Christmas spirit

There really is a Christmas spirit and it is alive and well. I have to share this story. A nice little old (80) lady, healthy and does everything for herself, lives alone. While driving to church, somehow got off the freeway before her exit, as she was driving down the road she runs into the curb and stops. A man following her stops and walks up to her door and asks if she needs help. She feels confused and says I don't know. He walks her to his vehicle, helps her inside then goes back to move her car to a parking lot. He asks where she was headed and she tells him to church, she is starting to remember now, at first she gives him the right name but the wrong address, then she says no and gives him the right address. He drives her to church and along the way calls her son to tell him what has happened. The stranger walks her into church and helps her sit down, then he's gone...She gets help from the other parishoners to get communion then to sit back down. Her son comes in and sits next to her, after the service she asks her son to take her back to her car...he says I think you should go to the hospital, she actually agrees and takes her to the hospital. She is doesn't remember why she turned off the freeway, that few minutes are just gone...but wow, was she lucky. All of her symptoms are gone and it was most likely a TIA but, how badly that scene could have turned out. It really made my day to hear that story.I hope it helps renew your belief in Christmas and the good left in the world. Merry Christmas and non noc nocere.

what do you think

Yep, that's me, Standing on the corner in Winslow Arizona...we stopped there on our trip back from Oklahoma in November. We had stopped in Winslow before but never went to the corner. It was a nice day...a little cool then but they have been getting snow lately, it's up in the high country. Just one of those places you have to stop and see.

So, here's the scenario. 56 year old hispanic male comes in post op from ortho surgery after trauma, lets say he was hit by a car, it was a right femur fracture. He gets 2 units of blood post op. He codes at about 1am and doesn't make it. No real medical history to speak of. The first unit of blood was hung at about 1330. The second not until 1900. His iv infiltrated at some point in the afternoon and that's why it took so long for the second unit to go in. A couple of side notes...the same tubing was used for both units of blood. The tourniquet was accidentally left on his arm for over an hour. There was still a pulse in the arm. So, what do you think killed him...and what was the worst nursing error. What would you do if these were your nurses? or your family member?

first do NO HARM

GSW

Another sight on I-40, the largest cross I think in the Northern Hemisphere...in Groom Texas. You know everything is bigger in Texas. My husband just loves these action shots at 80 mph driving down the freeway he'll just pull out his camera and get a shot like this...amazing.
Ok, I know it's the holiday season and we should all be of good cheer and all that but, this week has just blown me away. This trauma stuff is just pitiful. I can't tell you how many gunshot victims I have taken care of this week. And most of them have no insurance, so the wonderful state of Arizona will help pay their bill. But, you have to give them all your info like a bank statement and your birth certificate...hard to find when you are laying in the hospital after being shot. So, you get to sit there until we can find someone to get the information and then the process takes like another week.
Then there are the illegals. I spoke with the case manager this week. We have a couple of people who need to go back home...and it's not going to be a short trip. $38,000 by ambulance. The hospital tried to send one person back yesterday with a medical person to transport by commercial airplane but, they wouldn't let him on because he didn't have a passport....duh, he's going back, he didn't have a passport to get here...how do we send him back now? I say call Sheriff Joe. Just really frustrating.
Then someone tells me that Santa Claus is not allowed to say HO HO HO anymore. What is up with that? Are we afraid he's going to offend someone? He has been saying HO HO HO for hundreds of years...the hoes know he isn't talking to them. Are we that afraid of offending someone, anyone? Now he's supposed to say HA HA HA...well, who is he laughing at? Yeah, are you laughin at me? Yeah, that's so much better.Ugh. It's hard enough for me to muster up some holiday spirit then I hear something like that...just kills it.
I'm looking forward to moving to a different hospital. I will be going to Banner Desert...sounds warm huh? It's in Mesa just south and east of Phoenix. We will be getting a new apartment...yeah no more music at 3am...I think any other company would have moved me to another complex as many times as I have complained...not real happy with Banner right now. We will be in the same complex as our friends from PA. The weather here has been pretty cool and a little rainy but still better than 30 degrees and snow.
My computer guru husband added a couple of things to my blog to make it a little more interesting. Can you find all 3?

Holiday trip

We made the trip from Phoenix to Oklahoma mostly on I-40. There are a few attractions on I-40 in Texas that you just have to stop at once. We actually made a couple of fun stops just to break up the monotony of driving. One was the famous Cadillac ranch..it's by Amarillo on I-40. It was a sunny day and about 40 degrees figured we could brave it easily. Wow, we forgot about the wind..it's one of those winds that no matter which way you turned it was still in your face. Of course we weren't the only ones to stop, there were plenty of people braving the cold. There are 10 Cadillacs buried nose down and completely covered with graffiti..we added ours with a Sharpie...no spray paint available. I'm glad we stopped when we did...I had suggested stopping on our way back but when we left to come home we left at 6am and it was snowing. The pics turned out pretty good. We also stopped at the Continental Divide on our way east...no real picture taking spots there.

