I'm glad they're not my bosses

When you come out of a meeting and want to scream, it's not always good.

When people come to a meeting with an agenda on their yearly visit, it's always interesting. Either, I'm getting better at it, or the inspectors are becoming more transparent.

Needless to say, when they complain about things that are absolutely crazy, my lack of poker face showed.

So glad MY boss wasn't there at that meeting.

More to come.

Boo Vortex

I'm tired of the cold. The groundhogs are still hibernating. The Hotel is the same. I'm hoping the witch that jinxed my pay raise is freezing everything off.

Meanwhile, I found a recipe I want to make to forget about this cold: rum punch cake.

Wish it could take me to the tropics, too. At least, it might make me happy enough to forget the cold.

Enjoy!

The plot thickens

Lots of craziness going on in the Hotel. Hustle, bustle, and renovating in my world. The painting part is going slowly, so I've been relocated to the office I started out in when I transferred. I don't really mind, since I enjoy my office mates.

I may get some new compatriots in the SU, or the ones who are there may stay on permanently. This is a hot topic on the unit, since everyone wants to run away from the boss. They'll do anything to get on day shift so they can take off and run.

Very few people are happy right where they are. They think there are too many changes. It would have come to us no matter what. It's been a year since Boss said he/she was moving on, but he/she didn't leave right away. Many people are still marooned and not coping well. The New Boss had to reiterate that his/her door was open, so ask if you want something, don't gossip. Seems like an easy concept, but it's not really as much fun to not gossip at the Hotel.

We will just have to wait and see, as the plot thickens.

More later...my Malbec is calling me. I've been good!

When the cat's away...

Some folks can look so busy doing nothing that they seem indispensable.~Kin Hubbard


The mice will play. I am so glad I am not responsible about telling the big boss about all the havoc the sister hospitals have perpetrated by NOT doing what they're supposed to do. Had to report it, but nothing will ever happen at the rate Madison moves.

Oh, so much fun. At least, it won't harm patients or the innocent, but I wish the guilty parties would just get over it and do their work for once.

Ah, love flashbacks to the old life...it's just the same as the floor without as many bodily fluids. So much fun....stay tuned.

Ethical dilemmas

In rehab, we keep people for a long time, as long as they're progressing. In the Hotel, we keep people a long time, because we can for a variety of reasons.

Sometimes, we even have staff get entangled in the issues. Here are some that have come up since I arrived at the Hotel.

1. The infamous, "He said, she said". Someone overhears part of a conversation, and reports it. Patient and nurse have two different stories. Reporter decides to write it up and nurse, of course, gets in trouble, because, as in most service industries, "the customer is always right." Patient is mad at nurse for rest of stay, and nurse is in hot water.

2. Patient stays with us for protracted periods of time when they actually need to be somewhere else. Examples: 86 year old patient with metastatic cancer says, "I can be rehabbed." Oncologist says patient has six months max due to the nature of the mets. We lose a rehab spot, because our boss says, "Go ahead and try." Hospice case worker fortunately has his head on straight: "We'll keep a bed for whenever he's ready to cross that bridge."

3. Nurses get involved (financially, sexually, etc.) with patients. It's no help when said nurse is a favorite of your nursing administration. Nurses also abuse the kindness of patients by eating their snacks, etc. I counsel them to report to no avail, because they fear retribution while they're still here.

4. Boss trains two people for a specialty position over the  past year. Both people will be gone from Hotel by September, and boss knew this. WTH is the matter with the boss? Does he/she like training people for other companies? Obviously...training wheel starts over again in a few months.

5. Succession planning. What's that you ask? Well, it means that you train in advance for people moving, retiring or just quitting your organization. As usual, this is just another thing lacking at the Hotel.
Happily, this is not a bad thing. At least, it gives me a topic for my latest grad school paper to write about due this coming week.

An interesting equation

Full house + scheduled maintenance to rooms = pandemonium.

Why? Just when you thought a couple of people would go home, so you could use their rooms as the first place to start, they stay.

Ah, the joys of springtime construction abound at the Hotel. Before you know it, we'll be getting hard hats issued.

