Woke up again to a stuffed up nose and clogged ears, which by the time I get upright equals a headache.
'Tis summertime again in RehabLand and all the pollen's come out to play.
Will resume normal postings as soon as my head cooperates...
Thursday, June 30, 2011
Tuesday, June 28, 2011
Change up
Here I thought, at the beginning of the week that I would have to work day shift for a while and lo and behold the boss switches my schedule around.
So working half in one shift, and half in another, I got to see some crazy stuff I don't normally see.
We occasionally have discharging patients who don't want to go home. We had one this week. This patient tried to think up every excuse in the book. It doesn't help it if the patient also has psychiatric issues and is not only anxious, but getting manic.
Psychiatrist, psychologist, and MD get patient a nice dose of something especially calming for the road. Nevertheless, the patient gets halfway home and calls to say, "I need to come back." MD tells transportation to take patient to nearest emergency room if things get crazy.
Another patient gets in his wheelchair with snacks and a soda and proceeds to roll his chair off a wheelchair ramp in front of the Hotel, into the curb and somehow flip the chair. Thankfully, he couldn't go too far away. We have no idea why or how he did it. Called our docs, called the on-call doc, called the super. Patient gets the all clear. Lots and lots of fun paperwork to do for the charge nurse.
Another anxiety attack was averted when Mr. Z's nurse finally found his soda and snacks in his room. I don't think he could handle losing those items, which would have been worse than breaking his leg!
Stay tuned...we'll see what shift I work next!
So working half in one shift, and half in another, I got to see some crazy stuff I don't normally see.
We occasionally have discharging patients who don't want to go home. We had one this week. This patient tried to think up every excuse in the book. It doesn't help it if the patient also has psychiatric issues and is not only anxious, but getting manic.
Psychiatrist, psychologist, and MD get patient a nice dose of something especially calming for the road. Nevertheless, the patient gets halfway home and calls to say, "I need to come back." MD tells transportation to take patient to nearest emergency room if things get crazy.
Another patient gets in his wheelchair with snacks and a soda and proceeds to roll his chair off a wheelchair ramp in front of the Hotel, into the curb and somehow flip the chair. Thankfully, he couldn't go too far away. We have no idea why or how he did it. Called our docs, called the on-call doc, called the super. Patient gets the all clear. Lots and lots of fun paperwork to do for the charge nurse.
Another anxiety attack was averted when Mr. Z's nurse finally found his soda and snacks in his room. I don't think he could handle losing those items, which would have been worse than breaking his leg!
Stay tuned...we'll see what shift I work next!
