K. Tree, CNA

Kainolophobia

2012-01-15T11:29:00.001-06:00

"Ugh. It's pill time," Mrs. A groaned as I pulled up to her door with the medication cart.

"Yes, it's pill time," I said. "Ya know, you're supposed to do a cheer when you see me coming." I proceeded to demonstrate a very small cheer, bouncing on my toes and waving my arms.

"I can't do that. Once I started shaking, I might never stop."

Welcome to Hell (Slightly O/T)

2012-01-07T09:32:00.000-06:00

I'm starting to question the existence of Hell as a place we go to for punishment after death. I think we're already there. Before you roll your eyes because yet another person is questioning their faith, hear me out.

What could be more horrible than waking up one day unable to walk or speak or eat? What could be more upsetting than thinking your spouse is still alive and then finding out they're dead - and have been for years? How much more awful can anything be than watching yourself slowly lose your motor functions, so that people have to feed you and clean you up after you've soiled yourself like a baby? What about being constantly put in a wheelchair when you know damn well you could walk just fine, if they'd let you?

I'm sure you can think of your own horror stories.

Here's the second part of my argument: I've had a couple of dreams about people who probably should have gone to Hell, but obviously hadn't. Both had broken at least one - probably more than I knew about - of the Ten Commandments. Both had delved into at least one of the Seven Deadly Sins. In both cases, they were dressed in white and were not afraid. One was confused, but probably because he had not expected to die. The other was smiling and walking purposefully away. In both cases, if they were heading for Hell, would they not have been kicking and screaming and begging for another chance?

The first part of my argument is rock solid. You can't disagree with any of that. You could roll your eyes at the dream part as if it were some New Age mumbo-jumbo. Let me throw into the ring that I don't recall my dreams very often and that when they jar me awake, I believe that's a sign that I should pay attention. Also, the first dream was about friend. I would expect to dream about him after he died. The second was about a man I had medicated at work but I did not know him personally. There was no reason for him to show himself to me unless I was supposed to learn something from it. My last argument is that there are many stories in many religions about the gods contacting their people in dreams.

I've been trying to make sense of this since I had the second dream, about a month ago. This is the only conclusion that makes any sense to me. Until I have solid proof to the contrary, this is my Truth.

Just This Once

2012-01-06T15:32:00.001-06:00

"Uh oh," said my charge nurse as she hustled past me down the hall.

When I looked her direction, I saw Mrs. A tottering down the hall, no walker, no wheelchair, no nothing.

I locked my cart and rushed for Mrs. A's room and located her wheelchair.

"Where's your wheelchair?" Nurse B asked Mrs. A as she took her arm.

"I didn't know I needed one," Mrs. A said.

"Well, here it is," I said from behind her. "We forgot to tell you." Nurse B and I shared a smile.

"Oh, that's OK," Mrs. A said as she sat down. "We'll just let it go."

Happy New Year!!

2012-01-01T09:27:00.001-06:00

Whatever you do today, you'll do all year. Kiss your family, clean your house, and work if you have the opportunity.

Merry Christmas Everyone!

2011-12-25T08:29:00.003-06:00

Hope you have a safe, blessed and happy Christmas and New Year.

See you next year!

Dirty Old Women

2011-12-12T11:29:00.002-06:00

We only have a couple male nurses on staff. One of them worked last night.

I walked into Mrs. A's room. She wasn't there, but her walker was. I knocked on the bathroom door.

"Yes?"

"Mrs. A, are your legs still bothering you?"

"Yes."

"Do you need a pain pill?"

"Yes. And some of that stuff you rub on my legs."

"OK. The nurse has that. Let me go tell him."

So, I located the nurse, told him what she needed and returned to the room.

When I arrived, she was sitting on the side of the bed in her nightgown. As I was watching her take her pills, Mr. Nurse knocked on the door.

Mrs. A looked up and her eyebrows shot up on her forehead.

"Come in. We're dressed appropriately," she said in her best coquette voice.

I just started laughing. And she did, too.

"Heh heh heh. I'll bet he's half my age," she said to me.

Which made me laugh harder.

"Do I even want to know what you're talking about?" Mr. Nurse asked.

"Just you," I said and left him to his fate.

First Cold of the Season

2011-12-11T12:01:00.001-06:00

Well, I finally caught it. Everyone around me has been sick at least once since September, some two or three times. Now, I'm sick.

No fever, so I'll be going to work. We don't get sick pay and it's Sunday. Even if I could afford it, there isn't anyone who will cover for me on a Sunday.

I still have my tonsils, so it's resting in my throat. I'm trying to avoid taking any cold medicine, so I'm treating myself with lots of tea during the day. At night before I go to bed, it's a shot of Jack and a spoonful of honey. I don't know if it's helping, but I'm not all fuzzy headed like I would be if I were taking OTC cold meds. I'd rather feel sick than like my head is floating somewhere three feet away from my body.

I've got four days off in a row coming up this week. I can tough it out for three more days. If my coworker who got in a car accident is released to come back to work, I might even have six in a row. That, I fear, is a pipe dream, but we'll see.

Do you ever wonder...

2011-12-06T10:22:00.001-06:00

...if we might only exist to be lab rats for the pharmaceutical companies?

This is a little off topic, but not much. In the last year I have had several residents who have come in with only two or three prescriptions, who now have over 9. Not because they have necessarily had anything really wrong, but because the pharmacy consultants give the doctors recommendations and they take them.

For example, Resident A can no longer take care of themselves at home. They come in with a blood pressure medication and a multi-vitamin. Then, the pharmacy consultants come in. Now they need vitamin D once a week. Oh, and they are at risk for osteoporosis, so lets give them calcium. Then the blood tests start. So, their triglycerides are high. Let's poke four fish oil pills down them a day. Now they're getting confused, so let's put them on a memory pill. Well, now their appetite is not good and they're losing weight. Of course, we can't stop the memory pill, because they're confused, so lets put them on an appetite stimulant. A couple months later we do another blood test and now their sugar is high, so we treat that.

And on, and on, and on.

I'm not against folks being as healthy as they can be. I am against taking medication just because a study shows that it might be good for me. That includes vitamins. Further, I'm against taking medication to counteract the side effect of another medication. I'm pretty sure a memory pill never saved anyone's life. If the memory pill is ruining your appetite, how about just discontinuing the memory pill?

I have heard that you shouldn't be on more than nine different medications as a general rule. Nine. I have resident's who are on over twenty. Yes, over 20, including all the vitamins. Someone's benefiting from this. I'm not sure that it's the resident.

Can you repeat that?

2011-12-05T08:58:00.001-06:00

"Can you call my daughter for me?" Mrs. A asked the nurse.

"Sure," she said, picking up the receiver.

"Her number is 30301."

"I'm sorry," said the nurse. "I didn't catch all of it. What was it again?"

"30301. I can't remember the other two numbers."

