Frights aren't just for Halloween

It's been scary in the Hotel Rehab lately, and it's not because of ghosts or Halloween. We've seen a lot of our folks get sick and go out on leave. Our latest one is the building greeter. Believe it or not, having a greeter is part of the overall improving patient and employee satisfaction.

M. our greeter, shows people where to go, gets wheelchairs, makes phone calls and does all sorts of stuff that I often don't have time to do for patients and visitors.

M's boss told us that he's getting surgery and may not be back for at least two months. I will certainly miss him and so will our patients. Some have even gotten grumbly when I can't do stuff for them because they were so used to having him around. Maybe this news will improve their behavior.

Our nurse practitioners had a major job analysis done throughout the hospital system. For some, the changes that will happen mean they'll have to go back to school. Ours are lucky, they shouldn't have to do that, but the work they can do will change. Not sure if our medical staff are really aware of what all they do. They will be aware soon.

Finally, I'm constantly reminded that not everyone who's in rehab is totally well. They do get sick, again, and they do die. It's sad and yes, sometimes frightening. Some cases are sudden and some are not. I'm really glad we have many options for hospice for our patients. One of my SU patients recently decided it was what he/she wanted.

A whole lot of interventions doesn't always equal quality of life.

I've got to stop here. The frog singing outside is making me crazy...and I'm tired.

More later...

It all boils down to this

Life is short. We are seeing that in the news today. A celebrity and her mother die within days of each other.  Some people say you can't die of a broken heart, but yet, some people do.

This year has flown by quickly. I'm happy that in the grand scheme of things, I've had some time to reflect and relax. It's a privilege not granted to everyone and I know it and cherish it, especially this week. There just aren't enough nurses at the Hotel, or anywhere really. Bedside nurses are a rare enough commodity in these parts, they are paying five figure bonuses to get to work in various institutions.

The mood of this country has been tentative and taxing. The elections didn't really help anything. When I heard about history and Hoover and trying times of the Depression my relatives talked about when I was a kid, I now think, "Wow! Some of this stuff is really happening here to us now."

A lot of things will end this year. New ones will begin next year. I'll work on what I can and do my best. Hope you enjoy the rest of this week and this year. May we all be here to discuss it all again in 2017. There are no promises but we can hope for the best.

See you next year.

Monday on Tuesday

Yes, the day after a holiday sucks on so many levels. People who can't take it (or imbibed too much) take off.

Otherwise, it seems like any other Tuesday. Except today didn't seem like a day after a holiday or Tuesday. Today, after our regular weekly meeting, (which was blissfully short) had a terrible pall.

One of my favorite interdisciplinary team members, C. is dying. Dying as we had our meeting, and were talking about our current crop of rehab patients. It reminded me of one other time where I went into report and the boss told us, "As we speak Mr. Warhero is dying." He was right: Warhero died that night. To me, how small and insignificant the meeting seemed today.

I finally left the meeting (after our chaplain prayed for him/her) and it got a little better. I buried myself in a project or two. As a result, I had to look at the way things have been going over the past few years. Thankfully, they are getting better.  C. helped us to get where we are. C. helped inspire other folks in his/her discipline to do the same.  We are not where I want us to be for our little group in the Hotel Rehab (I thought we'd be there three years ago...) but we are closer.

I was sad for so many things when C. retired last year, due to health reasons. Sad that I could no longer go down the hall and see him/her. Sad that we'd never get to work together and get your rehab program where it rightly belonged. Sad that I knew this day would eventually come.

'Twas a pity it came so soon. Godspeed you on your journey, C, and may the angels greet you and lead you to paradise. You've earned it.

I'm still a kid

When I think of that day 30 odd years ago. I was on my way to school. I knew my mother was dying of cancer, but I didn't realize that I wouldn't make it there before she did.

I came into my grandmother's house and all I heard were laments. My father was silent and hugged us. He let my brother and I see Mom before my uncle called his friends at work (who were the undertakers). My father was always the one who was there, when his mother and his wife died.

My grandma was a mess. My mother was her youngest child.

There are a lot of things that are a blur, but a lot of things I will never forget. I learned much later that I could spend all my time thinking about the horrible things a teenager could have to witness (the stretcher, the body bag, the death rattle), or I could choose to remember the things my mother left me.

