Luke.... I am Your Father

I know, you are shocked. Another post so quickly?

Well, since I'm sitting here with my foot iced and elevated and no where else to go I thought I might regale the vast emptitude of cyberspace with my continued trials and tribulations.

Recently, (and I use recently in the current bureaucratic sense of health care meaning in the last 6 months) I had a sleep study done and I travelled to Indianapolis to get my results yesterday. Now, this would be a boring post or Facebook update except for the crippling heel pain that I was suffering from some unremembered injury this past holiday weekend. That converted an otherwise ordinary and boring drive to the Indy area into an unrelenting exercise of controlled torture. Every fissure in the road surface converted itself magically into a jolt of agony much like that of an icepick being driven into my left heel.

Upon arriving at my designated appointment, I had to park 1/4 of a mile away in the parking lot and hobble to my destination whilst watching spry 80-somethings leap from their vehicles in the handicap parking and sprint to the entrance. It was about this time that I thought that the doctor should be able to prescribe a temporary handicap parking permit with any other medications...

After limping/crawling my way to the second floor for my visit, I learned what has no doubt been apparent for many years, that I do have sleep apnea and I need a CPAP machine. Fortunately, I did not receive my machine yesterday, as I doubt I could have carried the damn thing. I am returning tomorrow for the fitting and such. I did, however, manage to make an appointment to see the orthopedic guy regarding my crippling heel pain. After some ridiculously expensive x-rays and some none-too-gentle prodding of the sore heel I was informed that I have a Haglund deformity. This is a fancy medical way of saying I have a bone growth on my heel that shouldn't be there. By hyper-flexing my foot, I managed to irritate the bursa sacks near my Achilles tendon with the aforementioned genetic monstrosity protruding from my posterior end of my calcaneus.

So I received a giant Aircast for my foot. When combined with the two knee braces and the forthcoming CPAP machine, I am quickly turning into Darth Vader. Or perhaps, since these things are so damn expensive, I should just change my last name to Austin and be done with it.
Either way, I won't be uttering the most misquoted phrase of the Star Wars movies, because I am a geek and I know that this is a Misquote. The actual quote is here.

Christmas

I had an awsome Christmas this year. Sure I had to work, but it was an amazing day.

This is my forst Christmas as a nurse, and I do not think I have ever worked on the actual holiday itself before. About a week or so ago, my wife decided that since I was working for the Holiday, she was going o provide dinner for some people at a recovery center. My initial reaction was, "whatever..."

Christmas morning found me in the kitchen, preparing and roasting the turkey and stuffing While my wife slept after her long night of work on Christmas eve. As I was working on the food, I realized that I had not ever done this before. I was cooking a meal for a group of less fortunate strangers and I was doing it for free. Gratis. I'm sure during my years in the restaurant business I may have cooked a meal for someone less fortunate than me, but I damn well got paid for it! I don't even know these people and I am making Christmas dinner! After the food was in the oven and going, I had an hour before I had to prepare for work and I decided to call the center and let them know that my Wife was not cooking the meal there like originally planned but that the food was indeed coming. The gratitude I heard in the voice on the other end of the line was profound. I just threw a turkey in the oven and MacGuyver'ed up some stuffing using some Hardee's Sausauge biscuits instead of real sausage. It was nothing to me, but this guy on the other end was almost in tears.

Bolstered by this experience, I went to work in the nursing home. One of our residents has been declining in health and I was there for her and her family when she passed away a couple of hours after my shift started. I had the privledge of caring for her since my first day of work as a nurse, and in fact she was the very first patient to whom I administered medications. It was a really rough Christmas for her family and I was glad I was able to be there for them and honored to help.

Before Christmas this year, if you had told me that this was going to be my Christmas experience, I would have thought that it sounded like Christmas was going to suck. After yesterday, I can only say that I had one of the best days of my entire life. I have always heard that there is great joy in selfless giving, I just never really believed it until now.

Work, Drugs and Time to Go...

