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I was voted again “Nurse of the Year” by my fellow nurses.*

Last year’s award came only with the satisfaction of knowing my co-workers value me.

This year’s award came with an Ipod Nano.

Oh, yeah.

 

*  “Nurse of the Year” of my floor only as voted by the two units I work on.  Still nice, but not nearly as cool as it sounds.

“You’re good.  I don’t know what you’re good for, but you’re good.”

* Out of the mouths of 90-something-year-old babes.

** Or who I want to be when I grow up.

They can happen, but the odds are so very small if you follow protocol.

I walked into the station one day, and I was told that I was missing a page of med orders from my new admit last night.  I looked at the chart.  Ummmm, no.  These are all the orders I had.  Why do you say I’m missing orders?  Apparently pharmacy placed additional meds on the patient’s electronic profile.  The night nurse couldn’t find an order to verify them.

I picked up the phone and called pharmacy, wondering why the night nurse hadn’t done this already.  I explained the situation and asked if pharmacy could please fax me a copy of whatever orders they used to place the extra meds.  Silence.  They had none.  I asked them to take them off immediately. Please.

Mistake #1.  What probably happened was that they received several faxed pages of different patients and somehow entered two different patient’s meds under one name. However, there are checks in place. This could have been caught had the nurse followed protocol.

When new meds are added to the electronic profile, there is an additional measure where the nurse has to acknowledge them – manually click a box that means the order is correct.  We scan meds at the bedside, and you cannot scan a new med to administer without first acknowledging it.  (After you acknowledge it the med is then able to be scanned and given for the rest of the patient’s visit unless discontinued.)

So I asked the night nurse how he acknowledged the medication if he had no order for it.  Shrug.  He was scanning meds in her room when one little annoying box popped up.  Instead of verifying it with the chart, he said he asked the patient if she took it.  He said she said yes, so he acknowledged the med and gave it to her. Mistake #2.

Mistake #3 was throwing the chart at me and telling me that I was missing orders. Dumb ass.

* Patient was fine, doctor notified, manager notified, variances filed, etc.

** Interestingly enough, I asked the patient during my first rounds if she was familiar with those meds or had ever taken them (without going into any details).  She recognized one as a heart med but said she didn’t take any of them.  Hmmmm….

A certain cardiologist’s nurse ran into me in the hall the other day and said, “We were looking for you last week! Do you remember the patient with the two first names?  First….”

“First?”

“That’s it!  Well, his INR had jumped from 2-ish to 8-ish, and he told the doctor that you had given him Coumadin IV. And then Dr. Gullible asked me about it. ”

“….”

“I know.  I asked him just how did he think you did that.”

“When I see him again I’ll tell him I crushed the tablet, put it on one of the impossible to find metal spoons with .75 cc water, heated it with the lighter I stole from the patient who’s “just going for a walk”, mixed well, and used a filter needle to draw it up into a syringe.  Piece of cake.”

A wife’s question as I’m leaving a patient’s room after my first round:

“Honey, his penis is turning black.  Don’t you think someone should look at it?”

In report:

“We couldn’t find his penis [to insert foley].  It turned out he was sitting on it.”

In med room:

“Nothing’s happening.”

“Squeeze harder.”

I’m at work.

On a day off.

For a scheduled inservice.

7a-1p.

Or later.

Blegh.

I better learn something valuable.

A patient’s family member returned to the hospital to bring me treats and a card.

 

Combating work-related negativity since October 2010.

Nursing students are specifically requesting me to precept them.

 

*Combating work-related negativity since October 2010.

It’s that time of year.
Job evaluations.
Mine rocked.

 

*Combating work-related negativity since October 2010.

My Happiness Project

1. Set a bedtime.
2. Make my bed every morning.
3. Always be reading something.
4. Move more.
5. Toss and organize.
6. Give proofs of love.
7. Leave the past.
8. Fight right.
9. Don't expect praise or appreciation.
10. Kiss more, hug more, touch more.
11. Aim higher.
12. Find some fun.
13. Ask for help.
14. Smile.
15. Realize it's possible.
16. Don't compare;be inspired.
17. Focus on what I have.
18. Beware of drift.
19. Take a chance.
20. Listen.
21. Be mindful.
22. Cultivate gratitude.
23. Spend out.
24. Do good, feel good.
25. Show up.
26. Have the courage to be imperfect.
27. Find joy in the ordinary.
28. Work smart.
29. Enjoy now.
30. Talk to strangers.
31. Go outside.
32. Start where I am.
33. Show up on time.
34. See art everyday.
35. Love with abandon.
36. Be colorful.
37. Dress the part.
38. Revel in accomplishments.
39. Learn something new.
40. Fear less.
41. Take pictures.
42. Speak with integrity.
43. Don't be critical about small things.
44. Manage my pain.
45. Surround myself with creative people.
46. Practice, practice, practice.
47. Don't force it.
48. Deal with something once.
49. Trust my instincts.
50. Avoid gossip.
51. Choose to see the best in people.
52. Take time to be silly.
53. Throw my own party.
54. Be a mentor.
55. Lean into my fears.
56. Find the others.
57. Do the unexpected.
58. Don't break the chain.
59. Do things others aren't.
60. Slow down.
61. Be cool with not being cool.
62. Be kinder than necessary and more generous than reasonable.
63. Pretend I'm good at it.
64. Keep in touch.
65. Row my own canoe.
66. Do what only you can do.
67. If it doesn't work out, find something that does.
68. Dream bigger.
69. Notice what's right.
70. Stop talking. Start doing.
71. When in doubt, choose laughter.
72. Don't let the perfect be the enemy of the good.
73. Respect everyone.
74. Be early.
75. Delete the unnecessary.

Three Simple Rules

1. If you do not GO after what you want, you will never have it.
2. If you do not ASK, the answer will always be no.
3. If you do not MOVE forward, you will always be in the same place.

All I Need

1. Someone to love.
2. Something to do.
3. Something to hope for.

What I’m Reading

Blood Meridian
by Cormac McCarthy
Their Eyes Were Watching God
by Zora Neale Hurston

U.S. States I’ve Visited

Alaska
Arizona
Arkansas
Colorado
Georgia
Florida
Louisiana
Maryland
New Mexico
North Carolina
Ohio
Oklahoma
Pennsylvania
Texas
Utah
Virgina

Countries I’ve Visited

Mexico
Colombia
Thailand
Vietnam
Bermuda (British territory)

I write about…