A little this, a little that

I've been escaped from the office and I've been busy. Dahey and I got Bubba from camp and took him on a road trip.

We're not the Griswolds, but we had a similar adventure on this trip. I inadvertently only read some reviews of the Hotel Hell we stayed at. I missed the good ones that said "Don't ever stay here."

It was really, really hot where we were. I packed lots of drinks in the truckster just in case.

The first clue we were in Hotel Hell was the neighborhood once we got off the highway ramp. It was sketchy. The lobby of HH looked decent, but I'm always a little concerned if they have doors to the outside, especially if the neighborhood is not so good. When you have to ring the doorbell to get into the lobby at night, it's not good.

Next, we got a non-smoking room with cigarette burns in the comforter. And if that wasn't enough, crumbs were on the floor (between the beds).

The room had a slightly musty odor and the air conditioning wasn't on. We turned it on, I inspected some more. There were no bedbugs or any other visible bugs and the in-room fridge looked new and was COLD. I got the extra strength Febreeze out and sprayed the room. I knew it would come in handy someday (have carried it, but never used it). I figured it would get better. It didn't.

All night we heard noise from the AC the room temp never went below 85 degrees. It was horrible. On top of that, there was a lot of noise from the parking lot. When that got quiet, the trains came by.

I probably slept about 4 hours all night. Needless to say, once the boys fell asleep, I booked another room in a nearby town for the second night. In the morning, I told the hotelier we were checking out.

We went off to see the sights and had fun. We even saw a movie while we waited for the check-in at the new hotel.

Our new hotel was an oasis. I checked everything then took a nice shower, so I could go out into the heat and sit at a baseball game.

It didn't matter. With more air conditioning and a clean room (and bathroom) I could tolerate anything.  Even a 110 degree heat index!

Now, it's back to staycation.  It's going to be fun.

Stay tuned!

The weekend is here!

I'm not complaining one bit. I've been productive so far today. I had a nice, restful sleep and I woke up to make my breakfast, then to get my coffee and take my car, the family truckster, for an oil change.

After that, I headed to get coffee again (because one really ISN'T enough) and visit my sister. We enjoyed her patio in the gorgeous, only slightly steamy weather.

Now I'm back at home doing laundry and assessing all the tasks I have to do before work Monday.

Again, it's not a bad option, doing chores. I could be stuck doing something completely different.

Hope you enjoy your weekend wherever you are!

Say amen, somebody!

It's Wednesday.

I made it through the RehabLand license office (to renew my license plates) in less than 15 minutes.

I survived the craziest day I've had in a while (thankfully, no one got sick, fell,  or pulled a fire alarm).

I completed my first webinar for my advisor. It was a success.

Yippee! Now it's time for bed.

Stay tuned!

So glad

Monday finally flew by at the Hotel. I went in early to check mail and messages, and my phone rang. One of our patients passed away over the weekend. It wasn't entirely unexpected, but that call really changed the tone of my day.

Mr. C. had a wonderful Christmas according to this relative. He even got to celebrate a major wedding anniversary. He saw family and friends and experienced the fun of the holidays with his immediate family around him. His grand kids all opened gifts at his house.

Ms. Relative thought he was getting a cold and was possibly getting sick. Mr. C. said, "No, I just need some sleep." Mr. C. went to sleep smiling, she said, because he had so much fun seeing his family. When she went to check on him later, he was gone.

Considering the wild, crazy last few years Mr. C. had, this was the best way for him to go: at home in his sleep.

I worked a lot with Mr. C. and his family in the last year, I'll miss him, too.

More later.

How to know you are sleep deprived

I had great plans for this Saturday early morning. I didn't make it.

Guess I needed  to sleep in more than I thought!

Happy weekend wherever you are!

As heard on the radio

A few months ago, I heard an advertisement on the radio for a drug study for a compound like this. I never realized the gravity of non 24 syndrome until I took care of a blind patient. Mrs. Z. was always tired in therapy when I worked at Saintarama. This drug came a few years too late for her.

Here at the Hotel, we are fortunate that we have a blind rehabilitation program next door. It's really amazing what they do.

The thing that stunned me when I read this most recent article was this: "...wholesale cost (per capsule) for this drug is $324." 

An enormous amount of money for folks who just want to be able to sleep at the right time.

Stay tuned!

Blowin' in the wind

Yes, it does seem like answers lately ARE doing that. It's been extremely windy here in RehabLand lately. From the "dirty fronts" to the Alberta Clipper, the winds are blowing.

The winds of change are also coming soon to RehabLand. We know it because it's leaking out of the management suite slowly, but surely. Our manglement finally GETS what I do in the SU, and they know realize how woefully executed my programs are (due to lack of cooperation from manglement, staff, etc.)