Ok, so I've been working as an LPN for about 5 weeks now, and here are my observations so far. First, I am liking the job so far, which is good since I am investing a great deal of time, energy and money into it. Second, I've realized that a lot of my co-workers DO NOT like it. Maybe because they are burnt out from working in nursing homes for so many years, maybe just from years and years of nursing, but a lot of them complain constantly.

We did have a big drug scandal at work last week. There was a mandatory meeting and in it it was revealed that an audit of the narcotics drawer for one of the wings (thankfully not the one I work on) was a total mess. Narcotics were signed out to residents that denied getting the drugs and there was an order written to the pharmacy for a narcotic that was perscribed by a doctor! Of course, this order was never filled. The offending person even went as far as to call the pharmacy and pretend to be the DON. This tactic didn't work either. They apparently got away with taking the meds from the patients for a few days, but that's about it. I say they because her husband worked for us too as an aide. They both are no longer employed with us, since they never called or showed up after the meeting was called. I'm learning that there is a lot of substance abuse in nursing. We have at least 3 known (known as in self-proclaimed) substance abusers who are in recovery and a few more that seem like they might need a program.

Lastly, I actually had a bad and rough situation at work this past weekend. We have, as you might suspect, some residents that have dementia and Alzheimer's. I witnessed a nurse flat out refuse to admister an as needed medication. For those of you not in the medical field, As needed medications are medications the patient can have upon request, such as Mylanta 15 ml every 4 hours as needed for nausea. The patient can have 15 mL once per 4 hour period if they need it for stomach upset. Apparently, this patient, who has Alzheimer's, refused is afternoon pills and then requested the Mylanta. The nurse told him he could not have the Mylanta since he did not take the pills. This is wrong on so many levels it isn't funny. First, the patient does not remember refusing the pills since he haas Alzheimer's. This is like punishing a dog 3 hours after it pissed on the carpet. Second, the word punish. It is not in the nurse's scope of practice whatsoever to discipline a resident at all. The word home is used in a nursing home to note the fact that this is the resident's home and we work for them. And lastly, when I politely (really, I can be polite) iformed her that it was illegal to refuse the medicine, sher stated. "I really don't care, I fucking hate him." From there it's a short step to physically striking the patient. So, after deliberating all night and sleeping poorly, I decided to report my co-worker to the Director of Nursing Monday morning. Of course, this will no doubt make me the nurse with the target on his back next time I work.

So, that's my first month of working as nurse in a nutshell.

Crazy School Days

I have recently returned to Nursing school after huge gap of, oh...4 weeks. Here are the highlights of what I have learned so far:

According to one instructor, the Obama health care bill is 'forcing' small critical care hospitals like the local one to spend 'thousands and thousands of dollars they don't have" to go completely digital with doctor's orders and patient records. This puts an unfair burden on the small hospital. Apparently, my instructor feels that the patient records can be hand-written and illegible if it means saving a few bucks. Also, the 'unfair' burden of the 'thousands of dollars' the hospital might have to spend on digitizing their charting doesn't explain the need for the hospital to expand to the tune of approximately $6,000,000...Yes you read that right, Six Million dollars over the last two years!

Remember, this hospital sits in a town of around 7,000 people. But building new rehab facilities and a dialysis unit and now a huge ER addition and, Get this, a building that will stand empty until such a time as it is needed, is normal growth for this area, while $100-200,000 to update charting is an unfair burden.

Also, from another instructor, I learned that the Obama health care bill is not going to pay for medicare and medicaid treatments at hospitals so more people will be going to the hospital but there will be less jobs in nursing because there will be no money. Really? Do you think that even Democrats would have passed a bill that said hospitals won't get paid? Oh, and this instructor also believes that the current Salmonella outbreak with the eggs is really a terrorist attack by Al Queda and our socialist government is covering it up.

What do politics and conspiracy theories have to do with nursing school?

Nailclipper Debacle

Well, only the third day of my orientation and I was left on my own for 4 hours. Well, technically, there was an RN down on the south wing that was supposed to help 'orient' me on my tasks and all, but she never came around to see how I was doing. Mind you, I was glad she didn't come around, she seemed clueless.

