Mr. J. comes in regularly to get  his  methadone prescription and get checked out.

I can't sleep

The toads are croaking really loud tonight...need the earplugs! So thankful Dahey gets them at work.

I took care of some interesting characters lately. First one, is in rehab due to thoracic spinal fusion. Once his vertebral problems were solved, Mr. X. couldn't walk, and docs realized he suffered a high thoracic spinal cord injury.

Just to add to the fun, Mr. X. was a raging alcoholic and has Korsakoff's psychosis. One night, he was particularly mad, so he called security and told them we were holding him against his will and restraining him. Security asked that we disconnect his phone, so we did. Thankfully, his call light is not nearly as fun to play with for him. He's been a handful, but keeps quiet for me because I give him cups of coffee. This also helps when getting him up, since coffee is the real reason I get him to go to therapy.

Me: "Okay, we're going to get you ready to go."
Mr. X: "Where?"
Me: "To therapy. They're waiting for you."
Mr. X: "I don't want to go there."
Me: "Here's the deal. You go there, and after, I'll get you another cup of coffee."
Mr. X.: "Okay, when do we leave?"

Mr. X has had a lot of other typical issues that alcoholics have in addition to the psychosis. Keeping his skin healthy has been one of the main challenges. I got a handle on things this week, but it will be interesting to see how long that lasts.

I love it when it's easy to find motivators to get people to do things. One of my developmentally disabled patients at Saintarama loved Diet Pepsi, so I always made sure I had one (and a cup of ice on the side) whenever she completed therapy. Too bad I don't have motivators like that at the Hotel. No sodas here, unless they come from me or the volunteers.

Another patient is one motivated character. All Hoss wants to do is to go on a Harley ride this summer with his brother. He'll do anything to get there, so he's another quick sell on going to therapy.

They are challenging characters, but I was very happy with their behaviors this week. I'm hoping I'm on a roll!
Back to writing the last paper of the semester.

More to come...

Firing on all cylinders

Yes, it was a little strange, but it was a decent day. My patients got rolling and I got them out and going.

I had students to work with again today and it was a joy. I sent one on a field trip to the SU after I called my buddy Sue. She had loads of patients for procedures and she was happy to have the student. The doc was very complimentary. I think he just likes the nursing students better than some of the residents.

The end of the semester keeps the students hopping, and thankfully, we have lots to do at the Hotel. I got to instruct one on how to change a suprapubic catheter, then have him/her do it with my instruction and standby to help (this was a large patient and he/she really needed someone to hold the pannus).

Next, I helped to hang blood for another patient and brought another student along so he/she could learn how that's done. It was pretty satisfying.

Finally, I calmed one of the worried rascals who was dropping one too many f-bombs. I calmly asked him to stop, and he complied. The other nurses were pretty happy, too.

And now, it's back to homework as the semester winds down. I can't wait! More later...

Come hell or high water

Yes, we're getting the water part...better go look outside for the ark.

So far, the Hotel remains untouched. Will be crossing fingers.

Pulling the race card

Yes, I had the misfortune of having one of the nursing staff doing this recently, so here's how I would have addressed it if I could have written a letter.

Dear Mr. Veteran Employee:

Yes, I am distinctly aware that you are a male and a minority here at the Hotel. I am also aware that you have many years of seniority. I think you have many good qualities, but one keeps rearing it's ugly head. You keep pulling the race card.

As a woman, you offend me because you think when I am not busy, I'm here to serve you. Well, guess what. I am not. As one famous singer said, "I'm not gonna spend my life being a color."

Since you are not wearing a patient armband, you are not entitled to free meals and beverages just because you figure you deserve them for your service. No, you sir, are an employee, and the cafeteria is that way. Open the wallet, remove cash and in exchange, they'll give you whatever you pay for. Novel concept, no?

Years of slavery did not cause the mess you, others and our management has got us into on the floor, in our local, state and federal governments or with your credit card statement. And please, when you're done trashing my sex, my job (because I make more than you since I bothered to get a degree), and the fact I buy "expensive" coffee, which I just so happen to share with you ('cause you're too cheap to buy any of your own coffee), please go and actually do your work.