Monday, June 27, 2011
My Monday
1. Rain.
2. Drop kid off at camp.
3. Take car to mechanic for funny noise. Get rental.
4. Go to work late.
5. Take care of usual suspects.
6. Hear one of suspects "compliment" me on what a "fun" person I am. (Said suspect is up to something).
7. Suspect leaves for doctor's appointment with specialist.
8. Idiot pulls fire alarm.
9. Get ready to evacuate, but figure out there's no fire.
10. Notify boss and security. Secretary gets to tell fire department, who have arrived looking for a big fire.
11. Go back to charting.
12. CNA logs me out of system because I rolled 3 feet away from PC and wasn't using it.
13. Suppress urge to kill CNA. Get computer back and start charting.
14. Five minutes before I leave, get new patient weighed (forgot about it earlier).
15. Five more minutes, get weight charted and finally leave.
16. Come home and find out Dahey's car needs help.
17. Call tow truck.
18. Thank lucky stars I have a rental. Dahey picks up Bubba.
19. Lather, rinse, repeat (hope not!) tomorrow.
2. Drop kid off at camp.
3. Take car to mechanic for funny noise. Get rental.
4. Go to work late.
5. Take care of usual suspects.
6. Hear one of suspects "compliment" me on what a "fun" person I am. (Said suspect is up to something).
7. Suspect leaves for doctor's appointment with specialist.
8. Idiot pulls fire alarm.
9. Get ready to evacuate, but figure out there's no fire.
10. Notify boss and security. Secretary gets to tell fire department, who have arrived looking for a big fire.
11. Go back to charting.
12. CNA logs me out of system because I rolled 3 feet away from PC and wasn't using it.
13. Suppress urge to kill CNA. Get computer back and start charting.
14. Five minutes before I leave, get new patient weighed (forgot about it earlier).
15. Five more minutes, get weight charted and finally leave.
16. Come home and find out Dahey's car needs help.
17. Call tow truck.
18. Thank lucky stars I have a rental. Dahey picks up Bubba.
19. Lather, rinse, repeat (hope not!) tomorrow.
Sunday, June 26, 2011
Fun Sunday
This is for M., one of my dearest friends in the world who manages a pharmacy out west. She would have been a helluva math teacher if she hadn't decided to be a legal drug dealer for the Evil Empire.
You can check out other cartoons here: http://www.xkcd.com/
You can check out other cartoons here: http://www.xkcd.com/
Saturday, June 25, 2011
Ethical dilemmas
In rehab, we keep people for a long time, as long as they're progressing. In the Hotel, we keep people a long time, because we can for a variety of reasons.
Sometimes, we even have staff get entangled in the issues. Here are some that have come up since I arrived at the Hotel.
1. The infamous, "He said, she said". Someone overhears part of a conversation, and reports it. Patient and nurse have two different stories. Reporter decides to write it up and nurse, of course, gets in trouble, because, as in most service industries, "the customer is always right." Patient is mad at nurse for rest of stay, and nurse is in hot water.
2. Patient stays with us for protracted periods of time when they actually need to be somewhere else. Examples: 86 year old patient with metastatic cancer says, "I can be rehabbed." Oncologist says patient has six months max due to the nature of the mets. We lose a rehab spot, because our boss says, "Go ahead and try." Hospice case worker fortunately has his head on straight: "We'll keep a bed for whenever he's ready to cross that bridge."
3. Nurses get involved (financially, sexually, etc.) with patients. It's no help when said nurse is a favorite of your nursing administration. Nurses also abuse the kindness of patients by eating their snacks, etc. I counsel them to report to no avail, because they fear retribution while they're still here.
4. Boss trains two people for a specialty position over the past year. Both people will be gone from Hotel by September, and boss knew this. WTH is the matter with the boss? Does he/she like training people for other companies? Obviously...training wheel starts over again in a few months.
5. Succession planning. What's that you ask? Well, it means that you train in advance for people moving, retiring or just quitting your organization. As usual, this is just another thing lacking at the Hotel.
Happily, this is not a bad thing. At least, it gives me a topic for my latest grad school paper to write about due this coming week.
Sometimes, we even have staff get entangled in the issues. Here are some that have come up since I arrived at the Hotel.
1. The infamous, "He said, she said". Someone overhears part of a conversation, and reports it. Patient and nurse have two different stories. Reporter decides to write it up and nurse, of course, gets in trouble, because, as in most service industries, "the customer is always right." Patient is mad at nurse for rest of stay, and nurse is in hot water.
2. Patient stays with us for protracted periods of time when they actually need to be somewhere else. Examples: 86 year old patient with metastatic cancer says, "I can be rehabbed." Oncologist says patient has six months max due to the nature of the mets. We lose a rehab spot, because our boss says, "Go ahead and try." Hospice case worker fortunately has his head on straight: "We'll keep a bed for whenever he's ready to cross that bridge."
3. Nurses get involved (financially, sexually, etc.) with patients. It's no help when said nurse is a favorite of your nursing administration. Nurses also abuse the kindness of patients by eating their snacks, etc. I counsel them to report to no avail, because they fear retribution while they're still here.
4. Boss trains two people for a specialty position over the past year. Both people will be gone from Hotel by September, and boss knew this. WTH is the matter with the boss? Does he/she like training people for other companies? Obviously...training wheel starts over again in a few months.
5. Succession planning. What's that you ask? Well, it means that you train in advance for people moving, retiring or just quitting your organization. As usual, this is just another thing lacking at the Hotel.
Happily, this is not a bad thing. At least, it gives me a topic for my latest grad school paper to write about due this coming week.
Friday, June 24, 2011
Not your average day
What a day. All was going well, I was on time getting our patient ready to roll when, as I was carefully prepping a dressing, I inadvertently snipped an access line. Nothing like lopping the end off a central line that was scheduled to come out Tuesday.
