When you absolutely, positively need a break before the end of the week? You call in sick (or in my case, exhausted).
The last straw? The doctor who almost no showed my last patient appointment of the day, then shows up in the last 10 minutes. What does this mean? My patient is taken care of but, I miss my important diagnostic that my PCP had ordered, but I couldn't do at lunch time. More unpaid OT...not fun.
Never fear, however. This nurse case manager found out that Saintarama urgent care can indeed do the tests that Dr. H. put in electronically. The outpatient area was closed when I left work.
"Come on over" the lady in the urgent care said. "We'll take care of you. We're here until 8."
Happily, no pneumonia, but a nasty, nasty case of viral bronchitis. The only thing I didn't have was some codeine cough syrup.
Problem now solved...and I stopped barking and coughing a while ago.
Back to work tomorrow, then excitement with Bubba who starts spring break.
Never a dull moment at the Hotel or at home. Stay tuned!
Showing posts with label orders. Show all posts
Showing posts with label orders. Show all posts
Thursday, March 16, 2017
Friday, September 28, 2012
Sometimes you're the windshield...
And sometimes, you're the bug, as the song says. Nevertheless, it's Friday and I survived.
It was a busy week punctuated by technical difficulties, rascally coworkers, and stressed out providers who bark orders at you, then apologize later (after you've got a nice case of indigestion).
That was just my side of the house in the beauty of the old, untouched, 70s era Hotel. The new, renovated part of the Hotel is shiny, and the infection control nurse is worried about me. "If you don't have a sink in there where you see patients, what are you going to do?"
Turns out I do have a sink, since I use a clinic room that has one. Problem averted. He/she makes me nervous since one of the therapists tried putting the popcorn machine used by the volunteer group in my clinic room. "No dice." I told the therapist. "We have to move it or it will be confiscated." Thankfully, we found a couple of legal spots for the machine in the renovated Hotel section down the hall. Yes, we'll have to walk, but it has its own spot ensconced next to the nutrition refrigerator.
There was sadness, too. One of our very sick patients got back home and died the other day. He was a sort I wasn't sure would get out of the Hotel. He was elderly and got sick while he was over for his annual check-up. He just bounced back and forth for a while. I was happy to see he was up and motoring around with his wife, who became a minor celebrity on the unit when she was featured in a newspaper story about our town before he left us. They never did hold that "autograph session" I was always teasing them about in the lobby, since we have a paper box nearby.
Godspeed Mr. V. You fought the good fight. We'll miss you and your "famous" wife, too.
It was a busy week punctuated by technical difficulties, rascally coworkers, and stressed out providers who bark orders at you, then apologize later (after you've got a nice case of indigestion).
That was just my side of the house in the beauty of the old, untouched, 70s era Hotel. The new, renovated part of the Hotel is shiny, and the infection control nurse is worried about me. "If you don't have a sink in there where you see patients, what are you going to do?"
Turns out I do have a sink, since I use a clinic room that has one. Problem averted. He/she makes me nervous since one of the therapists tried putting the popcorn machine used by the volunteer group in my clinic room. "No dice." I told the therapist. "We have to move it or it will be confiscated." Thankfully, we found a couple of legal spots for the machine in the renovated Hotel section down the hall. Yes, we'll have to walk, but it has its own spot ensconced next to the nutrition refrigerator.
There was sadness, too. One of our very sick patients got back home and died the other day. He was a sort I wasn't sure would get out of the Hotel. He was elderly and got sick while he was over for his annual check-up. He just bounced back and forth for a while. I was happy to see he was up and motoring around with his wife, who became a minor celebrity on the unit when she was featured in a newspaper story about our town before he left us. They never did hold that "autograph session" I was always teasing them about in the lobby, since we have a paper box nearby.
Godspeed Mr. V. You fought the good fight. We'll miss you and your "famous" wife, too.
Monday, August 8, 2011
You know it's Monday when...
