The next two weeks...

Will either kill me or make me stronger. I'm hoping for the latter. Can't wait to actually ENJOY the holiday season once grad school is over for the semester.

May pop in and out from time to time, but will have to set aside the stories for a bit later. So, so many here in the SU.

Now, I'm writing papers and flying a desk and chilling to these sounds...ahh!



Stay tuned...

I had to do it...

I broke down and bought a clipboard, so I could keep my paperwork arranged when seeing patients.
Guess you can call my a clipboard nurse now.

At least, I'll never lose my pens and paper again!

A beautiful mind

I'm using my knowledge of neuroanatomy and learning more every day I'm on the Sister Unit. Consequently, I thought the photos in this latest book were absolutely fascinating.

Off to work I go...more to come.

RIP Leslie Nielsen

Lt. Frank Drebin (from the Naked Gun 2 1/2: The Smell of Fear)
Go ahead, threaten me like you have the American people for so long! You're part of a dying breed, Hapsburg, like people who can name all fifty states! The truth hurts, doesn't it, Hapsburg? Oh sure, maybe not as much as landing on a bicycle with the seat missing, but it hurts!

Oh, it was a crazy sort of day today. Frank Drebin, we could have used your logic to figure out why our unit had no electric all day when our neighboring unit across the way had lights for all those meetings I could see from the window.

And finally...
Lt. Frank Drebin:  Looks like the cows have come home to roost. 

More to come...stay tuned.

A sweet tribute

I love Cake Wrecks. As an amateur cook/baker/decorator, this is one of my favorite sites out there.

So I really enjoyed the latest version of Sunday Sweets, where they feature really cool cakes. Check out this week's version dedicated to police, fire, ambulance AND medical personnel, including nurses.

Hope you do too! More later...

Burnin' down the house

I wasn't just thinking of this song...I had a rack of spare ribs browning in the oven, when a little too much grease met a little extra broil power. Kitchen fires are just not my thing.



Thankfully, everything survived intact. The smoke alarm didn't even go off. Boy, it sure made my safety director Dahey jump, though.

Santa Claus is comin' to town...

And Bubba will be seeing him at a local charity Breakfast with Santa. Hopefully, he has a good time, and all of Santa's beard stays on this year.

Stay tuned...

The kindness of strangers

Yes, I was enjoying my day off shopping on this Black Friday. We shopped early, but enjoyed the lull between the early shopping crazies and the lunchtime shoppers. Bubba had a blast.

When we rested for a short time, I set down my purse. I didn't even notice it until later in the day when I went to look for my cell phone, which also happened to be the most valuable thing in there. (I keep my wallet and keys on me at all times). I started calling around to the stores I was in, to no avail.

Later, I went back to the stores tracing my path. Lo and behold, I found the purse at the bookstore. The lady told me someone found it in the back. I had been trying to call the phone four or five times before I got it back.

"Honey, it's been so loud in here, we never noticed."

Profuse thanks to the bookstore staff. We frequent the store often and will continue. You are all the best.

Happy Thanksgiving

Greetings!

I am so thankful to be off today. Please do not forget the coworkers, friends, and neighbors who may also be working today, especially your favorite nursing staff.

I will be raising my glass at high noon to all of you and hoping you all get out early or on time. Cheers!

I'm not coming back!

That is, until Monday. Oh, the joy I will have, until, of course, I have to submit the class paper that's due on Monday, very early since I have to work.

I was busy, busy  all day and the special lunch we were going to have was canceled, so I just started the Christmas spirit by dressing one of the department skeletons in holiday attire. It's all been approved by the director, and since one skeleton is in his office, thereby sanctioned, and can be easily hidden in a large closet should the PC police come around.

Our patients showed up for the most part and I got to do my first random drug screen. It was interesting to say the least. I was happy that I was not required to accompany the patient, nor was I required to find someone to accompany the patient.

Finally, I got to see a lot of patients rolling around on the sister unit going to therapy and getting lost. It was a lot of fun. More than one of them told me they miss me there.

Happy Thanksgiving all! Off I go to cook and prep!

Stop, drop and roll

Stop

I did not want to jump down the unit secretary's throat today; although I thought about it. I calmly took breaths every time I felt the urge to strangle her. It helped. We made some headway. I am so happy.

Drop

You know the doc you're working with loves the new sterile gloves so much that he's dropping things, just so he can change them.


Roll

Out with one piece of equipment, in with another, and so it goes all day long. At least, I get my workout moving furniture! Patients in and patients out and we did really well today. What a team.

More to come...stay tuned.

Yes, it is Monday

Yes, it is a short week. How  is it that people who just had a short week last week don't want to work this week?

I just don't get it.  I'm going to go soak...Calgon take me away!

Truly lucky me

 Let us remember that, as much has been given us, much will be expected from us, and that true homage comes from the heart as well as from the lips, and shows itself in deeds.  ~Theodore Roosevelt

One of my friends pointed out that nearby big city made it to this list: Worst Cities for Finding a Job.It's just one big reason I am thankful this Thanksgiving.  Another is that I am actually going to meet one of my classmates this semester and potentially another when both are nearby for the holidays and business. Taking online classes is fun, but I do miss meeting your classmates in person. Hope all of you out there have plenty of blessings and things to be thankful for this year.

I'm also reminded of the sign one of my supervisors used to have on her desk: Be thankful for the things you didn't want, and didn't get.

Stay tuned....

Countdown to T-day

Since I'm not working this year, I'm getting the battle plans set for Thursday. This means an assault on the home and checking all the cabinets, etc. to purge old items and get ready for the new onslaught of foodmania.

Wish me luck...at least the refrigerator's clean!

Stay tuned.

Very much joy

The Evil Accrediting Agency is gone, and to tell the truth, they weren't really evil. They were actually nice. Our surveyor actually gave us a stellar report, and I got to hear it all in the exit meeting. It was just too cool!

Our surveyor liked us so much he/she actually mentioned us by individual name from his/her notes, which really made the big boss puff up like a proud papa. Thankfully, as a result, he is giving us a get out one hour early card anytime before the end of the year, which is really nice. I was hoping for a raise for getting in the cross-hairs again of  the surveyors (i.e. being the chosen person for both JC and EAA), but alas, I'll take an hour here or there, especially to do some holiday shopping.

Black Friday is coming...so I can get out there in the mix and shop away for an extra hour. I'm still on cloud 9 after all the prep to get here, and my celebratory champagne is going to my head. More later...

EAA part one

Yes, the Evil Accrediting Agency came today, and thankfully, they send a relatively congenial inspector. He/she was observant and noticed only one detail out of place (relatively minor).Despite this, he/she kept telling us things looked good and the area has a bright future at Madison.

Yours truly got to escort the inspector and the intern with him/her to a special lunch on the unit the volunteers have on a regular basis. Inspector was impressed. We were, too. Lots of Thanksgiving food was out and everyone was having a good time.

Happily, the afternoon meetings passed quickly. I'm hoping things go well tomorrow on the final day 
of assessment.

Stay tuned...

A shout out to the A-team

No, not that one, but I have been noticing lots of visitors from A-named places: Austria, Australia, Aruba, Alexandria, Arizona and even occasionally Austin.

At this point in time, I wouldn't mind visiting any one of you...especially Aruba and Australia, since you all will be warm and toasty there compared to RehabLand.

As always, thank you for visiting. Off I go for a day of accreditation excitement. Me, my boss, and the chief nurse. Can't wait to get it over with...stay tuned!