(I love how they think we can just pull this information out of our pants. We "grow up", then we "grow down".)

Control

2011-12-04T08:06:00.001-06:00

We spend the first 15 or 20 years of our life trying to get control of it. You find me someone on the planet who hasn't started a sentence with "When I grow up I'm not going to..."

After that, hopefully, we get things running in our general preference of direction. It's not perfect, but at least our mistakes are our own.

When we get to the end, the people around us start to take over again and we're stuck back where we were. They decide what we eat, and when. What medication we take, and when. What clothing we wear, what time we get up and go to bed and a thousand other things that we have managed to control for 40, 50, or 60 years.

Is it any wonder the residents get mad at us? We're just doing our best to make sure everyone gets taken care of, but they see it as us stealing their independence.

I got accused of treating a resident like an animal yesterday. If you think about it, they're right. We do the same thing to our pets and farm animals. When you put people in a group setting, it becomes harder to treat them like individuals. Especially when your nursing center is still operating under the old mindset of "Breakfast is at 7:30, Lunch at 11:30, Supper at 5:00 and everyone needs to be in bed by 10:00".

Every once in a while I hear mumbling about culture change. I'm looking forward to it. Giving the residents a little control back will make things more chaotic, but it will also make them happier about being in a less than ideal situation.

Some Things are More Important...

2011-12-03T07:03:00.001-06:00

"Mrs. A was unresponsive this morning. We sent her out. I think they're sending her back."

This is what I was told as soon as I came on shift yesterday.

A little later, the nurse came and gave me the paperwork and told me she was coming back. I figured she was going to be sick and worn out, so I got her bed ready and laid out her night gown so we could get her back to bed.

I got busy passing ice and snacks and when I looked at my watch, an hour and a half had passed. I started heading for the nurse's station, thinking that maybe something had happened and they decided to keep her. As I'm walking down the hall, here comes Mrs. A, peddling herself back up the hall with an armload of trinkets.

"Hi Honey!" she called to me. "I won three times at Bingo!"

The Angel Tree

2011-12-02T07:05:00.001-06:00

Our nursing center does an Angel Tree at Christmas. All the employees pick a resident's name and bring them a gift so that they have at least one thing to open at the Christmas Party.

Last year I picked two. Neither one really got to use my gifts because they both passed away within a month or so of Christmas.

So, to minimize the damage, I only picked one name this year. Thankfully, it's a resident I know. Unfortunately, I have no idea what to get them. They are bed-bound. They don't read. They are not really capable of watching television because they can't follow it or they think that it's real. (I spent a couple hours one afternoon trying to convince them that the house fire on the TV was not actually happening in the building.) They are at the point where they often eat with their fingers because it's "easier". They are in that awful Limbo between not really being able to live, but being too strong to die.

I think I'm going to have to go the route of bath products. At least I know they'll get used. It seems like a lame gift. Maybe when I get to the store something will inspire me.

Stuff Seniors Say

2011-12-01T15:58:00.001-06:00

Sometimes you just want to know that you're not alone.

"Are you busy?" Mrs. A wanted to know.

"What can I do for you?" I asked.

"Nothing. I just wanted to know if you were busy or if you were pretending to be busy."

"I'm not sure," I said, because I had no idea how to answer that.

"Well, good. I thought I was the only one who didn't know what was going on."

***

Proof that we never really outgrow adolescence.

"I can't roll all over this place just to catch you," Mr. B said to Mrs. C.

(Yes, Mrs. C. There's a Mr. C and they both stay at the nursing center.)

"Well, you better quit because you're not gonna get me."

O/T: You're in trouble now

2011-11-26T10:34:00.001-06:00

One of the girls I work with recently lost her father-in-law. Her mother-in-law watches her kids (she has a half of a baseball team's worth). Once the funeral was over and life settled down a little, the kids went back to Grandma's, as usual.

"Grandma, will you take me to heaven?" one of the boys asked.

After some conversation, she figured out that he was asking to go to the cemetery.

So, she gathered everyone up, loaded them in the van and off they went. Once they arrived, they piled out and the one who had requested the trip marched right over to the grave.

"Grandpa, Grandma has not made me soup yet."

Busted.

Happy Thanksgiving

2011-11-23T23:02:00.001-06:00

I actually have the day off, but I'm working Friday. I'll be home long enough to mess up the kitchen, but good, and then back to work for a day before having Saturday off.

Enjoy your Turkey Day!

Body Language

2011-11-16T09:15:00.001-06:00

Yesterday I was standing and talking to my husband with my hands on my hips. It wasn't a hands on hips type of conversation, that was just how I was standing.

"Don't stand like that. It makes you look aggressive."

Funny, but I think about this at work all the time. For some reason, arms akimbo is my default. I catch myself standing that way constantly. My first reaction is to put my hands behind my back when I notice it.

The other day Mrs. A asked me if I stood with my hands folded behind my back to keep myself out of trouble.

"That's exactly right," I told her.

Residents notice. Even if they aren't able to get the words out, they can tell how you are feeling by the way you stand when you're working with them. Arms akimbo can make them feel like you are being bossy or are in a hurry. Arms crossed is defensive and makes them feel like you aren't listening or you don't care. Keeping your arms relaxed at your sides when talking to them shows that you're listening and are willing to do what it takes to help them. If they feel comfortable, they are less likely to get upset or angry and that automatically makes the day go smoother.

Dating Coworkers

2011-11-10T09:25:00.000-06:00

I'm absolutely against coworkers dating. And, yes, I am a hypocrite because I have worked at several jobs with my husband over the years. I'm still against it.

This is coming up because we have a boomerang CNA who likes to date coworkers. Who likes to live with coworkers. And then, when the break up happens, it rocks the nursing center. People quit, people take sides, people try to run other people off. It's stupid, disruptive, and frustrating. Can you imagine what the resident's think?

I could tell you, but you'd be surprised at how raunchy our elders can be. Let's just say that whatever you just thought about it, they've already thought a hundred times before. And their executive function is not what it used to be, so some of them just say it. Loud. Because they can't hear. But a lot of other folks can.

If you simply must date a coworker, you should conduct your relationship so no one else you work with knows about it. I worked with a couple for nearly a year before I knew they were a couple. Even after I knew, they didn't do anything at work that indicated they were living together. They kept their work and their home lives separate. As it should be.

Regardless of that one good example, I've seen, oh, probably five couples break up since I started working as a CNA. It's not good for anyone. It hurts the residents, the rest of the staff, and the business itself. Better to avoid it altogether. It's a big world out there. Find someone else to date.

Thoughts

2011-11-03T12:34:00.001-05:00

Resident's with dementia are like the weather in Chicago. If you don't like it, wait a minute, it'll change.
One eight hour shift working the floor nets me about 14000 steps according to my pedometer. Conversely, giving 25 people meds for one shift gets me about 5000 steps, 35 people, 7500.
The only right answer to "Are you busy?" is "What can I do for you?"
Raising children is good training for being a CNA. The goals are the same. Keep them warm, clean, dry, fed, and don't let them knock the snot out of each other.

