Why executives should proofread e-mails to staff

Dear Chief Executive:

Thanks again for taking time out of your busy day to send us a weekly update. I like that your updates aren't just boring old hospital numbers on admissions and outpatient visits, but include real stories.

I have to say, though, that your recent missive was one that will go down on the books as probably the most entertaining one we've had around here in years.

No, there were no inappropriate funny photos or jokes that could offend someone. There was just an inappropriate acronym (yes, I know we love them at the Hotel as much as anyone). Please remember: if we have an Iraq War veteran patient, most likely he has suffered as a result of an IED attack, not an AED attack.

We use those occasionally when our smokers fall out in the middle of the cafeteria (as you mentioned last week.)

Consider this your education session for this week. We just want you (and everyone else here at Madison) to feel safe when they see an AED in the hallway by the water fountain or near the ATM.

Sincerely (really!) yours,

RehabRN

TGIF (for so many reasons)

Yes, I'm thankful it's Friday because I don't have to work on Monday. Happy long weekend to all of you fortunate enough to be able to celebrate our country's presidents Monday.

I have been doing research for another conference abstract (the story of my life lately) so I've managed to find some interesting articles, including this one on writing a good one. Some of these are even appropriate for the abstracts.  Here are a few of the ones I found below.

While I'm not looking for a job right now, I try to keep my reference list up to date. This article talks about how to ask references the right questions to get good information on candidates. While I don't actually check the references, I have interviewed people. One of the folks I interviewed provided us a list of references to check. Surprisingly, the candidate's name and phone number was on his/her list. It gave me a chuckle, as the other interviewers didn't immediately pick up on this. This got said applicant in my "Interesting Interviews Hall of Fame".

The end of this week was sad, though. One of the national folks for our program died suddenly this past weekend just as he was getting ready to watch the Super Bowl. His team won, so despite everything, there were a few smiles knowing that. He was not old and it was not expected.

We found out that one of our coworkers has a family member with cancer. What makes it worse is that it's a child. Being new at the Hotel is crazy enough, then to have your family member have cancer is just awful.

These moments remind us all to be grateful for health. It's never guaranteed.

Until next time...

Hope turns to sadness

This patient's journey to us for rehab was long and arduous. One day you're minding your own business and start having these unusual pains. They find out you have this terrible condition.

The doctors save your life, but it was rough. You seem to be getting better when all Hades breaks loose. You go back to the OR, get almost triple digits of PRBCs, and abdominal washout and have all sorts of complications. You lose so many things. But you are here with us, so you are hopeful.

You come to us, are barely here a week, and we have to send you to World Renown, because we aren't staffed (in surgery or anywhere else) to resolve your latest issue. Unfortunately, we have seen this scenario before. You have a problem even World Renown can't fix. They send you back.

They leave us to tell you the bad news. You cry and yell. But to me and the other nurses, you are nice. You're not sure of what's going to happen, but I tell you, that no matter what I'm here with the staff for you to help give you some control in your room; to help you do what you need to do.

It is bittersweet. I have seen this before, and while the characters change, the stories all end the same. I just hope we can make some good memories before the clock runs out.

Stay tuned.

Hearing noises?

After reading this, you may realize that it's really nothing...or not.

I hate bugs, but bugs in body cavities...ugh! We've seen our share of maggots at the Hotel (some hospital grade, some homegrown).

I'll pass, thank you very much!

Things not to do, part 77

It really seems like it. It's so very easy to find things folks should not do.

1. Don't wear jewelry to CPR class.
Especially, if it is a long necklace and is going to get tangled up in the AED simulator. Shock anyone?

2. Diss the nurses.
Not my patient, but even my doctor relatives know this is not a good thing.

3. Stick a q-tip up your nose.
Because it really, really is a bad thing if you break off the long wooden stick, and the rest of it stays in your nose. We will have to send you for an extraction.

Stay tuned!

I wish it weren't true

I saw these news stories and unfortunately, we can identify with them in the Hotel.
Unfilled vacancies take a toll (from FierceHealthcare)

And if that's not enough, we may not hire some folks. We need to keep people, so here are some ideas (hint, hint to Manglement!)

That is my $0.02.

Stay tuned!

Heard on the unit...

