Holiday weekend thoughts

"The more we assign the soldiering to a select few volunteers—we don’t have an equalizing draft and there is no required national service—perhaps the easier it is to forget what it means to share a common citizenship or feel a sense of indebtedness or appreciation. If we no longer share in the service, risk and obligation, maybe that explains why many of us no longer observe Memorial Day."

This is a quote from John Bussey's worthwhile assessment on why Memorial Day needs to be more than a day off or shopping.

I do believe that we are living in troubled times, and unfortunately, the sacrifices aren't shared.

I hope you have time to reflect this holiday weekend. I know I will.

More later...

Kids these days

I feel like an old lady reading this article, or perhaps, rightly so, like a person from another century. This is a non-nursing publication, but I hate to say this could have been about some folks (and some spots) at the Hotel.

I know startup companies (from reading, and hearing from my friend's kids who have one, not experience) often allow booze at work. That's not too shocking, probably because I did once work in an environment where we talked of imbibing all day, and we actually did it after work ("product testing").

However, who'd a thunk that you'd have to tell people not to have sex in public parts of your office building.

Different strokes. Ugh!

Stay tuned.

Not just nice

Sometimes, it's necessary. Introducing yourself to the specialist who may be visiting your unit is not just a common (really uncommon) courtesy, it's important. Especially to your patient who needs him/her and his/her expertise.

Thank you Suzanne Gordon for reminding us of this very important fact.

Remember, look up and introduce yourself. Your patient is worth it (and so are you)!

Stay tuned.

Preaching to the choir

Most people don't think about death happening in rehab, but it does. Probably more often than you know. Right now, we're rehabbing a patient who has been seeing palliative care.

It may not happen immediately on a unit, but we prepare as if it might.

I read this recent article on death from author Suzanne Gordon with more than a passing interest. It hits home to me. Sometimes I wonder why we let people get set up for false hope. Is it so we have a rehab goal for therapy? Is it so we might record a FIM gain?

Or is it because, we're just like everyone else. We don't want to be the "bad guy". If we tell the truth, we could be the bad guy and make the patient and/or his her family upset.

But if we perpetuate the illusion of hope, aren't we stealing the shred of truth the patient relies on us to give him or her?

It makes me wonder...more later.

Weekend diversions

What kinds of movies will a rehab nurse watch before hanging out with hundreds of other rehab nurses? Well, if you're into history and sports,like I am, you'll watch The Best of Men. My favorite part was watching it on Bubba's computer (which has a big screen). Somehow I got it on closed captioning by mistake.

Maybe because I have a lot of parental controls turned on (maybe note), but I noticed that all the swear words were not included.

Another interesting article I found today was this article about the big cheese at one hospital taking a pay cut. What a novel idea. Hope this one spreads.

Now I just get to make dinner and get ready for Monday.

More to come, so stay tuned!

Resources I wished I had

This article for my patient who was so very unhappy with her ex-husband's last name. If the former Mrs. U. comes in, I'll print it out.

More often than not, I'd like opportunities like this one to volunteer. Some of my coworkers need rejuvenation more than others.

After a wild, blood moon kind of week, I am so happy it's the weekend!

TGIF all wherever you may be!

Sometimes, you really can't

Go home again. You can't go home without it changing you.

In this article in the NY Times, they discuss how many Africans who believe in female genital mutilation are sending their daughters out of the country for the process to occur in their former home countries, such as Somalia or Mali (including a few others).

I learn something new every day...

The story of my life, part 12

I read this quote recently in an article and it really struck me:

"The good workers get disheartened and demoralized if they see these non-performing workers making as much as them and they're not doing their job."

I have seen this daily since I started at the Hotel. It really does practically take an Act of God to get someone fired, unless of course, the state takes their license.

However, I am stubborn. I stick around and do my job to the best of my ability to spite them all (and trust me, there are enough of them). It's a challenge, but some days ARE really better than others (today was pretty decent).

I will let it all take its course before I decide to do something else, but the clock is ticking. I have never been so glad to be on the downside of my service contract for graduate school!

Not just for travelers

I saw this article recently in one of my e-mails. As one other article mentioned, there are a lot of myths out there (some perpetrated by well-meaning and not-so-well-meaning folks).

One of the biggest issues is that you may need legal representation, regardless of whether you are sued by a patient or not. If you are investigated by your State Board of Nursing (SBON), your license could be in jeopardy.

Another reason: if you volunteer and use your nursing skills, your employer's malpractice may not cover you in the event something goes wrong because you are not at work.

Many malpractice policies can help you to pay for your defense (as most employers do not cover that). Losing your license often means losing your job. Losing your job means losing your income.

