This man walks into the ER (classic start of a bad joke, why should today be any different). He noticed that some thick, black smoke was pouring out of one the the chimneys in our very old building as he was passing by a couple of hours ago. He was on his way to an appointment and just didn't have time to stop but, hey, nice of you to check in with us on your way home to make sure we were not burned to a crisp in the interim. He suggested we might want to have our maintenance guy check it out.
Ellen gets nervous about these things and wondered if we should call maintenance now, on the off-shift and also off-site, or if I thought it could wait until the following day. Or if she should call the fire department. I'm the nurse in charge which I guess also makes me in charge of everything else. Besides, six months earlier there was a back-up of thick smoke that cleared out the building and left an odor for days.
Me: Yeah, put a call in. What the heck is a little overtime when we might be fully engulfed in flames in a little while?
Ellen: Wouldn't we have a lot of black smoke if there was a problem in the boiler room?
Me: Well it's a catholic hospital so white smoke means that a new pope has been elected. Black smoke would mean they haven't made a decision. Although I'm pretty sure the old pope has to be dead first but I don't really keep up with that type of thing.
Ellen: I don't understand.
Me: I'll go check the boiler room; you call maintenance.
Ya gotta love Ellen. She is so earnest; she always means well and would do anything for anybody. She has at least 10 "get well" or "Happy Birthday", cards going around. New people are powerless to escape the Spanish Inquisition when it comes to Ellen's Vital Records: Life Events, Spouse's name, Children, Pets (and their names), and especially Birthdays. Everybody gets something; a cake, brownies, raspberry bars, or our favorite, Whoopie Pies. And hers are goooooooooooood. But I digress.
On another night I had a problem with a strong odor of smoke. Cigarette smoke. It was coming from somewhere......close. REEEally close. From inside the building. From....Holy Shit! That asshat was smoking.... in the bathroom?
Old Drunk: "Nope, I wasn't smoking"
Riiiiiiight. "Sir, you cannot smoke in here. If you do it again, I will call the police and have you escorted out"
I had to open up the ambulance bay doors to get the smell out. It is bad enough that people reek of cigarettes in triage while they claim to smoke "2 or 3 cigs a day"; sometimes at the end of the day all I can smell is stale cigarette smoke. It is so disgusting.
I am a reformed smoker. I last smoked 33 years ago, my final pack of cigs hitting the trash bucket at the same time as my first positive home pregnancy test. It was tough to do, no doubt about it. I just don't get that people with kids think that they are not exposing them to the dangers of third-hand smoke by merely smoking outside. The chemical residue clings to clothing, skin, hair, furniture, and builds up in the car. If you are "only smoking outside", you are exposing your family unnecessarily to harmful toxins.
OK. Off my soap box.
Monday, May 14, 2012
Sunday, May 13, 2012
No Filters
I have had people call 911 from the waiting room on many occasions, usually by disgruntled individuals with relatively non-urgent complaints who felt that their problem deserved attention ahead of minor complaints such as chest pain. Mostly by people who were not as sick as they thought they were. Some who thought, erroneously, that they would be magically whisked into the back door and immediately ensconsed in a comfy bed, or taken to another hospital. Never, ever have I had an 11 year old female do it for attention.
(Heard on police scanner): "Got a 911 hang up from XXX st., the ER. Came from a phone in the waiting room".
Me: "WTF"??
(Heard on police scanner): "Got a 911 hang up from XXX st., the ER. Came from a phone in the waiting room".
Me: "WTF"??
Saturday, May 12, 2012
Lady, Lady, Lady
Lady is still up to her old tricks; frequent visits (mostly during the day), speed-dialing the patient services rep to complain about some imaginary slight, or for perhaps calling attention to her obesity, poor eating habits and lack of diabetic control cause-effect.
She had some abdominal surgery a while back, but at Ginormous University Hospital in another state. Naturally, because she is a poor healer she had some wound dehiscence. Said hole in her belly has been plugged up on a daily basis by the home care nurse.
The thing about home care is that the patient must, oddly, be at home to receive a service. Lady's home care nurse, understanding what a deep personal relationship we have with Lady, gave us a heads up that we might hear from her. She didn't happen to be home at the time of his visit and she would only be able to stop back at her house late in the afternoon. It depended on his other scheduled visits.