We had a great time in Oklahoma. It was great to see my family. Pulls at the old heart strings when you leave though. On the trip back we stopped in Winslow Arizona and took some pics there...they'll be on the next blog. Having trouble with windows vista and windows xp, they don't see to want to play together. I have to get my live in computer geek to help me.

Still waiting to go back to work...I signed up with the agency for Monday Tuesday and Wednesday...no needs...I called the hospital where I am contracted and no luck there either. I start my week tomorrow, so, we are going to find something fun to do today.

Non noc nocere.

Thankful

Happy Thanksgiving all. We made the 16 hour trip to visit family in Oklahoma City, I actually got to drive a couple of hours. I am thankful for so many things...all my wonderful family, my friends, the ability to work and persue my dreams. With all the bad things we as nurses see on a daily basis, it make me thnkful for the littlest things. Hope ya'll have a great holiday and be safe wherever you travel. Thanks to those who are working today.

So Close

Looking good,huh? I spent a few days in Columbus this past week trying to help my husband finish up our house. It was a great feeling to help out. I wish time were slower. It's funny how when I am at work time is so slow but when I was at the house time flew. The last thing to do is sand the floors, we got most of the painting done while I was there. As you can see above we got the new counter tops in and a new sink with stick on tile back splash...doesn't look too bad does it?

Work has been pretty good. I have mostly been on med surg overflow...with all the other travelers so work has been fun. I have said for years I would love to open a hospital that has only experienced travelers working there. As a whole we seem to be very flexible easy going people. In general we don't complain when we get an admission or have a busy day. We ask for help when we need it and remind our fellow nurses of things that weren't done rather than writing them up. I know there are some exceptions but for the most part I would rather work with travelers than staffers. I hope that doesn't offend anyone. To their benefit, staffers do know the little subtle things of the unit and usually share them with the rest of us.

Did have some interesting patients this week. More GSW than I have had in my entire career..4 this week. Had a tough guy who had an off roading accident and sat at home for 10 days with a hemopneumothorax and a torn spleen. Amazing what drugs will do huh? Positive for meth and marijuana on admission...but how else could he have been able to stay home with that pain? Yeah, he's pretty tough, amazing he's still alive. I also had the pleasure of caring for a very sweet young woman who has recurrent melanoma with mets to the brain spine and lung...shes so positive, but it still tears at your heart. I know the ultimate outcome...just makes me sad. No other days on tele here at Good Sam although I pass my friends in the halls, I don't get to work with them.

The weather is beautiful. I have good friends here. I miss my family and most of all my husband. But, I continue to work to help us reach our goal of being financially free. Thanks for reading and coming along for the journey. Non noc nocere.

Workin and waitin

Yeah it's hard to tell but the walls are painted and the woodwork is being salvaged. I guess we a re restoring and remodeling. Wish I could be there for the transformation more. It's coming down to the wire. I imposed a deadline to try to help speed things up. Hopefully my husband will be out here in Phoenix in the great weather by Halloween. Lots of little things left to do, paint, counter tops, ok some big things left to do too. We still need stairs out the back of the house and all the floors except the kitchen are hardwood and need sanded and stained. Some days I think it's easier to be here working.
Yesterday was not one of those days. I have been complaining about not being on tele, well, you know what they say about paybacks. I had 2 people go to the cath lab one after the other. My first lady came back with no closure device and had to be flat for 7 hours. She was nice enough to go into flash pulmonary edema and had one of those doctors that won't call you back. This poor old lady needs an aortic valve really badly. She had been NPO all night getting IV fluids at 125/hr. So, by the time she got back from the cath lab and I turned them to his prescribed rate of 100 for 3 hours , she got about 45 min of it before she started coughing and her lungs were crackles all the way up...just freaked me out. I called the doc for 45 min then I got the clinical manager. This poor little thing, her sats were in the low 80"s on room air. By the time we got the doc on the phone and the lasix in her her sats were 91 on 4 liters. Then, the jackass is like all worried about her and calls to check on her a couple of times. Then, he shows up at like 6pm and has to borrow my stethoscope to listen to her lungs. The patient tells him what a great nurse I am and he says yeah she is and caring too. What an ass. The poor thing has a long road ahead of her Monday she's having TEE,a pacemaker, an aortic valve replacement, and a MAZE procedure...she is 85. Tell me your thoughts on that...she is alert and oriented still lives alone and her family is very involved in her care. How would she fair in Hillary's world?
While that is happening I got a 32 year old who was admitted the nite before to the ICU for bilateral pyelonephritis and urosepsis. She had dopamine to keep her bp up and it infiltrated..they used the ante dote to save her skin. They sent her to med surg and when she got there her bp was 60/40...so we'll send her to tele for the dopamine this time. Oh, she needs a PICC but they are backed up so, she has IV fluids going at 250/hr and she needs another IV for the dopamine. The PICC nurse is arguing with me on the phone that the doc needs to come and put in a central line if she's that sick, he's really busy and won't get to her today. We get a second line in her but itsonly a 22. She is a pain in the butt rolling all over the bed. By the end of my shift it went bad. I tried to get another line twice and had to leave the next nurse with the same thing I got...one line but dopamine, IV fluids and antibiotics to go in. All this fun on no break and no lunch yet at 2:30 in the afternoon.
I got my second pt back from the cath lab...luckily she is ok and had gotten a closure device. But 2 hours into her 4 hour bedrest she starts crying and getting nauseated because her bladder is full and she can't go. No orders to straight cath her of course, I get the doc who says bladder scan her and if it's greater than 200 straight cath her. Meanwhile her bladder is hard as a rock and she's starting to lose her lunch...yeah I straight cathed her...850cc later( I clamped it off so she won't spasm) she is happy and smiling. Got a total of 1250cc from her. Bladderscan her...what am I stupid? Let's see him sit in a bed flat on his back being pumped with I fluids at 150/hr, after being given medicine with a side effect of urinary retention. And he has to wait for some doctor to call me back (at least a half an hour) only to give a stupid order to bladderscan him. So now I have to go find the machine (which takes at least another 10-15 minutes because every floor doesn't have one)to mash on his bladder (which hurts like heck because it's being stretched to capacity) with a cold hard ultrasound probe that weighs about a pound and a half, only to discover, that he needs his bladder emptied...oh, let me just wipe all the ultrasound gel off then go and get the straight cath kit and hope no one stops me and asks me a question or to do anything else for you while you lay there in agony. Guess they don't think about it because they never have to watch the patient or the family wait for the call back from them.
So, that was my day yesterday..oh plus I had a patient who went to dialysis and came back and wanted to go home but no doc I called would write the orders and I had discharged someone at 10am. Ya gotta love nursing.
Non noc nocere.