Just say hello, goodbye

One patient, Mr. Smack, leaves, and boy, does he treat the nurses. A humongous box of fancy schmancy pastries and absolutely divine chocolate dipped brownies appear in the nurses' lounge. Can you tell his sister, who brought all this stuff knows how to butter up the nurses? It surely helps that she IS one.

Darlin' you and Mr. Smack have a good ol' time driving to Margaritaville, just keep him away from drunk drivers!

And Mr. X., who I checked in last week with my trainee came back. Nothing like a little crashing to send you out to the ICU. Thankfully, they cleared that all up. What's a little sepsis among friends?

Now, I wait for judgment, er, my trip before the accreditation people tomorrow. I'm going to celebrate by doing homework with P. and my group.

More later...

I pinch myself

Every day, when I realize the caliber of  my classmates, and even more so when one, with many years of experience, asks me for advice.

Thank you  S., for your confidence in me, even though, I feel like these guys...

Tired and still kicking....

How many IVs did I start today for the clinic? How many times did I say, "Hold still while I put on these EKG pads."?

Things really slowed down, though, when we had both the neurology resident AND the med student with us. Thank heavens our patients realize we're a teaching hospital!

So glad we got out on time...now I just  have to wait for Evil Accrediting Agency to show up this week. At least, the doc and I will have fun with it...if our boss doesn't intervene.

More to come...

Flying solo

So far, the sky has not fallen. My first day was pleasant, even if some of our administrative staff were not. Most of our patients arrived on time, and one was even early.

We will see how the rest of the week goes...more later.

Out and about

And listening to this album on my laptop on this windy, cool fall day.

Hope your day is equally exciting...stay tuned. My maiden voyage is coming!

Joy in the Hotel...

Yes, I know, we're not supposed to have Christmas music before Thanksgiving, but today was marked by lots of joy, and not just the "Joy to the World" medley I heard at Borders.

First, Bubba got a new cast and all his classmates signed it. When he came for an impromptu visit at lunch time today with Dahey, he also got a couple of nurses' signatures, too.

Next, one of our coworkers had her baby.  Her kids are thrilled with their newest family member, and so is the dog.

Finally, one of our patients ended a long period with a major piece of metal. Mr. Smack got his halo removed today. The neurosurgeon told him he could not shower his head, but our doc let me put a shower cap on him and hose him off, so the dirt that was stuck on him could be removed. Talk about joy! I thought he was going to dance around the Hotel, he was so happy.

No other day in November

"A celebration to honor America's veterans for their patriotism, love of country, and willingness to serve and sacrifice for the common good." History of Veterans Day, from www.va.gov

Say thank you to a veteran today, and remember those who fought and died for our freedom.

Learning is so much fun

When you're out with the journal club, with good food and good companions. And I so loved the chocolate hazelnut bars for dessert....yum!

Gotta keep the tummy happy to keep learning!

So happy I got to escape after a day of moving furniture and soothing uneasy souls at the Hotel. I love admissions and getting psych consults. At least, I had a trainee on the admission to help out. I think she's got it and will make a fine admissions nurse.

Stay tuned...

Nothing like a little rehab...

I love being a rehab nurse, but I'm starting to think people think I'm a drug rehab nurse, not a rehabilitation nursing professional. I leave the heavy-duty counseling to the professional counselors, and licensed therapists.

It is interesting, though, in the rehab clinic, since we deal with lots of issues, especially pain management. One of Madison's finest pharmacists, Mike, came over today to talk to some of the patients in afternoon therapy groups.

Not sure if anything will change, but you have to start somewhere...stay tuned!

In mere days

I will be flying solo in the SU, since my training period will officially be over. I've documented, documented, documented and I've run the systems and managed the patients on the last few days I've worked.

Telephone triage is still interesting, but I'm getting the hang of it. Thankfully, everyone seems to be helpful.

Crossing fingers as I get ready to fly solo.

More to come....stay tuned.

I'm so glad

They've made us get new high-tech ID cards. The photo on it makes my driver's license photo look like a glamour shot.

You'd think the old ones would be blurry and boring. Alas, no, but the new one sure is.

My favorite veterans

Valor is stability, not of legs and arms, but of courage and the soul.  ~Michel de Montaigne

Working in the VA has its advantages in finding your very own favorite veteran, since you gotta be one to get in here.

In the short time I've been here at the Hotel Rehab, I've started adding to my list of favorite veterans. First, let me tell you about the war heroes and the major battle veterans. Mr. Z. was injured in a famous battle in Korea. He was a kind soul who brought an old-timer's perspective to his injury. Our newest veterans from Iraq and Afghanistan particularly appreciated his view point. He wasn't preachy, he was just a "give 'em the facts" kind of character, who always used himself as an example.

Mr. A., a large hulk of a man must have surely frightened our foes in the South Pacific theatre during "the big one" as he called World War II. Before he lost limbs to a land mine while on a reconaissance mission, he was a giant of a man, well over six foot four inches tall. He always made us laugh because he always said, "You girls are the best," all the time, much to the chagrin of some of the male staff.

My favorite Marine, I'll call Skippy. Skippy was a grunt in the Corps in Vietnam. Skippy is the party man, even though he's been injured a long time. Skippy's company always finds out when he's in the hospital, via phone, mail and internet, and they show up to see what he's doing. Skippy is a character  and has been a regular around our place for a while, and completed an extended stay when I first started. Skippy bonded with one of his roommates, Bob, and they now call each other at least weekly, if not daily. Skippy keeps telling Bob he's going to get a kangaroo and start a private zoo on a few acres he has.

My favorite sailor, was just like my veteran at home--a submariner. Mr. Tom taught me a lot of things and was thrilled to meet another silent service character (Dahey) while he was on the unit. Like Skippy, Mr. Tom's sub crew found him and kept him busy with phone calls, letters, and the occasional visit.

And finally, I'll never forget a couple of characters who are no longer with us. Pitt Phil (a major Steelers fan) was another WWII guy who didn't talk the first week he was with us, due to some trach issues. I remember getting him enthused about getting out of bed when he found out we had a big screen in the patient lounge. He got up every day after that. Mr. Ron yodeled our names whenever we were in the room. If I close my eyes, I can still hear his yodel. We got him all fixed up after a long stay. He went home for a short time, then got sick and died suddenly.

So as my career goes on, my list gets longer. I am honored to be a nurse who gets to call every day a Veteran's day in my job at the Hotel. If you don't have your own special Veteran and want one, go talk to your nearest VA and volunteer your time, talents or treasure. They'll appreciate it.

Juxtapositions

A wild night on the floor recently at the Hotel:

One of my patients (aka RR for Ring-Ring) rings the light constantly. He "acts" upset that I'm his nurse (not really--just for show). He gets his heart set on delivery food that was turned away once, and finally, when he's totally dejected and swears it'll never show up...in walks the delivery guy. DG gets a huge tip and RR gets the meal he's been dreaming about.

Even with RR, I'm able to work on homework, in between rounds, look up an article, write a review and study for my exam.

And on the way home, while throwing my book bag in the front seat, I pull a muscle in my back (yes, that book really is heavy, even if it's small!). Despite hot shower, massage and an Aleve, it's still sore.

So yours truly takes out the goodies for the open book test which ends on Sunday at midnight. And despite the pain, I get an A. Thank you P., my class partner, for encouraging me to take my time.

It was easy...the back still hurts. I'd be awake anyway tending it. Why not take a test at the same time?

