Ethical considerations

My boss's boss wasn't sure I encountered any of these in my job in the SU, so she left them off the requirement for my performance review. Consequently, they sent it back and did not review me.

Luckily, she was able to unearth the review this past week and send it back. Of course, it was late. Even more BS to put up with....

Nevertheless, I was not at all surprised when I saw this article about a little boy awaiting a heart transplant.

I have encountered this attitude much more than I'd like at the Hotel and our sister hospitals.

It really makes me sad.

The perils of modern technology

This article on cnn was interesting, because it talks about a variety of ailments that never existed when my parents and grandparents were growing up.

I can almost hear those sage characters laughing when I read about...

Tablet neck and BlackBerry thumb 


Grandma L: (on tablet neck) Hunched over? Sit up straight! (on Blackberry thumb) It has a speakerphone? I need one of those. Who cares about typing? I never wanted to be a secretary anyway!

Grandma L. was a housewife who raised 7 kids and called everyone of them (including my mother) every morning. If she could have had a cell phone, she would have had one.

Earbud-induced hearing loss  

Grandpa K: (great-grandpa --GG--actually): GET THOSE  F**&^% out of your ears, you moron!

NOTE: GG was a foreman in a brewery back in the day. You had to yell for people to hear you on the production line. Another fun part of his job: wake up drunks who fell asleep. He was known for speaking his mind. Ahem...

Screen-related sleep disorder  

Grandpa L: Turn off the lights. They're not free.

Grandpa worked nights, and he was not a big light fan. He was retired by the time I was born, and while I don't remember him much, he spoiled me (and my sister) rotten according to reports.

Stiletto strain

My mother: This is why you carry a big purse (so you can stash a pair of flats).

I have lots of photos of my mother in high heels in her youth.

Offbeat biorhythms

Grandma R:  It's not good to eat after 6PM.

Grandma R was a tenacious survivor: married three times (first was a youthful romance gone bad, except for my dad) second was the love of her life (widowed) and third was a complete idiot (divorced after 3 years and infidelity on his part). 

She worked as a real estate agent and died when I was a little girl. I read a few of her letters my father had, and I admire all she had to deal with in life. I'm sure my tenacity comes from her German-Anglo-Irish background.

Happy Thanksgiving

Gratitude unlocks the fullness of life.  It turns what we have into enough, and more.  It turns denial into acceptance, chaos to order, confusion to clarity.  It can turn a meal into a feast, a house into a home, a stranger into a friend.  Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow.  ~Melody Beattie

May you enjoy your day wherever you are.

A classic FML

Doc, you are the best. Please don't tase me, though! Enjoy!

Today, my boss's obese bully of a grandson had a seizure. Being the only physician around, I had to rush in to tend to him. Except it wasn't a seizure as such. My daughter had found my taser and used it on him. FML

Bubba in public health?

Who knows?

As I had correctly guessed, there was no call from the teacher, etc., because Bubba decided to show off the infamous teen book at the end of the day. Apparently, it sat on his desk all day, untouched.

He decided to show a friend one of the drawings. There really aren't that many in the book, but there is one that shows a circumcised penis and an uncircumcised one and the changes in puberty.

He was written up and had to spend two hours in the Principal's office doing work. His offense: "Not respecting other's body parts". Even if the "other" was a book illustration. (The boys pointed at the drawing and laughed.)

Ah, growing up is full of all sorts of adventures.

More to come...

Never a dull moment

Bubba likes to tell me he's a "preteen". He's growing up.

So to get ready for the those awkward years, I bought this book, geared to 10-12 year olds.  He was not even remotely interested in it. It's written by folks from the American Medical Association, who have over 2600 other titles there.

Today he decided to take it to school, and it was promptly confiscated, after he showed it to another kid.

I explained that it was not his job to educate his classmate. My job is to educate him, and that was not a choice I would have made.

We shall see how this goes. So far, no note from the teacher or phone call.