Just Work

Just biding my time...I have been working 4-5 days a week. I have worked a couple of shifts at Paradise Valley a little north and west of Phoenix. It's a different pace and a different clientele. The staff is really nice and it's paper charting so it was easy to pick up. I got sent home today from Good Sam...not really happy about that. I've been to Rehab and neuro and today to same day surgery/ procedures. I love working in same day procedures, start iv's send some labs then they leave and someone else finishes the job. We are still trying to finish our house and we need the cash flow, so I called the agency I work for to try to get 4 hours in..no luck, guess I'll have to watch baseball.

The house is coming along slowly but it should only be another 2 weeks...that sounds familiar, have I said that before? The kitchen is the next big obstacle but the island is already completed so we are part way there. That's the picture above..it was hand crafted by my awesome brother.The there's some painting and the floors.The next question is whether to rent or sell...we'll leave that up to the experts.

I have seen a few of my friends since I have been back here in Phoenix. It is nice to see the familiar faces. Just wishing I could work with them more. The floating thing is ok but it's already getting a little old. We'll see what happens.

First do no harm.

Working away

Work at the house continues, slowly the rooms are getting painted and the little things are getting done. Not fast enough for me or my husband though. It's been a long time apart to get this done. I know it will be worth it in the end. Just hard right now.

Hey all, the weather here has been great. Nice and cool in the mornings still a bit warm in the evenings but you won't hear me complain. I worked at my travel job on Saturday and Sunday....it was nice to be "home". I worked with my friends on Saturday and floated to Med surg on Sunday...hey if they want to pay me tele wages to work med surg I'm ok with that. They have Cerner Millenium computer charting...gonna take some time to get the flow of it. But, at least I feel comfortable with the hospital and the type of patients. I went to John C.Lincoln North Mountain on Friday with the agency. Very nice and well organized...it was PCU so I only had 3 patients with an aide. They have paper charting so that was easy but they use something called a med station instead of the pyxis...it was ok. Sometime I amaze myself at what I can do...just walk in and start working. They are using the new Alaris IV pump, I had done an inservice on it about a year ago but had never had hands on. I went in and figured it out without asking anyone. It was a good feeling for this old dog. Just like the medication/ drip test I had to take my first day of orientation here. I thought since I had tested at my agency that I wouldn't have to take any tests at Good Sam. Plus my friend that is here and working at a different Banner Facility didn't have to take any additional tests when she started, so I thought I was in the clear. Nope...I had to take it...and it was all figuring mcg/kg/min or how many mcg the patient was getting given the ml/hr. I freaked...I don't do that on a daily basis. Plus, I have my cheat sheets. I couldn't get it for about 10 minutes I sit there sweating..then i just started at the top and did it. I probably did it the really really long way but, I did it and I passed. I was so proud of myself. Little things that make your day huh?

Remember non noc nocere.

