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.

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I picked up this metal artwork while in St. Augustine for the wedding.  It’s now hanging in the dining area.

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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.

Debbie and I are both precepting new nurses.  Her new nurse is struggling with time management.  Everyone takes a little time to adjust to the pace of our unit, but New Nurse hasn’t been improving.  Debbie asked me if I had any advice.

New Nurse’s problem appears to be that she hasn’t adjusted yet to a big picture plan.  She focuses on specific tasks so much that she loses sight of all that needs to be done.

Most brain sheets I found on-line are great for keeping together information about each patient. New Nurse doesn’t need this.  We already have a working system for that information through our morning reports: a detailed print-out with additional/current information written in.  She needs an hour-by-hour schedule for her day.  A worksheet that shows all the work to be done for all her patients on one page.

I played around on Word and created a  shift worksheet that fits our unit’s needs.  It’s not fancy, but I think it’ll do the job.  Since we already have pages with the detailed info, this worksheet is simply for writing in tasks (meds, treatments,etc).    I put in places to fill in timely info such as vitals, accu checks, rhythm strips, and drains.  This also serves to remind the new nurse to look at said information.

Update:  I gave the worksheet to Debbie who gave it to New Nurse who promptly put it at the bottom of her clipboard’s stack.  She told me later she didn’t like it. (She continued to flounder that shift.) Debbie liked it and told me she plans to use it.  Another new nurse asked for a copy to use.  And asked for another at the end of the shift.

Allergies: demerol, ex-lax, pudding

I received a patient the other from ICU, admitted with exacerbated COPD.  He’s still tight and very wheezy.  Without oxygen, his sats drop to the low 80s.  So what is the first thing he does upon arriving to the floor?

If you guessed take off the oxygen and leave the floor to smoke…you win!

It’s lovely, really.  I talked with him about how this kind of activity would land him back in ICU.  I explained what was happening to his oxygen levels every time he did this.  Did he understand?  Lots of nodding.  Did he want to talk to the doctor about getting help to quit smoking?  No comment.

My orientee was really worried and anxious about this patient repeatedly leaving the floor.  I told her there wasn’t much more that she could do.  The patient was educated concerning the risks.  The doctor was aware of what was happening.  It was all charted.

I’ll bend over backwards to help someone who wants my help and is trying to help him or herself. If  a patient is alert/oriented and consistently non-compliant, I document the education provided, the patient’s actions, and the provider notification.  Then I let it go.  I’ll still keep a close eye on those patients, because, as much as I am annoyed by them, I don’t want them crapping out during my shift.

If someone is belligerent and insisting they leave now, I educate them concerning the risks of leaving and not finishing treatment.  I educate them about the effects leaving against medical advice has on insurance.  I’ll notify doctors of any imminent AMAs.  I give the patients all the information they need so that their stupid decision to leave is an informed one.  I don’t fight anymore after that.  I don’t let it frustrate me.

If you don’t want to cooperate with us and your ordered therapy, leave.  Please just leave.  There’s always someone waiting for your bed.  Someone who wants to receive care.

poster

“Habitually isolated in her quiet apartment, a vulnerable girl ventures out to a local video store, where she meets a charming store clerk who immediately falls for her and tries to win her affections. Leading actress and screenwriter Palka makes her directorial debut with this appealing story about finding love and handling new relationships.”

Don’t let Netflix’s description of this movie (or its movie poster) fool you.

IMDB has a somewhat truer synopsis: “Good Dick is a modern fairy tale about a troubled, reclusive young woman and the persistent video clerk who draws her out of her claustrophobic world by starting up a unique courtship with her.As they become closer, her sexual antipathy is met with his unflinching optimism, until finally her aggressive defenses overwhelm them both and the relationship bursts apart.Profoundly affected by his presence in her life, she finds that she has the courage to face her past.”

Unfortunately, I had checked it out based on Netflix’s recommendation.

Habitually isolated?  Vulnerable?  This girl is screwed up.  She goes to video store for old erotica.  She never voluntarily speaks to other people. She doesn’t appear to leave her apartment for anything else.  She has some mystery source of income that allows for such a life.  She doesn’t allow any physical contact.  She’s constantly insulting the guy and both physically/verbally trying to push him away. It’s obvious from her interactions with the guy that she has had some emotional, probably sexual, and possibly other physical trauma in her past.

Persistent? The guy seems nice and normal compared to the girl, but he’s not so much charming as he is manipulative.  He’s a former drug abuser living in his car.  He’s intrigued by the girl who comes into the video store, looks up her address on the computer, finds ways to get into her apartment,and peeps through her window to watch her masturbate to the rentals.  He then lies about why he’s in the building, and then he lies to force himself into her apartment after she has repeatedly told him no – and is holding a knife to him.  His creepiness knows no bounds.  He worms his way into sleeping on her couch and then later her bed. (Note that they didn’t actually have sex in the film.  She was disgusted by penises, and she would go absolutely insane when confronted with an erection.)

He used her, and he called it love.

She desperately needed  a human connection, so the movie seems to say, “Look how he’s helping her.  See?  How sweet.” But this is someone who obviously had been trampled and run over by a person (or several) in her life.  A person who didn’t listen to her cries to stop.  Now we have someone new in her life doing the same.  Sure, the movie says his intentions were good, but he didn’t respect her voiced wishes.

She needed someone to help her find the strength in herself.  She needed someone to help her find the confidence and self-esteem to expect others to respect her.  She needed someone who had a interest in her well-being who didn’t also have a vested interest in free housing.

