Thursday, March 24, 2011

I'm gonna wash that gray...

...right outta my hair. (Remember that commercial?)

Or not.

I have this bad habit of speaking my mind. Yesterday I was talking with a resident's family about a couple of co-workers who had recently dyed their hair... um... unusual colors.

"If I was meant to have hair of a different color, god would have given it to me," I said.

Yeah. In the room with two ladies who dye their hair.

I wonder if I ever will learn to think before I say stupid stuff.

Speaking of gray hair... the other night I was washing my face when I saw a white hair sticking straight up from the top of my head. It was about a half inch long. I have three dogs, so I thought maybe one of their hairs had gotten stuck in mine.

Nope. It was firmly attached to my head. And it had a partner about two inches away from it, also standing up on end. I had to laugh, because they looked like tiny horns growing from my scalp.

Sunday, March 20, 2011

How pushy is too pushy?

One of the really fun things we get to do is convince people to do things they don't want to do. Sometimes this is just a matter of re-approaching them. Sometimes it involves a bribe. Sometimes you just have to do it and apologize later.

But at what point does "No" mean "Go away and don't bother coming back today"? I had to pass meds yesterday to a new resident. 40 minutes (and no, I am not exaggerating: 1800-1840) I got about 2/3 of it out of the cup but I'll bet she spit out more than half. At one point, she started coughing, meaning she could have aspirated if I had continued.

I told the charge nurse we need to do something because A.) I cannot spend 40 minutes with one resident and B.) She has the right to refuse, even though she's not completely in her right mind and C.) If she does aspirate, then I'm to blame, even though the family really wants her to take her meds.

We're constantly walking a fine line between abuse and neglect. I don't care what you say, it's true. 40 minutes cajoling and slipping little bites of medicine in a resident's mouth could be construed as abuse. Not giving her the medication could be construed as neglect. Same thing with a resident who doesn't want to be bathed even though she clearly needs it. If you force her to be bathed, even with a bed bath, it could be abuse. If you let her lay in her own filth, you are guilty of neglect.

My solution is to get the charge nurse involved. Not just tell her about it; make her come with you and see what is going on with her own eyes. Ultimately, she's your shield and if she sees what's going on, she should either offer suggestions or back you up when you just can't get the task accomplished.

(Yes, sometimes I use this blog to think things through and figure out the best course of action.)

Wednesday, March 16, 2011

Step away from the rumor mill.

The DON at my facility seems to be still firmly ensconced in her office. Although the next inservice should prove interesting.

I received two really good lessons on not playing in the rumor mill yesterday.

The first was when I heard story A from one of my third shift co-workers. She made it sound like the third shift charge nurse and the CMA from that shift got in an argument over dress code and the CMA was being belligerent. When I got the rest of the story, it turned out the CMA was not arguing with the charge nurse, but asking a question about the dress code. (My third shift co-worker does not like the CMA on that shift.)

The second was when I was told that the DON got rude with a resident's family and that it resulted in them moving the resident out. Turns out what really happened was that the family was just waiting for the doctor to write the discharge order and the DON helped facilitate that. Unfortunately, the resident's family wasn't entirely ready for the resident to be discharged, but they were complaining that they were waiting for the discharge order so they could take their family member home. (From the "be careful what you complain about to whom" file.)

Most of the time, things are not what they seem. Perception is reality and it's amplified tenfold in the rumor mill. You have to choose between plugging your ears or listening harder for what else is being said.

Monday, March 14, 2011

You know you're in for a bumpy ride...

...when someone compares their day to the movie Bad Day at Black Rock. (Feel free to Google that. I had to.)

I received a text from one of the girls (OK, "ladies", since she'd have to be older than me to be familiar with that movie) that I work with containing that reference. I told her she was making me really excited to go back to work on Saturday.

The blessing about working the weekend is that I miss a lot of the Monday-Friday drama that goes on. My current schedule is Saturday - Wednesday, so I get the quieter weekend and then I have my days off when the office crew is getting tired and cranky.

In any event, it sounds like today will be interesting. We may be going through a DON change if the rumors are true. Again. I've been there three years and have had as many Administrators and DONs. Although, this pair has stayed on the longest.

All I want to do is go in, take care of my guys and dolls, and go home. I don't really want to hear about a bad day before I get to experience it personally. Sometimes the fear of the ride is worse than the ride itself.

Tuesday, March 8, 2011

Preexisting Condition

"Is tomorrow Tuesday?" Mrs. A asked me last night.

"Yes. Tomorrow is Tuesday, March 8th. Fat Tuesday."

She looked down, laid her hand on her belly and said, "Well, I'm already that way."

Sunday, March 6, 2011

You can't always get what you want...

...but sometimes, you get what you need. (Hope you don't mind me paraphrasing the 'Stones.)

What I want is to work with a full crew for a full shift. I realize this is asking too much. Still, one can always aspire for perfection.

That said, Mrs. A rolled up to me in her wheelchair after supper as I was desperately trying to get my med pass finished.

"Dr. Tracy, I'm going back to my room and I'll have to wait for a while before they can come and help me to bed." (She calls me Dr. Tracy when I'm passing meds.)

"I know Mrs. A. I'm sorry."

"You know, there's a bible verse. I think it's in James. The beginning of the verse says 'If anyone considers himself religious and yet does not keep a tight reign on his tongue, he deceives himself and his religion is worthless'." (She's quoted this to me before and it always makes me think she's overheard me swearing.) "But the second part says, 'Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress...' That's what you all do. You could work anywhere else, but you choose to work here and we are thankful for everything you do and everyday you are here. And the next time someone gets in your face, you tell them, 'Hold on, buddy. My Father in heaven is proud of me and all I do'."

I thanked her and gave her a hug and went back to running around like a decapitated hen. For the rest of the shift, I felt like Wonder Woman.

Wednesday, March 2, 2011


I occasionally get residents who want to pay me for my services. I turn them down and explain that I already get paid. This usually gets me something along the lines of "it's not enough for what you do".

I call shenanigans.

No one does this kind of work because they want to get rich. Yes, we're trying to support ourselves and our families, but generally we do this because we get some kind of joy out of it. If we didn't, no amount of money would be enough.

I don't need a bonus. Unless they can convince my co-workers to show up when they're scheduled. That I'd take in a heartbeat.