Recert Blues

I have recently taken both my semi-annual PALS and ACLS recertifications for the 15th time (possibly 16th, can't recall).  It has always, ALWAYS been a source of tremendous stress for me.  Nothing strikes fear into my heart more than the word "MEGACODE".  Seriously.  More than "woman in labor".

This stems from the olden days when ACLS was taught by paramedics with one mission: to fail each student.  I was so paranoid about possibly failing this course that I paid a bunch of money to take my initial certification at a Big Town university, many miles away from my tiny hospital so that if I did fail, I could do so in obscurity.  I passed the megacode portion, a one-on-one situation in those days, but I was so traumatized that I promptly failed the written portion and had to return the following evening for a retake.  Thus I suffer from ACLS induced PTSD.

Pseudocity does not run ACLS recert classes.  Oh no.  They offer online review, and then you must make an appointment for Megacode with one of the educators.  I just couldn't fit it in, so I jumped at the chance to take the recert with Best Paramedic on the Planet (BPOP) at a location right near my home.  Piece of cake, right?

Always, more complicated than it seems.  Class consisted of me, another nurse and 10 paramedics.  After the requisite DVD viewing, airway station, CPR run-through (that I just did 2 weeks ago), and a too long break for pizza lunch, it was time for the dreaded Megacode.

For added fun, Best Paramedic set it up as a field experience.  Victims (mannequins) set up, ambulance with equipment on scene, back boards, monitors, med boxes.  The other nurse and I could not have been more out of our element.  Plus, she was wearing a dress.

First scenario, "52 year old man climbed up a flag pole after drinking a bottle of vodka and a couple of energy drinks, felt dizzy and fell.  Complains that his butt hurts" ( the butt hurting thing was a common complaint in these fictional scenarios, I was later to discover).  Group leader  was expected to run the scenario like a regular call, something all the pre-hospital types do 100 times a day.  Other Nurse and I were all,  "which one is the first response bag?", "where do you keep the c-collars?", "how do you get the drug box opened?".  We were useless.  Best Paramedic excused us from that portion of the exercise and just let us do our own (gentle version) of Megacode in the back of the ambulance, but even that was intimidating.  I could feel the internal eye rolls of the medics as I stuttered my way through an easy v-fib to PEA to asystole scenario and had to list all the H's and T's.  Like I said, megacode makes me paranoid.  One year I was so nervous I gave my maiden name although at that point I had been married over 30 years.  But I digress.

BPOP  was anxious for my feedback on including nurses in the megacode portions of the course set up for paramedics as we were the first two guinea pigs.  I had to tell him that, personal nerves aside, it was eye opening for an ER nurse

Ambulances are mysterious things to nurses who have never worked in them, and even in a short handed ER there are always resources.  Not so in the back of a moving ambulance.  Sure, I have been on transfers, but it generally consisted of sit here, don't touch that, push that med, is that IV running type of thing.  Never really had to do too much and spent that time finishing up my charting or whatever.  And I didn't enjoy it, except for that time we did the CPR Marathon back in the 80's.  That was fun.

Observing experienced medics in their natural habitat was an interesting and invaluable experience, and they occupy a spot on my pedestal, just a little higher up now.

As to the PALS recert?  Given by the education department and included 3 office pediatricians who haven't run a code in 20 years, a pediatric office nurse who was essentially a new grad, and me.   I felt like a rock star.

Holidays….'n Sh*t

Ah,  the holidays.
I usually work on Halloween.  I really have no use for this particular holiday even though my daughter says "Halloween is the best!  It's my Christmas!".  Whatever.   I have not had a kid come to the door in the last 10 years in spite of leaving a dish of candy out.  Well, one year I did, then had to eat the candy.  I would just rather work, it's easier.

I asked a co-worker last year if the nurses in our ER tended to get dressed up for Halloween.

"Of course!", she chortled.  "Well, I do!  I dress up everyday!"

The other nurse in the med room during this exchange grinned and shrugged.

"Ok, I mean does anybody OTHER THAN YOU dress up for Halloween?  Like teeny devil horns, or a spider on my headband?"

"No, not really.  But lots of people have halloween scrubs".

That's what I thought, I asked exactly the wrong person.

This fashionista nurse has an extensive and varied scrub wardrobe (scrubdrobe?) and by far surpasses this gal.  I don't think she has a single repeat, even for the "everyday" variety.  As for holidays, they are numerous.  There is even a collection of Hello Kitty attire, which I though was a riot and so wrong for a woman of her age, yet…she pulls it off.

