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We don't want to lose you!

Note: I am feeling much better now that Nurse Dahey barricaded me in the house until this afternoon when he told me I would not be cooking and would have to go out to eat with him and Bubba.

Not a bad deal. I just wish I wouldn't have eaten so much and strayed from the diet (with a very delicious hot fudge sundae).

More to come...

So very true

Yes, as the saying goes, it ain't braggin' if it's true. GuitarGirlRN had this interesting case waltz in the door and despite the hue, he wasn't oxygen deprived.

Go ahead and enjoy the story. And score one for the observant RN.

Enjoy!

1500...wow!

Has it really been 1500 posts later in my nursing blog career? Well, that's what the number says as I'm getting this ready. Wow!

I almost have a feeling of a school commencement, where I'm supposed to say something meaningful and lasting to mark the occasion. Hmm...maybe I'll have to think of something profound for later? Or, I can just say, "Have a look at the body of work out there, and see what you think." (doesn't that sound positively literary?) (giggles)

For me, this blog has been a journal, diary, soapbox, and a creative outlet that has often been a lifesaver when work, grad school or the craziness of life has made things seem impossible.

I have learned in my short career as a nurse, that nothing really is impossible. It might be annoying, smelly, obnoxious, or darned scary, but never impossible in the long run.

As the maxim says, "The race is not always to the swift, but to those who keep on running."And so I go.

Thanks for coming along. I enjoy the company.

More later...

So glad I wasn't drinking

When I read this article and this quote:“I think parents need to teach their children safe texting,”

So glad, because I probably would have choked, laughed, and coughed whatever I was drinking all over the computer.

Kids, here's RehabRN's advice: PAY ATTENTION.

It just may save your life, and not only when you're walking and texting ('cause I know you're going to do it). I have to make sure Bubba doesn't play a game on the iPhone and walk, because I already know he can't do it.

That is all.  Enjoy your weekend, all, wherever you may walk, text or roam.

The relief...for a moment

Ah, thankfully the technological gremlins ran away early. I got my deadline material submitted ahead of time.

Yes, RehabRN is hitting the road again. I'll be playing a hotel conference center to talk about my job in the SU. Some of the folks are impressed, but I'm just hoping I don't have any flight delays, because if I do, I could be very grumpy before I talk.

For fun, a couple of my grad school classmates and I are getting together to take our own collective show to Vegas. (that deadline is soon, too)

It should be fun to see if they take us up on the offer.

More to come...

The siege continues

The bad cold turned into some random infection, but from the bleeding, snotty sinuses, if this is a sinus infection, it's the worst I've ever had.

My teeth even hurt.

Hope those antibiotics kick in soon.

Stay tuned.

You the citizen, decide!

Yes, we have a show in RehabLand that has a reporter who goes out and "exposes" local government and administrative hot messes on a regular basis.

It's a good thing he doesn't visit too many hospitals, or the Hotel Rehab's parent hospital (Washington) would be on his show.

One of our patients was getting discharged, but the "approved" transportation method to get him home was denied at the last moment because Mr. X. was not eligible for that type of travel due to his insurance.

Cost to discharge Mr. X as requested:
$500.

Cost to Washington to keep Mr. X until he CAN get "approved" travel:
$2000.

Cost of "approved" travel available tomorrow:
$12 (payable by patient, not hospital).

Difference to keep patient an extra day to get his $12 travel:
Cost of $1500 to the hospital. (And extra food, laundry, and maybe an ER diversion or two...)

Cost of patient going AMA because he's so p*&sed off  over the administrative idiocy of the hospital and wants to get to his wife's birthday party:
PRICELESS

As that reporter says, "You the citizen, decide...was it worth it?"

Some hospital genius needs a good ol' dope slap...

Taking some advice

Mondays are a blast at the Hotel. I'm always in for a surprise or two. Today's menu included:

1. Two pieces of equipment down. Guess who got to resolve their issues...me! Why? We were short tech folks today.

2. I get the call, "you need to go to xx clinic". No biggie. Was going over that way anyway. Since most of their patients are on holiday (or just didn't bother to schedule an appointment), it was dead slow, which gave me plenty of time to talk to the nursing supervisor, etc.

3. While I was at a meeting today, one of the docs told me, "Haven't you toughed out that cold long enough? I think it's time for a Z-pack." Off I go at lunch to call my PCP.

4. I miss an afternoon meeting. Why? Well, a patient who just needed "one little thing done" stayed for an hour. I couldn't resolve his issue, so he called two 800 numbers and then one transferred him three times until he got someone who took his info and will have to call him back.

I wasn't too upset on the last one. That would have been one meeting too many today.