I love M and Em, two of our RNs who work weekends. They both have a hilarious sense of humor. M works AM 12 hour shifts and Em works the PM ones. M came from a gero unit, and Em came to the Hotel from a cardiac ICU at an academic medical center where they do groundbreaking stuff, including chilling folks after heart attacks.

So this is a story M told me about what happened recently when she answered a call light for Mr. X., one of our regulars.

M: Good morning can I help you your call light is on?
Patient X: Yeah how the hell do I check out of this swanky hotel!!
M: As soon as you are able to walk out of here. (Patient is paralyzed and has been for many years)
Patient X: Hell, if I could have done that I would have stiffed this bill long ago.

Yes, just another day at the Hotel. Sometimes, I miss working the weekends, but not always.

Stay tuned!

Legends are lessons

Bubba, Dahey and I had a lot of fun watching Brave recently. We decided that sometimes, when the weather is just not good for going out, staying in is a better option.

As a kid, I always liked hearing stories, so this movie, centered around a legend, was pretty interesting.

With a warm home, snacks and a good movie, it was a lot of fun for all of us.

Stay tuned...

Baseball on the brain

Yes, it's not a nursing topic, but in these parts of RehabLand, you know when people have had enough of winter, because they start talking about spring training. It's on television, it's in the newspaper, it's the stuff of discussion on the unit amongst the locals. (The non-locals are all about football and basketball right now...)And even more so since two old ball players got their heavenly rewards this week: Stan Musial and Earl Weaver.

A few of our old timers talked about their memories: radio stories, pros buying an enlisted guy a drink on his birthday, harmonicas, confetti, and screaming matches. One old character told us about his friends from the Negro Leagues. This guy actually showed up to tell the story about how he always was the target of fights since he liked throwing pitches "high and tight".

Nothing like thoughts of spring to help ward off this winter chill. More later...

Turning the tables...

Usually, I have lots of stories, so I decided to turn the tables and tell you all about some of the stories I've heard on the unit from people passing through the Hotel.

I don't check for veracity, but I do enjoy a good story, true or not. And no, I'm not going to tell you about the stuff they tell us to get drugs. (The ER nurses like my classmate Q. get a new one of those every day.)

Police stories:

Dim bulb

In some professions, people developed a heightened sense of awareness of things. Police officers are trained to be highly alert, but some of the scenarios Good Cop (he called himself that when he roomed with another former cop--Bad Cop) told me about were just crazy.

GC was out on patrol one night and noticed a guy had his license plate light out (an infraction that would win a ticket in his town). Once GC got to the window and took the guy's license he said, "I didn't do it."

GC said something about the way he said that wasn't right. He asked again, and the guy says the same thing and "I didn't rob that liquor store."

GC asks Mr. Chatty to step out of the car. GC proceeds to cuff and stuff him. Before he knew it, the call came out on the radio about the robbery. GC calls his coworker back and asks him if he wants him to bring Mr. Chatty back by the liquor store (about 4 blocks away). Coworker says "come on over." Meanwhile, Mr. Chatty keeps talking...

Mr. Chatty is identified as the perpetrator by the store owner, and off he went to the police station and booking.

Get it straight

GC pulls over a man for speeding. Mr. Lam is apologetic and GC says, "I almost let him go. Just seemed like a really nice guy."

But Mr. Lam was not a nice guy. He was a fugitive wanted on federal warrants for murder. The warrants were 16 years old.

So how did GC figure out Mr. Lam wasn't who he said  he was? Well, if you give a bogus drivers' license to a police officer, make sure you sign the same name that's on the drivers' license you give to the officer. If you sign your real name (not your alias), someone, like GC, might figure you out.

Demotivating employees

Ah, spring is in the air (for the moment) here in RehabLand, and the hospital administrators (aka PHBs) have emerged from their coccoons, er lounge chairs, to start rabble rousing the troops and demotivating away.

How can they do that you say? Well, here are some stories (I wish they weren't true) on how they do this.

NOTE: the names of all parties and sexes, etc., have been centrifuged to protect the guilty and the innocent, since I don't want the HIPAA police to come carry me away.

1. Medical personnel are allowed $xxxx per year for continuing education. (Not nurses, though). But, good luck, Ms. Overworked MD trying to use yours. You're not properly certified yet, so your slug compatriot MD gets your share. Call HR and file a complaint.