In the end, she’s suddenly able to clean up, brush her hair, put on a dress, and confront the person who didn’t understand the word “no” so that she can go to another man who doesn’t understand the word “no.”  Yea!  Another happy ending!*

*Please note the dripping sarcasm.

I understand that relationships are not simple, but I’ve always believed in being with someone because you want to be with them.  I don’t want to be with someone because I need to do so in order to survive.   I’ve never bought into the “You complete me” line.  I’d rather hear “You complement me.”  Perhaps that’s why I didn’t like this movie.  I don’t like seeing such a co-dependent relationship put in a positive light.

I had been dreaming that someone was in my house.  It was what appeared to be a sweet, older lady at the door. She was pushy and made her way in.  Once inside her costume fell away and revealed a tall, thin man with a menacing smile.  I yelled at him to get out of my house.

I woke up while sitting up straight and yelling, “No, no! Get out!”  I opened my eyes to see the man standing at the foot of my bed.  As I continued to stare at him he slowly faded away into the darkness.  I sat still with my heart pounding for a long time.

It was as if I had seen a ghost.

Update: Likely explanation: threshold consciousness

Nurse Manager was so wrong for that.

Our hospital has  quarterly town hall meetings.  They always take place during the busiest part of my morning.  There’s no way I’m leaving the floor for an hour and getting behind so that I can sit in a folding chair and watch our CNO not answer our valid questions.

This morning was different.  Nurse Manager practically skipped through the station and announced that every nurse on our unit had to attend so that we could accept an award for *mumble, mumble* highest *mumble* satisfaction score.  (Her mumbling vagueness, not mine.)  And she got a neighboring unit and education nurses to come cover the floor.  We left no one behind.  Our group consisted of Nurse Manager, four nurses, one aide, and our housekeeper.

The general meeting was a blur of statistics and figures from the last quarter.  I was content because they provided the breakfast I had missed that morning.  Then they got ready to recognize units and departments.  First up was the four highest scoring units/departments, scores ranging from 96-99%  We were not on that list.

- And can I just say, the top scoring people are always outpatient/radiology/therapy.  The places that spend the least amount of time with patients.  Inpatient units get screwed in those ratings, because patients will dock us for everything.  They are with us long enough that -if looking- they will find something to bitch about.  Oh, you don’t like your food?  Ding.  You think you have too wait too long for your doctor? Ding.  You don’t like your doctor? Ding.  You get woken up for vitals/lab draws/x-rays? Ding.  Your room’s too small?  Ding.  You were happy until your family came to visit, and now they’ve poisoned your mind?  Ding.  You’re not my only patient? Ding. The best my unit seems to receive is in the 90-93% range.

The next list to be recognized were the top four most improved units.  We were fourth at 88%.

Everyone else only had one or two people go up to collect their goodie basket and balloons.  Nurse Manager herded us all to the front of the room while following behind clapping and cheering loudly.  We took up the entire first row while grouped together for pictures.

It was ridiculous.

There was a unit meeting last week.  I didn’t make it, but one of the other nurses gave me the highlights.  There was one item on the agenda that particularly intrigued me.

Day shift has been noticing an occasional lack of vitals, weights (done by night shift), and blood sugars.  When this was brought up in the meeting, the answer was simple.  If there wasn’t an aide that night, the nurses simply didn’t do it.

What the hell?  There are days when there are no aides for us, too. Only we don’t decide , “Oh, well.  Not today.”  On those days I take all my vitals every four hours and take my blood sugars myself.  When I see a weight missing, that gets added to my list.  And that’s on top of the regular work that keeps me running even with our aides present: medications, rounding with doctors, getting exams and lab work done, speaking with family, admits/discharges, prepping for surgery, and the other million and nine things I can’t even think of right now.  (And that’s on a good shift when my patients aren’t crapping out on me.)

I’ve worked the occasional night shift.  Several of the day nurses used to work nights.  Besides the random shift when all goes to hell (I know it happens), there is simply no excuse to not do the work.

I need this.

In the first grade I went through all the books my teacher had, so she had to borrow from others.  That summer my mother started taking us to the public library every week.  I got hooked on the Bobbsey Twins.  My mom saw this new love forming, and she did what she could to encourage it.  When second grade began, my mother went to the school librarian to see if the school had the series.  They did not, but the librarian introduced me to Nancy Drew.  Rows and rows of Nancy Drew.  It was on.

My grandfather gifted me the Chronicles of Narnia when I was eight.  My mother put them up on top of the fridge, and I wasn’t allowed one until my chores were done. Reading had completely taken over. I was in the library every morning before school to get a new book, two or three if it was the weekend.

Family life was rough, and I truly believe those books saved me.  They took me far, far away from all the screaming and fighting.  They kept me quiet and still so that I didn’t trip my father’s temper.  They gave me a glimpse into families who didn’t act like mine, so that I knew this wasn’t the way it had to be.

The pace slowed by the time I reached high school.  College nearly put an end to it.  I was still reading a lot, but it was all for class.  The joy was gone.  And now?  There’s always something in the way.  The same book has been sitting on my nightstand for five months.

Enough already.

LiefEnger

“Read all the time, as widely as you can manage, fiction and non, old and new.  Recogize and avoid distractions.  Write every day; let the language play but be ready to edit.  Find a few readers you trust.  Serious stuff works better along-side humor.  Remember: It’s fun.”

“How I Write”

The Writer November 2009

 

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Categories

Upcoming Reads

Water for Elephants-Gruen
The Kite Runner-Hosseini
The Sociopath Next Door-Stout
One Perfect Day-Mead
The Namesake-Lahiri

Cannonball Read Count

2

Netflix’n

Sangre de Mi Sangre
Grace

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