Wednesday, December 31, 2014

Happy New Year's Eve!

Celebrate what you want to see more of.~ Tom Peters

I agree! Will be enjoying some fun with my family tonight. May you have a wonderful evening wherever you are.

May 2015 bring you health and happiness, two things of which that you never can have enough.

See you next year!

Saturday, December 27, 2014

I was tempted

To do what this person did. Bubba was driving me nuts.

Pre-teens can be a handful in more ways than you think. Going to the mall and not being able to sell back your old game system really IS upsetting, but it just reflects the concepts of economics: supply and demand.

No demand for your game console (actually oversupply) means they won't buy yours back.

Whine, cry all you want, you need to think of something else.

That is all.

Friday, December 26, 2014

The things you find

Since I've been on vacation this week, I've been trying to get my end of the year stuff done. Dahey has some financial stuff to take care of that he finally got around to today. 

It was a lovely day in RehabLand, so we took Bubba outside and taught him about how you can quickly clean up piles of leaves from the old oak, which, of course, never sheds them all until you have a lot of wind (or snow) in winter. We put leaves in cans, we put leaves in bags, so we will be ready the next time they come by to pick them all up. Bubba was tired by the time we were done.

I filed some paperwork. I thought I was only filing this year's stuff. Well, 2013 must have been really crazy, because most of the paperwork was still unfiled for that year. Luckily, this was easily fixed (by sorting it out and filing it). 

Besides filing, and giving away old stuff, I found some new stuff. I put a DVD player a relative didn't want in the closet.

I figured I might as well get it out and start using it to get my exercise program back on track. Each year, I write down my top 10 goals for the year. I only accomplished 3 of the ten this past year.

The appointments that needed to be made were made with all the folks who were still in their offices this week. The rest will wait until next year. A couple of resolutions written down, and hopefully the start of many more successful ones.

More to come...


Wednesday, December 24, 2014

An oldie but goodie the night before Christmas - nurse style



I am fortunate to be home with my family for the holidays. I love this take because it was very much like my very first Christmas as a nurse. I got all nestled, then I floated.

Merry Christmas to all and to all (celebrating or not), good night!

A Nurse Christmas

Twas the night before Christmas.., and all thru the floor
Lasix was given, filling the foleys galore.
Stockings were worn to prevent emboli,
they came in two sizes, knee and thigh high.
The patients were nestled half-assed in their beds,
while visions of stool softeners danced in their heads.
We in our scrubs, and they in their gowns,
Fashions created to hide extra pounds.
When down in the ER it became such a zoo,
they called with admissions for me and for you.
They're coming, they're going, and they're all looking the same.
My patience for patients is starting to wane.
Now call lights are ringing, the patient 400 pounds, says-"
Didn't get my pericare, now send my nurse down."
And now delegation seems the best plan,
We try to send others, to the needs of this man.
When what to my wondering eyes should appear,
But Santa himself and 8 tiny reindeer.
He says he comes from Central Supply.
To bring us LR,NS, & D5.
The doctors then scribbled what no one could read,
Orders on patients, to measure their pee.
We try to decipher illegible words,
orders for patients, to guaiac their turds.
The new shift arriving, our day is now through,
How did stool & emesis get in my shoe?
We give them report and pass on the facts,
and tell them of duoderm lining the cracks.
And the nurses exclaim as they limp out of sight,
"Ativan to them all, and to all good night.!!!"

Sunday, December 21, 2014

Great blog post on nursing

I don't regularly follow NPR, but I came upon this blog post because of a therapist I work with at the Hotel. It speaks volumes.

Don't miss it! BTW see the movie if you get the chance. Kids or no kids, it's a good one.

Happy weekend wherever you are. You deserve it.

Saturday, December 20, 2014

Just in time for the holidays...

Ah, it is always an interesting time reading the RehabLand Board of Nursing newsletter. So here's today's edition of what not to do as a nurse.

Don't say those licensing people forget the holidays...be careful out there!

Things not to do as a nurse: the holiday edition.

1. Don't sleep on the job. 
Yes, that nicely made bed looks comfy, but if you forget to wake up, you have a problem. NOTE: some facilities do let you take power naps, but remember, you are PAID to come to WORK (notice the items in caps).

There are some expectations that come with that.

2. Forget to pay your income taxes.
Here in RehabLand, the Department of Take it all Revenue can report you if you don't and you can lose your license. According to the numbers, almost 25% of nurses lost their license last year due to tax issues.

3. Don't force someone to do something they refuse to consent to do, like take a bath.
Do the words assault and battery mean anything to you? I knew they did.  Patient says no, you document to CYA.

