A little light cynicism

Oh, it's the latest initiative...put everyone in a room, have them bring their lunches and talk. Yes, they've brought back the famous "lunch and learn" but not on any topics you want to learn about. (I'm just hoping most people aren't bringing this lunch along, or it will probably negate whatever they learn.)

No, our topic is, in a nutshell, "how do we get along and play well with others without acting like primadonnas." Guess we gotta start somewhere.

Thankfully, none of these are mandatory...and many are planned on my regularly scheduled day off. I'll be thinking about the stress relievers as I relieve my stress at home cleaning or at the salon getting my regularly scheduled services.

As they say, charity does really begin at home.

Nuggets for August 13

There were a whole lot of interesting items out there recently, so here are a few of them for your viewing pleasure.

You've got questions...

They've got answers, and no, it's not an electronics store. ConsultantLive had this great article on the ubiquitous purple urine bag. I've seen it a few times before (also blue) and asked questions about it, and never got a straight answer until I found this article. They also have a number of other articles of interest, so peruse at whim.

Crispy and brown

Feeling burnt out? Need to read something to get you going? Laura Wisniewski has this great article over at www.nursinglink.com called Re-Engage Your Passion for Nursing that has a few interesting points to ponder.

A telling anniversary

It's been ten years (yes, it was 1999) that the IOM published To Err Is Human: Building a Safer Health System.

There are still lots and lots of mistakes happening out there. The Houston Chronicle (a Hearst Newspaper) recently ran a series called Dead by Mistake on what the state of error reporting is in the US, and it's not so hot. Don't miss it.

Study, study, study

I'm still doing some certification study (yes, it seems like forever...) and I ran into some terms I didn't recognize, so I went searching and found some articles of interest.

Glossopharyngeal breathing is used with some ventilated SCI patients. This article explains what exactly it is and how it works.

Figure ground deficit is explained in this Google Book called Neurological Disabilities: Assessment and Treatment.

I always feel weak in my studies of the brain, so I found this article about a particular TBI patient very interesting as an aside. (from http://www.nytimes.com/)

Privacy (or lack thereof)

And you thought a prescription was private (from http://www.nytimes.com/)
I just shuddered reading this article...what will they think of next? I'm sure all you pharmacists out there have some stories like this.

And everything else about bloggers

It seems like life is very electronic these days...with good and bad results. Here are a few articles about various topics related to blogging I've seen lately. And, no, some things just don't need to be blogged or explained electronically, at least not in my little world, thankyouverymuch!

Mommy bloggers and ethical conflicts (from http://www.cnn.com/)

A no tweet, no blog party (from http://www.nytimes.com/)

Wild and wonderful

That's been my story at work lately. The transition from one shift to another sometimes can be wild.

One day, I walk in, get going and the gates of Hades open all at once. Nurse Assistant has a patient who's got shortness of breath and "looks funny". Well, he's not acting funny, but probably is a little shaky from the albuterol he just took. Get him situated, tell docs, do vitals, get more albuterol. In a few minutes, patient looks happy as a clam and is chatting away as the nurse assistant gets him ready.

Another day, the specialists round. They like me. Not only do I get to deal with my patients, I have to help them with paperwork on a couple of others, because I know how to work the computers for that feature, even though, all I do is act as a witness. Gee, I feel so special! Thankfully, boss and company only follow these people around once a week. Other nurses thank their lucky stars that they don't get "picked". I've known the specialist for a while before I came to Madison. He can be loud and obnoxious, but underneath, he's a softie. He just doesn't want any of the nurses to know that.

Doc Specialist is also a running doc. It seems like the specialists drift to one of two categories--they either golf or they run. Our leader is the exception. He's too brainy to do either; although, if I had to guess, he'd probably fall in a lot easier with the runners rather than the golfers.