More later....

Comings and goings

Sit still long enough on our unit and talk to a few people and you'll find out a lot of things in a short amount of time.

One of our long-time nurses is heading to one of Washington's outpatient clinics. He/she finally decided to go back to work full-time, after a long time part-time. The economy sure changes things, as well as our big boss.

Another nurse and his family will be packing up the homestead this summer to head on out to a new location out of state. The unit is sad he's going, but he and family are excited.

And suddenly, one of the newer nurses will have a position on our unit, since we have comings and goings.

It all falls into place sooner or later.

The boss told me yesterday to enjoy the holidays this year, so since I'm in the SU, I'll be able to take vacation days whenever the staff there is off. I have my Christmas present already and the vacation requests are in the system.

'Cause next year, if I'm still in the Hotel, I'll be working the entire holiday season. Gonna enjoy what I have now!

Stay tuned...more later.

Fridays on the floor follies

Ah, I'll be playing the Hotel lounge (and a couple of rooms) this weekend for a limited engagement, before I'm sent off to toil the holiday season in the sister unit.

Today's entertainment...two skinny (thank you!) characters who have bowel issues. One's constipated, one's runny. Oh, the joy of bowel mania! Nothing a little chugged Miralax can't fix, unless of course you chug it in front of the med nurse so fast with that cold juice that you promptly vomit most of it up five minutes later. Next, same patient coughs so hard that it's coming out both ends. Happily, (if there is such a thing) this was not a bowel prep, and the volume was low.

Most of the characters are happy to see me back. Some of the floor staff, not so much. No vacation yet, but am planning to enjoy some of the holidays at home this year. It warms my heart just thinking of it.

More later, so stay tuned. The day has just begun.

EKG...

Check. Titers, check. All I need now is an assignment for the volunteer corps.

Back to studying for this week's test. After all the excitement of dealing with Dahey's car and running around town with a rental, I barely touched a book.

This is going to be interesting....stay tuned.

Now I know why...

Nurse K on the night shift posts signs all over a patient's room, intercepts the breakfast tray, and yells if she has to in order to keep people NPO.

If I'd have followed her lead, I would have remembered today was the day for all those tests...that required me to be NPO....arrrgh!

Better luck tomorrow...

Too ironic

Scenario 1 - Pills, pins and needles.

Today was an interesting day. The specialists are busy at the Hotel and you would have thought it was a full moon.

One patient called into the SU stating, "I need more pain meds and to fix my record. I am not a drug seeker." Also, the patient mentioned that he/she had a numb leg for the entire weekend ("all pins and needles"), telling me how many falls, etc., and how terrible it was, so couldn't we just fill the script.

I mentioned to said patient that it might be prudent to go straight to the ER. "Naw, I can't do that, my leg is numb."

"So how will you get to the drug store to get your script?" I ask.

"Aw," says patient, "I'll just get a ride. Or I'll wait until my appointment tomorrow up at Washington (our main hospital)"

Well, HELLOOO in there! If you can get a ride, you surely can get to the ER, can't you? What made you  wait three whole days to call?


Scenario 2 - My nurse is with me today

We had a couple of patients lately in the sister unit who came in with family members. We don't allow them in the room for procedures, but we allow them to talk to the doc and consent and ask as many questions as they desire.

One patient came in with his healthcare professional sibling (supposedly a nurse--no idea what kind). Patient stated in his/her last consult that they had issues and needed x,y,z intervention, all of which we do not do here. Patient still wanted to come. This seemed odd, but we do lots of odd stuff here.

Patient arrives at appointment happy and with sibling and all looks good, except patient has some doubts. This is where Dr. X shines. Dr. X was an internist in another life and he loves talking to people. If he wouldn't have been a doc he probably could have been a wonderful minister. He's folksy and honest and people just genuinely like to talk to him.

Doc excuses me and the trainer from the room and he and his resident talk to this patient and sibling. While we were away, sibling argued with Dr. X and made it sound like Dr. X was the world's biggest jerk. Dr. X. was very exasperated. Patient and sibling actually stormed off out of the room.

Weird thing...same patient called back breathlessly and wanted to talk to us while we were restocking. When I called him/her back, I got voice mail.

To be continued....more to come.

If you build it...

They will come. Thanks Shawn and Online Schools for featuring my blog.

Muchos gracias! Go have a look-see folks!

Jo, I feel for you

Yes, I am feeling the effects of all the assorted pollens hanging out in the air this year. After seeing my niece demonstrate nasal irrigation and how it's helping her allergies, I thought I ought to get one of those sinus irrigators. And I read Jo's post on the necessity of using this in her situation.

Let me tell you, this is not for the faint of heart. There are a million instructions with my particular model irrigator, and of course, I read them first, but missed an important part.

"Contact your physician if you have ever had ear surgery."

I have always had problems with one particular ear, despite surgery (mostly stuffiness). Now I get to nag the ENT to find out if I can continue to use this cool tool, which sure flushed the pollen out yesterday.

Ears feel fine, but I'd like to keep them that way...the joys of fine print.

More to come...only mere days before my move to the SU for a lengthy holiday stay...yes!

Yes, there's relief.

This week's assignments done. Laundry done, dishes in the dishwasher, little kid scrubbed and tucked in bed after a motherlode of goodies in a plastic pumpkin full of at least 5 lbs. of candy, and early to boot! Vegetating listening to this album.

WildDog at my feet after an Indian summer afternoon lounging in the yard, barking at passersby.

Dahey's celebrating his OT today by soaking in the tub.

Wish these hours of stillness could last a little longer!

Be happy, eat chocolate

Bubba and I are bonding as we make pumpkin pies and I just baked a really good brownie with items you wouldn't expect.

It is Halloween, after all. Even if you're on a diet (like me), you need chocolate.

More later...

Blame it on me...

The title of an album with one of my very first iTunes purchases...and a little studying on the brain lately, along with work and the rest of school.

Yes, Kim has another rousing edition of Change of Shift up at emergiblog. Head on over, people, and enjoy!

Off the clock tour of duty

Yes, I got to see the other side of the fence when Bubba broke bones during his soccer game. Dahey and I were less than five minutes from the nearest peds ER, and so we whisked him off the field and down the road, with cardboard splint and ice in tow. Our nurse Kim kept him quiet and happy. Gotta love a little morphine!

The whole crew was amazing. All you peds ER folks--nurses, techs and the man with the hands,  aka the ortho doc who guided those bones back into place--you rock!

Wrapping up the week...

Where there is no imagination there is no horror.  ~Arthur Conan Doyle, Sr.

The week is winding down and I am enjoying my training and my time on the floor.

As always, it can be a soap opera kind of world at the Hotel. Love and lust figures into the installment this week. Lovelorn housekeeper falls for the charms of one of our artistic characters and wins a transfer to another unit. No fraternization allowed, just like the military, remember?

Another one of our patients decides he may go home immediately if one person comes back. Former roommate made a pass at his significant other and he's not too darned happy.  The guilty party is in another unit, but as always, misses the Hotel and will do whatever to come back to our place. Don't think it's gonna fly this time...I hope anyway.

It could be a November to remember, though. Boss decided to come in and actually talk to me, and let me know I could apply for the part-time position working in one of our clinics. This is, of course, because no one else has yet applied. Another older nurse is applying, so out of respect for him, I'm declining that "opportunity", because he'd really like it. He has a lot going for him, too--over 10 years experience and an affable manner. The Slug may apply, but ON still has a chance at one of the positions available, and I hope he gets it over the Slug, who doesn't deserve it.

