Another aftereffect of the Polar Vortex?

I hope not. I already have a longstanding dislike of the pollen in springtime.

Polar vortex = pollen vortex

One word (or interjection): UGH! (scratching eyes as nose runs...)

More to come...

How many more days?

Yes, it's only Thursday, but as one patient relative said to me yesterday, "The days are all running together." Yes, that happens a lot at the Hotel.

So is it flow, as this theory says it is? 

Not sure, so, c'mon Friday!

What a difference

Yes, a day does make a difference. I did not feel as if I was running around like a chicken with my head cut off.  Same patients (minus the admit), but more quiet and getting things done. I felt as if I accomplished something.

There always is something lacking in communication, though. One of my patients was crabby, because I took his wheelchair from his favorite spot and moved it. This was for a number of safety reasons, but he was pouting  all day, according to our NP. I did a couple of treatments and he slept most of the day.

My other patient is a rehab nurse's worst nightmare or trainwreck. Imagine a non-compliant diabetic who has survived major, major surgery (and has the scars to prove it), a G-tube among other tubes, and is just plain flighty. One minute, he/she can't get up, then family comes, poof! All's well. We push him/her to do therapy and sometimes it works, sometimes not. If we were a CMS supported rehab, he/she'd have been out on the streets long ago. 

At the end of the day, I went to a meeting. I was horribly unprepared because the nurse who actually attends our regularly scheduled department meeting just forgot to tell me about it. I was supposed to report nursing's views on a patient I've seen, but barely know. Guess I'll be busy learning about him/her for the next meeting!

Now, Bubba has enlisted me to hang the hummingbird feeder. We'll see how that goes...more to come.

I need track shoes

On some days this is true and recent shift was one of those days. My two patients were slow, so I read up a little on them, got things going, then my admission (one of several, so all RNs got one) shows up almost 2 hours early.

It was just run, run, run after that. One catheter works, one doesn't. Had to call in the catheter cavalry (our resource nurse) to get the  last one in. Not sure how the patient's home health nurse got a non-Coude in him, but I went with the resource nurse's suggestion of a Coude. Happily, we had one in his size. Much joy!

At least, I wasn't ordered to get urine drug screens on a few of our folks, like some of my coworkers. Apparently, the weather was so nice this weekend, a few patients found some interesting "herbs" in the nearby forest area. The doc on call was suspicious yesterday and he/she decided to make it a fun Monday by requesting the drug tests.

I also got a couple of other tasks since one of the nurses went home early, but got them done and out the door I went. It was just stupid.

Bubba decided not to go to baseball practice this afternoon. With the beginning of spring, we are now getting into the beginning of allergy season here in RehabLand.

More later...stay tuned!

Stiff and sore

I'm gonna pay for that little running episode today....stiff and sore, and hotel beds don't help, either.

Off I go...more later.

Get out the running shoes...

Run to this required class, run to the door, 'cause with the holidays coming, they'll be lots of running in the Hotel Rehab. The weather's nice, so everyone wants to get out.

I'm so glad I can recuperate this weekend! Stay tuned!

How fast can you run?

To get two patients, up and out of their rooms, to therapy, and get their stuff moved so Bob, your favorite housekeeper, can get the waxing crew, in and out?

Never fast enough...arrgh!

At least, they'll have a bright, shiny floor today. Thanks Bob!

Wild and wonderful

That's been my story at work lately. The transition from one shift to another sometimes can be wild.

One day, I walk in, get going and the gates of Hades open all at once. Nurse Assistant has a patient who's got shortness of breath and "looks funny". Well, he's not acting funny, but probably is a little shaky from the albuterol he just took. Get him situated, tell docs, do vitals, get more albuterol. In a few minutes, patient looks happy as a clam and is chatting away as the nurse assistant gets him ready.

