Because it's December 30

We will celebrate with relatives we haven't seen in a LONG time! Lots of kids, food and drink.

Today, we will get ready. It will be fun.

Stay tuned...

Brrr!

The polar vortex has arrived. It arrived just at the start of the weekend. I have already fallen even in "slip-proof" nursing shoes. They don't help when it's also windy. I added some of these to my shopping list.

Some virus from the neighborhood has invaded. Dahey is recuperating and Bubba is acting a little out of sorts, despite my hand washing protocol and cleaning schedule. We've all had our flu shots, so hopefully, it's just something random. Another joy of winter!

I'm happy this week will be the last one I work this year. More to come in 2017. Stay tuned!

Never a dull moment

It may be a holiday week, but it's been busy! The Hotel is always hopping around the holidays because people want to go home. If they can't get home, we have to take care of what we can before lots of other people take off for the long weekend.

While some of our folks would like to go home, they get sick. One character mentioned that he/she had a transient loss of vision. He/she was worked up, then he had another incidence. Between the opthomologist who said the patient had a fugax and the neurologist who wanted a stat carotid exam, he/she ended up with a quick trip to Washington for an overnight to get all the diagnostics done and issues resolved.

In rehab, it's very rare to have a patient on TPN. In fact, I've yet to see one in any of our units (acute or otherwise) because if you're on TPN, you're usually sick and not a rehab candidate NOTE: this may vary in other settings.

However, if you end up with a chyle, a not uncommon sequela of the infamous triple A, you could need TPN for a while, as one of our recent patients did. Thankfully, no more TPN and patient is working up on the diet list, slowly but surely.

One of my favorite things to do is to read imaging reports. We have lots of rehab patients with CTs, Xrays and many, many MRIs. I follow along in the reports and learned this week about Thornwald cysts which popped up in a patient's report.

Finally, since it's turning to winter here in the northern hemisphere, I also learned about thunderstorm asthma, which was sending people to emergency rooms all over the southern hemisphere recently. Just makes me wonder how many of these sent me to the emergency room as a new asthmatic. My poor mother!

Thanks for following and reading along! May you all have a wonderful Thanksgiving  (or rest of the week) wherever you are!

An Irish wake

Dahey's boss was also named Dahey. He had a lot of similarities, besides his heritage: the same number of siblings, they were from the same state, and they both lived in the same town for a while. Off and on, my Dahey worked with Boss Dahey since 2000.

However, on this beautiful day, we loaded Bubba up in the family truckster and we traveled about an hour from our home in RehabLand up the river to celebrate Boss Dahey's life at an Irish wake. His family rented a big hall, they had lots of food, and Boss Dahey was there: in a Chicago White Sox urn.

Boss Dahey lost his life at 52 recently because he had a hard head and procrastinated. His doctor told him he didn't like a mole he showed him in May and that he should see a specialist. Boss Dahey figured he'd do it later, but later never came. Boss Dahey was tough.

Right before the holidays, Boss Dahey had a seizure, which he had never done before. He was checked up, then sent home until he could see a specialist the next week. On the weekend, he had another seizure at home and he coded. His girlfriend saved him. This time, he didn't get to go home. He got stabilized, they ran tests, and then they told him. Boss Dahey had a brain tumor.

My Dahey called me from work when he had the first seizure. I knew it was probably something unusual. When he called me up at work, to tell me the boss had a brain tumor, I told him and his friends, they'd just have to wait until the workup was done. There are lots of brain tumors.

It turns out Boss Dahey's brain tumors were mets. From the nasty mole he procrastinated on. Boss Dahey had metastatic melanoma. When my Dahey  told me what the stage was (he always asks), I knew it was not good. He was Stage 4. Needless to say, this scared a lot of Dahey's coworkers.

Boss Dahey showed up a couple of times at work after he was diagnosed, but after two days, he went home. He was accepted into an NIH trial at World Renown Hospital.  His prognosis was six months. Boss Dahey made it to seven.

As terrible as everything was,  a lot of good came out of Boss Dahey's short time. He reunited with his family. He married his girlfriend. His friend from North Dakota came and visited him every time he could during that time (which was about four times). He settled his affairs and arranged this party we attended. The management at Dahey's work is being more flexible about letting staff leave early or take time off for medical appointments. They never realized that the macho attitude Boss Dahey exhibited made people afraid to take time off until the staff told them.