The movie in health class is scheduled for March right before spring break.

More later...

TGMG (Thank goodness Monday's nearly Gone)

Every day begins with an act of courage and hope: getting out of bed.~  Mason Cooley

Yes, it was courageous in RehabLand today because it's cold again. I am happy it was not as cold as Sunday, or that my sister-in-law's holiday wish (snow) did not come true. Bubba needs to go to school as long as possible.

I worked on a lot of weird stuff because I may be relocating soon due to construction. Our business manager returned from medical leave recently, so I'm hoping the construction manager will give her information on when that might take place.

I just love being in limbo.

Stay tuned...

 

Sunday Stealing, Thanksgiving edition

 The Thanksgiving edition of Sunday Stealing. Enjoy it!

1. What do you have for breakfast on Thanksgiving?
Depends on when I get up. Usually something light.

2. Do you go to a Thanksgiving parade or watch one on TV? 
Watch on TV.

3. Do you serve appetizers, lunch, or snacks during the day? 
We eat around lunchtime and nibble the rest of the day. If I'm really prepared, I have appetizers (nothing too big or heavy.)

4. What are the traditional favorites?
Turkey, bread stuffing, mashed potatoes and gravy (all scratch), green bean casserole, cranberry sauce and pumpkin (and other) pies.

5. What new recipes will you try this year?
Maybe a dessert.

6. What part of the meal do you never compromise?
Stuffing.

7. Who gets to carve the turkey?
Usually my husband.

8. Family style around the table or buffet style and everyone sits wherever there’s room?
Combo. We have a small kitchen.

9. How many will be at your table this year?
Under a dozen.

10. Once you're at the table, do you say grace or a toast or does everyone go around and say what they're thankful for?
We say grace, then the race begins.

11. Cranberry sauce… yay or nay?
Yes, my husband would have a coronary without it.

12. What time do you eat Thanksgiving Dinner? 
We like lunchtime or early afternoon.

13. Three best pies for Thanksgiving dessert?
Pumpkin, pecan and chocolate (although Dahey doesn't think it's a holiday without mincemeat)

14. Do you have dessert right after the main meal or later on? 
Depends. I try to wait a bit before I serve it.

15. Favorite leftover?
Everything.

Doctor data?

You may very well see one, as personalized medicine becomes more common, according to this BBC article.

Having seen how far in the dark ages we are using the technology around us in healthcare in my own family, I am not surprised.

Enjoy!

Gender bender

A sad story about an upcoming clinical trial to fight cancer.

We are going places in healthcare we never dreamed of going and sometimes we can't keep up.

A little light reading

I was reading this funny article about hair dye gone bad when I found out about butter "bulletproof" coffee.

Interesting concept, but I really like my butter with a side of toast, coffee made in a cup (not a blender) and two fried eggs over easy, with two sausage patties.

BTW I eat eggs every day. My cholesterol is good and so is my skin.

Now I'm hungry...stay tuned!

Give life

I've been thinking more about organ donation this week because Rexie lost her son in an accident.  While they couldn't donate all his organs, Rexie made sure his family donated the ones they could.

So many things are done now for organ donation that were not even possible a few years ago. Today the HOPE Act was signed into law (HIV Organ Policy Equity), so research can begin so HIV positive patients can receive viable organs from other HIV patients.

Hep C patients can also receive organs from Hep C positive donors as UC Davis advises patients in this article.

Don't wait. Let your family know that you want to donate. Give the gift of life.

Weird uses for alcoholic beverages

In my spare time, I like to cook. I also like to eat and drink.

These articles on odd uses for red wine and vodka are certainly unlike any of the ones I normally read.

I'd take a bath in red wine, but clean mold with vodka? I don't think so.

That is all...more to come.

What not to do as a nurse postscript

Normal nurse: you obey the law, because your state can (and will) revoke your license if you don't.

Our nurse: was dodgy and always on his/her cell phone. Now we know why. Must have been to the lawyer or the bail bondsman or someone else.

