Happy Nurses' Week!

In case you missed it, the yearly celebration of nurses has begun. We got the whole week covered at the Hotel with "fun" stuff in between work.

Since the theme for this year's celebration is "healthy nurse, healthy nation", maybe it is time for some nurse-centric play-by-play from yours truly.

Yes, the Hotel has some great facilities, so we are fortunate that a lot of the celebrations occur right by our unit, but the problem: many people don't attend. Why? Because they don't have time.

So consequently, if we could get ANYTHING we asked for this Nurses' Week, here's what would be on the list.

1. Unlicensed staff that actually listen, work, and communicate with the RNs. Too many of them on our unit have a bad habit of dissing the RNs. It needs to stop. Period.

We work together as a team. If you diss the RN you're assigned to on your shift, it's a rubber-glue scenario. You make yourself look bad, too.

2. How about the Captain Obvious question: if you want everyone to document everywhere, why not make it easier at the bedside?

Just saying! If you think logging in after walking 300 feet to the nurses' station, then opening the software, then logging in again, finding the patient, then starting your note is good, you haven't taken care of a bedside patient lately.

No, rehab supposedly has stable patients, but you really need things, like computers that accept the data from the beds, the scales, etc. without double charting.

3. Since I went big on #2, why not on this one. How about a fully stocked cabinet outside each room with the basics, a la TCAB projects of the not so distant past? It would have helped if they had planned this on the last remodel, but here's some food for thought.

Having supply staff actually supply it, would also be nice. If you can't do it outside every room, how about on every wing. Steps do make a difference in a workday (you could be charting, checking labs, etc.)

Finally, no matter where you practice, I wish you a very Happy Nurses' Week. Your work matters and you make a difference.

More to come...

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...

Why I have hope

I found out today that the Slug will retire in eight or so years at one of the retirement parties for K. K was my preceptor and definitely one of the best nurses ever.

The Slug was not allowed to be my preceptor.

Three words: Thank you God!

More to come...

Just another Monday

Still Nurses' Week..YES! The psychology staff are celebrating on Florence Nightingale's birthday at the Hotel, but they have to send an e-mail every day so people don't forget.

I celebrated today by having lots of technical difficulties in my clinic. Now I have to find a creative way to get a gift basket of coffee, Mountain Dew, chocolate and other terribly fattening things to my favorite support technicians. Yes, it's been that kind of week and this is only Monday. We have a "special notes" section of our intranet, so I recognized two of the folks today. I had to...those two saved my derriere so much already.

Bubba got out of school early today and is counting the days when school ends here in RehabLand. Since his school had no snow days (we had a school boss from Minnesota who wasn't scared one icy day) this year, they'll actually finish on the day they said. Bubba, however, may notice those last days are different. For the first time ever, he has final exams. Should get him ready for high school!

Now Bubba is at his friend Jorge's house, helping him get some of the music homework done before the big party this week at the last band class. If Jorge gets the magic number, he'll be in. Bubba, his partner in crime, wants to provide moral support so it happens.

Stay tuned...one more day of Nurses' Week left. Enjoy every moment. You deserve it!

Saturday special

Oh, adventures with Bubba are never dull. It's fun for a tween boy  if...

1. You can make $40 moving boxes with Dad before 9AM. Dahey and Bubba were helping a friend (along with some big, burly guys Dahey works with) clean out his house and move.

2. You can laugh hysterically at the talking birthday cards in the store.

3. You get to hang out with one of your buddies (and 12 other boys from school) at the local laser tag adventure place, shoot hoops, and generally act silly.

4. You get pizza and you convince your mother to take you to a place that still may have an old fashioned cake donut at 6PM. (and it's not the local donut shop seen on TV either, 'cause they closed at noon).

My weekends are never dull.

Got an earworm?

You will with this Sunday Stealing.


This is the latest meme available this week at Sunday Stealing, since it's almost someone's birthday over there.

1. as you get older, are you jazzed about your birthday? 
Yes,and no. 