Speaking of this particular nurse, we have our first nickname of the new job! Granny Spacey seemed to not know any of the patients on the north hall, where I was working, or the south hall, where she was working. Of course, being left by myself for 4 hours one would expect something unusual to happen, and of course it did. This sweet little resident was spotted by the CNA attemting to amputate her toenail with contraband nail clippers. After assessing the damage and cleaning the wound, I contacted the doctor's office. Par for the course, her doctor was out of town and being covered by another doctor. I called the covering MD and left a message for him to contact me with an order for treatment of the wound. After never hearing back, this is the conversation at shift change:

McNurse: "I think I filled all the paperwork out correctly. I have the non-breakdown wound form, the incident report, I charted the findings in the nurses' notes and I called the doctor, but he hasn't called back yet."

Granny Spacey: "Oh, there was a a call from some man about 30 mins ago, I couldn't understand him at all. He had such a horrible accent, you know those foreigners."

McNurse: "He should have asked for me, I'm pretty sure almost any accent can pronounce my first name easily."

Granny Spacey: "Oh, he did say that, I'm sorry, I forgot your name."

McNurse: Well, did he ask for the North wing?"

Granny Spacey: "Yes, but he couldn't tell me the name of the resident, so I hung up."

McNurse: " Let me get this straight; He said my first name and asked for the the North wing and you didn't page me?"

Granny Spacey: "Well, he couldn't name the patient, so I thought it might be a Hippa violation to connect him."

McNurse: "Well, I guess I'll have to call him back."

Granny Spacey: "Twice."

McNurse: "What twice?"

Granny Spacey: "I hung up on him twice, he called back."

McNurse: "?????"

I was speechless. At least now I know why the DON walks around with such a miserable look on her face. Granny Spacey works there.

First Impressions

Wow. I'm feeling a bit overwhelmed. Lots of meds to pass. It takes me forever to get them done. Of course, this is only after my second shift, I assume that this will get better. Hoping to develop a system of sorts tonight and tomorrow.

There are lots of characters where I work, so I will start describing some of the folks this weekend.

The Shoe Cult

Every Morning, I take a healthy walk down the street and over the bridge into The Other State. I enjoy walking on the bridge, I see all sorts of unusual stuff. Unlike the road, where anything that might fall of a vehicle going 60 mph will bounce off into the weeds and disappear for ever, the bridge is like a giant tray with 3-foot high walls. It is a repository of reflections, if you will.

For example:

"Hmmm, I wonder what caused that radiator cap to pop off a moving vehicle? For that matter, how old was the car to have a radiator cap like that?"

"Wow, that is a pretty expensive and space age-looking bolt. What the hell did that fall off?"

"That looks like some giant tie-down mechanism off of a truck. How could you miss THAT falling off?"

"WTF??? a shoe??"

How the hell does one loose a shoe while driving at 50+ mph? I have been pondering that question since I was about 9 years old. I'm not talking a flip-flop; I've seen enough people with their feet on the dash and hanging them out the passenger window on warm summer days that I would expect the highways of America to contain a lost flip-flop or three. No, I am not talking children's shoes here, either. I am well aware that young children often fight and squabble and throw their sibling's things out the windows of moving cars, having been a victim of that particular cruelty myself. (Although, in hindsight, the Jackson Five lunch box my brother tossed out the window on the Major Deegan one summer was a potentially fatal projectile.) I'm talking about the adult-sized single athletic shoe, the odd work boot and the single loafer. I mean, is there some clever practical joke I was never party to where someone in the car wrestles another person down and snatches one of their shoes off and tosses them out the window? I have driven all across this country during my 40+ years of life and I have seen these odd relics of footwear littering the roads and highways of every state.

I have begun to suspect that these shoes are part of some sinister cult network. Perhaps these are beacons to the secret locations of the local meetings. What other explanation can there be? No one accidentally flicks a laced up athletic shoe or work boot out the window while driving. As for loafers, who wouldn't throw both of them out the window? Nope, it's a cult.

Either that or the Free Masons, everyone knows those guys are freaks.