Some folks are even seeing cryptic messages in the media. They are slow on some things, but may be smart on others.

I'm having flashbacks to my other life before nursing. And some of them ain't pretty.

How to tell when change is in the wind (my $0.02)

1. Headquarters hires a new boss from outside who has a reputation for "cleaning house" in a Fortune 500 company. 

Some of our armchair pundits at the Hotel may have missed the hint when he/she said, "Some folks won't be with us on the journey." in that welcome e-mail.

Translation: If we can fire you, we will. If we can downsize/rightsize or RIF (reduction in force) you, we will.

2. Said head honcho gets permission to bring in a bunch of high-powered consultants with whom you can sit in a meeting (where you're supposed to be asked about your job) and they will grill you like your at Nuremberg. 

The grilling will have very little relevance in relation to you or your job or the reason why they (Manglement) asked you to come in the first place.

My favorite part: watching one of the old doctors (not a consultant, but an "expert") nod off during your session. The runner up was the grilling they gave the education chief. Best description: deer in the headlights. This was scary.

Translation: We're already paid for our time, so this is just a foregone conclusion, but we're trying to figure out how we can get more work "analyzing" your organization.

3. Head honcho publishes a "manifesto for change".

Believe it or not, the Hotel is in it. People like that at work because it makes them feel "safe".

Translation: You'd better believe the Hotel is going to change. Don't feel too comfortable just yet.

Should be interesting to see what happens...

State of the union

I missed the actual address because I've been busy with Bubba, the birthday boy, the last couple of days. No wonder I fell asleep early!

Stay tuned...

My patient gig is up...for now

Recently, I got to go on the other side of the fence. I had a sleep study in a sleep lab, after my two home studies looked funny.

I got basic prep over the phone, but I still had to call to make sure it was okay to take my meds in advance, etc. Preparing Dahey and Bubba was fun, too. They are always wanting instant communication when I am gone, so I had to let them know I was going to spend most of my time there sleeping. Translation: Don't call and send me a bunch of text messages. 

To keep the environment quiet, I had to turn off my cell phone and all my electronic devices since I was going to be wired up in bed. They budget 45 minutes to do this. My tech was great. I got wires on my head, which seemed to involve sandpaper, to make sure the electrodes and the goop got a good seal. I also got belts around my chest and waist. For good measure, I even had some leg electrodes with weights (kind of like those used when fishing). All the leg ones were attached with a good amount of goop and sealed with Medipore tape.

My room looked just like a hotel: heavenly bed type setup with a million pillows, flat screen TV and there was even a very nice leather recliner. Since I hadn't had any caffeine all day, I was ready to go to sleep when I got there.

Lights out were at 9PM for me. It took me about another hour to fall asleep. Then the fun started. My cannulas came off, not once, but twice. My room got hot, so the tech had to come in and cool it down. She warned me of this earlier, because if you sweat, the electrodes can come loose. (No way I was going to do this one twice!) Finally, the room got cooler (I think the duvet and the pillow top on the bed made me hot, but not sure.) I slept, but it was not quality sleep. I could hear trucks going down the road outside.

Miraculously, I woke up and it was nearly the wake up time we discussed when I started. I had to take all the wires in the bathroom with me, but when I got back, she took them all off. Relief!

The PhD who interprets the labs was in before I left, so I got a report. Yes, I have periods of apnea, but since none was severe enough for CPAP during the night, I probably won't get one. (My best sleep is on my side, so he recommended that). I just missed the score for a CPAP (barely). What does this mean? I will have to discuss with my doctor and see what he can wrangle with the insurance company.

As Dr. X, the pulmonologist told me, the PhD said he'd just put me on one, too. A borderline score shouldn't be an eliminator, but since insurance companies look at the almighty dollar, it is. CMS even has guidelines on this for Medicare. There are alternatives which I will have to check.

Now, I just have to wait until my next appointment to see what the verdict is.

There but for...

Yes, I thought the anatomy book that got to fifth grade was a big deal, until I saw this article recently about liquor chocolates going to school.

I was that super tired parent when Bubba was a young'un, because whenever he got sick, he was up and down all night. Not much changes, either. (His last bout of illness was proof that nothing has changed).

As the saying goes, there but for the grace of God go I...

More later.

A sign of the times

The weather here in RehabLand is cold, cloudy and rainy. The birds are still singing.

Great day to roll over and go back to sleep.

Enjoy your weekend wherever you are.

The perils of modern technology

This article on cnn was interesting, because it talks about a variety of ailments that never existed when my parents and grandparents were growing up.

I can almost hear those sage characters laughing when I read about...