Your female coworkers, sistahs and non-sistahs alike, will appreciate it.

Sincerely (only if you actually listen...),

RehabRN

Just do it!

The Nike slogan was my mantra the last night I worked, and thankfully, most people got it.

Everyone got an equal assignment (myself included.) I don't mind taking an extra load, but tonight I needed an equitable assignment!

The nurse who decided his/her feet were swelling and he/she needed a different assignment so he/she could sit down, talked to another nurse and they traded (he/she got more people until relief came, he/she got a lesser assignment for part of the night).

I got to do multiple suctionings on one of my antsy trach patients, clean his/her wheelchair from seat down in the shower due to an accident, scrub him/her up,  wash his/her clothes, and change a catheter, in addition to the dressings this patient has.

Next, I got to do an emergency scramble when one family member breezes by the nurses station and says, "Oh, I tried to wake up, Bob, my brother, and he's not waking up." Run down hall with blood pressure machine and oxygen sat. Brother is sleeping, but easily roused. Nice. People just don't get saying something like that will get a nurse's dander up. Sheesh!


Needless to say, I was absolutely thrilled that my other patients were not so needy. My only exception: Mr. Bottled Water. Since he's run out, we can only get him water from the ice machine, since it's filtered, "and tastes so much better."

Too bad the honchos won't just buy filtered pitchers for all of them. Maybe I'll suggest that to his family for their next visit.

More to come...

What winds will blow...

Happy Easter to all of you who may have celebrated yesterday.

How many admissions will we get? And when will they go home?

All these questions will be answered soon enough. Thus, I keep on charging away...one more evening shift.

Stay tuned!

Not routine anything

You know you're going to have an off-the-wall night when...

First thing after dinner, one of your veteran nursing assistants wants a new assignment. Her patient with visitors is being an a$&, and it's his birthday. Thankfully, family member is an RN, made him apologize after a long heart-to-heart talk, and all is well. Except NA still got reassigned to another patient at his/her  request. Who got birthday boy? Me.

Next, right as your finishing your charge nurse paperwork and after dinner, the powers that be call a storm warning. Everyone out into the halls...if they'll go. Only about 50% of our people did despite much cajoling. The fun part was dragging in the people who went outside to watch before security brought them inside. One guy came from next door looking for the poker tournament in the rain (none was in progress).  Patients are getting really tired of going into the hall for weather warnings. Had to batten down the rest of them and cross my fingers. Thankfully, it all blew over, slowly.

Another NA wants to go home early. I'm really getting tired of the "I should get to go home early" spiel I'm noticing on my shift. He/she checks with night super, super says OK and he/she leaves, all work done at 2230. Turns out it wasn't so bad after all...he/she had storm damage at home and needed to help family get a generator and a chain saw. Didn't feel so unhappy after all that. However he/she  had  fun getting home. All but one road was blocked by debris from the storm.

Just hoping the Easter bunny doesn't get too wet and I survive my next trip to the Hotel. May need a boat to come home next time.

Stay tuned. It's all good at the Hotel Rehab...most of the time!

Let it rain?

Will it rain on my Easter egg hunt? Only time will tell. May have to move it indoors.
If so, no real Easter eggs will be used. They smell funny if you don't find them right away.

More to come...

Boys will be boys

And idiots sometimes. You could tell the moon was full recently, since we had so much juvenile antics lately.

Scenario #1
Patient X doesn't like Patient Y. Patient X decides to duke it out with Patient Y in front of the table in the dining room. Security is called. Patient X gets a ticket, and will be considered for discharge soon. Patient Y fell down, so this causes tons of paperwork mayhem for Ella, our harried night charge nurse, who is late giving report, since she's filling out incident reports, info for security, fall reassessments, patient assessments, and calls to the on-call MD. Word spread fast around the unit, since one of our characters says to Mr. Y. when he saw him today, "I heard you had an exciting time earlier."

