No, it's not another Virginia earthquake today, but the sounds of construction at the Hotel Rehab.
Turns out, though, the construction crews may just get a little more work. While they've been busy on one wing of the Hotel, the other started showing some serious cracks recently.
What does this mean? The engineers to the rescue. Apparently, the other crew has fixed one thing that caused problems on another.
What does it mean for us? A pleasantly lower census while they fix the bathrooms and everything else. Mr. Crabby left today, so I'm sure there was much rejoicing.
Stay tuned...
Wednesday, August 24, 2011
Monday, August 22, 2011
There but for...
The grace of God go I...the old saying goes.
I absolutely loved the following line in one of KevinMD's posts entitled, What this doctor learned when he was a patient.
Dr. D’s orthopedist has about the communication skills of a mentally-retarded clam.
Sometimes we nurses say the same thing...about everything I just mentioned. Thanks KevinMD having such a great guest post. It's a great story.
I absolutely loved the following line in one of KevinMD's posts entitled, What this doctor learned when he was a patient.
Dr. D’s orthopedist has about the communication skills of a mentally-retarded clam.
Sometimes we nurses say the same thing...about everything I just mentioned. Thanks KevinMD having such a great guest post. It's a great story.
Sunday, August 21, 2011
Misspent youth, part 2
1. Aerodynamics tests off the roof at school.
2. Planes, trains and automobiles in college. My first plane ride, riding the trains of Europe, and a series of old clunkers before I was able to get a real job (read one that allows you to afford a car that is all one color!)
3. Partying it up dancing the night away in clubs, discos, and bars long gone by here, there and everywhere. And who can forget the electric slide..?
2. Planes, trains and automobiles in college. My first plane ride, riding the trains of Europe, and a series of old clunkers before I was able to get a real job (read one that allows you to afford a car that is all one color!)
3. Partying it up dancing the night away in clubs, discos, and bars long gone by here, there and everywhere. And who can forget the electric slide..?
Saturday, August 20, 2011
Don't stand so close to me...
What I wanted really wanted to tell a few people at work the other day...
Friday, August 19, 2011
Shave and a haircut...
Not 15 cents, but sometimes priceless.
I took care of a cranky, old man who changed significantly once one of our staff gave him a haircut. He went from looking like the Unabomber's uncle, to looking more like himself: a seventysomething year old man.
Another patient got a haircut and feels wonderful because he can wash his hair himself with a wash cloth...just like his days in the Marines.
I took care of a cranky, old man who changed significantly once one of our staff gave him a haircut. He went from looking like the Unabomber's uncle, to looking more like himself: a seventysomething year old man.
Another patient got a haircut and feels wonderful because he can wash his hair himself with a wash cloth...just like his days in the Marines.
Thursday, August 18, 2011
Families
We see a lot of families crossing the threshold of Hotel Rehab. You name it...we get it. We get regular Joe and Jill nuclear families with 1.5 kids, and the whole enchilada of all those plus grandma, grandpa, all the aunts, uncles and cousins.
In addition, we see families in various forms dysfunction often caused by divorce or disagreement. Since I've been at the Hotel, I've seen examples of the cute family with that 1.5 kids break down because, lo and behold, Wifey finds out (while Hubby is with us) that Hubby has another woman, and she's pregnant with his kid and wants to know who's going to support her now Hubby's been injured. Hmm...calling Social Work and Psychology right now for this one!
But lately, lots of people are coming in who don't really have a family nearby. They've estranged them for one reason or another, have family members with their own significant health, financial or employment issues, or have simply outlived everyone in their families. We become their families, and they get really upset when they realize that they can't stay with us forever. One character mentioned suicide just to buy more time.
Some others, however, end up going over to another unit, down the way, with the great view of nature and what awaits us all. Yes, we keep getting more and more people with terminal illnesses, and we are becoming a feeder unit for hospice. One of the non-nursing staff did ask a good question recently: if they stay so long that we're like their families, why do we throw them out when they're dying?
If only I had the time to tell him/her that we do it because we love them. We care about them, but sometimes it's a terrible duty for a rehab nurse to have to admit defeat. This patient will never regain function beyond what they have, and most likely, they'll lose it all before they die. We aren't set up to do hospice, and don't have all the comfort things they have readily available.
