If it was good today...

On a Monday, what, oh, what will it be like tomorrow?

At this point, I don't mind that Monday breezed by. It was lovely. Patients were happy and did as they pleased with relatively little irritations for the nurses or the medical staff.

We did have some weirdness go on. Check out the following and see what you'd do.


Supplies, supplies, supplies. 
Searching for them has been the story of our charge nurse's life. She spends way too much time being the unit purchasing and acquisitions agent.

Per usual on Monday morning, she gets her list and send it to the supply folks. Here are a couple of things on the list and what we got:

• tracheal suction kits: asked for 24 (for all our patients on trachs --about 4, so 6 per patient); got 4 kits.
• trach care kits: asked for 4 patient's worth, got one. One lousy trach care kit.  I say we make the patients (or their nurses) arm wrestle for it! 
• catheter bags (one for every current inhabitant with one--approximately 8 patients). What did we get? Three.

So glad I was not in charge as charge nurse vigorously banged head on desk while on hold with supply people.

If the Manglement calls this quality, I'd hate to see what they call disaster!

 Stay tuned...never a dull moment at the Hotel!

Finally!

Someone read my name on my board and sent a letter telling the boss what a wonderful experience he/she had while I took care of him/her.

I had taken care of this character before, and he'd always "forgotten" to mention me.

It's nice to be remembered once in a while.

Stay tuned!

Adios SU

I left the SU in good hands. The nurse I replaced temporarily came back and she looked quite happy. All that had been in shambles in her world at was right with the world and she was ready to celebrate at work.

We celebrated by eating donuts. She and I ate most of them, since many people chickened out, since they all started New Year's diet programs. Life is made to be lived and a good donut is still a good donut, she said.

The floor is still the floor. It was the crazy busy place it always is, only there was much quiet today. I don't know why, but things were very, very slow when the lunch trays came (we pass out any to isolation patients). A couple of senior nurses and I just looked at each other wondering where everyone went.

I had a decent assignment, but as many of you already know, when you go from one job to another, it can be challenging. I use a completely different set of skills when I work the floor vs. SU.

The majority of people were happy to see me--one so much that even though he usually squanders time lolling around in bed driving nurses nuts, he actually got up when I went on rounds and stopped in his room. This particular patient has been around regularly since I started at Madison and we have a very good rapport.
"What are you doing here?" he asked me and his nurse. I replied, "I came back and I'm here to tell you to get your a&$ out of bed." We chuckled and he complied and got up when his nurse came back.

The doctors acted as if they hadn't seen me in years, even though, I saw some of them every day while I was reassigned. Surprisingly, they were happier to see me than some of my coworkers. The Slug, happily, was at a conference and not available.

Overall, the day flew by. I was lucky enough to squeeze my lunch into it all. We'll see how it continues...stay tuned.

Juxtapositions

A wild night on the floor recently at the Hotel:

One of my patients (aka RR for Ring-Ring) rings the light constantly. He "acts" upset that I'm his nurse (not really--just for show). He gets his heart set on delivery food that was turned away once, and finally, when he's totally dejected and swears it'll never show up...in walks the delivery guy. DG gets a huge tip and RR gets the meal he's been dreaming about.

Even with RR, I'm able to work on homework, in between rounds, look up an article, write a review and study for my exam.

And on the way home, while throwing my book bag in the front seat, I pull a muscle in my back (yes, that book really is heavy, even if it's small!). Despite hot shower, massage and an Aleve, it's still sore.

So yours truly takes out the goodies for the open book test which ends on Sunday at midnight. And despite the pain, I get an A. Thank you P., my class partner, for encouraging me to take my time.

It was easy...the back still hurts. I'd be awake anyway tending it. Why not take a test at the same time?

More later....

In case you're wondering...

Dear Nosy Coworkers:

Yes, I did already talk to the boss about leaving early today. Maybe you should have too, since you like to observe (loudly) that I'm "always getting off for something." Reminds me of the verse, "Seek and you shall find..."

I did earn my kudos for that project I'm working on...remember you didn't want it when it was offered to you, because it was "too much work."

No, I don't mind doing whatever it takes to keep my people happy. I will turn on the computer and set it up for the quad, since it's his/her only link to the outside world via that laptop. Yes, taking care of people and their stuff really IS nursing. Hopefully, if you're ever in a similar situation someone will do the same for you.

And finally, if someone can have a cold Diet Coke on the rocks in a room that's steaming, you'd better believe they're getting it from me.

That is all.

RehabRN

Planning

Lots of things in my life require planning.

1. Getting patients cleaned up. This sometimes is a mess. Luckily, I had one guy ready right as the docs came by and was able to talk to them about changing his dressing orders with the wound nurse. Why you ask? Because it's a whole lot easier to talk about what would be best, when an area is clean and you can see everything going on there.