Boss Dahey bought Jameson whisky which he wanted used in a toast to celebrate everyone being together.  We raised our glasses in a toast to Boss Dahey. As we left the gathering, I thought of this Irish blessing:

May the road rise to meet you.
May the wind be always at your back.
May the sun shine warm upon your face.
And rains fall soft upon your fields.
And until we meet again,
May God hold you in
the hollow of His hand.

We left into the sunshine of a beautiful day, and the soft rain came just as we were rolling up to our house.

RIP Boss Dahey. Until we meet again...

Happy Fathers' Day

"My father gave me the greatest gift anyone could give another person, he believed in me." - - Jim Valvano

It comes the same weekend every year, but never gets as much interest. That holiday is Fathers' Day.

Since I volunteered to take a father's place at church this weekend, my own celebration was broken up. (My husband agreed to it). I got up early and made Dahey and Bubba a breakfast casserole. The route to a man's heart may be through his stomach, but for these two, there had better be meat and cheese on the way, too. (Sorry vegetarians! I try all the time and sometimes I'm successful!)

I took care of my church volunteer obligation, then came home. We ate leftovers for lunch, and we went out for dinner at a swanky steakhouse nearby. Bubba wasn't thrilled that there were few kids there but he got used to it, and enjoyed the food.

We left and got dessert at home since the two wanted to watch the NBA finals. Dahey's father would have enjoyed that--he loved basketball. My father would have just taken the pie and gone on his merry way. Bubba was happy to see Cleveland win.

For all of you nurses out there, who are dads and are working, I hope your organization treats you right. Some do make things better when working these holidays. If you are working and can't see your father, I hope you can soon.

For the rest of us, who wish our fathers were here today, I wish you peace. I feel your pain everyday. I am so glad I have lots of happy memories with my dad, who loved us, pies (and just about any sweets) and being a dad. I'll never forget him.

More later.

Viruses, virii and a mouse in my kitchen

Oh, it's been one heck of a week. I just finished my Z-pack and Dahey feels crappy. A mouse got into my cabinet and trashed a bag of barley and one box of Inca Red quinoa. 

The Christmas pageant starts soon. Bubba gets to do a solo instrumental song. We'll cross our fingers that he doesn't get stage fright. Looks like I'll have some fun tonight.

At the Hotel, the patients are getting loaded up with all sorts of goodies: blankets, books, snacks, cookies, you name it. The Manglement are getting ready for our next inspection in January (what a Christmas present!).

I'm praying it snows like mad.

Hope you're enjoying your night wherever you are. Stay tuned.

I love research

Especially when research journal authors, like these good folks at BMJ have a sense of humor about a wonderfully seasonal PICO question.

Enjoy!

TGIF

So happy I got my job forecasts, policies, procedures, narratives, spreadsheets and diagrams taken care of for our next inspection.

And, ding dong, the witch is dead. Joint Commission closed out today. We passed (hooray!) We'll never have floors this clean again.

One more inspection left this year...right before the holidays.

How many days until Christmas vacation? I'll be counting for sure...

Plugin supplied by Your Christmas Countdown

Happy Pancake Day

Woo hoo! One of Bubba's favorite holidays.

We had a grand old time eating pancakes for dinner.

Stay tuned...leap day tomorrow!

Christmas is now officially over

The decorations have finally been boxed and put away at the RehabRN household.

It's amazing how much you can get done when you don't feel like your head is going to explode.

That is all. Enjoy the remaining moments of your weekend.

Seven survival skills

Stuff I've taught Bubba over the Christmas break from school so far...

1. This is a washing machine. This is how the clothes go in (adding detergent, etc.) I don't know if he's old enough for it to stick, but it can't hurt trying.

2. This is the dryer (refer to #1).

3. These are sharp knives. Be careful (as I nick my finger with the chef's knife I just got sharpened today.)

4. While Mom and Dad drive old cars, you need to know how to get out when the doors are locked. These old fashioned things are called buttons. Pull them up to get your door unlocked. If that doesn't work, slide across the seat to the other door. Voila! It opens (even if it sets off the alarm). Do not sit unattended in the car  in the driveway and cry when you can get yourself out.