Admitting our job is over doesn't mean we don't care. We do. Sometimes, though, we have to know when to say when and let someone else take over. Some of them will always be in our hearts and minds, especially on days when we remember them, as our unit did recently.
To live in hearts we leave behind
Is not to die.
~Thomas Campbell, "Hallowed Ground"
In addition, we see families in various forms dysfunction often caused by divorce or disagreement. Since I've been at the Hotel, I've seen examples of the cute family with that 1.5 kids break down because, lo and behold, Wifey finds out (while Hubby is with us) that Hubby has another woman, and she's pregnant with his kid and wants to know who's going to support her now Hubby's been injured. Hmm...calling Social Work and Psychology right now for this one!
But lately, lots of people are coming in who don't really have a family nearby. They've estranged them for one reason or another, have family members with their own significant health, financial or employment issues, or have simply outlived everyone in their families. We become their families, and they get really upset when they realize that they can't stay with us forever. One character mentioned suicide just to buy more time.
Some others, however, end up going over to another unit, down the way, with the great view of nature and what awaits us all. Yes, we keep getting more and more people with terminal illnesses, and we are becoming a feeder unit for hospice. One of the non-nursing staff did ask a good question recently: if they stay so long that we're like their families, why do we throw them out when they're dying?
If only I had the time to tell him/her that we do it because we love them. We care about them, but sometimes it's a terrible duty for a rehab nurse to have to admit defeat. This patient will never regain function beyond what they have, and most likely, they'll lose it all before they die. We aren't set up to do hospice, and don't have all the comfort things they have readily available.
Admitting our job is over doesn't mean we don't care. We do. Sometimes, though, we have to know when to say when and let someone else take over. Some of them will always be in our hearts and minds, especially on days when we remember them, as our unit did recently.
To live in hearts we leave behind
Is not to die.
~Thomas Campbell, "Hallowed Ground"
Tuesday, August 16, 2011
Swan song
Well, not quite, but my last evening shift in charge recently was definitely interesting.
First problem: Since it was the boss's first day of vacation, I knew someone would call in sick. Mike, one of our nurse assistants (who will not miss me as a charge nurse) decided to be the one. No surprise, really. Mike likes those extended three-day weekends just like the rest of the slacker patrol and he's made it a habit of taking off the day before and the day after his weekend off, or when I'm in charge.
Second problem: one of our RNs, who has a chronic medical condition gets sick at the beginning of the shift. Docs are called (ours, not hers) and lots of fuss is made over her, because she could have gotten all wigged out on us. I let some of the crew keep her safe while I got the rest of the folks to hold down the fort until the super could determine whether I needed an ambulance or not.
Happily, she was fine within a couple of hours, but was pissed at me once she felt better. I was a witch and changed her assignment, so she had very little chance of potentially hurting any patients. Sure, she was bored, but what choice did I have? Not much. Oh, the joys of lots of CYA documentation!
Finally, I redistributed the load to the rest of the crew and we did well. My patients did well. I was so happy they were cooperating with everything, especially when I took a little longer on my regular rounds.. Even with all that, I still managed to get one in the shower, so he could get ready for an appointment tomorrow, and wash his hair, which he said was driving him crazy. Head and Shoulders to the rescue!
It was crazy, but we survived, even if no one stuck around to leave with me once I'd finished giving report to the next crew.
I won't miss the BS at all....come on clinic!
More to come...
First problem: Since it was the boss's first day of vacation, I knew someone would call in sick. Mike, one of our nurse assistants (who will not miss me as a charge nurse) decided to be the one. No surprise, really. Mike likes those extended three-day weekends just like the rest of the slacker patrol and he's made it a habit of taking off the day before and the day after his weekend off, or when I'm in charge.
Second problem: one of our RNs, who has a chronic medical condition gets sick at the beginning of the shift. Docs are called (ours, not hers) and lots of fuss is made over her, because she could have gotten all wigged out on us. I let some of the crew keep her safe while I got the rest of the folks to hold down the fort until the super could determine whether I needed an ambulance or not.
