Where there is no imagination there is no horror. ~Arthur Conan Doyle, Sr.
The week is winding down and I am enjoying my training and my time on the floor.
As always, it can be a soap opera kind of world at the Hotel. Love and lust figures into the installment this week. Lovelorn housekeeper falls for the charms of one of our artistic characters and wins a transfer to another unit. No fraternization allowed, just like the military, remember?
Another one of our patients decides he may go home immediately if one person comes back. Former roommate made a pass at his significant other and he's not too darned happy. The guilty party is in another unit, but as always, misses the Hotel and will do whatever to come back to our place. Don't think it's gonna fly this time...I hope anyway.
It could be a November to remember, though. Boss decided to come in and actually talk to me, and let me know I could apply for the part-time position working in one of our clinics. This is, of course, because no one else has yet applied. Another older nurse is applying, so out of respect for him, I'm declining that "opportunity", because he'd really like it. He has a lot going for him, too--over 10 years experience and an affable manner. The Slug may apply, but ON still has a chance at one of the positions available, and I hope he gets it over the Slug, who doesn't deserve it.
Sometimes you just have to say no to one thing to enjoy another.
Back to studying and have a great weekend all.
Showing posts with label housekeeper. Show all posts
Showing posts with label housekeeper. Show all posts
Thursday, October 28, 2010
Tuesday, October 5, 2010
Water, please!
What makes the desert beautiful is that somewhere it hides a well. ~Antoine de Saint-Exupery
My day seemed like a desert at the Hotel. It was hot, and I was thirsty. If I move another bed from room to room because we keep having odd isolation situations coming up, I think Mike the housekeeper can, and will take his mop bucket and dump it over my head.
My orientee and I ran from patient to patient and got everyone taken care of, including getting one another bed, since he needed a new one for a couple of reasons.
Besides moving everyone around, we got to take one of our patients outside to our garden and patio area. A few patients congregated out there and had a good old time. We checked on him from time to time to bring coffee and check his water pitcher. It had been a very long time since he was allowed up and he relished every moment of it.
I finally slaked the never-ending thirst for moment by getting a diet soda at lunch. I hate diet soda, but this one was actually pretty good. Gradually, I'm getting used to more fruits, and especially vegetables in my diet. I love bread, but I cannot eat much of it anymore. I have to save it for special occasions.
Now, it's back to studying...more later...
My day seemed like a desert at the Hotel. It was hot, and I was thirsty. If I move another bed from room to room because we keep having odd isolation situations coming up, I think Mike the housekeeper can, and will take his mop bucket and dump it over my head.
My orientee and I ran from patient to patient and got everyone taken care of, including getting one another bed, since he needed a new one for a couple of reasons.
Besides moving everyone around, we got to take one of our patients outside to our garden and patio area. A few patients congregated out there and had a good old time. We checked on him from time to time to bring coffee and check his water pitcher. It had been a very long time since he was allowed up and he relished every moment of it.
I finally slaked the never-ending thirst for moment by getting a diet soda at lunch. I hate diet soda, but this one was actually pretty good. Gradually, I'm getting used to more fruits, and especially vegetables in my diet. I love bread, but I cannot eat much of it anymore. I have to save it for special occasions.
Now, it's back to studying...more later...
Tuesday, October 28, 2008
Bed bingo on a crazy Monday
You know you're in for some excitement when you get to work and everyone's all shuffled around. This is known as "bed bingo". Bed bingo happens for a number of reasons, and it's mostly related to isolation status. We had one patient come up positive for a new organism, so as a result, five people got moved around to get rooms ready and everyone in their correct group.
Note: our facility cohorts patients in the same room with the same organism and we only have one (yes, one) private room among our rooms.
I got the same assignment and the med wagon far away again. This can be frazzling, but I dealt with it. The thing that is most frazzling is when one shift forgets to do the things to which they're assigned. Since our boss has been in and out with things, the tasks that normally get done on the floor have gone to the wayside a bit.