5. This is a key. It opens the door. Use it.

6. Life is too short not to have pumpkin pie, cookies and cakes for the holidays. Be certain to add in a few fruits and vegetables, too.

7. Say what you mean and mean what you say. Be kind. Say please and thank you. And tell your family and friends you love them when you see them. You may not get a second chance.

Reminscing...

Here at the RehabRN household, we've gotten into the mechanics of the holidays. When I was a kid, that meant Mom had to clean the house and get all the boxes out of storage. The large box was the Christmas tree and the smaller one, the rotating musical tree stand that played Jingle Bells.

We had an aluminum Christmas tree for many years. One of my favorite memories was to turn the tree on, get the color wheel on it, open the drapes, turn off the inside lights, and look at the tree from outside. My siblings and I always wanted to stay out forever, but Dad wouldn't let us, so we indulged ourselves by turning on the tree stand and lying under the tree, watching it as it rotated and ornaments passed us overhead. I spend many a Christmas season hearing Jingle Bells under the tree.

Today, the tree and the stand are long gone. I don't decorate to the extent Mom did, but I like to have friends and family over and cook. After all the cooking is done, I'm busy cleaning and getting ready. Bubba still believes in Santa, but as he gets older, it's harder. We just tell him Santa really does read his Amazon wish list (since he usually gets what's on it)

One Christmas was especially memorable. I remember the Christmas when I was a new nurse, one of my patients rode around in his wheelchair in a Santa hat. His room was covered in Christmas cards from everywhere, because his wife, a writer, got her clients his address and the mail room was inundated with mail for him daily. His family was nice, especially his wife, and she brought us a cherry whip dessert that was her family's holiday tradition. We had a whole lot of snow, and luckily, no one called out. Even though I had to work, it was fun.

Fast forward to this Christmas season. In between, Santa Hat man died on Groundhog Day the next year, which was a horrible shock to us. Writer Wife had a rough time dealing with it all and her own health issues, too. We kept in intermittent contact. Things started getting better. She started writing again after a long hiatus.

Writer Wife wrote on her web site recently, "Merry Christmas all. Meet my new husband, who was a childhood friend." They are as happy as can be.

Christmas wishes still come true, if you only believe. Enjoy your holidays, and make memories wherever you are!

There really is a Santa Claus

1. Congress passed a budget extension. Guess they were afraid of what might happen on Christmas morning. (or Hanukkah, which is even closer, or Kwanzaa...pick your day).

2. Some people don't just go out and give in the traditional ways. They drop in from no where and make it happen.

3. Even if you can't give a lot, you can make a difference.

To top it off,  my group won the Hotel holiday decorating contest with a wild idea from up north. Yes, sirree!

Mr. Marine, you've got it right, it is a Merry Christmas, Happy Hanukkah, Happy Kwanzaa, and a Maximus Festivus here in RehabLand.

Escaped

What better Christmas present to have...

1) You defrost the office refrigerator to kudos from your coworkers.
2) All of your scheduled patients show up early.
3) You get all of your notes done early.
4) You wish farewell to one of your coworkers who's now off to retirement.

I got all these and a partridge in a pear tree...true, all except the partridge.

Even if one of your friends you haven't seen in a long time can't make it home, you go to the restaurant you all go to every time he/she's in, and have your favorite lunch.

You begin the holiday season with family who loves you, who are healthy, and you are blessed with so many good things, including a toilet that is no longer stopped up (love that enzyme stuff!).

Happy holidays, everyone. No matter what you celebrate, enjoy life this weekend.

More later...

Home for the holidays

That's what I told K, the charge nurse today, when Mr. B. came back to us. As usual, he was a thin, straggly mess, and on top of it, sick. It was so sad; a flashback to Christmases past. I've been at the Hotel for a few years now and I can only remember one Christmas without him. Scary.

Since we take in patients from other hospitals to our lovely Hotel, one of the feeder hospitals and their bright medical staff decided a patient we sent home on hospice needs to come back. For what, pray tell? Why their doc seems to think Mr. I. needs more surgery to address his wounds. Do you remember us mentioning that metastatic cancer thing? Or that Mr. I has a very greater than normal chance of dying far away from home, without the support of his family no matter what we do?