"It's a cruel, crazy, beautiful world./Every day you wake up/I hope it's a blue, blue sky." --Johnny Clegg
1. Your patient is the heaviest one on the floor.
2. The first thing you have to do when you walk into the room and say hi, is suction said patient.
3. After that, you have to change the patient's external catheter, since the last shift somehow managed to pull it off. Said patient has a wet pad beneath him.
4. Clean up patient and change pad.
5. Wait for docs to round. Hold bowel routine, 'cause heaven forbid a doctor see a patient who poops whilst they're in the room!
6. Once Dr. HarvardMedSchool gives you crazy orders (like attach dressings without attaching them and you're not using one of these), start bowel routine.
7. Bowel routine over, so bathe patient. Suction again, and again, and again, before shave, after shave, after turning, etc.
8. Feed patient lunch. Suction patient.
9. Be so happy you follow the rules re: isolation gowns in rooms because as you dress patient, patient has a lot of gas, which is accompanied by a moderate amount of loose stool, which sprays bed rail, bed, and some gets on you.
10. Take off gown, wash hands, put on new isolation gown and other assorted PPE, then suction patient again.
11. Get patient dressed, into wheelchair and adjusted. (This takes 30 minutes including cleanup after explosion).
12. Get patient out door.
13. Patient returns in two minutes frothing. Suction again.
14. This time it works, get patient to therapy for evaluation for new wheelchair.
15. Patient is gone for not quite an hour. Lo and behold, the PT inadvertently pulls off external catheter during transfer. Put patient back to bed and clean up.
16. Suction patient again once in bed. Finish cleanup.
17. Dress patient in new clothes. Get patient adjusted then resupply room for next nurse.
18. Give report.
19. Wash wet cushion cover.
20. Go home.
And in between all that, I had 1) other patients and 2) lots of documentation to do.
So glad I eat fast and early! And I'm thrilled my work Monday is over, over, over!
Stay tuned...
1. Your patient is the heaviest one on the floor.
2. The first thing you have to do when you walk into the room and say hi, is suction said patient.
3. After that, you have to change the patient's external catheter, since the last shift somehow managed to pull it off. Said patient has a wet pad beneath him.
4. Clean up patient and change pad.
5. Wait for docs to round. Hold bowel routine, 'cause heaven forbid a doctor see a patient who poops whilst they're in the room!
6. Once Dr. HarvardMedSchool gives you crazy orders (like attach dressings without attaching them and you're not using one of these), start bowel routine.
7. Bowel routine over, so bathe patient. Suction again, and again, and again, before shave, after shave, after turning, etc.
8. Feed patient lunch. Suction patient.
9. Be so happy you follow the rules re: isolation gowns in rooms because as you dress patient, patient has a lot of gas, which is accompanied by a moderate amount of loose stool, which sprays bed rail, bed, and some gets on you.
10. Take off gown, wash hands, put on new isolation gown and other assorted PPE, then suction patient again.
11. Get patient dressed, into wheelchair and adjusted. (This takes 30 minutes including cleanup after explosion).
12. Get patient out door.
13. Patient returns in two minutes frothing. Suction again.
14. This time it works, get patient to therapy for evaluation for new wheelchair.
15. Patient is gone for not quite an hour. Lo and behold, the PT inadvertently pulls off external catheter during transfer. Put patient back to bed and clean up.
16. Suction patient again once in bed. Finish cleanup.
17. Dress patient in new clothes. Get patient adjusted then resupply room for next nurse.
18. Give report.
19. Wash wet cushion cover.
20. Go home.
And in between all that, I had 1) other patients and 2) lots of documentation to do.
So glad I eat fast and early! And I'm thrilled my work Monday is over, over, over!
Stay tuned...
Tuesday, July 6, 2010
Sunday Monday Tuesday
One patient yesterday told me it was a nice Sunday. No Mr. R., it was actually Monday. It surely seemed like Sunday on the unit when I got there.
It quickly turned to Monday, however, since our doc on call started ordering labs here, there and everywhere, on healthy and sick patients.
So now it really is Tuesday...and I'm taking a breather. More later, so stay tuned.