Of course she called to inquire if she should come right down for us to handle her emergent wet-dry dressing change. She didn't know about the call from the home care nurse.
Lady: "Yeah, I'm having some issues with my home care nurse. She's beginning to be a real pain in my ass. She said that just because I missed her visit by 7 minutes she couldn't come back because she had to go way out to Booneysville and it would take her out of her way. That is unacceptable, I was out buying groceries so I could have healthy food for my diabetes, and groceries don't buy themselves. Should I come in and have you change it?"
Me: "No, Lady, your home care nurse is the one you see every day who knows about your wound and how best to do the dressing. What exactly did she say? Maybe that she would TRY to come by and that she would call you?"
Lady: "Uh, um.....well, she's really beginning to bother me. She might be able to come back but she didn't say when"
Me: "It is the weekend, any issues you are having with her will have to be dealt with on Monday. In the meantime, she is your nurse. I suggest you wait until you hear from her. She did say she would try to get back to you, but to be fair, you were not home when you agreed to be there. That's not her fault, is it? And if she had to go to Booneysville waiting around for you when she didn't know when you would be there isn't fair to her or her other patients"
Lady: "Well, so you're saying I shouldn't come in?"
Me: "No, I said wait to hear from her. If she can't reschedule your visit, have her call ME"
Lady: "Oh. So she can tell you how to do the dressing"
Me : "Yes" (actually because I know she will not be calling me which means you will not come in by that big white taxi with the flashing red lights for a dressing change that doesn't need to be done)
Come Monday, two things happened; Lady fired the home care nurse, and the home care nurse stopped by to thank me.
She had some abdominal surgery a while back, but at Ginormous University Hospital in another state. Naturally, because she is a poor healer she had some wound dehiscence. Said hole in her belly has been plugged up on a daily basis by the home care nurse.
The thing about home care is that the patient must, oddly, be at home to receive a service. Lady's home care nurse, understanding what a deep personal relationship we have with Lady, gave us a heads up that we might hear from her. She didn't happen to be home at the time of his visit and she would only be able to stop back at her house late in the afternoon. It depended on his other scheduled visits.
Of course she called to inquire if she should come right down for us to handle her emergent wet-dry dressing change. She didn't know about the call from the home care nurse.
Lady: "Yeah, I'm having some issues with my home care nurse. She's beginning to be a real pain in my ass. She said that just because I missed her visit by 7 minutes she couldn't come back because she had to go way out to Booneysville and it would take her out of her way. That is unacceptable, I was out buying groceries so I could have healthy food for my diabetes, and groceries don't buy themselves. Should I come in and have you change it?"
Me: "No, Lady, your home care nurse is the one you see every day who knows about your wound and how best to do the dressing. What exactly did she say? Maybe that she would TRY to come by and that she would call you?"
Lady: "Uh, um.....well, she's really beginning to bother me. She might be able to come back but she didn't say when"
Me: "It is the weekend, any issues you are having with her will have to be dealt with on Monday. In the meantime, she is your nurse. I suggest you wait until you hear from her. She did say she would try to get back to you, but to be fair, you were not home when you agreed to be there. That's not her fault, is it? And if she had to go to Booneysville waiting around for you when she didn't know when you would be there isn't fair to her or her other patients"
Lady: "Well, so you're saying I shouldn't come in?"
Me: "No, I said wait to hear from her. If she can't reschedule your visit, have her call ME"
Lady: "Oh. So she can tell you how to do the dressing"
Me : "Yes" (actually because I know she will not be calling me which means you will not come in by that big white taxi with the flashing red lights for a dressing change that doesn't need to be done)
Come Monday, two things happened; Lady fired the home care nurse, and the home care nurse stopped by to thank me.
Friday, May 11, 2012
Nurses...Advocating. Leading. Caring.
This statement has apparently been adopted by the American Nurses Association, which I didn't know until I Googled it. I did this because I KNOW my hospital didn't come up with it on their own. It appeared as a caption on a list of "Nurses' Week Activities" in a previous post, with all of the crappy offerings letting nurses at this facility know just how valued we are. Massive eye roll here.
Not a fan of Nurses Week, never have been. It's a Healthcare Hallmark Holiday. Like Grandparents Day, or National Potato Chip Day, or any one of hundreds of silly recognition days.
