Happy New Year's Eve!

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

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

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

See you next year!

I was tempted

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

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

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

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

That is all.

The things you find

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

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

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

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

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

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

More to come...

An oldie but goodie the night before Christmas - nurse style

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

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

A Nurse Christmas

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

Great blog post on nursing

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

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

Happy weekend wherever you are. You deserve it.

Just in time for the holidays...

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

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

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

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

There are some expectations that come with that.

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

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

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

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

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

And finally the topper of this edition:

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

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

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

Viruses, virii and a mouse in my kitchen

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

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

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

I'm praying it snows like mad.

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

Happiest of Fridays to you

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

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

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

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

Hope you enjoy your weekend wherever you are!

More to come...

In an instant

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

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

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

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

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

Joining in on the fun...

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

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

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

Stay tuned.

Giving Tuesday

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

 However, it is what you make of it.

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

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

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


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

It is greatly appreciated.

Stay tuned...

Serendipity

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

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

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

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

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

Happy Thanksgiving!

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

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

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

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

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

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

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

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

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

More to come..

Add a little on top

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

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

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

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

More later...

Preaching to the choir

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

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

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

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

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

It makes me wonder...more later.

Snow has arrived

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

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

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

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

Oh Polar Vortex!

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

Now, today it's snow.

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

That is all. More later...

Maybe...

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

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

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

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

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

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

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

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

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

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

More to come...

Rehab nursing in a nutshell: the series

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

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

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

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

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

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

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

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

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

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

More to come...stay tuned.

Follow your arrow

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

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

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

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

Enjoy your weekend wherever you may roam.

 

Getting older...

Not better if you feel like c#$p from headaches. Not to mention, these symptoms stink. At least, all the tests came back negative.

The week has flown by in a blur, which always seems to happen the week after vacation.

Friday won't get here soon enough.

Stay tuned...

Still recovering...

But darn it, it was FUN!

Beautiful days no need for a coat. Pretty nights and safe surroundings. Fireworks I could watch from my room and music. Lots of rehab nurses from all over the place.

I learned a lot. I had fun meeting everyone. It was pretty cool.

Yes, it really was the happiest place on Earth for one brief moment now it's back to work.

Stay tuned...

Amen, sister!

 From CNN: Quarantined woman to be discharged, Christie's office announces

"It is not a sound public health decision and well-thought out," Hickox said. "Many of the experts in the field have come out to agree with me. So I think that we need to stress the fact that we don't need politicians to make these kinds of decisions. We need public health experts to make these decisions."

Two things:

One: How come Kaci Hickox, RN, a Real Nurse, isn't even noted as one? Sure might have been a different headline if she were an MD.

Two: It's about freaking time: we need more public health people working on this problem than the public health spin doctors, who know absolutely nothing about medical diagnoses.

Too bad, Mr. Christie is not here. Impersonating a medical professional (RN or MD) is a crime in RehabLand.

I'd have been hot, too, with all this c#$p!

Weekend diversions

What kinds of movies will a rehab nurse watch before hanging out with hundreds of other rehab nurses? Well, if you're into history and sports,like I am, you'll watch The Best of Men. My favorite part was watching it on Bubba's computer (which has a big screen). Somehow I got it on closed captioning by mistake.

Maybe because I have a lot of parental controls turned on (maybe note), but I noticed that all the swear words were not included.

Another interesting article I found today was this article about the big cheese at one hospital taking a pay cut. What a novel idea. Hope this one spreads.

Now I just get to make dinner and get ready for Monday.

More to come, so stay tuned!

Big Brother? Maybe...

Just minding my own business meandering around ye old Internet while I'm taking a break from chores, and look what I find.

Sounds innocuous enough: harness energy from the body.

Once you look at the photos, though, it doesn't look very comfortable or sanitary to me.

More to come...

Sometimes

It does not pay to air out your home storage area.

Especially when Dahey inadventenly lets in wildlife that dies there and stinks up the storage, and the whole house. It makes bowel programs at the Hotel smell good.

I am so glad I'm leaving for a week soon.

That is all. More to come...

Do it again? Well, maybe

I went to see my internist yesterday. I got my labs back pronto, so tonight I get a note that says "Take Vitamin D."

Yes, that lab was low. I thought the research that said calcium supplementation was hogwash so I started eating more cheese and Greek yogurt.

Too bad that's not fortified with Vitamin D. Yes, Dr. H., I'll be picking up the supplement tomorrow.

For fun, I decided to take an online course through work. Tonight I found out that the superduper steroid version on that subject that is limited to 35 people per session is still open. The best part: I may have to go visit my favorite pharmacist next year, since one of the class requirements is presenting your project at next year's conference.

