A profound statement

"You’re not where you work and your work is not you."  Howard Behar

Be true to yourself. Jobs will come and go.

Happy Birthday Bro!

Cramming in a few more things

It's that time of year, otherwise known as June, the due date month. Due date for presentations and my annual review (which I have to prepare feedback on every year, even if I don't get promoted.)

I have fun doing slide shows. Since we have to have everything we present approved in advance by legal, I have lots of fun. For a long time, I refused to use photos (I'd use free license cartoons, but no pictures). I decided this year that was dumb. For fun, I have added some old home ones with interesting captions. I'm actually in one, so I'm not technically picking on just relatives. And I don't have to ask for permission from anyone, which is helpful.

My annual review, unfortunately, doesn't include pictures. If it did, I could have a lot of fun.

Things I'd take pictures of to put in my review if I could:

1. The ethics consultation (no photo available) part. Can you photograph integrity? Maybe not, but our ethics chair looks like he came out of a film noir. (His photo would be  good in black and white).

2. The associate chief nurse looking befuddled when I explained that her simple project wouldn't be so simple.  It only took her a couple of years for her to believe that I actually knew my job. She thought another manager (who was directly assigned to his/her position with no experience) knew everything.

That look was priceless. I wanted to say "I told you so" but I didn't. Hindsight is 20/20.

3. The pie my coworkers and I bought after a long ride to take care of a patient in his/her home. The famous pie place was on the trip back. I'd have given our driver a gold medal, but it wasn't available.

I guess if they ever make us do a portfolio, I'll have to add more photos.

Hope you enjoy the rest of your week wherever you are. Friday will be here soon enough.

So not rehab

***Deviation ahead, please stand by...***

I'll never profess to being a hip, happening fashion or movie blogger. I'm just too "straight" as one of my patients told me recently.

However, I really enjoyed this article featuring Helen Mirren discussing fashion, insecurity, butt, and thighs.

I hope you enjoy being who you are as much as I do. Live like you want to live, baby!

More to come...

The little people

We finally found out where the VIP entourage went while they were touring Washington recently, and we were patiently waiting on the floor for them to stop by on our unit. The VIPs stood us up.

Since everything our hospital system does is now posted on Facebook, the photos told us where they went.

I'm used to being "cut" from the A list in my area all the time. Nurses are used to it. My bosses, he and she, are not.

It's not fun finding out you are the "little people" after you come to work when you really could be doing something better.

Life is full of small victories. Enjoy every minute.

More to come.

Dear Coworker

Sometimes I hold my tongue, not to embarrass you, but to keep from getting prosecuted.

First of all, I eat "quickly" because while you're regaling the bosses at our business lunch and one-upping everyone with your stories, I'm eating. Plain and simple. You might just catch up if you stopped talking.

Second, it would also help if you actually left the table when your phone rings. Have your phone ring six times while we were eating is not acceptable. It shows that you really cannot be present with our boss (who has better reasons to answer his/her phone) and actually listen.

Constructive criticism is helpful if you choose to learn from it.

Quietly yours,

RehabRN

A rehab fact: inaugural edition

Since we see lots of stuff in the media about cool technologies and procedures, did you ever want to know more?

Fear not, as a rehab nurse, here's my take (with a little help from our PTs) on some topics of interest.

Our first installment is about one of the hottest topics out there in rehab: exoskeletons. I worked with a general surgeon who actually said in a meeting, "We could solve every problem with our SCI patients if we could get them an exoskeleton, and what wonderful PR it would be for Madison as a whole."

My first thought: wow! Yes, exoskeletons ARE cool, but unfortunately, they don't work for everyone.

Here's a list of criteria (which is also on the website of one manufacturer)

1. You must be between 5'3"-6'3" tall. Too short or too tall disqualifies you.
2. You must be able to use a walker or crutches. Certain SCI patients who cannot grip adequately would be disqualified.
3. You cannot be over 220 lbs.
4. You have to meet bone density requirements.
5. You must have a companion with you at all times.

In general, cost is often a prohibitive factor with these devices, which can cost $70,000 and up. Another factor to consider: you need to plan on taking 20-25 minutes to both don and doff this device. As with any prosthetic device, proper use is crucial.

Finally, this technology will continue to evolve. Nurses, don't just think it's for your SCI patients, you very well could be using this daily in your own tasks on the job. If so, the concept of robonurse might not be so far behind. Baymax here we come!

