Back to business

Working always makes things interesting. From my space near the front door of the Hotel, I see a lot.

This week, I've had a lot of visitors. Folks looking to learn stuff I can teach them, families learning about when and where they'll go when they go home. I've even gotten to plan some projects and pitch new ones that need resources. I feel like I'm going somewhere, even though I'm running.

My regular characters come see me. One rolls in and it's obvious he needs help. His leg is dangling. He's slumped a little more than usual. He tells me the new wheelchair is having issues. His headrest is messed up and his foot pad won't stay on the chair, so we have to carry it upstairs.

Thankfully, he didn't have one of those spasms, that to the uninitiated, look as if he could just fly right out of the wheelchair. If I had a dollar for every time he's frightened new staff, I'd be rich.

Nevertheless, I fix what I can, empty his leg bag, and get him to the motor pool, otherwise known as therapy, so the wheelchair specialists can fix him up, literally, and figuratively. One smiles and tells him she knows where the "real tools" are.

He follows along, and I leave, knowing I've done my warm handoff to the next discipline.

Now for more fun...FIM certification!

Stay tuned.

Torn...

The dilemmas I've faced this week.

The first one was the dreaded certification renewal (one of them, anyway).

Getting a nursing certification is a little like qualifying for an equestrian event: lots of jumping over obstacles and looking perfectly put together.

After months of combing all my files for CE certificates to put in the application, making sure my membership was updated, then filling in the rest of the application and credit card info, I sent it off. A few hours later, I got the "we're reviewing it" e-mail.

Today, I got the all clear. I'm renewed for another five years. The hamster wheel starts again...

The last couple of days, not throttling some of my coworkers about the US presidential election has been another dilemma.

For those of you not in the know, we not only elected a new president this week, we will, on Bubba's birthday, January 20th, inaugurate the nation's first reality TV star, thrice divorced president married to only the second non-US citizen First Lady. Some of my coworkers want to talk about it all the time.

I'm not one of those people. We give out blood pressure meds for a reason at the Hotel. We're not supposed to be inducing conditions that will send people into rehab.

However, I'm looking forward to the weekend. I'm celebrating my favorite US veteran, Dahey.

Happy Veterans' Day to all of you who have served!

Take ownership

Yes, I had to do this in a few different ways lately.

First, my fancy new external hard drive got messed up when I changed a security setting. It looked as if I totally erased the drive. Thankfully, that Windows certification came in handy (haven't used it in a decade, but...) I finally found the page on www.microsoft.com about Taking Ownership of a drive.

My data wasn't gone. It was just hiding (since I didn't have permission to view it). What a relief!

At work, I finally got to the bottom of what happened to my dream job a while ago when I was stuck waiting with one of my coworkers. It was enlightening,  and frankly, nice to hear, that no matter what, I did my best. The other person involved probably was not too happy, either, but I still had my day job.

One of my coworkers mentioned that there was an incident with a patient this weekend. He/she knew because the patient had confided in him/her. Some of our staff are being rather surly. While it's not disruptive yet, it's certainly becoming hostile on the floor at the Hotel.

Since I had a similar issue recently, I sent my coworker to the other team provider. He/she will tell him/her to take ownership, too.

Hostile and/or disruptive behavior is really not welcome in a healing environment.

Hope you will take ownership of your space wherever you are.  You and your patients deserve dignity.

More to come...

Certified, baby!

Yes! We got another nurse certified recently at the Hotel. (Thought he/she would take FOREVER!)

C'mon CARF...we'll be ready!

Stay tuned.

Happy!

So, so, so happy. Found my lost gas cap AND...

I'm a RN-BC. Woo hoo! Those months of studying paid off. And I sent special thanks to two former Navy nurses who helped make it happen. I couldn't have done it without them.

It is indeed a Happy Monday in RehabLand.

Hope you enjoy the rest of your day.

Demotivating employees

Ah, spring is in the air (for the moment) here in RehabLand, and the hospital administrators (aka PHBs) have emerged from their coccoons, er lounge chairs, to start rabble rousing the troops and demotivating away.

How can they do that you say? Well, here are some stories (I wish they weren't true) on how they do this.

NOTE: the names of all parties and sexes, etc., have been centrifuged to protect the guilty and the innocent, since I don't want the HIPAA police to come carry me away.

1. Medical personnel are allowed $xxxx per year for continuing education. (Not nurses, though). But, good luck, Ms. Overworked MD trying to use yours. You're not properly certified yet, so your slug compatriot MD gets your share. Call HR and file a complaint.

2. Allied health person gets invited to a national conference to speak. Your boss, who's been at the place forever, fills out all your appropriate paperwork. In the meantime, you sign up to present and pay your conference fee, hotel and airfare.

