Happy Nurses' Week!

In case you missed it, the yearly celebration of nurses has begun. We got the whole week covered at the Hotel with "fun" stuff in between work.

Since the theme for this year's celebration is "healthy nurse, healthy nation", maybe it is time for some nurse-centric play-by-play from yours truly.

Yes, the Hotel has some great facilities, so we are fortunate that a lot of the celebrations occur right by our unit, but the problem: many people don't attend. Why? Because they don't have time.

So consequently, if we could get ANYTHING we asked for this Nurses' Week, here's what would be on the list.

1. Unlicensed staff that actually listen, work, and communicate with the RNs. Too many of them on our unit have a bad habit of dissing the RNs. It needs to stop. Period.

We work together as a team. If you diss the RN you're assigned to on your shift, it's a rubber-glue scenario. You make yourself look bad, too.

2. How about the Captain Obvious question: if you want everyone to document everywhere, why not make it easier at the bedside?

Just saying! If you think logging in after walking 300 feet to the nurses' station, then opening the software, then logging in again, finding the patient, then starting your note is good, you haven't taken care of a bedside patient lately.

No, rehab supposedly has stable patients, but you really need things, like computers that accept the data from the beds, the scales, etc. without double charting.

3. Since I went big on #2, why not on this one. How about a fully stocked cabinet outside each room with the basics, a la TCAB projects of the not so distant past? It would have helped if they had planned this on the last remodel, but here's some food for thought.

Having supply staff actually supply it, would also be nice. If you can't do it outside every room, how about on every wing. Steps do make a difference in a workday (you could be charting, checking labs, etc.)

Finally, no matter where you practice, I wish you a very Happy Nurses' Week. Your work matters and you make a difference.

More to come...

Thank goodness

It's almost time for vacation again. Surprisingly, I'm partaking of a little office escaping for one week for not one, not two, but THREE months in a row. In the computer, it's not vacation (I'm actually going out on the road for conferences, etc.) but to me, any day outside of the Hotel is freedom. I'll take it! Traveling partner and I get to have a reunion, too, which is even better.  Look out folks, as we shop and eat in interesting places in our off time (plans are underway...)

This week was a full moon. Somehow, I didn't realize this until I was driving home one night from an event. The sky was hazy but relatively cloudless. There it was: the big monster sturgeon moon right up there. It explained the craziness that was this week.

I work with technology that helps patients see their providers from home, so in theory, I shouldn't have people not show up. In a week with a full moon, don't count on it. One patient couldn't make it (we always call to check) because he had last minute visitors, or patients (he/she's also a healthcare professional). This happened last week, too, but that patient is a sweetheart and invited his/her guests to see us and talk to us before he/she completed our assessment. We dispensed with the usual formality, got the visit done post haste and wished them all well until the next visit.

Besides the fun at work, I'm doing plenty of work in advance for a committee that audits nurses' training and continuing education. What does this mean? I look at a lot of CEU certificates. My favorite one this week was a CE class on humor in healthcare. It is worth 20 CEUs. I thought to myself: if I could market a 20 CEU experience here in the Hotel, I'd bet I could make some money too. If that's too expensive for you, however, the author does belong to this group you can check out for free.

Now that Bubba is being a typical teenager, it's driving me nuts. Pray we survive...

Stay tuned...

RehabRN book club: Summer 16 part 3

I've been busy reading, since Bubba is in the home stretch of the local reading club. We take at least 1-2 trips to the library each week.

I'm still working on We have the technology, which has vignettes by sense, and I really enjoy it.

However, on our latest trip (since they are closed Monday for the holiday) I found a book I've been waiting to read, When Breath Becomes Air by Paul Kalanithi. I saw his interviews and knew some of the story, but the little book (I actually read it all this afternoon) was so much more than the videos of his interviews.

You read about what it's like for a doctor to get cancer and be a patient. You read about happy things, but things are also very sad. Many reviewers, big name authors themselves, recommend this as one of the most important books you'll read. I have to agree. Life is short, and only some of us will have the courage to live it, in the face of some terrible things, on our own terms with dignity.

More later on what's new on the reading list...

Perils of modern living in the office

If you have e-mail, it just might get hacked if you open attachments you shouldn't. I'm so glad one of my technical people actually confirmed my suspicions recently. Our mail has been terrible. The issues we have with technology are scary, but not surprising.

My latest issue: some of my coworkers want to be exempt from policies and procedures that can cause issues with billing some services they provide. This is another example of following the chain of command. They do it (or suggest it) so I have to make their boss aware of the situation. It sucks, frankly, when these same folks could have been doing this job (they've been dodging) for a few years now, had they let me put the resources in place.