2. do people usually remember your birthday?
Most people do.

3. an ex-coworker used to begin 3 mos. before her birthday flat-out reminding us that it was coming up. it's amazing what no self-esteem does for you. anyway, do you know anyone who pre-announces their birthdays? 

I don't preannounce, but I try to take a vacation day every year on my birthday. If it follows close to or on a weekend (like this year), I make it a three day weekend. (Only Bubba can make it four. His falls very often on a Federal holiday).

4. what was your best birthday? why?
I had a party as a kid (I think I was 7) with tons of people and lots of food in our little house. Not sure how my mother did it, but we had fun.

5. what was your worst birthday? why? 
Can't recall any. Some are better than others.

6. name your best birthday gift.
Hmm...hard one. One year I got an engagement ring right after my birthday.

7. name the best birthday gift you've gotten for someone else.
I like surprises. Totally throws people off.

8. as i age, i value SLEEP as a priceless commodity. i didn't get any for my birthday, however. what do you want this year for your birthday?
Sleep is good, so is a trip to the spa for a day, and a relaxing evening with Dahey and something fun for Bubba to do.  

A raise would also be nice. I'm hoping that really happens, since I'm up for a promotion.


Yes, that Beatles Birthday song is going through my head...

You the citizen, decide!

Yes, we have a show in RehabLand that has a reporter who goes out and "exposes" local government and administrative hot messes on a regular basis.

It's a good thing he doesn't visit too many hospitals, or the Hotel Rehab's parent hospital (Washington) would be on his show.

One of our patients was getting discharged, but the "approved" transportation method to get him home was denied at the last moment because Mr. X. was not eligible for that type of travel due to his insurance.

Cost to discharge Mr. X as requested:
$500.

Cost to Washington to keep Mr. X until he CAN get "approved" travel:
$2000.

Cost of "approved" travel available tomorrow:
$12 (payable by patient, not hospital).

Difference to keep patient an extra day to get his $12 travel:
Cost of $1500 to the hospital. (And extra food, laundry, and maybe an ER diversion or two...)

Cost of patient going AMA because he's so p*&sed off  over the administrative idiocy of the hospital and wants to get to his wife's birthday party:
PRICELESS

As that reporter says, "You the citizen, decide...was it worth it?"

Some hospital genius needs a good ol' dope slap...

There will be partying

My dear Bubba is having another birthday. I, of course, will be running around like crazy to make sure all the party tasks get done.

Dahey, however, will be relaxing and helping kids wreak havoc with all the balloons, crepe paper, and marching through the halls.

Should be an interesting time...stay tuned for updates.

'Tis the season part 2

Yes, it's the holiday season here at the Hotel, and no one is afraid to say "Merry Christmas", "Happy Hannukah," "Happy Kwanzaa," or "Festivus Maximus", 'cause we have people who say, "Damn it, I'm gonna say whatever I want and who's gonna stop me?"

"No, Mr. Old Marine," I say. "You've fought for your right to wish people merry in the jungles of Vietnam. I most certainly will not stop you from spreading the joy, sir! BTW here's another cookie." (as he covets the lovely plate I had in my hand from one of our volunteers.)

And when I'm not entertaining all the folks awaiting their rides and the volunteers singing Christmas carols in the lobby, I decided to go to the Madison Christmas party, which the bigwigs decided to hold in the psych dining room. What fun!

Thankfully, Nurse Bobby, our resource nurse of the day and I didn't get stuck listening to much of the new assistant director's "happy holidays, let's take care of patients and be excellent" speech. The cake and punch line was long, and everyone was all excited about the prizes. It's actually not a bad deal. Each employee's name is put in for a gift and our unit actually won some (usually the psych people always  win...lucky stiffs!) Bobby and I ended up carrying the loot back for our a few of our coworkers.

So what did they win, Pat. Let me tell you...you could tell we work at a hospital with caffeine deprived people. They had not one, not two, not three but six coffee pots as prizes. The dietitians obviously won't be doing a "Healthy Choices" seminar with the staff anytime soon, because they also gave  away three home-sized deep-fryers, one of which went to one of our unit's nurses.