Scenario #2
Patient Z, one of our resident COPDers was scheduled for discharge recently. Patient Z likes it at our place, so he turns off his oxygen to make us think he's "sick". Try as he might to sabotage his discharge, we figured out that Z could indeed reach the oxygen valve from his perch in bed, and yes, he did turn it off. He got crazy, so the chiropractor came down at the boss's request and gave him a mini-adjustment, the specialist gave him his specialty consult, and finally, three hours late, his transportation showed up.

Scenario #3
Patient A tells our student nurse, who's doing an assessment for her master's program, that, yes, he is indeed still smoking weed. Despite everything, we have to keep him for a while. Patient A has developed a new problem and we cannot simply discharge him for non-compliance. So far, no one's found his stash.


So needless to say, I was happy, happy, happy to be going home after a long day. Stay tuned for more excitement. You never know what will happen at the Hotel Rehab.

So happy...

I'm no longer cleaning. My husband's sibling and family have left the abode. I'm no longer expected to entertain, or clean heavily. Everyone had a wonderful time, even if I did not get the windows cleaned for their arrival. It wouldn't have mattered anyway.

Back to reality...and work. And work was still the same. Just hoping and praying someday I'll find out about the new job and will get to leave the Hotel. This time of year is always so hot, especially in temperature and temperament.

Now I'm vegetating while the Dahey, Bubba and WildDog play in the yard. I love a house that's still, and full of peace and quiet.

More to come...stay tuned.

Between day and night

Maturity is achieved when a person accepts life as full of tension.  ~Joshua L. Liebman

That was my story recently. I had to work a shift I don't normally work and it messed me up. I'm used to the rhythms of the unit and at that hour, I was thoroughly confused.

Prioritizing everything was crazy, especially when one of your patients decides to be sick near the end of the shift. Thankfully, I had help in getting things done. I would have never made it without the crew and a few others jumping in as their shift was just starting.

Now I'm still stressed, but progressing. Family visiting from out-of-town means I'm busy cleaning, being soccer mom, being an innkeeper, providing entertainment, on top of it all finishing my semester of grad school.

One of these days, all the events will be over and I'll wonder what happened.

When is my next vacation? Not soon enough! Stay tuned....

A sweet surprise

One of my coworkers made me this treat for helping him/her with BSN homework. The RehabRN household gives it a two thumbs up.

And in honor of Tax Day, and in honor of the not one, not two, but three call-ins on night shift, yours truly gets to go into work at O'Dark 30 and escape at noon.

Just in time to pay the taxes...

While I wait

It only seems as if you are doing something when you're worrying.  ~Lucy Maud Montgomery

So consequently, I'm going to do nothing while waiting for my new position, even if I'm asked a million times about it. According to the boss, the chief of nursing will be instituting a staffing freeze.

No one gets in, out or moved around in any nursing areas until further notice. Nice.

Charging on

Yes, I'm out of the charge nurse racket for another bit. Thank heavens!

It was reasonably pleasant on the last round of Charge-o-Rama, even though RPIA LPN  tried starting a riot by mentioning all the lazy people I had on my shift. Really? I replied. I'm keeping everyone busy, myself included, and we still had time to sit down.  I was just thrilled to death I didn't have her to schedule around now that she's on light duty for twisting her ankle. (Thank you boss!)

I'm still in holding pattern re: my future in a new position at the Hotel. It looks good, but  I'm not holding my breath. HR around here is slower than dirt, and to top it off, they're even advertising on TV more lately. I'm sure my lowly, newfangled Hotel position is way down the list, since they're recruiting ICU and OR nurses, as well as ICU docs on the slick commercials in our area. "Come work at Washington, where we know patients."

We'll see...back to grad student studying while I have some free time today. Stay tuned!

Just because

Just because I could...

I got one nurse's assignment changed, even though I wanted to him/her suffer, since the lazy a$% is off the next two days. Why? Because I like the patient, and he asked nicely. Slacker Nurse was really a pain over the last few days, and even though he/she had a lower acuity assignment, he/she was perturbed about not texting friends every 10 minutes or so per usual.

