Nuggets : Leap year edition

You may not have seen too many of these lately, but just like February 29 coming around every four years, the nuggets have taken a leap and come back.

Here are a few items I've encountered this week out on the internet. I've been reading, but just not the kind of stuff most folks who visit would like to read. (Such is the life of a grad student!)

Sleep? Who does that?
This BBC article discusses the myth of eight hours of sleep. Interesting history.

On the subject of sleep, one WebMD article talks about the safety of sleeping pills.

Dental care
It's really hard for patients without (or with, even) insurance to get dental care due to costs. Some people are going to the ER to get dental care that prevention might have avoided.

Food safety
If it's not one crisis, it's another. Who would have thought you needed to worry about fungicide in your fresh squeezed juice?

And if you think you need to remove any of that OJ from your system, some people are trying detox diets (from WebMD). While there's little science involved, one thing is true: if you eat more fruits and vegetables, (not covered in fungicide, etc.) you just may do better than you think.

Stay tuned...we'll be back.

Happy Pancake Day

Woo hoo! One of Bubba's favorite holidays.

We had a grand old time eating pancakes for dinner.

Stay tuned...leap day tomorrow!

My nightmare

Shooting outside rehab hospital (from Washington Post)

It is my nightmare because some of my coworkers remember when the same thing happened on one off-hours shift at the Hotel. It happened on one of our sister units and our folks were dispatched to respond.

Even though no patients were involved in our incident, the mere thought of it brings shivers down my  spine. I am happy as a clam when security comes by for their regularly scheduled panic button check.

Because I hope and pray that it never, ever happens again.

Thank you Kim

For keeping the story of Amanda on the front page.I am absolutely thrilled that the AzNA bothered to comment about this issue.

Keep it up. We're all waiting to see where it goes.

It just makes me wonder what will happen if and when the rights of nurses are fully recognized and acknowledged. So many possibilities...and maybe that panacea of practicing to the "fullest extent of our licenses" will actually be true and respected among ALL our colleagues.

Stay tuned.

Another one's coming...

Another week that is. And a busy one at that, so I'm getting ready.

Enjoy your day wherever you spend it!

Here's to the chief

Or at least to the general...In the Off the charts blog (AJN) Shawn Kennedy, AJN editor recently noted about the new Army Surgeon General, who is not only the first woman, but the first nurse:

General Horoho said in an interview, (following) “the Vietnam era, we lost sight of the importance of rehabilitative nursing and health care,” and noting that this would be a significant area of emphasis for her.

Moral of the story: Never underestimate the power of a rehab nurse.

And from Dahey, a profound bravo zulu!

More to come...

Demotivating employees

Ah, spring is in the air (for the moment) here in RehabLand, and the hospital administrators (aka PHBs) have emerged from their coccoons, er lounge chairs, to start rabble rousing the troops and demotivating away.

How can they do that you say? Well, here are some stories (I wish they weren't true) on how they do this.

NOTE: the names of all parties and sexes, etc., have been centrifuged to protect the guilty and the innocent, since I don't want the HIPAA police to come carry me away.

1. Medical personnel are allowed $xxxx per year for continuing education. (Not nurses, though). But, good luck, Ms. Overworked MD trying to use yours. You're not properly certified yet, so your slug compatriot MD gets your share. Call HR and file a complaint.

2. Allied health person gets invited to a national conference to speak. Your boss, who's been at the place forever, fills out all your appropriate paperwork. In the meantime, you sign up to present and pay your conference fee, hotel and airfare.

You get an e-mail that you've been disapproved, but when your boss tries to appeal to the higher-ups, he doesn't get the dignity of a response. Nice. So much for having seniority. You can't even take off unless someone with more seniority lets you have the time. Go file an EEOC complaint.

And my personal favorite...

3.  Become an advance practice nurse, get certified, speak at a national conference, and then submit your request for one lousy conference (subsidized by a private foundation) because you need more education to take care of new patients we have on the unit. All you want to get are your days off as official absence.

Get rejected because the "man with the plan" says we "can't afford to give you days off to learn" at the premier (and also free, since you got it paid for) conference in the world.

Reminds me of this Dilbert scenario...stay tuned for more to come!

PHB: You may have heard that our company has been accused of unethical business practices.
Alice: Is it the falsified product safety reports?
Wally: Is it the false stories planted in the media about our competitors?
Dilbert: Is it the crime family connections?
PHB: What?! Are you saying those are considered unethical too?!? Good God, this thing is just snowballing!

A thought

Maria: When the Lord closes a door, somewhere He opens a window. --The Sound of Music, 1965

Dear Chief of Staff:

You are not the Lord of anything but that imperial desk of yours.

Please stop closing my doors of opportunity and making me go through the windows to get my patients the care they truly need and deserve.

