With all due respect to Jack Handey, I've been pondering the following lately.
1. Why, oh, why would someone's family think it's appropriate to bring granddad alcohol to the hospital? Especially when he's on meds that will make him really, really stupid (and potentially sick)?
2. What doctor would purposely forget a patient's Baclofen order, when s/he's been on a high oral dose for ages?
3. Why on earth, in this, the 21st century, do we still have to have books that read like this? And why on earth would your coworkers tell you, in a diverse organization, "That's just the way it is."
That, like rehab bowel programs, smells really bad and for one, I'm tired of it. It's one of the things that drives me nuts about Madison.
And on that note, I leave you, back with Jack...check out the notecards. They are a riot!
More to come....from happier climes.
Tuesday, June 9, 2009
Sunday, June 7, 2009
Another full moon
Yes, today, folks, we'll finally see it...if the storms blowing through don't cloud the sky this evening.
On our unit, we've known it was coming for days, since all of the patients start acting up in a variety of ways. The full moon will do that to some folks, I guess...
I've been encountering a lot of interesting stuff lately. I took care of a patient who had this listed on his diagnosis chart: Hypermetropia. Since I must have been snoozing during that part of the opthamology section in pathophysiology, I decided to look it up, and alas, it's simply farsightedness. I did find a really cool page on WebMD called How to read your eyeglass prescription which tells you why it's written the way it is. Very interesting...even if I don't need anything for my eyes just yet! I'll be ready for a family prescription to come my way.
One thing I was getting confused on was an SGPT result. Turns out it's just the same as an ALT, which I was looking at somewhere else.
Next, I ran into a diagnosis for mitral valve insufficiency and aortic valve stenosis. While it's not heavily clinical, I found a great set of heart articles on this very subject from the Texas Heart Institute in Houston. If you have to explain this diagnosis to a patient, go check them out. Note: they also have a special section for professionals, as well.
We had an interesting situation recently. One patient with generalized swelling was a difficult stick for a blood draw. When you missed the vein, you got fluid. Anasarca is a very challenging condition to deal with, especially when doing blood pressures or any other procedure that may put pressure on the skin. Just putting a stethescope on to do a blood pressure left a mark on this patient.
Finally, be careful how you use OTC medications. This information about ibuprofen is very good from www.rxlist.com. Remember, there's a reason why they say, "All things in moderation."
On our unit, we've known it was coming for days, since all of the patients start acting up in a variety of ways. The full moon will do that to some folks, I guess...
I've been encountering a lot of interesting stuff lately. I took care of a patient who had this listed on his diagnosis chart: Hypermetropia. Since I must have been snoozing during that part of the opthamology section in pathophysiology, I decided to look it up, and alas, it's simply farsightedness. I did find a really cool page on WebMD called How to read your eyeglass prescription which tells you why it's written the way it is. Very interesting...even if I don't need anything for my eyes just yet! I'll be ready for a family prescription to come my way.
One thing I was getting confused on was an SGPT result. Turns out it's just the same as an ALT, which I was looking at somewhere else.
Next, I ran into a diagnosis for mitral valve insufficiency and aortic valve stenosis. While it's not heavily clinical, I found a great set of heart articles on this very subject from the Texas Heart Institute in Houston. If you have to explain this diagnosis to a patient, go check them out. Note: they also have a special section for professionals, as well.
We had an interesting situation recently. One patient with generalized swelling was a difficult stick for a blood draw. When you missed the vein, you got fluid. Anasarca is a very challenging condition to deal with, especially when doing blood pressures or any other procedure that may put pressure on the skin. Just putting a stethescope on to do a blood pressure left a mark on this patient.
Finally, be careful how you use OTC medications. This information about ibuprofen is very good from www.rxlist.com. Remember, there's a reason why they say, "All things in moderation."
Friday, June 5, 2009
War stories
Yes, there was a lot of storytelling going on during my latest turn on the evening shift. It's kind of funny that way, when you're gone a day or two, and things are really different when you come back.
War stories are common on our unit, since we're a government-run hospital, but how you get the guys and gals to talk, or let them talk can be a whole 'nother story in itself.
One of our more cantankerous folks was rolling by on his way to getting something, so I stopped him and asked if he wanted his pills right now. Sure, he says, I'll take them. We chitchat for a minute and I keep doing my thing. Mr. C. starts talking about his time in the military during the Korean war. "See that scar" he says. Sure, I see it, because I'd just given him his heparin shot. "I got that on my way to Korea. I never made it to the front." I shake my head, therapeutically listen, and he keeps going.
Mr. C. never made it because he had a bad appendix and developed complications. An astute medic pulled him out of the crowd and when they landed in Europe, Mr. C. got a trip to the hospital. The docs didn't want him going too far once he was released, so they found a job there on a base to keep him busy moving supplies along to Korea.
We have also had some World War II vets hanging out with us. One of them was a Marine injured in the Pacific. He's a character and I'm sure his stature alone may have scared more than a few folks in that theatre. I think about some of my relatives when I talk to them, because they'd tell the stories of the war, when I was a child, and my brother and I listened very intently. Most of our relatives who went to World War II came back. One did not. I think of him a lot and the family he left behind.