Just out of curiosity I checked around the web to see what kind of floral or gift offerings exist specifically for Nurses Week. I came up with coffee mugs filled with Hershey Kisses, as well as snack baskets filled with M&M's, Kit Kats, Snickers, cookies and other bad stuff. These are apparently interchangeable as Teacher's Week gifts. A few contained "healthy" stuff like commercially prepared granola bars, cheddar cheese popcorn, etc. Yikes.
I get that food, candy, and coffee (hence the candy filled mugs) are the first things on the list when it comes to "treats" for nurses. But I envisioned that our twisted marketing department had their own perspective on "Nurse Feeding" and came up with this:
Keeping nurses full of fatty, high calorie and/or sugary foods will contribute to obesity and other health problems. The benefits, while minimal both short- and long- term for nurses, will be increased for the corporation patient satisfaction scores:
1. Long term health issues guarantees a steady stream of nurses as patients due to the increase in diabetes, obesity, cardiac disease. Revenues will be markedly increased.
2. Patients, with careful marketing, can be lead to view RNoUS (RN's of Unusual Size) as more empathetic, and thus perceived as more caring. Satisfaction scores will be increased exponentially.
I would be happy with a salad, thanks. And because I can never find anything I need to do my job, my constant running about insures that my activity level remains high. Hey! Maybe we could get some coupons for decent footwear...
Not a fan of Nurses Week, never have been. It's a Healthcare Hallmark Holiday. Like Grandparents Day, or National Potato Chip Day, or any one of hundreds of silly recognition days.
Just out of curiosity I checked around the web to see what kind of floral or gift offerings exist specifically for Nurses Week. I came up with coffee mugs filled with Hershey Kisses, as well as snack baskets filled with M&M's, Kit Kats, Snickers, cookies and other bad stuff. These are apparently interchangeable as Teacher's Week gifts. A few contained "healthy" stuff like commercially prepared granola bars, cheddar cheese popcorn, etc. Yikes.
I get that food, candy, and coffee (hence the candy filled mugs) are the first things on the list when it comes to "treats" for nurses. But I envisioned that our twisted marketing department had their own perspective on "Nurse Feeding" and came up with this:
Keeping nurses full of fatty, high calorie and/or sugary foods will contribute to obesity and other health problems. The benefits, while minimal both short- and long- term for nurses, will be increased for the corporation patient satisfaction scores:
1. Long term health issues guarantees a steady stream of nurses as patients due to the increase in diabetes, obesity, cardiac disease. Revenues will be markedly increased.
2. Patients, with careful marketing, can be lead to view RNoUS (RN's of Unusual Size) as more empathetic, and thus perceived as more caring. Satisfaction scores will be increased exponentially.
I would be happy with a salad, thanks. And because I can never find anything I need to do my job, my constant running about insures that my activity level remains high. Hey! Maybe we could get some coupons for decent footwear...
Tuesday, May 8, 2012
Nurses Week
It is Nurses Week. Time to roll out a day by day schedule to honor the wonderful nurses:
Sundaes on Sunday, all shifts all units: note that our unit did not get them, being off-shift and off-site. Apparently none of the oh-so-important 9-5'ers considered us worthy of ice cream.
Appetizers in the Lobby: an Invitation-Only event singling out advanced practice nurses, nurses with professional certification, or nurses who have completed the clinical ladder "Jumping Through Hoops in Order to Get a 20 cent Raise If You Are At the Top of The Pay Scale" paperwork. Way to exclude 95% of the nurses, dear employer, as if our profession isn't divisive enough as it is.
Bagels: only for the home care people. Didn't say if cream cheese was included, or if it was BYO.
Nursing Grand Rounds: Always a boring affair, not worth the drive. Usually some doctor hijacks the meeting. No food either.
Mini Mall in the Lobby: Big whoop. I am assuming that since it is in the lobby, it is also open to the public. Wonderful opportunity to spend money on ourselves, during our scheduled breaks of course, if there is enough staff to take them. If so then there will be smoothies, candy offerings and soft pretzels. For purchase in the cafeteria. So much pampering. I can hardly stand it.
Midnight Breakfast: For the night shift, between 12 and 2 AM. In my experience and years of working nights, this is the busiest time. Except from 6-7, when it would be more convenient for the Suits who claim to be coming in to serve breakfast. Most likely the same Suits who said we would be getting Sundaes, so be sure to bring a snack, kids
Hourly Raffles and Free Giveaways: Most likely free swag from drug reps and cheap crap like key chains and water bottles with the company logo so we can be walking advertisements. Nice. It would be considered a sincere gesture if they raffled off a day off with pay, or a massage, or even a donation to a charity of our choice.