Happily, she was fine within a couple of hours, but was pissed at me once she felt better. I was a witch and changed her assignment, so she had very little chance of potentially hurting any patients. Sure, she was bored, but what choice did I have? Not much. Oh, the joys of lots of CYA documentation!
Finally, I redistributed the load to the rest of the crew and we did well. My patients did well. I was so happy they were cooperating with everything, especially when I took a little longer on my regular rounds.. Even with all that, I still managed to get one in the shower, so he could get ready for an appointment tomorrow, and wash his hair, which he said was driving him crazy. Head and Shoulders to the rescue!
It was crazy, but we survived, even if no one stuck around to leave with me once I'd finished giving report to the next crew.
I won't miss the BS at all....come on clinic!
More to come...
Monday, August 15, 2011
What is old school anyway?
We had a lively discussion about this on a recent evening shift.
What really is "old school nursing"? Does it mean you do your job, then do some more, and walk with the fear of the Almighty in you, that you would never think of whipping out your smartphone and talking for an hour?
Do you really think we need the big woman in whites and the "hat" to come back and tell you if you're not moving that you should be cleaning?
Every shift, I'm beginning to think that. I get so tired of trying to figure out if I have everything I need, that I just bring my "emergency pack" into a room, because I can never expect someone to think ahead, or be nice enough to leave anything in there.
Maybe a little less "There, there" and a little more "Get your arse out of the chair!" would be appropriate.
We can only hope....stay tuned!
What really is "old school nursing"? Does it mean you do your job, then do some more, and walk with the fear of the Almighty in you, that you would never think of whipping out your smartphone and talking for an hour?
Do you really think we need the big woman in whites and the "hat" to come back and tell you if you're not moving that you should be cleaning?
Every shift, I'm beginning to think that. I get so tired of trying to figure out if I have everything I need, that I just bring my "emergency pack" into a room, because I can never expect someone to think ahead, or be nice enough to leave anything in there.
Maybe a little less "There, there" and a little more "Get your arse out of the chair!" would be appropriate.
We can only hope....stay tuned!
Sunday, August 14, 2011
No matter what...
"There's a time and place for everything/For everyone,
We push with all our might,
But nothin's gonna come...
(and then things change...)
...No matter what I say or do/
You know my heart is true/
I can't stop lovin' you."
--Van Halen, "I can't stop lovin' you" 1995
Word to the wise: Rehab nurses are ALWAYS rehab nurses, no matter where they put us!
We push with all our might,
But nothin's gonna come...
(and then things change...)
...No matter what I say or do/
You know my heart is true/
I can't stop lovin' you."
--Van Halen, "I can't stop lovin' you" 1995
Word to the wise: Rehab nurses are ALWAYS rehab nurses, no matter where they put us!
Friday, August 12, 2011
Whiz bang technology
In the form of a temporary tattoo. We could have a lot of fun with these at the Hotel with rehab patients of all sorts.
Maybe I'll send the inventor the boss's name...
Maybe I'll send the inventor the boss's name...
Ready, set...
Go! I flew out of the gate on my latest shift, and it, happily, went smoothly. Everyone cooperated, I got stuff done and for the most part, the warts on the night didn't show.
The genie came out of the bottle. Today I received a letter from HR that I am to report to the clinic for my first day very soon. In fact, it's much sooner than I could have imagined. My boss said, "The big guy did it (pointing to the ceiling)" but it was not a miracle. No, it was the big cheese, the CNO, who made it all happen. When it comes down to brass tacks, as Momma used to say, let the brass do it (or their designees).
I'm in for a wild final run here in the Hotel. Cross your fingers!
The genie came out of the bottle. Today I received a letter from HR that I am to report to the clinic for my first day very soon. In fact, it's much sooner than I could have imagined. My boss said, "The big guy did it (pointing to the ceiling)" but it was not a miracle. No, it was the big cheese, the CNO, who made it all happen. When it comes down to brass tacks, as Momma used to say, let the brass do it (or their designees).
I'm in for a wild final run here in the Hotel. Cross your fingers!
Wednesday, August 10, 2011
Captain Obvious strikes again
Or he put someone up to this particular article about nurse retention.
