Fall weekend

It's so beautiful in our neck of the woods, even though the weather's been really weird for our part of the country. Most of our trees in the yard have turned red, yellow or orange. With all the wind, many of the leaves have fallen.

Bubba's had fun at the many Halloween parties he's attended. One more tonight and we're done! At least I can say we got our money's worth from his costume, which he picked out himself. He's quite the shopper--it was also on sale.

Dahey's driving again delivering goodies and swapping and trading hither and yon. Thankfully we have cellphones or I'd never know where he was.

And I'm here studying away before we start all the fun tonight. Should be an interesting weekend...stay tuned!

Run, jump, and play with scissors

That's been the story of my days, for weeks it seems.

Running...I do that all day long. And with the remodel, they plan on making my trip longer. We will have the entire building for our unit, so it will be a very long walk. I suppose this means they'll get those tracking devices again soon, for our own safety, of course.

Jumping...was what I did after I got all my notes written. If it wasn't someone coming in, it was someone going out to a test or procedure. One patient had a test and then was sent to acute to resolve an emergent issue. Yes, they do really happen that fast. Why no one noticed is beyond me. I've given up trying to figure out what other people think. My job is to think on my feet and call the cavalry when needed.

Playing with scissors...ah, the joys of teaching. I'm becoming the Queen of WoundVACs, promoted from Princess since the Queen has been on vacation this week. (We like to think we're royalty anyway.) The orientees were impressed. I was impressed with the way the sore I used it on is looking already, after two days of use. I never cease to be amazed at the way some things heal. And I can't understand when some of my coworkers say, "Well, we could just use a wet to dry dressing!" Not on everything you can't. It's just not the same.

I also got to dress and redress a couple other wounds due to various bowel and bladder accidents. Some people will never learn, nor listen to their nurses...arrgh!

More to come...

Thriller CoS is on the rise

Check out the latest Change of Shift over at Reality Rounds if you dare...and no, Michael Jackson won't be there...BWAHAHAHA!

Nuggets for October 21

Yes, it's that time again, folks, so here's a roundup of the latest and greatest goodies I've found in between reading for grad school (aka the secret escape plan at your very own desk) and stuff from my daily life on the floor.

Medical goodies

In nursing school, you learn about all the different lab values. Some, like the various cardiac enzymes, are taken a little more seriously than others. Some values can be off. This article at www.medscape.com called False Positive Cardiac Troponin Results described my day recently.

Another interesting article, also on Medscape, discussed the Cutaneous Complications of IV Drug Use, which has been more apparent in some of our patient population recently. Note: there are photos with this one, and some are very graphic.

Reuters recently had an interesting article about stress: Stressful childhood may mean earlier death. And probably the best article, One pair of dirty hands equals many infections, describes what happens if one person doesn't wash their hands.

The Sneeze Sleuths are featured in a Wall Street Journal article about allergies.


Etc.

Want your husband to do more housework? Check out this article called the Sex-Housework Link from the folks at the Wall Street Journal of all places.

Wanna find out what telemarketing company is calling you? Check out whocallsme.com for more information on some of the phone numbers telemarketers like to use.

Sliver of moon...

That's what I saw when I looked outside tonight. The new moon is nearly upon us.

Work is still the same old, same old, which will get more fun and exciting when the annual vacation schedule for next year is turned in soon. Lots of wailing and gnashing of teeth. Boss enjoys the position of keeping people in suspense, so we're still waiting to see who he's going to assign to work Thanksgiving, since everyone knows the nurse with the most seniority, S, is already off anyway, just like every other holiday (and day after, if she chooses).

It's always fun asking the specialists questions they don't expect...like why were using a product off-label. Thankfully, the guy I asked has a sense of humor. His boss, the chief, vacillates on humor on, humor off some days, so he doesn't always like to be asked. I did get an interesting answer, so I was happy I asked. Met one of the specialist's new residents who is really good. Now if they could keep her from writing goofy all acronym orders, that would be even nicer. No wonder JCAHO has a fit at our place all the time!

The Slug did an unusual thing today...missed a personal phone call during business hours. Yes, indeed, another sign the moon is changing!

I've had fun so far this week. I got to play with some new tools and get them to work after only a couple of uses. I'm one of the few people who use this product right now, but it's so much better than the old stuff. I can't wait until Santa brings us a couple more!

School is still school. I attended an optional conference via web today, so that was interesting, especially since my instructor was there, too. (She must attend all of them). Hopefully, my redone paper got a good grade.

On top of that, I've got my date for the my certification exam...just days after the semester is over. At least, I'll have a little time to celebrate.

More later...still tired from yesterday. Stay tuned.

Take a break...

Bubba and Dahey are doing the fun stuff and I'm theorizing here and searching for stuff for the next paper.

Arrrgh! So glad I'll get a break tomorrow at work!

And now for something completely different...the Nobel Prizes have already been awarded and so have the igNobel Prizes, but you've gotta love this igNobel one for the bra that will save your life.

Maybe if we run out of N95s at Madison, I could use one of these!

You gotta go...

See this post at the Jage Page. Well said!

That is all...back to homework. More to come...stay tuned!