Maybe it's just because of demographics, but we have lots of Vietnam-era guys at our place, including some of the employees. Lots of folks talk about the jungle and dreams they had while they were there. Some were more premonitions than dreams, but they colored their lives just the same. One guy told me about the lost opportunities from Vietnam--delayed families, deferred education, the bad attitude of some folks that often caused other problems in the jobs they came back to or started after their service. The angst among some who were injured, while other folks their age were in school and never drafted. The volunteers. Some people say, "Who'd volunteer for Vietnam?" and on our unit, you'd actually see some hands, proudly raised, almost defiant. "That was me," one guy told me. "Better to volunteer than be drafted," he thought.
Today, we see some of the Iraq and Afghanistan vets coming in with stories of their own. Swimming at Saddam's place. Guarding air fields in Kuwait. Driving through Afghanistan in the Hindu Kush mountains with snipers everywhere.
And while they're not my words, I leave you with a story I received recently from my husband's old dear friend who is at a southern US air base. His story is a short, but a compelling look at the life of an airman who lost her life recently.
I previously wrote many of you about the presentation of an Air Force Cross, the second highest medal an Airman can receive, next only to the Medal of Honor.
At 1000 yesterday morning, we met in the same hangar, not to pay tribute to a warrior amongst our midst but homage to one who would no longer be physically present with us. SrA Ashton Goodman was a 21 year old (22 next week), from Indianapolis, IN who served as a vehicle operator in the 43d Logistics Readiness Squadron. She had three short years in the AF but had already served as a truck driver, ferrying supplies and personnel from Kuwait into Iraq, been promoted to SrA six months below the zone, and called upon to brief the Chairman of the Joint Chiefs of Staff.
This time she volunteered for a one year tour working with a Provisional Reconstruction Team (PRT) in Afghanistan. SrA Goodman was killed last week when her vehicle was struck by an improvised explosive device (IED). Her funeral was Tuesday in Indianapolis. The Wing took up a collection and flew the family here for yesterday’s memorial.
It started with a slide show presentation, a speech by her squadron commander (it was obvious she had made a positive impact on him and the unit), presentation of the Combat Service Medal and Purple Heart to her parents and several comments from squadron members. One squadron member sang a gospel tune that started eyes watering.
Then came the final roll call. Names of squadron members were called and answered until they came to her, silence. Her name was called again with more silence. Once more, still silence and then her full name followed by a 21 gun salute and taps. I challenge any of you to sit through that with a dry eye or after attending such a ceremony to ever hear taps again without a deeper sense of pride and commitment to those who have paid the ultimate sacrifice.
War stories are common on our unit, since we're a government-run hospital, but how you get the guys and gals to talk, or let them talk can be a whole 'nother story in itself.
One of our more cantankerous folks was rolling by on his way to getting something, so I stopped him and asked if he wanted his pills right now. Sure, he says, I'll take them. We chitchat for a minute and I keep doing my thing. Mr. C. starts talking about his time in the military during the Korean war. "See that scar" he says. Sure, I see it, because I'd just given him his heparin shot. "I got that on my way to Korea. I never made it to the front." I shake my head, therapeutically listen, and he keeps going.
Mr. C. never made it because he had a bad appendix and developed complications. An astute medic pulled him out of the crowd and when they landed in Europe, Mr. C. got a trip to the hospital. The docs didn't want him going too far once he was released, so they found a job there on a base to keep him busy moving supplies along to Korea.
We have also had some World War II vets hanging out with us. One of them was a Marine injured in the Pacific. He's a character and I'm sure his stature alone may have scared more than a few folks in that theatre. I think about some of my relatives when I talk to them, because they'd tell the stories of the war, when I was a child, and my brother and I listened very intently. Most of our relatives who went to World War II came back. One did not. I think of him a lot and the family he left behind.
Maybe it's just because of demographics, but we have lots of Vietnam-era guys at our place, including some of the employees. Lots of folks talk about the jungle and dreams they had while they were there. Some were more premonitions than dreams, but they colored their lives just the same. One guy told me about the lost opportunities from Vietnam--delayed families, deferred education, the bad attitude of some folks that often caused other problems in the jobs they came back to or started after their service. The angst among some who were injured, while other folks their age were in school and never drafted. The volunteers. Some people say, "Who'd volunteer for Vietnam?" and on our unit, you'd actually see some hands, proudly raised, almost defiant. "That was me," one guy told me. "Better to volunteer than be drafted," he thought.
Today, we see some of the Iraq and Afghanistan vets coming in with stories of their own. Swimming at Saddam's place. Guarding air fields in Kuwait. Driving through Afghanistan in the Hindu Kush mountains with snipers everywhere.
And while they're not my words, I leave you with a story I received recently from my husband's old dear friend who is at a southern US air base. His story is a short, but a compelling look at the life of an airman who lost her life recently.