The Valley of the Sun

We decided to try the kitchen tile ourselves. I thought it might take 2 days, it took 2 days to prep and start and 2 more for my poor husband to finish alone. I spent 4 out of the 5 days in Columbus helping my husband at the house...I really enjoyed it. So much different than being a nurse. Just as physically demanding but not as emotionally draining. I'd love to do it full time.
How do you like the yellow? Different,huh? I thought it appropriate since I am now in the valley of the sun. It has been beautiful here in Phoenix, alright ,it rained a little, but, it's so much better than the east coast. I just love the views of the mountains. I also love watching the airplanes, they tend to stack up in the sky over the city...at night especially it's a cool sight. Some of my favorite times here have been spent watching the airplanes.

I have passed all my tests and start my orientation tomorrow. It seems I have 4 days of orientation scheduled for the hospital and probably 2 on the unit...they converted to paperless charting since I was here last. So, that's the reason for the extensive orientation.

I was able to get some work from the agency ,CNS, that I signed up with. Granted it was 30 miles away,but it was work. A newer hospital and the unit had just been remodeled , it was really busy and I got little to no orientation. I made it through though...did my 12 hours and drove the 45 min home.

Still debating about a car. My husband is supposed to join me out here in the next 3-4 weeks...I really don't want to own a vehicle and have another bill but renting a car is pretty darn expensive. Still trying to figure that one out.

The house is coming along...just taking longer than we thought.Keep the good thoughts coming.

Remember first do no harm.

6 days but who's counting

The bathroom is almost complete...as you can see we have a floor and a new bathtub and some paint. I will be helping to floor the kitchen when I get to Columbus...yep, I'll still be working.

Oh, it must be similar to being released from prison. This is a great feeling...I am almost out of this place. After 3 months I am really tired of my little studio apartment. I am sick of the drive to the hospital. I am REALLY tired of having to do everything myself and alone. The old phrase you don't know what you've got till it's gone is so true. I actually feel very lucky and grateful for the opportunities I have. Not many people get to do what I do. There are thousands of people out there who are only existing and surviving. They get up everyday and go to the same job for the same pay in the same car in the same town. They work with the same people and come home to the same house. I'm sure it's comfortable, I think it would drive me nuts.

I remember when my husband and I first started out on this adventure 6 years ago. As soon as we decided we were going to do it, my perspective changed. I began to look at things differently. I distinctly remember walking into work one morning and I got the overwhelming feeling I was a rat in a maze, taking the same path as everyone else looking for the cheese. It was creepy. I felt that way until I left that job.

I got the opportunity to go back to that job and work as a traveler a couple of years later. I got to see that most of the same people were still there only bigger and older. No one really looked happy and there was a lot of complaining. It was good to go home though. I enjoyed going to work and knowing the doctors and the protocols. I still had the respect of my boss, my coworkers and the doctors..there was no proving myself. But, along with that came the added responsibilities that our superiors put on us. I miss the people, not the job.

It will be the same here when I leave, I will miss the people I work with, not the job. This was a tough assignment. The culture, the socioeconomic level of the patients really stood out. Again, sad, but it opens my eyes to the truth of what is out there that most people don't get to see, or choose not to see. If you are poor and don't go to the doctor and get your check ups you can die the first time you come into the hospital. If you send your loved one to nursing home and don't check on their care they can die a slow agonizing death. Most of the doctors here cannot effectively talk to families and patients about a DNR, a lot of that is cultural, and it's very sad. There is a lot of suffering here.

Our little hospital has had 6 deaths in 2 weeks...that's a lot. Even the chaplain looks a little depressed. But, these people are so sick by the time they hit the ER, there is little chance for them.

The people who work at this hospital are a great group. They laugh a lot and get along with each other pretty well. It's hard to believe 90 % of the staff is LPN's. They know their stuff,though.

I will be losing my internet tomorrow until the 17th when I pick up again in Phoenix. Ya'll be safe. As they say here at Richmond Community...Holla at a sista whe you see her on the street, ya hear? Alright sugar.

Remember first do no harm.