And finally, I got to call our clerk to figure out where one patients ride was. It seems he/she called earlier, but had been roaming around waiting for the ride to no avail. I left and they still hadn't come.

So I gave the patient the ombudsman number and directions to the nurses' station, so they would make sure he/she was off without a hitch.

Tomorrow, thankfully, is another day. And so it goes...

Stay tuned!

The joys of sinus headaches

And yes, indeed, I do have a doozy, since the cold remainders are still hanging out in my upper respiratory system and sinuses. Laughing (or breathing just right) leads to coughing which leads to rattling the remaining junk...ugh!

Too many things to do today, so it's gotta go away.

Stay tuned...

Dear idiot on the Starbucks parking lot

Hey!

Don't know if you and the girlfriend noticed today, but it's hot.

Since I got into the parking lot BEFORE you, I indicated my choice of spot by doing a very normal thing: turning on my blinker, stopping, then putting the car in reverse to back into the shady, available spot.

Yes, I did see you in my mirror, but only because you sped up behind me as soon as I put the car in reverse.

Guess what? I'm first so I win. I will get my parking spot. Please drive around. I'm not moving until you do. You have plenty of room.

Too bad you have to find another that's not in the shade. I have folks who don't tolerate the heat well with me today (I'm on a respite trip to Starbucks, anyway.) and I got here first.

Sorry Charlie. Maybe you'll just have to spend extra and buy her an iced, cold Frappuccino.

Sincerely not,

RehabRN

When you see

Several police cars in the parking lot and two hospital police officers in the lobby on your way into work, it usually means something is going on.

Boy, it's going to be an exciting day!

Stay tuned...

Mistaken identity you'll love

Grumpy:

I hope they enjoy this one as much as I did. Most of my docs hide out from patients, but you took this one head on!

Bravo!

Stay tuned...

I love the internet (or this week's Nuggets)

Which is where I ran into these articles, thanks to my favorite publications, as well as some fellow bloggers.

Hope you enjoy!

Mistakes
Frankly, since I've started working at the Hotel, I've been mistaken at odd times for a doctor, a nurse assistant, a sales person, a stripper and a random person in scrubs. I have never been offended by these descriptions because I take them at face value: the patient was delirious, delusional, demented or just plain oversexed (sorry couldn't think of a D adjective for that last one).

I ran into this KevinMD op-ed (which I highly enjoyed the angst because of the Nerdy Nurse) of this obviously almost 30 something year old woman who is mistaken for a nurse, when she has those coveted MD letters on her white coat.

All I have to say is, if you had the demented character who said you reminded him of a stripper, you'd have thanked your lucky stars he called you a nurse instead. Far worse has happened...

An innocent abroad

All I have to say is, I'm not going to say to much, or I'll have to plead the Fifth, but this is a very interesting article if you are a little technologically inclined. It's just the tip of the iceberg, and I thank my lucky stars that my only cultural barriers right now are between hospital departments.

If you only read the first two sentences...

You may very well see your own career trajectory right before your very eyes. The words that struck me:
"hospitals need to create a patient-centered culture founded in principles of compassion, service and high quality"

You got it, Sabrina. Indeed.

War on the summer cold

Wake up off and on all night. Get sleep in small chunks of time.

Wage war on congestion with:

• 2 pots of herbal tea with honey
• Multiple, multiple cups of every kind of coffee
• 3.5 liters of cold water
• Two Mucinex DMs (takes 16 oz of water all by itself!)
• Four Aleves
• Liberal amounts of Vicks Vapo-Rub (I'm old school)
• One nap before dinner (refreshing!)
• Ate three light, but vitamin rich meals.

If I don't flush it out, I'm going to make things very inhospitable with a veritable flood.

That is all. Back to sleep and thinking good thoughts. Hopefully, all the barking dogs will go in for the night soon!

Welcome to Monday

Here comes the week.

I feel like I've caught the dreaded summer cold. On top of all of it, I had a busy day all day, inspections, and I had patients in two clinics to take care of.

Tomorrow is only one clinic, so we'll ride it out and see how it goes.

If I feel crappy, I'm leaving early.

Stay tuned...

Sunday stealing, just for you, dads

I'm not exactly sure if this is truly the Father's Day edition, but I'm posting my answers below today for a selection of the questions.

Bubba was the pancake master for breakfast, and so far, our day has gone really well. Dahey liked all of his gifts.

Enjoy your Father's Day wherever you are!

What is your ring size?
Depends on which hand. One ring finger is an 8. My mother told me not to crack my knuckles, but I didn't listen...

How often do you wear jewelry?  
I'm not an accessory freak, but I wear "work-appropriate" jewelry every day.

When was the last time you consumed alcohol?  
Last weekend.