It quickly turned to Monday, however, since our doc on call started ordering labs here, there and everywhere, on healthy and sick patients.
So now it really is Tuesday...and I'm taking a breather. More later, so stay tuned.
Wednesday, August 19, 2009
Remember that patience thing?
Thank goodness I had a lot of patient patients today. Oh. My. Freaking. Heavens. If it wasn't one thing, it was another.
I never do EKGs and I had to do two today. I am so, so, so happy one of our new (to us) nurses was working, because, with her help, F. and I tag-teamed to get them done right after another when the docs would go from "Hi how you doing?" rounding, to barking this order and that STAT! F., I wouldn't have made it without you!
Other people who are getting ready to go home decided to get sick...or get a PE or something. Just what I want to do near the end of the shift.
And my regularly scheduled people? They went with the flow...no whining or no crabbiness.
Even though my back hurts, I ended up having a good day.
More to come...stay tuned.
I never do EKGs and I had to do two today. I am so, so, so happy one of our new (to us) nurses was working, because, with her help, F. and I tag-teamed to get them done right after another when the docs would go from "Hi how you doing?" rounding, to barking this order and that STAT! F., I wouldn't have made it without you!
Other people who are getting ready to go home decided to get sick...or get a PE or something. Just what I want to do near the end of the shift.
And my regularly scheduled people? They went with the flow...no whining or no crabbiness.
Even though my back hurts, I ended up having a good day.
More to come...stay tuned.
Thursday, July 9, 2009
Is it psycho Thursday again?
That was my question this morning. Oh, why, oh, why do some people insist on being complete idiots?!
Psycho #1: The crazy patient who threatened everyone earlier in his stay was getting antsy when his pain meds were wearing off. So he asked for Tylenol. Which I didn't have an order for. Which required pulling (or finding) a doctor who was rounding willing to give me a verbal.
Got that, so all is good, right? Until...
Psycho #2: One of my coworkers made a mistake and started cleaning up one of my people. All this right after I had told him, "Go back to sleep and we'll get you cleaned up at 1030ish."
For some odd reason, the Slug decided she needed to yell at me and demand that I clean up another patient of mistaken employee. "No, I'm busy. (since I was still working on the order for Psycho #1 and I had my own other patient, in addition to med delivery). You're not the charge nurse. Go tell him/her if you have a problem." The Slug just kept getting in the way. Somehow, I managed to get everything done.
Psycho #3: The dreaded patient came in, and thankfully, left without issue. Said patient provokes PTSD in some of our nurses from the abuse on his/her last visit. Many people were really, really happy they didn't have to deal with that admission at this time.
To top it all off, we got the news that JC folks are on the prowl and should be visiting our hospital soon. If I wasn't having nightmares before, I'm sure they'll start now.
Less psychosis and more fun to come...stay tuned!
Psycho #1: The crazy patient who threatened everyone earlier in his stay was getting antsy when his pain meds were wearing off. So he asked for Tylenol. Which I didn't have an order for. Which required pulling (or finding) a doctor who was rounding willing to give me a verbal.
Got that, so all is good, right? Until...
Psycho #2: One of my coworkers made a mistake and started cleaning up one of my people. All this right after I had told him, "Go back to sleep and we'll get you cleaned up at 1030ish."
For some odd reason, the Slug decided she needed to yell at me and demand that I clean up another patient of mistaken employee. "No, I'm busy. (since I was still working on the order for Psycho #1 and I had my own other patient, in addition to med delivery). You're not the charge nurse. Go tell him/her if you have a problem." The Slug just kept getting in the way. Somehow, I managed to get everything done.
Psycho #3: The dreaded patient came in, and thankfully, left without issue. Said patient provokes PTSD in some of our nurses from the abuse on his/her last visit. Many people were really, really happy they didn't have to deal with that admission at this time.
To top it all off, we got the news that JC folks are on the prowl and should be visiting our hospital soon. If I wasn't having nightmares before, I'm sure they'll start now.