2 more weeks and counting

I don't have the updated pictures of the bathroom yet, because my poor husband has been too busy to get them out of his camera and email them to me. He did send this picture over my phone (I love technology) to me while I was at work the other day. We have some landscaping finally...the tree root was actually dug out later the same day but I didn't get an updated pic. The bathroom is ready for paint and the flooring will go in Tuesday morning. The furnace and central air will be in tomorrow. Things are coming together. The guy who is going to put down the floor in the bath might also do the kitchen. He owns/manages about 25 rental properties himself and he might have a renter for our place already. I will be so happy. Only one mortgage payment and to have it done and rented would be awesome!
Yeah, I'm working my butt off. They aren't letting me slack off at all these last couple of weeks either. It's been busier than ever. I have missed lunch a couple of times this week and left after 8pm yesterday. Tomorrow is day #5 this week...then I get a day off...woohoo. I have to spend it doing laundry because I have no more white uniforms that are clean. They get me in whatever I can find tomorrow... These patients are really sick. They are so poor and don't get any health care whatsoever. The ER is their primary source of health care. Lots of them have never been to the doctor and they are in their 70's. This week was also drama queen week. My goodness these women can carry on. We had this one "diva" who was yelling and throwing things. She was calling out to every doctor who got off the elevator...Are you my doctor?...they all answered no..but really thought I hope not. She would ring for the nurse every 10 or 15 minutes, literally. Then all she would say is I want to see my nurse. Of course the nurse she had was very shy and timid...it was sad to watch really. Even the nurse manager and the acting DON couldn't handle her. It's amazing this clientele here. They get away with so much that anywhere else they wouldn't put up with. Guess that's why I can't wait to go back to civilization.
I got my apartment and my cable and my plane ticket...I'm ready to go. I wish I could drive out to Phoenix with my husband, I'd love to stop in Oklahoma and see my family..but, he will have to drive out with the dog on his own. The house won't be ready in 12 days.And he has to stay to finish up. At least my traveler friends will be there...they arrive on the 7th or 8th. I'm being daring. My flight is the morning of the 17th and I have to be at the hospital for my physical at 1300, my plane lands at 1030. I hope there are no delays. I have gotten set up with an agency to work for the first week and I told them I would give them at least one 12hr shift a week for the next 13weeks. The recruiter sounds pretty new. So new in fact that he was flirting with me over the phone after he saw my drivers license picture...not very professional. But, if he can get me work I'll be happy. Wish me luck...non noc nocere.

Rain...

The bathroom is coming together...I wish I was there to help...I would much rather do that than work overtime here. But, that is my lot in life. I worked 6 days last week and back to 3 this week, cuz I get to go and see my house (oh yeah and my husband...lol). It will be a 5 day trip...a good reward for my hard work.
Work has been busy as always. A couple of codes last week and hopefully I'll get out without one this week. You know it's not gonna be good when they call a code and everyone just looks around at everyone else...instead of heading for where the code is. Needless to say, they didn't turn out too well, but it got me thinking about my ACLS again. Which, is really good because I'll have to take a test when I get to Phoenix. Yeah, not only a rhythm and med test but a physical test too. it caught me off guard last time, but not this time, I'm gonna be ready. I have to do the dreaded 3 minute step test...do you all remember that from what High school? Yeah, last time I almost passed out, not this time...yes I am actually practicing. It's pretty good cardio.
Amazingly there is one patient who has been at the hospital since I got here...about 3 weeks shy of 3 months...and there's no plan for her to go anywhere. It's weird, but, it's not the first time I have encountered this. Some hospitals just can't get rid of their worst patients, they are always the sickest, and I always seem to have to take care of them ...a lot. Maybe it's because the regular staff is just in need of a rest from them...but, I need a rest too. You hear a lot of people talk under their breath..she makes the big bucks, let her take care of them. That's what I hear most often...the funny thing is I don't tell anyone what I make, it's just their guess. It's funny they don't think about the down side of traveling. You are away from all your friends and loved ones. You don't have your stuff, only a small portion of it. You can be cancelled, heck your contract can be cancelled and then where are you left? The company might be able to find you a new contract unless they are the ones who cancelled you. Then you only have 48hr to move out of your apartment, how many people do you know who could move out in 48hr? There are some down sides...I wish I didn't have to ad getting the rotten patients and the first admission and the extra patient but, I do. It happens. But, I'll take it all knowing I get to leave in 3 months and hope the next place is better.
This time I know it will be...any weather out west beats this east coast stuff!!
I'll let ya know how my trip is and I'll take lots of pictures. As they say down here in good old Richmond Community Hospital...Holla at a sista....and remember first do no harm.

This week in Richmond Virginia

Just a few shots of the progress....

Hey all, it's been really hot here. And really busy. the heat is keeping the hospital full. I have been able to get in some overtime...5 tweleves last week and 6 this week. I am TIRED. I couldn't do them all in a row...I had 3 on and one off then 4 on and one off...I will be getting 5 in a row off this coming week. Headed back to Columbus to check out the remodel. Then I will have just 2 weeks left here in Virginia...then it's off to Phoenix. I already have my job and apartment and utilities lined up...that's the way it should be. I don't know why some of the companies make it so difficult.

My new traveler friend that is here is pretty miserable and home sick...I told her to tell her recruiter how she feels. And gave her some advise about ending her contract early. I have done it,only 2 times and it was on the last few days or last 2 weeks of the contract. Each one I was paying for housing so, the company didn't ask for a dime back. You have to check the fine print on the contract though. Every company is different. I wouldn't make a habit of it, although I have met travelers who have and still manage to find jobs. But, if you are really miserable or fear for your license, you can leave, the company can't stop you from leaving.

Husband of a nurse

Got this in an email....it is so good I had to share enjoy and pass it on......