So after all the wild and crazy antics, I get a phone call. Miraculously, I got a scholarship for grad school. They confirmed I was there to send the fax to me. I looked it over and saw it was for the entire amount of the program. You could have knocked me over with a feather. I'll have some other restrictions and requirements as a result, but my financial burden will be lessened. I was so relieved. I don't have to keep doing number-crunching to figure out how many extra shifts I need to pick up to pay for each semester. Now, I just have to concentrate on getting my work done and my schoolwork done...just like Bubba, who starts school soon. Should be fun getting into school routine after some time away from it.

More to come...stay tuned.

Heard on the unit...

Aw, it's been forever since I've had enough goodies for this segment! But when patients speak, sometimes we just bite our tongues and run as fast as we can to our lunch break, so we can share with the rest of the folks on the unit and with the audience at home.

Situation 1

RN is educating patient about the proper way to use an incentive spirometer. After demonstrating proper technique, patient says, "Oh, that's just like what I do at home with my bong." RN listens as patient describes how marijuana "relaxes my legs so I can get into my chair."

Sorry, remember that non-smoking thing you signed to come here for rehab? Yep, it applies to Mary Jane, too.

Situation 2

RN is talking to patient re: helping himself (He's a lower level thoracic paraplegic, so he can do it) by dressing and turning himself. "Oh, I'm not going to do that (turning) at home. I'll just wake her up." (implying whatever woman happens to be in his bed.)

Nice. My reply, "So since Babe #1 is not here, could you just move the pillows and turn yourself, please?"

Situation 3

From patient who is not really observant about following his intermittent catheterization rules or fluid restrictions.

"Where's my nurse? I missed my appointment." says Mr. Drinks-A-Lot.
"What appointment?" I asked.
"My catheter appointment. I've got a headache."
"Yes," I replied, "and you realize this is a sign of dysreflexia, correct?"
Patient shakes head.

If only Tom and Ray were here to do this...more to come...eventually!

Ironies

There are just some things that are very ironic in my job.

First, no one expects anyone at the Madison to be efficient. As a professional, I expect my coworkers and team members to act that way, but apparently, it's only an illusion. We have people who are really, really professional, and others, who somehow missed the professional boat. Or it's just a hope, by some of the medical staff, that the nurses will screw up so they have something to complain about.

I'm not a transporter but occasionally, I have to transport my patients, when our one lowly transporter decides to do something else and not bother to notify the nurse manager or the charge nurse. This week, I had a person from another department actually stop me and ask me if "transporter" was somehow now on my badge, since she was so incredulous that RNs actually transport patients to and fro. Yes, Tina, RNs really do transport people in rehab! It's annoying, but it's just one of those tasks we get to do...and things that interrupt us (see page 7 in this article).

Second, doctors really need to have a communication class. For grins, we were reading notes on one of our patients. Note one said patient had been in an ICU situation and has a trach. Said patient wanted to talk so patient told attending, "Take this trach out." Said patient was so seriously ill that attending viewed this as the patient wanting to end his/her life. Attending, probably freaked out by patient wanting to end it all in his/her ICU, consulted psych. Note two said psych visited and patient repeatedly denied wanting to end his/her life. Patient stated, "I just want to take this thing out so I can talk." Can you imagine what would have happened if psych didn't get involved? This could have been the ultimate whoops situation.
One other good thing did occur: patient decided to have a family member act as healthcare POA in the event he/she really can't communicate.

Finally, I'm starting to think life is really like a collection of Seinfeld episodes. One of our patients looked just like a recurring character from the show. Many other folks on the floor (including myself) have bitten our tongues laughing as we want to yell his name as we stroll to his room down the hall. Besides humoring ourselves with this patient, we also spent a lot of the week talking about the Seinfeld episode about the English Patient. Yours truly finally got a copy and watched it...so that Seinfeld finally makes sense. We don't have any English patients, but the ironies of that movie and Seinfeld linger in our little world.

Stay tuned. More merriment to come...

It's that time of day...

...when you can say, "go on and head for the mountains."

Wait, this ain't no beer commercial! Head on over to Man-Nurse Diaries and check out the latest version of Change of Shift. And, I'm not going to spoil it, but you HAVE to read the fine print at the end. MND, you surely had fun with this one...in more ways than one!