What is your favorite comfort food?  
It depends. I love bread (my greatest loss while on this low carb diet) and anything bread-like.

Do you prefer broccoli or asparagus?  
Asparagus would be first.

What color are your bedroom walls?  
I think the color is called "linen" (basically a white color, chosen by my husband).

With whom do you live?  
Dahey, Bubba and WildDog. We have visitors occasionally, but none lately. Dahey's got a couple of coworkers and a couple of cousins who've lived with us at one time or another.

Which Star Wars movie is your favorite?
Return of the Jedi. I'm old school.

How about Harry Potter?  
Don't really have one.

What was the last movie you saw in theaters? 
Probably Paranorman.

Did you get the popcorn or candy?  
Always candy. I'm a Sno-caps kind of girl (if it's chocolate, I get it).
 
Have you ever played miniature golf on a date?  
Yes. Over and over and over. Not a lot to do for teens on dates when I was growing up.

Do you always use good grammar?
I try.

Do you have an accent or a speech impediment?  
I have been told I have an accent, based on the region of the country I'm from.  I'm often mistaken for a Canadian. (You know, eh?)

What did you eat today?  
Breakfast omelette. I really wanted lots of pancakes, but I didn't make those low carb ones.


Do you prefer to watch or play sports?  
Play, definitely. If it's pro, I'll watch.

What size engine is in your vehicle?  
Depends: one four, one six cylinder.

What do you need to do tomorrow?
Get up and go to work (ugh!)

Another fight

This one in California over unlicensed personnel and insulin administration.

Reminds me of the "Just a nurse" campaign. "Just a nurse" keeps patients from getting DKA or hypoglycemia.

Stay tuned!

So happy TGIF

Yes, so, so happy. Go to work, do work, get lunch and coffee, go to a meeting, come back and finish the day on an up note. Stuff actually gets done. I don't feel like I wasted my day sitting at the computer sending endless e-mails.

Joy, joy, joy!

Hope you all enjoy whatever the Flag Day weekend brings you.

More to come.

Time to update the slides

I do an education presentation for a local non-profit organization which many of our rehab patients belong. Traveling partner and I discuss the favorite rehab nurse topic: bowel and bladder issues.

We did a thorough research on the internet and in journals, etc., since the folks we work with publish stuff.

But, I never realized until today when I attended a presentation with a urologist that we forgot a surgical intervention: bladder augmentation. (And yes, it does make the bladder bigger.) I guess one of these days I may actually meet a patient who's had this done. So far, not yet.


Finally, they mentioned this device. I got flashbacks to nursing school when I had to do a soap suds enema (without a balloon, which would have been nice).

Stay tuned...

What I missed in 2011

Yes, since I was busy getting a new job, getting highly stressed from life and grad school, and running from airplane to airplane going to three conferences in the span of a week, I missed the good stuff on the internet.

However, Shrtstmtrooper posted about Guy on a Buffalo recently. Since Bubba has been obsessed with wild animals (such as the monarch of the Plains lately), I thought why not.

Two words: hysterically funny.

The back story is here from a 2011 Forbes article. (you know you're big time when you are in a business magazine's website)

Episode 2 is below. More available on YouTube.

Auditions

First of all, I have never read this book. Hopefully, my lack of reading won't matter. Since there's low census at the Hotel, I figured I'd look for a gig I can do in my spare time, like writing or teaching (things I've really enjoyed).

Well, lo and behold, I found a company who was interested. I've been on many, many interviews (no idea how many, so it must be that creeping senility) but never an audition.

There's always a first time.  I prepped as well as I could, since I had advance instructions on what they wanted me to do.

Hopefully, I was successful. More to come...

A different kind

Since I was searching for rehab articles today, I came upon this one.

Dr. Drew (from NY Times)

Not exactly my type of rehab, but much needed nevertheless.

Raise your hand if your "lawsuit sensing" antennae went up after reading the first half of the article.

More to come...

Fun: Sunday Stealing

Gotta love the Weird Questions, Part 1 from Sunday Stealing this week. Here are my contributions below.

Do you wear slippers?  Yes, if you call Crocs around the house slippers.

How many pictures are in your living room? Photos -3, artwork-2.

Do you ever watch Brady Bunch reruns?  Not lately.

Are you allergic to anything?  If it's outside, most likely.

When was the last time you called in sick? Can't remember.

Have you ever been in a car accident?  Yes. Mostly fender benders. Nothing terrible (knocking wood).

What is your favorite snack food? Depends. On this diet: peppers and hummus.

 Have you ever seen a tornado? Yes. Got very close and NEVER ever want to do that again ever (if I can avoid it!)

 If you won a million dollars, what would you buy first?  Another lottery ticket.