4. Drive while intoxicated.
They shouldn't have to tell you "when to say when" if you are a health care provider. But if you tend to be indulgent, get someone else to drive.

5. Fail to monitor a patient and act accordingly.
The example used in RehabLand's newsletter was disgusting. An RN (old one at that--we can tell by their license numbers) flat out did NOTHING for a patient who became sick in the morning. Let him/her throw up, wait until nights when said patient drops the phone, while satting at 82%  (normally 100% person on room air) and passes out.

The night nurse had to call EMS to take this person to the ER.

And finally the topper of this edition:

6. Don't let residents who are supposed to be on the unit (per orders) out.
Another old RN decided to go on a smoke break and six (not one two or three...) residents who were confined indoors got out of the facility. One, Z., was gone for so long that he/she did not get scheduled insulin, had glucose issues, passed out and fell out of his/her wheelchair.

Old RN left Z on the ground, got the other 5 back into the building, hoisted Z back into a chair and told a CNA to take Z to his/her room. No assessment, no documentation, no nothing.

Z sustained a head injury, which was later diagnosed when Z started having other issues.


Wednesday, December 17, 2014

Viruses, virii and a mouse in my kitchen

Oh, it's been one heck of a week. I just finished my Z-pack and Dahey feels crappy. A mouse got into my cabinet and trashed a bag of barley and one box of Inca Red quinoa. 

The Christmas pageant starts soon. Bubba gets to do a solo instrumental song. We'll cross our fingers that he doesn't get stage fright. Looks like I'll have some fun tonight.

At the Hotel, the patients are getting loaded up with all sorts of goodies: blankets, books, snacks, cookies, you name it. The Manglement are getting ready for our next inspection in January (what a Christmas present!).

I'm praying it snows like mad.

Hope you're enjoying your night wherever you are. Stay tuned.

Friday, December 12, 2014

Happiest of Fridays to you

I didn't run away. I've been busy cramming everything in, so I could have a day off. One project plan, three appointments, a consult, a specialty service visit, four phone calls, one patient portal enrollment, one transferred patient and a grand rounds presentation.

So today, I escaped.The sun came out after what seemed like weeks of clouds and rain. I found my sunglasses and wore them.What a day it was!

I visited friends I had not seen in a long time. I shopped and went out for breakfast, lunch and dinner, which meant no dishes for me to wash ALL DAY. It was like being on vacation at a hotel without leaving.

I also celebrated another birthday this week. It was fun. Health IS wealth, and I feel like a millionaire now that I am almost done with my antibiotics (from whatever URI I got around Thanksgiving.)

Hope you enjoy your weekend wherever you are!

More to come...

Thursday, December 4, 2014

In an instant

A police officer puts a person resisting arrest in a choke hold. He ignores the pleas that the person can't breathe. The person dies.

A guy driving through a protest march hits a pedestrian. He's arrested for assault.

Another guy goes to work. Someone asks him to come out to the parking lot. It's his son. He proceeds to club his father to death with a baseball bat in the middle of the day in the parking lot.

It doesn't take long for a life to disappear. Robbing someone of one breath, one moment, one defensive move can have consequences that last forever.

Life happens in an instant. Be aware. Some things you can't get back after that instant is gone.

Wednesday, December 3, 2014

Joining in on the fun...

On my next eye doc visit, I get to take Bubba.

I just didn't want to be alone. At least he is off school and I am off work.

A fun mother-son outing (once we escape.) I'm not sure if he'll like the eye drops.

Stay tuned.

Tuesday, December 2, 2014

Giving Tuesday

Yes, after Black Friday and Cyber Monday, Giving Tuesday sounds like another crazy day.

 However, it is what you make of it.

 I challenge you, readers, to go out and give your time, talent or treasure to your favorite local,   regional, national or international group. Start today and make it a habit. Dahey and I are in our 15th year supporting many groups from religious organizations to housing corporations to food security and holiday giving groups. One of our favorites is this one for war veterans (amputees, spinal cord injury, or TBI) which we found when a local guy was raising money for his house. See, rehab related!

Not sure who to pick? Check sites such as Charity Navigator or Charity Watch. Ask questions, too, like how much of my donation actually goes to research, your target audience, etc. Who cares about pretty stationery if they spend too much on what they mail you!

Pick charities that work with your own beliefs, philosophies, and who give a large portion of their donations directly to folks in need. Check with your tax adviser re:deductions.


All in all, give whatever you can today whether it is your time, talent or treasure, and don't forget to share your #unselfie.

It is greatly appreciated.

Stay tuned...

    Sunday, November 30, 2014

    Serendipity

    It can't exactly be summed up in one word. When I read this article, I thought of my own experiences on subway trains all over the place.