Another day, the specialists round. They like me. Not only do I get to deal with my patients, I have to help them with paperwork on a couple of others, because I know how to work the computers for that feature, even though, all I do is act as a witness. Gee, I feel so special! Thankfully, boss and company only follow these people around once a week. Other nurses thank their lucky stars that they don't get "picked". I've known the specialist for a while before I came to Madison. He can be loud and obnoxious, but underneath, he's a softie. He just doesn't want any of the nurses to know that.

Doc Specialist is also a running doc. It seems like the specialists drift to one of two categories--they either golf or they run. Our leader is the exception. He's too brainy to do either; although, if I had to guess, he'd probably fall in a lot easier with the runners rather than the golfers.

So after all the wild and crazy antics, I get a phone call. Miraculously, I got a scholarship for grad school. They confirmed I was there to send the fax to me. I looked it over and saw it was for the entire amount of the program. You could have knocked me over with a feather. I'll have some other restrictions and requirements as a result, but my financial burden will be lessened. I was so relieved. I don't have to keep doing number-crunching to figure out how many extra shifts I need to pick up to pay for each semester. Now, I just have to concentrate on getting my work done and my schoolwork done...just like Bubba, who starts school soon. Should be fun getting into school routine after some time away from it.

More to come...stay tuned.

The story of my day

I have always liked words. The dictionary was my friend as a kid. I always liked to look up obscure words so I could use them in my spelling sentences....when I had to do them (I got out of this homework frequently through some other endeavors...)

As I finally got a minute last shift to start documenting, I thought about what was really happening and a couple of words came to mind.

While I ran myself hither and yon the first four hours, I really wasn't idle (my first word), but I'd suspect some of the chitchat here and there was. As I'm running around, I don't mind speed chatting or bantering with the patients as I hang all of my patients IVs for the shift. My night--come in, run an IV, stop, flush, run another IV of Vancomycin, stop, flush, hold and run another IV, and so on, like a bad TV commercial. I can't get too in-depth.

Unfortunately, sometimes oncoming report is a little too idle. We have some nurses who will give you the new orders list (we write one as we take things off) and your report the same way every time and it's complete. A couple of our people are new and they still haven't learned how to give report, so they tend to engage in idle chatter and miss the big stuff. Like the blood cultures ordered three hours before end-of-shift that have to be done today or the 102 temp that the patient getting blood just spiked near the end of his transfusion, or the report on the patient who returned from acute. It wasn't a big deal for anyone else, but it was for me, since I was his nurse.

Eventually, the last four hours drifted into the idyll category. Our neighborhood isn't exactly pastoral, but sometimes, it is pretty, just before dark, and this night, it was exceptional. The sky was a pinkish-red that glowed as the sun set. I only noticed it because I had a minute to look out the window when I called my husband. It made me think of that old saying, "Red at night, sailor's delight." My patients, including the returning one, were quiet and happy. They got all their nightly pills and drifted off to sleep. The only thing that broke the idyll was a fever in another patient, which required an all-hands fire drill to get all the labs pulled before the oncoming shift came.

So we left our coworkers with an idle, idyllic moment of their own, with sleeping patients, as we walked out the door into the cool of midnight.

More later...

Sleepy Sunday

Try as I might, I just couldn't go back to sleep this morning. It probably has to do with waking up once and the old sleep button just does not re-engage for me....arrgh!

Last night was busy. I had three patients, two of whom were the same as the night before and two of the three were out on pass at dinnertime, which was nice. I also inherited the med wagon up in the front from J. when she left her 12 hour shift at 2000.

It's only one med run (around 2200) so what should be so hard? The answer: a whole lot of needy patients. If it wasn't one thing, it was another. People would not ask for stuff in advance, they all waited until I got to the room. I doubled back and got everything filled reasonably quickly, but I was still pushing pills at 2355, which really sucks. I just figured I get stuff done before the night shift came on to do their turns.

M. the charge was off last night and P. took over. That team has the neediest patient on the floor--Mr. B. He rang the light over and over and over. Poor P. was never out of the room for more than 5 minutes and the light would go on. Mr. B. is typical of many post-ICU patients: he thinks we only have 1-2 patients and are waiting outside his room for him to call. No dice. Most of the time, we have people assigned to us all over the place on the unit and we are trying to get them turned, bowel routines done, fluffed and buffed and ready for bed all at the same time. Hopefully, he'll get a little more relaxed, but so far, it's not happening. We shall see...