What time is it right now?   1353.

Do you think it's cool for men to wear flip-flops? Cool? Not really. Practical? Sometimes, yes.

How many pairs of shoes do you own?  Over 30, mostly black.

Do you think you are a hypochondriac?  No. I hate to bug my doctor. I only call if I am sick.

Do you own a dictionary?  Several, in multiple languages.

Are you actually fat but in complete denial about it?  According to BMI, yes, I am technically over 25. Denial? No, or I wouldn't be on a diet, silly!

What color is your mouse pad?  Don't use one.

Does your kitchen have a theme? No. It's all white. Maybe snowstorm or whiteout would be more appropriate.

Falling in rehab

Falling is really not a good thing in rehab, whether it is patients or staff falling.

Equipment falling in other parts of the hospital are equally unwanted and sometimes deadly.

More later...

Old school

It's always interesting to see people you don't normally see on a daily basis. I did that recently by going to one of the local watering holes and meeting up with some folks from high school.

We were mainly there since one of the group was in town for various graduations, weddings and other assorted upcoming trips. Another classmate drove across the country to RehabLand to pick up some relatives and head on out to a destination wedding.

The weather was glorious so we sat outside and just enjoyed the weather.

As usual, there are some curious dynamics. Many of the folks who were there are school teachers and assorted professionals. One is a housewife who raises animals for sale (chickens and pure breed dogs). Another person worked in health care on the administrative side. We had a nice long conversation.

But simmering beneath the surface, is always  something. While I had that long conversation, I realized that some people are nursing grudges that are nearly 30 years old. I kept my therapeutic communication hat on, but later, the nurse appeared.

"You have options. You can let it sit there and drive you crazy, or you can do something about it and let it go. You are not where you grew up. It's only a part of you. What you choose to do with it, is your choice."

I don't think she really ever understood it that way, before.

And so we took off into the night, and left our erstwhile waiter a big tip. Because after all, we did take up his table forever.

More to come...

Fascination

This was interesting, even though I can't eat it.

Gluten free naturally colored cake

I would not have thought the carrots would have made a decent color for icing on a cake.

Siege, day 2

True discipline is really just self-remembering; no forcing or fighting is necessary.~ Charles Eisenstein

Okay, it's not really a siege. I often worry about that when the safety guy drills us on the phone-in bomb threat (yes, apparently they still do that, even with Caller-ID) or the shooter who walks in the lobby.

The siege is happening every time I walk into the kitchen. Over to the cafeteria. Out in the mall.

Yes, dear friends, due to liberal imbibing of those fine Hefeweizens, and all those yummy cupcakes, I'm now on a diet.

I have just decided that I should have never let that nursing school flab (and brownie habit) come back.

Coping with stress with food when you have a job where you sit a lot more than you used to, is not a very good thing.

My goal is not impossible, but it sure seems that way when I look at dark chocolate or ice cream.

Stay tuned.

Let's be blunt...

Okay, sometimes as a rehab nurse, you have to do it.Using grandiose medical terms like micturition and defecation just don't cut it.

We have to ask "Did you pee lately? " (due to a variety of reasons) and "Did you have a bowel movement?"  Yes, nursing students, if you can't observe it, you have to get reports from your patients, and like those videos, you have to ask questions: color, consistency, etc.

We sometimes even resort to the old standby, especially for the really deaf hard-of-hearing folks, "SO-AND-SO (insert name here) DID YOU POOP LATELY?" This is always especially fun when the soundproofing is not so good in the exam room.

So, needless to say, since I have some of those old characters (many of whom don't hear well) as patients, I really enjoyed reading the headline below (which wouldn't surprise me if I heard it out of our folks..)

Michael Douglas: Oral sex caused my throat cancer (from the UK Guardian)

While Michael still needs some patient education, he may have already inferred something from the literature from the comments he made.

I just wonder how Catherine Zeta-Jones took it all when she picked up the paper.

More later...

Rain, hail, tornadoes

Dear Mother Nature:

Who says our Friday night wasn't exciting? I thank my lucky stars that I have a finished basement in which to hide from the rousing storms that were going through RehabLand.

Yes, we missed some fun Friday night stuff at baseball and the mall, because it got windy and spooked a lot of people, but there are bonuses. As I already mentioned the basement, I was thrilled that we still had electric and cold beer.

So let me just say thanks for avoiding my neighborhood. My nerves were frayed, WildDog was stressed, but happy with us.

At least, with a cold Hefeweizen, I could watch the storm reports and chill in a safe area.

Please send the next set of storms somewhere else. We (and all the folks in Oklahoma) have had enough water, hail and wind for quite a long time.

Sincerely (really, if it works...),

RehabRN