Quality or not

We had the long (not awaited) meeting with our nurse manager. I like the manager, I just detest being stuck with some of my ne'er-do-well coworkers.

Our manager had the not enviable position of beginning the discussion about changes coming to our Hotel clinic and home care group. Some folks just rolled their eyes. One person was on vacation. My cohort had a migraine. I thought I would have one, too.

The Slug made a comment I'll never forget when the nurse manager talked about liking Madison since he/she "can make a difference here."

The Slug replied, "I don't want to make a difference, I just want to be."

Be lazy? He/she's got that down.

Be greedy? Absolutely, when all you're worried about when your job title is going to change in the computer to care manager (because that title usually--but not always--gets you a pay raise).

Be an idiot? Completely. But when you have YEARS of nursing experience, especially doing stupid things, it's not surprising.

Quality, caring employees might be just the Christmas gift for the Hotel this year.

Stay tuned...

Far too much entertainment...

When I am not at work. This is not an endorsement, but I found this app because of Rob Fraser, a very nice Canadian.

Nothing like looking at stuff you can see at work and see the comments that are listed.

In the notes

Since I don't always see everyone in the Hotel in the SU, but I'm still on the team, I have to read the notes to stay current on all the patients we take care of. To do so, I skim the notes.

This was my favorite from one of our consults to audiology (who never tells their patients that they're really in the basement next door and half of them end up in my office...).

"Patient's bilateral ears full of cerumen. Please irrigate and re-consult this service, as testing cannot occur at this time."

Hello?! WT...? Nice. I know the NP who's in charge of ear wax removal, is going to love this one. I'll bet we're not going to send anyone to Ms. Audiology without those Debrox drops first!

Another favorite: we had  a patient who needs a urology service consult while he/she is an in-patient. Patient is leaving for the great Rocky Mountain state next week.

RN in charge of this clinic writes in the consult (for the secretary to schedule):

"Please schedule xx urology procedure at earliest date, as patient to discharge by 5/21."

When does the stellar secretary schedule? Consult read: "Patient scheduled at 0930 on 7/30/12 per request". (head plants firmly in desk)

Urology's idea of urgent, surely isn't mine or this patients,  either.

I only made it halfway through the patients before I had to get away....stay tuned.

Patient comments and assorted shenanigans

Ah, being in charge ain't all it's cracked up to be. Here's a few things I had to deal with recently during my time in charge.

Playground politics

Patient needs help, doesn't get it, so he makes a mess. Other patients give him trouble about it. Muttering and rolling around follow up and down the hall.

One nurse solves problem: give patient his own little trash can. No more stuff on floor, and no more complaints from other kiddies.

Common sense...it's amazing! Now if the rest of the staff will pay attention...

Signs of a patient who needs to go home
Patient decides to keep wheelchair, walker (which he can't use anymore) and other wheelchair in his room. Problem: he has two other roommates and we don't allow wheelchairs in rooms overnight due to safety hazards (mainly for staff). Patient throws fit when I try to take the last wheelchair out of room, and he barricades it in a corner so far that I would have to rearrange furniture to get it out, turning on all the lights and possibly calling security.

Decision: bounce ball back to nurse manager...make her decide. The night crew did not need anymore excitement,  thankyouverymuch!


Yes, I miss you too
Patient X (who was recently admitted), "I thought you didn't work here anymore?"
Me: "No still work here, you just saw me on the SU, when you went to the clinic."
Patient X: "Oh, that's why you were there."
Me: "Yep. Any questions?"

Stay tuned...

Can you tell it's Monday?

One wrong push of the button and that comment you meant to approve goes up in smoke....ugh!

Hope the rest of my day is not like this!

Stay tuned...

There is a light...

At the end of every tunnel, if you really look hard. Sometimes, you have to dig through a lot of dirt and excrement to get to it, but you get there.

I had a really crazy last few days. I realize that some of the people I work with really don't work as a team if certain people aren't there to influence them to do so. It really pisses me off, but I can't do anything about it.