More construction starts at the Hotel. We got some equipment (they forgot until I asked and money was found) for our exam room, so once we get our security devices (probably next month) we can officially say construction is over in our office.

Bye, bye convenient parking when the monsoon comes through later this week. Guess I may actually start wearing my backup scrubs. Our parking lot shuttle is a joke. I often see them at the local Wal-mart. Last time I checked, Wal-mart was not our parking lot.

Patients will be patients. They are now asking pointed questions and so it makes our lives very interesting everyday.

Off I go to another exciting day. Stay tuned.

RehabRN book club: Summer 16 edition

The reading clubs (yes, even for adults) are back at RehabLand's library system and Bubba and I are reading away. Dahey always does (he could spend every waking minute reading if left to his own devices...) but never competes in the contest.

While my boys have methods to selecting the books they get, I don't really have one, outside of the fact that I like new books. Ones with catchy titles and authors I recognize also helps. Lately, I've taken to just picking up a book while I wait for Bubba, randomly opening the book, and reading a few pages while I wait.

If I like the book, I check it out.

The two books on my reading list right now are those kinds of books.

The first one I'm reading is Beyond the tiger mom: East-West parenting for the global age by Maya Thiagarajan. I liked it because Ms. Thiagarajan is a teacher. She's got street cred. She's not just avowing a philosophy to make us working mothers look like slackers. To top it off, she has some great ideas for interventions you can try at home with your kids.

My favorite quote in the book is not just applicable to education, it's also applicable to my job as a nurse:

"Don't worry so much about making everything "fun"...I personally believe "fun" is the wrong word to use. Learning should be challenging, meaningful, rigorous, engrossing, interesting, and satisfying." (p.132)

You could easily switch learning to work and it would still make sense.

The next book on my list right now is We have the technology: How biohackers, foodies, physicians, and scientists are transforming human perception, one sense at a time by Kara Platoni. I'm only a couple of pages into this book but it's looking promising.

More updates to come. Hope you enjoy whatever's on your reading list. Feel free to discuss.

So many things

I've had a lot of really diverse things going on. Is it busyness? Not really, just a lot of disruption to my regular routine.

Am I happy? I'm just rolling with the changes.

I'm working to get things done in my little world in the Hotel. Some things are incredible (technology IS nice) and some will be game changers for how we care for our patients. Many of these things have been done elsewhere, but no one's sharing a lot of info about how they did it. I'm trying to keep up with everything I can and make sure I avoid the potholes others have already run into on this road to modern health care.

My work has taken me out on the road--literally. That part has been fun. I've been out and about with staff I don't get to work with during my normal day.

I hope to write more in the next couple of weeks. I have some time to think. I can't wait.

I hope to see you again soon. Thanks for visiting. You are always welcome.

Stay tuned...

The end of the week

This is almost the middle of July. I hear the siren song of summer, since here in RehabLand, Bubba and the other kids will be in school before Labor Day early in the morning (clutching pearls).

I have many warm memories of starting school in September (when it was still blasted hot) and one year, I dreaded going to school since my classroom was on the second floor. I was in fifth grade. I had horrendous headaches that year. I figured it was the ragweed (since all the windows were open way back when).

The Hotel was hopping this week, and so was I. I actually got to go out on a field trip. That part was fun. When I wasn't busy doing that, I was getting some groundbreaking work done. Since I volunteer for pilot projects (because our boss volunteers our department), I got to work with some new stuff. It was so cool to make care work anywhere! It also helps that the patients like it, too!

I'm going to stop here. It's time to relax and enjoy what I have of the weekend: housework and a little fun. Vacation is in sight. I can't wait.

Stay tuned!

Learning every day

I tell my patients and other nurses that I learn something new every day. Lately, it's been very true. So many things in my life, at home and at work are precipitating the changes. I'm hoping they are all for the better.

While I'll never become a maternal/child nurse, I learned about STABLE the other day from one of my e-mail groups I belong to related to technology. This course is provided virtually for those nurses who are in rural areas who cannot attend in person, due to time or expense.

I'm learning more than I ever wanted to know about some new technologies. Just because it's expensive, doesn't always mean it will work. A long, arduous task was made harder. However, I shouldn't complain. I have a technical guy with a lot of history, who can figure out just about anything. I am extremely lucky.

I have to remind myself of that very fact, too. I am lucky to be able to learn so much.

More later...

The agony and the ecstasy, part 31

These are themes I've seen over and over in my life and practice this week.

