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...

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...

La rentree

No, I'm not a kid going back to school, but returning to work after escaping for a conference was very similar. I feel as if I was jarred out of a deep, restful sleep and thrown into a world that is constantly going and I'm running in, then looking forward to the time I can run straight out.

It's always nice to go to a conference just for nurses. People, for the most part, look at you, talk to you in the hall and are social. Some other disciplines (which will remain nameless...Freudian cough cough) often walk with darting glances because you might actually talk to them. We had lots of interesting sessions. I even gave one this year. One presenter brought her demo dog, as she was speaking about how to get a service dog and ADA guidelines.

Overall, I had a wonderful time. I may even look to turn my presentation into a journal article (one of the things on the bucket list). I'm fortunate that my subject is not typical rehab (bowel, bladder or skin), so I just need to sit down and do it.

This week, I get to interview new staff for the Hotel. It should be exciting. I just hope they can survive the Manglement.

Stay tuned...

Reality bites

Yes I'm still recuperating from my recent travels. It was fun, but tiring.

I did my presentation to lots of applause (along with my partner). Being scheduled after lunch is entertaining, since you get an upfront view of everyone in the room falling asleep. "No one was nodding off while you talked," my traveling partner said.

"Au contraire," I said. "You'd have seen them all snoozing from my seat." Luckily, she got some action shots of my speaking partner and I fielding questions at the end.

I got to see lots of people I haven't seen lately, including some folks who retired. They came for the CEUs.  We had a big group of folks go to dinner at one of these Food Channel-famous joints. It was interesting. After taking a stealth photo of the namesake owner talking to my traveling partner, I was waiting for security to come and throw me out. Needless to say, we're not famous, so said proprietor was not keen on a photo with us or my traveling partner, who told Mr. Big how excited she was to be there. Bubba, however, was impressed. (After watching all those episodes of MasterChef and MasterChef Junior, in addition to all the other food shows I miss...)

Thankfully, one of the folks who attended and works in a satellite office, knew that it was Restaurant Week in town and got us the "special menu" (similar to a prix fixe in normal places). It was good. The only thing that was annoying was the overcharging on the alcohol. I paid $14 for a glass of chianti when my traveling partner and I could have bought a bottle for the price of two glasses.

However, the happiest part of the trip, besides hanging out with my speaking partner and talking to the chief of staff of the organization (he/she was our main speaker one day), was escaping a hurricane. Despite Dr. H's insistence that he survived many a hurricane during his years in Florida, I was not keen on adding one to my own bucket list, thank you.

I made it home in time to do some chores, check my packed suitcases, then go out West with Bubba and Dahey to Dahey's niece's wedding. She's a sweet girl who was a guest book assistant at our wedding many years ago. Since then, she must have liked weddings, since she went into the wedding business herself. Needless to say, she had a whole lot of stuff and events. It was a busy weekend. Lots of food, drink and hanging out with the relatives, in-laws, and outlaws.

We even went on a horseback ride near one of the local wineries with the bride's Uncle Beau. Beau's brother, Bob, a professional rodeo star, had a party at his house for us when we were done. Bubba wanted nothing with riding a horse on the trails, so he went with the older folks on the wagon ride. However, he did ride the rodeo star's favorite horse, Biff at his house. We have lots of photos of Bubba smiling on Biff and he kept saying no, every time Uncle Beau asked if he wanted to get off. Thankfully, the other kids were busy playing in a water slide and didn't notice Biff was busy after a while. Despite keeping him up late, looking at those photos made him smile.

Thankfully, we didn't encounter any rattlesnakes or wild pigs in Bob's front yard as we were leaving. It was really dark and we could see the stars on a clear night. It was fun.

The day of the wedding we rested after all the excitement, because it was a long night. We went to the wedding at 5, had drinks after, then dinner, speeches, and dancing. Since everything was outside next to a famous creek side hotel, we also saw some wildlife. Mona, one of Dahey's relative's wives screamed when she saw a huge beetle on her side of the table. I wish we had a video of the encounter, because all of a sudden one of the flower girls appeared on scene. The bug rescuer was Dahey's five year old niece, Ella. She promptly rescued the flightless beetle and released him on a tree near the creek. She was smiling from ear-to-ear. Her father said, "Just call her my Crocodile Dundee."

