Yes, it's non-formulary at the Hotel

And no, contrary to popular belief, we don't supply it, either, but this order was entertaining:

MARIJUANA (MEDICAL) AS DIRECTED INHALATION AS  NEEDED

I always tell the flower children to go to the state next door (since they wrote this character's script.)

Alas, they continue to patronize our local drug dealers, even if it means we'll kick them out and some of our surgeons will refuse to operate on them if they need it.

Just a thought.

More later...

We have to ask

RehabRN's tips for new rehab nurses: stuff you have to ask.

1. Did you bring your medication list? 
We want to know. It's all part of our service, and it keeps you safe. It keeps all those accreditation people happy, too.

2. Do you have any guns, knives or weapons?
We cannot have them on our unit. We can get them taken care of for you, if you don't want to send home your prized Bowie knife (actually found one under a cushion once--in a scabbard) with your mom/wife/sister/random relative or friend. 

Those accreditation people like us to do that, too.

3. Do you use marijuana or other drugs not prescribed by your doctor? 
Your safety is involved here, too. We are not the police, but they will inform you that your "unofficial meds" (as one patient told me) cannot be kept or be available for "sharing" or sale here in our lovely Hotel.

Unofficial pharmacists are not allowed to practice here, either.

And my personal favorite:

4. Do you have any concerns about your sexual health? 
No, at the Hotel, we don't ask directly (our psychologists and MDs generally ask), but I will ask if I get some smart alecky comment about some nurse's butt or how someone is "interested" in x, y, or z (pick your favorite salacious comment).

It is a big deal in rehab. Many folks have been through horrible experiences before they got there. You always know they're starting to feel better when they start getting frisky and/or asking directly (or indirectly).

Just remember, a lot of times, it really is about them, and not you. Be aware and learn how to get other members of your interdisciplinary team involved. If it is about you, bump it up the chain with your nurse manager, and if needed, human resources.

It does takes a village to take good care of rehab patients.

More later...

Everything old is new again

This medical marijuana story will make you wonder about why more research is not taking place.

And if that's not enough, the before and after photos will blow you away.

More later...

It could have been worse...

I could have had a whole lot of meetings today. Two big ones were cancelled, so I HAD to do my required education at my desk and close the door to keep the rabble out all afternoon

But, never fear, friends, I still had lots of other entertainment at the meetings I did attend.

I got to hear about Dr. R's trip to the Big Ditch and the ride on the mule. In some spots, you can't see the bottom. Good thing for that sure footed creature!

We got to discuss our patients in our weekly meeting (that's what rehab centers have to do on a regular basis). I got to discuss my interventions from my office to keep some patients out of trouble. (Always fun.)
I couldn't do anything about the character offering to "help" another patient with his stash of marijuana.
No matter what we do, some of these folks just don't get it that we are not in a state that allows Mary Jane for medicinal purposes (keep driving west, please!)

And for a finale to my day, I heard rain outside my window. It was only S, the rec therapist with the patients watering the garden below. Everything was fine and dandy, and S. went back to her office and brought patients inside. Well, we thought they all came in...Mr. G., a particular character decided he was going to move the sprinkler. When he did that and started rolling in the front door, he started dragging the hose inside underneath his electric wheelchair.

A man in the lobby saw Mr. G. coming in and helped him get the hose out from under the chair, just as he was dragging the sprinkler inside. Thankfully, only Mr. G. got wet. A Good Samaritan turned off the hose, so Mr. G. wouldn't flood the whole front entrance.

All in all, it was a pretty good day. One (or even two) less meetings in life is a very good thing.

More later...

A case of senioritis

I should be studying for my next test coming up very shortly, but I've been surfing again. Surprisingly, I've found articles on some other kinds of seniors, you may want to check out.

Senior citizens find the grass is greener (from Daily Reckoning) I'll bet our clerk M. who retired, is at one of their seminars (he was thinking about this when he left).

An unusual pilgrim (from CNN's religion blog) College kid (may or may not be a senior) takes a hike in search of a saint.

So now, off I go, to study again...stay tuned.

Boys will be boys

And idiots sometimes. You could tell the moon was full recently, since we had so much juvenile antics lately.