Security came recently and escorted him/her off the premises.

Never a dull moment at the Hotel.

I hope they count the chocolate covered ones

Almonds as cancer fighting food? Wow!

Food as medicine...bring it on!

Pain at a distance

I talk to a lot of people I don't normally get to see through Facebook. Yes, I know Facebook is now for old people, but in terms of socializing, with the crazy life I sometimes have, it's the only way to be a part of someone's life.

Most of my friendships are cemented by life events. Kindergarten. High school. College. Nursing school. Rexie and I met in nursing school. The knockdown drag out year that was accelerated nursing.
We decided to sit near each other. Being creatures of habit, we gravitated to the same spot with our friends, D and J. We anchored our section in the lecture hall, and we bonded. We collected papers for each other. We called each other if anyone got sick. We commiserated after exams at the local coffee shop.

Rexie has been teaching since we got out of nursing school. She had another interesting life before nursing school which helped her land that job. It also helped that the professor wanted to train someone before she retires.

But today, Rexie is back in the town she grew up in, and I can't help her. I can't make anything better, because Rexie's son died in a terrible accident. It was supposed to be fun: the men out for the weekend. It wasn't supposed to end like this.

As her friend, I can only see her pain from a distance; an uncomfortable space I have only travelled reluctantly in my life. I watch from afar. And pray. Pray she makes it through everything in the coming days.

More later...

The pain of misdiagnosis

Trigeminal neuralgia is not uncommon in the patients we see at the Hotel. How this lady was treated is unusual.

Thank goodness we do not do this as a common treatment.

Dear Mother Nature

Please stop the tornado/severe weather crap. Tornado season officially ended November 1.

Yours truly (because I would like the SU to be standing tomorrow, so I can go to work),

RehabRN

Ask me...

That's what this week's version is called at Sunday Stealing. Enjoy!

The ASK Meme, part one

What’s your favorite candle scent?
Vanilla

Do you know a hoarder?
Yes. Dahey is one.

Can you do a split?
Regular = no. Chinese = back in the day I could!

How old were you when you learned how to ride a bike?
Six

How many oceans have you swam in?
None. Have waded into two.

How many countries have you been to?
Six.

Is anyone in your family in the military?
Yes.

What’s the worst grade you got on a test?
I've flunked a few tests. (I have always passed the classes, though.)

What was your favorite TV show when you were a child?
Emergency.

What did you dress up as on Halloween when you were eight?
Don't remember. Went as a hobo more years than I can count.

Have you read any of the Harry Potter, Hunger Games or Twilight series?
No.

Would you rather have an American accent or a British accent?
I am fine with my accent (American) thank you very much.

Do you know who Kermit the frog is?
Yes...why are there so many songs about rainbows? And now that you have that song in your head, see the bottom of this page.
 
What language, besides your native language, would you like to be fluent in?
Chinese

Do you spell the color as grey or gray?
Depends. Earl Grey tea and a gray sweater are fine and dandy, as my old sales manager used to say.

Is your father bald?
Nope.

The classic song that question made me think of...

Animal adventures

WildDog is a typical senior citizen dog. He eats, he sleeps. He goes outside.

Lately, his "going" outside is turning into "going" inside. Thank goodness for protective finishes on floors, but I think the carpet cleaning firm is going to send me a thank you card this year for all the business WildDog has made for them. Scotchgard or not, we still have to have them cleaned regularly.
WildDog is very attached to the carpets Dahey has on some of our floors, because he sleeps on them.

He's getting better. Most of the time he's having accidents on the reasonably priced (and easy to clean) doormats my friend F. told me about at the hardware store where she works. They also keep him from sliding on the shiny parts of the floor.

Bubba is having adjustment issues to his braces. He's wearing some interesting spacing appliance now that has to be tightened each day. He's keeping his mind off the soreness right now by watching animal shows.

