Back to business

Working always makes things interesting. From my space near the front door of the Hotel, I see a lot.

This week, I've had a lot of visitors. Folks looking to learn stuff I can teach them, families learning about when and where they'll go when they go home. I've even gotten to plan some projects and pitch new ones that need resources. I feel like I'm going somewhere, even though I'm running.

My regular characters come see me. One rolls in and it's obvious he needs help. His leg is dangling. He's slumped a little more than usual. He tells me the new wheelchair is having issues. His headrest is messed up and his foot pad won't stay on the chair, so we have to carry it upstairs.

Thankfully, he didn't have one of those spasms, that to the uninitiated, look as if he could just fly right out of the wheelchair. If I had a dollar for every time he's frightened new staff, I'd be rich.

Nevertheless, I fix what I can, empty his leg bag, and get him to the motor pool, otherwise known as therapy, so the wheelchair specialists can fix him up, literally, and figuratively. One smiles and tells him she knows where the "real tools" are.

He follows along, and I leave, knowing I've done my warm handoff to the next discipline.

Now for more fun...FIM certification!

Stay tuned.

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.

FIM-what?

Can you tell I have CARF on the brain? Yes, they are going to be here before we know it, and the Hotel Rehab is abuzz with excitement (more aptly called overstress).

I got the following in my Word of the Day e-mail from my favorite people at www.m-w.com.

fimbriated \FIM-bree-ay-tud\
adjective: :having the edge or extremity bordered by slender processes : fringed

No FIM scores were calculated in the definition, but that's okay. FIM and all sorts of other rehab related measures can be found on the RIC Rehab Outcomes page.

I'm still a 7 today!

Stay tuned for more (bad) rehab puns. I'll be playing the Hotel all week...

Nuggets for June 19

There were just too many good things I found out there this week, that I had to add this special edition of Nuggets (special because they only usually appear once a week...).

Enjoy!

Rehab-o-rama

As a rehab nurse, I know the FIM, but truthfully, it sometimes drives me crazy when I have to look at someone and when we talk about them in a meeting spit out their FIM numbers. Some are easy, since we take care of bowel and bladder all the time. Those other ones, however, tend to mess me up.

I found this article about how one hospital educated staff on their FIM scoring. It's very clever and involves a cartoon character. Hey, if it works, go for it!

Play nice

Since my OR pal reminded me...It really sucks that they have to write articles like this, but a recent one from AdvanceWEB talks about how nurses in the OR sometimes need to be reminded to be civil.

Relax

Need a quick, contemplative moment? This article by a certified hospice nurse may help you achieve your goal (also from AdvanceWEB).

And from the blogosphere....

Not Nurse Ratched is a new nurse who talks about making her first big med error. Listen up, all you new nurses!

Crass-Pollination had this great post about the inpatient shell game. Just call it bed bingo on steroids or you know it's bad when someone needs to die for you to get a free bed.

And Keith wins the most interesting day post for this one: Bat in a Basket. We have critters all around Madison, but thankfully, no bats.

Nuggets for January 5, 2008

Does the FIM scoring instrument used by many rehab hospitals make you crazy? Check out these links for more information:

MedFriendly has this FAQ about FIM
FIM is the product of UDS, or Uniform Data System for Medical Rehabilitation

NursingSpectrum has a nice short description on what rehab nurses do for students.