I had a patient tell me that the reason his blood pressure went up the night before was that he was watching UFC.
My God, today sucked.
Our hospital is currently doing a number on our hours. Overtime is no longer able to be scheduled. This means that we’ll be having a lot more people working 8 and 4 hour shifts rather than just the usual 12. This means our assigned groups change more often as we take on the patients of those leaving.
On top of this change, the lovely people above us decided to “tweak” the matrix as well. Our unit and the neighboring one are now considered one single unit to staffing. This means there are technically two nurses charging now. Though they each tend to their own unit as before, they have to do a lot more together to figure out assignments. While we occasionally would cover a few of their patients (and vice versa) when they were short, it is now a regular occurrence. It sucks for us, because we are literally having to work in two different stations. Our assigned group of patients are split onto two different sides of a floor. It’s a long walk. Charts are kept in different locations. You miss your doctor rounding because you’re at the other station. The other station can’t find you quickly. Our poor aides have to deal, too. Due to the “single unit” change, we now will have a total of 3 aides instead of the usual 4 when staffed as separate units.
In order to cut back on hours even more (temporarily they say), the two units are having to share one ward clerk. It makes for a massive jam on busy mornings. I try to put in at least my own orders, but I can’t keep up and get my regular work done, too.
New busy work: a sheet of paper is now put up in each patient’s room that is supposed to be initialed and checked ever hour. Even hours by nurses, odd hours by aides. I suppose to prove to someone (patients? families? administration?) that the patient has been seen every hour. (After 10p or so it drops to every 2 hours.) A useless paper that proves nothing because anybody could fill in however many time slots at any given time. It doesn’t go into the patient’s chart. (I don’t really know where it goes. To the manager?) And I know I didn’t get to it all tonight. It’s a new change, and by the end of the shift I have everything but that stupid little paper on my mind. I thought about it just before I clocked out, and I swiped my card anyway. What the hell. I was seeing some patients a lot more than once an hour.
Another new change thanks to a recent Walmart lawsuit: clocking out for lunches. Before we simply had 30 minutes automatically docked for lunch each shift. Apparently if it isn’t done just right, we’ll get put on some list that gets sent to administration. Cue the scary music. Ooooohhh
All of this was enough, but today Maria (New Nurse) worked with me since her precepter was out sick. My orientee Cindy was on her 2nd day officially on her own, and she had an overwhelming shift dealing with many, many new (to her) issues. So, I was basically precepting two nurses and covering two groups. My charge nurse was busy dealing with the clusterfuck of staffing issues all day long, rounding with all the docs, putting in orders, taking care of her patients,and at times covering for the other unit’s charge nurse.
And I was handed some packet (that I should have gotten months ago) to fill out and turn in at the end of the day. A packet that had to detail the time Cindy spent with me, the patient diagnoses we covered, her progress and goals week-by-week, and a whole lot of other bullshit. To be done and left in education’s box before I left. So that Cindy could work her next shift.
Today sucked hairy monkey ass.
*That didn’t occur as a direct result of patients and/or family
For one carefree moment, he's forgotten that he has no balls.
She's pure evil genius in the form of a hidden hole in which I'll nearly break my ankle. Again.
I roll my eyes at pet owners who refer to their animals as their babies while secretly…way down deep in my cold, cold heart…. I feel the same way. Even if they can’t dance.
It’s almost a year since I bought my house, and it’s still kind of bare. Furniture is expensive. I’ve been to a few estate sales the last month. I haven’t found anything yet, but its fun to poke around though a stranger’s house. The prices are steeper than a garage sale, but there are usually some nicer items mixed in with all the junk. It’s a lot like a treasure hunt. You never know when you’ll hit something big.
I’ve picked up a few tips already.
1) Get there early – at least 30 minutes. There are always early risers who will have been there an hour already. The people running the show pass out numbers before the sale begins, so first come first serve.
2) Bring those sticky address labels. You know, the ones that organizations send you when they’re asking for donations. You can stick them on any items that may be too big to lug around while you’re still looking.
3) If you see something you like that is out of your budget, try coming later when the estate sale is ending. The prices often go down, and the people are more willing to negotiate with you.