Then there are the accessories.

For the hair, there are bows, barrettes, and headbands.  There are bracelets, earrings and necklaces.  There are tennis shoes, clogs, and nursing shoes of every color and description.  Watches.  Pens.

The day after Halloween, before the candy corns had a chance to become stale, her  Christmas and winter wardrobe came out.  Turkeys and cornucopias and snow globes, oh my.

We were subjected to hearts, hearts and more hearts signaling the end Christmas scrub season, around January 7.  And round and round, St Patrick's day, spring, Easter, Flag Day, Arbor Day.  There was not one holiday or observance left uncelebrated by some sort of attire.

Out of curiosity I once asked how many holidays and seasonal sets of scrubs she had.  I rarely see a repeat, I had to do it.  She had no idea.

 "A lot!", she grinned.

I was invited to her house after work for a drink, and I got an idea of how many sets of scrubs she had. Hundreds.  Literally.  Hundreds.

Which is exponentially more than my 3 sets: one navy, one ciel, one black.  And a black fleece vest which I pair with a 3/4 sleeve rolled cuff shirt.  Height of fashion.

I figure since I have been working back here at Pseudocity more than 1 1/2 years, I should go ahead and order the fancy vest with hospital logo and my name on it.  4 years to retirement.  Guess I'll get my money's worth.  But no holiday scrubs, rest assured.

Well, so...

I haven't actually run out of gas, just motivation to finish pretty much anything I start.    I have volumes of posts that I can't quite….wrap up.  Or can't remember why I started them in the first place.   Or that I think are stupid…mostly that.  As well as a shit load that I haven't even started yet.

I wrote a book, of sorts, culled mainly from some of my more ridiculous observations of my 42 years working in health care.  I suppose it's  entertaining.  It ends somewhat abruptly because I can't finish that, either.  To quote John Irving, "A sentence boiled in her, but she can not yet see it clearly". (The World According to Garp)

I am down to two jobs, both per diem.  I dropped BWOM Hospital out of the rotation about 6 months after I started….5 months later the Director called me to ask if I wanted any shifts for the holidays.  Yeah, no.  So, quit by default.  I tried to make it until the first of this year just so I could put on any future resume that I had worked there for a year, but….didn't finish out that way.   Although actual hire date was in December, my paperwork said January 2014.  So 11 months.  Whatever.

I have not worked at the Med Center in about 5 months, so I expect I will be getting the inevitable call about holiday shifts, or if I want to work there anymore.  Actually I would, but 1) I refuse to work 12 hour shifts, and 2) my badge, computer access, and payroll codes no longer work.  That is a potentially ominous sign, but I lack the initiative to rectify it.  Or give them my updated BLS, PALS, ACLS cards and flu shot affidavit.  So I suppose that the writing is on the wall.

At Pseudocity, there is no paucity of available shift work as I prefer 3-11.  I will accept a rare 12 hour shift and avoid the 11A-7 P as much as possible.  The added incentive to work extra on designated premium shifts means that some weeks I wind up, through requested switches or coming in a bit early on a weekend with about 8-12 hours of DOUBLE TIME pay.  I have never heard of an ER paying double time, but what the heck, it will not last too much longer as the very young orientees will be finishing their precepted shifts just in time to eliminate all double time for the holidays.

Selecting shifts is easy as my boss is a procrastinator, and filling in the per diems like me is a piece of cake.  "What days do you want to work?" is texted from my boss a couple of times a month, and I just tell her, "Oh, Mon, Wed, Fri, Tues, Thurs Sat on the next sched", or "Whatever, your choice", or "Any day but the 13th, weekend of the 20th, or ___ date  because I have a dental appointment".  This seems to work quite well for both of us.  Keep in mind that I also get multiple daily texts or calls from panicked charge nurses who ask me to come in early ("PREMUIM PAY!!!"), stay late, work an extra day, cover a sick colleague; plus requests from nurses who need last minute time off for a kids' game, recital, or spousal liver transplant.  I can be accommodating, to a point, but you know, sometimes the money is not worth the wear and tear on the body.   I am so much better at saying no these days, while still retaining my cool kid status.