Sometimes you just have to say no to one thing to enjoy another.

Back to studying and have a great weekend all.

A little light discussion...

Travelling partner and I went out to a focus group tonight. It was interesting, fun, and we had food. I had so many leftovers on my plate, since I'm counting calories that I got a large to-go bag. My clinical nutrition professor would have been so proud of me!

Dahey was a happy camper...so much so that he devoured the dessert before bed. Mega Steak House had huge, delicious portions of everything.

So glad I don't do this every night...I'd weigh a ton!

Back to the Hotel and homework tomorrow.

Things sure look different up here...

That could have been the story of my day hanging in the Sister Unit.

In order to protect the guilty and the innocent, I'll present these out of order.

1. When you get a warning (as we do via our system) that a patient can be violent, you get a little worried. So glad I didn't know about that until AFTER I walked this guy here and there (because I had no place to go for him) and I got him to the doctor in the office with the panic buttons.

It became more ironic when the Doc managed to get him to agree to a treatment that can be quite painful. Thankfully, he was lying prone and I was out of reach. The doc was not, but all went well and the patient was happy with us.

2. No, the housekeepers aren't just happy people strolling around. They are strolling that way in violation of policy with their earbuds in jamming to whatever tune strikes them. And no, just shaking your head and smiling is not going to get me to tell you what you want while you bop your head to the tunes, buddy.

3. Yes, no really means no when the treatment team asks you if you've smoked with Mary Jane in the last month, even if it did help your spasms. Saying no and your pee says yes gets you thrown out of that rehab program. Better luck next time!

4. Finally, I got to redirect a lost patient to the elevator, then to his room. At first when the trainer and I came upon him in the hallway, I didn't recognize him. Then I realized he was one of the patients from my unit at the Hotel. Some people really do look different when they're up in their wheelchairs rolling around!

Stay tuned...tomorrow it's run, run, run as the procedures and exams rule the schedule. It'll be a fun day.

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...

I'm not there...

But I'm inclined to go back again after this flew up on iTunes. Sometimes, you just need a study break wherever you can get it!

Training down...now more

Yes, it's the end of my first week of training in the sister unit, and surprisingly, things are going well. The day was not jam-packed today, so I was able to get some extra work done.

First, I came in and worked with a trainer for the position I'll be doing. She's really good and I think I got notes on just about everything. I'm going to transcribe everything, so I get it done and so she can review it prior to my start.

Next, I got an hour of orientation from one of the main staffers. My job is to support him/her and several programs the SU runs. I understand the materials, but the actual process of getting people in and out is a bit different. It's rehab, but mainly similar to something you'd see in a mental health setting.

I'm really happy I'm a rehab nurse, or this would have all blown me out of the water by now. I also got the call today that I'm being featured in a nursing newsletter soon, and I've been appointed to a committee due to my  "leadership skills." I had a chuckle about that....I never feel like I'm leading anything but the poop cleanup parade. It's nice to feel wanted.

After that, it was a slow afternoon, so we did follow-up calls and paperwork. All in all, not a bad week at all. I will get to learn new skills, and hopefully, wow all the inspectors who'll be coming around in my first month. My boss will let me continue training on a regular basis until my start date. The grumblers on the floor are finally quieting down. I shouldn't take their grumblings personally, but I get really irritated when they direct their angry comments at me.

As Dahey says, expressing displeasure at the treatment I get is not a bad thing and needs to be done right away. Guess I've been used to being the whipping-boy, er, girl for too long.

And off I go into the weekend. There's plenty to do here at the ranch. Stay tuned!

A little scorched earth...

Oh, it'll be mighty exciting the next time I'm working with Senior Charge. She acted friendly the other day just before delivering her scorching response when she asked me if I had seen any of our patients at the sister unit (SU)clinic. "So, seen any of our people there? Well, that's not a very good use of a rehab nurse for that department." Most of this venom had to do with Big Boss who mandated that SU and their clinic be supported while certain staff members are out on medical leave. I told her, "Well, ask them to send our people to me. I'm ready!" She didn't find that humorous.

Since that incident, she's steered clear of me. I'm not sure if it's the fact that I'll not be available to hear (mostly via others) that Senior will get the pick of the holidays off, or if Senior now wishes he/she would have picked my gig. Who knows....I've given up trying to resolve that logic.

Meanwhile, I'm building my reputation as a quick learner. Got to do a few things by myself and got checked off for my orientation. Thanks to SU's boss, I'll also end up with more orientation. There's a lot at stake getting things online and thoroughly inspected, so after my success with the craziness of JC earlier this year, I think they realize I can deal with whatever comes my way...if I get prepped and have some time to study. Big Boss and nurse manager seem to have confidence in me, so I'm going with it.

I have nothing to lose and everything to gain. This is the most visible position I've held as a nurse. I'm not a supervisor, but I am important to the team. The floor will still be there when I get done, and so will the attitudes and characters out there. I have to forgive...but I never forget.

On we go...stay tuned.

Day 2...Up and at 'em

Yes, it was a full day of work in the clinic at the sister unit. Lots of assists and learning new procedures and how machines work. Even had the big boss trailing me for a while asking me how it was.

I felt slightly behind, but felt pretty good about actually getting into things and doing some tasks today.

Hope to learn even more tomorrow. Hopefully the rest of the week is so productive.

More to come...

Day 1 in the Land of Oz

Spent the day hanging with the crew from the SU (sister unit) where I'll be spending my time answering calls, writing notes and assisting the MDs with whatever procedures come in during my stay.

Lots of admin stuff today and not too many procedures. A note here, a note there, vitals here and there and a whole lot of note taking for me. I figure I'll just alter my colors in the notes to keep things interesting.

I have a checkoff to complete before my week is over. One item's been removed, since it's no longer appropriate, and another's been added for the accreditation and compliance folks.

Tomorrow should be busy with lots of docs, patients and procedures. We'll see how it goes. Stay tuned...

Monday - Day 1.5

Back to the sister unit for training...and cramming for our inspection.

Should be an interesting day, so stay tuned.

Hey, mambo!

On a study break here...makes me want to find Cinema Paradiso and watch it again!

Bedraggled

I often write when I am feeling like the classic definition of bedraggled. It may not be raining, but after working all these days straight, I do feel limp. It did not help matters when the neighbor's car alarm went off at 0300 this morning, either.

Alas, I survived to fight another day...today. Work was challenging, but the pace was slow. I welcomed it by sitting on the occasions when I could. It was a delight to have uninterrupted reading time to finish some of my reading for my class in a quiet lunch room. Most of the loud folks weren't working today.

My patients were very good. I even got a new one who came back to us following surgery. He's a reasonably happy fellow and he was happy to see me. Mr. Z looks like he should have a sombrero on his head, but he prefers baseball caps. The other folks got up, dressed, to therapy, and then on an outing in the afternoon sunshine on a glorious fall day.

I had a nice conversation with one of our senior nurses today. She made me feel much better about myself and my temporary assignment to our sister unit (SU). Many think I'm a turncoat; yet a few others are envious. I may not be off during the holidays, but there are opportunities and there will be more freedom in this position.

There are challenges, though. We are set for yet another series of inspections by accrediting agencies. Senior nurse was prepping me and the sister clinic on what one particular agency actually looks for. Since I'll be the newest member of the SU team, she thinks they'll pick on me first, to make sure I'm being trained right.