Joy of joys. Now to just get management approval and apply by the end of the week.

Never ever a dull moment around here.

Stay tuned.

Mixed messages

We have a fledgling nurse manager on one of the rehab units. He/she's getting his/her feet wet. It's been nearly a year.

He/she has gone on record saying he/she'd really like to develop the people on his/her unit.

We work in a CARF certified rehab facility and someone today actually told me, "I want to get certified." Hooray! (There is an ulterior motive: our facility pays you a bonus to get certified.)

However, the next thing out of this person's mouth was that the "nurse manager says I shouldn't do it, because I don't want to be here forever."

I wanted to plant my head firmly into the desk, but I did not.

Looks like someone may need to attend a seminar on developing your staff soon at the Hotel.

Stay tuned...

We salute you

All of the front line health care personnel putting it on the line every day in today's environment.

This quote from a recent article about hazardous waste generated by Ebola patients was telling:

“It’s totally shocking,” Ms. Sharpe said. “It would take me anywhere from four to six weeks to train an employee to work in a high containment lab in a safe manner. It’s ludicrous to expect doctors and nurses to figure that out with a day’s worth of training.

Thank you, Ms. Sharpe. Hopefully, someone will listen and take care of the folks on the front lines, including all the staff who help take away all the remainders.

More to come.

We are getting there

Slowly, but surely our HAPU rate is going down. Why would we worry about it, anyway?

In rehab, HAPU is something that will derail the most eager patient. It can even kill you. 

As I tell the patients, your skin is a force field.If you damage it, your bones and everything else can suffer when dirt and microbes from the environment decide to invade and make you sick.

Simple but effective...for most people. All we can do is repeat and maybe by the hundredth time, it will stick.

So, we'll keep on going. TGIF to all wherever you are.

Jumpin' Jack Flash

It really is a gas eating all these vegetables on my current diet (clean eating with lots of vegetables and lean protein).

So far, so good. 

More later...

Hit the nail on the head

This could have easily been the theme of my week this week.

1. Yes, slacker coworker, when you sit in our weekly meeting and chart, instead of participating, you look like an idiot. When a patient with a LOS of 25 days and you really know NOTHING about him or her and they are your assigned patient, I only have one question. Why in Hades didn't you read THE CHART?! 

I know, rocket science...

2. The boss finally decides that the hallway consults are causing issues with continuity of care. Yes! That only took a year to convince him/her. We shall see what happens...

3. Thank you jo at Head Nurse for the link to this Suzanne Gordon article. Yes, communication is vital, and lack of it is deadly.

So far no Ebola in the Hotel Rehab and our specialty docs like it that way. We will keep praying it gets contained.

It's one souvenir from Dallas I'd prefer not to get on my next connecting flight.

Stay tuned...

Happy (Canadian) Thanksgiving!

Since it's Thanksgiving, it's time to give thanks!

First, I want to wish a Happy Thanksgiving to all our readers in Canada, who are enjoying their turkey and pumpkin pie today. I miss you so much Scrappy, Pierre, Monique, and Gord. Ah, another lifetime ago...(I am still going to visit EVERY provincial capital 'cause it's on the bucket list.)

However, since search engines can be flaky, I am happy to say I'm so thankful for the folks out in the audience who help you find your way here.

These are just some of them (and a couple of reviews). I am eternally thankful for you all, especially At Your Cervix (who sends more readers here than any other blog.)

Enjoy your day wherever you are!

http://www.rasmussen.edu/degrees/nursing/blog/nursing-blogs-you-need-to-read/

Rehab RN by RehabNurse

Rehab nurse offers a light-hearted and often comical view into the issues encountered by nurses working in rehabilitation. Chock full of relatable commentary – at times with life lessons outside the scope of nursing – this blog could easily be housed in the “entertainment” section as well.


http://ernursescare.blogspot.com/2013/05/top-30-nursing-blogs-2013-boy-i-am.html

RehabRN features the thoughts and experiences of a rehab nurse. The blog is engaging and shares stories of both success and failure, seeking always to provide the reader with a realistic sense of the job.


Other places to find me:
http://www.northeastcenter.com/links_nursing_blogs.htm
http://www.blognation.com/blog/9498/rehab-rn
http://ajnoffthecharts.com/nursing-blogs/

Something for the science teachers

My high school science teacher was a nun. She had a sibling (also religious) who would work with her on research and mission projects during summer vacation.

Sister L. was kind of out there but wickedly funny. She was also from Fargo. I could see her laughing about this one.

Many science teachers can appreciate the irony of physics.

Stay tuned...Nobel season continues this week.

Fall is here in RehabLand

The leaves have been turning shades of red and gold here in RehabLand. They aren't at their peak, but they are getting close.

