Monday on Tuesday

Yes, the day after a holiday sucks on so many levels. People who can't take it (or imbibed too much) take off.

Otherwise, it seems like any other Tuesday. Except today didn't seem like a day after a holiday or Tuesday. Today, after our regular weekly meeting, (which was blissfully short) had a terrible pall.

One of my favorite interdisciplinary team members, C. is dying. Dying as we had our meeting, and were talking about our current crop of rehab patients. It reminded me of one other time where I went into report and the boss told us, "As we speak Mr. Warhero is dying." He was right: Warhero died that night. To me, how small and insignificant the meeting seemed today.

I finally left the meeting (after our chaplain prayed for him/her) and it got a little better. I buried myself in a project or two. As a result, I had to look at the way things have been going over the past few years. Thankfully, they are getting better.  C. helped us to get where we are. C. helped inspire other folks in his/her discipline to do the same.  We are not where I want us to be for our little group in the Hotel Rehab (I thought we'd be there three years ago...) but we are closer.

I was sad for so many things when C. retired last year, due to health reasons. Sad that I could no longer go down the hall and see him/her. Sad that we'd never get to work together and get your rehab program where it rightly belonged. Sad that I knew this day would eventually come.

'Twas a pity it came so soon. Godspeed you on your journey, C, and may the angels greet you and lead you to paradise. You've earned it.

RehabRN book club: The TGIF edition

Yes, dear readers, it's been a while. Books just take forever anymore, especially when I spend an inordinate amount of time with my new baby computer, trying to get everything where I want it. Online backups are wonderful, yet slow.

However, I must say, I've found some good stuff to read. As I may have mentioned earlier, Brief by Joseph McCormack is a keeper. If you're a fan of the Elements of Style, it's more concept than rule. It really does give practical advice. I'll be buying one (since I got threats from the library if I didn't return it).

My most recent finish (on Wednesday) was Presence by Amy Cuddy. To me, there's a lot to like in this book. As a rehab nurse, you'll be cheering for Amy because she's a rehab patient who's made it (she had a DAI for all of you who are interested.) As an escaped business person, she went to work at Harvard Business School and changed up a lot of things with her research. Overall, Amy's book is stories of how presence changes things (see her TED talk for the rest of the story).

Trust me, I'll be posing it up before my next set of meetings. Why not?

Have a great weekend! Enjoy every minute.

Paint a picture

Some things aren't really believable until someone actually sees them. I heard this story recently and had to share because it is both hysterically funny and horrible on a professional level.

Our wound RN Dee rounds on patients at the Hotel in our hospital system, wherever they are. Her counterpart at Washington got a consult from a resident for a "new pressure ulcer", and said "You have to take it." Since she's conscientious, and likes the patient, she drives  up to Washington from the Hotel that day (since pressure ulcers require immediate intervention assessments: mattress, etc.) Mr. I is sick and no one knows if he'll make it.

She gets to the ICU Mr. I  is in and the nurses tell her, "I can't believe he came from there (meaning Hotel) with a new pressure ulcer." Dee is stunned, because Mr. I looked fine just before she left for a couple days off.

Dee visits with Mr. I. He knows she's there and shakes his head. She rolls him over to look at the "pressure ulcer". Mr. I. really needed a washcloth. Once she got one, she realized that he did not have a pressure ulcer, he had a rectal discharge from his colostomy.

Apparently, the resident and none of the nurses realized this was what happened. This consult, time, money, and energy could have been spared by a single washcloth.

Somehow, I really don't think that kind of picture is what's going to get us on the Magnet journey at the Hotel.

More later.

Stress relief

As many articles mention, stress can kill you. It can also have some nasty side effects, like weight gain, and depression.

What I've found lately are two things that help me deal with stress. One is quiet time. I have to have time to be quiet and reflect. It doesn't have to be a lot of time, I just need time. Most often, it's right before I go to sleep at night or if things get crazy at work, I just take five minutes to myself.  Sometimes I have to hide to get those five minutes, but I know that if I have them, I will be able to keep myself on track.

I've also been exercising. The scale's not moving (probably because I've indulged) but I'm finally getting some definition back in my arms, legs and even abdominal area. I'm not lifting heavy weights, but I'm consistently exercising and doing strength training with cardiovascular exercise.

My favorite exercise class right now is cardio kickboxing. I believe it's a double duty exercise because it's a great way to relieve stress. All those stupid things people might say to me--BAM! The dirty looks--BAM! I box and kick it away.

So as my favorite t-shirt says, "Don't let the turkeys get you down." Reduce stress in your favorite, most constructive way, and take care of you.

You deserve it, and so does your family, friends, and even your irascible coworkers.

More later...

It's Tuesday

However, for some folks, it's Friday. Forever. One of our retirees came in for the last time and left today. Sadness.

Tuesday for me means patient appointments (if someone doesn't cancel them at the last minute) and meetings. Fun meetings where people who insist that it start at one time (0800) casually stroll in at 0815 and throw off the folks who have to come in at 0830 from another site for a short report.