Cancelling everything (after some other committee approves it) my boss does will not win you too many friends.

Sincerely not,

RehabRN

Love the stranger

Always give a word or sign of salute when meeting or passing a friend, or even a stranger, if in a lonely place. ~ Tecumseh 

If I were not a rehab nurse, I'd want to be a transplant nurse. I've enjoyed working with transplant patients and learning about how to care for them, particularly while they stayed at Saintarama or at the Hotel.

Lately, I've enjoyed reading the articles in the news about transplant chains. This BBC article describes how one chain brought together 30 patients and 30 kidney donors. Another NY Times article discusses how the system isn't perfect. I even found one on a complication: CMV infection, which I could have used when I took care of a patient who got CMV post-transplant.

Always lots to learn...more to come.

Phone calls you don't want to get

"Hi. We're calling to tell you that your xxx credit card number has been compromised. We're sending you a new card."

Nice...

What a time it was...

A human life is a story told by God. ~ Hans Christian Andersen

Dahey's Aunt Gracie's story ended yesterday. She was 90 years old.

Aunt Gracie was a sweet lady who welcomed me to the family a dozen years ago when I first met her at her son's house. It was like she knew me my whole life. She and Uncle Ralph were very sweet when we visited them down the street from where my cousins lived. We did not know that they lived about half a mile away from them.

Uncle Ralph died almost four years ago, and she started going downhill. After a while, Aunt Gracie couldn't live alone, and she got too bad for family to take care of her. She spent the last years of her life slowly slipping away.

While it was sad, she was comfortable and with family at the end. Since one child is a physician, and her daughter-in-laws are very good nurses, we knew she was well cared for. We may be sad, but we rejoice in the life that was hers, and was shared with us all: children, grandchildren, great-grandchildren, nieces, nephews, and even in-laws like me.

My pharmacy friends

Part 1: SmartRx's story

I talk to one of my pharmacist friends at least weekly. She lives far, far, away from the area we grew up in near RehabLand. We talk about kids, husbands and the public school systems. There's always something going on.

SmartRx went to school in the cornfields and developed a sense of adventure out on the prairie at a PrivateU syndicate school. She met her husband there, and after working a year in the midwest, she decided it was time to follow her man. Just like the Beverly Hillbillies, she loaded up the truck (and the car) and headed west to Californie. She stopped plenty of places along the way with one of our high school classmates who hitched a ride, including the Grand Canyon (a la Thelma and Louise).

After making her homestead, marrying the man she followed, she built a successful practice with a big pharmacy chain. She's known as a miracle worker, so she's often sent to places that really need a lot of TLC (code name s&%t hole). Her most recent store is no exception.

What could you say that might make a two decades long career in community pharmacy exciting? How about this for a week:

1. Your store makes the local top 10 list of places you never want to shop at. SmartRx told me what to look up in Google and lo and behold, there it was.
2. Customer (in a muumuu) comes to your counter and while walking out, in the middle of the waiting area, leaves a surprise (and it ain't a nice one).
3. Crazed customer takes a swing at you because you blatantly agree that you won't see your doctor for an appointment and he refuses to renew your script.

This last one was exciting. "Whoa!" I said. "What did you refuse? Narcs? Benzos? Amphetamines?"

"No. Metformin", she replied.

"WT...?"

"Yep, the diabetic drug."

Word to the wise, community pharmacists, they must be putting something funny in that Metformin.
Or as SmartRx says, the crazies just like her.

Someday SR, I'm really gonna help you write that book. There are too many stories not to share about life behind the counter.

More to come...stay tuned.

The perils of non-ergonomic chairs

Why oh why did our office manager volunteer me for the random inspection job at the Hotel? Yes, it's required by Joint Commission, but couldn't someone else do it?

Of course not. Send RehabRN. She'll go. Those chairs they made me sit in...ouch!

Nothing like a little sciatic flareup for the team...ugh.

Another view of today's holiday

“There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are messengers of overwhelming grief...and unspeakable love.” Washington Irving

I thought of this quote when I talked to a lady who had left the hospital to ride on the shuttle van with me. She had left the hospital to return today to collect some things her husband had in his room when he died.

She told me she wished she didn't have to go back, but she wanted to have the items left behind, not for any value, but to have something tangible. The sudden death of her husband was not unexpected. After so many years of fighting (and winning) after disease and blood clot and everything, she thought this was just another hurdle he'd jump over.

But the race ended, and her trip alone back home to her family faraway begins today.

I just cannot imagine starting a Valentine's Day like that....

So glad...

My PCP likes me.

He/she managed to convince Dahey he needed a DRE and a colonoscopy, since he didn't decide to have his physical on his birthday, like I asked.