Scenario #1
Patient X doesn't like Patient Y. Patient X decides to duke it out with Patient Y in front of the table in the dining room. Security is called. Patient X gets a ticket, and will be considered for discharge soon. Patient Y fell down, so this causes tons of paperwork mayhem for Ella, our harried night charge nurse, who is late giving report, since she's filling out incident reports, info for security, fall reassessments, patient assessments, and calls to the on-call MD. Word spread fast around the unit, since one of our characters says to Mr. Y. when he saw him today, "I heard you had an exciting time earlier."

Scenario #2
Patient Z, one of our resident COPDers was scheduled for discharge recently. Patient Z likes it at our place, so he turns off his oxygen to make us think he's "sick". Try as he might to sabotage his discharge, we figured out that Z could indeed reach the oxygen valve from his perch in bed, and yes, he did turn it off. He got crazy, so the chiropractor came down at the boss's request and gave him a mini-adjustment, the specialist gave him his specialty consult, and finally, three hours late, his transportation showed up.

Scenario #3
Patient A tells our student nurse, who's doing an assessment for her master's program, that, yes, he is indeed still smoking weed. Despite everything, we have to keep him for a while. Patient A has developed a new problem and we cannot simply discharge him for non-compliance. So far, no one's found his stash.


So needless to say, I was happy, happy, happy to be going home after a long day. Stay tuned for more excitement. You never know what will happen at the Hotel Rehab.

Things sure look different up here...

That could have been the story of my day hanging in the Sister Unit.

In order to protect the guilty and the innocent, I'll present these out of order.

1. When you get a warning (as we do via our system) that a patient can be violent, you get a little worried. So glad I didn't know about that until AFTER I walked this guy here and there (because I had no place to go for him) and I got him to the doctor in the office with the panic buttons.

It became more ironic when the Doc managed to get him to agree to a treatment that can be quite painful. Thankfully, he was lying prone and I was out of reach. The doc was not, but all went well and the patient was happy with us.

2. No, the housekeepers aren't just happy people strolling around. They are strolling that way in violation of policy with their earbuds in jamming to whatever tune strikes them. And no, just shaking your head and smiling is not going to get me to tell you what you want while you bop your head to the tunes, buddy.

3. Yes, no really means no when the treatment team asks you if you've smoked with Mary Jane in the last month, even if it did help your spasms. Saying no and your pee says yes gets you thrown out of that rehab program. Better luck next time!

4. Finally, I got to redirect a lost patient to the elevator, then to his room. At first when the trainer and I came upon him in the hallway, I didn't recognize him. Then I realized he was one of the patients from my unit at the Hotel. Some people really do look different when they're up in their wheelchairs rolling around!

Stay tuned...tomorrow it's run, run, run as the procedures and exams rule the schedule. It'll be a fun day.

Heard on the unit...

Aw, it's been forever since I've had enough goodies for this segment! But when patients speak, sometimes we just bite our tongues and run as fast as we can to our lunch break, so we can share with the rest of the folks on the unit and with the audience at home.

Situation 1

RN is educating patient about the proper way to use an incentive spirometer. After demonstrating proper technique, patient says, "Oh, that's just like what I do at home with my bong." RN listens as patient describes how marijuana "relaxes my legs so I can get into my chair."

Sorry, remember that non-smoking thing you signed to come here for rehab? Yep, it applies to Mary Jane, too.

Situation 2

RN is talking to patient re: helping himself (He's a lower level thoracic paraplegic, so he can do it) by dressing and turning himself. "Oh, I'm not going to do that (turning) at home. I'll just wake her up." (implying whatever woman happens to be in his bed.)

Nice. My reply, "So since Babe #1 is not here, could you just move the pillows and turn yourself, please?"

Situation 3

From patient who is not really observant about following his intermittent catheterization rules or fluid restrictions.

"Where's my nurse? I missed my appointment." says Mr. Drinks-A-Lot.
"What appointment?" I asked.
"My catheter appointment. I've got a headache."
"Yes," I replied, "and you realize this is a sign of dysreflexia, correct?"
Patient shakes head.

If only Tom and Ray were here to do this...more to come...eventually!