    Consequently, I find the same thing happening as I do my job. Sometimes, when I was on the floor, I'd have those moments with those super-needy patients where I felt as if every ounce of caring was sucked out of me. I was spent.

    Before I knew it, someone would come and change everything, in that very moment. One particular moment I remember was working on Mother's Day. My coworkers swore our weekend always encompassed the holidays, like Mother's Day. I finally got everything done for my patients and headed for the nurses' station to chart (since we don't do bedside, nosirree!). One of our chaplains came to the desk and gave all the mothers a rose. It was sweet. He has moved to a different area, so I smile when I see him and think of that day.

    That same article made me think of one of those super needy patients. Partly because he lived in New York City for a while. I think of some of our folks, like him, even more this time of year, because he died not long before Christmas. His sister, an old nurse, liked to bring donuts.

    We may not be in a subway car, but in our little unit at the Hotel, we find fortunate happenstance in places we never expected. I hope you do, too, wherever you are tonight.

    Thursday, November 27, 2014

    Happy Thanksgiving!

    Yes, it's been a crazy week. I am however so thankful for so many things.

    I have so many things: I have a nice home, a car for each driver, and a good job to pay for it all.

    I was able to take a couple of vacations with my family this summer. I also got to travel for work and for a group I belong to. I was able to afford it (or my employer paid my way).

    I got a raise. It seemed like it took forever (almost three years), but when I read an article recently about a man who worked in a fast food restaurant (and two other jobs) who had not gotten ANY raise in three years, I count myself fortunate to have been given a substantial raise.

    I have my health (even if I have a pesky cold right now). I have good health insurance (that came with my job) so I could afford preventative care.

    I followed preventative care guidelines and hopefully (will know soon) will avoid losing one very important sense. I can't say I'm thankful enough for that. I hope to be a voice to advocate to others, to not skip on this important means of detecting life-changing conditions.

    When I watch the news, we see so many terrible things. Riots, looting, destruction of small businesses, and death. I am thankful that as a caring member of my community in RehabLand (and as a citizen of the world), I can make a difference. I can donate to the food pantries, homeless shelters, and even to the small business owners of Ferguson, MO.

    I am immensely thankful. Thank you for reading this and sharing my blog with others. I appreciate it.

    Happy Thanksgiving to all wherever you are. Real nurses celebrate Thanksgiving every day, because they work every day. Thank you police, fire and EMS folks, who are also there with us. We couldn't do it without you.

    More to come..


    Thursday, November 20, 2014

    Add a little on top

    So, since we've had the eye saga of late, I now get to add a little more fun to the mix: sleep apnea.

    Yes, sleep apnea can indeed affect your eyes. Dr. X, our CPAP prophet, would be patting me on the head for getting my doc to get me a home sleep study. Unfortunately, I get to go spend the night with the sleep specialists. The prep sheet doesn't sound too bad, but I am sure I will not sleep well.

    And yes, it had to happen. Someone may be infected with ebola here in RehabLand. 

    Can you tell I'm glad tomorrow is Friday and I'd like to do this (see below)?

    More later...


    Monday, November 17, 2014

    Preaching to the choir

    Most people don't think about death happening in rehab, but it does. Probably more often than you know. Right now, we're rehabbing a patient who has been seeing palliative care.

    It may not happen immediately on a unit, but we prepare as if it might.

    I read this recent article on death from author Suzanne Gordon with more than a passing interest. It hits home to me. Sometimes I wonder why we let people get set up for false hope. Is it so we have a rehab goal for therapy? Is it so we might record a FIM gain?

    Or is it because, we're just like everyone else. We don't want to be the "bad guy". If we tell the truth, we could be the bad guy and make the patient and/or his her family upset.

    But if we perpetuate the illusion of hope, aren't we stealing the shred of truth the patient relies on us to give him or her?

    It makes me wonder...more later.


    Sunday, November 16, 2014

    Snow has arrived

    Yes, it's powdery and pretty here in RehabLand. Bubba was busy looking for his sled, which he soon discovered is not working anymore. After seven years, it's time to get another one.

    It does keep him busy though. He likes to move snow around. Move the snow off the cars, onto the ground, then into the grass with the broom. We will see how successful he really was.

    With the polar vortex in the neighborhood, we are awaiting record cold for this part of the year this week. I'm so glad I bought Bubba new snow boots when I saw them. He hasn't needed them this early in a very long time.

    Now to get ready for the week...stay tuned.

    Saturday, November 15, 2014

    Oh Polar Vortex!