More fun as the week goes on, with even more parties next week. I'd better get those scrubs out now just to be ready.

Stay tuned...

Good ol' PA

Ah, I thought that only floor nurses could be wildly passive aggressive. Little did I know that some of our office staff, supposedly "professionals" are just as bad (aka PAP).

You know it's going to be interesting when your new boss asks you how you liked the pool party after the conference, 'cause he/she saw the photos PAP took. Yes, yours truly did the air guitar contest with the rest of the rehab team from our network. We had a blast.

Sending photos to someone's boss unbeknownst to them, however, is a little odd. All I have to say is Karma's a b*tch, honey....just you wait!

Stay tuned.

Misspent youth, part 2

1. Aerodynamics tests off the roof at school.

2. Planes, trains and automobiles in college. My first plane ride, riding the trains of Europe, and a series of old clunkers before I was able to get a real job (read one that allows you to afford a car that is all one color!)

3. Partying it up dancing the night away in clubs, discos, and bars long gone by here, there and everywhere. And who can forget the electric slide..?

A little coincidence here...

A little bit there could be construed as a little more than coincidence.

What a wild weekend! I escaped from the Hotel, so it's been fun working on the final paper of the semester. The coincidence: when your instructor is also a film maker who made a movie about an area where more than a few of your patients are from. I only got to see the trailer, but it was eye-opening to see the remoteness of the area.

Bubba had a party and the kids had a good time playing soccer until the rain came. At least, no tornadoes came with it.

Who knows what the week will bring. Just hoping it's not a ton of admissions.

Stay tuned.

Things to do on your day off

1. Get kid a passport. Bubba can't go see Uncle Fester's neighbors in Canada if he doesn't have one. It doesn't take an Act of Congress, but you do need both parents, random identity documents and about 105 bucks.

2. See old friends. Giacomo needed an excuse to play hooky from work on a January thaw kind of day, so he stayed and had coffee with the crew today. Gave me some excellent pieces of advice. Also told lots of stories. Many good laughs were had by all.

3. Run around and do errands. I had to do a few things I don't normally do, so I got them done.

4. Prepare for the all-out monster party for Bubba, since we had to postpone the last one due to snow. I'm just glad he left the goodie bags alone...for the moment.

So long Skippy

It's hard to imagine that the party man Skip will never host another night of drinking and playing cards in his "club" (aka back bedroom). Skip's club wasn't just any bedroom, it was a remodeled extension put onto his house to accommodate him when he was first injured.

Once he was able to gut rehab his house and make it more accessible, it was remodelled, too, and became the place to go in the little community he lived in when the American Legion post down the street closed for the night. Everyone went to Skip's and continued to play cards, and of course, down a few beers at the bar, or play a few hands at one of the four card tables, and eat Mama Skip's meatball sandwiches from the kitchen.

Sadly, on the biggest party night of the year, Skip told his visiting nurse he wasn't feeling so hot, so please come over later. She did and Skip was found in his chair, with the phone lying beside him on the floor.  Since Skip was a long-time customer at the Hotel, a group of nurses carpooled over to the little town and to the funeral home. It was a sight to see.

In this part of RehabLand, flags fly every day from nearly every house:  American flags, flags for your branch of service (Marine standard for Skip), POW/MIA flags for the guys Skip couldn't bring back with him, and even flags with flowers and birds saying "Welcome." A dozen American flags and the Marine flag flew outside Little Town's Funeral Parlor. While it looked small, the inside was big and it was packed. It seemed as if everyone in town was there to comfort Skip's family: friends, neighbors, and all the veterans: the Marine League, the Amvets, the VFW guys, and of course, the American Legion post from Skip's neighborhood.