Thanks for including me in this edition, and go crack open your favorite beverage, if you're so inclined.

More to come...

Cookin'

That's what I'm doing on my day off, enjoying the overcast skies. If I could sing on key, I'd probably pen an ode to my favorite kitchen appliance.

A little housecleaning, a little shopping and a little visiting with friends will make my day complete.

Stay tuned...it's back to the ranch soon, so more fun ahead!

Life and death

I've been lucky this week. Things finally calmed down. My first couple of days were pretty exciting.

There is always a hustle and bustle on one particular day of the week, because it's this day that we get the most patients admitted to the unit. This day also is the day I work my evening shift after a day of rest. Sometimes, I have time to get rolling and other times, I have no time at all and that was the case.

I got in and one of my patients needed blood after the first two hours of the shift. Only no one got his consent, which means I had to track down our doc, who was long gone and out of pager range, then call the local on call doc to get him/her to come over to do the MD portion of the paperwork. Said patient was a little perturbed because his favorite MD never told him he might need blood. Happily, he got over that, and I got the blood started before the end of my shift and even led one of the new nurses in the process so he/she would get some practice, since we don't give too much blood at night. All was good.

The next day, everyone's happy and I'm actually getting into my rooms right after report. In one room I smell something funny. I look and see my quad patient has bursted his colostomy. Get goodies and clean him up. I think the wafer is intact, so I get ready to put the new bag on, and discover it's not. Get all stuff set up and put on new wafer. Three sides are taped with pink tape (because he needs it) and all of a sudden I see a geyser. Thankfully, I caught it with the nearby towel. (Nursing students: never change a colostomy bag without one...if you do, do so at your own risk!) Finish cleaning, finish taping and I kept praying all night he wouldn't do that number again.

Another patient recently asked me about last rites and whether he got them when he was very ill. Since we have an active chaplain service, it was really easy to check the chart. Besides, I told him, spiritual care is also mandated by JCAHO.

One day, I came in to the news that one of our recently discharged patients had died. It was shocking, because, he/she was young and in a way, it wasn't. This patient always denied suicidal ideation, but something about him/her caused a faraway look on their face that made you think they would not be around for a long time. We often talked about ghosts and somewhat about death, because our unit has a reputation for being haunted. Said patient even stated that he/she saw something in one of the rooms he was in that lead him/her to believe that the stories were true--curtains jiggling at night, and a reflection in the mirror when no one was around. He/she wasn't worried, because he/she hoped his/her roommate, who died during his/her time was the ghost hanging out in that room, because it was comforting.

And so the week of work is ending, and the sturgeon moon is on the way. We'll just wait and see how it goes. More to come...stay tuned!

Happy Birthday Emergiblog!

Yes, today's the day four odd years ago that Kim started her blog, and the multiple minions of the nursing world, myself included, in the big and small cities, megahospitals and clinics, have followed in her much larger footsteps.

How lucky we are, since Emergiblog not only tells you about life in the ER, but also brought Change of Shift to life, which has given the world a little slice of the realities of nursing life out there.

As they say in Poland, sto lat...may you have a hundred more!

Rain!

That means no weeding for me, but at least, I don't have to water the tomatoes. Busy, busy day. More to come later this weekend...stay tuned!

The story of my day

I have always liked words. The dictionary was my friend as a kid. I always liked to look up obscure words so I could use them in my spelling sentences....when I had to do them (I got out of this homework frequently through some other endeavors...)

As I finally got a minute last shift to start documenting, I thought about what was really happening and a couple of words came to mind.

While I ran myself hither and yon the first four hours, I really wasn't idle (my first word), but I'd suspect some of the chitchat here and there was. As I'm running around, I don't mind speed chatting or bantering with the patients as I hang all of my patients IVs for the shift. My night--come in, run an IV, stop, flush, run another IV of Vancomycin, stop, flush, hold and run another IV, and so on, like a bad TV commercial. I can't get too in-depth.