Her happy disposition despite many trials. Her stubbornness and relentlessness to see things right. Her wavy hair that always curled when you wanted and sometimes, when you didn't. Her enjoyment of the little things in life, like the salami sandwiches from our town's Italian section. The jello (red and green) that Santa left us at Christmastime.

My mother also left me her faith. Her faith that we are all actors in our own story and a little divine intervention never hurts. Sometimes we need to help and be helped. Those traditions of perseverance were more helpful than I ever knew later in life.

So while my mom is no longer here to be celebrated, I look every day for the places where she left her mark on my life. And I see her every day. I put a photo of happy times on my refrigerator, so I remember that. She and Dad took us to get family photos. It was the last group family photo we would get.

So I can mourn this day, or I can live it as Mom would want me to do. My mother always wanted me to be a nurse, so I know somewhere in Heaven she smiles. Even with my detours and stubbornness, she got her wish.

And so I rise...again

I rise again, because the crazy patient leaving Washington missed hitting me in the crosswalk. I really thought I was going to go down for the count. I had the right of way, but the hurried patient was turning right on red. No harm, but I did notify our local PD (took a photo while he waited at a stoplight nearby), in case Mr. Hurry-Yup decided to run down any students down the street at Private U.

I'm not sure why I decided to become a stair climber. I think it had something to do with running up and down all the flights of stairs at Saintarama to the rehab gym to take patients their pain meds. Ah, the days before bar coded medication administration! Pull the meds, mark the MAR, and give the pills. It wasn't perfect, but we made do.

This weekend, I'm going on my next stair climbing journey. It's the same set of stairs in the same skyscraper. However, I'm older, wiser, and a tad out of shape, but a promise is a promise.

I figure this old asthmatic nurse ought to do something right? I have been so lucky that my asthma is well-controlled. I drove my sainted mother crazy with my asthma attacks as a kid. We were on a first name basis with most of the Saintarama Childrens Hospital ER staff due to our regular visits.

My friend, a grade school teacher, had to tell her class that one of their classmates passed away on spring break. P. was a kid with asthma for years. This time was different: it got so bad he was put on a ventilator, then he crashed. They couldn't bring him back.

So I will rise, and as I go up all 865 steps, I'll think of P., and the 3,630 other folks who died last year due to asthma. Otherwise, the firefighting crews who race after me will just have to pick me up and take me the rest of the way to the finish.

Stay tuned...

He WAS a hard working man

We always liked having R. around our place at the Hotel. No matter the task, whether visiting M., his wife (and our RN coworker) on the unit or fixing something broken, he was happy and smiling.

He was a good old boy who had a whole bushel basket of gifts. He was courteous, kind, and a whiz in the machine shop. Our volunteers were stunned when he fixed one of their pieces of equipment and got his staff to bring it back to life. It wasn't just better. It was amazing. In fact, they thought they got a new one.

Today I heard R. left us. He passed away too soon. Being retired for almost two years, he was doing fun stuff until he got sick.

I thought of him when I heard this song.  And we at the Hotel mourn with his wife and family today. Yes, indeed, he was a hard working man.

RIP R., because you earned it.

TGIF (for so many reasons)

Yes, I'm thankful it's Friday because I don't have to work on Monday. Happy long weekend to all of you fortunate enough to be able to celebrate our country's presidents Monday.

I have been doing research for another conference abstract (the story of my life lately) so I've managed to find some interesting articles, including this one on writing a good one. Some of these are even appropriate for the abstracts.  Here are a few of the ones I found below.

While I'm not looking for a job right now, I try to keep my reference list up to date. This article talks about how to ask references the right questions to get good information on candidates. While I don't actually check the references, I have interviewed people. One of the folks I interviewed provided us a list of references to check. Surprisingly, the candidate's name and phone number was on his/her list. It gave me a chuckle, as the other interviewers didn't immediately pick up on this. This got said applicant in my "Interesting Interviews Hall of Fame".

The end of this week was sad, though. One of the national folks for our program died suddenly this past weekend just as he was getting ready to watch the Super Bowl. His team won, so despite everything, there were a few smiles knowing that. He was not old and it was not expected.