Maybe he'll be a doctor after all, like some of his relatives, but a doctor for pets instead.

For me, I just want to go here and see these animals as I slide down the water slide.

Hope you enjoy your weekend wherever you are!

Things not to do as a nurse

Yes, I got my quarterly newsletter from RehabLand Board of Nursing, and yes, they do have a fine list of things not to do if you want to keep your license to practice.

Some of them were (are) frankly pretty scary, and I only wonder how long they went on before they were reported.

 1. Patient in wheelchair wants to go to bed (common Hotel scenario) and comes to nurses station.

Normal nurse: talks to the patient and then assists the patient to bed.
Our nurse: pushes patient forcibly out of the nurses' station and give a Haldol shot where the needle gets stuck in the patient. License suspended.

2. Nurse gets a tax return and 'forgets' to pay the state taxes.

Normal nurse: gets the taxes paid.
Our nurse: doesn't bother, so license is suspended.

3. Nurse is asked yes or no questions re: felony history.

Normal nurse: knows better than to do that. Nurses are one of the most trusted health professionals for a reason.
Our nurse: just fibs, gets found out, and gets license suspended

4. Nurse takes patient into a video monitored room in ER and examines his "groin pain"

Normal nurse: takes information and completes assessment.
Our nurse: fondles, kisses the patient, compliments his eyes and shares personal details. After this performance, our nurse is put on probation for two years.

And finally, for another technology related story:

5. Nurse remotely monitors patients as part of his/her job.

Normal nurse: does work, makes phone calls to patients, providers and case managers.
Our nurse: doesn't do any of those things for over a month and fabricates documentation,and gets license suspended.

My dog would love it

Bacon toothpaste? I heard a story about this on  the news, and didn't really believe it.

Yes, it really exists. I like bacon, but will stick with my mint flavored stuff, thankyouverymuch!

Enduring manglement

Yes, that's the game we've been playing at the Hotel.

Bigwigs come and go, but power struggles last forever.

This week: the Manglement tried to suspend our boss, because he/she was one calendar day late on producing a document to his/her boss. It didn't matter that he/she couldn't take the class the day it was due because they had him/her doing something else "important" (as if 7 hours a week minimum of meetings isn't enough). 

His/her PHB, our feckless chief nurse, got HR to send a letter of reprimand over, with requirements they figured he/she'd never fulfill.

At the behest of the Hotel MD chief, he/she sent over the missive to the hospital director and his second in command. It was lengthy, and told a story of an LPN who became an RN, who now as a nurse manager, took over the position at the Hotel after several other people said it would never work.

He/she knows us. He/she was one of us on the floor, and us old timers remember that. The nurse who never said, "I'm too busy to wash Mr. Z's hair," or "I don't want to do x, y , or z." This is the nurse who got certified in rehab, worked hard to keep patients and their rooms immaculate, to really CARE about what happened to them. The nurse who is proud to be a nurse .

So now we endure as he/she awaits the results of the appeal.  Here's hoping they see the light before they screw up something else. The dim view of the Hotel could very well get worse.

More later...

It's always something, part 22

Yes, it is always something. I'm tired from running around, doing housework and cooking. I cooked so Dahey did not have to stand in line at the restaurants in town offering free food to veterans today.

I noticed something odd, and even though it's not birch pollen season, I guess I'll just have to watch out that I am not having OAS due to the lovely apple pie I made for dessert.

I'm going to relax and get ready for bed. More to come...

Gotta love the pharmacist

The Cynical Pharmacist, that is. I follow him on Facebook, and I enjoy many a rant, er, post about the vagaries of serving the public from behind the counter.

This post was there today (see below). Since I deal with specialists regularly in the SU, it was quite entertaining. Unfortunately, the infectious disease, renal and transplant folks were left out. Sorry docs! (I love you, but many folks never know you exist until they get superbugs, bad kidneys or need a liver).