Off goes patient for an early appointment to get this removed. No harm, no foul, but no one can bring back the "saved" time that was lost.
All I had to say once it was done...TGIF!
Stay tuned...
Off goes patient for an early appointment to get this removed. No harm, no foul, but no one can bring back the "saved" time that was lost.
All I had to say once it was done...TGIF!
Stay tuned...
Wednesday, June 22, 2011
A wonderful present
“My interest is in the future because I am going to spend the rest of my life there”
Charles F. Kettering quotes (American engineer, inventor of the electric starter, 1876-1958)
Today is my best friend's birthday. We went out to celebrate recently on my day off. We escaped children, dogs and husbands to sit and enjoy ourselves discussing everything and nothing at all. Thank goodness we had a wonderful waitress who didn't mind that we took a two hour lunch chitchatting!
And today, I got a present. Besides having a wonderful friend, I found out I was chosen to work in a different part of the Hotel. It will be a change from my normal routine, but it will be interesting nevertheless. I have never interacted with patients daily in this type of clinic, so it will be exciting.
I'm still on hold as to when I'll move to that area of the Hotel. I can now wait without wondering what was going on in HR.
Stay tuned...
Charles F. Kettering quotes (American engineer, inventor of the electric starter, 1876-1958)
Today is my best friend's birthday. We went out to celebrate recently on my day off. We escaped children, dogs and husbands to sit and enjoy ourselves discussing everything and nothing at all. Thank goodness we had a wonderful waitress who didn't mind that we took a two hour lunch chitchatting!
And today, I got a present. Besides having a wonderful friend, I found out I was chosen to work in a different part of the Hotel. It will be a change from my normal routine, but it will be interesting nevertheless. I have never interacted with patients daily in this type of clinic, so it will be exciting.
I'm still on hold as to when I'll move to that area of the Hotel. I can now wait without wondering what was going on in HR.
Stay tuned...
Monday, June 20, 2011
Word to the wise
Dear Royal Pain Lazy Slug RN:
If you particularly go out of your way to leave me out of a conversation about an important event when I know the answer to your question, I can and will not answer it.
When you ask me why, I also will explain to you (with appropriate people who saw and heard scenario #1) exactly why I did what I did.
And, of course, being a wonderful person (since I happen to like the patient this issue involves more than you) I will give the answer as professionally as possible when no one else finds it.
It's the least I can do.
Hope you enjoyed the results. At least, Mr. X did.
Sincerely (for now anyway),
RehabRN
If you particularly go out of your way to leave me out of a conversation about an important event when I know the answer to your question, I can and will not answer it.
When you ask me why, I also will explain to you (with appropriate people who saw and heard scenario #1) exactly why I did what I did.
And, of course, being a wonderful person (since I happen to like the patient this issue involves more than you) I will give the answer as professionally as possible when no one else finds it.
It's the least I can do.
Hope you enjoyed the results. At least, Mr. X did.
Sincerely (for now anyway),
RehabRN
Sunday, June 19, 2011
Saturday, June 18, 2011
Just for fun
My travelling partner and I went to a local patient symposium the other day to talk about stuff we do in rehab, complete with show and tell.
Had a lot of fun. I just hope the tape recorded version is not so bad. My makeup artist, hair stylist and wardrobe person were not working that day.
I'm glad I wore my *dress* scrubs.
More later...
Had a lot of fun. I just hope the tape recorded version is not so bad. My makeup artist, hair stylist and wardrobe person were not working that day.
I'm glad I wore my *dress* scrubs.
More later...
Friday, June 17, 2011
Dislike
I tell you if Facebook had a DISLIKE button, I'd be putting it on a few things here at the Hotel.
Some of the random chaos I came back to after a weekend off during inspection season:
1. Candy wrappers on the floor in a clean storage closet. Come on people, put them in your pocket until you can get to a trash can. There's a reason why there is no trash can in a clean utility room!
2. Paranoia, part 3. Boss thoroughly combed the unit for any little piece of paper in the wrong place, had us label, mark, time, date and initial everything. Then Ms. Inspector woman comes to a clean utility room and finds something unmarked. Automatic ding.