Less psychosis and more fun to come...stay tuned!
Monday, March 30, 2009
Dreams
Yes, I've been having that conversation with patients a lot lately. Maybe it has something to do with the sleeping pills. Otherwise, it just seems that people are a little more apt to talk about certain things when the sun goes down.
First, one of our guys keeps dreaming he's not sleeping at night. Yes, every time someone rounds on him, he's snoring and doesn't wake to calls of his name, but he swears to the docs that he's been up all night. Sure, they say Ambien can be a factor in sleepwalking, but for our non-ambulatory folks, I guess it could make the dreams seem as if they're awake all night. And, as you know, the patient is always right, just like the customer, until proven otherwise.
So what does that mean for us? More charting. Order that reads, "chart all times patient is awake at night." Nice.
Next, another guy, a fellow Ambien user, who never goes to bed earlier than 0300 anyway, was telling me about his dreams before he was injured: the new Harley that never was, the job offer that disintegrated, the house. He's working on some new stuff, now, since he'll be leaving us soon and going back to the area where he grew up. And he's hoping to make some of his new dreams come true. We're all excitedly crossing our fingers, since he's got everything set up for success.
Another guy seemed like he was dreaming, but he wasn't. He's going to leave us soon and he was just bawling his eyes out when I went into the room recently. Not because he's leaving right away, but that he's an old softie for a spot in one of these old movies they tend to show around Easter on TV. "Every time I see this, it gets me," he said between sniffles.
Finally, the nursing staff has a few dreams, too. Lots and lots of people are dreaming of vacation as the spring hits and summer is on its way. I'm dreaming of passing my certification and GRE exams before summer, since after that, it will be a long time before I get any more vacation. However, I do believe that we need to dream. It keeps you going.
To accomplish great things, we must not only act, but also dream; not only plan, but also believe. Anatole France
And so I go...to work again. More later...
First, one of our guys keeps dreaming he's not sleeping at night. Yes, every time someone rounds on him, he's snoring and doesn't wake to calls of his name, but he swears to the docs that he's been up all night. Sure, they say Ambien can be a factor in sleepwalking, but for our non-ambulatory folks, I guess it could make the dreams seem as if they're awake all night. And, as you know, the patient is always right, just like the customer, until proven otherwise.
So what does that mean for us? More charting. Order that reads, "chart all times patient is awake at night." Nice.
Next, another guy, a fellow Ambien user, who never goes to bed earlier than 0300 anyway, was telling me about his dreams before he was injured: the new Harley that never was, the job offer that disintegrated, the house. He's working on some new stuff, now, since he'll be leaving us soon and going back to the area where he grew up. And he's hoping to make some of his new dreams come true. We're all excitedly crossing our fingers, since he's got everything set up for success.
Another guy seemed like he was dreaming, but he wasn't. He's going to leave us soon and he was just bawling his eyes out when I went into the room recently. Not because he's leaving right away, but that he's an old softie for a spot in one of these old movies they tend to show around Easter on TV. "Every time I see this, it gets me," he said between sniffles.
Finally, the nursing staff has a few dreams, too. Lots and lots of people are dreaming of vacation as the spring hits and summer is on its way. I'm dreaming of passing my certification and GRE exams before summer, since after that, it will be a long time before I get any more vacation. However, I do believe that we need to dream. It keeps you going.
To accomplish great things, we must not only act, but also dream; not only plan, but also believe. Anatole France
And so I go...to work again. More later...
Tuesday, February 10, 2009
Only Grandpa today
Yes, that's what some of the folks call my patient and he was it today. Officially, I had two patients, but one was gone the entire day, so I really couldn't do anything for him. Grandpa was balky and happy, but never at the same time. I did his dressings, but he had to complain about them first.
Next, he complained about his bed, but he's been doing that on and off since the weekend, so I was told. He complained so much, I called the vendor's 800 number, the tech came out and he checked it out. Nothing wrong, the tech said, and Grandpa was happy...for about 2 whole minutes. Happily, since Grandpa is demented, he forgot about being mad and was busy watching TV the last hour I worked.