As we approached the casket, a cry went up that startled me. "They're here!" they shouted. "Oh, Skip would have loved it that all you nurses came to see him, " Mama Skip cried. Skip's kids grabbed us and hugged us. Some of our group had known Skip for many years. Skip's brother Bob (who was a double for Skip down to the laugh) took us and introduced us to all the neighbors and friends in the room.

"Here they are, folks. The best nurses in the world. Skip called them his angels."  

And now we call Skip one. Godspeed, friend...o bella, ciao!

Everyone knows everyone

Especially when you're from a smaller town.

Some examples (aka 6 degrees of separation):

J, one of our longtime RNs has a sick husband. We're chatting about him and I found out I worked with several docs in hubby's MD's practice. I even know some of their peculiar habits, like riding bicycles to work (one lives very close to the office).

One of our patients came from Saintarama to our rehab unit. People ask about him/her all the time, since patient comes in our place from time to time. (Hi, Zee! ) Patient visits them, but not as much (and the old coworkers are really jealous!)

Our boss is familiar with one of my docs. All I did was mention Dr. G's name and he diagnoses me. Nice. At least, I can keep a few things to myself. Besides, Dr. G. has known me forever. Dr. G. scared the bejeezus out of me recently when he/she asked, "Do you know what?" I was waiting for the "I'm retiring" speech. Thankfully, Dr. G. just told me I've been a patient more than half of my life.

Dr. G. forgot about seeing me in peds...must have just been doing research on those roaches or something.

Dahey had a party recently and invited all the geeks to our house. One has an MD relative, so I asked Dr. Specialist if he/she knew Dr. Miscellany. "Oh, I don't think Dr. Miscellany is (fill in specialty here)."

"Really?", I said, "I thought he/she was."

So what happens. Dr. Specialist's curiosity is piqued, and he/she heads to Google. "Well, I do know Dr. Miscellany was in xx practice. I know who trained him/her at xx university. He/she must be 60. Is your husband that old?" PA sitting next to Dr. Specialist is not amused (PA is 60+ and most of our patients enjoy his cameraderie).

Ahh, I love doctors! (tongue planted firmly in cheek)

Stay tuned...more excitement to come...

What's next? Beer?

Had a good chuckle over the latest, beverage-inspired political group:
Coffee Party, With a Taste for Civic Participation from www.nytimes.com

Nuggets for August 13

There were a whole lot of interesting items out there recently, so here are a few of them for your viewing pleasure.

You've got questions...

They've got answers, and no, it's not an electronics store. ConsultantLive had this great article on the ubiquitous purple urine bag. I've seen it a few times before (also blue) and asked questions about it, and never got a straight answer until I found this article. They also have a number of other articles of interest, so peruse at whim.

Crispy and brown

Feeling burnt out? Need to read something to get you going? Laura Wisniewski has this great article over at www.nursinglink.com called Re-Engage Your Passion for Nursing that has a few interesting points to ponder.

A telling anniversary

It's been ten years (yes, it was 1999) that the IOM published To Err Is Human: Building a Safer Health System.

There are still lots and lots of mistakes happening out there. The Houston Chronicle (a Hearst Newspaper) recently ran a series called Dead by Mistake on what the state of error reporting is in the US, and it's not so hot. Don't miss it.

Study, study, study

I'm still doing some certification study (yes, it seems like forever...) and I ran into some terms I didn't recognize, so I went searching and found some articles of interest.

Glossopharyngeal breathing is used with some ventilated SCI patients. This article explains what exactly it is and how it works.

Figure ground deficit is explained in this Google Book called Neurological Disabilities: Assessment and Treatment.

I always feel weak in my studies of the brain, so I found this article about a particular TBI patient very interesting as an aside. (from http://www.nytimes.com/)

Privacy (or lack thereof)

And you thought a prescription was private (from http://www.nytimes.com/)
I just shuddered reading this article...what will they think of next? I'm sure all you pharmacists out there have some stories like this.

And everything else about bloggers

It seems like life is very electronic these days...with good and bad results. Here are a few articles about various topics related to blogging I've seen lately. And, no, some things just don't need to be blogged or explained electronically, at least not in my little world, thankyouverymuch!