I previously wrote many of you about the presentation of an Air Force Cross, the second highest medal an Airman can receive, next only to the Medal of Honor.
At 1000 yesterday morning, we met in the same hangar, not to pay tribute to a warrior amongst our midst but homage to one who would no longer be physically present with us. SrA Ashton Goodman was a 21 year old (22 next week), from Indianapolis, IN who served as a vehicle operator in the 43d Logistics Readiness Squadron. She had three short years in the AF but had already served as a truck driver, ferrying supplies and personnel from Kuwait into Iraq, been promoted to SrA six months below the zone, and called upon to brief the Chairman of the Joint Chiefs of Staff.
This time she volunteered for a one year tour working with a Provisional Reconstruction Team (PRT) in Afghanistan. SrA Goodman was killed last week when her vehicle was struck by an improvised explosive device (IED). Her funeral was Tuesday in Indianapolis. The Wing took up a collection and flew the family here for yesterday’s memorial.
It started with a slide show presentation, a speech by her squadron commander (it was obvious she had made a positive impact on him and the unit), presentation of the Combat Service Medal and Purple Heart to her parents and several comments from squadron members. One squadron member sang a gospel tune that started eyes watering.
Then came the final roll call. Names of squadron members were called and answered until they came to her, silence. Her name was called again with more silence. Once more, still silence and then her full name followed by a 21 gun salute and taps. I challenge any of you to sit through that with a dry eye or after attending such a ceremony to ever hear taps again without a deeper sense of pride and commitment to those who have paid the ultimate sacrifice.
Wednesday, June 3, 2009
Nuggets for June 3
After a temporary hiatus, the Nuggets are back!
Multiple Sclerosis links:
Here are a few links I thought I'd share as a result of my conference last week.
National Multiple Sclerosis Society
http://www.nationalmssociety.org/index.aspx
MultipleSclerosisPro.org
http://www.multiplesclerosisprofessional.org/
PVA's page on spinal cord diseases
http://www.pva.org/site/PageServer?pagename=disease_main
From the blogs...
I'll never think of making someone NPO the same again...
http://serenitynowhospital.blogspot.com/2009/05/npo.html
Sadness for a traveling OB nurse
http://rvtravelerrn.blogspot.com/2009/06/can-you-help.html
And a related item: What is anencephaly?
http://www.ninds.nih.gov/disorders/anencephaly/anencephaly.htm
Things not to do on Twitter: announce your vacation.
http://casesblog.blogspot.com/2009/06/dangers-of-social-media-twitter-your.html
And for something completely different....
Therapists wired to write
http://www.nytimes.com/2009/06/04/fashion/04shrinks.html
Multiple Sclerosis links:
Here are a few links I thought I'd share as a result of my conference last week.
National Multiple Sclerosis Society
http://www.nationalmssociety.org/index.aspx
MultipleSclerosisPro.org
http://www.multiplesclerosisprofessional.org/
PVA's page on spinal cord diseases
http://www.pva.org/site/PageServer?pagename=disease_main
From the blogs...
I'll never think of making someone NPO the same again...
http://serenitynowhospital.blogspot.com/2009/05/npo.html
Sadness for a traveling OB nurse
http://rvtravelerrn.blogspot.com/2009/06/can-you-help.html
And a related item: What is anencephaly?
http://www.ninds.nih.gov/disorders/anencephaly/anencephaly.htm
Things not to do on Twitter: announce your vacation.
http://casesblog.blogspot.com/2009/06/dangers-of-social-media-twitter-your.html
And for something completely different....
Therapists wired to write
http://www.nytimes.com/2009/06/04/fashion/04shrinks.html
Tuesday, June 2, 2009
Slide on over, folks!
You'd think Tuesdays wouldn't be so bad...nurse brings in lots of pens from the conference, people are happy and we are slated for no admissions. I could dream about it, but it wasn't easy at all today. I told our specialist that I am one of the most highly paid janitors/support staff as I filled every single cart on the main hall with isolation gowns. Why? We have support staff, who don't really feel it's their job to do it. No, sitting in front of the boob tube (reserved for patients) and playing pool (also reserved for patients) is really a more productive effort. If my male boss only had some balls. Removing the pool table ones to his office might help the situation.
I had three patients today, and our clinic nurse actually got one ready, since she needed him for a procedure early. I was very grateful. The other two were their usual eccentric selves, and yes, for them it's all about bowels. One goes too much, one goes too little. One gets out of bed without issue and the other leaves a trail on the sliding board as he's transferring. What does the nurse win, Pat? Another heave ho back to the bed for the patient, with the nurse leading the charge.
Just remember all you nursing students out there, if a patient is stuck in transfer halfway on the bed, you can get them all the way there by employing a maneuver I like to call "the dump". Basically, you get their legs and heave them onto the bed. They may be on their side and a little off kilter, but once you get them to the safety of the bed, put up whatever rails you can on any side they could slide out on, and maneuver them around from the other. I love low air loss mattresses, especially if they're made up right, because, by nature, the sheets are slick and you can slide most people wherever you need them to go in bed with little effort.