Agony:

• Breaking very expensive equipment. Fibre optic cables that get stuck, then shatter in your hand and cut you as you're trying to gently extricate them. Ugh! I just hope the boss doesn't have a cow. Reported it already. Still terribly sad.
• Rousing the troops to no avail. Really? Not ONE of you could come to check this out? Yes, I know it was last-minute, but  heaven forbid we do anything on a Friday. No one will show (unless it involves free food or money). Disclaimer: I did manage to grab two RNs from the floor wandering by, though. My remote site loved it.
• Get one thing fixed, break another. Thankfully, I'll be able to resolve this, but it will take a while.
• Dahey will be going on a TDY odyssey soon without Bubba and me. If we're lucky, we may be able to visit him before he leaves.

Ecstasy:

• Dr. EI will get his Christmas present (hopefully) by July. All the planets have aligned.
• I finally got into a pilot program which will get our site new, fancy equipment to take rehab and health care out to patients. YIPPEE! (Have waited a LONG time for this, too.)
• Things in this house are starting to come together. New paint adorns a few of the walls and will continue as Bubba and I get ready to tackle some of the easier rooms Dahey left for us.
• Planning a little vacation. Bubba will have another item on his "dreams come true" list complete this summer.

Stay tuned. It's never dull at the Hotel Rehab!

Head banging or TGIF hurry up

Maybe it's because it's a long weekend. Maybe it's because I've had more than my share of head banging needed recently. If I were a pitcher, my ERA would be terrible. Two patients scheduled no-showed or refused to cooperate. Very frustrating.

Some of the people you work with have amnesia and screw stuff up no matter how many times you tell them something.Asking these same people to think is a dangerous thing. "Oh you mean I was supposed to answer when so-and-so called on the teleconferencing unit to discuss x patient." Yes, Dumbelina, you sure were supposed to answer. Even a master's degree in your discipline is of no use.

I think of the article I read about doctors not wanting to use stethoscopes in the 19th century because, "Why do that when I can just put my ear to someone's chest?" I want to yell the same thing about the technology at the Hotel, with which they do the same thing.

Thank goodness I already bought all the beverages I'll need for this weekend. I will be partaking of some nice cold ones as soon as it's feasible Friday.

Stay tuned and hope you enjoy your Friday.

Flo's birthday and this important celebration

Yes! Flo's birthday! Jump up and down folks, she's the reason why we have a profession. It's the last day of Nurses' Week to celebrate, and how appropriate it is.

But, did you know, May 12 is also a day to celebrate nursing informatics? Yes, indeed! This specialty was formally recognized in 1992 by the American Nurses' Association.

So thank the nurses who make sure your computers work for nursing work, to give you more time with patients, the nurses who make technology work for nurses (and often every other clinical staffer in your hospital).

Random thoughts

It's a stormy day already here in RehabLand, and Bubba's up early wanting donuts. My head is splitting. AND I double booked myself at work today. I can't wait for this day to be over.

Here are a few points to ponder:

There's always some new technology to learn in nursing. It just amazes me, though, that some people figure out how to "game" it as soon as they can. It really gets scary when this gaming potentially interferes with care.
There's an updated version of this code, but somehow, I don't think people like the Slug actually read (or practice) it.

If you get tired of the bullies, check out this advice on bullying or parallel violence from Katie Duke.

And finally, if you want to feel good about what you do, no matter what, check out this post from KevinMD.

Thank you patients. You are the reason why we are all here.

More later...

Spring break diversions

Yes, to keep the vacation atmosphere around here for one little boy: let's go out to eat more than usual. At least that part seemed like a vacation, even when you're staying home, and the parents are working.

I decided if I ever want to be a nursing instructor when I grow up, I ought to take some more education classes before I run out and get a terminal degree. I've been checking out MOOCs (Massive Open Online Courses) from all over the world here. It seems like a better option than handing over my checkbook for every class.

I actually found a nice course by Curtis Bonk (yes, it's his real name) about using technology in teaching on one of the sites. I knew of a few, but the MOOC list has many I had never even heard of at all.

Professor Bonk has some interesting viewpoints.

1. You need critical friends, web buddies, e-mail pals in online classes.

2. Your blog will be there 100 years later. What you post today might be usable tomorrow. Your digital history may be available for centuries. (Wow was my first thought). The professor mentioned a friend who published the Come and see Africa blog. The author's died in 2010 in a car accident. Her blog remains.

This tidbit of that course provided a lot of food for thought today.I can only imagine what rehab nursing will be like in 100 years, and what would they think of this blog?

Today, I read an article that people are still trying to keep rehab hospitals relevant, when the pointy haired policy wonks want to send everyone to a skilled (nursing home) care facility for rehab.

Only time will tell...enjoy your night wherever you are.

The darnedest things

I love gadgets and technology, in part, because my job uses a lot of various technology at the Hotel.

However, when I read this article about dangers of wearable computers, some things just stood out.

1. Lifeblogging? Really? The Truman Show is so not HIPAA, kids.

2.Google Glass. Same as #1. I'm just waiting for a policy at the Hotel.