You get an e-mail that you've been disapproved, but when your boss tries to appeal to the higher-ups, he doesn't get the dignity of a response. Nice. So much for having seniority. You can't even take off unless someone with more seniority lets you have the time. Go file an EEOC complaint.

And my personal favorite...

3.  Become an advance practice nurse, get certified, speak at a national conference, and then submit your request for one lousy conference (subsidized by a private foundation) because you need more education to take care of new patients we have on the unit. All you want to get are your days off as official absence.

Get rejected because the "man with the plan" says we "can't afford to give you days off to learn" at the premier (and also free, since you got it paid for) conference in the world.

Reminds me of this Dilbert scenario...stay tuned for more to come!

PHB: You may have heard that our company has been accused of unethical business practices.
Alice: Is it the falsified product safety reports?
Wally: Is it the false stories planted in the media about our competitors?
Dilbert: Is it the crime family connections?
PHB: What?! Are you saying those are considered unethical too?!? Good God, this thing is just snowballing!

Did you know...

Today is Certified Nurses Day? Yours truly got her name in the newsletter.

At least they didn't put my face on a wanted posted at the Hotel.

Nuggets for August 13

There were a whole lot of interesting items out there recently, so here are a few of them for your viewing pleasure.

You've got questions...

They've got answers, and no, it's not an electronics store. ConsultantLive had this great article on the ubiquitous purple urine bag. I've seen it a few times before (also blue) and asked questions about it, and never got a straight answer until I found this article. They also have a number of other articles of interest, so peruse at whim.

Crispy and brown

Feeling burnt out? Need to read something to get you going? Laura Wisniewski has this great article over at www.nursinglink.com called Re-Engage Your Passion for Nursing that has a few interesting points to ponder.

A telling anniversary

It's been ten years (yes, it was 1999) that the IOM published To Err Is Human: Building a Safer Health System.

There are still lots and lots of mistakes happening out there. The Houston Chronicle (a Hearst Newspaper) recently ran a series called Dead by Mistake on what the state of error reporting is in the US, and it's not so hot. Don't miss it.

Study, study, study

I'm still doing some certification study (yes, it seems like forever...) and I ran into some terms I didn't recognize, so I went searching and found some articles of interest.

Glossopharyngeal breathing is used with some ventilated SCI patients. This article explains what exactly it is and how it works.

Figure ground deficit is explained in this Google Book called Neurological Disabilities: Assessment and Treatment.

I always feel weak in my studies of the brain, so I found this article about a particular TBI patient very interesting as an aside. (from http://www.nytimes.com/)

Privacy (or lack thereof)

And you thought a prescription was private (from http://www.nytimes.com/)
I just shuddered reading this article...what will they think of next? I'm sure all you pharmacists out there have some stories like this.

And everything else about bloggers

It seems like life is very electronic these days...with good and bad results. Here are a few articles about various topics related to blogging I've seen lately. And, no, some things just don't need to be blogged or explained electronically, at least not in my little world, thankyouverymuch!

Mommy bloggers and ethical conflicts (from http://www.cnn.com/)

A no tweet, no blog party (from http://www.nytimes.com/)

Nuggets for July 13

There are just too many exciting things going on outside in July. So when it gets hot, this nurse heads inside and surfs away. Here are a few of the interesting tidbits I've run into lately.

Enjoy wherever you are!

More Big Brother?
Someone is always talking about new accessibility tools in rehab. If you can't move a finger, there's a tool somewhere for you. Now, as these tools become more advanced, there are new issues. The next hacking frontier: your brain? (from www.cnn.com) talks about hacking and security for new neural tools.

Supporting nurses
As you know, a lot of nurses work to improve their practice by getting certified in their specialty. This article discusses the importance of support in nurse certification: Study Finds Work Satisfaction Tied to Certification Support (from www.nurse.com).

From the blogosphere...
I have to confess. I really love ImpactEDnurse. Those stories from the ED are just too funny. Here are a couple of my recent favorites:
What men really want in a hospital urinal
The well flocked swab

Maha at Call Bells Make Me Nervous has this great post about the q word (I'm not saying it!)

Psych Doc from Serenity Hospital has a great post about life in the clinic in Clinic Fun.

Cookin'

Yes, literally and figuratively, I've been cooking and baking for Dahey's party today. He's celebrating his upcoming natal day with a gathering of his friends at the house. Thankfully, we have a place to put all of them while they're eating, drinking and being merry.

Work was hot, but not as bad as it has been. The spring is turning back into winter again as we get that old, crazy weather back again. One day, it's 80, the next, 30 with snow. I just make sure I have a coat handy to handle everything!

I've kept busy reading the charts again, since I'm prepping for a couple of exams. I've decided I'd better take the GRE since I need it for most grad schools. I'll be doing that in a couple of months and I've sunk my money into the exam, so now I'm stuck! Guess I'll really have to read those study guides!