Hopefully, in my next month of training and meetings, I'll be able to keep my head above water and not goof up on anything.

Cross your fingers...more to come. Have a great weekend!

Drills and test demonstrations

Oh, today we just had to have one of these. It never fails that the Slug would volunteer to be a patient getting taken out of a building on a stretcher, since he/she probably thought they'd get less to do today by doing that.

I'm getting ready for another bit of fun in my class: starting our research proposal. Yes, like true NINR researchers, our group is refining our plan, which will end in a research project. I read and read more last night and when I went to read tonight, I realized I left my paperwork at work.

At least, I didn't forget the textbook. Now, I'll stop here so I can start reading a few chapters. There certainly will be no need for sleeping pills for me!

Stay tuned...the weekend is coming!

A little early Halloween antics

Yes, it's been going on lately, but I just have to wonder with the pre-Halloween antics going on at the Hotel. What do you get? A dash of irony in it all...

1. Convince one of your patients not to distribute his candy to everyone. He's really proud of it.

2. We get a "prank call" at the nurses' station that one of our people has fallen in the lobby. We investigate and find no person in the lobby. Turns out it wasn't a prank. The other rehab unit's lobby (on the other side of the building) was the place and yes, one of their people did go down...for you guessed it, trying to pick up candy he/she dropped to the floor. Moral of the story: new amputee + wheelchair + stuff out of reach often equals a tumble.

3. And the best one yet to close....Dr. Z., one of our internists kept telling Mr. C. he should not eat the Halloween candy he got recently. So what does Dr. Z. order on today's round of tests...a HgbA1c and gives him a bag of his favorite mini candy bars.

Oh, I foresee a boo-tiful time in the Hotel until Halloween! More to come...

Is this week over yet?

Not quite...I'm happy it's Monday, but with the week to come, it will be no stroll in the park here. No sirree.

Things could be worse though...I could end up on a years long ocean voyage and miss my intended target like this guy.

Better regroup with another cup of coffee... more to come.

Happening in threes, fours?

First,  in September, Michael Douglas reveals he has a head/neck cancer.

Next, Head Nurse jo tells us about her own cancer diagnosis.

Then, she tells us about another blogger who also has a rule out oral cancer test coming up.

And lo and behold, today, a story on Yahoo! says Tony Gwynn has a salivary gland cancer.

Folks, please pay attention. What can you do? Don't miss your next dentist appointment and screening. If something feels funny, check it out with your favorite health care provider.

Weekend...still?

It surely seemed like Sunday yesterday, even if it was a hopping day. I ran with people, ran with call lights, ran, ran, ran, all shift.

I did squeeze in time to get my preceptee's goodies out and we had a small impromptu party before some of the staff left for the day. She enjoyed it.

So needless to say, I was glad I was nearly out the door when WannaBeHippeeSlacker RN complained about how she was busy all night. I was not about to spend one second of my own time to berate her, when I had run all night myself.

A little work (and all finished by the end of the night with no OT) never killed anyone.

More to come...stay tuned.

Understaffed

What does a local Starbucks have in common with my world at the Hotel? Our local Starbucks had call-ins, and with that, the manager took the audacious step to close the store for one hour so they could honor labor laws by allowing the employees to get a break.

We don't have to admit any people today, but boy, I sure wish we could close the unit for one hour of uninterrupted quiet for a break since I'm subtracting more than I'm adding to staffing today.

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

Into the weekend

We're getting into a holiday weekend at the Hotel. Things usually calm down. Right now, we're so booked up, that the Hotel Rehab is not taking any new patients. This could possibly change at any time, but it's the first time in a long time that we have no admissions scheduled on our board.

My time with my preceptee is winding down. She has demonstrated so many skills that she will be an excellent nurse. I just hope she can stay focused and not get distracted by internet, etc., like so many of her peers of the same age range. My patience is wearing thin with a few of my coworkers because they are spending way too much time on internet items, and not on work. IV pumps and call lights ring and ring because they will not get up promptly to take care of them. It makes me very agitated.

Since it's a holiday in our neck of the woods (nothing big--just one of those bank holidays observed), there won't be too many folks around Monday, either. Hence, my boss just felt the need for me to be in charge. I'm not too happy about it, but I'm sure he's getting ready for the day when I'll go to our sister unit temporarily while some of their folks are out. It's really not a bad place to be. The unit is very nice and several people coveted the spot I managed to get. It's kind of scary, because I've never done anything like it as a nurse. I will get to use skills I've only read about in books and seen during NCLEX preparation.

Bring it on...I'm ready. Stay tuned for updates.

Packing

So much to talk about, so little time...so a bit of my day in a nutshell.

I literally was packing a patient's belongings today, and it made my heart ache thinking about it. I packed up stuff for a patient who is on the express train to the hereafter. You know it's heartbreaking when the boss says, "Can you look for his cell phone? They need some numbers only he (Dad) had to make calls for the funeral." Happily, I found it amid all the stuff, but packing and sorting all the toiletries, t-shirts, therapy items and treats was hard. I liked him. He was one of my best patients ever.

We moved people around again. If only the transportation fairy comes to our unit and takes us to the sister unit for a remodel. Maybe Santa Claus will visit next year...

Finally, before I left I was packing supplies to distribute to my rooms down the hall on the way out. A couple of my more macabre coworkers thought I was smuggling out a urinal for a novel "beverage container".

No recycled beverages for me, thanks.

Off to bed...one more day to study...stay tuned.

Water, please!

What makes the desert beautiful is that somewhere it hides a well.  ~Antoine de Saint-Exupery

My day seemed like a desert at the Hotel. It was hot, and I was thirsty. If I move another bed from room to room because we keep having odd isolation situations coming up, I think Mike the housekeeper can, and will take his mop bucket and dump it over my head.


My orientee and I ran from patient to patient and got everyone taken care of, including getting one another bed, since he needed a new one for a couple of reasons.


Besides moving everyone around, we got to take one of our patients outside to our garden and patio area. A few patients congregated out there and had a good old time. We checked on him from time to time to bring coffee and check his water pitcher. It had been a very long time since he was allowed up and he relished every moment of it.


I finally slaked the never-ending thirst for moment by getting a diet soda at lunch. I hate diet soda, but this one was actually pretty good. Gradually, I'm getting used to more fruits, and especially vegetables in my diet. I love bread, but I cannot eat much of it anymore. I have to save it for special occasions.

Now, it's back to studying...more later...

Chilly!

Fall is here in Rehab Land, even if the leaves aren't turning yet...brrr!

Not surprisingly, the unit is still unseasonably warm in many areas.

Now it's off for another day of adventures with specialists and protecting the patients (and ourselves) from the new resident (Dr. Haroompf) who's still learning how to use our computer system.

Stay tuned!

This is only the beginning...

Of lots of things, including the week. I already feel tired and I've just gotten started.

First of all, I got back for my first day of work. It's a really long week when I get ready to work the weekend. I'm getting annoyed already when I hear people say, "I don't know how she does it. I'd hate working that schedule." Well, that schedule is my life, so I deal with it.

Trust me, I've tried to get it changed, but the boss is not eager to do anything about it. Showing up and doing a excellent job at work can be an advantage, though. Said boss is going to put me on assignment working with our sister unit on another floor. This will only be temporary, but hopefully, will be helpful in the long run. It will probably unleash the crazies among my coworkers, but we'll see.

And now, I'm at the beginning of prep for my first test of the semester. School can get the best of you if you're not careful. Happily, we have a good team this semester,and hopefully, we'll keep our near-perfect record intact.