After all the wedding excitement, we got up early and saw the Grand Canyon. It was clear, pretty and windy. Bubba was most impressed with the ambulance we saw about halfway through our hike. We heard no screams or saw any hysterics, so we kept moving along, since help had arrived. That definitely was one of the bucket list items I got to check off my list.

We returned home at the end of the holiday, then I went to work. It was tiring. I'm finally feeling like I'm not jet-lagged anymore.

So now it's almost the weekend. Hope you enjoy yours wherever you are. Hug your family members (human and furry) today. Life is short.

In honor of mothers

It's that time of year again. One I never fully understood until I joined the sorority of women over a decade ago.

The things you learn...

1. That those nine months seemingly last forever, but you never realize, the end may be a sprint.

2. After the sprint, you hit the marathon. Only a couple of other times in my life was I ever as physically exhausted as I was by taking care of a newborn. It's almost like a semi-permanent state of jet lag.

3. You'll never forget that first smile, or that first laugh.

4. You'll become the sentinel, the guardian, the protector, because that little cherub really is your heart walking around (or just plain escaped) outside of your body.

5. Everything and little things are milestones you'll want to record. Don't sweat it if you run out of film or space on your device so you have proof. A good story (told over and over) will be a family memory for generations.

6. Be kind and curious. So many folks don't appreciate those things anymore.

7. You'll miss your mother so much when she's no longer with you. I know I do. My mom never got to know Bubba or any of her other grandchildren. Losing her as a teenager meant she missed so much.

If you've never known your mom or the love of a mother figure, you may be sad today, too. But remember, if you are or planning on being a mother, you'll write your own story. Be the mother you want to be. The past is in the past for a reason. The present is a gift for you.

Enjoy your day and weekend! Happy Mothers' Day!

RehabRN reading continues...

It's so nice that Bubba's been feeling like reading, so Dahey and I take him regularly to RehabLand's public library (which is pretty darned good).

Here's a couple of things on the burner right now.

1. Child, please by Ylanda Gault Caveness. This author works the parenting sites and has lots of interesting perspectives as the mother of three kids.

While my childhood deviated on many planes from hers, due to ethnicity, etc., there were more than a few common sayings mentioned in the book that I heard in our house among my parents.

I chuckled to myself more than a few times reading this book, and frankly, there are some hilarious moments that will make you laugh out loud. (and even disturb your neighbors sitting nearby).

Little book with a whole lot of parenting wisdom. I highly recommend it.

2. Shrinks: The untold story of psychiatry by Jeffery Lieberman I just started this one, and the intro is just right. It sets you up in a patient story, and draws you in. The stress, anxiety and the ambivalence of the general public to consider the benefits of a medical psychiatric workup.

I can't wait to continue down the road of this story penned by the former president of the American Psychiatric Association.

Stay tuned!

It's almost over...

But we won't stop enjoying what we have left of the weekend and of my vacation, darn it!

Bubba and I had a great time out and about in our aunt's neighborhood. It was a food truck fest and a charity concert, headed up by my favorite police captain (and the power point/satire master) Cap'n Ned. Cap'n  Ned and I worked together nearly two decades ago (kind of scary) in MegaBurg, way before any of the niceties were added all around town, such as the cool amphitheatre.

Cap'n Ned's own band headed up the concert, and they had a U2 tribute band as the headliner. It was fun watching folks from many generations up there dancing in front of us. It was also homecoming in the neighboring towns, and since the MegaBurg park is scenic, we saw dozens of kids (and parents) walking by dressed up and taking pictures. A couple of times, they timed their parades to song lyrics that talked about young'uns being places they shouldn't...which made for some hysterical video clips.

Bubba even got ME up there and dancing to the U2 tribute band, but with all the smoke from the stage, cold air, and other assorted pollutants (this was outside), I thought I would have an asthma attack and require paramedic attention (because, of course, I never figured I'd need to bring my inhaler along). I sat out. Consequently, Bubba danced his heart out and had a blast, while I watched from the second row.

We spent money, Bubba got his pic taken with some famous football cheerleaders and bought a calendar they had, since proceeds went to their charity for fallen first responders. He had a grand old time, and so did I, spending some time in my old workplace of MegaBurg, marveling at all the good that's come there, and talking to old friends I don't see nearly enough.