Every day, I am more certain that the Captain (and his followers) work in Manglement at the Hotel.
That is all...resume your fun, all. I'm back to homework. Stay tuned!
Every day, I am more certain that the Captain (and his followers) work in Manglement at the Hotel.
That is all...resume your fun, all. I'm back to homework. Stay tuned!
Tuesday, August 9, 2011
Thank you Susie
Who ever you are. One of our patients owns a bakery and liked the care he got on our unit so much that to repay the nurses, he brings in pastries of all sorts regularly.
The latest one: one of his bakers made a mistake on a huge, chocolate-covered strawberry birthday cake. He put "Happy 50th Birthday Susie" on the cake. Lo and behold, Susie was only turning 40 at her birthday party...oops! It would have made CakeWrecks proud.
So one of our nurses, who's getting ready to retire, volunteered to be Susie (and pulled out the plates), so we could cut the cake. We even sang to her. If only they didn't ban video at the Hotel, or we'd have had a fine one for YouTube.
It was absolutely divine, and as a result, I'll still need to work on doing more 30 minute workouts this week. The agony!
More to come...when Sam brings another cake...stay tuned!
The latest one: one of his bakers made a mistake on a huge, chocolate-covered strawberry birthday cake. He put "Happy 50th Birthday Susie" on the cake. Lo and behold, Susie was only turning 40 at her birthday party...oops! It would have made CakeWrecks proud.
So one of our nurses, who's getting ready to retire, volunteered to be Susie (and pulled out the plates), so we could cut the cake. We even sang to her. If only they didn't ban video at the Hotel, or we'd have had a fine one for YouTube.
It was absolutely divine, and as a result, I'll still need to work on doing more 30 minute workouts this week. The agony!
More to come...when Sam brings another cake...stay tuned!
Monday, August 8, 2011
You know it's Monday when...
"It's a cruel, crazy, beautiful world./Every day you wake up/I hope it's a blue, blue sky." --Johnny Clegg
1. Your patient is the heaviest one on the floor.
2. The first thing you have to do when you walk into the room and say hi, is suction said patient.
3. After that, you have to change the patient's external catheter, since the last shift somehow managed to pull it off. Said patient has a wet pad beneath him.
4. Clean up patient and change pad.
5. Wait for docs to round. Hold bowel routine, 'cause heaven forbid a doctor see a patient who poops whilst they're in the room!
6. Once Dr. HarvardMedSchool gives you crazy orders (like attach dressings without attaching them and you're not using one of these), start bowel routine.
7. Bowel routine over, so bathe patient. Suction again, and again, and again, before shave, after shave, after turning, etc.
8. Feed patient lunch. Suction patient.
9. Be so happy you follow the rules re: isolation gowns in rooms because as you dress patient, patient has a lot of gas, which is accompanied by a moderate amount of loose stool, which sprays bed rail, bed, and some gets on you.
10. Take off gown, wash hands, put on new isolation gown and other assorted PPE, then suction patient again.
11. Get patient dressed, into wheelchair and adjusted. (This takes 30 minutes including cleanup after explosion).
12. Get patient out door.
13. Patient returns in two minutes frothing. Suction again.
14. This time it works, get patient to therapy for evaluation for new wheelchair.
15. Patient is gone for not quite an hour. Lo and behold, the PT inadvertently pulls off external catheter during transfer. Put patient back to bed and clean up.
16. Suction patient again once in bed. Finish cleanup.
17. Dress patient in new clothes. Get patient adjusted then resupply room for next nurse.
18. Give report.
19. Wash wet cushion cover.
20. Go home.
And in between all that, I had 1) other patients and 2) lots of documentation to do.
So glad I eat fast and early! And I'm thrilled my work Monday is over, over, over!
Stay tuned...
1. Your patient is the heaviest one on the floor.
2. The first thing you have to do when you walk into the room and say hi, is suction said patient.
3. After that, you have to change the patient's external catheter, since the last shift somehow managed to pull it off. Said patient has a wet pad beneath him.
4. Clean up patient and change pad.
5. Wait for docs to round. Hold bowel routine, 'cause heaven forbid a doctor see a patient who poops whilst they're in the room!
