Nurses just do it

WiseOldRN stopped by my office today. Actually, he/she is on a schedule and comes by regularly. WORN has worked in an administrative job for over 15 years, but WORN is a proud diploma nurse licensed for many years, who could work "any service on any shift, leave and come back for more".

We have chats regularly and this week's was a doozy. WORN goes all over our hospital system so he/she has some tales. While I'm sure some are peppered with hyperbole, I know some of the characters involved so I'm aware that there is truth.

WORN started ranting when I brought up training. As a diploma nurse, WORN regularly went all over the hospital and worked everywhere. His/her last assignment (as a nurse) was in risk management and quality, but as WORN noted, the only place he/she didn't regularly work was case management. WORN figured being a registered nurse made him/her a case manager every day.

When nurses feel they don't have the skills, I remind them what the overall goal of the day is: managing their assignment. This can vary on the status of the patient, but in our world, bowel, bladder and skin are very important. When we forget about the little things: helping someone with a 4-5 day old beard shave (like I did on my lunch hour while visiting our satellite unit while his nurses charted) and comb his hair, it reminds us all that we are taking care of people, not just completing a task list.

Sure, we have plenty of tasks, but when we can't put care at the top of our task list, are we slowly but surely degrading the importance of having an RN care for each patient?

As WORN says, nurses just do it, if the patient needs it. We don't wait for a million other things, like policies, procedures, or unlicensed personnel.

We see what's in front of us, and do the work. We use that nursing process AND we care.

That's all for now. Gotta leave and take care of my patients. Hope you have a great day with yours, wherever you are.

Nurses unite

It's kind of funny when you think about it. About three million of the nation's most trusted profession labor in relative obscurity day in and day out.

All of a sudden a bunch of ladies on morning talk show get catty about the Miss America pageant. They diss a nurse AND boom! Social media mayhem!

It probably wasn't a good idea. You know, pissing off the people who wipe your backside when you're ill and can't, who make sure you don't lie in that excrement and get contact dermatitis, or worse, a pressure ulcer (since if you can't clean yourself up, you may not move either) is not a good thing.

So in light of some of the nurses who proclaimed nursing as their talents, here's mine (minus the video).

You know, I've been you. I've been on the outside. I've wondered, "How in the heck can someone say nursing is a talent?" Nursing requires a lot of skill. You have to know what you are doing to keep people alive, perform procedures and to document a lot of stuff, so your hospital gets paid.

But alas, after more than a decade living in the "real world" a couple of nurses said, "You know, you ought to think about being a nurse." And after having a kid, going to business school and working in the business world, I thought, "Why not?" So I went to nursing school and learned skills and went out, got a license and started on my way. And by the way, nursing school was a LOT harder than business school!

However, on the floors and in the rehab centers, you find out skills will only take you so far. Anyone can get skills. You have to put it all together and hustle and some days, when all the planets align, the supplies are there, everyone is on time to therapy, you high five and patients are happy. And other days, no one wants to get up, important stuff is missing, patients crash, you are exhausted and you cry.

Handling it all with grace, compassion and all those skills really is a talent. Because we're not taking care of a balance sheet, we're taking care of people.

So yes, after almost a decade as a nurse, I'm ready to say, nursing really is my talent, too.

Kelley Johnson: I'm with you--stethoscope, scrubs and all. No matter what our costume may be, providing excellent, clinically competent care as a caring nurse is a part of the ensemble that's never out of style.

The latest in the news

This is the etiquette edition (aka don't do this). Enjoy!

They've got it right...and funny
Top 10 things not to say to someone in a wheelchair is a great article from the good folks at the Shepherd Center in Atlanta.

Not exactly a funeral in a stadium, but...
Don't take selfies at a funeral is the point of this Mashable post.

Don't emit noxious fumes
In the ongoing saga, Huy Fong Foods, manufacturers of the famous "Rooster" sriracha sauce have halted shipments.

Not necessarily a no-no anymore...
In the old days, no one in their right mind would bring their dog to the hospital. This AJN article talks about how your pet can help you just by visiting.

For that one patient...

Who claims to have met lots of famous people. This story reminded me of you.