So, we'll be off on our day soon, to make some more memories today. Stay tuned.

Planes, trains and automobiles, NOLA version

It was the best of times, it was the worst of times. It was only 24 hours, but darned, it was so good. I felt the pangs of frustration of Steve Martin, the screaming kids, the shuttle that was crammed with folks, but it was really amazing.

Our shuttle driver gave tips on some of the best things to do (and most importantly, eat) in New Orleans. I promptly made my way to Central Grocery to try out their muffaletta, and I made it, just before they closed. On the way back, I ate dessert first: beignets with cafe au lait at Cafe du Monde. My other culinary adventure was to Acme Oyster House, while I was roaming around Bourbon Street before I left. You can't beat an oyster poboy! (NOTE: I don't eat raw oysters, so try it if you are not a fan of these runny bivalve mollusks. They are delicious fried!)

While I was in the neighborhood, I fulfilled a mission: I went back to the French Market and got the silver pendant I figured I didn't need two years ago to go with the earrings I bought to remember the Crescent City.

Coming home I met a nice lady from another conference at our hotel. She worked for a very famous beauty company, and picked up my tab for the cab ride. Thank you Angela! Will definitely buy your products at the store!

The rest of my trip included a layover, but since the massage shop was too busy, I opted for a salty summer brew, then I talked to some fun folks at the airport's Starbucks. And listened to live music in the terminal.

I attended the meeting and longed to stay for the awesome conference I went to last year, but family comes first. I went home to get Bubba and he was happy. He got an awesome trumpet T-shirt souvenir to replace the one he grew out of, and a good one to wear for Mardi Gras this year.

I can't wait to go back and hang out among the many rehab nurses again. It's always a blast. See you all in Philly next year.

Stay tuned...vacation is never dull.

Wheels of change

The construction still continues. Our administrative leader is optimistic it will be done early. It helps when our folks get early finish bonuses.

I run back and forth, round and round in the interim. I found out last week, when I went to get something ordered for a patient, that the item I was looking for wasn't available to order. It makes me wonder if I'll even be able to do the things my management wants, if I don't have equipment.

Dahey hopes his TDY duty will be done before Halloween. The fun aspect has worn off. He wants to come home. Bubba and I had a pretty good weekend. We roamed around town and even saw a hot air balloon land in one of the local parks. It was unscheduled, so all the kids in the neighborhood came out. (We were driving by, and went to look). We even fixed a fancy meal he planned and that went well, even though he could have done more work.

More motivation and fun this week. Stay tuned!

Homework

Bubba's been getting homework after I decided to go online and find some reading materials appropriate for his situation.

Here are a couple of the ones I picked:

• Dude, That's Rude (Get some manners) by Pamela Espeland & Elizabeth Verdick
• Speak and Get Along! Learn the Mighty Might, Thought Chop and More tools to make friends, stop teasing and feel good about yourself by Scott Cooper

They are entertaining, and only time will tell if they really stick. Gotta start somewhere.

Sadness

Back to school is full of newness and possibilities. Lots of kids with new clothes, school supplies, and meeting new friends.The school year shouldn't have kids getting shot. Kids trying to do better than their best while doing their homework.

It's just not right. We must stop killing each other.

More later...

The best things in life

Some are free, some not so much.

It's been a fun week. Bubba started seventh grade. He's happy enough, but wishes more of his friends were in his classes (only half of the classes contain at least one friend, which according to Bubba will make them "very boring.").

The school district here in RehabLand is having budget cuts this year. I always know which teachers talk about them (the ones most affected). It's very interesting. There won't be any intramural sports this year, so we have to find Bubba a boys' volleyball league he can play in. He is set on trying out for v-ball in high school, so we must prepare. This will be interesting. He may have to get on a girls team.

So today, we hung out, did homework and we had fun. We went to a local hamburger joint that's been around for ages. It's a tiny place (counter serves 10 people on each side) that makes their own root beer. We got a burger, fries and root beer. It was fun. One item crossed off the bucket list.