6. Once Dr. HarvardMedSchool gives you crazy orders (like attach dressings without attaching them and you're not using one of these), start bowel routine.
7. Bowel routine over, so bathe patient. Suction again, and again, and again, before shave, after shave, after turning, etc.
8. Feed patient lunch. Suction patient.
9. Be so happy you follow the rules re: isolation gowns in rooms because as you dress patient, patient has a lot of gas, which is accompanied by a moderate amount of loose stool, which sprays bed rail, bed, and some gets on you.
10. Take off gown, wash hands, put on new isolation gown and other assorted PPE, then suction patient again.
11. Get patient dressed, into wheelchair and adjusted. (This takes 30 minutes including cleanup after explosion).
12. Get patient out door.
13. Patient returns in two minutes frothing. Suction again.
14. This time it works, get patient to therapy for evaluation for new wheelchair.
15. Patient is gone for not quite an hour. Lo and behold, the PT inadvertently pulls off external catheter during transfer. Put patient back to bed and clean up.
16. Suction patient again once in bed. Finish cleanup.
17. Dress patient in new clothes. Get patient adjusted then resupply room for next nurse.
18. Give report.
19. Wash wet cushion cover.
20. Go home.
And in between all that, I had 1) other patients and 2) lots of documentation to do.
So glad I eat fast and early! And I'm thrilled my work Monday is over, over, over!
Stay tuned...
Sunday, August 7, 2011
The weekend draws to a close...
Lots and lots of fun was had by all at the RehabRN household.
I got lots done in the house and started getting ready for the next road trip coming in a few weeks. Travelling partner and I don't have to share a room this time, but we plan on learning AND having fun, even if Manglement makes us give three presentations on our spiel when we get back to the Hotel. We may even let Big Boss buy us lunch this year (he/she ditched us last year in Vegas).
Bubba went to his last baseball games and had a grand old time, hitting and fielding. He even talked Dahey into a bounce-back thingamajig so he can practice all the way up until soccer season. Dahey managed to find it on the local sales board at the grocery store.
WildDog actually got to go outside once or twice, and get spoiled with freshly broiled chicken and the occasional leaf of salad (he loves veggies as much as meat).
So now, I return to chores, until I get another moment of freedom. Stay tuned...
I got lots done in the house and started getting ready for the next road trip coming in a few weeks. Travelling partner and I don't have to share a room this time, but we plan on learning AND having fun, even if Manglement makes us give three presentations on our spiel when we get back to the Hotel. We may even let Big Boss buy us lunch this year (he/she ditched us last year in Vegas).
Bubba went to his last baseball games and had a grand old time, hitting and fielding. He even talked Dahey into a bounce-back thingamajig so he can practice all the way up until soccer season. Dahey managed to find it on the local sales board at the grocery store.
WildDog actually got to go outside once or twice, and get spoiled with freshly broiled chicken and the occasional leaf of salad (he loves veggies as much as meat).
So now, I return to chores, until I get another moment of freedom. Stay tuned...
Friday, August 5, 2011
Coincidence?
I often wonder about some people. When Mr. X, our demented howler, came back from Saint Suburban's acute wing after a bout with urosepsis for rehab, I wondered how did I get so lucky to admit him.
Well, turns out, later in the week, I also got lucky enough to take care of him on my regular shift. Thanks Charge Nurse! Just up my alley...I get (just about) all the people no one wants. I fluffed and buffed him (including shampoo, shave and nail filing), got him up to therapy, got him lots of nice equipment, then bam! He comes back to the unit and says, "My butt itches."
If he wasn't so old, and RehabLand was not so far away, I'd think it was this patient who visited Nurse K in Montana.
I am just so happy I don't get to work this weekend, even if I have to stay home and clean my house. There are worse things to do...
Stay tuned.
Well, turns out, later in the week, I also got lucky enough to take care of him on my regular shift. Thanks Charge Nurse! Just up my alley...I get (just about) all the people no one wants. I fluffed and buffed him (including shampoo, shave and nail filing), got him up to therapy, got him lots of nice equipment, then bam! He comes back to the unit and says, "My butt itches."
If he wasn't so old, and RehabLand was not so far away, I'd think it was this patient who visited Nurse K in Montana.