CP, I am thankful you are here. Here in RehabLand, we love our pharmacy folks. They are the only ones with a sense of humor as macabre as ours.

Enjoy!
=======================================================================

Thanks to Shiraz for sharing...

The American Medical Association has weighed in on Obama's new health care package.

The Allergists were in favor of scratching it, but the Dermatologists advised not to make any rash moves.

The Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve.

Meanwhile, Obstetricians felt certain everyone was laboring under a misconception, while the Ophthalmologists considered the idea shortsighted.

Pathologists yelled, "Over my dead body!" while the Pediatricians said, "Oh, grow up!"

The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.

Surgeons decided to wash their hands of the whole thing and the Internists claimed it would indeed be a bitter pill to swallow.

The Plastic Surgeons opined that this proposal would "put a whole new face on the matter."

The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea.

Anesthesiologists thought the entire idea was a gas, and those lofty Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to the assholes in Washington.

What's what: this week's Sunday Stealing

Getting ready for the week and Veterans' Day. Here's the latest meme from Sunday Stealing. Enjoy!

What is on your bed right now?
Dahey. He's asleep.

What is the best ice cream flavor?
Hmm...pistachio

Did you wake up smiling this morning?
I woke up in a hurry, so I don't remember.

What time do you wake up on a typical morning?
Between 4 and 7 a.m. (varies, but alarm assisted during the week.)

What holiday makes you sad?
It depends on who is with (or not) with you.

Where does a good night’s sleep rank on your priorities?
Top 2. Must have sleep!

One song that makes you cry?
"I drive your truck" is one that gets me.

What food do you find disgusting?
Liver. Just don't like it.

A robot in every room

I'm sure every patient will have one of their own if they only have to power it with urine.

Gives new meaning to drug testing and economical helpers at home.

Technology...who would have thought?

TGIF everyone! Enjoy every moment of this weekend. The fall leaves are still falling here in RehabLand.

Toppers

I was talking to my friend recently, and since she lives on a coast, she lives in a major metropolitan city. A city lots of tourists from all over the world come to visit: a town celebrated in song and verse.

So when I thought I had a bad week, we discussed her week. She topped me. When I was looking at the news, it went from spectacular to excrement covered really quickly.

Here's the list.

1. Minding her own business, Friend, her husband and two kids take a walk on a beautiful weekend day. They go to the beach. The moment they get there, a woman's body washes ashore. Police are called and say, "We've been looking for her--she's a suicide victim. We're on our way." Kids are herded off while they wait a safe distance away.
   
   Thirty minutes later, they show up, and an hour later, her husband is released after a statement. Needless to say, the weekend really was a washout.
   
2.  I thought I was being harassed until I saw this article. No, I'm really not nearly as harassed as this guy.

I am content that someone else did top my week.

My life is really boring in contrast. Frankly, I like it that way.

More later...

Twilight zone

"Help! I'm stepping into the twilight zone!"--Golden Earring (thanks Grumpy for that post! Another earworm.)

Signs your entering the Twilight Zone:

1.  Was really annoyed when BoyWonder from my enterprise performance improvement committee decided to take credit for my work with the network cheese.

Thankfully, my cohort stepped in with the cheese and set him straight. Thanks, Zeus! I owe you one very large caffeinated beverage.

2. I'm trying to help the governance council, but it's surely a twilight zone I really don't want to step in. A group of strong personalities is an understatement.

You'll come to know...I hope. Stay tuned...

Choices

My travelling partner was not feeling well Monday. Her blood pressure was up when I checked it the other day, by machine and manually. She came in because we are short of staff. "This vertigo won't go away." she said. Yesterday, it was so bad, she went to the ER. They admitted her.

He was one of our regulars. A mustachioed man with a syrupy accent so heavy, I was occasionally called in to translate (because I'm good at translating) for the new nurses who don't recognize the  cadence and drawl from his part of the South. One nurse I worked with had known from the time he was injured. He knew our programs so well he could have taught them, she said. We were the safety net: if he got sick, he always came to us (even drove himself this time).