Said sliding mess patient eventually did get cleaned up, got lunch and got to the wheelchair for afternoon therapy. It was a workout though, for him and for me. I read this article tonight very carefully, so I can keep my back out of trouble!
After all that excitement, I got to move another patient because his roommate was isolated for a new bug. Yes, I'm an expensive mover, too.
More later...stay tuned.
I had three patients today, and our clinic nurse actually got one ready, since she needed him for a procedure early. I was very grateful. The other two were their usual eccentric selves, and yes, for them it's all about bowels. One goes too much, one goes too little. One gets out of bed without issue and the other leaves a trail on the sliding board as he's transferring. What does the nurse win, Pat? Another heave ho back to the bed for the patient, with the nurse leading the charge.
Just remember all you nursing students out there, if a patient is stuck in transfer halfway on the bed, you can get them all the way there by employing a maneuver I like to call "the dump". Basically, you get their legs and heave them onto the bed. They may be on their side and a little off kilter, but once you get them to the safety of the bed, put up whatever rails you can on any side they could slide out on, and maneuver them around from the other. I love low air loss mattresses, especially if they're made up right, because, by nature, the sheets are slick and you can slide most people wherever you need them to go in bed with little effort.
Said sliding mess patient eventually did get cleaned up, got lunch and got to the wheelchair for afternoon therapy. It was a workout though, for him and for me. I read this article tonight very carefully, so I can keep my back out of trouble!
After all that excitement, I got to move another patient because his roommate was isolated for a new bug. Yes, I'm an expensive mover, too.
More later...stay tuned.
All the world's a stage...
And men and women merely players, according to William Shakespeare.
I'm back playing the Palace as I tell my regular customers at the Hotel Rehab, and still getting my bearings, or should I say, catching up on sleep, from the past week of conference excitement.
More to come...I promise! Stay tuned.
I'm back playing the Palace as I tell my regular customers at the Hotel Rehab, and still getting my bearings, or should I say, catching up on sleep, from the past week of conference excitement.
More to come...I promise! Stay tuned.
Thursday, May 28, 2009
Conference rules
Still here in big Southern city for the monster conference for one of our Hotel Rehab specialties. Still blogging from Starbucks, since I can get internet here for free.
Nevertheless, here are a few things I've learned this week.
1. Be creative.
When you hang out with a bunch of people who have fun doing their jobs despite budget cuts, crazy bosses and whacked-out administrators, you can learn some new tips that you can use on your job.
2. Be kind.
Number one can really shell-shock people. Being out of it, for even a short time, can be like visiting an oasis.
3. Do what the leader tells you.
Especially when you're having a blast at the party and she starts the conga line...who can resist?! Yes, June, I'm talking about you!
4. Budget your time.
Just like on the floor, you have to budget your time, but always have some wiggle room. You never know who's going to show up that you just may want to talk to or listen to for a while.
Oh, yes, there's all the administrative stuff--wear your badge, say hi a lot, and get to the buffet early, but that pales in comparison to those vaunted pearls of wisdom. Not the pearls you find because some PhD, MD or HIJKLMNOP person has said with a microphone.
No, the ones you discover sitting across from someone you don't know, or riding in an elevator with, who, when you've travelled miles and miles, actually lives within a short distance of you.
It really is a small world, and yes, politics is local, as the saying goes. I'm just looking around here and there for the opportunities that arise. Some of those impromptu moments are the best ones of all.
More to come...stay tuned!
Nevertheless, here are a few things I've learned this week.
1. Be creative.
When you hang out with a bunch of people who have fun doing their jobs despite budget cuts, crazy bosses and whacked-out administrators, you can learn some new tips that you can use on your job.
2. Be kind.
Number one can really shell-shock people. Being out of it, for even a short time, can be like visiting an oasis.
3. Do what the leader tells you.
Especially when you're having a blast at the party and she starts the conga line...who can resist?! Yes, June, I'm talking about you!
4. Budget your time.
Just like on the floor, you have to budget your time, but always have some wiggle room. You never know who's going to show up that you just may want to talk to or listen to for a while.
Oh, yes, there's all the administrative stuff--wear your badge, say hi a lot, and get to the buffet early, but that pales in comparison to those vaunted pearls of wisdom. Not the pearls you find because some PhD, MD or HIJKLMNOP person has said with a microphone.
No, the ones you discover sitting across from someone you don't know, or riding in an elevator with, who, when you've travelled miles and miles, actually lives within a short distance of you.
It really is a small world, and yes, politics is local, as the saying goes. I'm just looking around here and there for the opportunities that arise. Some of those impromptu moments are the best ones of all.
More to come...stay tuned!
Go get your CoS
Yes, it's out there folks, and Gina at codeblog's hosting the party...check it out here:
http://www.codeblog.com/archives/carnivals/change-of-shift-vol-3-number-24.html
http://www.codeblog.com/archives/carnivals/change-of-shift-vol-3-number-24.html
Wednesday, May 27, 2009
So far, so good post 1 from Starbucks
5/26/2009
It was the best of times, it was the worst of times.