"Selling Buicks" and Other Not So Fun Body Functions

2011-10-28T16:01:00.000-05:00

So, we've got some kind of stomach bug making it's way around work, staff and residents included. It's just a twenty-four hour thing, but I've been "better" for five days now and I still have waves of nausea now and then.

For the record, I worked through it. Amazing what enough Dramamine and Immodium will do for you. Probably why I'm still not over it. But, everyone got taken care of Sunday and the rest of my week and no one had to cover for me.

I realize I am opening up the "working sick" can of worms again. If we had enough help, I probably would have stayed home. Without me there, the facility wouldn't have had the legally required amount of staff. And, I promise you, NO ONE will cover for you on a Sunday. So, there's probably someone who is sick just because I carried that pathogen into their room, but the rest of the facility is better off because I was there.

Rock. Hard place. I chose the rock.

Got Mentioned in a Post

2011-10-19T09:48:00.002-05:00

20 Useful Online Tutorials for Nursing Assistants

Nursing Assistant Guides mentioned this blog in the above post. I don't have time to read more today, but it looks like a good site and I'm adding it to my "Good Stuff" list for perusal on my days off.

Put THAT in Your Care Plan (NSFW)

2011-10-16T09:29:00.000-05:00

"Mrs. A, I have your vaginal cream," the nurse said as she entered the room.

"Oh, you have cream for my cockroach?" Mrs. A asked.

(I had to stop breathing here so I wouldn't start laughing.)

"Your cockroach?" asked Nurse B.

"Yeah. You know. My hoo-ha," she said, waving vaguely that direction.

"It's not going to hiss at me, is it?"

"No. It won't even bite."

***

How does that go in the care plan?

"Mrs. A refers to her vagina as her 'cockroach'. All staff may refer to it in this way as well."

Seriously.

Goodnight Sugar

2011-10-09T09:11:00.001-05:00

(My friend's been out of the hospital for a few days now. She made it up to work to get her check without oxygen the other day, so she feels she's improving. If the doctor releases her, she'll be back to work on Wednesday, at least part time, I'd guess.)

***

"Mrs. A, do you need your eye drops tonight?"

"No, my eyes are feeling fine. All I need is some goodnight sugar and I'll be ready to sleep."

So I closed my drawers and locked my cart and went to give her a hug and a kiss.

***

There aren't many jobs out there where hugs, kisses and laughter are desirable. You can't get this stuff working at McDonald's or in an office cubicle. They might pay more in cash, but they can't touch it in emotional dividends.

Lack of Activity

2011-09-30T15:19:00.001-05:00

Sorry about the lack of activity here. It's not that I've run out of things to say, but a friend of mine is in the hospital. I've been taking care of her cats in the morning and so haven't been online much at all. She's hoping they'll spring her tomorrow. Once she's back home, I'll get back on track and post more regularly.

Opposite Day

2011-09-23T23:56:00.000-05:00

If I didn't know better, I would think that I was dropped off in an alternate universe where everything you get is the opposite of what you expect.

The owner came to inservice and was appreciative and complimentary. Not one disparaging comment during his entire speech. He almost seemed sincere.

The new DON ran the meeting and it went quickly and almost painlessly. And, we got carrot cake cupcakes with cream cheese frosting and candy pumpkins on top.

I got my check, it had the correct amount of pay on it and included my second week of vacation which I had asked to be paid out.

I'm not sure what I did to deserve a smooth inservice like that, but I hope I figure it out so I can do it again.

Changing of the Guard... Again.

2011-09-18T09:38:00.000-05:00

So, as I'm walking into work yesterday, I see large pieces of furniture moving out the front door.

Our DON is leaving.

At the end of the month, our Administrator is leaving.

So, once the new ones are ensconced, that will be the fifth DON I've worked under and the fourth Administrator. And I have only worked at this one facility and I've only been there three and a half years.

Really?

You know what's not changing? (Well, as far as I know, anyway.) The owner. And, frankly, from what I've seen so far, that means nothing is really changing at all.

Honesty

2011-09-11T08:44:00.001-05:00

"So, Mrs. A, how do you like your new room?" I asked.

"Well," she said, "it's better than sleeping in the hallway."

Memorial Book

2011-09-02T21:31:00.002-05:00

Losing residents is the nature of the nursing center beast. You learn to cope real quick. I've created a Memorial Book where I write down anecdotes about the folks I've lost. (I'd do this online, but, you know, HIPAA and all.) It gives me a chance to remember them and do a little crying without doing it at work. I also have a page dedicated to folks who I didn't get to know because they only came to the nursing home to spend their last days.

I could collect obituaries, but writing my memories about them seems to help me more than reading what someone else wants me to read. I write it, get it out, and then I can put it in a little box where it can't bother me unless I choose to open it up and let it out again.

Nursing Fashion

2011-08-31T09:00:00.002-05:00

Whoever invented those hip-hugger pants and then expected people in nursing to wear them must like looking at butt cracks. I have to wear t-shirts under my scrub tops to tuck them into my pants so that everyone doesn't get mooned 45 times a night.

And is it sad that the most joy I got out of last night was pulling up a co-workers pants when she had an armful of books and was about to be seriously overexposed? I have to wonder what that says about me.

Parallels

2011-08-28T07:42:00.002-05:00

We're constantly losing skin cells. We shed them a little at a time and we generally don't notice it. Sometimes we speed it up by scratching or exfoliating, but even then it's not uncomfortable.

Sometimes we get an abrasion. A rug burn. It hurts for a day or two, we put some antibiotic ointment on it and maybe a bandage and we go on.

Every once in a long while we take a tumble that leaves a deeper wound. We sit, stunned, watching ourselves bleed and we might even cry. This time we need to stop the bleeding, clean the wound and use a more serious dressing on it. Maybe even gauze wrapping to keep it in place. Now it hurts for a long time, affecting everything we do until we are significantly along the road to healing.

Losing co-workers is like this too, You have that layer that comes and goes and that you don't notice much. You have some that make you pause when they leave but you get over it. And then there's a few that go away that really affect you and make you re-learn how to work without them. Those are the ones you really miss. You heal eventually, but there's always a scar left behind to remind you of your loss.

NSFW...

2011-08-24T08:32:00.002-05:00

...unless you work in a nursing center.

It doesn't take long before you realize that you have conversations in a nursing home that you wouldn't have in public. And certainly not as loudly.

"What can I do for you ladies?" I asked as I walked in to answer their call light.

"You need to call my daughter-in-law and tell her to bring me a bra. And not just any old one. I want the new black one without the cut straps," Mrs A told me.

"And she needs it. She has large, pendulous breasts. When I turned around yesterday and saw those things, I was shocked," Mrs. B said.

