Little things

Lately, little things mean a lot, or little things can get on my nerves. I'm working hard to let the latter ones go.

Bubba waits for making decisions and it drives me crazy. I almost had a heart attack over him changing his mind about a field trip. I forgot important stuff and had to come back home before I could go to work. A little stop and check would have solved everything.

Some people get on my nerves at work. It might be their attitudes or habits or anything. I just think sometimes, it gets magnified. I am singing that song "Let it go" in my head a lot lately. I can't fix them, so I have to let it go. I'll let them fall on their faces first, because no matter what, they are right. Once they get scraped up, they'll get it.

It's time to live for the good little things, not the bad. Savor the good and let the bad ones go.

Things not to do as a nurse

Yes, I got my quarterly newsletter from RehabLand Board of Nursing, and yes, they do have a fine list of things not to do if you want to keep your license to practice.

Some of them were (are) frankly pretty scary, and I only wonder how long they went on before they were reported.

 1. Patient in wheelchair wants to go to bed (common Hotel scenario) and comes to nurses station.

Normal nurse: talks to the patient and then assists the patient to bed.
Our nurse: pushes patient forcibly out of the nurses' station and give a Haldol shot where the needle gets stuck in the patient. License suspended.

2. Nurse gets a tax return and 'forgets' to pay the state taxes.

Normal nurse: gets the taxes paid.
Our nurse: doesn't bother, so license is suspended.

3. Nurse is asked yes or no questions re: felony history.

Normal nurse: knows better than to do that. Nurses are one of the most trusted health professionals for a reason.
Our nurse: just fibs, gets found out, and gets license suspended

4. Nurse takes patient into a video monitored room in ER and examines his "groin pain"

Normal nurse: takes information and completes assessment.
Our nurse: fondles, kisses the patient, compliments his eyes and shares personal details. After this performance, our nurse is put on probation for two years.

And finally, for another technology related story:

5. Nurse remotely monitors patients as part of his/her job.

Normal nurse: does work, makes phone calls to patients, providers and case managers.
Our nurse: doesn't do any of those things for over a month and fabricates documentation,and gets license suspended.

Every little bit

 Not all of us can do great things. But we can do small things with great love.― Mother Teresa

I came across this blog last year when I read about it on BBC. One woman talks about raising her child as a single parent and subsisting on very little.

Now she's been blogging over a year, and talks about doing little things to make life better for others.

Important thing to ponder...

Don't let the door hit you on the way out...

Quote from one of our docs who's leaving to 1) go to greener pastures or 2) is having a late mid-life crisis.

When I asked him/her if Mr. Z. one of our patients who saw a specialist could get an order printed for his nursing home printed out, he said,


"Oh, I don't believe in using that stuff like Dr. S. I think it's hocus pocus, so I'm not going to write that order for the nursing home."

Said doc is patient's primary care provider at the Hotel, but I don't think he/she gets the EBP part.

Good riddance.

A few of my favorite things

1. Fresh garlic sauteeing in butter.
2. Nice long soak in tub with a good book and a good drink.
3. Escaping work (finally) and passing on the rest of my admission duties to the next shift. Patient didn't show up until the very last minute.

More to come...stay tuned.

Can I just have one more thing?

One more thing to give me a headache
My sick brother repeating over and over and over that he wants to come home every time I go visit.  I need a Tylenol stat, please, with a coffee chaser!

One more thing to make my feet hurt
Dodging wheelchairs and dodging the wheel that fell off a guy's wheelchair as I was walking out the door today. We got it back on (with some assistance from two bystanders). Oh, "that's where that screw came from!" Mr. X assured me that the screw would be put in at home, since he knew exactly where it was.

One more thing that makes me go "Hmm..."
Why, oh why, do the docs tell Patient X, he/she can be up "as tolerated" and never bother to write the order? I document it over and over and over again, in my notes, of course, but my colleagues on other shifts don't really believe it if they don't see an order. And the way some of our docs act some days, it doesn't surprise me.

