This patient's journey to us for rehab was long and arduous. One day you're minding your own business and start having these unusual pains. They find out you have this terrible condition.
The doctors save your life, but it was rough. You seem to be getting better when all Hades breaks loose. You go back to the OR, get almost triple digits of PRBCs, and abdominal washout and have all sorts of complications. You lose so many things. But you are here with us, so you are hopeful.
You come to us, are barely here a week, and we have to send you to World Renown, because we aren't staffed (in surgery or anywhere else) to resolve your latest issue. Unfortunately, we have seen this scenario before. You have a problem even World Renown can't fix. They send you back.
They leave us to tell you the bad news. You cry and yell. But to me and the other nurses, you are nice. You're not sure of what's going to happen, but I tell you, that no matter what I'm here with the staff for you to help give you some control in your room; to help you do what you need to do.
It is bittersweet. I have seen this before, and while the characters change, the stories all end the same. I just hope we can make some good memories before the clock runs out.
Stay tuned.
Showing posts with label control. Show all posts
Showing posts with label control. Show all posts
Thursday, April 30, 2015
Friday, August 28, 2009
Bed-lam
Yes, I'm being silly after my most recent evening shift because I can. I feel fortunate that I left with my mind reasonably intact to drive home.
It's not even a full moon, but the crazies are out. We must be running a special, and while we're not a polytrauma unit, we keep getting TBI patients, who just came off one-to-one status. We don't have enough regular staff, nor PRN agency staffing, like the mothership, but they can send us people and suddenly, they don't need that one-on-one anymore. Hmm, must be a lot of miracles going on these days at Madison. The only miracle I see is the patient leaving one place for another (our little unit).
The crazies aren't actually the TBI people. Happily, they've been quiet. The crazies are our regular, crochety characters who really need to go home. They're bored, so they create problems to get attention diverted to them from other patients.
One regular decided his bed was too hard. (Remind you of someone...maybe Goldilocks?) We called the bed vendor. They check out fancy low air loss mattress on the bed. Bed works based on all their requirements. Patient waits until bed vendor is gone. Patient goes crazy, rings lights, spews expletives and acts all sorts of silly, just below the level where we can call security and get him some nice Haldol (a spray can of that would have been a delight). Charge nurse had to get one of our regular beds and plop Crochety on it, so he'd finally be quiet, for a moment. He continued to be a regal pain all night, for one reason or another. Sometimes, I think this patient did this because he was genuinely bored and it is truly a control issue.
My patients were reasonably good, but I always wonder why the boss gives me the assignment I get. It never ceases to amaze me that I get an assignment to give out pills to half the unit and try to feed two people at once.
Besides Mr. Crochety, we had a guy get unstable on us, so he took an ambulance trip. He was diverted from the hospital we intended to send him to, so the charge had fun getting with the ambulance crew to find out where indeed he was, since she had no idea to whom to give report. Turns out this patient verbalized chest pain and they pulled off and got him to the closest hospital en route instead of trying to get him to Madison.
I ended the night by finally doing all of my charting. I usually chart as I go, but there was no way to do that on that shift. Finishing with my faculties intact was enough relief for me.
Stay tuned...who knows what wild and crazy stuff the weekend will bring!
It's not even a full moon, but the crazies are out. We must be running a special, and while we're not a polytrauma unit, we keep getting TBI patients, who just came off one-to-one status. We don't have enough regular staff, nor PRN agency staffing, like the mothership, but they can send us people and suddenly, they don't need that one-on-one anymore. Hmm, must be a lot of miracles going on these days at Madison. The only miracle I see is the patient leaving one place for another (our little unit).
The crazies aren't actually the TBI people. Happily, they've been quiet. The crazies are our regular, crochety characters who really need to go home. They're bored, so they create problems to get attention diverted to them from other patients.
One regular decided his bed was too hard. (Remind you of someone...maybe Goldilocks?) We called the bed vendor. They check out fancy low air loss mattress on the bed. Bed works based on all their requirements. Patient waits until bed vendor is gone. Patient goes crazy, rings lights, spews expletives and acts all sorts of silly, just below the level where we can call security and get him some nice Haldol (a spray can of that would have been a delight). Charge nurse had to get one of our regular beds and plop Crochety on it, so he'd finally be quiet, for a moment. He continued to be a regal pain all night, for one reason or another. Sometimes, I think this patient did this because he was genuinely bored and it is truly a control issue.
My patients were reasonably good, but I always wonder why the boss gives me the assignment I get. It never ceases to amaze me that I get an assignment to give out pills to half the unit and try to feed two people at once.
Besides Mr. Crochety, we had a guy get unstable on us, so he took an ambulance trip. He was diverted from the hospital we intended to send him to, so the charge had fun getting with the ambulance crew to find out where indeed he was, since she had no idea to whom to give report. Turns out this patient verbalized chest pain and they pulled off and got him to the closest hospital en route instead of trying to get him to Madison.
I ended the night by finally doing all of my charting. I usually chart as I go, but there was no way to do that on that shift. Finishing with my faculties intact was enough relief for me.
Stay tuned...who knows what wild and crazy stuff the weekend will bring!
Sunday, May 10, 2009
There is a light...
At the end of every tunnel, if you really look hard. Sometimes, you have to dig through a lot of dirt and excrement to get to it, but you get there.
I had a really crazy last few days. I realize that some of the people I work with really don't work as a team if certain people aren't there to influence them to do so. It really pisses me off, but I can't do anything about it.