We found out that one of our coworkers has a family member with cancer. What makes it worse is that it's a child. Being new at the Hotel is crazy enough, then to have your family member have cancer is just awful.

These moments remind us all to be grateful for health. It's never guaranteed.

Until next time...

So eloquently said

While I haven't posted a RehabRN reading list lately, I'm still reading. Right now, I'm really getting into Atul Gawande's Being Mortal. It's a story about living, moving on, assisted living, aging and dying.

The stories are really vivid and I can just about picture the folks they are discussing in front of me.

There are so many things we need to learn about aging, death, and dying.

Stay tuned.

So glad

Monday finally flew by at the Hotel. I went in early to check mail and messages, and my phone rang. One of our patients passed away over the weekend. It wasn't entirely unexpected, but that call really changed the tone of my day.

Mr. C. had a wonderful Christmas according to this relative. He even got to celebrate a major wedding anniversary. He saw family and friends and experienced the fun of the holidays with his immediate family around him. His grand kids all opened gifts at his house.

Ms. Relative thought he was getting a cold and was possibly getting sick. Mr. C. said, "No, I just need some sleep." Mr. C. went to sleep smiling, she said, because he had so much fun seeing his family. When she went to check on him later, he was gone.

Considering the wild, crazy last few years Mr. C. had, this was the best way for him to go: at home in his sleep.

I worked a lot with Mr. C. and his family in the last year, I'll miss him, too.

More later.

We get attached

It's very easy to get attached to some of our patients. When I think about this topic, I hear all sorts of scenarios from my psychiatric nursing class, where we talked about why we like some patients more than others.

Some of them remind us of someone we liked, didn't like, was our neighbor, relative, or friend.

It's not confined to patients, either. Sometimes, we nurses, meet some incredible physicians and other staff in the hospital.

Our docs in the Hotel, while often quirky, are our doctors. So when one wins a major prize, we celebrate. She has been with the Hotel for almost her entire career. Other doctors just visit us, and while we're nice to them, we're not nearly as fond of them as we are of our own.

However, since I have been roaming around on behalf of the Hotel at our sister unit, I've met a lot of doctors I first learned about while reading notes. One of those docs was Dr. M.

Dr. M. was a surgeon at the Washington. We waited for him for a long time. The first specialist retired, they hired someone, then the other never showed up (got a better offer while awaiting information from our HR--the specialty is in demand). We had one doctor (on loan) but PrivateU called him back to work in their hospital (when he wasn't sitting outside the US awaiting his Green Card.)

After years of waiting (literally), Dr. M. came on board from oceans away. He was a jovial fellow for a surgeon. The patients really liked him. He was kind and down-to-earth. Many of our doctors liked him, because he had a phone number and answered the phone whenever possible when he was at his desk. He was also happy to answer any questions they had when they saw him (the infamous hallway consults). I got to help Dr. M. occasionally when he was on the sister unit, visiting folks after surgery. Dr. M. always seemed to be smiling. Eventually, Dr. M. had a real department with another surgeon and a nurse practitioner.

However, our happiness was short-lived. We got the news that Dr. M. died at home over the weekend. Arthur Schopenhauer said “Mostly it is loss which teaches us about the worth of things.”

The happy, smiling surgeon left us physically, but we'll never forget him or the good work he did for our rehab folks.

More later...

An obituary for Yogi

There is much sadness these days for all the baseball fans here in RehabLand. While we are far away from New York City, many mourn one the passing of the last great characters in baseball, Lawrence Peter "Yogi" Berra, the pride of the Yankees.

Here in the wilds of the middle of America, it ain't proper to like anything coastal. "Them people are strange" is a comment that is not uncommon. In the villages, towns and small cities, baseball is the life of summer. People come out, see neighbors, and have a good time.

Yogi, however, was someone people could identify with in RehabLand. He was a son of immigrants who grew up in St. Louis, MO and never forgot where he came from. He was tough and never let people's impression of him become his destiny. Beneath that smiling, crinkly face was a sharp guy with an eye for baseball, and how to navigate it successfully.

In later years, Ron Guidry wrote a book about going to spring training with him. I highly recommend it. It's a fun book to read.

It really wasn't over, 'til it was over, and what a life it was. Thank you Yogi for giving us a lot of smiles and excitement watching our national past time. You will be missed.