No, Dr. X et al think we are Mr. I's (and Mr. B's) family. It's a shame that a) we actually are closer to some of these people than their families and b) we do our job so well.

The only good thing about all of this: at least Mr. B. will get a hot meal tonight. I worry about him every single time I see him.

Stay tuned...more to come.

The end of the specialist

Our specialist and his crew left recently. I hadn't seen them much since I went to the SU, but the specialist, being the old surgeon he is, was as surly as ever. Maybe just a chance to posture before I got out the door. So to be silly, I went and whispered to his senior assistant NP, and got a chuckle or two. I was nice, though, I thanked him for the things I learned while he was around via e-mail. His assistant may come back, so who knows when we'll meet again.

The SU has been hopping recently with the hustle and bustle. As usual, we have our cancellations, but on a recent day, we needed them. The doc can get overwhelmed. I'm just trying to keep him afloat. If  we don't have him, we don't have an SU. He has been a joy to work with.

On another note, the Big Cheese told me first (can you believe it?) that he may have a new job for me, that is right in line with my grad school work. I'm so excited. I'm hoping I get it, and the sooner, the better. Even if it  is a new position, with new responsibilities, I'm ready. Going to the SU has been a good thing for me, and getting out of the floor environment is refreshing. Yes, every department has something going on, but hope abounds up here. Maybe it's the atmosphere or maybe it's the fact that I feel like I'm wanted.

Nevertheless, even when it's hard, it's making my holidays happy. They'll be even happier when my grad school project is done.

Not long now...back to work! Stay tuned!

Snow?

Brr! It's so cold now, does it really have to snow in RehabLand for people to get in the holiday spirit? I'm just crossing my fingers that Dahey and Bubba don't get frostbite goofing off, since they never do that.

The end of semester and holidays are not coming soon enough.

I'm not coming back!

That is, until Monday. Oh, the joy I will have, until, of course, I have to submit the class paper that's due on Monday, very early since I have to work.

I was busy, busy  all day and the special lunch we were going to have was canceled, so I just started the Christmas spirit by dressing one of the department skeletons in holiday attire. It's all been approved by the director, and since one skeleton is in his office, thereby sanctioned, and can be easily hidden in a large closet should the PC police come around.

Our patients showed up for the most part and I got to do my first random drug screen. It was interesting to say the least. I was happy that I was not required to accompany the patient, nor was I required to find someone to accompany the patient.

Finally, I got to see a lot of patients rolling around on the sister unit going to therapy and getting lost. It was a lot of fun. More than one of them told me they miss me there.

Happy Thanksgiving all! Off I go to cook and prep!

Truly lucky me

 Let us remember that, as much has been given us, much will be expected from us, and that true homage comes from the heart as well as from the lips, and shows itself in deeds.  ~Theodore Roosevelt

One of my friends pointed out that nearby big city made it to this list: Worst Cities for Finding a Job.It's just one big reason I am thankful this Thanksgiving.  Another is that I am actually going to meet one of my classmates this semester and potentially another when both are nearby for the holidays and business. Taking online classes is fun, but I do miss meeting your classmates in person. Hope all of you out there have plenty of blessings and things to be thankful for this year.

I'm also reminded of the sign one of my supervisors used to have on her desk: Be thankful for the things you didn't want, and didn't get.

Stay tuned....

Joy in the Hotel...

Yes, I know, we're not supposed to have Christmas music before Thanksgiving, but today was marked by lots of joy, and not just the "Joy to the World" medley I heard at Borders.

First, Bubba got a new cast and all his classmates signed it. When he came for an impromptu visit at lunch time today with Dahey, he also got a couple of nurses' signatures, too.

Next, one of our coworkers had her baby.  Her kids are thrilled with their newest family member, and so is the dog.

Finally, one of our patients ended a long period with a major piece of metal. Mr. Smack got his halo removed today. The neurosurgeon told him he could not shower his head, but our doc let me put a shower cap on him and hose him off, so the dirt that was stuck on him could be removed. Talk about joy! I thought he was going to dance around the Hotel, he was so happy.