Unfortunately, sometimes oncoming report is a little too idle. We have some nurses who will give you the new orders list (we write one as we take things off) and your report the same way every time and it's complete. A couple of our people are new and they still haven't learned how to give report, so they tend to engage in idle chatter and miss the big stuff. Like the blood cultures ordered three hours before end-of-shift that have to be done today or the 102 temp that the patient getting blood just spiked near the end of his transfusion, or the report on the patient who returned from acute. It wasn't a big deal for anyone else, but it was for me, since I was his nurse.

Eventually, the last four hours drifted into the idyll category. Our neighborhood isn't exactly pastoral, but sometimes, it is pretty, just before dark, and this night, it was exceptional. The sky was a pinkish-red that glowed as the sun set. I only noticed it because I had a minute to look out the window when I called my husband. It made me think of that old saying, "Red at night, sailor's delight." My patients, including the returning one, were quiet and happy. They got all their nightly pills and drifted off to sleep. The only thing that broke the idyll was a fever in another patient, which required an all-hands fire drill to get all the labs pulled before the oncoming shift came.

So we left our coworkers with an idle, idyllic moment of their own, with sleeping patients, as we walked out the door into the cool of midnight.

More later...

Nuggets for July 29

Yes, we're back with another exciting installment this week. Yours truly is sifting the wheat from the chaff so to speak from all around the internet, and it just keeps getting more interesting.

In the rehab neighborhood

As a rehab nurse, you learn a lot about insurance, whether you want to or not. Insurance dictates just about everything in one way or another in private rehab hospitals. Dr. Ford Vox, a rehab physician in St. Louis, MO discusses the implications of the Obama health plan in this article at http://www.salon.com/. We're not talking politics here, we're talking people and what happens in his state if you get a SCI (or doesn't happen), so check this article out.

Cool nursing stuff

I always enjoy reading LaTonia Denise Wright's Nursing Law and Order because she always has some interesting legal stories or great links. Here's the latest link she posted from the Center for American Nurses about a study on Respect. Read the PDF. It's worth printing!

From the web

I don't think of Forbes as a health magazine, but they did a great review of a recent health book called How To Debunk a Health Myth which is worth a read. The book sounds pretty interesting, so I'll have to get it on my reading list.

When I went to a conference a couple of months ago, I met a great person from the Cleveland Clinic. The Washington Post had a recent article about what President Obama saw there on a recent visit. (Hi Marie!)

Need a cardiac cath soon? You just may care if they have enough technetium-99 soon, according to this recent NY Times article: Radioactive drug for Medical Testing is in Short Supply.

Out in the blogosphere

Here is an excerpt below from an old story I ran into when I went down the list of blogs I've bookmarked on one of my several computers. The story is sad, but the lines below are some of my favorites, because they make you think outside of yourself. Moral of the story: tell people you love while you are alive if you want to be an organ donor.

"A little girl hugged me today. I think maybe I’m on the right path. I’m not sure if I like where the path might lead, but it is a really nice path. Is it possible that we, as a culture, focus too much on the light at the end of the tunnel, the pot of gold at the end of the rainbow. Isn’t it enough to realize you’re standing on a goddamn rainbow."

Enjoy your rainbows wherever you find them. More to come!

The start of something big

Yes, the big ol' week, that is. Thankfully, it's been more entertaining than irritating so far.

It's always nice to come back after a vacation of any sort. I was discussing this with one of my coworkers today and she mentioned it was the first time in months that she would be off a week. I told her my last vacation (of about the same length) was just wonderful. The freedoms of waking up when you want and doing things that need to be done when you want is incredible.

The unit's getting more occupants this week. Some are regular suspects, such as the drug addict who's always got problems with his teeth. This time, he just added a couple more problems and most of them were courtesy of non-specialty physicians in his neck of the woods out-of-state. We could have saved him some time and trouble admitting him earlier, but when he's such a handful, no one really wants him back.