Finally, Bagels: from 6-8 AM on Saturday morning. I suspect they will be leftovers from home care several days previously. Frankly I would prefer Pop Tarts.
Bobo, our medical director and somewhat socially challenged on his best days has actually paid out of his own pocket for some nurses day gift (I think his wife is a nurse). In the past we have received lunch bags, t shirts, and coffee mugs. But slogans like "Nurses Call the Shots", "Love a Nurse PRN", "Nurses Rock" and other silliness goes right to the bottom of the charity bag for me. Let me say that I truly appreciate that he has taken the time and effort to do this. I really do. But I actually hate that more than the company logo.
At my nursing school graduation 35 years ago, one speaker exhorted us as newly minted nurses never to condone slogans that exploit us as men and women in health care, perpetuate stereotypes, and fail to present nurses as professionals. Big boobs, thigh highs and stilettos, giant syringes.....you know what I'm talking about. I have a few Emergency Nurses Association coffee mugs from a former boss that are tasteful, but other than that I say NO to silly slogans.
The only Nurses Week recognition I'm looking for is just a little sincere appreciation for the job I do from my employer. Sincerity is not one of their strong points, so hopefully my boss will come through with the ice cream.
Sundaes on Sunday, all shifts all units: note that our unit did not get them, being off-shift and off-site. Apparently none of the oh-so-important 9-5'ers considered us worthy of ice cream.
Appetizers in the Lobby: an Invitation-Only event singling out advanced practice nurses, nurses with professional certification, or nurses who have completed the clinical ladder "Jumping Through Hoops in Order to Get a 20 cent Raise If You Are At the Top of The Pay Scale" paperwork. Way to exclude 95% of the nurses, dear employer, as if our profession isn't divisive enough as it is.
Bagels: only for the home care people. Didn't say if cream cheese was included, or if it was BYO.
Nursing Grand Rounds: Always a boring affair, not worth the drive. Usually some doctor hijacks the meeting. No food either.
Mini Mall in the Lobby: Big whoop. I am assuming that since it is in the lobby, it is also open to the public. Wonderful opportunity to spend money on ourselves, during our scheduled breaks of course, if there is enough staff to take them. If so then there will be smoothies, candy offerings and soft pretzels. For purchase in the cafeteria. So much pampering. I can hardly stand it.
Midnight Breakfast: For the night shift, between 12 and 2 AM. In my experience and years of working nights, this is the busiest time. Except from 6-7, when it would be more convenient for the Suits who claim to be coming in to serve breakfast. Most likely the same Suits who said we would be getting Sundaes, so be sure to bring a snack, kids
Hourly Raffles and Free Giveaways: Most likely free swag from drug reps and cheap crap like key chains and water bottles with the company logo so we can be walking advertisements. Nice. It would be considered a sincere gesture if they raffled off a day off with pay, or a massage, or even a donation to a charity of our choice.
Finally, Bagels: from 6-8 AM on Saturday morning. I suspect they will be leftovers from home care several days previously. Frankly I would prefer Pop Tarts.
Bobo, our medical director and somewhat socially challenged on his best days has actually paid out of his own pocket for some nurses day gift (I think his wife is a nurse). In the past we have received lunch bags, t shirts, and coffee mugs. But slogans like "Nurses Call the Shots", "Love a Nurse PRN", "Nurses Rock" and other silliness goes right to the bottom of the charity bag for me. Let me say that I truly appreciate that he has taken the time and effort to do this. I really do. But I actually hate that more than the company logo.
At my nursing school graduation 35 years ago, one speaker exhorted us as newly minted nurses never to condone slogans that exploit us as men and women in health care, perpetuate stereotypes, and fail to present nurses as professionals. Big boobs, thigh highs and stilettos, giant syringes.....you know what I'm talking about. I have a few Emergency Nurses Association coffee mugs from a former boss that are tasteful, but other than that I say NO to silly slogans.
The only Nurses Week recognition I'm looking for is just a little sincere appreciation for the job I do from my employer. Sincerity is not one of their strong points, so hopefully my boss will come through with the ice cream.
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