2. Allied health person gets invited to a national conference to speak. Your boss, who's been at the place forever, fills out all your appropriate paperwork. In the meantime, you sign up to present and pay your conference fee, hotel and airfare.

You get an e-mail that you've been disapproved, but when your boss tries to appeal to the higher-ups, he doesn't get the dignity of a response. Nice. So much for having seniority. You can't even take off unless someone with more seniority lets you have the time. Go file an EEOC complaint.

And my personal favorite...

3.  Become an advance practice nurse, get certified, speak at a national conference, and then submit your request for one lousy conference (subsidized by a private foundation) because you need more education to take care of new patients we have on the unit. All you want to get are your days off as official absence.

Get rejected because the "man with the plan" says we "can't afford to give you days off to learn" at the premier (and also free, since you got it paid for) conference in the world.

Reminds me of this Dilbert scenario...stay tuned for more to come!

PHB: You may have heard that our company has been accused of unethical business practices.
Alice: Is it the falsified product safety reports?
Wally: Is it the false stories planted in the media about our competitors?
Dilbert: Is it the crime family connections?
PHB: What?! Are you saying those are considered unethical too?!? Good God, this thing is just snowballing!

I remember

We lost a local hero recently. He was from my old neighborhood, and my family knew his family.

He was a Navy man in Korea. "Cold, cold." was all he would say about it. But beneath the wavy dark locks turned white was a smile that lit up the room. He was a hero on the seas of war, and on the sports fields.

Eventually, this government employee turned sports coach led NCAA championship teams, not once, not twice, but for years. He became a legend at my alma mater, PrivateU. Legions of kids in town went to his sports camps to learn from the youngest man who played on a legendary team that brought down an international power house in one of the biggest upsets ever.

But to me, he was a neighbor, a friend, a man who told a good story about what our town was like in the old days, when ethnic groups stayed close together for support. How the community went wherever they needed to help each other. Because Mom said, "I want you to always be a good person."

After I heard the news, I went online and I watched the interview I recorded for the local historical society and smiled.

His stories live on in a web site dedicated to the area, for a man who was a hero, father, family man, neighbor, coach, and friend.

Godspeed Tom....and may you get all the goals in Heaven, before the clock runs out.

The saga continues

Kim's keeping the Amanda Trujillo story out front on emergiblog.

So while I'm not writing a bunch, it's not because I don't care. I do. I know but for a slight change of circumstances that could be me or any other nurse I know, here in RehabLand, or anywhere throughout the country, and it scares me. I'm not the most religious character, but I will be talking to my praying friends to get them to pray for Amanda, and for the Amandas to come.

The people who need protection--the patients--are being sacrificed. For what? The almighty dollar.

Friends, it is true: if you want peace, work for justice. Let's hope there will be justice for Amanda and for those patients out there, now and to come.

The next two weeks...

Will either kill me or make me stronger. I'm hoping for the latter. Can't wait to actually ENJOY the holiday season once grad school is over for the semester.

May pop in and out from time to time, but will have to set aside the stories for a bit later. So, so many here in the SU.

Now, I'm writing papers and flying a desk and chilling to these sounds...ahh!



Stay tuned...

RehabRN book club

After, I thought about working for an idiot recently I went searching for a few business books and grabbed these two:

The No Asshole Rule: Building a Civilized Workplace and Surviving One that Isn't by Robert I. Patton.

This is a nice, little book. If you read quickly, you'll breeze through it in an afternoon lounging. This book piqued my interest since the author was an academic for a while who wrote an article about workplace assholes for a large, conservative business periodical in which they would not use the A-word in the title. I found this quaint and hysterical at the same time.

The book has lots of facts, no figures, but a great story line we can all enjoy: they're out there, so learn to live with them (or learn to make them go away) or get out.

I also got Mobbing: Emotional Abuse in the American Workplace by Davenport, Schwartz and Elliott. It's also a shorter book, so I plan on reading that before I start my classes again and it's grad school nursing every time I want to read something.

More later, so stay tuned.

Disturbances

It's crazy, hot and stormy around here. The humidity hits you like a wet blanket when you go outside and though, it seems like it will rain again, not even the weather people know when.