The housekeepers are the biggest problem right now. They have had some turnover in the last few months and they can't seem to keep the paper towels in stock in the staff bathrooms, nor can they keep the trash emptied. I've mentioned this to one of the housekeepers who usually sets us up well, but I'm not sure why it's not getting done. A lot of people on the evening shift are getting frazzled, and I'm one of them. I'm not on evenings all the time, but I see things on days and then I go to evenings and it gets annoying. With cold and flu season here, I wish one of the docs would notice and throw a fit, since maybe that might get something done. Running out of paper towels in the bathrooms and patient rooms is not an option!
Besides that, some of our day staff are not even attempting to pull their weight. Unfortunately that saying, "When the cat's away, the mice will play" is very true. I dread working behind some people. You should not immediately have to empty urine bags when you get on your shift, but I have done it every single night on evenings this round. One day, I had to make the patient's bed and get all the linens. This is the job of nursing at the ranch, and the nurse who had this patient couldn't get it done before she left at noon, and the nurse who followed her for four hours had made no attempt, either. Thankfully, I had the bed made...just as the patient was returning with his family from a day pass. I also got lucky and had to empty the bed bag for this guy, too, since this was just one more thing they forgot. I have to say most people are consistent--when they don't do something, they really follow through and miss everything. End of soapbox.
Ahh...that venting felt better....on to more fun stuff. My younger patient is doing more every day. It's really good to work with him. He puts the active in active rehab. He's even paying attention to his diet, which is really important for SCI patients. We talked about his bowel routine protocol and despite the assessment of the docs and the charge nurse, he's probably going to stick to a daily routine.
One of my other patients was really depressed because his blood pressure would not stay up even with his TEDs, binder and Midodrine. We talked about it and hopefully, it can be resolved soon enough.
I'm going to stop here...more later! I'm going to enjoy my off day! (Happy Birthday, Mom!)
Note: our facility cohorts patients in the same room with the same organism and we only have one (yes, one) private room among our rooms.
I got the same assignment and the med wagon far away again. This can be frazzling, but I dealt with it. The thing that is most frazzling is when one shift forgets to do the things to which they're assigned. Since our boss has been in and out with things, the tasks that normally get done on the floor have gone to the wayside a bit.
The housekeepers are the biggest problem right now. They have had some turnover in the last few months and they can't seem to keep the paper towels in stock in the staff bathrooms, nor can they keep the trash emptied. I've mentioned this to one of the housekeepers who usually sets us up well, but I'm not sure why it's not getting done. A lot of people on the evening shift are getting frazzled, and I'm one of them. I'm not on evenings all the time, but I see things on days and then I go to evenings and it gets annoying. With cold and flu season here, I wish one of the docs would notice and throw a fit, since maybe that might get something done. Running out of paper towels in the bathrooms and patient rooms is not an option!
Besides that, some of our day staff are not even attempting to pull their weight. Unfortunately that saying, "When the cat's away, the mice will play" is very true. I dread working behind some people. You should not immediately have to empty urine bags when you get on your shift, but I have done it every single night on evenings this round. One day, I had to make the patient's bed and get all the linens. This is the job of nursing at the ranch, and the nurse who had this patient couldn't get it done before she left at noon, and the nurse who followed her for four hours had made no attempt, either. Thankfully, I had the bed made...just as the patient was returning with his family from a day pass. I also got lucky and had to empty the bed bag for this guy, too, since this was just one more thing they forgot. I have to say most people are consistent--when they don't do something, they really follow through and miss everything. End of soapbox.
Ahh...that venting felt better....on to more fun stuff. My younger patient is doing more every day. It's really good to work with him. He puts the active in active rehab. He's even paying attention to his diet, which is really important for SCI patients. We talked about his bowel routine protocol and despite the assessment of the docs and the charge nurse, he's probably going to stick to a daily routine.
One of my other patients was really depressed because his blood pressure would not stay up even with his TEDs, binder and Midodrine. We talked about it and hopefully, it can be resolved soon enough.
I'm going to stop here...more later! I'm going to enjoy my off day! (Happy Birthday, Mom!)
Saturday, September 20, 2008
Fun Friday
This happens when one, the census is down, two, both of your patients have doctor's appointments at the same time and three, you are not working the weekend. Oh, what joy!