Our coordinator called some of them on it. I don't really think it will stick or embarrass anyone enough to show up on time. It's the Hotel way, and they (the Hotel "team") aren't going to change for anyone. Even if it is terribly inconvenient and they are the first people who think the meeting is going too slowly.

I'm all for locking the doors and deducting the time from their pay, but unfortunately, management doesn't feel the same. We should ALL suffer together.

Just another reason why I hate team building exercises. A few divas always screw it up.

The gift horse (aka "I ain't got time...}

Heard at the Hotel (or relayed by stunned observers).

1. When our nurse manager (who now does quality review) asked one nurse about his/her documentation and lack of a shift assessment, the answer was "I don't have time for that".

Really? So what is it we hire an RN for...assessment skills? Maybe you need to take one of our open CNA positions.

2. One nurse got a chance (was selected) by the Hotel to go all-expenses paid to a national conference because he/she has gone for years on his/her own dime. The catch: since we have a new chief nurse at our location, she told him/her that he/she would have to do a presentation to the unit staff when he/she returns.

After lots of paperwork, discussion, permission from umpteen people (because  you can't just GO to a conference anymore at the Hotel....) he/she comes to my office and says, "Oh, I'm going to call and let them know that I'm going to go on my own. I don't have time to do a presentation."

3.  One (actually several) of our professional staff notes that patients request information, etc., via  e-mail or text message. This is even in their notes.

Will he/she/they even contemplate using the Hotel's patient portal, with secure e-mail included (it even writes your notes for you)?

Nope. It requires one training class (about 30 minutes) and you have to teach your patients (most of whom already use the portal) to contact you that way.

I just wonder what everyone is doing with all that extra time...

Monday, Monday

Oh, the joys of Monday.

First, Bubba is in such a rush that he forgets to take his medicine. I run back home, get it, administer and go to work.

Next, I go to work and my computer has some weird error message on the screen. I turn it off, then it won't go back on. Finally, after an hour of futzing around, it comes back on (after I unplug and replug every single cord under my desk.)

Maybe it just got too hot in the office over the weekend. (I love all the fancy thermostats in our office, which assume that it can go up to 90 degrees when I go home.

I surprisingly got a lot of work done on my big project, but now I have a new nurse shadow.

So much for finishing that tomorrow! Only time will tell...stay tuned.

How to perturb your coworkers, inaugural edition

Yes, this list will get long I'm certain, but here are a few things to make people really contemplate revenge.

1. Don't want to come into work? Call in tired. As in, "I'm just too tired to come in."
 NOTE: this is not a nurse who worked a double, but a cough, cough, provider who can't handle an eight hour work day...or children...or life.

Why no one's called the EAP for said MD is beyond me.

2. Wait for someone to leave, become the charge nurse, then reassign all the patients to the nurse with the least seniority. Can you say a$$H0l3? Why? Because said charge nurse can. (Thank goodness he/she will NEVER be my boss!)


3. Just be a general smarta$$. Don't have time for that! 

I think of arm wrestling

Or a juxtaposition of life where you wonder about things. For entertainment purposes, I checked out some interesting books at the library. The latest one: You are a badass: How to stop doubting your greatness and start living an awesome life.

Yes, this is indeed a book title. I didn't make it up.

When I read this opinion piece in the New York Times recently, it struck me for a few reasons. One, it's written by a doctor. Two, it's written by a young doctor with cancer. Three, it reminds me of a character at the Hotel struggling with his own diagnosis.

We can't give him time. We can only tell him that if he gets treated, he will most likely be cured. If he delays, he jeopardizes that chance of living until his grandchildren graduate from school.

He's cheated death a few times, so maybe he's jaded. Or maybe he'd just believe us if we could give him a number.

We can't.

So he's just going, as Becket says, to keep not going, and going along.

If it's Sunday...

Here in RehabLand, it's time for Sunday Stealing. This week's meme is about time (and will cause you another earworm, if you're not careful).

Here are my responses, which I would have posted earlier, but hey, with that extra hour, I've already gotten lots of work done. It will get dark soon enough, so I'll be turning in early for all the excitement as the week starts tomorrow.

Enjoy! ============================================================================================================================== 1) Do you think Daylight Saving Time is still necessary? 
To sell lightbulb and batteries, yes. For me personally, no. I just like it to be light in the morning, which will last for a bit, so...not really.

2) How long does it take you to adjust to the time change? 
Not long on fall back. That spring forward messes me up.

3) What's the hardest part of the time change? 
None.

4) How many clocks are in your house? 
Too many. I'm really enjoying the auto-set ones.

5) Are you generally early, late, or on time? 
I hate being late, so I am most often early or on time.

6) If an invitation to an event listed the time as 8-11pm, what time would you arrive? 
By 8, and be gone by 11.

7) Do you wear a watch? 
Yes, every day.

8) Have you ever glanced at the time and had to glance again because you didn't pay attention the first time? 
Of course!

