Critical thinking

Is critical thinking in nursing really dead?

Sometimes, I wonder if it died recently, because many of the nurses who work at the Hotel tell strange stories.

What would you think of a rehab unit where...

1. Nursing staff don't want to get patients up to therapy after lunch? They went all morning, they say.

2. Nurses want scheduled pain medications because (I'm quoting because they actually said this) "He has to ask for prn meds and he never does, so we can't give it to him."

Pain is a part of rehab, but not taking care of it, especially in folks with addiction history, is criminal. Nursing is about alleviating suffering and promoting wellness.

Hmmm...wonder what part of the pain assessment they missed? How about the first part where the nurse actually talks to the patient. If Mr. Z. tells me is pain in his legs is a 10 after his first rehab session, even though he's got his long-acting on board, guess what I'm doing?

That's right...looking for PRNs. If those aren't appropriate, how about ordered adjuvants like cremes, gels or patches? Or my personal favorite: doing the interdisciplinary thing and calling your PTs (or whoever has them) and getting some warm packs if this might help (since we don't have a towel warmer like Saintarama).

If his pain isn't resolved, then we should consult the pain specialist group that is right down the way. They do take consults.

My $0.02 on this rainy night.

Dear Manglement

Yes, it is rough when no one wants to do your job. With guaranteed bonuses taken away because your performance sucked last year, yes, I really do feel for you.

It's terrible to come into work and be coddled with free snacks, coffee, etc., and your own reserved parking space at our multiple locations. I'm not really surprised with your recent actions of not notifying the campus here at Madison regarding security events, since you have a stellar track record to uphold.

Even though, RPIA, our former chief nurse, (and the rest of you who are still left) knew we were under a bomb threat at our Washington location one beautiful March day, you didn't "bother" anyone to pass that info along, because, "You know, the police will handle it." It was nice of you all to evacuate the building, just in case with RPIA.

Yesterday, we figured something was up when our retired veteran air traffic controller patient noticed an odd helicopter pattern down the street near a strip mall after therapy. He and Mr. Z., another patient who is a retired police officer made a few phone calls. As usual, no one bothered to notify us peons at the Hotel that a strong armed robbery occurred just a few blocks away and the helicopter pattern was due to the police tracking the suspect.

Just remember...we take care of those who take care of us. You might not like the next patient satisfaction (or employee) survey.

Sincerely not,

RehabRN

Six kinds of crazy

1. You don't get enough sleep, then have to go to work. Ugh!

2. Your procrastinating husband decides to empty a storage locker on the day before the rent on it is due. You're required to come along to haul back all the c#$p, er, stuff.

3. You find your lunch in the office fridge after it had been there too long.

4.  People who really need to read e-mails don't do it. Thankfully, that read receipt thing on your e-mail system allows you to prove to the manager, that, yes, indeed, the Slug may have heard you, but you have no idea if he/she comprehended, since there's no proof he/she can read.

5. Your colleagues elsewhere in the Hotel ask "Why So and So doesn't do this/that anymore?" Hmm...ask So and So maybe?

6. You schedule a patient to see a specialist, as part of your role as a care coordinator in your hospital system. Right after you schedule the patient, the patient's attending MD finds you to tell you he/she's already going for a procedure, so can the specialist see him/her while he/she's there? Panic ensues. You calmly make three phone calls and get a plan together. Finally, you get the details done and get to go home.

And that ends your six kinds of crazy day. More excitement for another day. Enjoy yours wherever you are!

Do it again? Well, maybe

I went to see my internist yesterday. I got my labs back pronto, so tonight I get a note that says "Take Vitamin D."

Yes, that lab was low. I thought the research that said calcium supplementation was hogwash so I started eating more cheese and Greek yogurt.

Too bad that's not fortified with Vitamin D. Yes, Dr. H., I'll be picking up the supplement tomorrow.

For fun, I decided to take an online course through work. Tonight I found out that the superduper steroid version on that subject that is limited to 35 people per session is still open. The best part: I may have to go visit my favorite pharmacist next year, since one of the class requirements is presenting your project at next year's conference.

Joy of joys. Now to just get management approval and apply by the end of the week.

Never ever a dull moment around here.

Stay tuned.

Wild New Year

Oh, it's going to be an exciting year.

We have a new nurse manager, we have retirements, and we have lots and lots of unhappy employees.

I'm just going to tie a knot and hang on, just like the saying goes.

Stay tuned...

Wild Friday

Yes, I'm so, so glad this week is over. My Friday was really, really weird and probably just the culmination of an extraordinary week.

Besides all the brouhaha of the new digs opening, one of our nurses, who works the home health side had to call an ambulance for herself from a patient's home this week. We still don't know what happened to her.

The boss's boss came over to inspect again. S/he's just so friendly--only talks to the people she wants to. I've given up doing anything but speaking when spoken to. Why bother when s/he doesn't acknowledge you anyway?

And on top of this, my sibling who was coming to town got delayed and so did our hospitalized relative who was supposed to be discharging this week. Logistical nightmare trying to get him/her home caused a problem that could not be resolved until Monday. I personally don't believe it was all logistics, but then again, just call me a cynic.

I know a long weekend when I see one, so I'm taking one, myself.

Stay tuned...it should be a fun weekend.

Countdown

In 14 (or so) days, I'll have another new boss. Lucky me! We can't hire enough nurses, but the Hotel can hire people to be administrators and bosses. So much for a flat management structure!

In 29 days, my latest grad school class will be over for the semester. And in 71 days, I'll be starting the last year of grad school. Hooray!

More to come...

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.

Call a spade a spade

Working with F, I learn a lot of things that happen on the night shift. She is in tuned to a lot of things going on.

Recently, F. discussed how many people we work with are passive aggressive. When we looked at what's going on, we figured that 90% of the people we work with fit the profile. Is it because of our boss, or our environment? It sure makes this look like it's happening at our place.

Besides the latest state of aggression, the latest wave of flu is hitting the unit. People are dropping like flies. It sure would be nice if those same people might think about getting a flu shot next year...or staying home when they're contagious, so they don't share it with the rest of us.

Should be fun to see how the rest of the week goes. Stay tuned!

Uniform uniforms?

In yet another effort to stifle the morale at ye old Hotel Rehab, the management has decided we would just "look better" if we all wore standard uniforms. Rumor has it we'll get light blue tops and blue pants.

The best suggestion was to go back to "nursing whites because they're so much more professional". Yuck! I work with poop and other bodily fluids a lot on some shifts (and I may get wet in a shower--or may sweat due to the heat and humidity on our unit) and I really don't want to see it if it does end up on my scrubs.

And who might have thought this was a great idea? It was the "Nursing Standards" committee, which consists of nurses who no longer work the floor anymore. Our representative did work the floor, until he/she got the office and is rarely seen anywhere near the unit, unless there are donuts or other free food.

Now if they do like the ORs and build a locker room for us and allow us to change at work, I might go for it. I doubt they'd go for it...I work the floor. What could I know?