3. Paranoia, part 4. Somebody let a patient keep his/her paperwork from Dr. X out of their storage closets, they then left it on a wheelchair, and in their haste to put the wheelchair into storage, it stayed on the seat. Ding #2.
4. And finally, the last dislike: coworkers acting like arses just because they can. What goes around comes around...
Stay tuned. The inspection madness isn't over yet.
Some of the random chaos I came back to after a weekend off during inspection season:
1. Candy wrappers on the floor in a clean storage closet. Come on people, put them in your pocket until you can get to a trash can. There's a reason why there is no trash can in a clean utility room!
2. Paranoia, part 3. Boss thoroughly combed the unit for any little piece of paper in the wrong place, had us label, mark, time, date and initial everything. Then Ms. Inspector woman comes to a clean utility room and finds something unmarked. Automatic ding.
3. Paranoia, part 4. Somebody let a patient keep his/her paperwork from Dr. X out of their storage closets, they then left it on a wheelchair, and in their haste to put the wheelchair into storage, it stayed on the seat. Ding #2.
4. And finally, the last dislike: coworkers acting like arses just because they can. What goes around comes around...
Stay tuned. The inspection madness isn't over yet.
Wednesday, June 15, 2011
Nuggets for June 15
Happy June 15! Since I haven't done a Nuggets section in ages, I thought, why not? I've been reading some really interesting medical stuff for my grad class, and lo and behold, some of my favorite MD bloggers have interesting posts that should be seen.
So here goes, folks. Please enjoy the scenery. There is some very vivid mental imagery here if you really think about these items...just sayin'
Enjoy!
So you have been living in this century for how long now?
ER Doc from Serenity Now Hospital has a great post about a really out there patient who is still figuring out how to use the telephone.
The epitome of tact or Why you should turn off the cellphone in the ICU
Grumpy, one great neurologist (and no, I don't work for him...he's nicer than our boss) has a public service announcement you'd think was obvious.
Never assume...
Last but not least
KevinMD has a couple of posts you shouldn't miss.
Medicine or family first discusses a series of articles running in the NY Times debating if part-time physicians should exist.
And now, since it's bikini season, he discusses a hairy (literally) topic which can have some significant complications.
Stay tuned....more to come.
So here goes, folks. Please enjoy the scenery. There is some very vivid mental imagery here if you really think about these items...just sayin'
Enjoy!
So you have been living in this century for how long now?
ER Doc from Serenity Now Hospital has a great post about a really out there patient who is still figuring out how to use the telephone.
The epitome of tact or Why you should turn off the cellphone in the ICU
Grumpy, one great neurologist (and no, I don't work for him...he's nicer than our boss) has a public service announcement you'd think was obvious.
Never assume...
Last but not least
KevinMD has a couple of posts you shouldn't miss.
Medicine or family first discusses a series of articles running in the NY Times debating if part-time physicians should exist.
And now, since it's bikini season, he discusses a hairy (literally) topic which can have some significant complications.
Stay tuned....more to come.
Heard on the unit
Call it the Chronic absurdity version of Heard on the unit. Guess which one(s) is(are) true?
1. So and So just lets his/her blood pressure get high to get attention.
2. I think X is paranoid and has a list of people to investigate if anything happens to him.
3. Did I get "any"? How could I get "any" in here?
4. Where is Mr. Z? I haven't seen him in a long time, so is he sick?
Answers: all true.
So is the Hotel Rehab really a crazy place? Well, some folks (like me) say rehab is a little psych and a little med-surg, so who'd be surprised with what patients (and some staff) say.
The first one shocked me because this is what one staff member said about another. I think she needs a vacation very badly and/or we have a whole lot of Munchausen Syndrome going on at the Hotel. There are some people who even suspect one of our insulin dependent diabetic staffers is overdosing on insulin for attention.
Hello, neuropsych! Can you help US? We need a real EAP folks. I'm going to go to HR and find out if they have one yet. Or I'm getting a poster of a beach in the tropics so people can chill out while eating lunch.