2. Finishing my class for the semester. I talked to my prof yesterday as part of a planning meeting (see part of the theme) and realized that I really need to maximize the lunch time I get. How am I going to do it? I've got to escape..or go to lunch early. If I don't do that, I get shortchanged. Shortchanging right now is not a good thing.

3. Surviving the day, despite planning, can go awry pretty quickly. I just cross my fingers and go.

And off I go...stay tuned.

I feel so loved...

The latest installment of Heard on the unit...

"So and so forgot to do all my laundry." Mr. Z.
Well, Mr. Z., So and so is a new nurse, so you need to help train him/her by telling them what you need.

It really is a crisis to deprive an Irishman of his green clothes on this, St. Patty's Day...thankfully, the Hotel has green PJs for our guests. Problem solved.

"I missed you this weekend." Groovy New Nurse #1
GNN#1 missed me because he/she got stuck with the Slug, who probably spent the weekend doing one or all of the following things: 1) talking on the phone, 2) goofing off on Facebook the whole shift, or 3) doing absolutely nothing.

Yes, dear, it does suck to work with the Slug and everybody else who thinks he/she "is a great person, especially at parties." Well, kids, this ain't no party all the time...

"I don't want one of those Port-a-Cath things. They kill people." Mr. Y.
You'd think they would educate the patient on his/her access possibilities, right? Nope. We got to be the lucky stiffs to talk about what exactly a port was and how it will be used.

"Can I sit in the shower and let the water run over my head while you make my bed?" Mr. X.
Mr. X hasn't had a shower in a very long time, so he was happy to oblige while I got things ready for him.

Anything to make you happy....more later

More Nuggets

They just keep coming! One more day before Honest Abe's 200th birthday. Here are a few interesting articles (honest!) that I've encountered on the internet recently.

The good...
A happy hospital makes for happy patients
You may think this is a joke, but this is a very interesting article. Too bad we all can't work in this type of hospital, where the boss gets calls on off hours!

New surgery may give amputees more control (from http://www.msnbc.com/)
This article discusses how a new surgery will help those with arm amputations.

A great first-person account of prostate cancer treatment: Love in the Time of Prostate Cancer (from http://www.nytimes.com/)

The bad...
Drugs recalled due to manufacturing problems (from www.msnbc.com)

Pentagon reports US troop obesity doubles since 2003 (from http://www.usatoday.com/) Not unusual to see 25+ BMI anymore in our neck of the woods.

And the really ugly...
We deal with a lot of bodily fluids on our unit, but this one is a story about one that is absolutely horrible.

It never happens...usually.

That was my day today. Even though, I'm coming down with another cold (I'll be happy to get rid of them once and for all!), my day went along smoothly.

Surprisingly, since it usually never happens, I had some of the same patients I had on my evening gig. I told them I was just as surprised as they were. I got both of them rolling quickly and it was great. I had to check the computer for orders, and that went well, too. One patient got up in his chair, rolled around and checked things out. It was a beautiful, sunny day, and the temperature even started creeping up to pleasant January levels.

My boss told me I got my permanent appointment. He was a bit taken aback which kind of makes me wonder about him. I think that four hour meeting he was in today fried his brain a bit.

Happily, the census is down for the moment. Hopefully, it will stay that way for a while. I know we'll enjoy the reasonable quiet.

More to come...stay tuned.

Heard on the unit...

Yes, I haven't had an installment of this in a while, so here goes...

"I'm so happy to see your smiling face." Mr. J.

Some people love to see you come back to work. Others...well, they aren't exactly thrilled. Mr. J. is a riot and he's always got a funny perspective on things. I think some of that has to do with his previous job--police detective.

"It really smells down here." Nursing supervisor last night when he was on the unit.
"That's the smell of success." Yours truly (RehabRN)

Yes, it's not really a secret, but to all of you nursing students going to rehab, especially with SCI patients, evening shifts tend to be...shall we say, aromatic. Many patients who do active rehab have bowel programs in the evenings, usually immediately (30-60 minutes) following dinner. The reason? This allows the patients to get the most out of therapy, particularly, in terms of time, since while nurses work 24/7, therapists do not. Most of them work the day shift Monday through Friday and usually they rotate the weekends, where they work a max of four to eight hours, depending on the rules of the unit, etc.

If you smell something, that means we have people with good, working bowels. If they're consistent, this also means that they won't have accidents in between, either and will get the most out of therapy. We start everyone on bowel routines daily, and then after two weeks, they will move to qod (or every other day). Some people do well like that, and if that doesn't work, they stay on a daily schedule.

"I don't know what her (MD's) rationale is, but I'm getting out of here on Monday." Mr. R.

I admitted this guy on Tuesday. Sure he's in for a short trip, but for some reason, we get a lot of patients who get sick once they arrive and then they have to stay with us. Mr. R. is very impatient to leave, which is pretty unusual for most of our patients. We tend to keep people a long time.