I hope you enjoyed this discussion about a current rehab topic. Feel free to share your thought or ideas for the next installment.

Stay tuned!

Memorial Day

I thank those who have gone before, leaving families, friends, babes in arms, children who would never know them except through photographs or home movies or stories told from the grieved spouses, siblings, brothers, sisters, parents and friends.

That sting of a lost loved one in the war was a pained expression I saw every year in my family. My grandmother next door wore it, some days with bearing and dignity, other days, with much distress.

These are a few of  the quotes that sum up what this day means to me.

I remember those brave men and women who answered America's call today and every day. I hope you will, too.

Until next time...

Deep thoughts

I really loved Jack Handey on Saturday Night Live. Some things they mentioned on that segment of the show were delightfully sarcastic.

While some of you might say the same thing about two things I'll address below, I'm going to say them. Because someone needs to mention them. Because my patients mention them.

So sit down and listen, please.

First, I enjoy getting my regular copy of the American Journal of Nursing every month. Since I subscribe to the newsletter, too, I also get a copy of the electronic table of contents. I saw this listed in the TOC and just about blew a gasket. Why you ask?

Because we have a whole lot more idiots, or shall we say "free spirits" out in the world who are so nervous they have to make fun of things they don't like or understand. Since I am not allowed to discuss politics in my home, I won't even discuss a certain political candidate who has endeared himself to the physically challenged, prisoners of war (also military veterans) and something I can identify with: women.

The point: Nurse researchers, please get with the program. While my folks may use safety belts, I have yet to see any "bound" to a wheelchair. If you are so up-to-date, please use modern terminology, please. Wheelchair user would do just fine in your article.

Finally, never assume. Wheelchair users most likely are not deaf, nor stupid. Treat them the way you'd want to be treated. In the fine words of one of my friends with multiple sclerosis (who celebrated World MS Day this past week), "I have MS, but it doesn't have me!"

And now for a moment from our sponsor. Stay tuned! 

Holiday weekend thoughts

"The more we assign the soldiering to a select few volunteers—we don’t have an equalizing draft and there is no required national service—perhaps the easier it is to forget what it means to share a common citizenship or feel a sense of indebtedness or appreciation. If we no longer share in the service, risk and obligation, maybe that explains why many of us no longer observe Memorial Day."

This is a quote from John Bussey's worthwhile assessment on why Memorial Day needs to be more than a day off or shopping.

I do believe that we are living in troubled times, and unfortunately, the sacrifices aren't shared.

I hope you have time to reflect this holiday weekend. I know I will.

More later...

Can you say...inappropriate?

One of my returned calls today:

Me: Hi this is RehabRN returning your call Mr. RehabEscapee (aka almost AMA).
Mr. RE: Yes, RehabRN, I know we need to do that appointment. (RE whispers)
Me: Sure, is it a good time right now? I notice you're talking lower.
Mr. RE: Well, I'm at the emergency room.
Me: For you or someone else? (I've gotten some weird calls before, but...)
Mr. RE: Oh no! I'm helping out. For someone else, so I have a few minutes and I figured I'd talk to you.

What Mr. RE doesn't realize that I have a long set of questions to ask him. And no, he might not want to answer them in the ER, since they can get personal.

If you're there to support someone else, wouldn't it be nice to pay attention to them?

I convinced Mr. RE it was. His wife might like him later if he does.

More later...

What not to do: Happy Graduation 2016 edition

Congratulations graduates! You worked hard and now you're prepping for that NCLEX. Some people say it's the hardest exam they've ever taken. You may get nauseated (I did) before it's done.

Please, grads, don't find your way into your state's Board of Nursing (BON) newsletter for getting a ding or losing your license. Trust me, keep it clean and shiny. You are worth it!

Here are some of the things I noticed in this edition:

1. Use respectful language.
Yes, believe it or not, one RN was censured due to this little problem. They just keep piling on the issues, too, as they did for this nurse, if you're really a pain (unauthorized record access, changing orders, etc.)

Just say no.

2. For all of you nursing instructors out there, don't dope slap your nursing students.  
One RN did and she was written up in this BON newsletter. One word: priceless. I think some of my nursing instructors may have thought it, but no one ever did it.

3. Don't steal a resident's purse, then get something from the med room and shoot up.
This nurse did. She obviously forgot the video cameras reported her every move.

4. Don't ask nursing students to do the wrong thing.
Telling your student to give a patient normal saline instead of Dilaudid is a perfect example. Someone will notice. The patient did and reported the nurse.