Surprisingly, the same person who noted this diabetic fact also noticed that since "X has become paranoid, there have been no hypoglycemic incidents." Hmm...
Number three was my fault. Never assume that patients understand pronouns or articles refer back to something you've already discussed when their minds are obviously somewhere completely different. The reply noted was when I had asked Mr. X, who keeps refusing to let the lab draw his blood (or let us draw his labs). I had asked if he had had any blood draws recently, and repeated, since he's quite deaf, "So have you had any...blood draws?" Of course, Mr. X missed the last part. Oops!
Mr. X was also startled to discover that RNs have magical "selective hearing" when necessary. Mr. X. had been dropping double entendres left and right and wondered why I was not playing along. I had to put on the RehabRN Old School Nursing Cap (which I had to borrow from F, my mentor) and lay it out, chapter and verse, according to Hotel policy, which meant, no, I cannot and will not discuss certain things at work with you. End of story. If you want Viagra, you have to talk to the psychologists, who then refer you to the appropriate medical team member for evaluation.
And finally, yes, Mr. Z. hasn't been around recently. He had a psychotic episode while apparently high/drunk/stoned on something on our unit. Security has been advised by the hospital legal staff that he cannot come back until he proves he has completed his substance abuse treatment program and meets other conditions.
Yet another thing I gloss over with a blank, "You know, I don't really know."
Stay tuned. You never know what I'll hear next.
1. So and So just lets his/her blood pressure get high to get attention.
2. I think X is paranoid and has a list of people to investigate if anything happens to him.
3. Did I get "any"? How could I get "any" in here?
4. Where is Mr. Z? I haven't seen him in a long time, so is he sick?
Answers: all true.
So is the Hotel Rehab really a crazy place? Well, some folks (like me) say rehab is a little psych and a little med-surg, so who'd be surprised with what patients (and some staff) say.
The first one shocked me because this is what one staff member said about another. I think she needs a vacation very badly and/or we have a whole lot of Munchausen Syndrome going on at the Hotel. There are some people who even suspect one of our insulin dependent diabetic staffers is overdosing on insulin for attention.
Hello, neuropsych! Can you help US? We need a real EAP folks. I'm going to go to HR and find out if they have one yet. Or I'm getting a poster of a beach in the tropics so people can chill out while eating lunch.
Surprisingly, the same person who noted this diabetic fact also noticed that since "X has become paranoid, there have been no hypoglycemic incidents." Hmm...
Number three was my fault. Never assume that patients understand pronouns or articles refer back to something you've already discussed when their minds are obviously somewhere completely different. The reply noted was when I had asked Mr. X, who keeps refusing to let the lab draw his blood (or let us draw his labs). I had asked if he had had any blood draws recently, and repeated, since he's quite deaf, "So have you had any...blood draws?" Of course, Mr. X missed the last part. Oops!
Mr. X was also startled to discover that RNs have magical "selective hearing" when necessary. Mr. X. had been dropping double entendres left and right and wondered why I was not playing along. I had to put on the RehabRN Old School Nursing Cap (which I had to borrow from F, my mentor) and lay it out, chapter and verse, according to Hotel policy, which meant, no, I cannot and will not discuss certain things at work with you. End of story. If you want Viagra, you have to talk to the psychologists, who then refer you to the appropriate medical team member for evaluation.
And finally, yes, Mr. Z. hasn't been around recently. He had a psychotic episode while apparently high/drunk/stoned on something on our unit. Security has been advised by the hospital legal staff that he cannot come back until he proves he has completed his substance abuse treatment program and meets other conditions.
Yet another thing I gloss over with a blank, "You know, I don't really know."
Stay tuned. You never know what I'll hear next.
Tuesday, June 14, 2011
Monday, June 13, 2011
Irony in the news
This story from South Texas just made me bristle...and want to cheer.
A fitting end to an unfit perpetrator.
A fitting end to an unfit perpetrator.
Who knows what...
Tomorrow will bring. We escaped the surveillance of the inspectors for a day. I admitted one very nice patient who drove on over and stated, "You said you'll be done Thursday. I have things to do this weekend, so I'll be out of here then."
We don't get that many who actually show up, then leave as promised.