Just like the weather, we have crazy people on the unit...and it's mostly employees. Why some of them are like this immediately following vacation is beyond my comprehension. They just cannot come to work and do a job. No, they want sympathy, or any kind of attention really. It's really nerve-wracking. Hello, neurospsych...can you do an in-house consult?

Besides the crazy people, a lot of crazy things are happening with the non-neurotic people who we work with--car break-ins, house break-ins, deaths, and assaults. All this in the last two weeks could be another thing making the unit hot, besides the ever-questionable functioning of the air conditioner. If we only had water therapy!

The patients I've had were reasonably good lately. No muss, no fuss, not even from the one I expected the most trouble. With all my extra time, I'm finally finishing some of my "required learning" for the computerized in-services. I can only hope it will be as sedate the rest of the week.

And if it ain't crazy enough at work, I'm just amazed at the news lately.

Steve Jobs gets a liver transplant (from http://www.cbsnews.com/)
It's somewhat shocking in many regards, not just because of wealth or status. Should keep those medical ethicists busy for a while.

VA has a rogue cancer unit (from http://www.nytimes.com/)
If Sister Mary Martha, my kindergarten teacher would have seen this, she'd have gotten out that big pointer she used to use and would have a) whacked said doctor, then b) poked him really hard. If only someone at that VA would have!

Finally...keep those cards and letters rolling for Change of Shift here on 6/25. I have to tell you, I may just have a section called the "men's edition" because so many guys are sending in great stories. C'mon ladies, let's give the gentlemen a run for the money, shall we?

Stay tuned...more to come!

War stories

Yes, there was a lot of storytelling going on during my latest turn on the evening shift. It's kind of funny that way, when you're gone a day or two, and things are really different when you come back.

War stories are common on our unit, since we're a government-run hospital, but how you get the guys and gals to talk, or let them talk can be a whole 'nother story in itself.

One of our more cantankerous folks was rolling by on his way to getting something, so I stopped him and asked if he wanted his pills right now. Sure, he says, I'll take them. We chitchat for a minute and I keep doing my thing. Mr. C. starts talking about his time in the military during the Korean war. "See that scar" he says. Sure, I see it, because I'd just given him his heparin shot. "I got that on my way to Korea. I never made it to the front." I shake my head, therapeutically listen, and he keeps going.

Mr. C. never made it because he had a bad appendix and developed complications. An astute medic pulled him out of the crowd and when they landed in Europe, Mr. C. got a trip to the hospital. The docs didn't want him going too far once he was released, so they found a job there on a base to keep him busy moving supplies along to Korea.

We have also had some World War II vets hanging out with us. One of them was a Marine injured in the Pacific. He's a character and I'm sure his stature alone may have scared more than a few folks in that theatre. I think about some of my relatives when I talk to them, because they'd tell the stories of the war, when I was a child, and my brother and I listened very intently. Most of our relatives who went to World War II came back. One did not. I think of him a lot and the family he left behind.

Maybe it's just because of demographics, but we have lots of Vietnam-era guys at our place, including some of the employees. Lots of folks talk about the jungle and dreams they had while they were there. Some were more premonitions than dreams, but they colored their lives just the same. One guy told me about the lost opportunities from Vietnam--delayed families, deferred education, the bad attitude of some folks that often caused other problems in the jobs they came back to or started after their service. The angst among some who were injured, while other folks their age were in school and never drafted. The volunteers. Some people say, "Who'd volunteer for Vietnam?" and on our unit, you'd actually see some hands, proudly raised, almost defiant. "That was me," one guy told me. "Better to volunteer than be drafted," he thought.

Today, we see some of the Iraq and Afghanistan vets coming in with stories of their own. Swimming at Saddam's place. Guarding air fields in Kuwait. Driving through Afghanistan in the Hindu Kush mountains with snipers everywhere.

And while they're not my words, I leave you with a story I received recently from my husband's old dear friend who is at a southern US air base. His story is a short, but a compelling look at the life of an airman who lost her life recently.

I previously wrote many of you about the presentation of an Air Force Cross, the second highest medal an Airman can receive, next only to the Medal of Honor.

At 1000 yesterday morning, we met in the same hangar, not to pay tribute to a warrior amongst our midst but homage to one who would no longer be physically present with us. SrA Ashton Goodman was a 21 year old (22 next week), from Indianapolis, IN who served as a vehicle operator in the 43d Logistics Readiness Squadron. She had three short years in the AF but had already served as a truck driver, ferrying supplies and personnel from Kuwait into Iraq, been promoted to SrA six months below the zone, and called upon to brief the Chairman of the Joint Chiefs of Staff.