One more office visit for Bubba's strep throat...
And I will have spent over $100 for treatment and visits. Now if they made the kids' copay like last year, the antibiotic would have been the most expensive thing lately. Nothing like cost sharing. Note to self: save more in flexible spending account next year!

One more this...
And one more that. I'm not a big lemon fan, but these are the bomb as J. one of our nurses says. The ginger ones aren't bad, either.

And finally, one more that...
A nice cool glass of limeade, and I'm off to bed.

Stay tuned. Something's always happening around the Hotel...

Some things you just can't forget...

1. Seeing a patient for the first time and how sick they look when they come to you for rehab.

2. Seeing that same patient after discharge and they look so alive they glow.

3. Nurse Practictioner's Place talks about those two dirty words that are unforgettable.

A few handy things for a new rehab nurse

Since I just realized that I'm closing in on one year as a nurse, I thought I'd share a few things for the students about to graduate who may be heading into rehab as their specialty. Your mileage may vary, but never fear...there's always room for innovation out there. Keep your eyes open!

1. Good shoes and socks.

You may have discovered this in nursing school, but if you have not, seek and find until you discover your favorite pair, and once you do, buy two pairs. Your back and your legs and the rest of your body will thank you.

I am also a disciple of Compression Socks. Some of you may think they're crazy, but I love them, since my feet feel great when I'm done with my shift. Besides, it's another way to educate your patients on wearing their TED hose. My favorite quote, "See, Bob (insert your patient name here), I've got mine on. Let's get yours ready to go."

2. Be prepared.

Just like they say in the Boy Scouts and Girl Scouts, it's good to be prepared. Especially when you have the patient in isolation who wants to be suctioned multiple times on your shift. I always try to keep a mental list of what my patients have in the room, so I can keep it stocked. It can get crazy, but you can do it. If your patients go to therapy, restock them while they're gone. If not, try to restock whenever you can. That extra minute of stocking can save you five when you're in a hurry.

3. Pillow cases work wonders in many situations.

This is a corollary of #2. I have used pillow cases as bibs, quick towels and as the occasional non-plastic Depend backup for a quad who had dig stim every morning but wanted a little more security when he went to therapy. They are also wonderful for use on the sliding boards (keeps the butt sliding to the commode, if you get my drift.)

4. Look, listen and learn from your peers.

Sure, you just got out of school (nursing program name here) and know lots of facts and figures, but on the floor is where the rubber hits the road. Hang back and watch first, then do. Pay attention and you will see who is doing things the RIGHT way (i.e. correctly following policy and procedure), and who is not. The older nurses on the floor may not do everything the way you think (or policy says) they should, but you can learn something from everyone. I would have never learned a better way to put a Foley in females had I not watched K. the pseudocharge at Saintarama. She was 99% on the first try with her Foleys on the floor and after watching a few times I noted some of her techniques--less lube and shorter grip.

5. The patient is the star of the show.

Yes, you'll have lots of competition in this category, especially doctors and other people demanding your time, but keep in mind that the patients on your assignment are your top priority.

When you get your assignment, they are yours until you hand them off at the end of the shift. Take care of them and give them your undivided attention while you are with them. Let them know if deviations may cause you to leave the room while you are working with them if this is feasible. Make each one feel like a million bucks whenever you can...even if you don't want to or feel horrible. That person in the room is someone's special someone, so make them feel that way when you are around, too.

6. Stay positive.

Yes, you may get into work and the sky may seem to be falling. Keep reminding yourself that you will have a good day, and you will get through whatever trouble may be cropping up here and there. You survived nursing school and have the license and skills to prove it. Use them, especially those coping skills. Just as animals sense fear, patients can pick up on crabby nurses pretty darned quickly. You'll make your patients feel better (and yourself) if you can model calm and collected behavior on the outside, even if you don't really feel too calm and collected inside!