That was my day yesterday. I felt like I actually accomplished something. I had two patients all day. My patients got a clean room, which was wonderful. I kept picking up my mess as I made it when working on my patients' dressings, etc., but some other nurses did not. There were wrappers and saline flushes and IV blue rubber stoppers and Tempadots all over the floor will-nilly. There were even some of these said items in one patient's bed. Arrgh! This is the same man who is a trainwreck in terms of skin integrity (massive sores--two out of four are unstageable), tubes galore and psych issues on top of everything. Let's just give him one more thing to mess him up! (Yes, I'm being facetious...)
Once both patients were out, I got the antibacterial, it-kills-everything wipes and wiped down their low-airloss mattresses. I did them well enough so that they actually stayed wet for the required two minutes. This requires a few wipes, but I had them. After that, I picked up all the stuff I could on the floor, including Mr. AB #1's case of 20oz. Sprite bottles, so the housekeeper could sweep and mop everywhere. He surely did. He did everything but burnish (aka super wax) the floors and that would have required both patients be out of the room most of the day. He was still working when AB #1 came back, so I had an even better excuse to keep him up and out of the room.
Mr. AB #1 stays in his room all day because of his sores. He's to be turned and repositioned every two hours, but often, he refuses to turn. This is really bad when you have the sores he has. The docs have been trying to figure out a way to get him up on a stretcher for an hour a day to just get him out of the room. (We put these patients on Roho mattresses or waffle air mattresses while on a stretcher). I tried selling him on going outside Thursday and he refused my offer. The neuropsych came in and she talked to him about going out of his room. Still, he refused. I thought about it, and when I talked to the neuropsych later, I told her about my plan to keep him out of the room...nothing like a little subterfuge. My plan: say the bed is not working. If a no-airloss mattress is not working, you can't put someone in it, since they sink like a rock. She thought this was a great idea. I told the other MDs and they went with it, too. I even told my boss that was the plan, so no one would goof up and tell Mr. AB #1 that it was not true.
The housekeeper was a great backup. He played along, too, and kept on cleaning. He was the real, physical excuse why I couldn't put AB #1 back in his room...whoops! He's still cleaning, I said, with his massive stainless cart and buckets galore, so the ambulance drivers put him in the TV room where I had a stretcher waiting. We got him on the stretcher and then he talked to the docs about his appointment. I set him up with a bedside table and some Sprite which was in the room. (No one is in a hurry to leave if they have a drink or snacks, I've found.) Apparently, it went better than what they had thought it would. His prognosis is still not the best, but if he keeps gradually improving, he may avoid the draconian measures we know in which he refuses participate, which could include amputation or worst of all, his lower body, in a hemicorpectomy.
All in all, Mr. AB #1 stayed up for an entire hour before I put him back in his room. His neighbor, Mr. AB #2 came back at around 1030 and I snuck out and checked him out and changed his dressings before I got AB #1 back in the room. I also primed and set up his feeding pump, so he'd be ready. I really like those Kangaroo e-Pumps. They are so user-friendly compared to our other pumps, and the water flush has it's own bag. No stopping to remember in four hours that the patient needs his water flush. It is such a time-saver! Now if they could get it to use 1000cc bricks, it would really be ideal (We use the bags and cans of formula).
Mr. AB #1 needed his dressings changed, too. The residents do the dressings when they do the debridement, but they never last very long after the ride back to Madison. Mr. AB #1 was leaking all over, so I just re-did his dressing so it would last until evenings changed it again. Mr. AB #2's was changed, too, but one hip started draining out of the dressing.I reinforced his, because I didn't want to disturb the packing again. He had some clots and is prone to draining, so this was the better solution and the NP and my collegues concurred.
I kept the guys fluffed and buffed. Mr. AB #2 even got a haircut when I saw the beautician on the unit. In theory, she's supposed to be coming every Tuesday, but since I was off, I didn't know if she had be on the unit. Once I saw her, I talked to her about AB2 and she did. He was thrilled with his haircut. Once she was done, I set him up and washed his hair and changed his shirt. "I feel like a new man!" he said.
Finally, I finished my day doing paperwork and hanging out at the front desk. It wasn't bad at all. Now it's time to cram everything into the weekend. Dahey is working this weekend, so Bubba and I will be keeping busy. Stay tuned for more next week!
