Sunday, May 29, 2016

The One Where Sobel screwed up his own suicide

I'm watching Band of Brothers. Yes. Again. Seems timely.
Just now, I'm thinking of Herbert Sobel, Easy Company's original CO, who was so entrenched in his resentment of Dick Winters' success that he tanked his own career.
This guy ended up fouling up his own suicide and lived out his days in a VA assisted living facility. Blind. Sad. Alone.
How much better might his life have been had he, instead of resenting Winters and attempting to sabotage him at every turn, worked harder to make himself better? Figure out where he was going wrong and fix it? Hell, maybe even befriend Winters and learn from him? Winters certainly never (from the reports of all who served with and under him as well as his family and, well, everybody) thought of himself as superior to Sobel and probably would have been happy to help Sobel improve his tactical skills and guide him in relating to his men in a less schmuck-like way.
My prayer in life is to strive for Winters and NOT be Sobel.

Sunday, April 10, 2016

I'm from the government...I'm here to help...

I love that staffing ratios are being discussed and I hope hospitals do make it a priority figure it out.

However, I also hope that my fellow nurses keep a firm grip on the reality of a nation wide nursing shortage combined with more and more people using hospitals. (ER, particularly).

I work in an ED where our assignment is 3 beds. Early in the shift, we may have 4, until our grid staffs up for the busier time of day.  Or, if the bus unloads, we may get 4.  Our charge nurses generally do an excellent job of considering the acuity of our other patients before assigning a 4th.

There are, sadly, those companies that operate hospitals that put bottom line as their primary driver and routinely overload their nurses -- I won't name names but suffice it to say I disliked Gov. Scott a long time before he was governor.

The fact remains that I have worked across the country and most hospitals realize that staffing ratios save lives and so try to keep safe ratios.  Damage to patients will damage a bottom line.

But, how is a hospital meant to give no nurse more than a government mandated number of patients, fill all the government mandated blanks in the computer charting system, complete all the government mandated forms and make everyone happy enough to not have the government provided funds diminished while also caring for all the patients the government mandates we see regardless if they have an emergency,  and whether or not they can pay...though the government mandates they have insurance.?

We need a fix.

We need to all recognize that there is no easy fix.

Saturday, April 9, 2016

Shoulda been an IT guy...

I grow weary of the cacophony of voices bemoaning the lack of 6 figure jobs immediately upon graduation from university.
1. University education USED to be something achieved only by those with plenty of money or a driving desire to better their situation such that they got scholarships or else they worked their way through college. Obviously, the first group already had a leg up, but let's consider the other two. This would be 2 out of 3, not 1%, with me?
* The one with enough drive and intelligence to get scholarships probably also had to work to get through. We are not talking about athletic, but rather academic scholarships. Those once required one to actually perform above expectations to achieve. Those tend to be handed out to folks who don't fit into the first group and are only successfully completed by people with a stake in their personal success.
* The one who only completed university by simultaneously working, sometimes menial labor, maybe more than one job WHILE attending school only completes their degree through strenuous hard work and dedication. (I may be in this category, so I speak with some authority).
These 2 of 3 people STILL did not complete their degree with any idea that they should immediately have money and opportunity rained on them. They realized it was only one step on a long road to achievement. And they worked hard to do just that.
2. Currently, the NORM is for people to have a university degree So, if you have the precisely same degree as millions of others, you are not immediately marketable. If your degree is not in one of the very difficult to obtain STEM (science, tech, engineering, math) categories, but rather fine arts (nothing wrong with fine arts, love fine arts, but we are talking marketability here) or "University Studies" (swear to Tebow, that's a real degree) or something similarly attainable by every average Joe, you have not yet found your way to shine. You may, with a degree in those fields, go on to change the world, but that does not legitimize some beef about not being able to find gainful employment immediately upon graduation.
3. Learn a skill. Check out mikeroweworks It's all about promoting skilled labor. Know what there is definitely a shortage of? Nope, not lawyers (really? Gonna sue your law school because you didn't land a partner track spot?) Plumbers. Electricians. Masons. Carpenters. Mechanics. You know, all those people we pay through the nose because there are so few of them and yet we ALL need them? Do that.
Do SOMETHING, but stop blaming the government, the establishment, the previous generation, anyone but yourself. And DO SOMETHING.

Tuesday, April 5, 2016

PSA from Nurse Bananahammock, the VIP edition

So...this showed up on my fb feed tonight...
Here's my $0.02:
When an administrator says to me,
"This patient is a VIP, give them good care.
What I hear is,
"Don't give your usual crappy care."
It's insulting. It demeans my professionalism and my ethics and belittles any of my other patients as being not worth my best efforts.
The speed at which I accomplish tasks in the care of my patient is not determined by their perceived importance to my boss, it is prioritized by the emergent nature of my patient's condition.
If I have a sick patient who is homeless, they will receive the very best care I have to offer, the most compassionate and diligent practice of my craft.
The same is true for a CEO, a fast food worker, a car mechanic or a famous sports star.

Thursday, March 31, 2016

PSA from Nurse Bananahammock, the coffee edition

PSA from Nurse Bananahammock:
If your loved one is currently parked on a stretcher in a hallway because there were no available treatment rooms and a steady stream of police, security, doctors, respiratory therapists and rad techs keep inching their way past you in the now crowded hallway -- to even ask the nurse to get you a cup of coffee is kind of unbelievably ballsy...
but to complain because you were not provided a coffee stir...
You, my friend, are a special kind of asshole.
My badge says RN (registered nurse, not easy to achieve) BSN (look it up, bachelor's in nursing is considered one of the very hardest undergrad degrees to attain) CEN (only about 15% of all ER nurses in the country are board certified).
This means I have studied and worked and continue to study and work to stay on top of all of the latest and greatest ways to save your life.
I suck at getting coffee.
You're welcome.