Mommy bloggers and ethical conflicts (from http://www.cnn.com/)

A no tweet, no blog party (from http://www.nytimes.com/)

Conference rules

Still here in big Southern city for the monster conference for one of our Hotel Rehab specialties. Still blogging from Starbucks, since I can get internet here for free.

Nevertheless, here are a few things I've learned this week.

1. Be creative.
When you hang out with a bunch of people who have fun doing their jobs despite budget cuts, crazy bosses and whacked-out administrators, you can learn some new tips that you can use on your job.

2. Be kind.
Number one can really shell-shock people. Being out of it, for even a short time, can be like visiting an oasis.

3. Do what the leader tells you.
Especially when you're having a blast at the party and she starts the conga line...who can resist?! Yes, June, I'm talking about you!

4. Budget your time.
Just like on the floor, you have to budget your time, but always have some wiggle room. You never know who's going to show up that you just may want to talk to or listen to for a while.

Oh, yes, there's all the administrative stuff--wear your badge, say hi a lot, and get to the buffet early, but that pales in comparison to those vaunted pearls of wisdom. Not the pearls you find because some PhD, MD or HIJKLMNOP person has said with a microphone.

No, the ones you discover sitting across from someone you don't know, or riding in an elevator with, who, when you've travelled miles and miles, actually lives within a short distance of you.

It really is a small world, and yes, politics is local, as the saying goes. I'm just looking around here and there for the opportunities that arise. Some of those impromptu moments are the best ones of all.

More to come...stay tuned!

Cookin'

Yes, literally and figuratively, I've been cooking and baking for Dahey's party today. He's celebrating his upcoming natal day with a gathering of his friends at the house. Thankfully, we have a place to put all of them while they're eating, drinking and being merry.

Work was hot, but not as bad as it has been. The spring is turning back into winter again as we get that old, crazy weather back again. One day, it's 80, the next, 30 with snow. I just make sure I have a coat handy to handle everything!

I've kept busy reading the charts again, since I'm prepping for a couple of exams. I've decided I'd better take the GRE since I need it for most grad schools. I'll be doing that in a couple of months and I've sunk my money into the exam, so now I'm stuck! Guess I'll really have to read those study guides!

My first certification exam will be the week following the GRE and hopefully, it will include another conference trip. After all that, I'm sure my head will explode in mid-air sometime around June 1. If all goes well, I'll round out the year by testing for the CRRN. This week I found out I'll be working on some stuff for the October annual conference, so that was really exciting.

Since I'm always nosing around to learn something new when I'm not pestering the specialists who visit us, here are a few things I've turned up recently.

One patient of ours had a nasty case of pyocystitis. Another we read about another who suffered a traumatic intraperitoneal rupture of the bladder (due to accident). This Google Book on Urology called the House Officer series, has a lot of interesting information on urological topics.

Finally, I got to look up some drugs. I'd say 90% of our people take similar stuff. Baclofen (or Lioresal) is pretty much the drug of choice on our unit for a variety of patients. I wish I had a $1 US for every Baclofen I've given since I became a nurse. (It hasn't been long, but boy, do we hand them out!) This week's excursions into the drug lists included Forteo (aka teriparatide, which is a drug used for osteoporosis) and prazosin, an anti-hypertensive.

Gotta go back to the party...stay tuned!

The party's over...

We survived, even though, the guest list was short again. The crazy weather drove away more than a few people. We did have fun, though. The cold has returned, as I found out when I got the paper today...no ice, yet.

The kids were a riot. Some of them just prefer boxes and bows to toys. You'd be surprised how long three boys were playing with some curling ribbon.

We cleaned up and were done by 2030 last night. We've all got colds now (guess Zicam didn't quite work...) so it wasn't too bad to turn in early. I washed my new scrub sets (came yesterday via mail) and tried to watch one of my new DVDs (I fell asleep before it finished).

More fun next week...from days to evenings again. It's always a trip doing that.