I helped one of our students (Student 1) find some research articles related to a patient. And yes, kids, this is considered business-related use of the internet at the Hotel. Student 1 said, "I always feel weird doing that. What if a call light rings?"

"Go answer it and come back to your research when you have time, " I said. Simple. Patients always come before any research. Period. Besides, most of those happy patients didn't ring the light much the last night when I worked with you.

I got Student 2 some networking info from a nurse I never met in another state. Connection? A national  nursing organization and Facebook. Since the job market is so crappy, I don't mind paying back the help I got myself when I was a Almost Done Nursing Student. (Thankfully, the market was great way back then!)

I got one of our patients his/her favorite snack. I brought it in myself.

I got everyone's care done in a timely matter one night recently. Why? I wasn't herding cats that night, i.e. dealing with primadonna doctors and nurses, as well as crabby patients.

Just because, I like to do the unexpected. It really messes some folks up. At least, it keeps them on their toes.

Stay tuned...

Life is like a box of chocolates? Maybe...

If any man has drunk a little too deeply from the cup of physical pleasure; if he has spent too much time at his desk that should have been spent asleep; if his fine spirits have become temporarily dulled; if he finds the air too damp, the minutes too slow, and the atmosphere too heavy to withstand; if he is obsessed by a fixed idea which bars him from any freedom of thought:  if he is any of these poor creatures, we say, let him be given a good pint of amber-flavored chocolate... and marvels will be performed.  ~Jean Anthelme Brillat-Savarin


And if ice cream's your thing, especially as the temps go up in the RehabRN household when Bubba plays more outside and comes in a sweaty mess:

Ice cream is happiness condensed.  ~Jessi Lane Adams

Smiling Saturday

Yes, we have a budget! I like the sound of a paycheck.

Despite the downpour early this morning, the weather is pretty. I visited with a friend, too, which capped it off.
Now I get to go back for another round as charge nurse today, with a break after that for a while.  It should be fun.

Stay tuned...

Charging away

I like being in charge...when I have enough people to go around! It can get exciting, but the excitement lately is due to circumstances beyond our control. Vacations, clampdowns on overtime and a pending government shutdown are causing issues at work.

A variety of illnesses, acute and chronic, are going on, too, just to mix things up. How many more people will have 1) complicated pregnancies, 2) orthopedic issues, 3) cardiac issues and 4) viral illnesses this week?

I get lucky, though, since we have a couple of students who don't count on our staffing this weekend. At least, I'll have someone to man the call lights.

Stay tuned! More to come...

An interesting equation

Full house + scheduled maintenance to rooms = pandemonium.

Why? Just when you thought a couple of people would go home, so you could use their rooms as the first place to start, they stay.

Ah, the joys of springtime construction abound at the Hotel. Before you know it, we'll be getting hard hats issued.

Stay tuned.

Tales of the young and demented

Yes, on our unit we see a lot of people whose lives are changed in an instant.

One moment, you're goofing around on a river bank with a buddy, the next, you tumble down the embankment into the water head first. Your buddy saves you, but you never walk again.

Another patient was driving down the road minding his own business when a wheel came off his car. It crashed and he's never been the same.

Our final guy started seeing double while he was working nights. He thought he was just tired. Then he started having trouble with his right hand, then right arm. At 24, he was diagnosed with multiple sclerosis. His disease became progressive one day, and all those cognitive functions we use a lot: memory, executive function, just melted away.

Demented patients can be entertaining. One of my mild mannered demented characters kept saying, "Don't mess with me, I'm so bad!" and would repeat several television commercials over and over, including the classic, "Where's the beef?" He also answered in a similar vein when I asked what his caregiver served him for dinner. "Steak and lobster" he said with a perfectly straight face. The caregiver laughed. "I would she said, if I could liquefy it and he could swallow it with a straw!"

You can't say rehab's never entertaining, but it sure helps to have some out-of-this-world characters! More later...

