Never forget

I won't. Ever.

Harbinger of things to come?

Sunday started with a migraine, which did not go away. It just subsided here and there until the migraine drugs came out (thankfully, no nausea and vomiting!)

Went over by the Hotel and saw one of my coworkers, F., getting ready for the night shift. Long discussion. Had to cut it short to do what I had to do and get two friends to bring home for Dahey and Bubba.

Those friends: Ben & Jerry. Yes, we ran out of ice cream (found this out yesterday) and you would have thought the world would indeed end.

But alas, as I'm leaving I saw it. The harvest moon. 

I hope F. has a really boring night.

That is all. Stay tuned...the night (and the week) is young.

Only in my dreams

Only in my dreams could we get a Hotel Rehab as "smart" and "accessible" as this new one going up in Nebraska.

I'm kind of worried about those gestures turning on and off appliances, lights, etc.

What do I do with the guy who has spasms whenever we turn him (or whenever he tilts just right in his wheelchair)?

It could get REALLY interesting.

Just sayin'...stay tuned. (I'd love to be there when it opens!)

The perils of rehab

While I was at my rehab conference, I talked to lots of folks. One of the biggest issues was reimbursement.

Now I know why there are issues. If companies only hire for a bare minimum set of qualifications for their staff (see below), it's no wonder why all the case managers in the audience said they were coloring their hair due to it turning white prematurely.

Clinical Appeals Reviewer 
Job Description:

Primary Responsibilities:

    Provide expertise or general support in reviewing, researching, investigating,and resolving all types of appeals.
    Communicate issues, implications, and decisions with appropriate parties.
    Analyze and identify trends for Appeals.


Job Requirements:
Required Qualifications:

    High School Diploma/GED.
    1+ year of Telephonic Customer Service experience.
    1+ year of Healthcare Insurance experience.
    Proficiency with Microsoft Outlook, Word, and Excel, including the ability to create spreadsheets and filter data.

Preferred Qualifications:
    Familiarity with Medical Terminology

Funny, but no where did it say this person ought to be a nurse. You get what you pay for...just sayin'

More to come...

Another t-shirt moment

I love conferences, since you get to see people you haven't seen in ages and learn new stuff.

But I really hate it when you are so tired, you want to pass out, because you've been trapped in freezing cold rooms and staying up late.

Thank goodness I convinced the boss I need time to recoup (aka vacation). I might not be going anywhere, but being stationary, is a very good thing.

Stay tuned.

Junior high excitement

Bubba is learning the ropes and discovering things I never though he would.

Like how to find your lost ID in the computer lab, how to buy pizza every day for lunch (one of the perks of junior high) and how to negotiate the neighborhood on foot.

Since they get extra points for attending the local high school football games (by sitting with the band-music points), he's learning about those, too.

Fun times in the land of the pre-teen....more later.

Smog + heat =

Misery. Just misery. Red air quality...yuck!

It is making my allergies go crazy. Either that or it is the 50 degrees in my office since some people need it freezing to work. I love getting sick!

At least the Diet Coke will stay cool if someone like Grumpy happens by.  (the ice machine is a long walk...)

Stay tuned...

It's HOT!

Dear Summer:

I know it's not Labor Day yet, and the kids are back in school, but this 100+ degree temperature thing needs to go.

I finally got used to not freezing to death at the Hotel. Now my space is so cold I have to either 1) talk to patients in the hallway, if it's possible or 2) turn the air off and sweat while I talk to patients.

All this stuff about designing rooms for patients is nice, but once in a while, couldn't we get a universal design that works for EVERYONE?

I know I'll be waiting for the remodeling (that may never come) in my end of the Hotel. Here's hoping the HVAC folks can get it right.

Sincerely (only if you fix climate control),

RehabRN

The joys of junior high

Bubba is liking his morning setup. Get up, get ready, go to school. The only thing he's not really liking is the carrying of the heavy books, along with his trumpet. Today was nice because he got a ride home from me.

And now, since a weather front is coming in, what better time for a migraine.

I know the feeling all too well.

Stay tuned...

The story of my life

I shall not change my course because those who assume to be better than I desire it.~  Victoria Woodhull 

I really wonder why some people just can't mind their own business.

That is all...more later.

They don't have a T-shirt for this

Being a certified nurse can be nice, but documenting all of those continuing education things can be a pain.

Hooray! You're a certified nurse! Fast forward (it really didn't seem that long) and before you know it, it's time to renew that certification.

However, it's not impossible. Here are my tips (from personal experience since I've done this a couple of times this year) on how to get your stuff together and submit without ripping all your hair out.


1. Be organized. Keep good records of what educational seminars, conferences, webinars, etc. you attend. I bought a small scanner for receipts, but I scan every single document I get and put it in a folder on my computer.

You can really collect a lot of stuff over most certification periods (three to five years is standard).

2. If you go the electronic route, always remember to back up your info and put it in a safe place. You don't want all that time and work to go up in smoke. You can backup stuff online or on DVD or in a fireproof file box.

3. Start early. Many organizations charge late fees (and many are not cheap). Some (like one East Coast organization I will not mention) like to audit the folks who file late. For the most part, organizations audit a certain percentage of recertification candidates (this percentage varies).

How do I know? I was one of the lucky folks who got audited when I forgot to mail in my stuff while I was on vacation this spring. 

4. Read the instructions carefully and make sure you send in the appropriate amount of contact hours. Some organizations distinguish between online learning, webinars, conference calls, etc.

5. File electronically if your organization allows it. See #3. No late fees if you can send it in online by the due date and most send you a confirmation e-mail once you're done.

6. If you can't file electronically, always, always, always keep a copy of your completed application.

One friend applied for a certification and the certifying body lost his/her application. Thankfully, he/she had a copy and after a couple of phone calls, resent it, and all was good on the road to certification.