We also got a VIP...or at least this patient thinks he/she's one. I'm so happy I got to admit the other character. I was so upset I didn't hear tons of complaints about how "backward" the unit is, either, among the litany of shortcomings said person regaled the admitting nurse over two hours. My response: Hello, please tell someone who can do something about it! We're still waiting for Santa Claus to remodel and get us all the goodies and toys, like wireless internet access, that you're looking for in your accomodation. Besides, you'll only be here a couple of days, so why not just go a couple of miles that way and stay in a hotel with the person who brought you if it's so rotten here? Yes, I'm thinking all of this, as I put on my best, fake, customer service smile, and thanking my lucky stars that those mind-reading things are not on the market right now!

The Slug came back, with somewhat of a Jekyll and Hyde personality going on...one minute, nice, one minute her usual pain in the arse self. Not sure why...but still happy from vacation, so I don't care. One of our new nurses, who's been around the block, had fun teasing her, so we just enjoyed ourselves. This nurse is a breath of fresh air and has been a nurse for a long time. She came to us because of local downsizing, and we're happy we could get her. She doesn't wear a cape, but she does have the skills to do a super job.

Happily, the day rolled along and I actually got out on time. All paperwork complete, people fluffed and buffed and everything done as ordered. Now I get my requisite days to prepare for my long stretch ahead...the something big called working the entire weekend.

Stay tuned...more to come.

Sort, shift, shuffle

And that's how I'm ending a pleasant vacation at home. A few major things done, lots of minor things, and lots of assorted miscellany in between. Now I'm sorting school-related paperwork.

Except for a little sinus craziness going on, I feel pretty good. I wish I could do this little three day thing every month. (My boss would kill me, I'm sure!). I am also thankful. In talking with people I haven't talked to in a long time, I realize that I am happy and healthy and I'd just better start to be grateful for that. Many of my friends have their own health issues and lots and lots of caregiver strain issues.

Well, back to paper shuffling...then on to dinner with friends. I can't think of a better way to end vacation.

I'll be back to the old grind tomorrow. Stay tuned...I've got lots of goodies planned next week. Thanks for stopping by everyone! You make my day...now leave a comment if you please! ;->

Friday, Friday...

Finally, it's sticking in my head that it's Friday. It should since I was able to do all of the things I enjoy on my occasional Fridays such as the following.

First, Bubba went on his weekly pilgrimage out with me and Dahey for breakfast. I can't remember exactly when we started this, but it's been going on so long, the staff remember when we hauled him in the restaurant in his carrier as a baby.

Next, I went to see my friend Giacomo. He survived vacation which included visiting the multitudes of sisters in his native land near the Erie Canal. Not just one sister, but the entire flock of them, along with mom and the requisite contingent of nieces. He was still reeling from being the lone male around and getting all the "attention." In his family, it's not always good to have attention...

Following that, I also saw some of the coffee people I haven't seen in ages. Dahey told me I need to get a medical file, since most of the oldsters are now answering my "How are you?" with all sort of medical complaints and requests for advice. It's hard to be blunt with them when a) they're old, b) they know your entire family--grandparents, parents, etc., and c) a few of them can tell you about your odd habits when you were younger. (just in case you think you're getting too smart for your britches!) For the most part, they're happy and for now, healthy, and I thank God for that. Besides, a few of them even love my zucchini bread!

Whenever I work evenings, or if I happen to be off, Dahey and I usually go somewhere for lunch. This is a good thing because we get to try new restaurants without having to bring our small restaurant critic along. Today, it was soul food near a place I used to work. This end of town was quite scary when I worked there, but every time I come back now, it's getting better and better. The food was magnificent. I thought I died and went to heaven when I got the smothered pork. The portion was so big, with the mac and cheese and the green beans, that I put half away. It probably won't last too long tomorrow.

I keep looking ahead and try to prepare myself for going back to work. I really understand when some of our older nurses say, "It was really hard for me this time to go back." This little vacation has been wonderful. I have made contacts with people I haven't talked to in years all over the world. I have had lunch with friends who I don't normally see, even though they live within two miles of me. I realize more and more how lucky I am in my life, as crazy as it sometimes can be. It has been a thoroughly amazing time.