It's very refreshing. Now if I could go on vacation and do the same. Only 42 days until then. It seems like forever.
Stay tuned for more inspection excitement...
We don't get that many who actually show up, then leave as promised.
It's very refreshing. Now if I could go on vacation and do the same. Only 42 days until then. It seems like forever.
Stay tuned for more inspection excitement...
Sunday, June 12, 2011
OMG inspection season
Yes, we all have to be fluffed, buffed and on our best behavior all week this week . The charge nurse cried, "OMG the OIG are back again."
It seems like they've come every year since I started here at the Hotel. And tomorrow is Monday, and said charge nurse is out-of-town with daughter who's getting surgery tomorrow.
I'm just praying I don't get stuck with the inspector like the last time.
Stay tuned.
It seems like they've come every year since I started here at the Hotel. And tomorrow is Monday, and said charge nurse is out-of-town with daughter who's getting surgery tomorrow.
I'm just praying I don't get stuck with the inspector like the last time.
Stay tuned.
Saturday, June 11, 2011
When it rains...
It pours, the lights flicker, the wind shakes the windows and WildDog starts opening doors to tell us he's not staying in a room by himself.
No, siree, I'm a guard dog and I'm "guarding" you whether you like it or not.
At least he does not destroy things or jump in bed. He just sits on my side of the bed and whines...and I wake up to pat him on the head to quiet him.
I love summer thunderstorms. At least, it wasn't a tornado!
No, siree, I'm a guard dog and I'm "guarding" you whether you like it or not.
At least he does not destroy things or jump in bed. He just sits on my side of the bed and whines...and I wake up to pat him on the head to quiet him.
I love summer thunderstorms. At least, it wasn't a tornado!
Friday, June 10, 2011
A fond sendoff for the week
Dear CNA:
What part of delegation do you not understand?
You have report and I am going home. While I am down the hall walking out the door is not the appropriate time to complain that I did not clean someone up when I found out about the person's status thirty seconds before I started walking out the door.
I choose delegation of an appropriate task to you today, as I have reported off to your shift and to the charge nurse and I really wanted to get to my car to get to Bubba's baseball game. I know you can't believe that I actually wanted to leave on time, since it so rarely happens, but it was true.
And no, I will not hold this against you, unless you decide to ruminate all week over this "injustice" of making you work immediately out of report, which is great for me, but not for you.
Sincerely not,
RehabRN
What part of delegation do you not understand?
You have report and I am going home. While I am down the hall walking out the door is not the appropriate time to complain that I did not clean someone up when I found out about the person's status thirty seconds before I started walking out the door.
I choose delegation of an appropriate task to you today, as I have reported off to your shift and to the charge nurse and I really wanted to get to my car to get to Bubba's baseball game. I know you can't believe that I actually wanted to leave on time, since it so rarely happens, but it was true.
And no, I will not hold this against you, unless you decide to ruminate all week over this "injustice" of making you work immediately out of report, which is great for me, but not for you.
Sincerely not,
RehabRN
Thursday, June 9, 2011
I'm sorry
Due to the nature of rehab nursing I occasionally have to do things I really don't like. For those things, I am sorry.
I really didn't want you to be in pain when I put in that catheter, but the fact that we had orders to catheterize you every four hours made me lobby with the physician that perhaps a Foley is not inhumane when you have a horrific case of prostatitis and an equally neurogenic bladder. No one needs that trauma every four frickin' hours when you're pushing 80 years old and are otherwise in good shape.
And yes, Dr. So and So, if you get your derriere chewed because you gave me an order for a lidocaine urojet so I could at least alleviate a little of the pain when putting in the catheter, please call me, and I'll offer to cath the non-impaired culprit WITHOUT it.
I'm not the greatest IV stick in the world. Thanks for understanding when I had to poke you twice to get you that IV for your infection, since we had no oral meds that would work equally well. I'm a "three strikes you're out" kind of girl, so if I don't get you in three, you're getting a nurse who's better at it than me.
Finally, folks, don't make fun of me giving patients suppositories and relieving impactions that come from having to take lots of narcotics to at least knock the edge of your pain for you to function in rehab. I'll order lidocaine for this too, if you need it, because I'm sure it hurts.