Without that copy, it would have been pretty ugly.

Enjoy your recertification adventure!

Will they ever learn?

"May we not succumb to thoughts of violence and revenge today, but rather to thoughts of mercy and compassion. We are to love our enemies that they might be returned to their right minds." ~ Marianne Williamson

May peace return soon to the streets of Ferguson, MO

Maybe this doc was a nurse

I ran into this interesting post at the ever surprising FML. It's not just about bad things happening to other people.

However, dear med student, most of the time the tasks mentioned that you may order actually are done by nurses. I have yet (in my short career) to see any docs insert and seat a catheter or give an enema.

I don't doubt that some of my docs could do it, but I'd suspect they won't be as good as we are (wink).

More later...

The greatest generation among us

Mr. N. was a character. From the moment the referral nurses talked about him, they weren't really sure if he'd even make it to the Hotel. He was old. He was sick. He was unconscious. He was deaf as a post without his hearing aids. He was as we say, "day to day."

He lived and for a while, Mr. N. inhabited a bright sunny room, where he had a good view of the construction going on nearby. Once he got his hearing aids, he talked. He was very opinionated, having worked for one utility, he had a pretty good idea what was going on outside his window.

In a way, Mr. N. reminded me of my father. He had the same ethnic look and the same blue eyes. He also had a gravelly voice of a man who smoked a few Chesterfields in his day. We talked about a number of things once we connected. I could always ask if it was really true what the guys said about his battle (the "no purple hearts" part).

Mr. N. even introduced me to his children. I got to meet all of them, including the bossy daughter ("she runs everything" he said). They were nice. They were amazed that their dad did as well as he did.

One day, Mr. N. came to see me, looking for change to get a soda. I didn't have any so I checked his chart.I realized he was not diabetic, so I offered him the soda Bubba made me take to work, in case I got snowed in.

His eyes brightened when he saw it. "Ooh!" he said. "The good stuff. Sierra Mist." He thanked me and rolled away down the hall for a cup of ice.

Mr. N. came by to see me when it was time to discharge. He said, "I hope to see you again. Thanks for everything." and winked. He left the next day to go to the nursing home.

We were told the other day that Mr. N's "bossy" daughter called. He had passed away in his sleep that day. His weak heart finally gave out. This week, with more than 500 others each day, he joined history. 

And I am thankful I have one more story about World War II to cherish, told by a man who made history in the Battle of the Bulge.

The summer's dwindling

Soon, Bubba will go back to school. It will be a new one and a new grade, so it should be interesting.

After a year of trying, I finally figured out how the school information system works.

More to come...

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

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

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

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

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

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

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

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

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

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

We have to ask

RehabRN's tips for new rehab nurses: stuff you have to ask.

1. Did you bring your medication list? 
We want to know. It's all part of our service, and it keeps you safe. It keeps all those accreditation people happy, too.

2. Do you have any guns, knives or weapons?
We cannot have them on our unit. We can get them taken care of for you, if you don't want to send home your prized Bowie knife (actually found one under a cushion once--in a scabbard) with your mom/wife/sister/random relative or friend. 

Those accreditation people like us to do that, too.

3. Do you use marijuana or other drugs not prescribed by your doctor? 
Your safety is involved here, too. We are not the police, but they will inform you that your "unofficial meds" (as one patient told me) cannot be kept or be available for "sharing" or sale here in our lovely Hotel.

Unofficial pharmacists are not allowed to practice here, either.

And my personal favorite:

4. Do you have any concerns about your sexual health? 
No, at the Hotel, we don't ask directly (our psychologists and MDs generally ask), but I will ask if I get some smart alecky comment about some nurse's butt or how someone is "interested" in x, y, or z (pick your favorite salacious comment).

It is a big deal in rehab. Many folks have been through horrible experiences before they got there. You always know they're starting to feel better when they start getting frisky and/or asking directly (or indirectly).

Just remember, a lot of times, it really is about them, and not you. Be aware and learn how to get other members of your interdisciplinary team involved. If it is about you, bump it up the chain with your nurse manager, and if needed, human resources.

It does takes a village to take good care of rehab patients.

More later...

Gotta love the men

I go to my gynecologist and he's asking what my secret is to losing seven pounds since last year. I tell him I watch carbs and sweets.

He must have missed lunch because we had a lengthy discussion about donuts. (Fortunately, his office is close to a donut shop and within 2 miles of a cable network rated one).

Then I come home and read Dr. Grumpy's post about nurses over at kevinmd.com. Aww! I know who appreciates me, and who doesn't.

Yes, indeed, it was a good day. Gotta love the men!

Just a thought

I have a bicycle sitting idle in the garage. Bubba goes to school down the street now, so he can walk home.

I'd like to ride my bike to the Hotel, but I'm getting a little skittish after reading stories like this one. It  might help keep my weight in check, too, since I've been indulging in one too many goodies at work.

NOTE: I've already gotten in my own bike vs.car crash in college and I lived (I got a really good look at the driver and totalled my bike). Not sure if I feel like doing that one again.

The joys of modern transit and obesity.

I survived!

My stint as an adjunct instructor at MegaCorp College is over. Hooray!

What did I learn?

1. Some people are just not motivated.

2. Some people don't really listen. I only told my students (orally and in writing) that all the written homework was due the day before the final.

I still had one goof say, "What? We can't turn in any homework tonight?"

Yes, Doofus, that's right. Working on your schedule at Taco Bell instead of finishing your uncompleted work was really not a good thing. Miraculously, he passed the course...with a whopping D.

3. Flunking students is not fun, but sometimes you have to do it. I had to flunk the one student in my course who would like to go on to the nursing program.

As Dahey says, if she can't hack it now, maybe she should be doing something else.