5. If you forget a specimen, get it to the lab. Do not take it home.
Yes, someone actually took a specimen from a procedure home, since the nurse forgot to send it along. A technician found it when cleaning the room. Admit your mistakes, but get it to the lab!

6. Drug testing is not optional.
Just remember: your facility policy is not optional. Compliant is a lot different than "slightly compliant".

7. Do not forget to document drug wastes.
Always, always, always waste drugs per your facility policy (we have special containers for various classes of drugs) and make sure you document appropriately. Your license really does depend on it.

Many happy returns and best wishes for a long nursing career!

You get what you wish for...

Or at least it seems that way right now. What a week!

For almost five years, I've been asking for help and/or equipment. While I can't get them to give me the help, in terms of personnel I want, I am getting equipment, so it's keeping me busy.

My favorite thing: I'm finally having days where I actually do the job I was hired to do for almost the entire eight hours I'm there (and sometimes then some...). The patient flow is something I have to work on, though. I follow the guidelines, but somehow, I always have a patient who wants to tell me more.

This week, I got to go to training that was cancelled many moons ago. It was interesting, even though I had to attend with my boss, who, with his/her MBA, knows everything. He/she succeeded in driving a lot of people nuts, which got me lots of sympathy from the folks I already know.

Finally, after working on my last patients this afternoon (and one emergency with a speech therapist), I got the e-mail I've been waiting for from the boss. He/she's recommending that the holdouts complete things they need to do to work with me in my clinic.

Five years is a short time where I work but almost a lifetime anywhere else. That e-mail made my week. I can only hope I'll get a few more wishes...

Happy weekend wherever you are. More to come...

I'm still a kid

When I think of that day 30 odd years ago. I was on my way to school. I knew my mother was dying of cancer, but I didn't realize that I wouldn't make it there before she did.

I came into my grandmother's house and all I heard were laments. My father was silent and hugged us. He let my brother and I see Mom before my uncle called his friends at work (who were the undertakers). My father was always the one who was there, when his mother and his wife died.

My grandma was a mess. My mother was her youngest child.

There are a lot of things that are a blur, but a lot of things I will never forget. I learned much later that I could spend all my time thinking about the horrible things a teenager could have to witness (the stretcher, the body bag, the death rattle), or I could choose to remember the things my mother left me.

Her happy disposition despite many trials. Her stubbornness and relentlessness to see things right. Her wavy hair that always curled when you wanted and sometimes, when you didn't. Her enjoyment of the little things in life, like the salami sandwiches from our town's Italian section. The jello (red and green) that Santa left us at Christmastime.

My mother also left me her faith. Her faith that we are all actors in our own story and a little divine intervention never hurts. Sometimes we need to help and be helped. Those traditions of perseverance were more helpful than I ever knew later in life.

So while my mom is no longer here to be celebrated, I look every day for the places where she left her mark on my life. And I see her every day. I put a photo of happy times on my refrigerator, so I remember that. She and Dad took us to get family photos. It was the last group family photo we would get.

So I can mourn this day, or I can live it as Mom would want me to do. My mother always wanted me to be a nurse, so I know somewhere in Heaven she smiles. Even with my detours and stubbornness, she got her wish.

In honor of mothers

It's that time of year again. One I never fully understood until I joined the sorority of women over a decade ago.

The things you learn...

1. That those nine months seemingly last forever, but you never realize, the end may be a sprint.

2. After the sprint, you hit the marathon. Only a couple of other times in my life was I ever as physically exhausted as I was by taking care of a newborn. It's almost like a semi-permanent state of jet lag.

3. You'll never forget that first smile, or that first laugh.

4. You'll become the sentinel, the guardian, the protector, because that little cherub really is your heart walking around (or just plain escaped) outside of your body.

5. Everything and little things are milestones you'll want to record. Don't sweat it if you run out of film or space on your device so you have proof. A good story (told over and over) will be a family memory for generations.

6. Be kind and curious. So many folks don't appreciate those things anymore.

7. You'll miss your mother so much when she's no longer with you. I know I do. My mom never got to know Bubba or any of her other grandchildren. Losing her as a teenager meant she missed so much.

If you've never known your mom or the love of a mother figure, you may be sad today, too. But remember, if you are or planning on being a mother, you'll write your own story. Be the mother you want to be. The past is in the past for a reason. The present is a gift for you.

Enjoy your day and weekend! Happy Mothers' Day!