That pretty much summed up my week as I tried to get ready to go. I worked just before the weekend, and as always, evenings are interesting. I usually do a week in a row, so I thoroughly enjoyed having the total cut in half, due to some vacation. I didn't get as much work done around the house on my vacation days as I would have liked, but I always plan to do more than I can actually get done.
It has been really interesting here at the conference. I've been studying for a certification and the organization throwing this workshop has spent a lot of time and money and it shows. We have just about all of the people who wrote the books for this certification test and they are really very eager to share their knowledge of how things work and are very approachable. We had a wonderful dinner at a very swank restaurant tonight, where we got to meet more people when they shuffled us around again. It turned out very well.
The weather has been rainy, but that's not a problem when you're stuck inside. The neighborhood's not that great, so you can walk some places away from the hotel, but not too far, because there's not a ton of stuff open. I've identified some of the more important spots, though--the mall and the closest Starbucks. This is very important, since this hotel offers no free internet access, unless, of course, you pay a room upgrade of 50 bucks. You'd think in this age you'd get it free, but...
Nevertheless, I'm typing away at this in anticipation of the dawn, and the opening of Starbucks....I wish you all good night!
It was the best of times, it was the worst of times.
That pretty much summed up my week as I tried to get ready to go. I worked just before the weekend, and as always, evenings are interesting. I usually do a week in a row, so I thoroughly enjoyed having the total cut in half, due to some vacation. I didn't get as much work done around the house on my vacation days as I would have liked, but I always plan to do more than I can actually get done.
It has been really interesting here at the conference. I've been studying for a certification and the organization throwing this workshop has spent a lot of time and money and it shows. We have just about all of the people who wrote the books for this certification test and they are really very eager to share their knowledge of how things work and are very approachable. We had a wonderful dinner at a very swank restaurant tonight, where we got to meet more people when they shuffled us around again. It turned out very well.
The weather has been rainy, but that's not a problem when you're stuck inside. The neighborhood's not that great, so you can walk some places away from the hotel, but not too far, because there's not a ton of stuff open. I've identified some of the more important spots, though--the mall and the closest Starbucks. This is very important, since this hotel offers no free internet access, unless, of course, you pay a room upgrade of 50 bucks. You'd think in this age you'd get it free, but...
Nevertheless, I'm typing away at this in anticipation of the dawn, and the opening of Starbucks....I wish you all good night!
Tuesday, May 26, 2009
"Reports of my demise
...are greatly exaggerated. " Mark Twain
Lots of stuff brewing as I'm wandering around a major Southern city sweating in the humidity that we usually get in my neck of the woods later.
Work was work, but more on that later. Gotta run to breakfast....stay tuned!
Lots of stuff brewing as I'm wandering around a major Southern city sweating in the humidity that we usually get in my neck of the woods later.
Work was work, but more on that later. Gotta run to breakfast....stay tuned!
Tuesday, May 19, 2009
Nuggets for May 19
Yes, it's Tuesday again, and I'm waiting for my car today. So since Starbucks is so lovely, I remembered the ear buds and am listening to intermittent Christmas music, yes, on May 19, thanks to Adore Jazz.
Here are a few goodies I've run into in between reading for my cert exam and writing an essay.
From my ANA SmartBrief (via e-mail)
Hospital secret shoppers looking for handwashing violators (at wcvb.com)
Just use that hand sanitizer or wash please!
Just another reason to get your red dress on...
Gender disparities seen in EMS care for chest pain (from reuters.com) I was thinking about this the other day when I was talking to my grade school friend who just got a new mitral valve (along with a free CABG x 4...yes 4)
On the job hunt
Okay, all you nursing school grads, and general job hunters, here are a couple of great articles on things to do for your interview and things not to do for your job interview (both from nursinglink.com)
'Tis the season
It's getting warm in our neck of the woods and sunny, too. Memorial Day is right around the corner, and you know what that means...the pools open and you spend more time out in the sun.
To keep your skin in shape keep an eye out for the signs of skin cancer. If you're high risk, like yours truly, stock up on your favorite sunscreen and stay out of the sun if you can avoid it. If not, use that sunscreen liberally and cover as you can. You'll avoid scars and wrinkles that way, too.
Here are a few goodies I've run into in between reading for my cert exam and writing an essay.
From my ANA SmartBrief (via e-mail)
Hospital secret shoppers looking for handwashing violators (at wcvb.com)
Just use that hand sanitizer or wash please!
Just another reason to get your red dress on...
Gender disparities seen in EMS care for chest pain (from reuters.com) I was thinking about this the other day when I was talking to my grade school friend who just got a new mitral valve (along with a free CABG x 4...yes 4)
On the job hunt
Okay, all you nursing school grads, and general job hunters, here are a couple of great articles on things to do for your interview and things not to do for your job interview (both from nursinglink.com)
'Tis the season
It's getting warm in our neck of the woods and sunny, too. Memorial Day is right around the corner, and you know what that means...the pools open and you spend more time out in the sun.