Tablet neck and BlackBerry thumb 


Grandma L: (on tablet neck) Hunched over? Sit up straight! (on Blackberry thumb) It has a speakerphone? I need one of those. Who cares about typing? I never wanted to be a secretary anyway!

Grandma L. was a housewife who raised 7 kids and called everyone of them (including my mother) every morning. If she could have had a cell phone, she would have had one.

Earbud-induced hearing loss  

Grandpa K: (great-grandpa --GG--actually): GET THOSE  F**&^% out of your ears, you moron!

NOTE: GG was a foreman in a brewery back in the day. You had to yell for people to hear you on the production line. Another fun part of his job: wake up drunks who fell asleep. He was known for speaking his mind. Ahem...

Screen-related sleep disorder  

Grandpa L: Turn off the lights. They're not free.

Grandpa worked nights, and he was not a big light fan. He was retired by the time I was born, and while I don't remember him much, he spoiled me (and my sister) rotten according to reports.

Stiletto strain

My mother: This is why you carry a big purse (so you can stash a pair of flats).

I have lots of photos of my mother in high heels in her youth.

Offbeat biorhythms

Grandma R:  It's not good to eat after 6PM.

Grandma R was a tenacious survivor: married three times (first was a youthful romance gone bad, except for my dad) second was the love of her life (widowed) and third was a complete idiot (divorced after 3 years and infidelity on his part). 

She worked as a real estate agent and died when I was a little girl. I read a few of her letters my father had, and I admire all she had to deal with in life. I'm sure my tenacity comes from her German-Anglo-Irish background.

The lost shall (again) be found

One of the characters came back today. Sometimes his memory's not so good, but he knows he's been here before.

Just turns out the nursing home sent him with a new driver who was clueless. The driver tried to take him to Washington instead of to us at the Hotel. Once he got on campus, he tried to take Mr. T to the wrong building.

The driver gets out and asks about the clinic. Yes, I tell him, he's ours. Bring him in. Dopey driver brings him in, then I take him where he needs to go.

Mr. T. looks much different than the last time I saw him. He was on his own, drinking heavily (since some of his "nice" caregivers made sure to buy his booze), but now, he's sober. He's old, but he tells me, I know this place.

He was right. And when he got done from his appointment, I saw him in the building looking all pleased. The driver from the nursing home fell asleep waiting for him to be done with his appointment. He snored so loudly, he was providing entertainment for the passersby.

Good thing the sleep lab is in another building, or they would have stopped him to discuss his snoring.

Never a dull moment!

More later...

Time to wake the lion...

Er, kid, I mean.

It is daylight longer so Mr. Bubba thinks it's fine and dandy to stay up goofing off as long as possible, since "my homework is done, and it's not dark yet."

Now, we have to get up for school (I love being the drop off queen for the neighborhood). Agony.

Stay tuned. The drama of statewide standardized testing starts soon!

Terrible tornadoes

Are currently terrorizing the middle of the country, and a really scary story..a tornado hits a hospital in Joplin, MO.

So happy our tribe made it back in one piece, since there were storms aplenty on our way back home. Bubba was content assembling his new toy dinosaur (which has a million pieces) and a trip to Dahey's favorite sandwich place. He wolfed down his Italian sandwich like we hadn't fed him in days. This couch potato child swam and played for hours and he ate everything in sight.

He also slept soundly every single night, which was lovely. Can't wait until the tribe can hit the road again one of these days.

It was nice to be away, though. I, am back to reality: housework, computer work and work at the Hotel. I'll be praying for no tornadoes.

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.

In the news...

I found this article intriguing, and I'm sure a few other nurses out there might, too.
Gotta go? You may make the best decisions with a full bladder (from www.yahoo.com)

So does that mean most of my coworkers, when we're on a busy shift, should have tip-top decision skills? If only it were that easy...

Another fave (I love it when they count...)
Five secrets women shouldn't keep from their doctors (also www.yahoo.com)

And finally, because I just woke up from a nap and I can agree...
One in three adults sleep less than 7 hours a night 

Stay tuned...now I'm awake, you never know what's gonna happen! Enjoy your day wherever you are.

What happens when I'm off a weekend I should be working

1. Cooking. Steaks, tater, and I even tried a new Italian recipe. Oh, my! Sure I steered clear of the carbs, but with the heavenly scent of sage sauteed in brown butter, I could not resist the final product.

2. I worked on a project I've neglected for a long time for work. It has to be done by the end of the year. And now it will be. Much joy!

3. Finally, I've studied and studied some more. We don't have a test for another week, but I figure it can't hurt to prep a little earlier than usual. All-nighters were never my style, because I enjoy sleeping so much.

Which I also did and even took some naps...heaven!

Tomorrow, it's back to work, to the sister unit, to finish orientation. Before you know it, I'll be on my own.