Off into indigo

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

Heartbroken

I just cannot believe it. One of my childhood friends asked me a while ago about getting another heart surgery. She had had several strokes in the past and wanted to get her problem fixed. I mentioned to her that ANY surgery is risky and to consider that in her plan. She agreed.

She went in for that surgery, and never came out. Her husband and four children, the youngest is Bubba's age (a preteen) are left behind.

She was almost 46 and a half years old. One year and months older than my own mother when she died.

The last time we saw each other was at a funeral for a relative of one of our classmates. We said we'd get together after she had some time to process her own loss. That time will never come.

I hugged Bubba tighter today. And tonight, I pray for all of them.

Hug your kids (and friends) today. You just never know...

Another Memorial Day

Many years ago, when we got home from a trip, we got a phone call. My father-in-law passed away. We had just seen him days before.

This year, we didn't go anywhere on Memorial Day, but we got the same news. Dahey's aunt passed away this time. A different date, a different year, but still on Memorial Day.

We will miss you Aunt M. You lived a good, long life with many children, friends and neighbors.

Every parent's nightmare

One morning, your kid leaves home, never to return. This recently happened to one of my therapy coworkers from Saintarama. We also know Marci and her kids, since Bubba is in school with them.

It was hard. We squeezed each other tight and prayed at the memorial. Bubba and the kids went off to look at the many pictures of their dear, departed brother and look at some of his stuff, which was also on display.

A life just begun as an adult was extinguished early one morning on the road.

Hug your kids today and everyday. I know I will.

More to come...

Hope turns to sadness

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.

Daily gratitude

Some days seem worse than others, but when I look around, it really isn't so bad.

1. I can afford to pay for my mistakes --traffic and parking tickets--without fear of going to jail.

2. I can go to work without fear of death while I'm there doing my job.

3. I am reasonably healthy. I woke up today.

These privileges are not afforded to everyone. So I go out happy I am who I am; imperfect as it is. I'll take it!

Enjoy your Wednesday.

It's beautiful outside, but it's sad

This past week's been a doozy. I'm hoping I never repeat some of it again.

Work was work. We had our yearly inspection and I survived. The inspection team had some new and some old folks, so it was interesting to watch them.

Outside of that, one of my mother's in-laws died. I hadn't seen her (or any of her kids) in ages. I like this family, so it was pleasant. The crazy relative didn't show up for the wake. Still don't know if he/she is alive or dead. 

I was just getting ready to go to bed when another relative called me. Her son didn't answer calls as usual that day, so she went to the apartment complex where he lived near her. No one answered when she knocked and one of the neighbor's let her know she could see inside the apartment from outside, since Max left the curtains open when he worked from home. (He had a job that could be done remotely, and hadn't worked in an office in years.)

When they looked in, Max appeared hunched over his desk. My relative watched, but Max didn't move. She knew Max was probably dead. While it wasn't a surprise (Max had problems), it was sudden.

So, since Max's family (girlfriend and teen child) was out of town and she didn't have a key, she had to call the police to break down the door. She found Max dead. He was in his early 50s. It was sort of a circus arranging the apartment, having the police roaming around, lots of questions, and waiting. Happily, things calmed down before I could get dressed and leave.

Now, we're just waiting for Max's family to get back to complete the arrangements, and for the medical examiner to do his/her part.

Stay tuned...

Read this

Several years ago, I was sleeping when I was suddenly awakened around 3AM. I went to work and found out one of my patients coded around the same time I woke up.

I thought of him when I read this post on the American Journal of Nursing's blog, Off the Charts today.

And I, too, thought of those family members who aren't around anymore. The pain subsides, but some of it never goes away.

Love, however, goes on.

In an instant

A police officer puts a person resisting arrest in a choke hold. He ignores the pleas that the person can't breathe. The person dies.

A guy driving through a protest march hits a pedestrian. He's arrested for assault.

Another guy goes to work. Someone asks him to come out to the parking lot. It's his son. He proceeds to club his father to death with a baseball bat in the middle of the day in the parking lot.

It doesn't take long for a life to disappear. Robbing someone of one breath, one moment, one defensive move can have consequences that last forever.

Life happens in an instant. Be aware. Some things you can't get back after that instant is gone.