Dahey, Bubba and I had a fun time taking a drive to the country to see my cousins who live in a quaint little town that dates back to the early 1800s. It's a blip in the road, but every year this time, the locals have their fall festival and people come from miles around. The cousins throw a party and invite all the relatives to see their place and go to the festival.

Bubba wasn't sure he liked it, because the corn maze was a longer walk than he expected. Some folks just don't get that, yes, there is indeed a big difference between 1/8 of a mile and 8/10s of a mile. He walked most of the way there, then decided to turn around.

We went back to the village green and signed up for the fun Money in the Hay contest. We missed the pumpkin decorating contest. Since he had a commitment at home, we couldn't stay long enough for him to enter the pumpkin pie eating contest. This was, of course, traumatic, for a preteen boy who can eat you out of house and home when you aren't looking.

Thankfully, he liked the soups and chili the cousins had, as well as the entire dining room full of sweets. He didn't make much money in the contest, but he had fun going out there with all the younger kids.

One of my cousins, an ER physician with three kids, showed up with his family. We talked shop among other things, since I rarely see him (he's always working). He's just hoping he never ever sees ebola at work. Since he practices in a much bigger town than PumpkinLand, but smaller than the regional centers, he hopes he's safe.

As we said our goodbyes, Bubba asked if we were coming back next year. I said "What do you think?"

He said, "Oh, yeah! Let's do it."

I'm so glad it turned out as well as it did.  Hope you enjoy your weekend wherever you are.

Resources I wished I had

This article for my patient who was so very unhappy with her ex-husband's last name. If the former Mrs. U. comes in, I'll print it out.

More often than not, I'd like opportunities like this one to volunteer. Some of my coworkers need rejuvenation more than others.

After a wild, blood moon kind of week, I am so happy it's the weekend!

TGIF all wherever you may be!

I'm waiting for this one to come to RehabLand

My ER nurse colleagues can tell you it's a common way to get out of the ER--go AMA when you don't hear what you want to hear, or when you hear you'll go to jail, or get a bill.

Now, instead of all those things, we have ebola showing up in ERs around the US, thanks to the marvels of modern transportation. 

Add them together and all you get is trouble.

That is all...stay tuned.

So many issues...

Two words: prosthetic butt.

Somethings really should be original....

That is all.

A reminder

Blessed are they who are persecuted for righteousness' sake: for theirs is the kingdom of heaven. RIP Alan Henning

The bitter and the sweet

So many things fit that description this week. Retirements and births in our little neck of the woods in RehabLand.

And I finally got the promotion I've been working on for the last three years. Sweet! Bitter: the attitude of the woman in HR who was supposed to answer my questions about it. (I wish SHE were on that retirement list...she needs something!) However, I was sweet in thanking her for her diatribe.

It doesn't matter when I get it, I know it's on the way...FINALLY!

The joys of parenting

Tonight was our first "free-for-all" parent/teacher conference in the RehabLand school district.

What does this mean? Take all the classroom teachers for a particular grade and stick them in the cafeteria. Leave the tables exactly as they are so no one can tell who is standing in what line. Put all the major subject teachers together, so the traffic jams are even more acute around their area.

Do this for three hours. Thankfully, Bubba took me over early and pointed out all the important teachers to talk to while we were there. And no, they weren't just the ones who gave him A's in their classes (although surprisingly, he loves school this year).

I hated it, but I cannot imagine what the teachers think of this.

Just like running the gauntlet...more to come.

It's Tuesday

However, for some folks, it's Friday. Forever. One of our retirees came in for the last time and left today. Sadness.

Tuesday for me means patient appointments (if someone doesn't cancel them at the last minute) and meetings. Fun meetings where people who insist that it start at one time (0800) casually stroll in at 0815 and throw off the folks who have to come in at 0830 from another site for a short report.

Our coordinator called some of them on it. I don't really think it will stick or embarrass anyone enough to show up on time. It's the Hotel way, and they (the Hotel "team") aren't going to change for anyone. Even if it is terribly inconvenient and they are the first people who think the meeting is going too slowly.

I'm all for locking the doors and deducting the time from their pay, but unfortunately, management doesn't feel the same. We should ALL suffer together.

Just another reason why I hate team building exercises. A few divas always screw it up.

What's NOT right with the world

1.  I could not believe this when I read it. Charging a victim of rape for a rape kit? Really? Add insult to injury and a little financial burden, why don't you?

2. Product branding in the age of social media savvy terrorism. No, I don't think I'd change the name of my product.

3. I feel the same way about the weather. When will it really be fall...for two days in November?

That is all. Monday will be over soon enough. Just felt the need to vent....ah!