4) Make friends. You’ll often see the same people at your local sales. If you’re looking for something in particular, it doesn’t hurt to let them know. They may find it for you.
5) While you’re waiting outside, take a look around the house. There is usually stuff outside for sale.
6) Don’t buy crap. You know you don’t need it. You probably don’t have room for it. If the chances are good that it will just end up in a Goodwill pile or in your next garage sale, let it go. Wait for the good stuff.
7) Get on the e-mail list of your local estate sale planners.
This isn’t just another dog on its hind legs. Watch it put its paw out to be turned. And his/her (didn’t look that closely) form during the turns. Look how it keeps in step with the owner. Look at that tail wagging. It’s so happy! I would swear that it dances better than I do, but that wouldn’t be swearing to much.
*And she’s only just now caught on to the complicated “bring it back” concept. Most of the time. Six years later. The hell. Also, I love my people. The cheese. God, the cheese.
I saw the show first. I was fascinated by the point of view of a serial killer, and I thought that, by their very nature, the books would provide more insight into Dexter’s mind.
I like the TV series better. Watch the show. If I didn’t have Michael C. Hall to be my own personal narrator in my mind, I would have given up after 50 pages – my magical number after which I allow myself to quit a book. (100 pages if I really want to like it.) The writing is just that bad, but the ideas are still there.
Dexter is taken in by Harry, a cop, after being found in a gruesome crime scene as a small child. Dexter is not a normal child, and Harry recognizes him for what he is. Instead of putting Dexter away in an institution, Harry trains him to carry out justice against those who hurt innocents. “Choose what… or who.. you kill. There are plenty of people who deserve it, Dex.”
The basic tenets of the Code of Harry: 1) Blend in. 2) Control and channel the urges. 3) Be absolutely sure of the target’s guilt. 4) Leave no traces behind.
Dexter, working as a blood splatter analyst, lives a life of manufactured normalcy with big waves and even bigger smiles. All of his rules for living can be summed up into one: imitate life. When he has two or more options, he chooses the “human” choice. What Would Average Joe Do? By night he lets loose his “Dark Passenger” on those deserving souls.
His expertise on human behaviors keeps him below the radar. That expertise allows him to see though others who are also faking humanity, and he senses a connection with those people. Like Vince.
“There was something just slightly off in Vince’s bright, Asian smile. Like he had learned to smile from a picture book… He kept making all the correct ritual gestures, but he always seemed to be faking. That’s why I liked him, I think. Another guy pretending to be human, just like me.”
Throughout the novel he is (professionally and personally) pursuing another serial killer whose style he admires. He is delighted by the art of the body displays, and he soon sees messages to himself. He can read this mystery guy so well that he begins to question whether this is actually another being or his own Dark Passenger taking over.
The ending is a complete disaster, and not worth another comment.
While not a book or, I predict, a book series I would recommend, I was able to look past the flaws and enjoy Dexter’s world. He is so damn logical and cold that the emotions and irrational behaviors he encounters mystify him. The same behaviors that he copies while not understanding them. Each day is another day to put on the appearance of being human.
I find myself intrigued by his interpretation of “human.”
***I’ll be reading the rest in the series for the same reason I am now regretting the surplus Halloween candy.
Update 11/05: I can’t do this anymore. Not the candy. If this were the Cannonball Feed, I’d be killing it right now. The books. Every time I pick up the second book, I have to go back a few pages to remember what is happening – or, rather, not happening. Last time a book did this to me, I was trying to read the Lord of the Rings trilogy. I think I made it. I just don’t remember anything about them.
Moral of this story: Watch the show.
Cannonball II starts today.
The book that has been sitting on my nightstand for the last five months was a collection of Jane Austen novels. I loved Persuasion and Pride and Prejudice. I haven’t been able to get through Sense and Sensibility. I don’t know what I’ll do about Emma as I don’t think I’ll be able to stop picturing her as GooP. Can’t. Stand. Her.
So, I put that away and picked up the Dexter books from my local library for a fun read. I hope I’ll enjoy them as much as I do the TV series.
