Tomorrow is Monday

Dear Boss.

I know what day it is. Again. I really enjoyed having the holiday weekend off.

Can I please do this again soon? It's a habit I'd really like to continue into 2017.

Sincerely,

RehabRN

Never a dull moment

It may be a holiday week, but it's been busy! The Hotel is always hopping around the holidays because people want to go home. If they can't get home, we have to take care of what we can before lots of other people take off for the long weekend.

While some of our folks would like to go home, they get sick. One character mentioned that he/she had a transient loss of vision. He/she was worked up, then he had another incidence. Between the opthomologist who said the patient had a fugax and the neurologist who wanted a stat carotid exam, he/she ended up with a quick trip to Washington for an overnight to get all the diagnostics done and issues resolved.

In rehab, it's very rare to have a patient on TPN. In fact, I've yet to see one in any of our units (acute or otherwise) because if you're on TPN, you're usually sick and not a rehab candidate NOTE: this may vary in other settings.

However, if you end up with a chyle, a not uncommon sequela of the infamous triple A, you could need TPN for a while, as one of our recent patients did. Thankfully, no more TPN and patient is working up on the diet list, slowly but surely.

One of my favorite things to do is to read imaging reports. We have lots of rehab patients with CTs, Xrays and many, many MRIs. I follow along in the reports and learned this week about Thornwald cysts which popped up in a patient's report.

Finally, since it's turning to winter here in the northern hemisphere, I also learned about thunderstorm asthma, which was sending people to emergency rooms all over the southern hemisphere recently. Just makes me wonder how many of these sent me to the emergency room as a new asthmatic. My poor mother!

Thanks for following and reading along! May you all have a wonderful Thanksgiving  (or rest of the week) wherever you are!

I'm praying...

For my patients, especially the sick ones. It really does suck being around here when you could be home for the holidays. Many come from far away, so they don't have family visits.

For my coworkers, you know who you are. Praying that saying that tough times never last really is true.

For my son, Bubba, who just decided to have a meltdown while Dahey had a friend in the house. Ugh! Being the disciplinarian, he got his attention, though.

For me, that I can get into the holiday season. I started reviewing my charitable contributions (which I do this time every year). I really do enjoy giving and receiving.

Peace, quiet, family happiness and a clean house aren't too much to ask for...are they?

We'll see...stay tuned!

Dysfunctional families at work

It's not just the patients at the Hotel who have dysfunctional families, but the employees act like a dysfunctional family, too.

Your boss decides to tell your office mate he/she is a "downer and never has anything good to say". Said nurse is always doing more than expected, unlike a large portion of the staff we work with. Said nurse is also stressed by an HR department that "forgot" his/her promotion (which means no more money on the payroll as promised, which is nice during the holidays or any season) and who is genuinely feeling awful. I finally convinced Neighbor to see the new PCP at the Hotel after failed attempts with one in another system who never returned calls. Neighbor has some scary symptoms that don't warrant a hospital stay, but are concerning nevertheless. Crossing my fingers that a specialist appointment (or two) is on his/her appointment list soon.

I had the distinct pleasure of participating in a facility-wide job fair. It's a good thing they rented out hotel space because we were mobbed. I participated in over a dozen interviews for nursing staff. It was amazing the amount of people we got to show up. I hope the nursing recruiter  has learned: be prepared for CNAs. They seem to always be looking for a job and freebies. A few were exceptional, a couple were good, but only about half were recommended for hire. It would have been nice to have another group to interview these folks, because we had so many people show up, it took FOREVER.

My partner was another nurse from our department who I don't see a lot. She is Ms. Right as in "I'm always right"and is well-known for spending most of our staff meetings fighting with the boss. She has years of experience, but sometimes doesn't act like it. She thinks what she thinks is more important than following policy, procedure or even, evidence-based practice. She came from another high-intensity area and sometimes, she needs to go straight back. She's gotten comfortable, though, in her role, so short of a egregious error of judgment, she'll never leave before she gets her advanced degree. I really wish her graduation date was soon...

The good thing: some of our staff scheduled appointments for me. This meant I had to show up, so I spend the last hours of my day taking care of them, reviewing what happened this week and it was pretty darned good. We had one of the best weeks ever for SU encounters. It was a bright spot to this Supermoon crazy kind of week. I'll take it.

May your weekend be full of joy. Don't let the turkeys (or Ms. Rights) get you down!

'Til next time...

Crazy Monday

I am more than familiar with the quotes mentioned in this article 30 things we hate to hear at work.

Please note that while I may ask for a second, I don't expect to get more than that. We know you're always way busier than the rest of the department, so, as my favorite old ER nurse says "Spare me".

Don't be spared. Read this and enjoy.

You might even be able to add some of these to your own special nursing unit Buzzword Bingo for some fun on Thanksgiving.

Have a happy Monday wherever you are! More later...

Torn...

The dilemmas I've faced this week.

The first one was the dreaded certification renewal (one of them, anyway).

Getting a nursing certification is a little like qualifying for an equestrian event: lots of jumping over obstacles and looking perfectly put together.

After months of combing all my files for CE certificates to put in the application, making sure my membership was updated, then filling in the rest of the application and credit card info, I sent it off. A few hours later, I got the "we're reviewing it" e-mail.

Today, I got the all clear. I'm renewed for another five years. The hamster wheel starts again...

The last couple of days, not throttling some of my coworkers about the US presidential election has been another dilemma.

For those of you not in the know, we not only elected a new president this week, we will, on Bubba's birthday, January 20th, inaugurate the nation's first reality TV star, thrice divorced president married to only the second non-US citizen First Lady. Some of my coworkers want to talk about it all the time.

I'm not one of those people. We give out blood pressure meds for a reason at the Hotel. We're not supposed to be inducing conditions that will send people into rehab.

However, I'm looking forward to the weekend. I'm celebrating my favorite US veteran, Dahey.

Happy Veterans' Day to all of you who have served!