To keep your skin in shape keep an eye out for the signs of skin cancer. If you're high risk, like yours truly, stock up on your favorite sunscreen and stay out of the sun if you can avoid it. If not, use that sunscreen liberally and cover as you can. You'll avoid scars and wrinkles that way, too.
Saturday, May 16, 2009
Change of Shift is up and at 'em
And if I weren't out on vacation, I would have posted it sooner!
Go on and check it out! You'll enjoy it! Beam me up, Scottie!
Go on and check it out! You'll enjoy it! Beam me up, Scottie!
Friday, May 15, 2009
The merry, merry month of May
Ah, yes, it is. And it's been merry so far this week. I was temporarily inundated with multiple patients, but nothing too difficult. Some of my people are even fighting to get me back! How nice it is to feel loved!
Anyway, feeling loved is a heck of a lot better than smelly C-diff. Ugh! I had one patient with it this week and it's always fun when the docs want a room, they start saying, "Well, his WBC numbers are down, let's take him off isolation." All I have to say is, "What happened to those ID rules (infectious disease, such as this sample one)?" No one asked for any more tests, so who knows!
Today there was a party and BBQ for the patients. People everywhere. I got my patient up earlier than usual and he tried to go back to bed before I left. He's not liking that rehab status at all! There will be more excitement next week, but I'll be at home until the weekend.
Ah...more to come. Stay tuned!
Anyway, feeling loved is a heck of a lot better than smelly C-diff. Ugh! I had one patient with it this week and it's always fun when the docs want a room, they start saying, "Well, his WBC numbers are down, let's take him off isolation." All I have to say is, "What happened to those ID rules (infectious disease, such as this sample one)?" No one asked for any more tests, so who knows!
Today there was a party and BBQ for the patients. People everywhere. I got my patient up earlier than usual and he tried to go back to bed before I left. He's not liking that rehab status at all! There will be more excitement next week, but I'll be at home until the weekend.
Ah...more to come. Stay tuned!
Tuesday, May 12, 2009
Nuggets for May 12
Here are the latest and greatest goodies I've run into in my various voyages on the internet. Enjoy!
Blind, miscellany
Being blind, 'you have to be adventurous' (from www.cnn.com)
BTW did you know that the VA is one of the leaders in blind rehabilitation? If not, check out the information here at the Blind Rehabilitation Service.
C. diff infection rate rising among US hospital inpatients (from www.nursezone.com)
And from our friends in ED land...
ImpactEDNurse has a great post on mouth-to-mouth resucitation on his blog. I'm so glad our policy forbids mouth to mouth in certain instances, such as this. I'm with you on the compressions, Ian...at least you can dodge the flying bits!
DisappearingJohn is on the way up. Good for you!
Finally, Happy International Nurses' Day May 12
On the birthday of Florence Nightingale, don't miss this op-ed piece by Sandy Summers today on solving the nursing shortage.
Blind, miscellany
Being blind, 'you have to be adventurous' (from www.cnn.com)
BTW did you know that the VA is one of the leaders in blind rehabilitation? If not, check out the information here at the Blind Rehabilitation Service.
C. diff infection rate rising among US hospital inpatients (from www.nursezone.com)
And from our friends in ED land...
ImpactEDNurse has a great post on mouth-to-mouth resucitation on his blog. I'm so glad our policy forbids mouth to mouth in certain instances, such as this. I'm with you on the compressions, Ian...at least you can dodge the flying bits!
DisappearingJohn is on the way up. Good for you!
Finally, Happy International Nurses' Day May 12
On the birthday of Florence Nightingale, don't miss this op-ed piece by Sandy Summers today on solving the nursing shortage.
Hurry up and wait
Yes, it's my day off again, so now I'm engaged in the latest version of Hurry Up and Wait, the car maintenance edition.
Since the mechanic's got wifi at the shop, I thought I'd keep busy, even if I'd really like to find a quiet corner with a big couch and go to sleep. Thankfully, I'm well-caffeinated with my Starbucks and working away.
Work was finally placid...at least for most of the night. We had bed bingo again because C-diff is loose on the unit again, much to everyone's surprise. It was bound to happen since our docs throw Vancomycin at everything all the time. One of our guys was even on prophylatic PO Flagyl and lactobacillus and still came up positive. So much for that idea...
I tagged teamed with another nurse to get one of my patients cared for, since he's a two person turner. It was nice. We got her guy situated, since he works better when he stays up longer than he wants. He's a rehab patient who would like to stay in bed all the time, but he is just starting to get his conditioning back again. Since the docs want him up, we have a good excuse to keep him there until he's ready for his nightly rituals.
Otherwise, I'm glad I'm off today. I need the break! More later...
Since the mechanic's got wifi at the shop, I thought I'd keep busy, even if I'd really like to find a quiet corner with a big couch and go to sleep. Thankfully, I'm well-caffeinated with my Starbucks and working away.
Work was finally placid...at least for most of the night. We had bed bingo again because C-diff is loose on the unit again, much to everyone's surprise. It was bound to happen since our docs throw Vancomycin at everything all the time. One of our guys was even on prophylatic PO Flagyl and lactobacillus and still came up positive. So much for that idea...