Neither rain...

Nor sleet, nor snow, or conference in Vegas will stop Kim from posting the latest version of Change of Shift.

Head on over and check it out!

Butter me up

I just couldn't resist passing this goodie along that I found at Serenity Now Hospital.

Gotta love a little gallows humor. Thanks Doc!

Crazy...?

I hope not...but who knows for sure.

Weather is frightfully cold this year. At the rate it's going, Bubba will have to go out on Halloween as a skier in a snowsuit.

Crazy patients were calmer lately. Could have something to do with actually scheduling anti-psychotics instead of making them PRN! I can leave the room being nice and still be nice to that same patient who thought I was back to kill him when I left for five minutes to go to the vending machine for his Coke.

I had free time to work on homework on my break.

May miracles never cease!

Nuggets for October 8

Goodies too good to pass up...some I see every day and some I just see and pass along to you! Enjoy!

Cool toy

Since some of my grad work is on tools to do a better job in healthcare, we'll have lots of talk in class tonight about Microsoft's H1N1 assessment tool, created with a little help from their friends at the Emory School of Medicine.

Other toys in the medical world

We're always fixing up lots and lots of people with sores of all sorts. Wound clinics can have lots and lots of sores--diabetic sores, pressure sores, and good old generic trauma.

How do you fix them up?

Sometimes we use radio therapy devices. Or we may use a combination of things, such as WoundVACs and hydrotherapy, as noted on this page. If we can get access, we might use hyperbaric treatments, but due to cost, this is rare.

And if all of this stuff doesn't work, there are folks working on a mathematical model for wound healing.

Freebies?

Oh, if only I could have a problem like this one mentioned in this article in the NY Times about bloggers and product reviews....

Hmm....and what would a rehab nurse be likely to receive or review?

I'd have to borrow some patients, because I surely would not review any bowel preparations. We have a character who comes to our place and preaches the miracles of this particular preparation.

I'm still a coffee girl (someone's got a mug that says "Coffee it gets you going"), so if Starbucks or some other really good coffee people come my way forcing samples on me (like they did the other night with that VIA when I was getting my latte), I'll gladly share some with my evening and night shift friends. (I stash my coffee in secret places at work). Shoes would be another weakness. Doesn't matter if it's high, low or in-between heel, sandals or boots. Work shoes would be welcome, but I'd have to practice wearing them at home first. No way do I wear shoes directly to work without hanging out in them a while to see what happens.

Now, if I could get a few samples of perfumes or chocolate truffles (or just about anything chocolate for that matter), I'd be in heaven.

And, of course, I'd share all my details with all of you.

More to come...back to papers and theory and paying bills...

Monday drifting

Its never easy
And its never clear
Whos to navigate
And whos to steer
So you flounder drifting ever near the rocks.

--Dan Fogelberg, Hard to Say, 1982

I knew something weird was going on when I awakened early in the morning after a lovely dinner at home with my family. I even got my paper all fluffed, buffed and edited and sent to my instructor. Dahey and Bubba had a nice day. It was one of those dreams that wakes you up and you can't go back to sleep. That was me, only I awoke to the smell of something cooking. I investigated and no one was cooking at my house.

Finally, cups of coffee later, I got Bubba out and rolling. Once I got in, the slowness of the hallway surprised me. Even at breakfast time, there's a rush at our place. Nurses feeding people, setting people up, giving meds. Today it was hushed. I found out why when I saw the code sheet at the desk. The procedure details told me something was up. I ran to one room and saw that patient was watching TV, with breakfast over. Once I saw him, I knew exactly who it was. I just didn't know the story.

Report comes in. It was my patient who I took care the last few weeks. The restlessness and dreams and the odd things said all came back to me. I felt like I was reading that book again. I was disturbed, so when I saw the chaplain come around, I talked to him. That helped.

Mondays at our place are usually nuts, so I went on and got my patient ready. Even with all the hubbub, it wasn't as bad as I thought it could have been. We talked amongst ourselves and laughed about this patient. He/she was just a character, and it was very evident in the last few days, as he/she got up and out of the room. Some days I just walked out of the room and chuckled to myself, "What a character!" And it wasn't just me, either, since he/she regaled the docs just as much as the nurses and staff.

Finally, I went home, and on the way, in the fall breeze, I just thought about how lucky I am...and how free one character is today.

Hope you two are enjoying that burger...wherever you are!

Not a hospital-sanctioned sport

Some people watch ESPN and pay attention to the sports.

Some people watch ESPN and pay attention to the commercials.

And some people who pay attention to the commercials and are pushing 100, ask their nurse how they can score some Levitra (which just happens to be on the commercial). Paging Dr. S.! Yes, indeed, Dr. S. is the man for any ED drugs at our place, after, of course, you get the "education" required.

I guess this means Mr. X is feeling better now, so it should be an interesting weekend!

Come on down!

Is it your turn on the Price is Right? It's is for me...thanks Bob! I mean Kim for inclusion in the latest edition!

If not, check out this latest edition of Change of Shift over at emergiblog.

http://www.emergiblog.com/2009/09/change-of-shift-vol-4-number-7.html