But it is so busy.  Almost too busy when you run from task to task and just try to get stuff done, with my aching knees, shoulder pains, and need to actually toilet from time to time.  Which is why I don't get much done at home; I sleep as late as I want, sometimes until 9 AM.  Have coffee and a leisurely breakfast, then take the dog out for minimum of an hour, sometimes 2.  By that time, I need to get ready to go to work.  The job is not 4 minutes away anymore, so no more jumping into the shower 40 minutes before I'm scheduled to be at work.  That cuts in on my motivation too.

Well, I guess that's all the update I have for now, if anyone still stops by.  The porch lights are on.  My motivation for this post?  Aesop has "dormant" next to my blog link.

A Puzzle for You

License plate seen in a hospital parking lot:

2MLX3

Thoughts?

Cat and Mouse, 2.3, or, I Hate Those Meeces to Pieces

If you have read any of my previous postings on  mice,  mice, and more mice, you may have gotten the impression that I don't mind them.  Seriously, I hate mice.  They are just so….rodent-y.  Filthy. Gag.  It is one thing to have them in the work place, but at home…..nope.  I was understandably VERY disturbed when I found mouse turd under my kitchen sink last week, having discovered that my packet of dishwasher gel packs was nibbled at the bottom.

"The dog got it",  Mr. Ednurseasauras told me.  "Two months ago".  As if it could ever be just a single mouse.

But, I bought it.  I don't do a lot of machine dish washing, probably only one load per week so it was possible that the packet had been nibbled months ago.  I put on two pairs of rubber gloves (which I threw out) and spent a morning clearing up and organizing the assorted cleaning clutter, vacuumed, bleached and decontaminated the entire area.  Then searched for further sign of the little f*ckers and cleaned every cabinet.  Having had enough mini drama for the day,  I washed my hair and puked.

There was no sign of additional rodents until yesterday when I FOUND MORE MOUSE TURD under the sink.

I have both a cat and a dog who have faithfully alerted me to the presence of mice in the past.  They have each caught a couple, and have even collaborated with mouse hunting/ slaying in the past.  The cat once left a mouse head on the kitchen floor to rebuke us for leaving her for the weekend, but the dog also impressive stats.  There was, however, no alert the time.

"You guys have failed", I berated them. Neither had the good grace to look ashamed.  The cat yawned, the dog licked herself.  Rude.

"We need to set traps", I announced to Himself.

Mr. Ednursesauras discussed the merits of various kinds of mouse-killing apparatus which we have collected and deployed, but never caught a thing.  We had some where they could wander in, but not out.  And some that are pads the rodent-y little feet stick to.  And of course the classic mouse trap-mouse traps, which are hazardous to human fingers.  Letting mice go is the same as leaving our borders unsecured, they just get back in.  Also, since our experience last spring with the beavers that resulted in the flooding of our property that we had just put on the market, I'm out for  invasive species annihilation.  My only rule is that I am not removing the carcass.  Nope.  Not looking at it.  NOT touching it.  Nope.

I do bees.  Hornets.  Yellow jackets.  I don't mind snakes.  I even had to clean up after a duck had gotten into our family lake house and died, and you can imagine the mess that made.  I have a lifetime of experience with body fluids,  both man and beast.  I think I am entitled to draw the line at dead mice.  Oh, and spiders.  I won't do spiders.

I baited the trap with a dab of almond butter and a small piece of 9-grain cracker believing that I would, a usual, not catch a thing.  I had the pest control service on speed dial and anticipated calling in the morning.

Two hours later I heard a rattling.  Shocking.

Dog: 0, Cat: 0, Human: 1.  Number of dead mice in the trap: 1

Mr. Ednurseasauras put on an old pair of work gloves and disposed of it.  I suggested he put in on our nosey neighbor's mailbox, but he wisely declined.

"Well.  That's that".

With the bait intact, the trap was returned to duty under the sink, Mr. Ednurseasuaras convinced that was the end of the problem.  Forty minutes later, I alerted him that there was a companion  dead mouse called to Final Accounting.

"What!?  How do you know that?  The dog hasn't moved".

I could hear it. Above the sound of the TV, my computer, and the air conditioner.   Call me crazy.

"Wow, you picked good bait", Mr. Ednurseasauras commented.

"Why, what did you use last time you tried this?", I asked.

"Provolone cheese".

NOW the dog was interested.

Today I cleaned under the sink, vacuumed, bleached, and disposed of another pair of Playtex Living Gloves.  Then washed my hair and puked again.

The dog has been at her post.

Tonight we hunt again…..
Stay tuned.