And I'd want someone to do the same for me.
I really didn't want you to be in pain when I put in that catheter, but the fact that we had orders to catheterize you every four hours made me lobby with the physician that perhaps a Foley is not inhumane when you have a horrific case of prostatitis and an equally neurogenic bladder. No one needs that trauma every four frickin' hours when you're pushing 80 years old and are otherwise in good shape.
And yes, Dr. So and So, if you get your derriere chewed because you gave me an order for a lidocaine urojet so I could at least alleviate a little of the pain when putting in the catheter, please call me, and I'll offer to cath the non-impaired culprit WITHOUT it.
I'm not the greatest IV stick in the world. Thanks for understanding when I had to poke you twice to get you that IV for your infection, since we had no oral meds that would work equally well. I'm a "three strikes you're out" kind of girl, so if I don't get you in three, you're getting a nurse who's better at it than me.
Finally, folks, don't make fun of me giving patients suppositories and relieving impactions that come from having to take lots of narcotics to at least knock the edge of your pain for you to function in rehab. I'll order lidocaine for this too, if you need it, because I'm sure it hurts.
And I'd want someone to do the same for me.
Wednesday, June 8, 2011
A song here
Another there. When the singing and dancing groups aren't visiting the Hotel Rehab, the cicadas are. They are all over the trees, and occasionally on a patient who decides to sit in the shade on the bench in the back.
I even had one land on me as I was coming out of the local library with Bubba. Thankfully, Dahey was with us to remove it. The cicada he said looked like an artsy pin on my lapel.
I'm just so glad it didn't fall off in the crowded library. That would have been interesting.
More later...back to reading for my grad class.
I even had one land on me as I was coming out of the local library with Bubba. Thankfully, Dahey was with us to remove it. The cicada he said looked like an artsy pin on my lapel.
I'm just so glad it didn't fall off in the crowded library. That would have been interesting.
More later...back to reading for my grad class.
Monday, June 6, 2011
No less momentous
On this very day in 1944, the largest assault of the Second World War occurred just off the coast of France.
It's summertime
As the song and an old friend used to say, and the livin' is easy. We'll see how many people call in sick on such a beautiful Monday.
Back to our regularly scheduled Monday...stay tuned!
Back to our regularly scheduled Monday...stay tuned!
Sunday, June 5, 2011
Thud!
Dear Bubba,
When you get a new baseball bat, swing a little too hard and klunk Dad (Dahey) in the head, you know it's time for a little education.
Please dear, do not inflict a TBI on your dad. Mom has enough TBI patients at work to take care of and I'd like to not have one at home.
Love and Kisses,
Mama (aka your personal RehabRN)
When you get a new baseball bat, swing a little too hard and klunk Dad (Dahey) in the head, you know it's time for a little education.
Please dear, do not inflict a TBI on your dad. Mom has enough TBI patients at work to take care of and I'd like to not have one at home.
Love and Kisses,
Mama (aka your personal RehabRN)
Saturday, June 4, 2011
The power of suggestion
It's been interesting lately at the Hotel. As usual, as the temperatures go up outside, the tempers flare on the inside. Lately, things have been wilder than ever.
We have a full house again, with lots of work and lots of scheduled vacations, we are back to some folks working overtime. People are crabby, whiny, and generally out of sorts. A few people are even angry, patients and staff included.
Several patients are angry at the doctors for keeping them at the Hotel when they could be home enjoying summer. This, in turn, makes them lash out at the nursing staff. A few of the people I have taken care of have gotten so incensed that they have mounted a campaign to get one staff member in trouble.
How? They composed a suggestion and put it in the suggestion box on the unit which is monitored by the Manglement for the sake of maintaining the ever-onerous "high satisfaction" ratings. Since the named staff member was already in hot water, said person got called to a meeting with the head honchos to determine his fate.
And when that drama is over, someone also "suggested" that staff is sleeping on the night shift. No one knows who did it, but it's caused lots of anger amongst the ranks of the night shift and among the supervisors, too.
So I'm thinking of making a few suggestions myself out of the box:
1. Get a framed copy of the patient agreement put up on our unit. You'd be surprised how many times we try to enforce the rules and patients say, "I knew nothing about that." even though they get a copy and are advised in advance.