Stay tuned...more to come this week! I'm back to cooking ahead for tomorrow.!

Singin' in the rain

Puddles abound here in Hotel land, but I don't care. I've escaped for a day off, ah! Then it's back to stats! Ugh! May take a dancing study break...

New month, new CoS

Change of Shift is up at emergiblog, so head on over and see the latest edition.

Lest I forget....

Chains do not hold a marriage together.  It is threads, hundreds of tiny threads which sew people together through the years.  Simone Signoret

Tonight...6PM a decade ago, I changed my life. Happy anniversary Dahey! What a wild ride it's been.

(clink) To many more...

Breathe...

It's so simple, but I don't feel like I've done much of that lately. The pace of the day today was a running one, and tomorrow it will be the same.

The weather has been lovely here, so I walked outside on my lunch break. Clear, blue skies and a light wind was beautiful. There's a hint of fall in the air. I strolled over to another building eating my fall apple we picked recently. It was simply heaven.

I have a new RN working with me and she's doing pretty well. The program she's in is helping. I wish they'd have had something like that when I was new. She'll be with me a little while longer before she goes to her next rotation. I got a good report from her previous preceptor, so I think she'll do well. I just hope she applies for an area of interest before her program is over. We have jobs for new grads at Madison and Washington, but they're getting snapped up fast!

The nice thing is that we've had some time to actually talk about our assignment and plan it. I had her take a patient today. We reviewed his orders, then went in and talked to him. He was a bit balky, but Mr. X. eventually cooperated with her. Newbie had worked with him before (when she first came to the unit), so Mr. X. did not have to be oriented to her.  Yes, sometimes orientation includes getting oriented to the patients and the patients oriented to you! Mr. X. was time-consuming, but he provided a lot of learning--learning about motivating people, teaching them how to care for themselves, and teaching them how to direct their own care if they can't do it for themselves.

Our other patients were easy. We set them up, and they did whatever they could themselves, which for a rehab nurse, is sheer, utter joy. I always tell them I'm not going to move into their houses, so they'd better get used to doing as much as they can for themselves.

We got all our paperwork done and even talked to a couple of wound nurses who were doing an in-service on the unit. It was a whole lot of learning rolled up into one day. By the time the day ended, it didn't seem like we did much at all! Time truly flew by, just like those fall winds.

More to come....

Back in the saddle update

You already know yours truly is back home at the Hotel, but did you know Tex is back doing the ED Sing-a-long way over NC way at Weird Nursing Tales?

You absolutely must check out his latest one, Mr. Drug Seeker (to Simon and Garfunkel's Mrs. Robinson).

Tex, welcome back buddy! Hope you enjoyed the vacation from Blogger land. We missed you!

Thank you ANA

Today's SmartBrief with this quote has successfully planted this song in my head.


"When the feeling's gone and you can't go on, it's a tragedy."
--The Bee Gees, pop music group

Another?

Somedays I wonder if I'll ever have enough time to get going. I feel as if I'm moving in slow motion today.

More to come...stay tuned.

Back in the saddle again...

So glad my favorite charge nurse is coming back. I had more than my share of excitement recently after I ran off the plane to get to work.

First, I had to deal with the family from Hell. Entitlement Trio (ET for short...which is quite a generous moniker) played the ugly American tourists at home. After standing around at the airport awaiting the shuttle to my car, I secretly wished these people would have been kidnapped by narcoterrorists. It's couldn't have happened to nicer people. These people even lived near the Hotel where I work, which also irritated me, as most of my neighbors have been socialized to be more polite.

The ET bumped into people with their enormous amount of luggage, and they proceeded to bitch at every single shuttle driver who came by because they wanted their shuttle right now. One shuttle driver actually called the office to get not one but two shuttles to come to pick up the mass of humanity now at our terminal door waiting.

Of course, after their whining display, ET boarded the shuttle first and ET daughter proceeded to check her e-mail. Mother and daughter b*&tched the entire way to the next terminal, where the driver had to stop to see if he had any other pickups. Father was absolutely silent. Daughter was loud and obnoxious in her comments when he did stop which irritated me even more. The man was just doing his job.

Once we arrived at the parking lot, ET wanted to be dropped off first and as luck would have it, they were in the closest row. Driver pulled right up to their car and they jumped off without even a thank you or even a tip for helping them get their bags off the van.

Finally, the driver got the rest of us off the van (we were all parked within two rows of each other). I was the last one off. I thanked the driver, an elderly gentleman, for being so nice to everyone, especially the ET group. I also gave him a good tip, since no one else bothered. I love leaving, but wish that some people would be grateful to come back once in a while.


After flying down the highway, and avoiding the usual speed traps, I was early and I went home and kissed Dahey and Bubba and scratched WildDog behind the ears.  I gave Bubba his souvenirs, which he paraded around the house (a t-shirt, a hat and a special commemorative medallion). I got dressed, made coffee and headed to work.

Stay tuned!

A little flippant

That's the word of the day today and kind of my philosophy of the moment. The conference is over. I achieved my goal of presenting. I proved a few things to the folks I work with.

And now, I hit the road. Traveling partner and I had a good time, despite the fact, that in many ways we are polar opposites. In many other ways, however, we are alike. We are adventurous and we enjoy meeting people and seeing the world.

Now it's off to home, then work, then decompression....stay tuned.

Things you learn at a conference

1. There are long lines for any good free stuff.
2. Occasionally someone you know will win a raffle.
3. Some conferences feed you exceptionally well (meals and snacks), and others, not so much.
4. Your boss,will get up and dance,if some nurses from another hospital pick him up under the arms and drag him.
5. One of your coworkers will document #4  for posterity.
6. You will volunteer someone else to babysit the boss and entertain him/her, so you can escape.
7. Some people can speak before hundreds of people, and others, not so much.
8.  You find that lots of people have problems similar to those on your unit.
9. When you work for a large healthcare system, everyone knows everyone in one way or another. Six degrees of separation? Nope. It's more like two.
10. Finally, enjoy your old and new friends whenever you get the chance. You never know when it will be the last time you see them.

Too many cool things...

I love it when you find interesting things at a conference.

While I felt brain-dead after the 0700 meeting today, I absolutely loved the fact that the presenter interspersed cartoons by this guy into a subject, that to many, is horribly depressing.

It's not depressing to me...it's dealing with a segment of my people at the Hotel, and they had a couple of things I know my folks would just love. Now if some more of our medical staff were present, things could be different.

Stay tuned! Some things just shouldn't stay here in Vegas...they  need to go  back to the Hotel!

D-Day...

Or Jour J as they'd call it in Paris.

Today is my conference presentation. Lots to tell once it's done...stay tuned!

The countdown

How many things can I cram into a day before the infamous conference trip with the boss? Plenty...stay tuned!

An important holiday...

Good ol' Talk like a Pirate Day!  Arrrgh! Shiver me timbers!

Enjoy!

Blame it on the rain...

Already used Rainy days and Mondays, and it's not Monday...yet...just couldn't resist this saccharine 80s rain song! Enjoy!

Drugs, bugs and shop talk

Things I heard at dinner recently with a few nursing friends and a pharmacist.

"I love JCAHO visits!" (from the quality nurse who has withstood many in her day). She's hoping to take the experience further in a new venture.

"Nursing is a lot about poop." One nurse who's a nursing instructor. "Some people don't last long if they can't handle poop."