I tagged teamed with another nurse to get one of my patients cared for, since he's a two person turner. It was nice. We got her guy situated, since he works better when he stays up longer than he wants. He's a rehab patient who would like to stay in bed all the time, but he is just starting to get his conditioning back again. Since the docs want him up, we have a good excuse to keep him there until he's ready for his nightly rituals.
Otherwise, I'm glad I'm off today. I need the break! More later...
Sunday, May 10, 2009
There is a light...
At the end of every tunnel, if you really look hard. Sometimes, you have to dig through a lot of dirt and excrement to get to it, but you get there.
I had a really crazy last few days. I realize that some of the people I work with really don't work as a team if certain people aren't there to influence them to do so. It really pisses me off, but I can't do anything about it.
So what do you do? You find the people who'll work with you, and you work with them. You help them and they help you. And if you need the other ones, you have to put on the RN hat and delegate. I don't like pushing people, but I'm getting sick of this crap. If they only knew that I don't ask them for help because I get really perturbed about their followup comments, "Oh, she's not very efficient," "Oh, she does it different than I do, " or my favorite, "Why does she talk to the patient before we turn them?"
One of my patients, who is a lot sharper than he looks told me last night, "I noticed a lot of people make you do stuff on their schedule, and if you don't they get mad." Surprise, surprise. I have found that if I give people options and tell them I have to do other things, too, 95% of them will make a choice when given two options. That other 5% is another story, but even they can often be convinced to cooperate.
A lot of people think therapeutic communication is hooey, but I look at it more as negotiation. Some people we work with need control, because so much of their lives are out of control. This establishes some for them, and saves me some time in the process. It may not be old school "my way or the highway", but they can't say I didn't give them a chance.
My day, although I missed a little sleep, has been delightful. Dahey and Bubba took me to brunch and gave me lovely little presents...just what I wanted! We went out to eat and let someone else cook and do dishes. I came home, did a little shopping and now I'm getting ready for day 4 of 5. I'll deal with it as I go.
My light is the fact that after this week, I won't be at work much for the rest of the month, due to vacation days and conferences. When I looked at the new schedule with this on it, my heart leapt for joy.
Plenty of days to recharge ahead...and lots of light at the end of the tunnel.
Happy Mother's Day to all of you out there, wherever you are, wherever your momma is, here or gone. Mom's responsible for this missive today! :-)
I had a really crazy last few days. I realize that some of the people I work with really don't work as a team if certain people aren't there to influence them to do so. It really pisses me off, but I can't do anything about it.
So what do you do? You find the people who'll work with you, and you work with them. You help them and they help you. And if you need the other ones, you have to put on the RN hat and delegate. I don't like pushing people, but I'm getting sick of this crap. If they only knew that I don't ask them for help because I get really perturbed about their followup comments, "Oh, she's not very efficient," "Oh, she does it different than I do, " or my favorite, "Why does she talk to the patient before we turn them?"
One of my patients, who is a lot sharper than he looks told me last night, "I noticed a lot of people make you do stuff on their schedule, and if you don't they get mad." Surprise, surprise. I have found that if I give people options and tell them I have to do other things, too, 95% of them will make a choice when given two options. That other 5% is another story, but even they can often be convinced to cooperate.
A lot of people think therapeutic communication is hooey, but I look at it more as negotiation. Some people we work with need control, because so much of their lives are out of control. This establishes some for them, and saves me some time in the process. It may not be old school "my way or the highway", but they can't say I didn't give them a chance.
My day, although I missed a little sleep, has been delightful. Dahey and Bubba took me to brunch and gave me lovely little presents...just what I wanted! We went out to eat and let someone else cook and do dishes. I came home, did a little shopping and now I'm getting ready for day 4 of 5. I'll deal with it as I go.
My light is the fact that after this week, I won't be at work much for the rest of the month, due to vacation days and conferences. When I looked at the new schedule with this on it, my heart leapt for joy.
Plenty of days to recharge ahead...and lots of light at the end of the tunnel.
Happy Mother's Day to all of you out there, wherever you are, wherever your momma is, here or gone. Mom's responsible for this missive today! :-)
Friday, May 8, 2009
Slam!
It was a crazy shift. On a normal day, we get one or two admissions. Today, not being normal (maybe in advance of the full moon the pharmacist told me about...) we got four. The Hotel is now full for the moment.
And if dealing with four admits wasn't enough excitement, we also needed the following. (as nurse hums "Bad Moon Rising" in the background...)
One patient crashing with a roundy, roundy draining blood pressure. In comes doc, out goes patient...
One nurse with two patients requiring two people at all times to move. Can you say chase down an assist?
One patient with the Hindenberg colostomy bag. Thankfully I averted the explosion, but he left a trail. Must have been all those goodies the kids brought in for all the patients.
One patient needed suppository inserter training. Here's two people again to transfer and set up.
One patient with swelling lips and a reaction to latex and/or antibiotic with hives.