9) Are most of your clocks digital or dial? 
Mixed.

10) What does your alarm clock sound like? 
A foghorn. It's ancient, but the new ones are too nice, and I sleep right through them.

11) Do you use the snooze feature on your alarm clock? 
No. I purposely put the alarm far enough away that I have to get up to turn it off.

12) Does clock ticking drive you nuts? 
Yes, this is why I don't have a clock in the room I work in (SU). If it's quiet (after all the patients are going while I'm charting) and it ticks, it drives me crazy.

Adieu to one of the best

Kim from Emergiblog has hung up the closing sign.

Thanks Kim for giving us some of the best of the nursing blogosphere posts and for bringing Change of Shift to life.

Best wishes on your next adventures in RL!

Is he really that old?

Duh, the most important thing this weekend...

Bubba is 10. I can hardly believe it. He changed my life (and Dahey's and WildDog's...). Bubba is an ebullient character who says things like, "What is going to be OUR commuting vehicle?" when we bought a new car.  He loves music (like his dad) and has a horrible sweet tooth (just like me).

I look at him and see bits and pieces of both of us, with shades of my late father-in-law, the stubborn, yet likable internist.

Time surely flies! I'm going to enjoy every minute.

So, so glad

It's Election Day, a day we should thank our lucky stars that many veterans have fought and died for us to stand in line and vote for what we believe will make our lives better.

I'm also so happy that the robocalls will finally stop. It's so sweet when a call comes over and says "Political call" on the caller ID.

Quiet at dinner time? I can only hope...stay tuned!

Sunday vegetating

The time you enjoy wasting is not wasted time.~ Bertrand Russell

Sometimes I just have to remember Bubba is growing up. He makes me laugh so much. He really is becoming a tween before my very eyes.

We plan on having lots of fun jumping in piles of leaves and doing nothing today with Dahey.

I need a little break after a marathon conference call  with my classmates yesterday.

Stay tuned...

I'm just wondering...

If the big boss is getting nervous about a project I have to do with him in three weeks. He/she acts as if I should take a different flight.

Hello, this is not the Royal Family. The world will go on if something happens to either one of us. The Hotel, despite all its construction, reconstruction and clogged toilets will go on.

My departing direct manager has two weeks before he/she leaves for the assigned new position. Will he/she get me the award I've been waiting for since last year for my special project when others on that team have already gotten theirs? I don't know, but I know one thing...he/she may get a rude awakening in the new job, if I don't get the time and consideration before he/she leaves.

Just sayin'...

How do you do it...

People ask me all the time how I survive as a wife, mother and generally busy person.

1. I fake it. I can't do everything and if you look under the beds in my house, you'll be able to tell that. I do my best and go from there. I vacuum as I see it in small increments. Some vacuuming is better than none!

2. I have to take time for myself. Sitting here in front of ye olde computer is me time. Yes, and I'm being nice and sharing it all with you, too.

3. I go out to eat occasionally. We shoot for cheap places and get fast food once a week as a treat for Bubba. My secret: I'm still eating the kids' meals. Lower calories AND you get a free toy. Not that anyone needs anymore toys, but they come in handy on occasion. I enjoy the food, but the weight gain...not really. This satisfies multiple needs (outside of chocolate).

4. I work ahead on whatever I can. Iron my work clothes and arrange them on a rack to pull off and wear for a month? Yep. Cook in my Crock Pot? All the time.

5. Finally, I drink coffee, especially the good stuff. If I'm going to be caffeinated to do all this stuff, I'm going to drink something that tastes good.

More to come...stay tuned.

Dear Preceptee

It's hard to believe the time you've spent with me on the unit is now drawing to a close, and you're a brand new RN going to work on your very first unit full-time. I'm so glad our neighbors in the building next door gave you the job.

Just remember a few things, as my parting gift to you:

1. Breathe. Yes, we count the respirations on our patients and sometimes we need to count our own. When things get tough, inhale AND exhale. Your brain needs that oxygen to think.

2. Keep learning. Even if they call you a geek, even if it's time-consuming, soak up new material like a sponge. You never know when the things you've learned before will come up again.

3. Know your own burnout level. Think of fun things to do away from work and family. You need to recharge the batteries once in a while to get optimum performance. If you can't get your own ideas to work, seek out other ones (people and ideas). Help is a very handy four letter word.

4. Believe in the mission. Our mission isn't the marketing one: it's real. You have a warm smile and great way of conveying it. Our patients can really relate to you. Carry that song in your heart, when the cynics want to turn up the din of distraction. (Trust me...you'll start hearing it much too soon!)

And if you're ever wandering across the parking lot in search of stuff for your folks, come by and say hi. The door is always open.

Your preceptor, 
RehabRN

Charge it, baby!

I just love being in charge...the authority, the paperwork, the personal interaction with families and staff.

Now if it really were as great as this, I'd have more time to post, wouldn't I?

Stay tuned for more excitement....