Stay tuned.

Spent

I'm still tired from my weekend shifts. It does not help that I slept horribly last night. I had what was one of my biggest meetings today. I am in contention for a brand new position at the Hotel and while it was posted on job hunting sites galore, there are very few people being considered.

Happily, I made it through our meeting/interview without a hitch. I believe I made my points that I would be a good person to work at this new Hotel position. It involves management, but is so far removed from my current work (and that of the SU). It will require a lot of mental stamina, more than physical, and not a lot of perks (no office, but plenty of freedom).

Only time will tell...more stories to tell later. Stay tuned.

The fugitive

I feel like a fugitive from the law of averages.  ~William H. Mauldin

That's the story of my life lately. Everything that can go wrong will, or at least it seemed that way on a recent shift.

I have the misfortune of having oddball things happen when I am the charge nurse. I've been in charge for a while (but too frequently) and things have been getting progressively weirder. Last time, some of the staff drove me so crazy I don't even want to talk to them anymore, because to ask them to do something is a burden. Eye rolls, heavy sighs, and flat out "no" on occasion gets my blood boiling. To top it all, these same people want to talk about teamwork....hello? I'm the captain of the team and I'd like you to, at the very least do your own work!

And if that's not enough, invite people in from outside and have them critique your work. I was this close (imagine index finger and thumb close together) to calling the ambulance supervisor for the crew who took one of our patients out. DweedleDee and DweedleDum complained about the patient, complained about the necessary items he/she had to take along, then complained "Why didn't the doc send this patient out sooner?"

I just asked them to get him/her out of the Hotel, but in the back of my mind, I really just wanted to blow it all and ask them when they got their MDs. Funny, I only saw EMT on their shirts. I'm no MD, nor would I presume to know everything about this guy. This was the second pain in the arse crew on our unit and if it were up to me, I would lodge a formal complaint. Your job is to get Patient X from us to point B that's it. Medical treatment philosophy is not my business.

Thankfully, both these people were out quickly. Acute situations are inappropriate for rehab for obvious safety reasons. Sure, I love giving blood out as much as the next guy, but if you're gonna need unit after unit, and potential surgical intervention, you need to go somewhere else.

Enough venting for me...off to vegetate until it's time to be Homework Taskmaster with Bubba before all the sports....stay tuned.

A little delusional

Delusion (from www.m-w.com)
Something that is falsely or delusively believed or propagated b : a persistent false psychotic belief regarding the self or persons or objects outside the self that is maintained despite indisputable evidence to the contrary; also : the abnormal state marked by such beliefs

Oh, that was the story of my life on a recent night at the Hotel. What sorts of delusions you ask? Plenty...

1. One patient, when asked the date, stated that it's 1893 or 1954, he/she couldn't decide. Same patient also said spouse was dead and could a couple of nurses please jump in bed with him/her so he/she could warm up. I don't think so...

According to the notes, spouse thinks patient may have Alzheimer's and cannot drive an electric wheelchair anymore due to too many accidents, running into people while shopping.

2. Another patient, with an alcoholic liver will be discharged soon. Patient says she's going home. Family says otherwise. The bus is coming, but no one's 'fessing up to the destination, especially not the POA.

According to the notes, doctor's not disturbing this delusion, either. Gotta thank the doc for this. This girl is a handful when perturbed, and our staff have the stories to prove it.

3. Maybe delusion, maybe not, but one of our patients actually likes the limb splints we have to put on  at night. "Hey where are you?" I heard on the intercom. "I want my thing put on, it's time."

If it makes you happy and isn't harmful, let's go! And off to sleep he/she went. Hooray!

Stay tuned...

Craziness part 3

My life:

Less staff for holiday, some patients on one-to-one, which makes staffing even worse. The Slug with a serious attitude problem. And of course, my techs ain't happy, either.

I thought about disposing a colostomy bag in a very inappropriate place as retaliation...like in his/her trunk. The weather's been just right, so it would ripen quickly enough.

This holiday surely is no holiday. The patients for the most part are good. Mr. Pain, though, is still a pain. They can't get his meds regulated. It is a crying shame.