Tomorrow I get to do a few more things, then start preparing for the return to work. We'll just keep cruising along...stay tuned!

Change of Shift is up in Australia

Head on over and see what Ross has running on his Nurse in Australia blog. Enjoy this installment!

http://www.nurseinaustralia.com/change-of-shift-sunshine-coast-edition/

Nuggets for July 22

Yes, it's back on its regular day. It's gonna be a long post with all the interesting stuff out there, so sit back and enjoy yourself or read in bits if you're working.

I'm really enjoying the heck out of this vacation so in between housework, networking and shopping (the other important "work"), I've been surfing away. Please enjoy as you see fit in your neck of the woods.

The nursing shortage

It's incredible how there is a Dr. Jekyll/Mr. Hyde thing on reporting on the nursing employment. One minute it's dire, the next minute, wonderful, since all those nurses contemplating retirement are staying. I'm just going to chalk it up to American business and the "short term syndrome". Basically, if it's not a problem now, it won't be later, even if demographic trends suggest otherwise.

I'm also crossing my fingers that I don't break my hip in the next 10-20 years, since I'll have to be my own rehab nurse the way things are going.

ACP internist (MD) weighs in on this topic and the glut of nurses.
Kathy Quan (RN) presents the other side: shortage.

Health news of note

Here are a few stories I found very interesting in the health arena. Somebody needs to take me to Greece to complete the one study, though. A long, faraway vacation would be very nice, thank you!

Sex and sleep are just as important as antioxidants (from the 360 blog at www.cnn.com)
This study about people on a Greek island was pretty hopeful in the long-term view.

Want to know if your health habits are making you younger or older? Check out the Longevity Calculator.

Disclosure: I do take an extra vitamin and mineral, but I don't traditionally recommend these as treatments to my patients. This article called Docs and nurses use and recommend diet supplements from www.reuters.com was interesting because it discusses how most doctors and nurses had little education in supplement use.

From the NY Times

This article from the NY Times shows Vets' Mental Health Diagnoses Rising among Iraq and Afghanistan veterans.

Cases-Our Scars Tell the Stories of our Lives made me think about how I look at scars on my patients.


Etc.

Yes, they're released annually, and Madison didn't even make it in as an honorable mention, although some of our system hospitals did show up....way down the list. The US News and Report of America's Best Hospitals even has a couple not far away, if I do need one for specialty care.

Our friends in Canada put a great story in The Globe and Mail recently: Pop culture gives way to peep culture.

Fun!

And last, but not least, who's not going to have fun on vacation? Well, I surely am, and from the looks of some of these goodies, even people at work are having fun and entertaining others, wittingly or unwittingly.

Lost on the Floor just moved, but he is finding some fun in Chart Bloopers.

Braden and many of the ER nurses are always finding great patient complaints. Here's one of his latest patient reasons for visits to the ER at 20 out of 10.

Ahoy! Yes, I'm married to an escaped sailor, so I'm just going to have to order one of these nursey things for my locker, because somedays, I'd really like to raise the Jolly Roger when storming the poop deck on evenings.

Shout out

Hooray! Vacation! Vacation! I just thought I'd drop by to share those thoughts. Lots of thoughts actually are whirling around in my head right now. While it's another semi-staycation at home, I'll be putting the fingers to the keyboard reading and writing. I'd like to say hi to all the folks I've been seeing showing up in my sitemeter recently, since I don't get too many comments (that moderation thing must scare off some folks).

To my friends in Picardie, France...
Salut mes potes! Soyez le bienvenue...merci de votre visites hier et aujourd'hui. J'aime la France!

...and in Quebec, la belle province...
Je t'ai envoye mon pote americain pour manger de poutine! Attention!

To my friends in the southern US...
Hey, y'all, thanks for visiting. I gotta find me some grits now that I had a patient from N'awlins talking about them all night last night. Hope y'all come back now!

To all my Aussie friends, especially in Sydney...
Thanks for visiting. One of these days I'm coming your way.