That was my day yesterday. I felt like I actually accomplished something. I had two patients all day. My patients got a clean room, which was wonderful. I kept picking up my mess as I made it when working on my patients' dressings, etc., but some other nurses did not. There were wrappers and saline flushes and IV blue rubber stoppers and Tempadots all over the floor will-nilly. There were even some of these said items in one patient's bed. Arrgh! This is the same man who is a trainwreck in terms of skin integrity (massive sores--two out of four are unstageable), tubes galore and psych issues on top of everything. Let's just give him one more thing to mess him up! (Yes, I'm being facetious...)
Once both patients were out, I got the antibacterial, it-kills-everything wipes and wiped down their low-airloss mattresses. I did them well enough so that they actually stayed wet for the required two minutes. This requires a few wipes, but I had them. After that, I picked up all the stuff I could on the floor, including Mr. AB #1's case of 20oz. Sprite bottles, so the housekeeper could sweep and mop everywhere. He surely did. He did everything but burnish (aka super wax) the floors and that would have required both patients be out of the room most of the day. He was still working when AB #1 came back, so I had an even better excuse to keep him up and out of the room.
Mr. AB #1 stays in his room all day because of his sores. He's to be turned and repositioned every two hours, but often, he refuses to turn. This is really bad when you have the sores he has. The docs have been trying to figure out a way to get him up on a stretcher for an hour a day to just get him out of the room. (We put these patients on Roho mattresses or waffle air mattresses while on a stretcher). I tried selling him on going outside Thursday and he refused my offer. The neuropsych came in and she talked to him about going out of his room. Still, he refused. I thought about it, and when I talked to the neuropsych later, I told her about my plan to keep him out of the room...nothing like a little subterfuge. My plan: say the bed is not working. If a no-airloss mattress is not working, you can't put someone in it, since they sink like a rock. She thought this was a great idea. I told the other MDs and they went with it, too. I even told my boss that was the plan, so no one would goof up and tell Mr. AB #1 that it was not true.
The housekeeper was a great backup. He played along, too, and kept on cleaning. He was the real, physical excuse why I couldn't put AB #1 back in his room...whoops! He's still cleaning, I said, with his massive stainless cart and buckets galore, so the ambulance drivers put him in the TV room where I had a stretcher waiting. We got him on the stretcher and then he talked to the docs about his appointment. I set him up with a bedside table and some Sprite which was in the room. (No one is in a hurry to leave if they have a drink or snacks, I've found.) Apparently, it went better than what they had thought it would. His prognosis is still not the best, but if he keeps gradually improving, he may avoid the draconian measures we know in which he refuses participate, which could include amputation or worst of all, his lower body, in a hemicorpectomy.
All in all, Mr. AB #1 stayed up for an entire hour before I put him back in his room. His neighbor, Mr. AB #2 came back at around 1030 and I snuck out and checked him out and changed his dressings before I got AB #1 back in the room. I also primed and set up his feeding pump, so he'd be ready. I really like those Kangaroo e-Pumps. They are so user-friendly compared to our other pumps, and the water flush has it's own bag. No stopping to remember in four hours that the patient needs his water flush. It is such a time-saver! Now if they could get it to use 1000cc bricks, it would really be ideal (We use the bags and cans of formula).
Mr. AB #1 needed his dressings changed, too. The residents do the dressings when they do the debridement, but they never last very long after the ride back to Madison. Mr. AB #1 was leaking all over, so I just re-did his dressing so it would last until evenings changed it again. Mr. AB #2's was changed, too, but one hip started draining out of the dressing.I reinforced his, because I didn't want to disturb the packing again. He had some clots and is prone to draining, so this was the better solution and the NP and my collegues concurred.
I kept the guys fluffed and buffed. Mr. AB #2 even got a haircut when I saw the beautician on the unit. In theory, she's supposed to be coming every Tuesday, but since I was off, I didn't know if she had be on the unit. Once I saw her, I talked to her about AB2 and she did. He was thrilled with his haircut. Once she was done, I set him up and washed his hair and changed his shirt. "I feel like a new man!" he said.
Finally, I finished my day doing paperwork and hanging out at the front desk. It wasn't bad at all. Now it's time to cram everything into the weekend. Dahey is working this weekend, so Bubba and I will be keeping busy. Stay tuned for more next week!
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