So glad I've got a grad school countdown going to keep me occupied!

More later.

Weekend madness

It's a whole lot of this and that on the weekends I don't work. A lot of errands, shopping and sometimes cleaning sandwiched in between working on grad school projects and scout stuff.

So is it really necessary for your husband or significant other to arrange entertainment at your house, which hasn't seen a mop in ages?

Arrrgh! I'd kill him if it didn't make another big mess I'd have to clean up!

Vacation...all I ever wanted!

Yes, I'm now officially on vacation until next Monday from Madison. Hooray! Hooray!

Yesterday's evening shift wasn't too terrible, but had enough weird little things going on to keep me busy. Our charge nurse, C., was busy getting mechanical problems resolved. One patient's bed stopped working (no head up, no head down, no lifting up or down.) and the air handler in one room became so noisy we could hear it hundreds of feet down the hall it was squealing so loud. It only took three hours, but the maintenance guy finally showed up to fix that.

I was the IV nurse, so I was busy hanging all the piggybacks on the floor. We have a couple of people on the famous osteomyelitis combo of Vancomycin and Zosyn and one guy on Phenergan and Tygacil. To top that off, Mr. K. was still on IV fluids. I brought him his Pepsi, so his locker should be full of them. Sometimes he won't take in any fluids, but he will cave in for a Pepsi. That usually gets him in a good enough mood that he'll actually take in enough orally for the shift. It's a sneaky way of getting him to drink, but we have to do it.

One of our patients will be coming back from flap surgery to a new Clinitron bed. The main problem: his roommate, who's also on MRSA isolation just like him, has an allergy to something in the Clinitron. (He had to move rooms the last time he was with a patient on a Clinitron) The charge nurse will have a fun task today figuring out what they'll do with Mr. HIJ #2 when Mr. HIJ #1 comes back and they have to turn the bed on and run it.

I had my same three patients that I had all weekend. The two in the same room were reasonably pleasant, and they work well with their third roommate, who is really funny. The three of them were having a blast making fun of the rubbery roast beef served for dinner. That's always helpful, especially, since the one patient, a COPDer can get anxious pretty quickly. He doesn't get so bad when he's busy chatting with the other guys. My other patient, Mr. AB #1 was vomiting again, but not as much. It never fails...he vomits just before I can hang the Promethazine, and then he promptly falls asleep once I hang it.

We had an interesting chat at the nurses' station last night. Some people are amazed that certain people on our unit have so much time to chat and lounge around when they have a bunch of patients and others seem to disappear for way longer than their assigned breaks. How do they do it? One RN figured out that they aren't doing the work. You look at their patients, the charting that's done on their shift and what do you find? Nothing. Our state says you have to have two assessments in 24 hours (usually no more than 12 hours apart) and if you leaf through our flowsheet book, sometimes you only see one assessment and that's from the night shift.

I followed one nursing assistant on our unit and took care of her patients on evenings. I discovered when she worked a double shift recently, she only recorded vital signs. She didn't record even one assessment. This is also the same person who has a habit of disappearing off the unit for a couple of hours each day (she's not a smoker) without notifying anyone. I discovered one of her hiding places on my way into work yesterday--her car. She goes off the unit to the parking lot and sits in her car, so she can avoid any of the end-of-shift work, like putting people back into bed or taking care of her assigned patients.

As I talked to some other folks about this, they mentioned that this is a management problem. It surely is. Our manager is loathe to call anyone on any infractions because he/she is afraid that the person will retaliate by not showing up to work for upcoming shifts. And, surprise, surprise, there are no regulations at Madison which say if you're out of work for three days or more that you need a doctor's excuse. It is just terrible. I understand now why I'm not a manager! What good is it if you cannot enforce any sort of rules of conduct?

Alas, I am on vacation. I'm going to putter around the house and do stuff, like get the cars maintained, get a manicure and pedicure and then get all dressed up and go out with my husband on Friday night to celebrate our anniversary. Bubba will be staying with my friends and their children and will get to have a day running around with them this weekend. It should be fun!

Stay tuned...back to work next week!