...

After I got my face arranged, I turned around and said, "Well, then she needs her bra then, doesn't she?" before I left the room.

Let Them Smoke

2011-08-14T09:16:00.002-05:00

I live in Oklahoma. Rural Oklahoma. I don't have any official numbers, but smoking seems more prevalent here than northern Illinois where I spent most of my life. Often, when we get a new resident, they come to us with an order for nicotine patches. If they're able to protest at all, they have us remove the patch as soon as they arrive and refuse all future patches so they can go out on the back porch end enjoy their cigarettes.

The residents who are able to successfully kick the habit seem to lose their faculties faster than the ones who continue smoking. Before long the new non-smokers find themselves unable to get around without help when their still-smoking contemporaries are walking or wheeling out the back door.

I'm for letting them keep on smoking.

Having their cigarettes taken away seems to kill their motivation to get better or even stay at whatever stage they're at health-wise. Smoking isn't just smoking. It's independence. It's conversation and camaraderie. It's sharing. It's something to do that's not "old person" centered like some of the activities can be. (Bingo, anyone?)

You could make the argument that the resident is in decline anyway and smoking doesn't make any difference. Maybe. But of the people I've seen who have successfully quit smoking, more than half became bed-bound while their housemates who still smoke were managing to get up by themselves every day. Even if it was just to wheel themselves out for their next cigarette.

And then this happened...

2011-08-07T08:30:00.002-05:00

I usually credit myself with being patient and thorough at work.

Last night at supper I took Mr. A's blood pressure and pulse and said, "OK, I'll be back in a couple minutes with your medicine."

I took off, got the meds, returned to him and he greeted me with, "Why are you in such a hurry?"

"I'm not. Why?"

And then I looked down and realized he was still wearing my blood pressure cuff.

Sudden Influx of Residents

2011-08-06T09:39:00.003-05:00

A side effect to this monstrous heat wave we've been surviving has been an increase in our residents. When it's hot like this, more folks are going to the hospital and their doctors and families realize that they "aren't what they used to be".

Unfortunately, we're in that space between having an increase in residents and not having quite enough staff. It takes longer to do background checks and drug tests and all that stuff to get new staff in than it does to admit someone to the nursing center.

From a monetary standpoint, this is a better position to be in than having it the other way around. From a care standpoint, it makes the residents upset and the staff resentful. I'm looking forward to the pendulum swinging back to center for a little bit.

To My DON

2011-08-03T09:17:00.002-05:00

I realize that you're busy and stressed. I understand that you have more on your plate than most people. I'm aware that each day ends with the same amount of things on your "To Do" list as you started with in the morning. And that's if you're lucky.

Still, when I tell you about an article that I've read and recommend it to you, it would be nice if you'd acknowledge it. If I make a suggestion, even if it's not feasible, I'd like to know you read it. You don't have to even explain why you're not implementing it. A simple, "I got your note," would work for me.

I believe that much of the complaining that we CNA's do is based on the feeling that we're just the "worker bees". We're expected to do the job without any questions or input. If we do say anything, it's just buzzing in your ears, easily shut out by closing your office door.

Just a little acknowledgement would go a long way with me. I'll bet at least a few of my co-workers feel the same.

Got Lost for a Bit

2011-07-29T14:56:00.002-05:00

Sorry for no updates. Work's been kind of a bummer and even the funny things aren't really making me laugh.

Taking a few more days off and then I'll get some more blog entries up, probably starting Monday. I've had several wandering around my head, I just need to get them sorted out and written down.

On a sad note, the other day was a year since my co-worker Sherman passed away. We had a short electrical outage that afternoon at work. Sherman always used to turn out the med room lights on us when he walked past. It was probably a coincidence, but we attributed it to Sherman saying hello to us anyway.

Repairs Needed

2011-07-13T09:01:00.002-05:00

"Honey?" Mrs. A called the CNA over to her table at suppertime.

"What can I do for you, hon?" she asked.

"Somebody has to fix my head," she said.

"Your head? What's wrong with your head?" the aide asked, bending down for a closer look.

"Well, I'm crazy," she said.

Patting her shoulder, the aide stood up. "Oh, that's OK, hon. You're in the right place because we're all crazy here."

It's a Zen Thing

2011-07-10T08:07:00.002-05:00

Last night at work it occurred to me that working in a nursing home is very Zen. From the little I've read, they talk about detaching yourself from expectation. So, you should work, but you should work without expectation of result.

So, just because you've taken Mrs. A to the bathroom, brushed her dentures, brushed her hair, helped her wash her face, put lotion on her hands, helped her to bed, adjusted the pillows, bed and blankets until she's comfortable, you shouldn't expect her to stay there.

Wait, that's not right.

2011-07-04T08:19:00.002-05:00

After supper, Mrs. A sometimes plays piano. Last night she played The Star-Spangled Banner, Yankee Doodle, God Bless America and O Come All Ye Faithful.

Catch that?

So did she. About three quarters into the first verse, she stopped playing and said, "Oh no, that's a Christmas song," and started laughing so hard she had to quit altogether.

Molested!

2011-07-01T20:19:00.002-05:00

"Mrs. A, what are you doing?" asked Mr. B who was at the nursing home visiting his dad.

"I'm patting your patties," Mrs. A responded and spanked him lightly again.

"Well, they're my patties and I'd like it if you'd leave them alone." Mr. B said. "Why don't you go pat his patties?" he suggested, pointing to a male CNA.

"No. Too big." she answered and sat back down in her chair.

Mamas Don't Let Your Babies Grow Up...

2011-06-30T16:29:00.003-05:00

...to think you want to live forever.

Our capacity for artificially extending life seems to be growing by the day. If you don't let your family know what you want, undoubtedly they will do everything in their power to keep you alive. Even if it means feeding you through a tube surgically implanted into your stomach and inserting catheters and tubes into places that were designed to be "Exit Only".

If this is how you want to spend the last few years of your life, please, have at it. However, if the thought of laying in bed in the same position until someone can turn you, having someone clean you up after you soiled yourself and watching your roommate eat while they put fluids with vitamins in them directly into your stomach through a tube, please fill out a Living Will and any Advanced Directives before you think you should. If you wait until you become injured and/or sick, you may not be able to tell your family to let you go quietly. They may decide that you like living in this condition or that you will be "up and dancing in no time" if you can just get over this bump in the road.

I am all for hope. I believe in miracles because I have seen them. But my residents who have been on a downward spiral for several years deserve to be put under hospice care and allowed to meet their Maker with dignity. A little preparation in advance of catastrophe would allow them to do that instead of being forced to exist just because their families don't want to let them go.

Frustration Post

2011-06-27T09:09:00.002-05:00

Rawr.

I find myself asking "Why?" so often that I think it might be the only sound I can make. Sometimes it's preceded by "I don't understand" when I'm making a statement.