So what do you do? You find the people who'll work with you, and you work with them. You help them and they help you. And if you need the other ones, you have to put on the RN hat and delegate. I don't like pushing people, but I'm getting sick of this crap. If they only knew that I don't ask them for help because I get really perturbed about their followup comments, "Oh, she's not very efficient," "Oh, she does it different than I do, " or my favorite, "Why does she talk to the patient before we turn them?"
One of my patients, who is a lot sharper than he looks told me last night, "I noticed a lot of people make you do stuff on their schedule, and if you don't they get mad." Surprise, surprise. I have found that if I give people options and tell them I have to do other things, too, 95% of them will make a choice when given two options. That other 5% is another story, but even they can often be convinced to cooperate.
A lot of people think therapeutic communication is hooey, but I look at it more as negotiation. Some people we work with need control, because so much of their lives are out of control. This establishes some for them, and saves me some time in the process. It may not be old school "my way or the highway", but they can't say I didn't give them a chance.
My day, although I missed a little sleep, has been delightful. Dahey and Bubba took me to brunch and gave me lovely little presents...just what I wanted! We went out to eat and let someone else cook and do dishes. I came home, did a little shopping and now I'm getting ready for day 4 of 5. I'll deal with it as I go.
My light is the fact that after this week, I won't be at work much for the rest of the month, due to vacation days and conferences. When I looked at the new schedule with this on it, my heart leapt for joy.
Plenty of days to recharge ahead...and lots of light at the end of the tunnel.
Happy Mother's Day to all of you out there, wherever you are, wherever your momma is, here or gone. Mom's responsible for this missive today! :-)
I had a really crazy last few days. I realize that some of the people I work with really don't work as a team if certain people aren't there to influence them to do so. It really pisses me off, but I can't do anything about it.
So what do you do? You find the people who'll work with you, and you work with them. You help them and they help you. And if you need the other ones, you have to put on the RN hat and delegate. I don't like pushing people, but I'm getting sick of this crap. If they only knew that I don't ask them for help because I get really perturbed about their followup comments, "Oh, she's not very efficient," "Oh, she does it different than I do, " or my favorite, "Why does she talk to the patient before we turn them?"
One of my patients, who is a lot sharper than he looks told me last night, "I noticed a lot of people make you do stuff on their schedule, and if you don't they get mad." Surprise, surprise. I have found that if I give people options and tell them I have to do other things, too, 95% of them will make a choice when given two options. That other 5% is another story, but even they can often be convinced to cooperate.
A lot of people think therapeutic communication is hooey, but I look at it more as negotiation. Some people we work with need control, because so much of their lives are out of control. This establishes some for them, and saves me some time in the process. It may not be old school "my way or the highway", but they can't say I didn't give them a chance.
My day, although I missed a little sleep, has been delightful. Dahey and Bubba took me to brunch and gave me lovely little presents...just what I wanted! We went out to eat and let someone else cook and do dishes. I came home, did a little shopping and now I'm getting ready for day 4 of 5. I'll deal with it as I go.
My light is the fact that after this week, I won't be at work much for the rest of the month, due to vacation days and conferences. When I looked at the new schedule with this on it, my heart leapt for joy.
Plenty of days to recharge ahead...and lots of light at the end of the tunnel.
Happy Mother's Day to all of you out there, wherever you are, wherever your momma is, here or gone. Mom's responsible for this missive today! :-)
Thursday, October 9, 2008
Nuggets for October 9
Yes, I was off yesterday. I found quite a variety of goodies out there I hope you all enjoy! Here's the fall harvest this week...
In the "you'll never look the same way at this again" category
Remember all that debate over embryonic stem cells? Well, scientists may be able to use cells found elsewhere on the body to do the same job. Head on over to the WSJ Health blog and this article to find out the latest stem cell generation location.
Last week, I pointed you in the direction of impactED's helminth therapy article. Yes, indeed, according to my allergist (a top researcher at PrivateU), people with worms tend to have less allergies. If you really want to get your own set of worms, you can't get it from him, you'll have to head to http://www.wormtherapy.com/ and figure that out on your own! I think I'll pass on that, thank you!
Health promotion articles
Like dark chocolate? Your heart may like it, too, if you eat small amounts every day according to this Reuters article.
More infection control guidelines courtesy of our friends at the AHA and JCAHO. (from http://www.nytimes.com/)
Another reason for a healthy economy and plenty of jobs: Family income impacts children's health (from Yahoo! News Health)
Quote
"I'm beginning to understand myself. But it would have been great to be able to understand myself when I was 20 rather than when I was 82." Dave Brubeck, jazz pianist
In the "you'll never look the same way at this again" category
Remember all that debate over embryonic stem cells? Well, scientists may be able to use cells found elsewhere on the body to do the same job. Head on over to the WSJ Health blog and this article to find out the latest stem cell generation location.
Last week, I pointed you in the direction of impactED's helminth therapy article. Yes, indeed, according to my allergist (a top researcher at PrivateU), people with worms tend to have less allergies. If you really want to get your own set of worms, you can't get it from him, you'll have to head to http://www.wormtherapy.com/ and figure that out on your own! I think I'll pass on that, thank you!
Health promotion articles
Like dark chocolate? Your heart may like it, too, if you eat small amounts every day according to this Reuters article.
More infection control guidelines courtesy of our friends at the AHA and JCAHO. (from http://www.nytimes.com/)
Another reason for a healthy economy and plenty of jobs: Family income impacts children's health (from Yahoo! News Health)
Quote
"I'm beginning to understand myself. But it would have been great to be able to understand myself when I was 20 rather than when I was 82." Dave Brubeck, jazz pianist
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