Happily, this can be remedied. Check out a malpractice policy of your own. NOTE: some specialties are more expensive to insure than others, but this may vary by carrier.

If you need a nurse attorney, see one of these fine nurse attorneys (if you are in their states) or contact a firm and ask them if they have nurse attorneys who handle cases before your SBON.

Taralynn Mackay
LaTonia Denise Wright

As always, when in doubt, check it out. Your career (and livelihood) may depend on it.

DVT management

Lots of customers come into the Hotel with history of DVT.

While I was reading the RehabLand news today, I saw a very interesting article about removing them to resolve issues.

There were no photos, so Dahey could read this article, too. (He has a weak stomach and ears).

Enjoy your day wherever you are!

You never forget

The people who die because of medical errors. One patient of ours died last year of ignorance, when a provider just didn't know what to do, and help was too far away.

Consequently, I read this PDF from the National Patient Safety Foundation a little more closely.

It is terrible that they died, but to have them die in vain, is far worse.

The darnedest things

I love gadgets and technology, in part, because my job uses a lot of various technology at the Hotel.

However, when I read this article about dangers of wearable computers, some things just stood out.

1. Lifeblogging? Really? The Truman Show is so not HIPAA, kids.

2.Google Glass. Same as #1. I'm just waiting for a policy at the Hotel.

3. The wearable/embedded device issue. Yes, I'm not really impressed with Dick Cheney and would not go hunting with him, but he does have a point.

4. Cop cam will show who is getting the free donuts and sodas...just sayin'.

5. Smartwatches. Duh! If you have a smartphone policy, just upgrade it appropriately.

6. I like the smart clothing idea, but I don't like the thought of someone making me wear it to work. The authors do have some valid points, and this type of clothing would be valuable for my Hotel patients.

7. Fitbit and insurance rates. I don't like it. Reminds me of that bad "nurses go to heaven" joke, only the HMO nurse doesn't have any repercussions.


Just my $0.02...feel free to chime in.

A cautionary tale

I read this KevinMD article today just because I liked the title: The toxicity of Medicaid.

Some of you may say, "This is a doctor writing this. Boo hoo."

Boys and girls, we should be up in arms, too. The patients described here don't just need nursing care, they DESPERATELY need it. (yes, I'm shouting again.)

The system has engendered dangerously bad habits in people. As nurses on the front lines, I'm sure our friends in the ED could tell us about how many patients might easily be triaged to lower levels of care...if they existed in their area and took Medicaid.

In rehab, we coordinate care regularly between specialties and help people get things they need, even if they are indeed expensive. We need to do more of this for Medicaid patients to keep them out of the ED.

Unfortunately, the EDs of America sit there like the vaunted Motel 6...we'll leave the light on for you. The light is on, but it is unfortunate that many folks miss the most important thing about the ED.

This place is for emergencies only. It's not for a one stop shop to get all your doctors' appointments done right now, so you don't have to get up in the morning, and (gasp) go to more than one place. It's not so you can avoid your copay. It's for emergencies.

Because one day, if you have a heart attack, stroke, or car accident, you may want them to be ready and waiting with the light on, for you.

The latest in the news

This is the etiquette edition (aka don't do this). Enjoy!

They've got it right...and funny
Top 10 things not to say to someone in a wheelchair is a great article from the good folks at the Shepherd Center in Atlanta.

Not exactly a funeral in a stadium, but...
Don't take selfies at a funeral is the point of this Mashable post.

Don't emit noxious fumes
In the ongoing saga, Huy Fong Foods, manufacturers of the famous "Rooster" sriracha sauce have halted shipments.

Not necessarily a no-no anymore...
In the old days, no one in their right mind would bring their dog to the hospital. This AJN article talks about how your pet can help you just by visiting.

Uncorked

It's not what you think. This mechanic (and father of five) invented a device being used during childbirth, after he won a bet with a friend to get a cork out of a bottle.

Necessity and mothers are really helpful for inventions, as Jorge points out.

More to come.

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.

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!

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.

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...

In the news

It's not Wednesday, but it's pretty close, so here are a few things I've encountered so far this week in my meanderings around the internet.

Should you be sincere?
Maybe not according to this CNN article.

Goals
Sometimes you just need a big, hairy, audacious goal to get you going where you want to be (from LinkedIn).

Tips from Harvard
As an escaped business student, I've read the Harvard Business Review for years. Despite the cases, they have some exceptional tips on management and growth. 

It's short and sweet, but Make a plan for professional growth will get you started.

Pearls of wisdom
This article was very appropriate for a couple of folks at the Hotel who just happen to be agitated on the evening shift.

Enjoy!