So I wandered around...and found stuff to do. My admission never showed up since they kept him at Washington instead of sending him here. I helped other nurses transfer people going to x-ray and therapy, I filled isolation carts with gowns, I filled glove dispensers with gloves and I passed out trays at lunch. I picked them up afterward and put them on the dirty cart. I took off orders. I witnessed a consent with one of our docs. It wasn't too bad. I hate sitting around doing nothing!
At 1530, we got a call that one of our patients had to be moved since he's now a double isolation patient, and one organism is C-diff. Joy. Nothing like bed bingo for four people (yes, that's how many we had to move to get them straight) so late in the day. Housekeeping had left the unit, so our charge was left to her own devices to get things squared away. We moved them in pairs and it worked out smoothly.
My second patient came in the building, just as I was leaving for the day. Evening shift was out of report, so I was relieved of my duty. Hooray! The weather's been great here, so I just hope it stays that way...without any tornadoes or floods thrown in. I could use a day to rest!
More to come...
Next, he complained about his bed, but he's been doing that on and off since the weekend, so I was told. He complained so much, I called the vendor's 800 number, the tech came out and he checked it out. Nothing wrong, the tech said, and Grandpa was happy...for about 2 whole minutes. Happily, since Grandpa is demented, he forgot about being mad and was busy watching TV the last hour I worked.
So I wandered around...and found stuff to do. My admission never showed up since they kept him at Washington instead of sending him here. I helped other nurses transfer people going to x-ray and therapy, I filled isolation carts with gowns, I filled glove dispensers with gloves and I passed out trays at lunch. I picked them up afterward and put them on the dirty cart. I took off orders. I witnessed a consent with one of our docs. It wasn't too bad. I hate sitting around doing nothing!
At 1530, we got a call that one of our patients had to be moved since he's now a double isolation patient, and one organism is C-diff. Joy. Nothing like bed bingo for four people (yes, that's how many we had to move to get them straight) so late in the day. Housekeeping had left the unit, so our charge was left to her own devices to get things squared away. We moved them in pairs and it worked out smoothly.
My second patient came in the building, just as I was leaving for the day. Evening shift was out of report, so I was relieved of my duty. Hooray! The weather's been great here, so I just hope it stays that way...without any tornadoes or floods thrown in. I could use a day to rest!
More to come...
Sunday, August 24, 2008
And if you don't have enough to worry about..
Check out this article from the UK on the use of "stripper therapy" for some Huntington's disease patients. Thanks MJ from www.nurseratchedsplace.com for that one.
What a can of worms this would open up here in the US....just a few things to consider...
1. What would our other patients think if they wanted to go along, but didn't have the requisite disease...I see trouble on the unit!
2. Would the rec therapy folks get fired, since all we'd have to do is take the folks to our favorite red light district for "therapy"?
3. Would they start hiring "nurses" from said red light district? And as MJ mentioned, could you imagine the care plans?
And now, since I've finished reading From Silence to Voice, I find it incredibly ironic that the "nurses" arranged this trip. Wouldn't the "nurses" need doctor's orders for the patients to leave the unit for said trip? And do you see the word "doctor" anywhere in this story? No, you don't.
Hmm...and we wonder why people think what they do about nurses.
What a can of worms this would open up here in the US....just a few things to consider...
1. What would our other patients think if they wanted to go along, but didn't have the requisite disease...I see trouble on the unit!
2. Would the rec therapy folks get fired, since all we'd have to do is take the folks to our favorite red light district for "therapy"?
3. Would they start hiring "nurses" from said red light district? And as MJ mentioned, could you imagine the care plans?
And now, since I've finished reading From Silence to Voice, I find it incredibly ironic that the "nurses" arranged this trip. Wouldn't the "nurses" need doctor's orders for the patients to leave the unit for said trip? And do you see the word "doctor" anywhere in this story? No, you don't.
Hmm...and we wonder why people think what they do about nurses.
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