Written by a husband of a nurse....... Ah, such mysterious, wondrous creatures are nurses. What treasures lurk beneath those crisp, white uniforms....What young man doesn't have fantasies of discovering those secrets for himself? SCREEEEEECH!!!!!!!!!!!!! Reality check! I've been married to a nurse for a quarter of a century, and let me tell you, nurses are not what you expect (and I don't even care what you expect, because you are wrong!).
Let's begin by tearing down some of the more famous assumptions about nurses right off the top: The Nurse as Sex Kitten: Any man who lived through the early seventies or has made it a point to rent such famous videos as "Night Duty Nurses" or "Student Nurses" or "Night Duty Student Nurses" or any one of several dozen nurse-centric skin flicks will immediately believe that all nurses have heaving bosoms, just millimetres away from popping out of skin tight white uniforms. You will also believe that nurses always wear white garters, fish-net hose, and stilettos. This, of course, is a handy dress code because movie nurses spend *a lot* of time hopping in and out of patient's beds. The reality is that most nurses wear scrubs - shapeless, draping hunks of cotton that could cause you to breeze past Pamela Anderson without a second look. Shoes are white and chunky with blobs of things on them better left unexplored. Socks replace white hose and garters, and when is the last time anyone saw a nursing cap? Graduation, perhaps?
The Nurse as an Angel: If you want to hear the latest gross jokes, just find a nurse. Some uninformed males seem to think of nurses as angelic creatures: demure and loving, a cross between a nun and their mom. Well, hate to bust your bubble, guy, but as a group, nurses are some of the rawest folks you'll ever run into. I don't care how sweet and demure they may look on the outside inside is someone who has seen things that would gag a maggot, break your heart, or drive a normal person nuts. So most nurses develop a very wicked sense of humour squarely lodged in the black-to-sick side of the scale. Also, in case you are looking for angelic sympathy for the little boo-boo you had in the shop, forget it! Let's say as a typical male klutz, you manage to saw your finger off. You go running to your nurse wife who is on the phone with a nurse friend of hers. As she continues to talk to her friend, she gives the stub a good eyeballing, slaps a towel on it, takes out a baggie to put the severed digit in, and tells you to get some ice while she is explaining to her friend that her dummy husband just sawed his finger off. As you stand there bleeding profusely for 15 minutes she calmly finishes her conversation as though nothing is going on until finally she says, "well I guess I better get him to the hospital."She hangs up the phone, looks at you, sighs and calmly says, "let's go." You have just learned an important lesson. On the nurse scale of emergencies, yours is about a minus 9! As my wife has told me, "when you are on a ventilator, with six drips running, your head down and your feet up, then you're sick. Anything less than that isn't worth getting excited over!"
The Nurses Mutual Benefit Network: As a male either dating or married to a nurse, you should realize one important thing. There are nurses everywhere. That, in itself, is no big deal. The fact is, every nurse knows other nurses who know more nurses, so that by the time you are finished, a nurse on the Island Nation of Chuuk who observes you doing something you shouldn't has the immediate capability of getting word to your wife. This system is way more reliable and efficient than the Internet and has existed for a much longer time. Take it for granted that your nurse wife will know about anything you have done, good or bad, before you get home! Your Social Life with Nurses: Nurses hang out with other nurses and soon you may find that all your friends are married to nurses. The reason this happens is because in situations where nurses mingle with nonmedical folks things can get ugly. For example, you are out to dinner with your nurse wife, another nurse couple, and two civilian couples. The nurses sit and chat, discussing fun things like bleeding bowels, open sores, how much fat was sucked out of some patient, projectile vomiting, traumatic amputations, etc., all over a nice pasta dinner. The nurses carry on talking as the civilian couples turn funny colours, make faces and suppress their gag reflexes (and this is if the nurses don't have any really gross things to share like the homeless guy with maggots in his bleeding sores!) After several dinners and gatherings like this, you will soon find your circle of friends has shrunk significantly. The key to avoiding this is to do the following: Never go out in mixed groups with more than one nurse. A lone nurse is ok. The trouble starts when you have more than one, and when that happens, keep the regular folks away. Also get used to the idea that some friends and neighbours will take advantage of the fact that your wife is a nurse by calling at all hours of the day and night for advice. This may include male friends "dropping by" to show your sweetie his rash. The best advice I can give is to just deal with it and hope it isn't contagious.
The Health Ramifications of being with a Nurse: Most nurses have been described as having the constitution of horses which isn't true because I've been around horses and they get sick more often. The reason for this is pretty simple. After about 3-5 years on the job, nurses have been exposed to so many bugs that they either end up dead or full of every antibody known to mankind. (If you want the ultimate booster shot, just get a blood transfusion from a nurse who's worked in a hospital for 20 years!) You don't have all these antibodies, though, so when she does come home with mild sniffles, a week later you're flat on your back with the worse case of the flu of your life!! Oh, and if you are the least bit squeamish, don't even think about the bugs she brings home on her clothes. It will mess with your mind as she talks about her resistant TB patient, the patient full of body lice, or the one with poison ivy in his mouth! so don't ask. Conclusion: Ah such mysterious, wondrous creatures are nurses