Since that wasn't enough calories, we decided to go to a local creamery known for it's oddball flavors. Bubba got one called Cookie Monster. It had both Oreos and chocolate chip cookie dough in it. I got old reliable double chocolate, which was amazing.  Bubba was a little scared of the teenage girl population, so we sat on the same side as the ice cream scoopers.

All in all, it was fun hanging out with Bubba. These moments are priceless. I would not trade them for anything.

More to come...

Dear Parent Scheduler

It's really nice to see that you can send and read e-mail. I've noticed something lately,though, of which you should be aware. If you notify the guy who MAKES the schedule two weeks beforehand, he won't schedule your kids to participate in the service on the weeks you are busy.

I know it works because I've told him each time we go on vacation, and Bubba isn't scheduled that weekend. Problem solved.

I know that means all of us on the mailing list won't know EXACTLY where C and J and your family are going on vacation, or dance competitions, or band recitals, but we will just have to live with seeing you every so often on the weekends, so we can ask about you in person.

Hope you enjoy trying it out.

Pleasant journeys (and you don't need to tell me about them, if you don't want).

Sincerely,

RehabRN

The end of the week

This is almost the middle of July. I hear the siren song of summer, since here in RehabLand, Bubba and the other kids will be in school before Labor Day early in the morning (clutching pearls).

I have many warm memories of starting school in September (when it was still blasted hot) and one year, I dreaded going to school since my classroom was on the second floor. I was in fifth grade. I had horrendous headaches that year. I figured it was the ragweed (since all the windows were open way back when).

The Hotel was hopping this week, and so was I. I actually got to go out on a field trip. That part was fun. When I wasn't busy doing that, I was getting some groundbreaking work done. Since I volunteer for pilot projects (because our boss volunteers our department), I got to work with some new stuff. It was so cool to make care work anywhere! It also helps that the patients like it, too!

I'm going to stop here. It's time to relax and enjoy what I have of the weekend: housework and a little fun. Vacation is in sight. I can't wait.

Stay tuned!

To our esteemed readers

Dear readers:

Thank you for stopping by to visit. It's been a crazy week. When you bury a relative as part of a large (we have so many kids/grandkids/nieces/nephews) that we can almost rent the entire hotel family, it gets a little crazy. Unlike most Irish wakes, Auntie Em didn't get to come to the party at the Hibernian hall after the funeral. However, she would have loved it.

Lots of food and drinks and even a little gambling going on at the bar in the other room. Since Auntie Em's state allows gaming in bars, it was fun dragging the kids away from their popcorn machine (aka kid magnet) before the state liquor commissioners passed by. Happily, the bartenders shut the door and the kids found the cookies.

The banquet hall was full. Lots of people came out in the middle of the week to say goodbye at the wake, the funeral and the luncheon at the Hibernians. Auntie Em's boss (a retired allergist who was younger) even showed up, which is something that doesn't always happen for folks who die in their nineties. Dahey and Bubba had a good time. Bubba with the other kids, Dahey with his cousins who he doesn't get to see nearly enough.

Dahey's family may start visiting in between weddings and funerals, but it remains to be seen. Sure would be nice to celebrate while we're all here to do it in the same room.

Again, thanks for understanding. It is deeply appreciated.

Sincerely,

RehabRN

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...

Things not to do as a nurse, part LVIII

Here's another installment of the popular section on what not to do as a nurse. Listen up, new grads. This is NOT the way to get your 15 minutes of fame.

If you think it is, just remember, NCLEX is getting harder. Here in RehabLand, the pass rate went down, but luckily, the licensing folks are thrilled we are still above the national average pass rate.

Here are a few things that got nurses in RehabLand in trouble lately. Just remember, don't try these at home (or work, either) if you plan on keeping that bright, shiny license.

1. If you're supposed to monitor someone in the ICU, monitor them.

Don't paint your nails, don't go on Facebook, don't blow off the newer nurse you're working with who points out the fact that your patient now has a heart rate of 160 and maybe you should call the doc for orders. Also, when said heart rate goes to 200, don't tell everyone that "I had no idea."

Doesn't work. End of story.

2. If you plead guilty to felony theft, you may lose your license.

Another pretty simple example.