'Tis the season...to retire

Not me (I wish!) but certainly a lot of people around the Hotel are retiring. More than a few messages have appeared in my mailbox for parties for people leaving at the beginning or the end of the month.

It's even happening at the Hotel. A couple of our folks are retiring. They are looking forward to lives where THEY dictate what the schedule looks like. I can't say that I blame them. Others, such as one of our NPs, can't wait to be a grandma (any minute really!).  What perfect timing...retire and spend as much time as you want with your grandchild. Another is working on his/her golf game and the travel associated with it.

Our boss really wants to retire, but since we can't find a replacement, he/she will have to set a date and retire and let the Manglement of the Hotel figure it all out. Waiting for years (yes, it's true) is really not fun.

It's too bad the Hotel only does lip service to succession planning. It might make the transition easier.

One of these days, they'll wake up...and someone will figure it out.

But I'm not sure if that will happen before I retire (many years down the road).

More to come...

Yes, it's non-formulary at the Hotel

And no, contrary to popular belief, we don't supply it, either, but this order was entertaining:

MARIJUANA (MEDICAL) AS DIRECTED INHALATION AS  NEEDED

I always tell the flower children to go to the state next door (since they wrote this character's script.)

Alas, they continue to patronize our local drug dealers, even if it means we'll kick them out and some of our surgeons will refuse to operate on them if they need it.

Just a thought.

More later...

Family reunion fun

All of the nurses myself included (a retired CRNA, retired COHN and a peds nurse) talk about disgusting stuff while eating BBQ. Pressure sores somehow seemed to be one of the big topics. Even the peds nurse (newly engaged) had a gross story. Her fiance went to talk to the cousin who was doing the cooking.

Thank goodness our family has a (warped) sense of humor. Everyone has been through some horror (or two) and survived.

Makes things very entertaining along with that snow cone machine my cousin brings every year.

Never a dull moment.

Stay tuned...

Old school communication

Call me a dinosaur, but I still love my e-mails. Especially stuff from the listservs I'm on.

Rehab nurses who rarely speak out about anything will have long, torrid discussions via listserv about the best way to put on a leg bag and how many times a night to turn patients.

It may be old, but it is still highly entertaining.

Never forget

I won't. Ever.

Harbinger of things to come?

Sunday started with a migraine, which did not go away. It just subsided here and there until the migraine drugs came out (thankfully, no nausea and vomiting!)

Went over by the Hotel and saw one of my coworkers, F., getting ready for the night shift. Long discussion. Had to cut it short to do what I had to do and get two friends to bring home for Dahey and Bubba.

Those friends: Ben & Jerry. Yes, we ran out of ice cream (found this out yesterday) and you would have thought the world would indeed end.

But alas, as I'm leaving I saw it. The harvest moon. 

I hope F. has a really boring night.

That is all. Stay tuned...the night (and the week) is young.

Only in my dreams

Only in my dreams could we get a Hotel Rehab as "smart" and "accessible" as this new one going up in Nebraska.

I'm kind of worried about those gestures turning on and off appliances, lights, etc.

What do I do with the guy who has spasms whenever we turn him (or whenever he tilts just right in his wheelchair)?

It could get REALLY interesting.

Just sayin'...stay tuned. (I'd love to be there when it opens!)

The perils of rehab

While I was at my rehab conference, I talked to lots of folks. One of the biggest issues was reimbursement.

Now I know why there are issues. If companies only hire for a bare minimum set of qualifications for their staff (see below), it's no wonder why all the case managers in the audience said they were coloring their hair due to it turning white prematurely.

Clinical Appeals Reviewer 
Job Description:

Primary Responsibilities:

    Provide expertise or general support in reviewing, researching, investigating,and resolving all types of appeals.
    Communicate issues, implications, and decisions with appropriate parties.
    Analyze and identify trends for Appeals.


Job Requirements:
Required Qualifications:

    High School Diploma/GED.
    1+ year of Telephonic Customer Service experience.
    1+ year of Healthcare Insurance experience.
    Proficiency with Microsoft Outlook, Word, and Excel, including the ability to create spreadsheets and filter data.

Preferred Qualifications:
    Familiarity with Medical Terminology

Funny, but no where did it say this person ought to be a nurse. You get what you pay for...just sayin'

More to come...

Another t-shirt moment

I love conferences, since you get to see people you haven't seen in ages and learn new stuff.

But I really hate it when you are so tired, you want to pass out, because you've been trapped in freezing cold rooms and staying up late.

Thank goodness I convinced the boss I need time to recoup (aka vacation). I might not be going anywhere, but being stationary, is a very good thing.

Stay tuned.