For example:

"Why can't the people who are scheduled to work, come to work?"
"I don't understand why someone keeps bringing Mrs. A potato chips when she's diabetic."
"Why don't they let a CNA attend the care plan meetings?"
"I don't understand why the doctor won't prescribe better pain medication for this resident."

Today is my "hump day". After this, it's all downhill until my "weekend". I think I may make brownies to bring to work on my "Friday". Chocolate doesn't cure anything, but it sure tastes good.

Time Warp

2011-06-17T14:30:00.002-05:00

"What are we watching?" Mrs. A asked her roommate.

"Lawrence Welk." Mrs. B answered.

"Lawrence Welk? I thought he was dead." Mrs. A said, sounding surprised.

"He is, honey. This is just a re-run." Mrs. B said, laughing.

O/T Eulogy for a Good Dog

2011-06-06T10:23:00.003-05:00

Jubilee passed away on Sunday.

We got Jubliee and her sister, Annabelle, after we lost Sam eight years ago. Jubilee was the biggest dog in the litter, bigger than her brothers. She was a "reverse brindle" Boxer, so she almost looked like a giant Boston Terrier. She has always been the protector. Her sister used to sit or lay on her constantly. After Annabelle found a new home (an interesting story there, too), Petrucci, our male Boxer, took her place in using Jubie for a seat. She tolerated this pretty well most of the time. When she was done being a tuffet, she was done and she would let them know.

Jubilee was the one who would wash you with her tongue as long as you would sit still. If one of the other dogs was sick or wounded, "Nurse Jubie" was the one taking care of them. When Brad's mom was staying here, she had a key chain with a black and white stuffed cat on it that meowed when you pushed it's belly. Jubilee took that thing and carried it around and talked to it like it was alive. We often wished we hadn't gotten her fixed so that she could have had a litter of pups. She would have made a good momma.

While we're sorry to see her go, we're glad she didn't suffer long. Jubie was always a strong, healthy girl.

We miss you, Choob. See you on the other side.

Dr. Jack Kevorkian

2011-06-04T08:13:00.004-05:00

I guess this is technically off topic, but I have something to say, so here I am.

Dr. Jack Kevorkian passed away yesterday. In the hospital and not by his own hand. It's kind of anticlimactic, considering the way he put himself on display with his suicide machine.

Dr. Kevorkian could have been an advocate for assisted suicide without acting the fool. If he had, maybe we would be farther along the road to legalizing euthanasia for human beings. Instead, "Dr. Kevorkian" is a punchline and we have people who are terminally ill, suffering, and are forced to watch themselves waste away instead of having a quick and dignified end. What a shame.

And that's all I have to say about that.

Just Wait

2011-06-01T10:16:00.002-05:00

I got yelled at by a resident the other day. Loud. In front of an entire room full of people. I wanted to crawl in a hole. I don't mind being the center of attention if I put myself there. I don't like when someone else does it for me.

That was my last exchange with this resident for the entire day. So, with this unresolved mess in my head, I went home, ate and tried to get some sleep.

Right.

I woke up at 4:00 trying to think of what to say to the resident. I fell back to sleep about 6:30 and had the dogs waking me up at 8:00 and found myself thinking about it all morning. To the detriment of my workout and chores, because one didn't get done at all and the other was done poorly at best.

When I got to work, the aide handing off the cart to me told me that the resident had given her a hard time that morning, too, and that she had finally gotten out of the resident that their stomach was bothering them. So, when it was my turn to talk to them, I asked how their stomach was, did they want their meds now and if not, can I check in with them later.

Not so good, no and yes.

So, I let this rent space in my head for nearly 20 hours, stressing out over what to do and all I really needed to do was relax and wait for the answer to present itself.

Lesson learned. Now I hope I remember it the next time I find myself in that space.

Glad to be back.

2011-05-31T10:17:00.003-05:00

I've been back at work for two days. My residents seemed to be glad to see me. I was glad to see them, that's for sure. Sadly, when you take vacation, you sometimes come back to find someone has passed away. That wasn't the case this time. Everyone is intact and there are even a few new faces in the facility.

On the other hand, when you go on vacation, you hope that some of the things that weren't working so well will have resolved themselves by the time you return. Unfortunately, I'm not seeing any of that either. Oh well. At least there aren't any glaring new problems.

A couple more days here and I should be able to collect some stories to tell. The other thing about returning from vacation time is that you have to get back into the swing of things and I'm not quite there yet. I'm having enough trouble getting my work done without trying to scribble down every funny thing I hear, too.

I'm Off

2011-05-20T10:36:00.002-05:00

I am taking a week of vacation.

I hope I do not think about work while I'm away.

Since I don't plan on thinking about work, I don't plan on writing about it either.

See you after Memorial Day.

Honesty

2011-05-16T09:31:00.002-05:00

"What are you doing?" Mrs. A asked when I knocked on her door.

"I need to give Mrs. B some medicine," I answered.

"Oh god! Please don't wake her up! She's finally sleeping and when she's awake, she drives me crazy."

Today is Pajama Day

2011-05-12T09:01:00.000-05:00

We're having a kind of Spirit Week for Nurses Week at work. You know, we've done the hat day and crazy sock day.

Today is pajama day.

...

I am really glad I have today off.

Still More on Roxanol...

2011-05-11T10:09:00.002-05:00

...and comfort care.

From the very little that I understand about the legal side of nursing, Durable Power Of Attorney (DPOA) is something you give someone who agrees to make important decisions for you when you can no longer make decisions for yourself.

So, your DPOA can decide to put you on hospice and have you receive comfort care only. They can say that you wouldn't want to suffer and that it's ok to do this. Sometimes this speeds up the end, sometimes it doesn't.

In any event, what if the resident's DPOA wants hospice (and therefore is vicariously speaking for the resident) but other family members want to do everything possible to keep the resident alive? Talk about a touchy situation. The family is fighting. The resident is sick and confused and gets combative when the "live forever" side of the family is in the room and is sick and confused and angry with the "rest in peace" side of the family is there. Regardless, you almost have to grit your teeth, focus only on the resident, and get out of the room and quickly as possible. There's no way you can satisfy the family's loaded questions, so you have to resort to referring them to the charge nurse. They don't like that either.

Sadly, it makes you wish the resident would pass away faster and that's an awful feeling, too. So here we are: feeling guilty for wishing the end would come, feeling guilty for giving comfort care, and feeling guilty because we are too uncomfortable to stay in the room for one second longer than required to do our jobs.

And here I thought this job was just about keeping people happy, healthy, and comfortable.

There's a cure for that?

2011-05-05T18:47:00.002-05:00

Mrs. A went to the doctor and had some X-rays taken. I asked her how the visit went.

"Oh, they asked me if I had all kinds of diseases. Then they asked me if I had the menopause. I said I didn't know. But, you know, I think I had it once and it all cleared up."

