Off into indigo

RIP Oliver Sacks. You made us see the beauty in life, death, transition, and quirkiness.

Anniversary, it is...

But a happy one? Not exactly.

This weekend is the anniversary of Hurricane Katrina wreaking havoc in New Orleans and along the Gulf Coast. It has gone on record as one of the deadliest natural disasters in US history.

We should learn a few things though.

1. No matter where you are, you should have an emergency plan. Yes, my plan's not the best, but I am fortunate, that most of the time, I work close enough to walk home if anything happened here in RehabLand. Bubba is close to home at school and we have some basic supplies on hand.

Don't forget your desk/locker/car trunk. You can store some basics in there too, just in case.

2. Figure it will take three days to get help. We are fortunate that a lot of important public services are less than a mile from us, but we still stay ready. When it's time to evacuate, you need to evacuate.

However, there are happy things. Very soon, in September, many rehab professionals will descend on the Crescent City (or the Big Easy) for their annual conferences. If you are there, and are free, I'd highly recommend one or both (ASCIP for all you SCI nurses or professionals and/or the Annual ARN conference, for any rehab nurse). New Orleans is a pretty city with lots of history and delicious treats. Don't miss it.

Who knows...maybe I'll even see you there. Stay tuned!

Dear Manglement

Yes, it is rough when no one wants to do your job. With guaranteed bonuses taken away because your performance sucked last year, yes, I really do feel for you.

It's terrible to come into work and be coddled with free snacks, coffee, etc., and your own reserved parking space at our multiple locations. I'm not really surprised with your recent actions of not notifying the campus here at Madison regarding security events, since you have a stellar track record to uphold.

Even though, RPIA, our former chief nurse, (and the rest of you who are still left) knew we were under a bomb threat at our Washington location one beautiful March day, you didn't "bother" anyone to pass that info along, because, "You know, the police will handle it." It was nice of you all to evacuate the building, just in case with RPIA.

Yesterday, we figured something was up when our retired veteran air traffic controller patient noticed an odd helicopter pattern down the street near a strip mall after therapy. He and Mr. Z., another patient who is a retired police officer made a few phone calls. As usual, no one bothered to notify us peons at the Hotel that a strong armed robbery occurred just a few blocks away and the helicopter pattern was due to the police tracking the suspect.

Just remember...we take care of those who take care of us. You might not like the next patient satisfaction (or employee) survey.

Sincerely not,

RehabRN

Dear Social Media Darling

Dear SMD:

It's nice of you to come back to the Hotel after your last momentous visit when you yelled, threw punches and screamed at a large contingent of staff.  It really is hard to expect a Hotel, because after all, we are really a hospital.

Posting your latest set of grievances on social media won't help.

We will be professional and do our jobs, but if you're looking for warm and fuzzy, there are plenty of pets available down the street at the local animal shelter.

Here's hoping this visit is more pleasant than everyone is expecting.

Yours professionally,

RehabRN

Chicken, little, and Chicken Little

It seems like chicken (or various fowl) are a big part of the menu for Bubba. He's working on getting stronger and has been reading nutrition sites about eating properly and the importance of proteins, such as chicken.

And when I was minding my own business watching a retro TV show, the Streets of San Francisco, I saw a Chicken Little-esque commercial.

Life really was so much simpler then.

Sadness

Back to school is full of newness and possibilities. Lots of kids with new clothes, school supplies, and meeting new friends.The school year shouldn't have kids getting shot. Kids trying to do better than their best while doing their homework.

It's just not right. We must stop killing each other.

More later...

The best things in life

Some are free, some not so much.

It's been a fun week. Bubba started seventh grade. He's happy enough, but wishes more of his friends were in his classes (only half of the classes contain at least one friend, which according to Bubba will make them "very boring.").

The school district here in RehabLand is having budget cuts this year. I always know which teachers talk about them (the ones most affected). It's very interesting. There won't be any intramural sports this year, so we have to find Bubba a boys' volleyball league he can play in. He is set on trying out for v-ball in high school, so we must prepare. This will be interesting. He may have to get on a girls team.

So today, we hung out, did homework and we had fun. We went to a local hamburger joint that's been around for ages. It's a tiny place (counter serves 10 people on each side) that makes their own root beer. We got a burger, fries and root beer. It was fun. One item crossed off the bucket list.

Since that wasn't enough calories, we decided to go to a local creamery known for it's oddball flavors. Bubba got one called Cookie Monster. It had both Oreos and chocolate chip cookie dough in it. I got old reliable double chocolate, which was amazing.  Bubba was a little scared of the teenage girl population, so we sat on the same side as the ice cream scoopers.

All in all, it was fun hanging out with Bubba. These moments are priceless. I would not trade them for anything.

More to come...

What not to do as a nurse, anniversary edition

Yes, I got the latest State Board of Nursing (BON) newsletter here in RehabLand, and it's never a dull moment. It's the anniversary edition because I found this sad anniversary from the NFL today. I'm not a big football fan, but I've worked with many patients like him.

Here are a few things to remember NOT to do as a nurse. Happy Graduation to the all the August grads!