This time she volunteered for a one year tour working with a Provisional Reconstruction Team (PRT) in Afghanistan. SrA Goodman was killed last week when her vehicle was struck by an improvised explosive device (IED). Her funeral was Tuesday in Indianapolis. The Wing took up a collection and flew the family here for yesterday’s memorial.

It started with a slide show presentation, a speech by her squadron commander (it was obvious she had made a positive impact on him and the unit), presentation of the Combat Service Medal and Purple Heart to her parents and several comments from squadron members. One squadron member sang a gospel tune that started eyes watering.

Then came the final roll call. Names of squadron members were called and answered until they came to her, silence. Her name was called again with more silence. Once more, still silence and then her full name followed by a 21 gun salute and taps. I challenge any of you to sit through that with a dry eye or after attending such a ceremony to ever hear taps again without a deeper sense of pride and commitment to those who have paid the ultimate sacrifice.

A note to all the civilians out there

Yes, your friends in the medical or healthcare industry may scare you.

I went out a while ago with some friends from high school. You could almost part the room by who's in a healthcare job and who is not or is not familiar with the healthcare industry.

Some interesting observations:

1. People with boys tend to know a lot about emergency rooms. One of my friends has several and rarely blanches when he tells the stories of Kid X running into the fancy glass table at the department store and getting a cut on his head or when Kid Y goes and has a compound arm fracture after some skateboarding stunt gone awry.

I just thank my lucky stars I don't work in the pediatric ER.

2. Allied health professionals often have their own interesting stories about doctors. One friend has a doctor she works with who asks her to call the special back office line so he can take care of whatever she needs for his patients right away. She can also tell you what doctors have the best staff in town.

3. Another one of my friends still works the night shift after several kids and 18+ years. I never cease to be amazed at how well she functions. I just shudder at the thought of 18 hours on the night shift, let alone 18 years! She works at a major teaching hospital, so she always has some funny stories about dazed and confused people on nights, especially the residents.

Sometimes I think she should have been a nurse. She'd be one kicka$s patient advocate. She is kind and pleasant and takes no crap from anyone.

4. One of my friends is a doc. I always think about this before I get really annoyed. Friend A has some great stories and some real heartbreakers, so I know the line Dr. K. told me a long time ago is really is true: "I have some patients I will never forget."

5. I am always surprised that these same healthcare professionals, who have years of experience tell me that they're amazed at what I do, and here I am, a newbie nurse. And no, I didn't pay them to say that. They work 24/7 just like we do. They've paid their dues and they've put on the flak jackets when some crazed MD or patient screams at them for no reason.

It reminds me that in many environments, nurses are on the front lines of healthcare. We are in the hospital trenches with patients. First, when things get down and dirty, we have to go and get whomever cleaned up and out of there. We're a little like infantry in that regard; a little like MPs, since we have to keep our guard up and watch out for trouble.

Finally, it gives me hope to know that these good people, doing their jobs in the other healthcare disciplines, are out there watching my back, too, even if they're not next to me in the trenches.

Nuggets for June 16

Here are a few of the latest finds from various blogs on the internet. Enjoy! Happy Monday!

Get some ed-ju-macation (or educating yourself in the blogosphere)

Spook, RN (aka Drug Pusher) talks about the vocabulary of the medical folks he found out there a while ago, called Gallows Humor.

Lost on the Floor has a link to another slang list you may enjoy, if you're looking for something in the same genre. Someone at Madison just told me about the 3H enema last week.

Although, it's not a nursing blog...

Stories of the Incredibly Stupid blog about life in the pharmacy has some really funny stories lately. My favorites are the Making it Fun series and Karma.

Nuggets for March 20

Here are a few items of note for today:

Heparin Discovery May Point to Chinese Counterfeiting (from http://www.nytimes.com/)
I suspect I may get a few refusals to take this if people have been watching TV.

For amputees, an unlikely painkiller: Mirrors
An interesting therapy being studied to relieve phantom pain.

We take care of our own
Another installment on gratitude (and what happens when patients leave) from Podunk Memorial. Short...but sweet.