Sometimes you have to go with your gut

New nurses: this one's for you.

We take care of a lot of people at the Hotel Rehab, and it's normal for us to see a variety of society strolling through the front doors. Sometimes we are given plenty of information to do our jobs accordingly. Other times, we aren't.

Since I work with all of the folks who complete rehab, as a specialty nurse, I have to understand how to use my assessment skills. When something seems strange, it usually is. Police come and go in the Hotel for a variety of reasons, and it's always for something.

I took care of one of our folks in the SU. Said patient did well in his/her rehab stay, and would seem like a good fit for our aftercare program that I manage. While I do chart reviews of all of the patients to determine eligibility, and this one passed all of my normal reviews, something still wasn't right.

Said patient was getting ready to discharge. Since he/she was not exactly confident about this program when I discussed it, I didn't worry about it. I do not push patients to participate, because it's voluntary. In one of our discharge planning meetings, another consulting staff member, who I greatly admire, voiced concerns over this patient's "legal issues." In rehab, this, too is not uncommon, as many people may be in rehab due to accidents and may be managed by legal or worker's comp case managers from outside.

When I looked at my credit monitoring service e-mail recently, I found out why Officer Friendly was pacing through the unit. It wasn't because we have staff parking scofflaws, it was because my SU patient was a registered sex offender. His/her pending litigation might end up in a prison sentence. This, consequently, disqualifies SU patient from my program.

So for all you new folks: what does this mean? This means you tailor your care to the specific patient, and remember, no matter what to be professional. This article mentions a number of things you can do to make this happen, as a floor nurse, and discusses things your risk manager may ask you.

In my decade of practice, I've seen nurses act like fools and discuss these patients  loudly and use computers visible at the nurses' station. My advice: don't do it. You will look stupid, and you may be disciplined. You should discuss this with your nurse manager in your area in a private location to make sure you ensure the safety of staff, visitors, as well as the patients on the unit.

Finally, all of those things you learned about therapeutic communication and ethics come to the forefront in these situations. Yes, you can take care of these folks and be honest and direct. I often tell students this is why you don't overshare in ways that may make your patients uncomfortable or create other issues. Seek help from other team members, such as psychology and your chaplains, so you can make your care plan appropriate for your patient.

Holiday weekend thoughts

"The more we assign the soldiering to a select few volunteers—we don’t have an equalizing draft and there is no required national service—perhaps the easier it is to forget what it means to share a common citizenship or feel a sense of indebtedness or appreciation. If we no longer share in the service, risk and obligation, maybe that explains why many of us no longer observe Memorial Day."

This is a quote from John Bussey's worthwhile assessment on why Memorial Day needs to be more than a day off or shopping.

I do believe that we are living in troubled times, and unfortunately, the sacrifices aren't shared.

I hope you have time to reflect this holiday weekend. I know I will.

More later...

Falling in rehab

Falling is really not a good thing in rehab, whether it is patients or staff falling.

Equipment falling in other parts of the hospital are equally unwanted and sometimes deadly.

More later...

Like risky sports?

Just another reason why I won't be taking up bungee jumping anytime soon.

https://www.nytimes.com/aponline/2012/01/08/world/asia/AP-AS-Australia-Zimbabwe-Broken-Bungee.html

Another...

I can hardly believe that another of my old coworkers from Saintarama has been diagnosed with cancer.

I never thought rehab was a dangerous specialty, but I'm wondering what might be causing this. So many epidemiological factors, so many people aging, so much time.

Whew...crossing fingers and hoping this ends soon. Too many people lately are getting lives stalled and retirements shortened.

Nuggets for March 26

Here are a few items of interest that I've read recently. Hope you find them useful!

If you haven't heard it already, your risk of cancer goes up if you work the night shift. (from cnn.com)

Are you getting ready for spring by dropping a few pounds? Here's a great list of cost-effective ways to do it from the Mayo Clinic's Low Cost Ways to Shape Up.

I had to chuckle when I read this one last week. It's not from a health publication, but it is entertaining: Old age begins at 27. (from the UK's Daily Mail)

There's been a lot of stuff in the news the last few months about new artificial sweeteners, particularly stevia (aka Truvia). However, just recently CNN did a story on miracle fruit, which alters your taste buds. It may sound like a marketing ploy, but there's some interesting research going on with cancer patients undergoing chemo. It seems, for some, that this little berry, helps food taste better while they're receiving treatment.

Breathing is a really good thing. If you can control your breathing effectively, you can reduce your blood pressure, especially with gadgets like these. It sounds crazy, but it looks like it can work with some people.

Finally, an article I truly enjoy: Caffeine: A legal performance enhancer (from www.nytimes.com). I'm not going to run a marathon, but boy, does coffee help my marathon at work!