And finally, to all you anonymous people...
Thank you, too, wherever you are.

More to come...

Pondering the universe

When it's a slow shift, I often go out looking for stuff. It's just my nature to be busy. Perhaps a little too much of the "idle hands are the tool of the Devil" stuff when I was a kid.

I was surfing away this morning and ran into this post at Reality Rounds. Thankfully, in rehab settings, we don't drop "the bomb" on people too much. That bomb has already exploded by the time we get people, due to accident, illness or other random idiocy, and we're busy picking up pieces and putting things back together for the rest of life.

As a result of too much time, I started looking at labs, and found a high alkaline phosphatase on one of our old timers. We don't diagnose, of course, but when you can historically look at trends, it makes you wonder what's going on with people. I also think it helps me to talk to doctors to see what their take of the situation is with said patient.

Of course, when we have free time, there's always something silly. One nurse buggered up her iPhone and it would not vibrate. We tried to get her to check out www.apple.com to find out what was wrong with it (maybe in the user's guide...hmm?!) but she waited to see what her significant other would say about this problem, since he could fix it since he has the same phone.

Another patient got a generic gadget catalog similar to Harriet Carter. But, he was in for a surprise when he opened one page...they weren't selling any Billy Mays stuff or SlamChops, no they were selling vibrators. He's wondering if the person who gave him the catalog is trying to drop a hint. We shall see, as this becomes yet another inside joke on the unit.

Yes, we have inside jokes everywhere at our place. It's simply a way of coping with time, space and personnel for a lot of our people, who spend an enormous amount of time with us. One guy has his "wife" on our unit. (that's what he calls one of our nurses, who constantly nags him to check his blood sugar).

Finally, a couple of our people said goodbye this week. They went home. One is travelling to a home he's never seen with his long-time fiancee. Another patient is going home, then travelling across the country to live near relatives and meet his online girlfriend. His wife has been gone for a long time and he's finally decided he doesn't want to be alone anymore, after surviving one health issue after another. He is a very smart man, often moody, but frequently nice when he wants to be. With all he's gone through, he deserves whatever happiness he can get.

More later...stay tuned.

Nursing practices and current trends

It surely sounds like I'm ready to go into an infomercial, doesn't it? No, I just got out of my state's "What's new in nursing" continuing education class recently.


The first part of it was, "Here's what YourStateNursingAssociation is doing in the Legislature", which is often very dry. When they started going over how a bill turns into law which turns into nursing practice, I had to imbibe in my highly caffeinated soda, since I got sleepy. Thankfully, we got a break right after this part.


After the break, we had the biggest, most rousing part of the seminar--the use of Propofol and nursing section. I almost felt like I was in the new Harry Potter movie, since the presenter and some others referenced "the recent case" (about Michael Jackson), but they never said any names. This issue is a big deal, not just for nurses, but also for physicians who use this drug. Just reading the package insert opens up a whole new world of liability if CRNA is not after your name in the right setting. Lots of ERs in our state are using this for small procedures, like dislocated shoulders, bone setting and stabilization, etc.

We also had fun stuff, too. A collegue of one of my mentors in nursing school gave a presentation on electronic records which was really cool, especially the one that compared drug prices for patients in our area. The disparity was glaring. Atenolol 20mg in one county was $3 for 30 days and in another section of the same county, $30. There were a couple of glitches in the presentation, as happens with just about anything technical. It would have been even more interesting if all of the government websites she referenced were actually working. I guess those pesky hackers are still loose!

Outside of that, I'm still taming the paperwork monster. I'm starting to view our paperwork queen for scholarships as Dr. Jeckyl and Mr. Hyde. One day, it's one thing, the next day another. I'm not sure why Paperwork queen wants all this stuff now, when I was told to wait for a cold day in the hereafter mere weeks ago, but I'm pushing the paper back and forth as fast as I can. They must have unearthed some money somewhere, somehow...and I'm not questioning it.

And school starts in a few weeks....and I already have homework. I'm so glad vacation is coming soon.

More later...