I know you'd deny it, but it would have been fun to share. Nevertheless...I digress.

More to come. Stay tuned.

Stop dumping

Dear Local Hospitals:

There haven't been any good stories in the news lately, but we know this practice still exists.

Many hospitals still practice dumping. Not hazardous waste, but people. Inconvenient people. People who are homeless.

So Little RiverTown Merciless Medical Center, cut it out. Stop discharging people you know are homeless.

Recently, one of your discharged folks came to the Hotel and is really a mess. Said patient should have been discharged to an agency program that can help him/her.

You did a great disservice. If my coworker has some phone numbers on that patient's discharge form, I'll be copying it and sending it along to OIG.

Because you should have known better. He/she has options.

Sincerely not,

RehabRN

================================

P.S. I found this info below when I did a Google search and I'm not even an LCSW.

Get your act together and make the calls you need before you discharge people to the community.

National Call Center for Homeless Veterans
http://www1.va.gov/HOMELESS/NationalCallCenter.asp
Phone: 1-877-4AID VET (877-424-3838)
VA has founded a National Call Center for Homeless Veterans to ensure that Veterans or Veterans at-risk for homelessness have free, 24/7 access to trained counselors. The hotline is intended to assist homelss Veterans and their families, VA Medical Centers, federal, state, and local partners, community agencies, service providers and others in the community.

Enjoying my time off...sort of

It's like my baby. I've managed this project from the beginning when Boss told me I was going to take it.

Now we're set up and ready to see our first patients.

I am nervous. The first encounters have to go on without me, since I'm going to take one of the biggest tests of my life that day.

I've trained my people, but I won't be there to support them. I have phone numbers, backup numbers, and more numbers. The tech guys will be on standby and my newbie is fully trained.

I'll be doing a lot of praying this weekend, and not just because of the Easter weekend.

Stay tuned...

Comings and goings

Sit still long enough on our unit and talk to a few people and you'll find out a lot of things in a short amount of time.

One of our long-time nurses is heading to one of Washington's outpatient clinics. He/she finally decided to go back to work full-time, after a long time part-time. The economy sure changes things, as well as our big boss.

Another nurse and his family will be packing up the homestead this summer to head on out to a new location out of state. The unit is sad he's going, but he and family are excited.

And suddenly, one of the newer nurses will have a position on our unit, since we have comings and goings.

It all falls into place sooner or later.

The boss told me yesterday to enjoy the holidays this year, so since I'm in the SU, I'll be able to take vacation days whenever the staff there is off. I have my Christmas present already and the vacation requests are in the system.

'Cause next year, if I'm still in the Hotel, I'll be working the entire holiday season. Gonna enjoy what I have now!

Stay tuned...more later.

Back in the saddle again...

So glad my favorite charge nurse is coming back. I had more than my share of excitement recently after I ran off the plane to get to work.

First, I had to deal with the family from Hell. Entitlement Trio (ET for short...which is quite a generous moniker) played the ugly American tourists at home. After standing around at the airport awaiting the shuttle to my car, I secretly wished these people would have been kidnapped by narcoterrorists. It's couldn't have happened to nicer people. These people even lived near the Hotel where I work, which also irritated me, as most of my neighbors have been socialized to be more polite.

The ET bumped into people with their enormous amount of luggage, and they proceeded to bitch at every single shuttle driver who came by because they wanted their shuttle right now. One shuttle driver actually called the office to get not one but two shuttles to come to pick up the mass of humanity now at our terminal door waiting.

Of course, after their whining display, ET boarded the shuttle first and ET daughter proceeded to check her e-mail. Mother and daughter b*&tched the entire way to the next terminal, where the driver had to stop to see if he had any other pickups. Father was absolutely silent. Daughter was loud and obnoxious in her comments when he did stop which irritated me even more. The man was just doing his job.

Once we arrived at the parking lot, ET wanted to be dropped off first and as luck would have it, they were in the closest row. Driver pulled right up to their car and they jumped off without even a thank you or even a tip for helping them get their bags off the van.