Sometimes I just don’t know how to respond to the things patients say. Two recent cases:
I had a elderly direct admit with a hemoglobin of 6.6 . I’ve got to transfuse 2 units, and I’m in his room taking his history and making a quick assessment. As we’re talking, I ask if he’s had a blood transfusion before and when.
“The last one was in August. I think I got some nigger blood because I’ve been craving watermelon ever since.”
He caught me off guard. I laughed… once. It was involuntary and out of shock over what I was hearing. He later told me something one of his friends had said about President Obama, and we both agreed that it was inappropriate.
***
Another patient of mine had just hung up the phone after talking with her daughter. She turned to her husband and explained that their granddaughter had skipped school again.
Her: “And do you know where she went? To a black boy’s house. A black boy’s house.”
Him: (shaking his head) “I’m not surprised.”
***
Even more amazing to me are the offhand comments patients say to me about Mexicans. How they’re ruining the country. How they’re taking all our jobs. How they’re lazy. (And wanting all our jobs?)
Living in the south most people think I’m Mexican. (Colombian, actually.) So why the hell would you say things like that to me? And even if you can’t tell what I am, I think its pretty damn obvious that I’m something different from you.
I’m not going to change my elderly (almost always Caucasian) patient’s mind-set that shift. If there’s an actual fact I can give, I’ll give it. I figure the best ways to combat the stereotypes is through my own actions and the patient’s experience with me. However, they’ll probably just consider me the exception to the stereotype.
I don’t take those things personally. Most of the time I find the situation humorous. And then sad. Another person living his or her life in ignorance.
You know it’s going to be a good morning when you walk into the station and the night’s charge nurse calls you from the hall to hold pressure in Room 16. Yeah, that cath she had yesterday afternoon? She’s now got a massive hematoma.
My preceptee is almost done with orientation, and she is awesome. This was her first experience with a bleed. We were in the room together, and I talked her and our patient through what I was doing. I had to sit tight for at least 30 minutes. I told my new nurse to get report and take care of the other 4 that were good. I’d handle the bleed for now. For now turned into hours.
She’s a big lady, so I had to hold pressure longer. I escorted her to ultrasound to check on the site. That took a while. We were good. Then I took her to CT for a chest scan. She came in for atypical chest pain. Her cath was clean, and we were experience that chest pain again. (No respiratory distress, clear breath sounds, good sats – but we’re looking) The machine would not work right. The table kept getting hung. We take her to another machine. We get her set to go, the contrast is started, and the contrast is not showing up on her scans. We go check the patient’s site. Blood is everywhere. Her arms are over her head (so she doesn’t see this), but the pillow and table are covered in blood and contrast. I glove up and take a look. The contrast tubing is loose at the clip. We take it off, clean her up, and set up again with new tubing. A towel over her head because she’s now feeling claustrophobic and doesn’t want to see the machine.
And on and on went my morning. Anything that could go wrong did. Thank God for New Nurse. I was so proud of her. This was the first time she completely went on her own as she’s always been a bit hesitant. She got patients ready for procedures, handled orders that were needed, rounded with doctors,etc. She’s knows when to get help, and she went to my former preceptor to check out what she thought might have been symptoms of a DVT. Turned out to be a flare-up of his gout, but she did the right thing to ask and then talk to the doctor about her concern.
I praised her and praised her all afternoon.
Here are some before pictures. And now…
Entryway: table from Ikea, mirror from Walmart, lamp was a gift, and bins from Target. Photo on table is of the girls and bride at my friend’s wedding. Photos lying in shelves are waiting to be hung up. Ignore ugly floor and dog bed.
I picked up this metal artwork while in St. Augustine for the wedding. It’s now hanging in the dining area.
And if you needed some further proof that I am in no way a professional, here are some before/after pictures of my bathroom after an unusually productive weekend:
The shower rod looks crooked, but it’s really not. The room needs a new light and mirror. The cabinet doors are waiting to be painted and reattached with new hardware. The rod, hooks, and curtain are from Walmart. The rug was from Target, originally $40 but on sale for $9. Yeah, baby.