"Needless to say, I'm learning a lot about illicit drug use." Another nurse who deals with an interesting group of folks.

"Get me outta here. I'm not picking up any more germs!"  Quote from the pharmacist who was hospitalized recently following an out-of-control staph infection. Said Rx got the doc to get the wish granted. Thankfully, a family member was an MD and made it so.

Thankfully, no people were near us!

Thoughts on escape

The World is a book, and those who do not travel read only a page.  ~St. Augustine

Despite my best intentions, I may have to go back to the Hotel Rehab to get some stuff before I leave for the conference with my travelling partner. Yes, I plan on being in the parking lot early AM for us to carpool, but I really didn't want to touch a computer or go inside. Nevertheless....I'll do what needs to be done. Manager asked if I could lose the Boss. Trust me...I'll try...when we're done! He/she will drive me nuts if I'm stuck with him/her for the whole thing!

This week has not been too bad. The mix of things in a day keeps me occupied. As one of my coworkers mentioned, I had an easy assignment. We also had the luxury of being fully staffed. Sometimes I think the boss does this so I can float around and help others. Many of my coworkers, when given a similar assignment, will not. They go hide in the break room or wherever they can to dodge work. In fact, I was chastised by the Slug when I dodged cleaning out the unit refrigerator when the maintenance crew came through to take care of our current one. He/she likes to comment that "I missed the real work."

Hmm...makes me wonder about his/her prioritization skills. In the same amount of time that the Slug sat glued to the table in the break room with not one, but two other nurses, I got my orientee access to the computer and we went to do a complex dressing change at the request of our charge nurse. I blew off the Slug's comment, because, yes, he/she can do some manual labor once in a while that is not nursing, even if dodging work is his/her game. I'd rather be too busy to notice.

And off I go...more updates to come. Feel free to cross your fingers, toes, light candles or invoke your religious figure of choice. Karma, good thoughts, prayers, etc., are all welcome. Gotta go ask Sr. Mary Martha if there's a patron saint for conference presenters (love the tagline of that blog, "Life is tough. But nuns are tougher."). I have never been so nervous in my life...presenting at a national conference IS a really big deal.

Stay tuned, all you readers...updates will be here first! Have a great weekend!

Is it Friday yet?

You know it's not close enough to Friday when...

One of your coworkers who's just quit smoking is b%4hing at every turn.

You have to attend the boss's party with the toadies. I loved how the toadies violated the "no alcohol on the premises" policy. (That was the boss's gift...can't we tell who drinks heavily?)

You just want to run down the halls and scream, "Take me away, now!"

That time off will not be here soon enough!

Stay tuned...

The fugitive

I feel like a fugitive from the law of averages.  ~William H. Mauldin

That's the story of my life lately. Everything that can go wrong will, or at least it seemed that way on a recent shift.

I have the misfortune of having oddball things happen when I am the charge nurse. I've been in charge for a while (but too frequently) and things have been getting progressively weirder. Last time, some of the staff drove me so crazy I don't even want to talk to them anymore, because to ask them to do something is a burden. Eye rolls, heavy sighs, and flat out "no" on occasion gets my blood boiling. To top it all, these same people want to talk about teamwork....hello? I'm the captain of the team and I'd like you to, at the very least do your own work!

And if that's not enough, invite people in from outside and have them critique your work. I was this close (imagine index finger and thumb close together) to calling the ambulance supervisor for the crew who took one of our patients out. DweedleDee and DweedleDum complained about the patient, complained about the necessary items he/she had to take along, then complained "Why didn't the doc send this patient out sooner?"

I just asked them to get him/her out of the Hotel, but in the back of my mind, I really just wanted to blow it all and ask them when they got their MDs. Funny, I only saw EMT on their shirts. I'm no MD, nor would I presume to know everything about this guy. This was the second pain in the arse crew on our unit and if it were up to me, I would lodge a formal complaint. Your job is to get Patient X from us to point B that's it. Medical treatment philosophy is not my business.

Thankfully, both these people were out quickly. Acute situations are inappropriate for rehab for obvious safety reasons. Sure, I love giving blood out as much as the next guy, but if you're gonna need unit after unit, and potential surgical intervention, you need to go somewhere else.

Enough venting for me...off to vegetate until it's time to be Homework Taskmaster with Bubba before all the sports....stay tuned.

Can you tell it's Monday?

One wrong push of the button and that comment you meant to approve goes up in smoke....ugh!

Hope the rest of my day is not like this!

Stay tuned...

Heard on the unit

Otherwise known as the evening shift edition

"Don't touch me!" Mr. U.
Mr. U. (short for Unhappy) is not liking the fact that his bowels are not moving. The dreaded combo of pain pills, cardiac (and other major organ problem) history, and new injury aren't helping either. I tried a suppository after he agreed, but I could not get the stool removed prior to insertion, like I usually do, so the suppository works.

Well, something worked, because about an hour later, Mr. U. passed not one, but two small baseballs of stool. That had to hurt more than the suppository! I made sure to alert the doc that Mr. U. definitely wants the stool softener.

Why he wasn't already getting it is a mystery to me.


"When you gotta go, you gotta go." Mr. C.
Mr. C., an old injury patient talked to Mr. U., his neighbor, about using suppositories, but  Mr. U. didn't want to hear it. Mr. C. just shook his head. One of these days, he'll come around, Mr. C. said. His neighbor, thankfully, was asleep.

"Whooooaah! Whoooah!" Mr. S.
Mr. S. likes to moan in his sleep. I woke him up to take his pills and he was startled. "Why did you wake me up? I was watching SportsCenter," he says. "I woke you up because I thought you were practicing for a Halloween party or working at a haunted house." I replied. I heard this while I was down the hall, minding my own business charting on one of our workstations on wheels.

Another one of our patients was talking about ghosts and what he'd read about them at our place. We suspect there are plenty, and many patients have stories of shadowy figures in their rooms, mostly on night shift.

Stay tuned for more interesting comments from the Hotel.

Rare and obscure

Sometimes we really get some obscure stuff to look up on our patients. One of our nurses found a few good articles to add to the learning folder for the staff.

I recently took care of some interesting characters.

• One patient has had issues with a new ostomy. This article describes issues when surgical revision doesn't help.
• Another patient came in with a really odd tumor. He's been undergoing radiation and has been really down in the dumps.
• Finally, I'm adding to my list of oddball tumors that can show up on your spinal cord.

In addition to all this excitement, my boss told me I'll be attending a class for preceptors soon. I am both honored and stunned. While I've been told I know how to teach people well, I've always felt like I haven't really been a nurse long enough to be in the preceptor role. At Saintarama, you had to be a nurse for five years before you could precept anyone officially. (Informally, anyone RN with a BSN or 5+ years of experience could be a preceptor for a day or two.). I'm still learning a lot of skills that we don't use often.

Off I go...so much to do today. Stay tuned.

It's raining here, too

It's a story that's sappy but worthwhile nevertheless. I just think the parting line is priceless, and you don't even need to appreciate basketball to enjoy it.

Dwight Howard makes a lady's day...(from Yahoo!Sports Ball Don't Lie blog)

You know it's going to be an interesting day...

When there are so many people going to Starbucks via drive-thru, that the line is backing out into the street....at a major intersection.

I'm just waiting to see a) when I can escape and b) when a traffic cop is coming to stop this mayhem, since there are plenty of places to park.

So glad I'm going to work...

The good news and the bad news

The good stuff first (aka Why wait until dessert?)