1. Make sure your documentation is complete. 
An advanced practice nurse was reported anonymously for regular and consistent documentation issues. He/she should have known better.

2. Don't come to work stoned/high on meth/drunk/sleepy.
It should be obvious, but too many people were listed in this issue for the above reasons. And as one person told the investigator, it really isn't "joyfully ironic" that you tested positive for two substances, either.

3. Know your basics about diabetes.
A school nurse was pulled out of a meeting to attend to a student with a blood sugar of 590 who was acting goofy. Student gets progressively worse. Does our school nurse dial 911? Of course not. He/she just called the parent, hung out, asked someone else to give the kid insulin.

Thankfully, a school administrator, without a license, but with a clue called 911. The nurse said he/she waited to call 911 because he/she was "confident" that the student would be okay. The kid was, eventually.

I'm so happy he/she doesn't work at Bubba's school.

4.  Know the protocols in your state for IV push medications.
Here in RehabLand, it's defined by a state statute, which clearly says no to graduate nurses and LPNs except in life-threatening emergencies.

Guess what this wasn't? An emergency. And it wasn't the first time, either. (Your drug dispensing units keep really good records for narcs, kids).

5. Don't threaten your coworkers or other staff at your facility.
If you run out of leave, then threaten HR, your nurse manager and a couple of other staff nurses, they may not take you back. Said RN wanted to "find a cure for HIV" and "didn't want innocent people to get hurt."

Thankfully, the court issued restraining orders to keep said RN off medical center property AND the BON revoked his/her license.

That's all for now, folks. Enjoy your day wherever you are until our next installment.

Ah, memories!

I was reading online and found a link to these NCLEX questions. The scenarios are the "what would you do" management ones. I love those.

For fun I decided to read them, and see how they'd be answered at the Hotel. The selected questions are located at this link: http://www.rnpedia.com/practice-exams/nclex-exam/nclex-practice-exam-management-care

Here's what would happen (or has happened) at the Hotel for the ones I selected. See if your place of employment is the same.

Remember nursing students: you have to answer as if you work at NCLEX Hospital, not at the Hotel or your current hospital. Your mileage may vary, but you'll get the answer right.

1. RE: substance abuse/unfit to work We've had our share of people who shouldn't come to work for a number of reasons. Frankly, I'm all about sending them home if they don't need to be there. Unfortunately, some of my coworkers, do not feel the same way, and contribute to everyone else doing double work so someone else isn't "found out".

Can you say "dysfunctional family"? I knew you could.

7. RE: abuse complaints. Please, please, please don't call the police FIRST, young'uns. I've seen this one in person and the manager ended up leaving and one of our students was basically run off the unit, because he/she did not use common sense.

Assess, mitigate, and notify your chain of command first.

8. RE: dates and patients. Yes, I do tell them it's inappropriate to ask me, a married woman, out on a date, psych or not. I'm here doing a job, which does not include interviewing the next Bachelor/Bachelorette candidates.

9. RE: client calling out asking for help all the time. This is great information, but good luck implementing it, if you don't have a cooperative crew. I remember many a night when some of my evening characters constantly badgered me (and often the rest of the staff) no matter what I told them.

Just remember: dementia and sundowner folks will keep you hopping on evening shift, kids. Don't forget: evenings do get quiet and dark, and that's when things like to fall apart.

11. RE: the surgeon and the chart. Remember: just say no. If he's on your facility medical provider list, he can look for himself. If he chooses to do so (which violates hospital policy in a great many places), it will be logged and he'll have some 'splainin' to do as Ricky Ricardo used to say.

15. RE: visiting hours. Here again, is another example of using common sense. If your family is quiet, calm and respectful, it makes this easier. Model it and they'll do it, too.

Don't be a Nurse Ratched. Taking care of the patient and his/her family (and well-being) really IS your job, no matter when visiting hours are.

You can survive

I tell myself this every day. I can survive.

Why? Because, yes, I can survive sitting in a conference for 2-4 hours per day this week, because this conference is talking about where we are going. I'm hoping with a little nudge, we can get people to make the push to see it happen.

I stop what I'm doing because people need me. I'm not turning someone away because I'm in the middle of this. If they bothered to knock, they needed something. I can survive five minutes of missing presentation time.

One of our old timers came by to tell me his wife is getting frail and he needs help. Finding the people who can get that help to him is important. The help will assure that he survives.

I just wish my arm would stop hurting. I pulled something in it doing my exercises tonight. I will survive and hopefully, it will feel better tomorrow.

Kickboxing awaits.

Stay tuned.

Back from vacation

Yes, it's always an experience returning to work from vacation. Thankfully, I missed all the excitement of the surprise Joint Commission visit, and the visit from some local VIPs.

Monday was meeting day. I started in one, did my regular rounds, then got trapped in another one, and found out this meeting fun won't end until Thursday. I am so happy that I don't have too many patients scheduled, since I'd have to work them around all these meetings.

At one of these meetings, a doctor presenting talked about how we have to make modern medicine fit the requirements of the Hippocratic Oath. Lots of changes are coming, so reviewing this classic does make things interesting.

I have a feeling this week will fly by, so stay tuned!