3. The wearable/embedded device issue. Yes, I'm not really impressed with Dick Cheney and would not go hunting with him, but he does have a point.

4. Cop cam will show who is getting the free donuts and sodas...just sayin'.

5. Smartwatches. Duh! If you have a smartphone policy, just upgrade it appropriately.

6. I like the smart clothing idea, but I don't like the thought of someone making me wear it to work. The authors do have some valid points, and this type of clothing would be valuable for my Hotel patients.

7. Fitbit and insurance rates. I don't like it. Reminds me of that bad "nurses go to heaven" joke, only the HMO nurse doesn't have any repercussions.


Just my $0.02...feel free to chime in.

The perils of modern technology

This article on cnn was interesting, because it talks about a variety of ailments that never existed when my parents and grandparents were growing up.

I can almost hear those sage characters laughing when I read about...

Tablet neck and BlackBerry thumb 


Grandma L: (on tablet neck) Hunched over? Sit up straight! (on Blackberry thumb) It has a speakerphone? I need one of those. Who cares about typing? I never wanted to be a secretary anyway!

Grandma L. was a housewife who raised 7 kids and called everyone of them (including my mother) every morning. If she could have had a cell phone, she would have had one.

Earbud-induced hearing loss  

Grandpa K: (great-grandpa --GG--actually): GET THOSE  F**&^% out of your ears, you moron!

NOTE: GG was a foreman in a brewery back in the day. You had to yell for people to hear you on the production line. Another fun part of his job: wake up drunks who fell asleep. He was known for speaking his mind. Ahem...

Screen-related sleep disorder  

Grandpa L: Turn off the lights. They're not free.

Grandpa worked nights, and he was not a big light fan. He was retired by the time I was born, and while I don't remember him much, he spoiled me (and my sister) rotten according to reports.

Stiletto strain

My mother: This is why you carry a big purse (so you can stash a pair of flats).

I have lots of photos of my mother in high heels in her youth.

Offbeat biorhythms

Grandma R:  It's not good to eat after 6PM.

Grandma R was a tenacious survivor: married three times (first was a youthful romance gone bad, except for my dad) second was the love of her life (widowed) and third was a complete idiot (divorced after 3 years and infidelity on his part). 

She worked as a real estate agent and died when I was a little girl. I read a few of her letters my father had, and I admire all she had to deal with in life. I'm sure my tenacity comes from her German-Anglo-Irish background.

Doctor data?

You may very well see one, as personalized medicine becomes more common, according to this BBC article.

Having seen how far in the dark ages we are using the technology around us in healthcare in my own family, I am not surprised.

Enjoy!

A robot in every room

I'm sure every patient will have one of their own if they only have to power it with urine.

Gives new meaning to drug testing and economical helpers at home.

Technology...who would have thought?

TGIF everyone! Enjoy every moment of this weekend. The fall leaves are still falling here in RehabLand.

Sometimes, we're cutting edge...

And sometimes, we're a little behind.

The cutting edge part: I work in the SU and we have the latest and greatest technology for dealing with rehab patients (and lots of other patients, too.)

The behind part: it's very telling, when your hospital finally gets the hint that this has been a Joint Commission recommendation since 2009.

We've had a few other changes happening, which just adds to the mix.

Why? Because people are starting to complain. And morale is low.

At least, we had some fun today, brightening up the area under construction. It was a blast for the patients, and for me, too.

TGIF all! Enjoy your moments wherever you are. I will!

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!

Taking some advice

Mondays are a blast at the Hotel. I'm always in for a surprise or two. Today's menu included:

1. Two pieces of equipment down. Guess who got to resolve their issues...me! Why? We were short tech folks today.

2. I get the call, "you need to go to xx clinic". No biggie. Was going over that way anyway. Since most of their patients are on holiday (or just didn't bother to schedule an appointment), it was dead slow, which gave me plenty of time to talk to the nursing supervisor, etc.

3. While I was at a meeting today, one of the docs told me, "Haven't you toughed out that cold long enough? I think it's time for a Z-pack." Off I go at lunch to call my PCP.

4. I miss an afternoon meeting. Why? Well, a patient who just needed "one little thing done" stayed for an hour. I couldn't resolve his issue, so he called two 800 numbers and then one transferred him three times until he got someone who took his info and will have to call him back.

I wasn't too upset on the last one. That would have been one meeting too many today.

And finally, I got to call our clerk to figure out where one patients ride was. It seems he/she called earlier, but had been roaming around waiting for the ride to no avail. I left and they still hadn't come.

So I gave the patient the ombudsman number and directions to the nurses' station, so they would make sure he/she was off without a hitch.

Tomorrow, thankfully, is another day. And so it goes...

Stay tuned!