Big boss was thrilled once he saw my article that was published. Immediately sent it to one of the bigwigs.

WildDog survived his yearly trip to the groomer recently, even if he is becoming eccentric in his old age. He tried to swim in a shallow bathtub, the groomer told me. What he most likely did: tried to escape. He hates water with a passion.

I got my toes painted Tutti Frutti Tonga. I skipped the French manicure, though.

The bad news

Brother was readmitted to the hospital...yet again.

In my haste leaving the meeting with travelling partner and the boss, I ran into a concrete pilon at work. I called security on-site to report it, and they did not want to write a report.

Everyone needs a little paint and new plastic once in a while. More to come...

Foul, smelly and otherwise crazy: update

I'm still finding words for what I saw and smelled recently.

We have a patient who's had an abdominal surgical procedure not once, not twice, but three times at the Hotel with us. He went to Washington, and I think every resident on that service must have worked on him/her. You'd think they'd get it right. Normally, this procedure is a slam dunk. It hasn't been lately for this patient.

Today, being a day after a holiday, is always a little weird. Things are done out of order since we have people still on vacation, meetings and bigwigs coming to visit. The unit goes from quiet one minute to absolute pandemonium all at once when you have 1) lunch trays showing up, 2) people moving around everywhere and 3) every motorized floor cleaner in our building rolling down the halls of the Hotel. It was not a pretty sight. I am so thankful I escaped with my feet unscathed.

The abdominal patient, seeing it was busy, and he/she didn't feel like moseying around early, decided to clean up after lunch. When I came back to pick up his/her stuff and dump a pan of water, I noticed the dressing and the towel he/she used was covered with tan drainage that seemed to ooze more fervently each time he/she pushed on the abdomen near the incision. By the time I ran to call the docs, he/she had an ABD pad soaking and a towel that was covered with lots of tan spots. MD and the trusty wound nurse were happy I called, because the stapled area of the incision did not seem to leak while they were in the room earlier.

For that dramatic, oozing display, said patient was whisked away to an emergency consult, where he/she was evaluated and then the specialists said, "Keep up the dressing changes. Bring him/her back next week and we'll re-evaluate it then."

The smelly: one of my patients with a newer colostomy can beat the nearest herd of cattle for methane production. If we could harness that gas, we could probably power the electric used in his/her TV everyday.

Finally, we just need a little crazy welcome back from a long holiday weekend...my brother's meds still aren't right. He's not happy, so he wins a trip to the unit where his psych actually is working now that he/she is not on vacation. I'm crossing my fingers that his regular doc can settle the issues once and for all.

And if that wasn't crazy enough, traveling partner and I are still dealing with the boss on various travel issues. Next time, I'll volunteer someone else to go to a conference with him instead.

More to come...stay tuned.

Foul and smelly

Those two words pretty much sum up my day.

More later...stay tuned.

Happy Labor Day

"The man who doesn't relax and hoot a few hoots voluntarily, now and then, is in great danger of hooting hoots and standing on his head for the edification of the pathologist and trained nurse, a little later on."  ~Elbert Hubbard

Hope you're not having too much hooting and hollering today...unless of course you want it!

In case you have an interview soon...

One of our regular readers has an interview with a SNF coming up, so I thought I'd put on the career hat and start a list of interviewing tips. Feel free to jump on in the comments section and add your $0.02.

Interviewing for a nursing job is not unlike interviewing for any other job, so keep the following in mind.

RehabRN's 10 interviewing commandments

1. Show up on time. Be nice to the receptionist/secretary/clerk. Some of them do make hiring decisions in one way or another.

2. Do not bring your cell phone. If you have to, turn it off. Do not make or take phone calls in your interview. It is considered rude.

3. Dress appropriately. Business attire is not bad, nor is leaning on the conservative side. You can save the bright pink shoes for when you have the job.

4. Practice your speech in your head before you go in. You'll have to introduce yourself, so make sure you can do that with a firm handshake. You may interview with one or multiple people, so make appropriate eye contact with each person.

5. Bring a portfolio with notebook and take notes. You'll need these notes to ask questions at the end. Be sure to note the name of the interviewer and any other people you may talk to during your interview.

6.  Have an additional copy of your resume and any important documents (i.e. license, BLS info, etc.) with you.

7. Pay attention. If you don't understand something, ask the person to repeat it. Maintain appropriate eye contact and actively listen.

8. Sit up straight and do not slouch. Posture is important in communicating that you're paying attention, just like your second grade teacher said.

9. Answer the questions posed by the interviewer after you count to 5 or 10, even if you already know what you're going to say. This helps you to keep calm and appear poised and thoughtful. If you don't understand something, tell the interviewer.

10. Finally, once all the questions are done, thank the interviewer and any other staff who may have participated in your interview.

Be certain to follow up with a personalized thank you note (to one or all of the people who interviewed you), using those notes you took during the interview and make sure to ask for the job. You can send them via regular mail or e-mail.

DO NOT blow off a thank you note...it may be the difference between hiring you and someone else.

An example:

Dear Nurse Manager:

Thanks so much for meeting with me today. I'm really impressed by ABC SNF and I'd really appreciate an opportunity to use my RN/LPN/CNA skills to work with your residents.

Please contact me at xxx-xxxx (NOTE: you can use e-mail also if you'd like here) if you have any other questions.

Sincerely,

Random Nurse

Also, check out the following nursing related interview pages below. Prepare, be courteous, and be confident.


Interview Tips and Tricks.com has a few questions to consider for nursing interviews.
Nurse Careers also has more questions and tips.
Nursing Link has some of the worst answers to nursing interview questions, so make sure you don't answer like one of these examples!

Last but not least, check out Jennifer LeClaire's questions on www.monster.com and related articles, such as How nurses can detect an unhealthy work environment and information on the behavioral health interview.


Happy interviewing! And as a veteran of more interviews than I care to count, if at first you don't succeed, try, try again.

If you want driving tips...

And search Google for them, most of them will be from lawyers like this one.

My shopping list was ready, and as I'm getting ready to head on out the door to our country lane, I hear a loud pop.

Turns out someone took a left into someone else at the intersection. Nice.

More excitement to come...

Oh! My! Saturday!

It's run, run, run as fast as you can here at the RehabRN household...for me anyway. Getting ready for a couple of gatherings that should be fun.

And speaking of fun, I have to hand it to ER Doc at Serenity Now Hospital...you made my day. I loved the Good Ole Mom post item #3.

But frankly, I was hoping for an oddball Milk of Magnesia story...off I go.

More to come...stay tuned.

Ah, weekend!

Without labor nothing prospers.  ~Sophocles

Just a thought for this weekend...will be prospering at a few gatherings. Hope you labor at something fun for a bit, too.

Change of Shift

Check out emergiblog for Volume 5, Number 5 of the perennial favorite, Change of Shift.

Thanks for putting me on the list, Kim!

Dear Dr. Idiot

(aka an open letter to the boss)


Dear Dr. Idiot:

Thanks for all throwing my mailbox over the limit because I dared to ask the graphics department for graphics. Thanks also for acting like a complete ass and berating me via e-mail. It's so passive-aggressive...have you been hanging around with some of our nurses lately? It shows.

BTW if you actually read your e-mails, you'd have noticed that I informed you I would contact the graphics department and awaited your response before our meeting.

Maybe if your head was somewhere outside of your anus you might have noticed, but then again, you don't get paid to do the work, just think about it and write orders.

Sincerely not,

RehabRN

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.