Stay tuned...

The story of my day

I have always liked words. The dictionary was my friend as a kid. I always liked to look up obscure words so I could use them in my spelling sentences....when I had to do them (I got out of this homework frequently through some other endeavors...)

As I finally got a minute last shift to start documenting, I thought about what was really happening and a couple of words came to mind.

While I ran myself hither and yon the first four hours, I really wasn't idle (my first word), but I'd suspect some of the chitchat here and there was. As I'm running around, I don't mind speed chatting or bantering with the patients as I hang all of my patients IVs for the shift. My night--come in, run an IV, stop, flush, run another IV of Vancomycin, stop, flush, hold and run another IV, and so on, like a bad TV commercial. I can't get too in-depth.

Unfortunately, sometimes oncoming report is a little too idle. We have some nurses who will give you the new orders list (we write one as we take things off) and your report the same way every time and it's complete. A couple of our people are new and they still haven't learned how to give report, so they tend to engage in idle chatter and miss the big stuff. Like the blood cultures ordered three hours before end-of-shift that have to be done today or the 102 temp that the patient getting blood just spiked near the end of his transfusion, or the report on the patient who returned from acute. It wasn't a big deal for anyone else, but it was for me, since I was his nurse.

Eventually, the last four hours drifted into the idyll category. Our neighborhood isn't exactly pastoral, but sometimes, it is pretty, just before dark, and this night, it was exceptional. The sky was a pinkish-red that glowed as the sun set. I only noticed it because I had a minute to look out the window when I called my husband. It made me think of that old saying, "Red at night, sailor's delight." My patients, including the returning one, were quiet and happy. They got all their nightly pills and drifted off to sleep. The only thing that broke the idyll was a fever in another patient, which required an all-hands fire drill to get all the labs pulled before the oncoming shift came.

So we left our coworkers with an idle, idyllic moment of their own, with sleeping patients, as we walked out the door into the cool of midnight.

More later...

Nuggets for July 22

Yes, it's back on its regular day. It's gonna be a long post with all the interesting stuff out there, so sit back and enjoy yourself or read in bits if you're working.

I'm really enjoying the heck out of this vacation so in between housework, networking and shopping (the other important "work"), I've been surfing away. Please enjoy as you see fit in your neck of the woods.

The nursing shortage

It's incredible how there is a Dr. Jekyll/Mr. Hyde thing on reporting on the nursing employment. One minute it's dire, the next minute, wonderful, since all those nurses contemplating retirement are staying. I'm just going to chalk it up to American business and the "short term syndrome". Basically, if it's not a problem now, it won't be later, even if demographic trends suggest otherwise.

I'm also crossing my fingers that I don't break my hip in the next 10-20 years, since I'll have to be my own rehab nurse the way things are going.

ACP internist (MD) weighs in on this topic and the glut of nurses.
Kathy Quan (RN) presents the other side: shortage.

Health news of note

Here are a few stories I found very interesting in the health arena. Somebody needs to take me to Greece to complete the one study, though. A long, faraway vacation would be very nice, thank you!

Sex and sleep are just as important as antioxidants (from the 360 blog at www.cnn.com)
This study about people on a Greek island was pretty hopeful in the long-term view.

Want to know if your health habits are making you younger or older? Check out the Longevity Calculator.

Disclosure: I do take an extra vitamin and mineral, but I don't traditionally recommend these as treatments to my patients. This article called Docs and nurses use and recommend diet supplements from www.reuters.com was interesting because it discusses how most doctors and nurses had little education in supplement use.

From the NY Times

This article from the NY Times shows Vets' Mental Health Diagnoses Rising among Iraq and Afghanistan veterans.

Cases-Our Scars Tell the Stories of our Lives made me think about how I look at scars on my patients.


Etc.

Yes, they're released annually, and Madison didn't even make it in as an honorable mention, although some of our system hospitals did show up....way down the list. The US News and Report of America's Best Hospitals even has a couple not far away, if I do need one for specialty care.

Our friends in Canada put a great story in The Globe and Mail recently: Pop culture gives way to peep culture.

Fun!

And last, but not least, who's not going to have fun on vacation? Well, I surely am, and from the looks of some of these goodies, even people at work are having fun and entertaining others, wittingly or unwittingly.

Lost on the Floor just moved, but he is finding some fun in Chart Bloopers.

Braden and many of the ER nurses are always finding great patient complaints. Here's one of his latest patient reasons for visits to the ER at 20 out of 10.

Ahoy! Yes, I'm married to an escaped sailor, so I'm just going to have to order one of these nursey things for my locker, because somedays, I'd really like to raise the Jolly Roger when storming the poop deck on evenings.