2. Maybe we all need to start spouting chapter and verse, so patients really get it when they have a complaint with staff. My line, "You need to notify the charge nurse, then the nurse manager. If that is not resolved appropriately, patient relations number is extension XXXX, because it is your right (as noted in #1) to get your needs addressed."
3. Do not whisper: speak and communicate. Tell other nurses if their patients have problems before reporting it to the boss as appropriate.
We have a full house again, with lots of work and lots of scheduled vacations, we are back to some folks working overtime. People are crabby, whiny, and generally out of sorts. A few people are even angry, patients and staff included.
Several patients are angry at the doctors for keeping them at the Hotel when they could be home enjoying summer. This, in turn, makes them lash out at the nursing staff. A few of the people I have taken care of have gotten so incensed that they have mounted a campaign to get one staff member in trouble.
How? They composed a suggestion and put it in the suggestion box on the unit which is monitored by the Manglement for the sake of maintaining the ever-onerous "high satisfaction" ratings. Since the named staff member was already in hot water, said person got called to a meeting with the head honchos to determine his fate.
And when that drama is over, someone also "suggested" that staff is sleeping on the night shift. No one knows who did it, but it's caused lots of anger amongst the ranks of the night shift and among the supervisors, too.
So I'm thinking of making a few suggestions myself out of the box:
1. Get a framed copy of the patient agreement put up on our unit. You'd be surprised how many times we try to enforce the rules and patients say, "I knew nothing about that." even though they get a copy and are advised in advance.
2. Maybe we all need to start spouting chapter and verse, so patients really get it when they have a complaint with staff. My line, "You need to notify the charge nurse, then the nurse manager. If that is not resolved appropriately, patient relations number is extension XXXX, because it is your right (as noted in #1) to get your needs addressed."
3. Do not whisper: speak and communicate. Tell other nurses if their patients have problems before reporting it to the boss as appropriate.
Friday, June 3, 2011
51 days...
Repeating it to myself...in 51 days, I will not be in the hot Hotel, in 51 days, in 51 days, in 51 days.
Counting down to vacation...yes!
Counting down to vacation...yes!
A very interesting perspective
In light of recent issues at the Hotel, (see previous post) I really enjoyed this Facebook discussion topic on the Oncology Nursing Society's page, especially this comment about patients and friendships:
Some people just don't get it
Case in point:
Dear HippieRN:
Being friends (or thinking you are friends) with patients is really not a good idea. Working here is really work, and since the Establishment says friendships are not a good idea, it means that it really isn't a good idea. You can think whatever you want to yourself, but verbalizing those thoughts with patients (and their significant others) is not a good thing. Yes, that's the reason why the boss changed your assignment recently and had a little chat with you.
What you did was not really therapeutic communication, so please don't do it again. Your count, as they say in baseball, is 3-2 right now, and you're not a home run hitter type.
Doing your work and not texting or chatting in person (or online) with patients really IS a good thing.
Here's hoping you get a clue, otherwise, your dope slap (and a pink slip) is waiting.
Sincerely,
RehabRN
Dear HippieRN:
Being friends (or thinking you are friends) with patients is really not a good idea. Working here is really work, and since the Establishment says friendships are not a good idea, it means that it really isn't a good idea. You can think whatever you want to yourself, but verbalizing those thoughts with patients (and their significant others) is not a good thing. Yes, that's the reason why the boss changed your assignment recently and had a little chat with you.
What you did was not really therapeutic communication, so please don't do it again. Your count, as they say in baseball, is 3-2 right now, and you're not a home run hitter type.
Doing your work and not texting or chatting in person (or online) with patients really IS a good thing.
Here's hoping you get a clue, otherwise, your dope slap (and a pink slip) is waiting.
Sincerely,
RehabRN
Wednesday, June 1, 2011
When they say evacuate...
They mean evacuate. I wish I could hang a few of these photos from St. John's in Joplin, MO up on the unit so my patients could see them. Maybe then, the next time we ask them to move for a storm warning, they'll do it.
I just don't think people get it.
That is all.
I just don't think people get it.
That is all.
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