Thursday, September 30, 2010

What Do You Do With a Day Off?

What do I do on my day off?  Well, since I live at 1927 House, my day off is spent working on something.  If you visit me, you'll get an hour of being fussed over, the dog will kiss you as long as you'll tolerate it, and there will be tea in the good china at the dining room table...but if you stay longer than that, the dog will go back to sleep and you'll be put to work.  You can start anywhere, and do anything you like; this place is a handyman's dream. Like to drywall or plaster?  How do you feel about tile?  Come by next week and I'll have plumbing for the Inner Plumber in you.  I promise, the sound of a sawzall does not disturb the dog at all, so have at it!

After ridding ourselves of the Great Striped Wasp Migration of 2010, (highly recommend the Rigid contractor's vac) we went to Homely Despot and loaded the van with materials to finish our countertops.  We're covering them in Weathered Stone ("The World's First Bendable Stone" The malleable plaster and vinyl "stone" is perfect for jobs like ours because I can wrap a bullnose counter edge and I don't have to spend a month cutting tile to fit.  We'll grout, coat the whole thing with clear epoxy floor finish, and it's a wrap.  My husband, Mr. Geometry, is laying the product out on-point.  Weathered Stone is made in Fairhope AL, and is the brainchild of Sean Howard, a former paperhanger who is a friend of ours. We like to give him a plug when we can.

As I'm standing at the wall taping drywall joints, I am thinking of my favorite squirrelly patients.  Hospitals spin off their own sort of humor, the best of which is the recent "There is a fracture" cartoon.   Patients tell me all sorts of things, mostly because I haven't yet learned to flee when they start to speak.  A 90-yr-old struggled to speak after a long convalescence; I wondered about his LOC and orientation when he said tenuously, "I know the man who invented the hospital gown..."  I stopped what I was doing and looked at him.  "His name was Seymour Butts."   I blinked; then laughed.  He got me on that one!  One could also never forget the garrulous patient with lower leg cellulitis who nevertheless stumped out to the station to ask, "What is it that the more you take away from it, the bigger it gets?"  Hmmm.  You got me there, pal; what is it?  "A hole.  Gotcha!" he chortled with glee.  So glad I could make his day. 

After the patient humor, I just couldn't let a good giggle opportunity pass, so I went to the internet.
Q: How many nurses does  it take to change a light bulb?
A: Twelve: One to do it. One to chart it. Ten to write the policy and procedure.

Vintage Nurse out.

Thursday, September 16, 2010

Time On Your Hands

First of all, after several months of utter mayhem q shift, it was an unexpected surprise to find two nights in a row where I was not hideously busy.  I was busy, mind you, but not ridiculously so.  In other words, I was able to think ahead rather than react to a series of crises.  This was nice.

I even had time to do the sorts of things I do to occupy myself when things are slow, like restocking syringes and changing IV tubing.  Sure, restocking is done once a week by Central Supply, but that's small comfort if you've ever been ultra-busy and needed a saline flush STAT only to find the box empty and had to hunt for backup supply.  Restocking is a good way to get to know where supplies are, before you need them in a hurry.  I like to tidy things up, because having the med room in a shambles is to me like visual "noise" which I find very distracting.  And I contemplate pressing philosophical questions such as, why do two med rooms have a full supply of Day-of-the-Week tags, but the 3rd never does?  Night Shift Nurse remains baffled.

At about 0200 the floor went quiet; not an infusion pump beeped, no bed alarm split the silence.  Aaaah.  There is something to be said for any job that takes you away from the clamor to be endured on days and 3-11.  I made a bed check just to be sure the patients weren't getting away from me.  They were all snug in their beds; Lung Lady, the Moaner,  Mrs.NPO, BatLady, and Smiley; all snoring, the IV's infusing beautifully.  "IVF, O2, and patient safety maintained." You have to be careful with moments like these; they make you  think you've become Wonder Nurse and created the present serenity, when in fact it's pure dumb luck.

Down the hall, the staff were beguiling the time in conversation.  "Do you all follow nurse blogs?" I asked.  They looked at me blankly.  "Noooo..." they responded, after a moment to figure out what I meant by Nurse Blogs.  I wanted to tell them about Head Nurse's surgery, and how proud we all are of Crazed Nurse, and the latest ER story from Storyteller Doc, but I didn't think they'd get it.  Instead, I heard gardening and canning tips, we discussed the whereabouts of the last 3 heavy-work patients who had left, and Blondie told us an amusing story of an elderly woman so reticent that she could never bring herself to speak of her genitalia as anything but "my kittycat."  (I'm not a native; it was a new one on me.)

We looked at one another.  Our hardworking CNA heaved a sigh.  "Well, who wants to help me turn patients?"  Several of us volunteered and wandered off to the next Code Brown.  The rest returned to charting.  And so it goes...

Wednesday, September 8, 2010

Commodores - Nightshift

Night Shift

I'll have to tell the story on myself:

Now I find, after all the aversion I experienced over the prospect of work on the 11-7 shift, I actually like it.  Really.  For many years I dreaded working the Night Shift, but it's far from an  unworkable situation now.  I have no trouble staying awake, little difficulty sleeping during the daytime, and I enjoy being the quiet voice of reassurance in the dark hours of the night.  Of course, I no longer have little ones depending on me for three squares and program direction.  My Darling Dog sleeps when I do, regardless; although she is puzzled about my going out late at night to work.   It's just as well that Dog Daddy sleeps nights and consoles her with biscuits.

What happened to the Night Shift Effect I recall?  The post-shift feeling of being among the walking dead, the days misspent lying in bed, and still feeling foggy with fatigue on arising?  What happened to the feeling of missing everything that was important in life?  I never could see how others did it.  For decades I swore I'd sooner be hanged than work the Night Shift. 

I promised myself the one thing I will NEVER, EVER do is work the Night Shift, yet here I am.  I offer you the next 10 minutes to laugh--gloat if you must--over my former silliness ( I really had worked myself into a froth over this) but your privileges expire in...9.6 minutes.  I'm counting.

County General is a well-run tertiary care hospital.  Our medical unit is a magnet for high-acuity patients who also have concomitent physical, psychological, and social challenges.  We see more than our share of non-compliant diabetics and COPD'ers, plenty of elders with UTI's and altered mental status, more people with clostridium difficile and MRSA than I ever thought existed, and the odd rara avis.  More on the Bird of the Day later.

The true beauty of the Night Shift at County General is not rank or privilege, but teamwork.  At the moment, we manage to work together through the most difficult nights, without calamity or expecting fanfare.  A sense of humor is indispensable.  For example:

At the start of shift, our census had been low; we knew it was too good to last.  At 0300 our capable CNA stopped me in the hall to chat; "Do you believe this," she asked me, looking not at all incredulous. "This is the--what?--fourth admit tonight?" Here she smiled ruefully. I had been wondering myself how many more new admissions the supervisor was going to send us.  My hands were full already with high-acuity patients when ER called to announce the impending arrival of yet another new patient. The one that would cost me two hours of work and more.

"Do you work tomorrow?" she asked solicitously.

"No, I'm off one day and then I'm back Tuesday night. Are you on Tuesday, too?" She nodded, continuing, "It seems like I never get time off.  I'm here all the time." 

I replied, "Well, after Tuesday I'm off for a week...but (noting her shocked expression) remember I only work part-time."

She blinked. "I'm not speaking to you," she said firmly. "A whole week off!  I'm not talking to you," and she strode off in the direction of our latest admit shaking her head, but smiling.

"I'm going to spend my day off hanging wallpaper, if it makes you feel any better," I called after her, still laughing.