My first certification exam will be the week following the GRE and hopefully, it will include another conference trip. After all that, I'm sure my head will explode in mid-air sometime around June 1. If all goes well, I'll round out the year by testing for the CRRN. This week I found out I'll be working on some stuff for the October annual conference, so that was really exciting.

Since I'm always nosing around to learn something new when I'm not pestering the specialists who visit us, here are a few things I've turned up recently.

One patient of ours had a nasty case of pyocystitis. Another we read about another who suffered a traumatic intraperitoneal rupture of the bladder (due to accident). This Google Book on Urology called the House Officer series, has a lot of interesting information on urological topics.

Finally, I got to look up some drugs. I'd say 90% of our people take similar stuff. Baclofen (or Lioresal) is pretty much the drug of choice on our unit for a variety of patients. I wish I had a $1 US for every Baclofen I've given since I became a nurse. (It hasn't been long, but boy, do we hand them out!) This week's excursions into the drug lists included Forteo (aka teriparatide, which is a drug used for osteoporosis) and prazosin, an anti-hypertensive.

Gotta go back to the party...stay tuned!

Read, read, read

That was my day today...after I took a nap to recover from my last evening shift of the week. I'm so glad Dahey works at an industrial site because I really needed those earplugs to silence the crazy barking Beagle next door (it always barks during the day just as I'm trying to sleep!)

The great countdown to the CRRN exam is on! I have until April 15 to apply and I have to take the test sometime in June according to the ARN web site. Hopefully, I can get a day off when(and if) I need it!

Here are a couple of the books I was reading today, some of which came from this list.

1. Rehabilitation Nursing by Shirley Hoeman. It's the classic, it's big, and it's got a lot of information in it. The fourth edition was revised in 2008, which also makes this book the newest one I have.

2. Gerontologic Nursing by Meiner and Lueckenotte. It's not the one on the ARN list, but I figured it looked pretty good.

3. Nursing TimeSavers: Neurological Disorders. It's 20th century, but has some really good sections with diagrams in a small package on neuroanatomy and signs and symptoms of various diseases.

4. Rehabilitation Nursing Procedures Manual, Second Edition. This book comes from the folks at the nation's premier rehab hospital, the Rehabilitation Institute of Chicago (RIC). It's 20th century, too, but just leafing through it today, I picked up a few new tricks about taking care of patients with TLSOs, halos and helping with donning and doffing clothes.

I also ran through a few units in the Rehab Nursing Series for the CRRN. It has a workbook which you must print from PDF (it's about 200 pages). I've been working with just the book and it was really helpful to sit down with both today.

Now it's time to get ready for work tomorrow. More to come.

Happy New Year!

Oh, it's still cold, and I'm still hacking from this cold/random virus, but it's great to get to sleep in before I go back to the evening shift tonight.

We had lots of fun here at the homestead last night. I actually made that red lentil soup in the crockpot, and even though I put a tad too much chicken stock in it, it worked. I packed up the remainers and Dahey will have a hot, steamy bowl of soup next week (a few times, actually) in his lunch. Since I've been on a soup run of sorts lately, he's had soup in his lunch just about every day. Right now, this is the fourth variety in our freezer.

Bubba went straight to bed at his usual time and Dahey and I retreated to the TV room with the remaining sparkly wine and watched this movie, since it's still technically the holiday season. We laughed and laughed. I got on the couch to watch the 10PM news, saw maybe two minutes and fell asleep. I woke up at 0035 to a talk show with Tiger Woods on it, and so I turned off the TV and went to bed.

Speaking of Dahey, no movin', movin' yet. Such is his work and contracting. Thankfully, he's still working, so we'll just be happy with that. Too many people are unemployed right now and work + paycheck = paid bills and no foreclosures, so I must say, that is the best gift of all.

I had some free time yesterday, so I ran through last year's resolutions. So far, this year's look about the same.

Work:

1. I will work hard to be a team player. (I notice that since there's a nursing shortage, people can act like NFL free agents sometimes, which can be hard to deal with. I don't want to be one of those people!)

2. I will learn something new every day. (It helps that I'm reviewing for certification!)

3. I will make sure I do one thing better than the day before.

4. I will grumble less and smile more. (Gotta keep those wrinkles away somehow!)

Home:

1. I will organize my paperwork. (This will be on my list forever!)

2. I will be nicer to my husband and son. (Sometimes Mommy can be a tad...bi%$chy...oops, glad "speller" doesn't read this blog! )

3. I will watch what I eat and drink more water. (Water = good, eating...well, not so good lately! Too much candy and cookies for the nursing staff!)

4. I will read more. (This is one from last year. I just need to put more in the RehabRN book club.)

Hope your start of the year is happy wherever you are. More to come!