Drawing the line

2011-04-29T13:18:00.002-05:00

Duty comes first. It is my duty to show up for work when I'm scheduled and to give 100% of what I have to give that day. Sometimes my 100% varies, but I show up and try to do my best. I don't think I was always wired this way, but I have been for the last ten years or so. I acknowledge that it makes me intolerant of people who I perceive do not operate this way. I also acknowledge that I should strive to be more kind and understanding when my co-workers disappoint me.

However, I draw the line at covering for them.

I'm not saying that I have never worked an extra shift on short notice, but I avoid it like the Plague. My reasoning is this: I work my schedule. I avoid calling in unless it is impossible for me to go to work. I have, more than once, called work and had them send someone to pick me up because my car has broken down. I work when I'm under the weather and injured. While I don't really expect everyone to be exactly like me, I don't expect them to call in more than ten times a year (multi-day illnesses count as one in my mind), either.

Once you say "yes", the powers that be start calling you to come in all the time. You become the "go-to girl". Pretty soon you can't count on getting a day off, ever. I don't know if this is true of every facility, but that's how it works at my workplace.

I'm not interested. I don't care if it means overtime pay. If I start doing this, I'm going to wear out and then I'm going to be the one calling in sick or injured. I'd rather be the girl that they can rely on to be in when scheduled. I draw the line at trying to be SuperAide.

Rumors abound.

2011-04-24T12:13:00.002-05:00

I'm hearing rumors about a not-for-profit nursing center opening up in town. I'm not sure where we're going to find residents to fill it up since we can't even fill up the two we have in town now. But both of the ones in town are for-profit, so maybe this will attract more people.

Anyway, I'm planning on jumping ship if they do open. And, yes, I'll take a cut in pay to do it.

Slightly OT: We're all going to die.

2011-04-20T10:33:00.002-05:00

Hopefully, not today, but eventually, we're all going to die. It's the one thing you can't escape. You can even get out of paying taxes if you really try, but death? Sorry, you don't have a choice.

So, if you're wondering what brought on this spate of vitriol, here's the story.

Grete Waitz passed away. She won nine New York City Marathons. She had been battling cancer for the last six years and she died on Tuesday. I saw the news on About.com this morning. There were two comments, both expressing amazement that someone that young could have died. They expressed their condolences to her family and then each made a comment to the effect of, "Wow, if an athlete can die so young, why bother trying to be healthy?"

Really?

Quality of life is greater than Quantity of life. Sure, you can live to be 100, but if you struggle and suffer through the last 50 years, is that really what you want? Frankly, you can have 40 of those years if the rest of my life is relatively free from pain and disease.

Yes, I know, that's just my opinion. But after working in the Nursing Center for the last three years, I feel pretty qualified to offer it up for scrutiny. I've had enough people tell me that they wished they were dead to believe them.

I didn't know Grete Waitz. I've never even read an interview with her. But I'm pretty sure that she wouldn't say that she wished she had never started running. I imagine that she regrets that she didn't get to run more.

Amazing scenes and nightmares...

2011-04-08T19:58:00.003-05:00

... and everything in between.

***

When I came on shift the other day, I heard singing. This isn't unusual. We have our fair share of volunteers who come in to entertain the residents. What was unusual was that this was a private show.

Mrs. A was laying in bed, hands raised and waving, as one of her male family members was singing a rollicking spiritual while dancing and playing the ukulele. It was the most awesome thing I have ever witnessed. There is a special place on the other side for this guy.

***

We had CPR class the other day. Mr. B was wheeling around in his own little world and, since the meeting hadn't started yet, we were letting him.

The next thing I heard was, "Hey! Mr. B 'jacked the mannequin!" and turned to see him wheeling out of the dining room with it on his lap.

***

I went into Mrs. C's room to administer her bedtime meds. While I did this, Mrs. D sat up and started getting out of bed.

"What time is it?", Mrs. D asked.

"Eight o'clock at night," I answered.

"At night?" Mrs. D laughed.

"Yes. Did you think it was morning?

"I was dreaming that we were voting on whether or not to quit that war over there. And then I dreamt that I was elected president. I guess that's what woke me up," she said, still laughing.

"Well, I don't blame you. That would wake me up, too."

Compassion Fatigue?

2011-04-04T10:22:00.003-05:00

Mrs. A can no longer speak. She still manages to make a lot of noise. Yesterday, she was sitting by the nurses station, letting us all know she was there.

Mrs. B was sitting in her wheelchair several chair-spaces away. Every time Mrs. A would slow down, Mrs. B would chime in. "Can you shut up? I wish you'd shut up," and other variations on that theme.

Yes, it's sad that I find this funny. (We did move Mrs. A to the dining room after that, so Mrs. B wasn't being tortured for hours on end.)

I'm gonna wash that gray...

2011-03-24T11:49:00.004-05:00

...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.

How pushy is too pushy?

2011-03-20T09:15:00.003-05:00

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.)

Step away from the rumor mill.

2011-03-16T09:33:00.002-05:00

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.

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

2011-03-14T10:01:00.003-05:00

...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.

Preexisting Condition

2011-03-08T10:08:00.002-06:00

"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."

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

2011-03-06T11:33:00.002-06:00

...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.

Bonus

2011-03-02T08:35:00.002-06:00

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.

Back in the day.

2011-02-24T14:01:00.003-06:00

Sometimes I wonder what my ladies and gents were like before they came to the nursing center. I can read their charts to find out their medical history and what they did for a living before they got hurt, sick or just wanted to retire. But their charts don't tell me what their favorite cookie is or who they looked up to as a kid or whether they prefer showers or baths.

Once in a while I'll get a little glimpse of who they were. Mrs. A told me one day that she loves toast with jelly dipped in her coffee. I do, too. Mr. B and I talk about playing poker and smoking marijuana. (I play poker, but marijuana is not on my list of vices, so I mostly listen when he talks.) Mrs. C used to be a CNA and, even though she can't tell me about it, I'll bet she was one of those who could move a resident no matter how heavy they were. Mrs. D and I talk about Boxers because she used to have two that would walk with her around her property and she says she was never worried about meeting up with a varmint while they were beside her.

It's easy to forget that these folks had lives just like we do before they became too disabled to care for themselves. They had their share of tears and laughter, joys and regrets. Sometimes, if we're lucky, we get to hear about some of them.

In the rush...

2011-02-20T07:48:00.002-06:00

... to get everything done, I sometimes forget why I like my job.

Last night I was pushing pills. I had a new resident to introduce myself to, which I did, medicated her and went on. Because that's what I do and what I HAVE to do to get everyone their "supper" pills before I have to start passing their "bedtime" pills.

New resident doesn't have any bedtime pills, so I don't go visit her and complete my med pass, finishing up just before nine pm.

