Is ICARE just letters?

For some people, it is. If you do a little research, ICARE shows up on Google about 535,000 times.

If you're a nurse educator, ICARE is a model for education design.

If you're a business person, it's a way of delivering excellent service based on the Ken Blanchard model.

If you're a cancer researcher, iCARE is a model for building risk models.

In some health care organizations, like VA, it defines a code of conduct.

I care about those who have served.

I care about my fellow employees.

I care about choosing “the harder right instead of the easier wrong.”

I care about performing my duties to the very best of my abilities


It's too bad that at the Hotel, some of our patients have told us:
"I'm not telling your manager anything. He/she is lazy and doesn't care."
"I asked that nurse to do something a different way, and he/she didn't."


However, my rehab nurse heart just skips a beat, when my patient recently said, "I've learned more today in the little time I spent with you today, than I've learned all month." Why? Because I took a few minutes to not just educate this patient about the specialty services of the SU (my job), but of the rehab unit as a whole.  I cared.


When do we realize, that as nurses, "I care" isn't just an acronym. It's a verb. It's actions: not just doing, but listening, being present, and doing right, even when it's hard. Even when you're busy, passing pills, doing dressings. Share the rehab wisdom you've developed (or for newbies, are developing)


ICARE is not I Come And Receive Everything. If you're a paycheck nurse, maybe you need another gig.


I care because I am a nurse and a human being with a conscience. It's my job and my philosophy (thank you grad school and Jean Watson).


Don't let the turkeys get you down today. Keep caring!


Enjoy your weekend wherever you are! 

The year of ethics

The American Nurses Association declared 2015 the Year of Ethics. They also updated their Code of Ethics for Nurses with Interpretive Statements this year, too.

Lately, there are lots of ethics issues in the news. This recent article series talks about risks for manicurists calls into question the ethics of nail salons. There are sections of major newspapers discussing everything from genomic issues to the latest celebrity ethical dilemma.

In the Hotel, we deal with issues, too. Is it ethical to share your cell phone number so patients can call you back promptly when the phones in the facility don't always work? Is it ethical to be Facebook friends with patients? Is it ethical to deny certain patients items during care that aren't denied of similar patients, when there is no risk to health and safety? Are prejudices appropriate as health care providers?

So many things to consider this year, and every day.

We are the most trusted profession after all. Shouldn't we be ethical?

More to come...

Random thoughts

It's a stormy day already here in RehabLand, and Bubba's up early wanting donuts. My head is splitting. AND I double booked myself at work today. I can't wait for this day to be over.

Here are a few points to ponder:

There's always some new technology to learn in nursing. It just amazes me, though, that some people figure out how to "game" it as soon as they can. It really gets scary when this gaming potentially interferes with care.
There's an updated version of this code, but somehow, I don't think people like the Slug actually read (or practice) it.

If you get tired of the bullies, check out this advice on bullying or parallel violence from Katie Duke.

And finally, if you want to feel good about what you do, no matter what, check out this post from KevinMD.

Thank you patients. You are the reason why we are all here.

More later...

Misspent youth, part 65

Yes, at one of my first jobs, I had a boss who was a major gamer in the bad old days when you didn't have high speed internet at home. He invited all his buddies (no use hiding the sex here...ain't no HIPAA among gamers!) for LAN parties at the office, which was closed for the weekend. This was, of course, explained to management, as "network load testing."

My job entailed a lot of internet surfing. I was the chief user on the user internet stats at Ye Old Government back in the day. All was for my job (and I had the stats on my side, too, baby!)

But, as a nurse, I have to say, I thought this was pretty cool, doing hospital orientation in a virtual world.
Wonder if I could frag anyone...or at least run a virtual code?

Stay tuned...you never know.

Lucky ducky

Yes, I am lucky.

So lucky that both of the codes I was called to today were resolved (or very near that) by the time I went to them.

First one was a fire code that I ran in the rain to get to the building. No smoke, no nothing. Just a whole lot of people standing around saying, "Okay, which smoke alarm was it?"

Next, was the code I got called to by the charge nurse, who said, "Come with me." in one of those voices that makes you think 1)one of the patients just did something horrible, or 2) someone just died. Happily, neither of those scenarios materialized. Visitor fainted in the parking lot by another building and was assessed by the folks there.

Walk back, wait, and it's time to go home....an exciting way to end the day.

Nightmares

Yes, I'm hearing about these, and in some respect, I'm living them.