3. Falling in love with a felon could get you in trouble.

No, it's not related to #2, but it could be. Jailhouse Nurse falls for an inmate she's caring for. She goes out and gets him a handcuff key and a gun.  To add to the fun, she smokes some marijuana (a friend brought it in from a legal state) and gets caught doing that while with said inmate/felon. Boundary violations are not a good thing.

4. Oxygen saturation is important for everything.

Remember your ABCs: Airway Breathing Circulation. Yes, those are important. Failing to notice low oxygen sats and to do something about it, can get you into licensure trouble.

5. When you are a private duty nurse, you have to be there (both physically and mentally).

Two examples: one nurse decided to run "personal errands" for almost two hours while caring for her private duty patient, who had hourly vital signs. She also "forgot" to chart that "errand."

Another private duty nurse decided to huff some Dust-Off while her patient's mother fell asleep. The mom found the nurse passed out in the living room on the couch, and when aroused he/she was in no state to work.

6. Why you don't want to become Walgreens/CVS/insert favorite drug store here.

This was pretty interesting. Two nurses were  cited related to "collecting medications to give to poor/uninsured patients" Surprisingly, my license does not say MD or registered pharmacist, either.
Some medications just should not be shared (one RN took unused vials to reuse).

7. Don't bring medical records home.

Ever. No matter how behind you are at work. Can you say HIPAA? This RN took home records that affected a patient's care. Very ugly.

And finally...

8. Don't spank your patients.

Even if they are kids who wriggle around and smack you on the nose while doing their dressing.

That is all. Stay tuned for more in our next installment.

School is ALMOST out

But I think Bubba's mind is turning to mush already. We worked on the health class project this weekend and of course, had to make last minute changes today before school. However, Bubba forgot to have me sign something this week, so he lost some points for this week. I sign whatever is in front of me, but I make him be responsible.

Tonight, for some physical activity, we decided to go to the rec center, shoot hoops and then play some pickleball. We really just practiced while a foursome played, but Bubba got to learn some skills and watch people play. Hopefully,  this summer, he'll get to play with other kids (and not boring old grownups).

Just counting down the days...stay tuned!

Monday, Monday (aka back to work)

It was a brief trip to MegaConference and it was fun. I even met some new friends on my whirlwind tour. I tried to meet one nurse blogger, but she wasn't coming in, until I left town. I got lots of looks at my poster and made sure I didn't take a single handout home, by using a couple of marketing gimmicks. (I marked my literature holder--aka a brown envelope--with the words TRADE SECRETS).

All that business experience helped. I also corralled a spot near my poster and carefully set my coat and a notebook there (with a glass) so I could go between sessions and not lose my spot. (We were expected to be by the poster at break times, so...)

Dahey and Bubba drove around the town exploring, watching dogs and sailboats. Bubba also proved that kids needing to go to the bathroom is really a universally understood problem, no matter in what sort of ethnic neighborhood you may find yourself. They also saw a movie, which was a good excuse for Dahey to find a dark place with a comfy chair for a nap. (We got up really early to get me to the conference on time, since our hotel was far away in the suburbs.)

There was a party once the session was over, but I literally had to fly out of there, after I talked to an exec I had tweeted to during the sessions. It was nice to finally meet her after conversing back and forth. It was bedlam--cars, taxis, buses, everywhere. It was a miracle Dahey and Bubba could get to me amidst all the masses escaping the conference hall looking for a ride. I was really happy one of the staffers there was able to get us back to the highway to RehabLand.

It was literally down the street and around one corner. So we drove away into the evening to RehabLand.

Today was a long day with lots of caffeine infusions. My last one is wearing off, so I will say good night.

More fun to come...

Random thoughts

It's a stormy day already here in RehabLand, and Bubba's up early wanting donuts. My head is splitting. AND I double booked myself at work today. I can't wait for this day to be over.

Here are a few points to ponder:

There's always some new technology to learn in nursing. It just amazes me, though, that some people figure out how to "game" it as soon as they can. It really gets scary when this gaming potentially interferes with care.
There's an updated version of this code, but somehow, I don't think people like the Slug actually read (or practice) it.

If you get tired of the bullies, check out this advice on bullying or parallel violence from Katie Duke.

And finally, if you want to feel good about what you do, no matter what, check out this post from KevinMD.

Thank you patients. You are the reason why we are all here.

More later...