My people were pretty good for the most part and I got everything done by midnight. It was pushing it, though. I'm going to work with a few other things tonight, so hopefully, things will go more smoothly.

More later...

Crazy, crazy day

I ran and ran again today, but at least, things were a little calmer than yesterday. Some people remembered that I helped them out a lot, so they helped me on a couple of things. It was nice. We had two call-ins, so the boss called one of our night people who was off and she came in pronto. I was happy because she took one of my assigned people, so I only had two patients and the med cart.

The Slug was in and she was slacking away as usual. She had to do one admission, but after that, when the boss left for his meeting, she took her 2 hour lunch while the rest of us scrambled to set up and/or feed our people who needed it. She does not get it that the time you take to run to X sandwich shop on your lunch hour is part of your lunch hour (which isn't really an hour--it's just 30 minutes).

Nope, she takes that time (anywhere from 15-30 minutes) and doesn't count it when she comes back and sits on her derriere. She started eating at 1215, and I ate my sandwich, and she didn't leave the lunch room until 1345. This did not include the time it took her to go get her lunch. This was just the time I observed. Management looks the other way.

Besides that, I just pray I work a shift that she doesn't because I get tired of these antics and all the "emergency" calls she gets. One of her callers actually sounded indignant today because I told him she was at lunch. "Well can't you just go get her?" "Well, no. I'm busy taking care of patients." I told him. (I was getting ready to give some meds and the secretary was at lunch. No one else was in sight.) I put the idiot on hold and I overhead paged her, even though I knew exactly where she was. I figured she needed the exercise to walk over to the phone, and I could go do something else.

I had my same two patients as yesterday. Mr. S. needed a new Foley (a special one at that--16 FR with 30cc balloon Coude) and I put it in as soon as it arrived on the unit. We change indwelling catheters once a month and then, per policy, we send a UA and C&S to the lab when we're done.

Mr. S. was supposed to get a loaner wheelchair so he could get up, but the PT couldn't get his configured right away because she was too busy. Mr. S. was very understanding, though. His neighbor, Mr. HIJ #1, who recently moved to this room since he got a special bed, was as demanding as ever, but I kept him relatively quiet. He wanted me to get him a soda, but he got distracted doing some crafts, so he didn't even worry about it.

I ran back and forth giving the meds on the last run, which at 1600 really isn't too bad. People were streaming in and out of the latest group meeting in our main gathering area, so I had to chase some of them. I got everything straightened up and passed on to C., who was taking my med cart. I got out of there as fast as my legs could carry me without running. P and I walked out the door as a camera crew was coming in to film a story. P. told me, "Stay here long enough and you'll be on TV, too! I've been on one show already. With those powder puffs, I felt like Oprah!"

Even though, it was gray and cloudy, it was good to escape. Off tomorrow and back to evenings on Thursday...stay tuned.

Every good turn deserves another

I have had a wonderful three days at work, even though I feel like all I've done is run. I was taking care of the meds on one hall and I took care of two guys at the other end of the hall. I hadn't taken care of those guys in a while, and it was really fun.

There's been a few posts I've seen regarding Phil Baumann's Eight Ways to Become a Better Nurse.

Here are my own ways (I also posted them in his comments)

1. Improve one thing you do every day. There may be a lot of things you need to do, but work on it by choosing one thing every day.

2. Leave work at work. Unload before you leave the door. Your family will appreciate it.

3. Find outlets for creativity in your work.

4. Make patients smile.

5. Be kind, especially to those in need, whether they're your patients, someone else's patients or your coworkers.

6. Take care of yourself.

7. Keep your eyes on the horizon. Look out for trouble that may be coming.

8. Say please and thank you to everyone...and mean it.

I'm off this weekend, so I'll be working on all sorts of stuff, here, there and everywhere. Stay tuned!