Some you win...

I felt like I was winning today until I got to my patient as arranged today. When I saw him, he was a mess. Bedraggled and anxious. Terrified. Lonely. I worked with him the best I could, but it didn't seem to be enough.

I called one of our other staffers to help.  I did everything I could.

Finally, I wrote my note. I finished my work that needed to be done. Even though, I accomplished much, it didn't feel that way.

I tried. It was all I could do today. I will do the same the next time.

Reality check

How many of you go to work sick? Raise your hands.

If I had a 100% rate, I would not be surprised. Nurses often come to work with illnesses for a variety of reasons. This article has one of the best arguments I've seen for a long time.

I have gone to work because I'm a master at assessment. I've had chronic health issues (nothing major) for years. My body is good at telling me what's wrong.

These are my rules:

1. If I have a fever and will be in regular contact with patients, I'm not going to work. Plain and simple. If I can't do paperwork that day and hide to avoid breathing on anyone, I'm out. I had nursing instructors beat this into me, I mean, reinforce this vigorously on my clinical rotations. As I know from my work in the SU, if you have a fever, you probably are infected with something. This red light is one you should not ignore.

Do everyone a favor. Don't share and stay home. This health system actually publishes an algorithm.

2. Diarrhea will also keep me home. If they only knew how busy our staff bathrooms are (and many times, it's not just staff using them).

3. If you have any other symptoms that are not normal or normal for you, i.e. vision or balance disturbances, you probably need to see what's going on first before coming to work.

My managers always love the "migraine with vertigo" call in (I've used it), but I don't care. You should like being able to keep affordable car insurance. If walking is a problem, driving will be, too.

Also, never take any open wounds (even paper cuts) for granted. If you can't cover them effectively, you need to consider staying home until you can.

I like my doctors. They know I won't bug them unless I think it's an issue for me and my patients. Be sure to have a PCP, so when you need them, you have them. I love mine because she likes nurses and always has our back (she has no problem talking to pesky nurse managers if needed).

To sum it up, if you're sick, don't buck it up. Take care of yourself so you can take care of your patients (and not contaminate your coworkers). You deserve to be well, and so do your patients and coworkers.

More later.

It's the weekend

Now I have enough time after a busy week to make an attempt at getting sick. I feel a cold trying to overtake me.

Happy Orthodox Easter to all who celebrate today.

Joy...stay tuned.

The Revenant

No, I was not mauled by a bear, but alas, I do realize that I've taken leave from here a wee bit too long.

Lots of stuff cooking, so I plan on adding some material soon.

The work of a rehab nurse is never done! Stay tuned.

Take ownership

Yes, I had to do this in a few different ways lately.

First, my fancy new external hard drive got messed up when I changed a security setting. It looked as if I totally erased the drive. Thankfully, that Windows certification came in handy (haven't used it in a decade, but...) I finally found the page on www.microsoft.com about Taking Ownership of a drive.

My data wasn't gone. It was just hiding (since I didn't have permission to view it). What a relief!

At work, I finally got to the bottom of what happened to my dream job a while ago when I was stuck waiting with one of my coworkers. It was enlightening,  and frankly, nice to hear, that no matter what, I did my best. The other person involved probably was not too happy, either, but I still had my day job.

One of my coworkers mentioned that there was an incident with a patient this weekend. He/she knew because the patient had confided in him/her. Some of our staff are being rather surly. While it's not disruptive yet, it's certainly becoming hostile on the floor at the Hotel.

Since I had a similar issue recently, I sent my coworker to the other team provider. He/she will tell him/her to take ownership, too.

Hostile and/or disruptive behavior is really not welcome in a healing environment.

Hope you will take ownership of your space wherever you are.  You and your patients deserve dignity.

More to come...

RIP

Dahey lost a relative this week. It was one we never actually met.

R. was from the old sod, a place from which Dahey's ancestor had escaped (and occasionally returned) a long while ago. We met him through Facebook. One of his cousins actually met R. last year with her family. It was fun to see some of the family resemblance.

We knew he was a relative once we saw his photo, because he was a doppleganger for Dahey's uncle (so much so, it would have been fun to have a photo with the two of them in it). Dahey's dear departed uncle was one of those folks who traveled a lot and looked for his surname in the phone books wherever he went.

I'd suspect that's how he'd found cousin R.

An Irish blessing

May your neighbors respect you,
Trouble neglect you,
The angels protect you,
And heaven accept you.

Until we all meet again...