I'm doing paperwork for the nightmare patient. This is the patient who refuses to take responsibility for his/her actions and blames everyone else, including me, for any trials and tribulations on the unit surrounding his/her pleasure. Same patient refuses to elaborate with me on any rehab goals as are needed regularly since he/she is a rehab patient.

I'm really ready to wake up and ask for a different patient. This one sucks. If one more neuropsychologist tells me to use motivational interviewing, I may vomit.

Recently, we had a patient code on the floor. Said patient had lots and lots of problems but the biggest one was with patient's MD. MD just would not listen to the nurses. We voiced concerns about the patient for days. I'm still very angry about this. I went and discussed this with a third party and the help and rationale was sound, but I still have misgivings. Thank goodness the third party didn't gloss over it. All those years of hospital experience are handy!

While I'm happy I CYA'd myself, I'm just not happy that I couldn't do anything about getting said patient the care needed. I feel like a failure. I know it's not my fault. I'm going to spend a lot of time on my days off vegging out, so I can forget what an a*& this MD is.

I will content myself with the fact that said patient told his/her family, who visited rather frequently, that our place was the best..."especially the nurses."

Did they really say that?

NP's Place had a Change of Shift theme called, "Oh, no you didn't" recently. Maybe I should call this one, "Oh no you didn't really say that!" about this type of incident in my world.

Nurse minding her own business gets a call from department to which nurse has sent patient for procedure.

Call 1
RN Department X: "Hi, this is So-and-So from Department X. Are you taking care of Mr. C?"
Me: "Yes, I am."
RN Department X: "Well, I just wanted to let you know that around xx time Mr. C. coded as we were starting our procedure."
Me: "What?"

RN from Department X proceeds to tell me about all the labs drawn, etc. So, just for grins, I ask a couple of questions.

Me: "Did you call Dr. Y. to let him/her know what's going on?"
RN Department X: "No."
Me: "Okay, what will happen now?"
RN Department X: "We'll just send Mr. C. back."
Me: "Thank you." (hangs up phone and immediately calls Dr. Y.)

Call 2
Me: "Dr. Y, did you know about Mr. C. coding."
Dr. Y.: "No."
Me: I fill in details on phone and point to note in computer. Dr. Y. affirms finding note about incident.
Me: "I just wanted to inform you re: this incident."
Dr. Y.: "Thanks."

Am I seeing a pattern?

Last year, one day after the traditional end of February, I was on my old unit at Saintarama getting some paperwork done. While I was there, a patient coded.

Yesterday, I'm walking in the door and notice one of the people I usually see was not there. I asked what was going on. The answer: he coded in the early AM on the night shift.

The day shift was busy, too. I ended up with one less patient on my assignment. This one didn't code, but he won a lights and sirens trip to the nearest hospital for a dose of tPA.

Just makes you wonder...

A real code and nuggets for March 1

I went back to work yesterday, just to get into the computer and get access to my timecard. Saintarama, in their infinite wisdom, doesn't make this accessible to employees from home (since that would be too logical, maybe...) After fun and excitement talking to the Kronos admin, he let me in and I downloaded my report and left down the hall. One patient, Mr. R., was in the room on the left. I talked to my manager for a little bit and told her what I had done, since I had discussed it with her on Thursday.

J and K were working and so I talked to them on the way out. Things had just quieted down from the AM therapy rush. I wished them well for the rest of the day. I even chatted with S., the secretary.

All of a sudden, the code lights flashed. This has been a regular thing on our unit, since we were blessed with all sorts of mechanical difficulties. However, this was not a drill. Apparently, Mr. R. went down and Y. the tech called for backup. Uh-oh. J and K ran down the hall. S. answered the calls and told everyone who called the code was real. She got Mr. R's chart and I saw the contingent of docs, residents and the rest of the code team go down the hall. Dr. D. was going that way, so I gave him the chart, just outside the room. He passed it on, since this patient coding, was not his. Hubby and I walked off the unit with him and I told him that I was finished at Saintarama. He was surprised, but wished me well. It turns out, he lives two blocks away from Saintarama. He knows how I feel.

After that, I came home and just surfed away. Here are a few of the interesting things I encountered yesterday, and some today. Enjoy!

Not sick, but TIRED (from aboutanurse.com)
A post that makes me tired just reading it!

An old poster with a timeless theme (at weirdnursingtales)
Thankfully, we don't see much of this bug in rehab, at least not in the ones I've worked in lately.

The Great White Hunter and the ER Nurse (from Nurse Ratched's Place)
I just love this story of bait and switch and revenge. The security part is the best.

The problem with "you" nurses (from first do no harm)
A great story from Podunk Memorial. Oh, CYA, the story of my life...