Hot and Humid

What is with this heat? Wow, the humidity here is just stifling. The kind where you walk outside and can't catch your breath. Good thing the hospital is letting me work some overtime...I get to use their air conditioning instead of mine...lol. This week has been brutal so far, 6 and 7 patients, no charge nurse and only 1 or 2 techs for 25 to 30 patients. The acuity is really high as well...then on my worst day ever they messed up staffing and a nurse who they thought was supposed to be there, didn't show. I didn't get to leave until 8:45. I had no words to describe it...I had a horrible day then my relief doesn't show...They are still using agency per diem nurses because their own staff is burned out, but they are not using as many. I have 5 shifts this week and next...if they allow me to work them all. I know Uncle Sam will be happy if they do.
Work is progressing slowly at our rehab because of the heat. Heating and A/C will be the first thing to be completed. I think we might be one of the only houses on the street to put in central air. Hopefully it will be a big help when it comes to renting the place.
I have begun the hunt for my next assignment to Phoenix. I called a couple of companies but I think I will go with the one I worked with last time. They have the best hourly rate and make the process so simple. I think this assignment has burned me out on trying new places for a little while. I also have had enough of nursing on this side of the Mississippi. Not that I can't handle a patient load of 6 or 7 or more but, I don't want to when I know I don't have to. All the hospitals talk about 5 star service and patient satisfaction, blah blah blah...how is it possible when you have 6 or 7 patients? What about nurse satisfaction? No one talks about that.
Remember first do no harm.

Rehab #1

Well, as you can tell, I have been a little busy. For instance, last weekend I worked Friday, Saturday and Sunday. Got on a plane Monday, which was delayed and forced me to miss my connecting flight in Cleveland. Luckily my husband loves to drive and made it to Cleveland shortly after I landed. Then we drove the 2 hours back to Columbus to the mortgage guys office to sign some papers. Then we went and visited my Uncle, the one who had surgery for his stomach cancer...he is doing very well. Then back to my brothers house to visit and sleep. The next morning we got up early because the sheriff was supposed to come and remove the renters from the house next to our rehab...but, it didn't happen. Columbus has a lot of foreclosures and the sheriff's office is overwhelmed. From there we went to our closing...only about a half hour or 45 minutes of signing papers. It's really hard to sign your name the same that many times in a row. Then we had some lunch and went to the new house...we cleaned a little put up a new porch light and changed the door locks. I'm so lucky to have a brother with skills...the door lock we bought didn't fit the hole that was made so, he went to his truck and got out his jig and drill and made it fit. Of course he had to use his half inch drill and of course it caught a couple of times and tried to rip his arm off. What fun would it be if it didn't? The my husband and nephew pulled down the awful wall paper..it's so old it came off in sheets...only thing left on the wall was some old glue. Then we got up the next morning and drove back to Virginia so I could go to work the next day. A little hectic but, oh so much fun....I'm so happy to be doing this rehab. Ok, I won't get to "do" most of it, but I will be seeing the work in progress via the internet.
Work has been interesting. There's a new sheriff in town...no just kidding ...they have an interim administrator who has decided to make some changes. No more per diems, we now daily have 6 or 7 patients, with 2 techs for 30 patients. They decided not to cancel the travel contracts...I don't know how I feel about that, I wouldn't have minded leaving but now they are giving me some extra shifts since the agency people are gone. It's not a pretty time. There's a lot of complaining and the nurses who were already pretty burned out are talking about leaving. I don't see this hospital staying open much longer...although no one else in the city wants the patients who come here, so, the other hospitals may keep it open for that reason. I'm just glad, once again, to be able to walk away from a bad situation before it gets worse. I try to be as positive as always knowing I don't have to stay and deal with the stupid changes that administrators make. It really makes me appreciate the good hospitals I have been in. That's why I do what I do. I will be updating you all on our progress and the hunt for a new job as well.September is just around the corner...thank goodness.
Remember first do no harm.

Only in the south

I was at work the other day, looking at the cafeteria menu, and I thought wow, I don't remember seeing these things on any cafeteria menu before. Things like grilled cheese with tomatoes and bacon, turnip greens, collard greens,and kale. Also lots of smothered stuff and meat with gravy. Of course no breakfast is complete without sausage gravy on biscuits, corned beef hash and baked apples...baked apples, that was a new on on me. Makes me think they are trying to get the staff to become patients with their heart unhealthy diet.
I met a new traveler the other day. I heard from my recruiter that she was coming, she's working night shift. She is living here at the apartment complex I discovered. I think she would have left if she had gone to the hotel they were offering us. It used to be something else and now it's a suburban extended stay...pretty old and dated and no pets allowed. She's really young and it's her first travel assignment. That's what I hate about these travel companies...they don't consider the whole picture. I don't think you should send a young white girl from a small town to an inner city hospital. She was scared to death when she drove up on the hospital...the projects are right down the street. A lot of houses surrounding the hospital are boarded up. She was outside the other night with some other nurses having a smoke, heard what she thought were firecrackers going off...the other nurses put out their smokes and told her to get inside that she was hearing gun fire not firecrackers. Things like that will make her think twice about traveling again. It's a good thing the nurses and other hospital personnel are so nice or she probably would have left by now. Just amazes me how little thought most recruiters put into assigning nurses. This hospital is for experienced travelers who have seen this part of the world before, she needed a little more mellow hospital to start, not the middle of the inner city. Maybe on her next assignment or the one after that this place would have been ok. I'm sure her Mom was not happy about leaving her here after she saw the hospital either. Just glad we found a nice quiet place to live.
Hope all is well in your world....remember first do no harm.