But he was more than sick:  he was septic, so the Hotel was not the place for him. We sent him on to Washington for more acute care, and he got worse. He survived some crazy cardiac stunts, but the last procedure set off a cascade from which he did not survive. His car sat on the parking lot when I arrived the other morning. The family came and picked it up yesterday.

Today, I read this story, passed along from one of my coworkers. He didn't want to live like many folks do at the Hotel. He just wanted to die, and with his family, he did. It was so sad because he chose to leave when his wife was  pregnant with his first child. "He'll never hold their child.", the article said.

He'll never see that child, either, or make a difference in his/her life. That is the part, to me, which is the saddest. I have worked with rehab patients who have raised children (yes, they need help), and they do parent them. They do discipline them. They do care, even if they cannot lift a finger.

The choices we make can change things forever.

Another week on the way...

Thank goodness the big visit came and went. The team that showed up loves the work we do. Some things need improvement, but we already knew that. My boss was happy I was around to answer questions.

We just hope they can convince the Manglement to keep their word as promised a while ago. They all showed up en masse in our building for the big wrap up meeting.

Because the day of reckoning for that will come soon enough.

Back to our regularly scheduled program, with a dash of rain.

Monday's back

Awake. Alert (thanks to those 2  large espressos already). As ready as I'll get for now before meeting-o-rama and one of the biggest sales pitches of my life for the SU.

This quote sums it up:

Opportunity does not knock, it presents itself when you beat down the door.~ Kyle Chandler

Here I go to knock on some doors, er beat on them...more later!

If it's Sunday...

Here in RehabLand, it's time for Sunday Stealing. This week's meme is about time (and will cause you another earworm, if you're not careful).

Here are my responses, which I would have posted earlier, but hey, with that extra hour, I've already gotten lots of work done. It will get dark soon enough, so I'll be turning in early for all the excitement as the week starts tomorrow.

Enjoy! ============================================================================================================================== 1) Do you think Daylight Saving Time is still necessary? 
To sell lightbulb and batteries, yes. For me personally, no. I just like it to be light in the morning, which will last for a bit, so...not really.

2) How long does it take you to adjust to the time change? 
Not long on fall back. That spring forward messes me up.

3) What's the hardest part of the time change? 
None.

4) How many clocks are in your house? 
Too many. I'm really enjoying the auto-set ones.

5) Are you generally early, late, or on time? 
I hate being late, so I am most often early or on time.

6) If an invitation to an event listed the time as 8-11pm, what time would you arrive? 
By 8, and be gone by 11.

7) Do you wear a watch? 
Yes, every day.

8) Have you ever glanced at the time and had to glance again because you didn't pay attention the first time? 
Of course!

9) Are most of your clocks digital or dial? 
Mixed.

10) What does your alarm clock sound like? 
A foghorn. It's ancient, but the new ones are too nice, and I sleep right through them.

11) Do you use the snooze feature on your alarm clock? 
No. I purposely put the alarm far enough away that I have to get up to turn it off.

12) Does clock ticking drive you nuts? 
Yes, this is why I don't have a clock in the room I work in (SU). If it's quiet (after all the patients are going while I'm charting) and it ticks, it drives me crazy.

I don't wanna

Get ready and start doing my homework.

Need more coffee...or something to start me up.

TGIF...fifty, fifty

TGIF all. I needed it to be Friday really, really bad, even though, I'll just have to do work and homework this weekend getting ready for the bigwig visit to the Hotel next week.

The day was 50/50. Win some, lose some.

This site about autocorrecting while texting made my day, especially since I often have to text our techs to get things done at the Hotel.

Have a wonderful, fall weekend wherever you are!

News flash

Yes, if you needed documentation on this very important subject, here it is:

Scientists decipher dog-tail wags (from bbc.co.uk)

Thank goodness WildDog has a long enough tail to really read!

That is all.