One bitchy nursing supervisor, who, when asked to get a med from another unit, stated (in the middle of all the anaphlaxis mess) "Can't you just get it yourself?" No, I wanted to tell her, it would interrupt my nap!
And two leaky, creaky Foleys!
Hopefully, it won't be as wild tonight. Whew! We shall see...stay tuned!
And if dealing with four admits wasn't enough excitement, we also needed the following. (as nurse hums "Bad Moon Rising" in the background...)
One patient crashing with a roundy, roundy draining blood pressure. In comes doc, out goes patient...
One nurse with two patients requiring two people at all times to move. Can you say chase down an assist?
One patient with the Hindenberg colostomy bag. Thankfully I averted the explosion, but he left a trail. Must have been all those goodies the kids brought in for all the patients.
One patient needed suppository inserter training. Here's two people again to transfer and set up.
One patient with swelling lips and a reaction to latex and/or antibiotic with hives.
One bitchy nursing supervisor, who, when asked to get a med from another unit, stated (in the middle of all the anaphlaxis mess) "Can't you just get it yourself?" No, I wanted to tell her, it would interrupt my nap!
And two leaky, creaky Foleys!
Hopefully, it won't be as wild tonight. Whew! We shall see...stay tuned!
Wednesday, May 6, 2009
Nuggets for May 6
Here are a few goodies I've found perusing the 'net this week. Enjoy!
Something to talk about later for me at work
Epstein-Barr Virus linked to MS from www.webmd.com
Grow, blog, grow (or things I need to be doing in my spare time)
I found these gems via KevinMD's blog:
How to grow your blog to the next level with SEO from problogger.com
How to write magnetic headlines from copyblogger.com
Etc. (stuff with no category)
Trendy baby names tend to fade fast Surprise, surprise!
CDC: Don't eat raw alfalfa sprouts. Thankfully, I stopped years ago.
Face transplant patient steps forward from www.nytimes.com
Finally, it's about time category
Health insurers agree to end higher premiums for women from www.nytimes.com
Something to talk about later for me at work
Epstein-Barr Virus linked to MS from www.webmd.com
Grow, blog, grow (or things I need to be doing in my spare time)
I found these gems via KevinMD's blog:
How to grow your blog to the next level with SEO from problogger.com
How to write magnetic headlines from copyblogger.com
Etc. (stuff with no category)
Trendy baby names tend to fade fast Surprise, surprise!
CDC: Don't eat raw alfalfa sprouts. Thankfully, I stopped years ago.
Face transplant patient steps forward from www.nytimes.com
Finally, it's about time category
Health insurers agree to end higher premiums for women from www.nytimes.com
Tuesday, May 5, 2009
Picture this...
Patient in bed, turn q2 hours. On Coumadin for DVT prophylaxis and owns a Greenfield IVC filter. Per report, patient bleeding from every orifice--that's right--every stinking one...drip, drip, drip. You turn patient and find a pool there, too, from a wound on back side.
Doc's not worried about it per nurse caring for patient on previous shift. I love my job, but sometimes I really scratch my head on stuff like this.
Doc's not worried about it per nurse caring for patient on previous shift. I love my job, but sometimes I really scratch my head on stuff like this.
Monday, May 4, 2009
Stuff you just don't want...
We've been having a few discussions at work about assorted stuff. Here are some of the goodies.
1. The dreaded triple A (abdominal aortic aneurysm). One of our patients has one and since his/her H&H has been up and down lately, we were crossing fingers once they went for scanning to see if it was leaking. Thankfully, it was not.
If one blows at our Hotel, just call us "Hotel California", 'cause you won't be checking out!
2. The CABG x 4. I know it's not Red Dress month anymore, but if you're female, please realize, heart disease is THE number one killer of women. Not that we don't like fighting breast cancer, but when they say an ounce of prevention is worth a pound of cure, start with the Quarter Pounder.
3. People messing with patient acuity and staffing. I consider myself very lucky to work in an area with mandated staffing ratios. When I talk to other people who don't have that luxury, I realize that I am a very happy nurse compared to my previous days before that happened. Very rarely do I feel that I don't have enough time with patients. That is a very important aspect of nursing today.
1. The dreaded triple A (abdominal aortic aneurysm). One of our patients has one and since his/her H&H has been up and down lately, we were crossing fingers once they went for scanning to see if it was leaking. Thankfully, it was not.
If one blows at our Hotel, just call us "Hotel California", 'cause you won't be checking out!
2. The CABG x 4. I know it's not Red Dress month anymore, but if you're female, please realize, heart disease is THE number one killer of women. Not that we don't like fighting breast cancer, but when they say an ounce of prevention is worth a pound of cure, start with the Quarter Pounder.
3. People messing with patient acuity and staffing. I consider myself very lucky to work in an area with mandated staffing ratios. When I talk to other people who don't have that luxury, I realize that I am a very happy nurse compared to my previous days before that happened. Very rarely do I feel that I don't have enough time with patients. That is a very important aspect of nursing today.
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