Agency nursing

I am so irritated. Sometimes this agency travel thing just gets to me. I still think it's better than a staff position in the long run but, it can be so irritating. First, this travel agency I am working for seems to be staying true to their word. Just remember to read every line of your contract and you should probably either read it and put it down for a while and pick it back up with fresh eyes or have someone else read it as well. My contract is actually for 14 weeks... I called my recruiter to see if it was a mistake, she said no, it's to help you get all your hours in because sometimes you don't get them all the first week. Well, I did, can I leave a week early? Probably not...so much for this stupid company. They all have their little things, they are all a little different, not always in a good way.
Next, I signed up with Nurse Finders when I got here. I told them where my contract was and they said no problem they had plenty of work for me. I have worked with them one day. It turns out, all the shifts they have are at the hospital I am contracted at and I can't work there for 2 companies. They put me at an adolescent psych facility which is so not where I am qualified to work. Today they called me to work there. I told them fine but I am not going to do a med pass, if that's what they need then I am not going. I don't know if y'all know what a med pass at a psych facility is but let me try to explain. You are locked in a little room with your med book. You have a tray that you put all your cups in and fill them with the meds. So, the checking the name band as a second check and asking their birthday, or even telling them what they are taking is out the window. There is a picture of each person that you put by their cup so you know who to give the pills to. Then you either open a little drive thru type window or open a half of a door and then your announce that it's medication time. They all file up to the door for their pills. Now, they aren't patient, they don't care if it's your first time, in fact, they will mess with you and tell you they are someone else and not take their pills or spit them out just to mess with ya. Also, if one of them goes off and needs a shot or some extra meds, it's the med nurse who administers it. Not to mention the fact that all the doors are locked and you have to watch who is behind you because they will try to escape. So, the agency was not happy with me and won't put me at that facility because I won't put myself in that position. I tried to call and talk with the office manager to explain that maybe they don't understand my position and that I was irritated that they had said they had plenty of work and it turns out that they don't. They said it was my unwillingness to go where they had shifts...I told them I guess I need to find work elsewhere. I am not willing to risk my license for a couple extra bucks.Why didn't they just tell me they couldn't help me when I went there...before they bothered my references, and I spend my time and money to drive to their office and take their tests. It is very aggravating and it seems to happen a lot. It has happened in every city that I have tried to get work except Oklahoma City and Phoenix.
Ok, I'm done, I feel a little better. Just be sure to check the fine print and don't be afraid to ask questions. Remember, the agencies are working for you, you are making them money and don't let them tell you what you can do. Know your limits and stick to what you are comfortable with because they probably won't stand behind you if you get stuck. They are in this purely to make money, we are here to help people and secondly make money. Remember first do no harm.

Life goes on

Hi everyone. I am still here in good old Richmond. The picture above was taken on Virginia Beach last week. The weather was not very good, by the time we got to the state beach, which is the only place we could take our dog, the weather had broken and started to clear up. It was about a 2 hour drive and the state beach was nice. Virginia beach was very commercialized, lots of big hotels and a boardwalk. We were going to try tandem bicycles but the weather kind of killed that idea. A wet butt on a cool beach didn't sound very romantic.

My time at the hospital has keep me sane while I am alone here.My husband went back to Columbus on Sunday last week. The clients are mostly poor or the poor from the nursing homes in the area. A lot of them are in pretty poor shape (otherwise known as a hot mess) and no family or anyone to claim them. It makes code status a difficult subject. It's also hard to decide what all should be done or that really needs to be done...luckily I don't have to make those decisions. I care for all my patients the same. I got a compliment from one of the doctors today on how good my patient looked. She had just been admitted from the ER about 2 hours before. With the assistance of my PCT ,I was able to give her good mouth care and clean and lotion her dry skin. My PCT has taught me just the right combination of things to use on their skin to make them less dry. I also passed on the compliment to my boss and the PCT...give credit where credit is due. I listen to my PCT's and LPN's, especially if they have been there awhile, they know the place and the people better than I do. I know my nursing, a lot of times they know the ins and outs of the hospital and can keep me out of trouble. Not so much trouble I guess as keeping my foot out of my mouth.

I am trying to pick up more shifts but the census is pretty low this holiday week. It's really messing me up having a holidayin the middle of the week. This particular hospital doesn't recognize the 4th as a holiday. They only pay time and a half for Thanksgiving and Christmas...kinda weird.

I pray for a quite time for all you ER nurses, but I know the holiday will bring some interesting times for y'all. Keep the peace and first do no harm.