Friday, January 15, 2016

Jimmie got me a book

Jimmie's on the right
So, my dear friend Jimmie

gave me a honest to goodness, paper, have- to - turn - the - page book for my birthday.

Now, several years ago, I gifted myself a Kindle.  Even then, I said, "I still love real books, I will never give up real books."  And I meant it.  But...somehow...

Well, it was gradual.

It started with just the novelty of the thing: "I can carry THOUSANDS of books in this everywhere I go!" and then it became just so easy to buy them and load them directly to the thing.  I was still a frequenter of the library, though, because I really do love books.  But, then my local library became a de facto homeless shelter for rude, smelly men who took up all the spaces on the bike rack, aggressively panhandled, parked themselves in all the cushy chairs by the magazines and generally camped out.

So...I stopped going to the library.

We have LOTS of books, however (the Rickster and I) and I have long made a habit of re-reading The Stand and have my own copy of the author's expanded edition that was my go-to.  But, then...they came out with that in a Kindle edition.

So, largely, I have kind of given up on real books over the last few years.  So, I was truly giddy when Jimmie sent me a book.  A really good book -- In a Sunburned Country, by Bill Bryson.  I gobbled it up and would find myself randomly sniffing it.

So, then My Girls (Jimmie, Wonnie - using Jimmie's name for her. and Bacon--who had a different moniker previously, but who will henceforth be Bacon) and I started this little book club together and I got a little OCD about it (NO! I hear you saying, surely not!).  The book club started with a cool list of books to be read in the year in a number of different categories.  One category was a book from the library.  One was "The First Book You See in a Book Store".

Now, the Rickster has never stopped being a person who goes to book stores and the library and he'd told me that the library had been revamped and is now pleasantly free of homesteading urban outdoorsmen.  So, I went to the library.  I swan I almost think I heard a chorus of angels singing when I walked in.  I renewed my library card and got the next book on my personal "To Read" list.

I then went to the book store.  Now, there aren't many of those left  It seems more used/rare/antique places than a place that sells new books, but Books-A-Million is still kicking.  So I went there.  Quickly made note of the first book I saw and left before I could spend all my money.

Now?  This is how I will spend the next little while.

Wednesday, January 13, 2016

Sometimes people will surprise you...and sometimes you'll surprise yourself

Nurse Bananahammock means business.

I have a well earned rep as a nurse who -- while I do feel and show compassion for my patients --  feels that an emergency department is for emergencies and I do not have a lot of tolerance for shenanigans in the form of acting out, cursing, rudeness, etc.

Recently, I had a little old POIAGG who from the moment they were wheeled into the department was just rude and downright mean.  Shouting at everyone, saying, "I don't even want to be here, that one (pointing to spouse) made me come in.  I just want to go home!"  POIAAG was brought in for shortness of breath, but it was hard to believe with the constant stream of just ugly comments that kept being shouted.

Thankfully s/he wasn't my patient.

However, s/he was the patient of my "neighbor".  So, when that nurse was headed off to lunch, I got to deal with little Mr/s. POIAAG.  My neighbor, being a stellar nurse, had just made sure all her patients were tended, vital signs up to date and no pending orders, so expected (and in fact suggested) that I would not have to engage any of them, just keep a lookout.

As it turns out, Mr/s. POIAAG started shouting out that nurse's name.  I heartily wanted to ignore the shouts and heed my colleague's advice, but I just couldn't.  You never know when something can go really badly. So, I took several deep breaths, said a prayer and pledged to myself that I would not allow this grumpy old geezer to get to me.

I went in the room to find the call light not in reach -- not this nurse's normal MO. I discovered why when I attempted to attach it to the siderail, s/he grabbed it and threw it onto the floor, saying, "Don't put that in my face."  I attempted to explain that having the call light close would alleviate the need to shout for someone who may not be around and provide help from anyone who was available.  S/he shouted at me and said, "I want out of this bed and I want to go home!"  I said, "Well, you certainly have the right to leave and go home any time you want.  But you have been short of breath, so you probably ought to see what's going on (s/he ended up being diagnosed with blood clots in the lungs). S/he said, I don't want to just lay here, it's not comfortable!  My back hurts and I want to sit up!"  As s/he had already refused to allow staff to keep monitoring equipment attached and had also removed the supplemental oxygen that had been placed, s/he was now an alarming shade of gray-ish

I kept my voice calm and soothing and made a couple of suggestions about ways we could make the patient comfortable and s/he had no inclination to do any of them.  So, I very calmly said, "If you do plan to stay here, you have 2 choices -- allow me to help you become more comfortable or stay where you are."

Eventually we got the patient up to a chair, but in doing so s/he became very short of breath and actually reached for the oxygen tubing and replaced it.

I then heaped blankets on and let the patient vent for a minute about the ordeal they had suffered -- recent diagnosis of cancer and all the attendant fear and side effects from treatment and frustration at lost independence.  I began to feel for this patient in a way I hadn't when it as just an angry voice screeching down the hallway.

S/he had also allowed me to put monitoring equipment back in place and update vital signs.  After a few minutes, s/he reached up arms in the universal sign of "I want a hug" and pulled me close and cried.  "I'm not a mean person."

Nah, s/he isn't.  But, it was easy to believe s/he was when I had no idea what was prompting such ugliness.

Hurting people hurt people.  I know this, but sometimes we need a reminder.

Don't worry, Nurse Bananahammock isn't becoming a bleeding heart, but sometimes I need reminding that everybody feels hurt and scared and vulnerable sometimes and sometimes they just need to feel that someone else gets it.