Now I just have to get him/her to get him a pain management consult to see why his goofy back and legs are having random pains again.My guess after working with Dr. S. in the SU is that Dahey may have this problem.

Crossing fingers. By the time this year is done, Dahey will be as good as new (at least he'll seem like it anyway).

Stay tuned...

Somedays, I wonder...

Dear Clerk:

Yes, indeed, it is 15 minutes before your day should end and I'm not too impressed that you decided to leave early. There was only a slight dusting (literally, not even an inch) of snow on the ground.

And yes, your cohort really thought I was causing trouble when I asked her to do your job, even when she's supposed to fill in for you when you leave. You are two peas in a pod: Dumb and Dumber, Lazy and Lazier, etc.

I particularly loved it when Clerk #2 called her Clerical lead, then the lead told me I didn't know what I was doing and I'd have to go ask the department IT liaison to fix the schedule. Yes, the clerical lead is the person who does all the scheduling, including inputting the main clinic data into the system.

Nevertheless, after 10 minutes, I got the two step job done by calling the IT liaison at home, because the administration does not allow nursing to input appointments, as this is called "working below our license" (aka doing your job).

Thank goodness the liaison knows how to do a job, doesn't give excuses and really knows that the important thing is that we make sure the patient has an appointment so he can see the doctor and we all get paid.

Too bad the rest of you don't think the same way, instead of just passing the buck.

Sincerely not,

RehabRN

Resting...

Hopefully, in peace, without the terror of drugs to haunt you.

RIP Whitney Houston.

Some of us will never forget you because of this song.

Cold and snowy

Yes, as Phil predicted, winter is back in RehabLand. It's cold and snowy and I've been snuggled in reading and playing on the computer.

Sometimes, I like the news I read, but this article about shortages of vital drugs just makes my blood boil.

Back to reading...and hopefully relaxing. I'm not going anywhere right now!

Stay tuned...

Friends don't let friends...

Sleep in and miss an opportunity to pick a group for their grad class. We weren't doing this, but at 0330 you'd have sworn we were!

Thanks P for the quickie update on groups, and yes, K., thanks for waking up in a good humor when I called so we could all register for the same group.

No worries about class crazies this semester! Hooray!

I remember

We lost a local hero recently. He was from my old neighborhood, and my family knew his family.

He was a Navy man in Korea. "Cold, cold." was all he would say about it. But beneath the wavy dark locks turned white was a smile that lit up the room. He was a hero on the seas of war, and on the sports fields.

Eventually, this government employee turned sports coach led NCAA championship teams, not once, not twice, but for years. He became a legend at my alma mater, PrivateU. Legions of kids in town went to his sports camps to learn from the youngest man who played on a legendary team that brought down an international power house in one of the biggest upsets ever.

But to me, he was a neighbor, a friend, a man who told a good story about what our town was like in the old days, when ethnic groups stayed close together for support. How the community went wherever they needed to help each other. Because Mom said, "I want you to always be a good person."

After I heard the news, I went online and I watched the interview I recorded for the local historical society and smiled.

His stories live on in a web site dedicated to the area, for a man who was a hero, father, family man, neighbor, coach, and friend.

Godspeed Tom....and may you get all the goals in Heaven, before the clock runs out.

How to have fun at work

I am so happy now most of our inspections are over for a while. Whew!

Now, I'm back to having fun doing other random stuff. Here's a few of the fun things I've gotten to do.

1. Keep the patient who wants to get me a plant for my office from getting in trouble with security. He keeps telling security he'll just borrow (er, steal) one or two from the lobby.

No thanks, I'm allergic to tropicals, especially ones that don't belong to me.

2. BLS class. Wow, things really have changed in the last couple of years.

3. Regular rehab groups. These support groups are arranged by our psychology staff and mediated by the presenters, which could be a physician one day, physical therapist another day or recently, yours truly.

I had the interesting class: I talked about education materials (like these) available at the Hotel's web portal. I even had handouts. To make it easier for patients to find information, the occupational therapists loaned me some laptops for patients to use.

I didn't have snacks, but it was a lot of fun.

Who knows what tomorrow will bring. Dr. X. is back in the house and she had me researching some equipment for the home health nurse to use. If we could get it, it would be very, very cool.

I won't hold my breath, but stay tuned...

Amen!

Finally, the ANA has a decent post about the Amanda Trujillo situation in Arizona. There's a great thread on Facebook in the American Nurses Association area for more information.

If we don't support our own (i.e. other nurses), who will?

Stay tuned!

Sometimes, I wonder

We're up for a big inspection soon and the Big Boss has an all-hands meeting.

He/she basically says, "Well, it probably won't be good." and doesn't tell us much anything else. WT...?