Sunday on Monday

Nope, I didn't forget. I just got busy!

Sunday Stealing: The Seven Deadly Sins Meme (from sundaystealing.blogspot.com)

1 - Pride. Seven great things about yourself.
Height proportionate to weight, smart, witty, multi-talented, muse, poet, sexy.

2 - Envy. Seven things you lack and covet.
Boobs, perky butt (had one once), smaller feet, prettier toes, whiter teeth, straighter hair, smoother complexion

3 - Wrath. Seven things that piss you off.
Assholes, jerks, slackers, child/elderly/animal abusers, people who steal your parking spot, people who illegally park in handicapped spots and run into stores, drivers who don't use turn signals.

4 - Sloth. Seven things you neglect to do.
Get up early some days, dust, clean more often, procrastinate less, write more, visit elderly relatives, bake more cakes,

5 - Greed. Seven worldly material desires.
More money, better job, nicer clothes, nicer shoes, fancier purses, froufrou perfumes, Ray-Ban sunglasses

6 - Gluttony. Seven guilty pleasures.
Chocolate, nuts, brownies, salted caramels, eclairs, bavarian cream donuts, fancy cheese cakes

7 - Lust. Seven love secrets.
Don't have seven...wish I did!

If you're bored...

And you're on our unit, you just might...

1. Cut your G-tube end off, because it was way too short anyway. What does Mr. Snip win, Vanna? Why a free trip to the ED, Pat!

Yes, it really is not RN scope of practice to float in a Foley instead, Mr. GI intern. That's your job to do it...or not, since you are on call for that specialty service.

2. Fall out of your wheelchair and require stitches. Yes, another trip to the ED and lots of incident report paperwork.

3. Tell your nurse on the daily health and welfare search, that yes, you do not have any more of a particular substance because you ate it. And no, you did not have any brownie crumbs on your tray.

It's not a full moon yet, but  it seems like it is! Stay tuned for more fun updates from the luxurious Hotel Rehab.

Knee deep in the hoopla

Yes, was thinking of those very lines today as I was working....




Got my last huge project (only a little bitty one left) done for my grad class today after much work, rework, and re-rework. Amen!

So, I found a great meme for you all to check out at Sunday Stealing. It's an older one, but my kind of meme since it's short and sweet. Will post my own results when I take a break later today or tomorrow.

The Seven Deadly Sins Meme

Off I go....more to come.

Every knock's a boost part 2

Patients are their practice (from www.latimes.com)

I work with some really awesome NPs. One has been in rehab at some of the most prestigious institutions for 30 years. Another has extensive neuro ICU and ER experience, which give her amazing depth when dealing with rehab patients.

And it doesn't really surprise me that the doctors mentioned in this story still don't want NPs to be used in primary care. When we have facts that people are not lining up in med school for internal medicine and family practice, what will we do?

It's like the line in Field of Dreams, "If you build it, they will come." They are coming to see NPs 'cause there's no other option (besides filling the EDs of this country).

Med schools take note: if you have more family practice docs out there, maybe they will really come your way, instead of to an NP.

Things I'd really like to say

To the hyperspazz out-of-wedlock pregnant idiot I work with:
"Hello, getting psycho just because it's the end of the shift isn't going to help anything when I ask you to do something for your patient. You're not the only one who's busy."

To the two people who called in "sick" today on a beautiful, spring, first day of baseball kind of day:
"You two are jerks. Karma's a bitch. I can't wait for it to bite you in the arse."

To the two ambulance drivers who took my patient to an out-of-network appointment and waited for him when his procedure was delayed:
"Yes, I know I thanked you, but I wish I could give you a bonus. Mikey really did like you guys."

To the legislators who are holding up the passage of the Federal budget:
"I don't care who you are. If you want me to come to work, you'd better pay me. And if I don't get paid, you and every last one of your staff, aides, etc., shouldn't either. You people are losers. F*&ing with nurses (and the ancillary employees we need around to do our jobs)  is not the way to solve problems. I just might mail a bowel program scented letter to you."