    Yes, it's not quite winter, but you'd never know it from the chill that's descended on RehabLand. Bubba played in a tournament for school and Dahey got some new glasses ordered after much cajoling.

    Now, today it's snow.

    I'm so glad I'm off tomorrow. I'd really like to just hide under the covers.

    That is all. More later...

    Wednesday, November 12, 2014

    Maybe...

    I was just SUPPOSED to lose my watch when I went through the Las Vegas airport earlier this year. It was a Mother's Day gift, not terribly expensive, but it worked. It had a second hand, was dressy enough, and I could read it in the dark. The present part made the loss upsetting to me.

    A month or so later, I bought a similar replacement. It looks pretty close to the other one, but I realized that the date window was really little compared to my old reliable. Some of my friends joked that since I'm getting old, I probably just need glasses.

    Being the good nurse that I am, I knew I needed to make an ophthalmology appointment, but I do not have eye problems. Dahey does. Dahey has worn glasses forever and  has always had the distinction in our house of having the most expensive glasses. I talked to my traveling partner and she recommended a doc from her old hospital, Dr. K.

    Dahey saw him, had a good appointment and passed all the tests. That was in April. I said I'd have to do the same.

    Of course, time got away from me and finally I decided to call their office and schedule an appointment on Veterans' Day, since I happened to have the day off. I thought, this won't last too long. Dr. K is very nice and is a veteran himself.

    But it did. Dr. K.'s tech did a lot of tests, but a couple of them, Dr. K. redid himself. So we had another long discussion. I hope my eyes did not bulge out of my head, because what I really wanted to do was shriek.

    The words, "you have a condition that will cause glaucoma", weren't really what I was really planning on hearing.  Dahey, my veteran, and I were planning a nice lunch somewhere, since he was off work, too.

    After the almost three hour appointment, I left. However, I count myself lucky. I never served on a frozen battlefield in Korea, like the man I talked to today while waiting for some labs. I felt like I was there when he talked about prisoners in "cotton uniforms and tennis shoes." I understood when he said, "I still won't eat rice." because of the memories it brought back. He is in his 80s and still working, even if he needs a rolling walker to get there.

    I may have been bombarded myself yesterday, but I want to let all the veterans out there know I thank you every day for your service. This year it's even more special, because one old Navy doc made sure I'll have a chance to see more in the future. I am so very lucky because it is treatable (which starts today) and I have no vision loss.

    Losing that watch was probably the best thing that happened to me this year.

    More to come...

    Sunday, November 9, 2014

    Rehab nursing in a nutshell: the series

    Oh, since I'm still thinking about  what I learned at a recent rehab nurses conference, I figure I'll share what I've learned along the way.

    If you haven't already read some of the old stuff in this blog, feel free to go back in time. I've tried to keep most of the stuff that captures how I felt as a new nurse.

    Frankly, being a new nurse wherever you are is scary. There are nice people out there, and there are the trolls and Nurse Ratcheds who will make your life hell (or at least attempt).

    First rule: DO NOT LET THEM.  Sometimes the best thing you can do is to find a mentor (if you are in a residency program, thank your lucky stars...) and learn how to be a good nurse.

    You can learn on your own some of the additional stuff you need to know in rehab.

    Just remember Rule number 2: you will never stop learning. Don't even try, don't get sedentary, don't get sedate.

    I can't tell you how many over 60+ year old nurses I saw at the recent rehab conference. Three of the original 12 nurses who started one group showed up. One had a cane, but let me tell you, she used that cane with confidence, and she went from session to session, several which I attended.

    Our closing speaker (a nurse) helped his/her mom complete her CEUs for her license. She's 84.

    Not sure if she's a rehab nurse, but she would have fit in fine with all of us (and would have ended up with lots of CEUs).

    That's enough of an assignment for today. Enjoy the rest of your weekend, wherever you are.

    More to come...stay tuned.

    Saturday, November 8, 2014

    Follow your arrow

    We talk a lot about how we work together as a team, but sometimes, it seems like we miss the point.

    I have had to work with Manglement to bring nurses into the Hotel. One manager has retooled all the interview questions (yes, we use them for a number of reasons) to ask questions about the team.

    One nurse wanted to transfer from one unit to another. No dice because this nurse has had an issue with the hiring manager in the past. We also had other unsuitable candidates. Why? Because some of them just don't come prepared. They don't sell themselves. You give them time and they don't know how to do it!

    So, if you're on a journey, and want to go somewhere new, follow your arrow. Learn along the way. Just because something fails once or twice, or even three to thirteen times, you will eventually get to success. Listen. Find mentors and read the signs along the way.

    Enjoy your weekend wherever you may roam.