When I'm done passing meds, I take a break. Sometimes, like last night, it's the first break I get. (Yeah, yeah, don't talk to me about "two 15 minute breaks and a 30 minute lunch". If that happens for you everyday at your facility, I'm happy for you. I get that once a week for sure, more if I'm lucky. This is not a complaint, just a statement of fact. Frankly, I do better on fewer breaks.) About five minutes in, I get a request for prn medication from the new resident, so I trot down the hall, to fix her and then try to scoot back to break.

She called after me, asking for a snack. I told her what we had, got her order and trotted back with juice and one of every cookie/cracker we had because the "good" cookies that the kitchen bakes were all gone.

While I'm getting ready to leave, she starts giving me her health history for the last six months. So, I listen, still standing. (If I knew her better, I would have sat down, but I don't know how she feels about staff in her room yet.) We chat about physical therapy and about how they will get her back on her feet and I suddenly remember that the reason I like my job is because something as simple as giving a person an ear to bend can make all the difference in their world.

My goal today is to remember this more than one time before 9:30 pm.

Off Topic: Dogs

2011-02-19T11:41:00.002-06:00

I can't remember when I last wrote about anything other than the nursing center...

Cliff, our terrier mix, is more intelligent than 50% of the people I know. The prize spot in the house to lay is the love seat. Only two dogs, or one human and one dog fit on it at a time. If Cliff is the "odd dog out", he will run to the lanai door, barking like every bad person in a six mile radius has converged on our backyard. When the other dogs follow him, he turns around, runs back, and lays down on the love seat.

I wonder if Jubie and Trucci will ever catch on.

And so the pendulum swings.

2011-02-17T16:33:00.002-06:00

We seemed to be in the business of losing employees there for a while. Now, suddenly, we've got a bunch of former employees coming back. Good ones, to boot.

Have I ever mentioned how much smoother things go with the right group of employees? Even on nights when we're short-handed, it's so much easier when everyone can work together. Then we don't end up with a time where everyone is stubbornly on break at the same time or one hall gets all the attention while the other hall's residents are left in the lurch.

Last night was one of those nights. Even though we had an employee leave early, we still were able to take care of everyone with hardly a glitch. (Well, except for the woman who was trying to hit people with her doll. But that's another story for another day.)

***

Quote of the day:

"What are you up to, Mr. A?" the CNA asked.

"Oh, just waitin' for my celly."

(I know. Another prison reference. I still found it hilarious.)

I'm sick...

2011-02-13T09:59:00.002-06:00

... so if I'm repeating myself, blame it on my cough-rattled, mucus-filled brain.

***

One day while the ladies were doing arts and crafts, Mrs. A asked Mrs. B to pass her a blue dot.

Mrs. B handed her a red star.

"No. I asked you for the blue dot," Mrs. A said.

Mrs. B cocked her head and for a moment, handed her the red star and started singing, "The old gray mare, she ain't what she used to be..." and was quickly joined by the rest of the table before they broke down into giggles.

***

Now, ask me if I'm going to work today. Yes, I am. My temperature is not over 100, I am not vomiting and I do not have uncontrollable diarrhea. I'm donning sinus pills and Mucinex as my battle armor and heading into the fray.

Been in a work funk.

2011-02-06T12:35:00.003-06:00

Work's been kinda rough lately. Rather than getting on here and complaining, I thought I'd take a break. Between the weather, sick residents, and sick staff, I've been up to my eyeballs in frustration. I'm taking a couple more days to straighten my soul out, then I'll be back. Some funny stuff has actually happened amongst all the muck.

Care to vote on the quote of the day?

2011-01-25T09:55:00.003-06:00

"You came into my life, then I thought I got rid of you. Now, here you are again, but I'm glad of it." --One old friend to another, who are now roommates at the nursing center.

or

"We'll be alright as long as they don't start screaming...one after the other... in three part harmony." --Said to me in the dining room during a relatively quite meal.

***

Personally, I'll take the second one. It kills me when they're catty.

Fashion Police

2011-01-18T10:00:00.002-06:00

"That's such a pretty dress you have on," said Mrs. A to Mrs. B

"Why, thank you! Santa Claus brought it to me, plus three more," Mrs. B replied, smiling.

"It's a good thing he did. You can't buy a dress like that anymore. They're all down to your boobs and up to your butt," Mrs. A said, pulling up the bottom of Mrs. B's dress to illustrate her point.

Mrs. B laughed a little.

"I'm serious. Haven't you seen those girls on TV?"

Fighting Dehydration

2011-01-17T09:30:00.002-06:00

One of the hardest things to do is to get my ladies to drink enough. I try to get them to take a full glass of water with their meds and they have big mugs of ice water in their rooms. Some of them do OK on their own, but most of them need to be encouraged to drink.

And they don't like water.

I don't either. Give me a choice, and I'll pick something flavored every time: tea, coffee, milk, juice, pop. Water is strictly utilitarian and I only drink it because I "have to".

I've started offering a couple of them juice with their medications. I'm also trying to take time to sit with the ones who can't hold a glass well and get them to drink while I talk with them. Sometimes I'll take break with one of them and bring them coffee or tea to drink while we're chatting. Unfortunately, these are more the exception than the rule, but every ounce helps, right?

Bizarro Nursing Center

2011-01-11T11:16:00.002-06:00

Everyone is behaving backwards lately. The nice ones are snarky and the mean ones are saying "please" and "thank you".

I was talking to Mrs. A (known to her doctor as "Meanness") the other day about how everyone seems off. Teasing, I asked "Are you normal?"

"No. How can I be when everyone around me is abnormal?"

Well, I bought new shoes...

2011-01-08T09:42:00.002-06:00

...and I'd like to say they made a world of difference, but, alas, no.

Unfortunately, I think I have pounded my feet to death the last month or so in those old shoes. I figure it may take at least that long for them to stop hurting with the new shoes. I also started some foot and ankle stretches last night. That's probably something I should have been doing a long time ago, too.

On the bright side, the new shoes didn't cause any new pain, so I figure that's a plus.

And into the trash they went

2011-01-05T09:10:00.002-06:00

OK. The shoes had to go. Considering I only spent $13.00 on them, they lasted a long time. I think I should have gotten rid of them a couple months ago, however.

I'm planning on spending good money on a new pair next week. In the meantime, my running shoes are doubling as my work shoes. And since I spend a lot of time running at work, it's fitting.

***

We have a new lady who can no longer speak, but cries out a lot. I'm hoping this will stop once she gets used to her new home.

The other day, Mrs. A was interrupted by a howl from Mrs. B.

"I'm glad that's not me," Mrs. A said (who has been known to let out a scream herself, now and again).

(Mm. That might be a "location" joke. But I thought it was hilarious.)

The Short-handed Shuffle

2011-01-02T09:41:00.002-06:00

Oklahoma is one of the states that has a minimum staff requirement for nursing centers. It sounds great until you realize that the staff that they can "count" are not necessarily staff that are working the floor.