I am just so happy I don't get to work this weekend, even if I have to stay home and clean my house. There are worse things to do...
Stay tuned.
Tuesday, August 2, 2011
Patient comments and assorted shenanigans
Ah, being in charge ain't all it's cracked up to be. Here's a few things I had to deal with recently during my time in charge.
Playground politics
Patient needs help, doesn't get it, so he makes a mess. Other patients give him trouble about it. Muttering and rolling around follow up and down the hall.
One nurse solves problem: give patient his own little trash can. No more stuff on floor, and no more complaints from other kiddies.
Common sense...it's amazing! Now if the rest of the staff will pay attention...
Signs of a patient who needs to go home
Patient decides to keep wheelchair, walker (which he can't use anymore) and other wheelchair in his room. Problem: he has two other roommates and we don't allow wheelchairs in rooms overnight due to safety hazards (mainly for staff). Patient throws fit when I try to take the last wheelchair out of room, and he barricades it in a corner so far that I would have to rearrange furniture to get it out, turning on all the lights and possibly calling security.
Decision: bounce ball back to nurse manager...make her decide. The night crew did not need anymore excitement, thankyouverymuch!
Yes, I miss you too
Patient X (who was recently admitted), "I thought you didn't work here anymore?"
Me: "No still work here, you just saw me on the SU, when you went to the clinic."
Patient X: "Oh, that's why you were there."
Me: "Yep. Any questions?"
Stay tuned...
Playground politics
Patient needs help, doesn't get it, so he makes a mess. Other patients give him trouble about it. Muttering and rolling around follow up and down the hall.
One nurse solves problem: give patient his own little trash can. No more stuff on floor, and no more complaints from other kiddies.
Common sense...it's amazing! Now if the rest of the staff will pay attention...
Signs of a patient who needs to go home
Patient decides to keep wheelchair, walker (which he can't use anymore) and other wheelchair in his room. Problem: he has two other roommates and we don't allow wheelchairs in rooms overnight due to safety hazards (mainly for staff). Patient throws fit when I try to take the last wheelchair out of room, and he barricades it in a corner so far that I would have to rearrange furniture to get it out, turning on all the lights and possibly calling security.
Decision: bounce ball back to nurse manager...make her decide. The night crew did not need anymore excitement, thankyouverymuch!
Yes, I miss you too
Patient X (who was recently admitted), "I thought you didn't work here anymore?"
Me: "No still work here, you just saw me on the SU, when you went to the clinic."
Patient X: "Oh, that's why you were there."
Me: "Yep. Any questions?"
Stay tuned...
Happiness abounds...
When you get lucky and some people actually want to work overtime. I was aghast when Madame Butterfly, one of our night shift nurses, called in sick. She left me in a lurch until another nurse (who wanted our rare OT) came in so I could go home.
Yes, I am a happy camper!
Yes, I am a happy camper!
Monday, August 1, 2011
Catastrophe and chicanery
It never fails...the Hotel doesn't change.
Who else would put up with one person who constantly talks about being on the "team" and working together and then when the team needs him/her the most, because two of the folks working have very close relatives who have had 1) a stroke and 2) mental status changes after hitting their head, calls in sick leaving the crew horribly short?
Another one of our nurses has sciatica (and a few other medical conditions) so bad that he/she cannot stand to work.
At least, it was pleasant while I worked. Everyone who could, including "Mr/Ms. Team" showed up. I'm just hoping none of our other employees get any ideas about calling in sick while I'm in charge!
Stay tuned...it's one drama after another at the Hotel Rehab.
Who else would put up with one person who constantly talks about being on the "team" and working together and then when the team needs him/her the most, because two of the folks working have very close relatives who have had 1) a stroke and 2) mental status changes after hitting their head, calls in sick leaving the crew horribly short?
Another one of our nurses has sciatica (and a few other medical conditions) so bad that he/she cannot stand to work.
At least, it was pleasant while I worked. Everyone who could, including "Mr/Ms. Team" showed up. I'm just hoping none of our other employees get any ideas about calling in sick while I'm in charge!
Stay tuned...it's one drama after another at the Hotel Rehab.
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