So what do you do? You find the people who'll work with you, and you work with them. You help them and they help you. And if you need the other ones, you have to put on the RN hat and delegate. I don't like pushing people, but I'm getting sick of this crap. If they only knew that I don't ask them for help because I get really perturbed about their followup comments, "Oh, she's not very efficient," "Oh, she does it different than I do, " or my favorite, "Why does she talk to the patient before we turn them?"

One of my patients, who is a lot sharper than he looks told me last night, "I noticed a lot of people make you do stuff on their schedule, and if you don't they get mad." Surprise, surprise. I have found that if I give people options and tell them I have to do other things, too, 95% of them will make a choice when given two options. That other 5% is another story, but even they can often be convinced to cooperate.

A lot of people think therapeutic communication is hooey, but I look at it more as negotiation. Some people we work with need control, because so much of their lives are out of control. This establishes some for them, and saves me some time in the process. It may not be old school "my way or the highway", but they can't say I didn't give them a chance.

My day, although I missed a little sleep, has been delightful. Dahey and Bubba took me to brunch and gave me lovely little presents...just what I wanted! We went out to eat and let someone else cook and do dishes. I came home, did a little shopping and now I'm getting ready for day 4 of 5. I'll deal with it as I go.

My light is the fact that after this week, I won't be at work much for the rest of the month, due to vacation days and conferences. When I looked at the new schedule with this on it, my heart leapt for joy.

Plenty of days to recharge ahead...and lots of light at the end of the tunnel.

Happy Mother's Day to all of you out there, wherever you are, wherever your momma is, here or gone. Mom's responsible for this missive today! :-)

How to know the moon is full

Listen up, all you nursing students, although you may have thought meteorology has nothing to do with nursing outside of being listed before it in the class schedule, the full moon can make a difference on your unit.

In my short time as a student and so far as a nurse, I've heard from psych to labor and delivery to LTC nurses that the change in the phases of the moon brings out the strange and unusual more than you'd think.

Well, since yesterday was the full moon, here's a few of the fun things that happened at Madison.

1. The crazy people get crazier. Yes, lil' ol' Mr. K. keeps forgetting he's a quad, even when he's reoriented, and in between, he even acts lucid. Last night's installment: he kept wanting to put on his pants and get up, so he kept ringing his call light. Not even the two Pepsis (he loves Pepsi so much they could use him in ads) I brought in as a bribe kept him quiet.

I'm starting to like the idea of aerosolized Haldol for not just patients, but some of my coworkers.

2. Your coworkers get edgy. When I asked about Mr. K. and his light buzzing, I remarked, "Wow, has he been quiet all night?" since Mr. K. did not buzz once while I was sitting at the nurses' station (which was not long). The Slug, true to her pain in the backside self replied, "You've been smoking crack."

Nevertheless, I blew her off, since I spent most of my night actually on the floor with patients, while she sat by the phone and played secretary in between her med passes. It's actually better for her to sit by the phone because whenever you work with her, because you'll get about 20-25 calls a night and 99% will be for her. It's just a whole lot easier not being at the desk so you don't have to be her secretary.

3. The normally quiet people decide they need something...now! Mr. H. decided to do this last night before the end of shift. I guess he got tired of me going into his room and always giving his roomies their PRN pain meds. I've delivered meds on his hall for a while and this was the first time I've ever given him a pain med.

One of his roommates is a basket case. He's taking every psych drug, pain pill, and sleeping pill we'll give him. That's what happens when you can't deal with the life you've created on the outside. The roomie is having problems with his wife and infidelity again. The story gets better and better--he was with the other woman when he was injured and she is having his baby. Other Woman decided to let the wife know once he was injured. Said wife was really perturbed when he visited Labor Day weekend.

With real-life stories like this, who needs to watch a soap?

4. Although it's not related to the full moon here in our neck of the woods, the weather's been crazy. Ike's remnants flew through the midwestern US and left us with a whole bunch of water. Lots of low-lying areas around here that don't normally flood filled up really fast. We had fun taking not one but two detours to get to a family reunion yesterday. After the second one, I told Dahey to just go back home and take the route closest to our house, since that doesn't normally flood and it worked out well. I just wish we could have stayed longer at the reunion. It stunk having to leave and go to work.

One more evening, then back to days. Stay tuned for all the excitement.