Thankfully, we have enough people who've been around long enough that they asked good questions and got more information out him/her. It was not very promising.

Yes, he/she hasn't been at the Hotel forever, but you'd think he/she might learn a few tips on how to be not only a good, but better leader.

I'm just gonna cross my fingers and pray...stay tuned.

Ah, Sunday!

The window on my week. The beginning, even if I'm not yet at work. If Sunday goes well, there is hope for the rest of the week.

And for a little light relief, I head on over to Sunday Stealing, to see what Sunday excitement they have.

Now, back to the music..and even one on Sunday.See you next week!

Homework

In the house, in the office, in the laundry room.You name it, I've got all sorts of homework: the housework kind as well as the school kind.

Assignment #1 due next week. I think the weekend will be busy...

More to come...if I survive the onslaught.

Heard on the unit

"Here's something for your office." Mr. G.

One of our patients made a ceramic planter in an art therapy class (part of our OT department) and put a small houseplant in it. He gave it to me because I told him my artwork in the office (made by another patient and Bubba) had flowers and plants in them.

It made my day.

A shout out to the docs

Yes, some physicians seem to think lately the nurses are out to get them. That we don't appreciate them. That we're conspiring.

Why? Because we talk amongst ourselves in online forums, blogs, etc., when we see injustice perpetrated in our hospital, in our state, in our nation. Injustice meted out by insurance companies, circumstance and by our fellow human beings.

And yes, some people think if we disagree with one thing, we're automatically against all physicians. So, I'm forced to use those debate team skills and favorite marketing tricks to demonstrate that I'm not.

Some days I am in awe of the physicians with whom I work. The physiatrists who know just how to stop spasms that wrack people with pain. The internists who craft treatment plans for some of our awful medical messes patients find themselves in. The surgeon, who even though he can be surly, stops everything in the hallway and says, "Do you need me? I'll be right there." when they page him from the floor.

Luckily for me, in my little world at the Hotel, respect is a two-way street. I make sure Dr. X gets coffee when she shows up because she takes care of my surliest patient first, and by the time he's done, he's singing. It makes life much better for me. When that spasm-reducing physiatrist Dr. Y sees me in the hall, she stops me to ask me what I think and she thanks me when I help her. Dr. Z, who works with us remotely, stays on task and does whatever she can for our patients to make them comfortable, and she teaches me something every day, by her actions, her demeanor, and her enthusiasm.

As the saying goes, there is no I in team. It's a good lesson to remember.

Stay tuned...

The ultimate irony

Dr. Richard Olney was an ALS researcher.

The irony: Dr. Olney died of the disease he fought to eradicate. RIP Dr.Olney. May your clinic (and your dreams) live on.

More stories

"A balanced life is the centered intersection of your values, time, and action. That's where integrity resides." Don Blohowiak

I decided as one of my New Year's resolutions, I'd do more volunteer work this year. My first gig: I was a judge for a writing contest at Madison.

I love to write, hence the reason why I volunteered to judge the writing contest. Patients submit poetry and short stories for our local Creative Arts Festival. There's a performing arts section, too, that's really good. The winners get to have their work/performances submitted to the National Creative Arts Festival.

I dawdled with the task at hand, but I finally sat down recently and read my entire book of submissions. Some were good, some were okay and only one or two was really not my cup of tea. Although, some of my counterparts said I rate too easy, I don't think I do. I like stories, poetry and other work that take me away.

Two pieces transported me to places I could see in my mind. One poem talked about the author going back and dancing with a woman, from the perspective of a guy in a wheelchair. I could almost hear the music, see the low lights and smell the perfume in the air. I also wondered which of my patients might have written this poem.

The other was a story, of love, disappointment, joy and unbridled happiness, woven into a story of birth. The center of the story was a curtain, sometimes open and sometimes pulled to protect her. In the  end, the author knew she wasn't alone, if she dared open the curtain up. It had a picture in the ending that was happy and bright, without being saccharine.

Hope you enjoy your next volunteer experience as much as I did!

Goodies in my world

Modern technology is a very good thing. The more we work with patients with disabilities, the more I am inspired. Ordinary things can do wonders. Extraordinary things blow our minds.

I heard one of our therapists talking about interacting on Facebook. We're finding more and more of our patients are doing that. So why not engage them on Facebook and let them know about our programs? Just another fun part of my job. At least I'm learning about what can and cannot be marketed on social media.

When I'm not getting people to use Facebook, I can evaluate more and better ways to interact with our specialists at Washington. As a rehab nurse, I am thrilled to be working with patients and using these tools to make their experiences better. I can do education in person, phone and via messaging devices.

Working together with a number of disciplines is not only making the experience better for me and the patients, it also makes it better for our providers and the rest of the healthcare team.

And yes, that is a very good thing!