Finally, the driver got the rest of us off the van (we were all parked within two rows of each other). I was the last one off. I thanked the driver, an elderly gentleman, for being so nice to everyone, especially the ET group. I also gave him a good tip, since no one else bothered. I love leaving, but wish that some people would be grateful to come back once in a while.


After flying down the highway, and avoiding the usual speed traps, I was early and I went home and kissed Dahey and Bubba and scratched WildDog behind the ears.  I gave Bubba his souvenirs, which he paraded around the house (a t-shirt, a hat and a special commemorative medallion). I got dressed, made coffee and headed to work.

Stay tuned!

A different atmosphere

One of the nurses I work with mentioned it is a different environment when certain people we work with don't come to work. She is absolutely correct.

Imagine my world for a moment. NOTE: this illustration below has several grains of truth and will be distorted enough to protect both the innocent and the guilty.

First, we have the "lunch ladies". These nurses remind you of the lunch ladies from grade school. They often wear matching uniforms and if they had them, they'd have those hairnets on, too. They're perfectionists and they like to run various aspects of the shift a certain way (as if they were still in their kitchens) and you'd better like it, or feel their wrath. The wrath, you ask? Why they whisper a lot, which irritates the charge nurse. They bugged me at first, because I really got tired of their furtive glances, then the whisper, whisper that goes on at the other end of the report area, but I got used to it. Later, they may tell me who they're whispering about, and I ask them to talk to that person. Sometimes it works, sometimes it doesn't.

Next, we have the GI Joes. GI Joe #1 takes care of his patients, does his stuff and is exemplary. He wants a long career and is working to become an RN one day, one class at a time.

GI Joe #2 has been around forever, most likely has untreated PTSD and another psych disorder or two, and can be both a good worker and an absolute nightmare. This changes from moment to moment, depending on who took the last cup of coffee from the nurses' station pot, to whether his favorite sports team is winning, to whether Mr. X. just rang his call light and asked him for ice. Sometimes this merry-go-round is exhausting. We always hope he takes the meds he has before coming to work.

Finally, we have the slacker brigade. Often, they have slacking competitions to see who can do less work. The Slug leads the brigade. He/she makes an effort to get as many phone calls as possible on a shift, start jobs that he/she doesn't finish (it's easier that way), and takes long lunch breaks. Since he/she's getting all those phone calls, he/she's always on the unit, but don't expect much. A phone call or Facebook game could be missed while some actual work gets done.

A couple of our newer nurses have also joined the slacker brigade. Their mission: stay in close contact with latest boyfriend of the moment by escaping from the unit to see boyfriend(s) on the parking lot, in full view of many of their patients, staff and visitors, or just sit in a very far off location and take phone calls, send text messages and update your status on Facebook out of paging distance. One has even made boundary crossing his/her favorite sport, by cruising through certain patients' rooms and asking them to get him/her snacks/treats/crafts whenever he/she can.

For me....I try to stay invisible. If I'm invisible, I'm less of a target. Some days are more on target than others. I'm still learning to cope with them. I like taking care of my patients and when I take care of them, they don't call me as much. When they do, I take care of their issues right away.

Finally, I always follow my mentor G's advice: start the shift by saying to yourself, "This is going to be a good day/evening/night." If you say it enough, believe it, and go out and act like it will, it will. Even if it turns into the night from Hell, keep reminding yourself. It can make things better for you and your coworkers.  If all else fails, remember, this shift too, will pass and let it go once you are gone.


 

Survival skills: conference edition

What to know at most conferences:

1. Bring a sweater. Those rooms are freezing.
2. Get used to getting close to people. Those rooms are freezing, 'cause they'll pack you in like sardines. I choose the seat near the door, myself.
3. Watch your schedule and move appropriately. Otherwise, you won't get a seat.
4. Keep your eyes open. You never know when you'll run into people you know...or would like to meet. There are famous characters all over the place. The one MD famous for a standard test we do was in a session I was in recently. Very nice fellow, too.
5. And when you see them, and they have time, ask questions. You are here to learn something.
6. Have  fun. Learning doesn't have to be all studying, sitting and getting hit by rulers (no rulers here!)

More to come...off I go again.