We were short again last night. Short by my standards. I would like to see 6 CNA's, 2 CMA's and 3 LPN's. We had 4 CNA's, 2 CMA's, and 2 LPN's. According to the staff requirements, that's enough people to take care of the number of resident's in my facility. The nurses don't work the floor and the CMA's are limited by what they can do between dishing out medication. (Technically, they are not supposed to stop their med passes to help out on the floor, but they never get through a med pass without taking someone to the bathroom or helping someone to bed or something.)

I understand that I should be thankful that the state has minimum staff requirements because it's likely that we wouldn't have had even that many if they didn't. (I work for a "for profit" nursing center.) But we would have been more effective if we'd had more help. Minimum staff just means the resident's are getting the minimum amount of care. In some cases, barely that.

I've been trying to think of a solution. I'm sure that if someone asked the Administrator, she'd say that her nurse's and CMA's help out on the floor. This is not usually the case and when they do, the help is limited as they have to get their work done too. Maybe the state needs to require a certain number of staff who are specifically dedicated to working the floor, regardless of their title. That way, a nurse could stand in for a CNA only if she was not also required to perform LPN duties.

In the meantime, I use my feet as a barometer. If they really hurt at the end of the night, we didn't have enough help. They were still tender this morning. (Yes, I also need new shoes, but that's another post for another day.)

End of Year Review

2010-12-30T15:35:00.002-06:00

So this is it. 2010 is soon to be left to the history books and 2011 is ready to take it's first breaths.

The most important question is "What did I learn this year?" because if you ignore the past, you are doomed to repeat it.

Fear is a lousy basis for decision making.
Slow down.
Listen.
Ask questions if you don't understand.
Taking breaks with a resident is good for you and the resident.
Taking breaks away from the residents is good for you and the residents.
Taking breaks away from your coworkers is not a bad idea, either.

The second most important question is, "What are my goals for next year?" because floundering through a year without a purpose is a waste of a perfectly good year.

Go back to working the floor versus working in the med room.
Take more breaks with my residents.
Take fewer breaks with my coworkers.

Have a happy and safe New Year celebration. See you next year.

How about we reconnect our frontal lobes?

2010-12-28T10:00:00.002-06:00

You may (or may not) have noticed that I blog in the mornings. It's not because I go to bed right after work. I'm generally up until one or two in the morning. It's because I need time to let what has happened marinate and filter through my mind before I write it. Sometimes it helps me be less judgemental and whiny on this blog. I hope I haven't been too much of either one of those. There's more than enough of that crap out on the Internet already.

That being said, can I complain about my nurses?

Sometimes, it's better not to say the first thing that rolls through your brain. Not everyone is brilliant on the first try. Better to take a deep breath and consider your words before you spew them into the world for everyone to see.

I had a resident with diarrhea last night. It was messy and smelly and embarrassing for the resident. It took nearly 20 minutes to get her and her room cleaned up afterwards. Toward the end of this, as I was taking the trash and dirty clothes out of the room, a nurse walked in, wrinkled her nose and said, "Eww. Who is that?"

Really?

My response was to sigh, grit my teeth and say "It's Mrs. A. Her stomach is sick."

I sometimes wonder just what my nurses do in their free time that causes their lips to become totally disconnected from their hearts. Do they not think that the resident already feels bad enough? Do they not think that the resident knows how bad it smells? Would not the proper, more "nurse like" response have been, "Who's sick?" or "Did someone have diarrhea?"

So, a call to engage our brains before we put our mouths in gear. Think before we speak today. And may we be forgiven for the hurtful things we've said that we didn't even realize stung the victim.

Holiday Gifts

2010-12-23T13:27:00.002-06:00

The policy at our facility is that we cannot accept gifts from the residents or their families. We're not even supposed to take food from them if they offer it. I hate telling them that I can't accept their offers, so sometimes I just take what they give me and turn it in to Social Services. Sometimes, if it's just a piece of candy, I'll take it. Fire me. It makes them feel good and keeps them from eating the whole box themselves, so I think it's worth the risk of getting in trouble.

So, I turned in a gift card one of the resident's had given me. I suggested they call the daughter (who had bought them) and tell her we can't accept them and ask her if she wanted to donate them to the facility and not tell the resident because I didn't want their feelings hurt.

I got a call today saying I could come in and pick the gift card up and keep it. Apparently, the daughter had bought a bunch of them and only two of us turned them in. Since the facility "didn't know what else to do or who had gotten them", the two of us who were honest about it are getting them back.

I'm not sure this is exactly how it should be handled, but there it is. And I need some jumper cables for my car, so that's what I'm going to buy. That way I'll be able to get a jump when I need it for old Pearl this winter which will keep my attendance good and that benefits the facility, right? Or that's how I'm justifying it to myself anyway.

Really?

2010-12-21T09:50:00.002-06:00

Full Moon.
+
Total Eclipse.
+
Winter Solstice.
+
Unusually warm weather.
+
A death in the facility.
----------------------------------
A shift I may never forget even
though I'm trying desperately hard
to do so.

Today will be better.

Brief Hiatus

2010-12-10T14:11:00.003-06:00

I'm taking a little vacation from the blog for a week or so. My sister's coming to visit me and I have my hands full getting ready and then will be busy while she's here. I should be back with stories to tell and opinions to foist upon you after the 19th.

What are they in for?

2010-12-06T11:26:00.002-06:00

Yes, sadly, another prison reference. But a valid question. When we get a new resident, I want to know why. Are we getting them well enough to go home? Can they not take care of themselves, so are in for a long stay? Are they just here to die?

I'm surprised at how many times I ask a nurse this and they answer me with, "I don't know."

How can we effectively take care of a resident if we don't know what they're in for? Going back to the prison thing, you can bet the warden knows what each of the inmates is in for. They need to know in order to effectively house and, possibly, rehabilitate the inmate. I argue that we are in the same lake, if not the same boat.

I intend to start being more proactive in this. If the nurse doesn't know, I'll go and read their history myself. I may just be a pill pusher and a butt wiper, but I think I can do both jobs better if I know what the goal is.

Belated Happy Thanksgiving and Other Stuff

2010-11-27T10:04:00.003-06:00

Happy Thanksgiving! Late though it is. A virus hijacked my computer and I had to wait until Friday to get technical support to help me fix the last little thing that the virus did to my computer. All should be well now.

***

So, here's the quote of the day from Thanksgiving:

"What are you doing?" Mrs. A asked the young aide.

"Oh, nothing," she replied.

"Well, that's about what I'd expect out of you."

And another:

"Honey," Mrs. B called the aide over to her with a wave of her hand.

"What can I do for you?" she asked.

"Tell me something. Are you as crazy as the rest of us here?"

"Yes, ma'am, I am," the aide answered.

Diagnosis

2010-11-21T09:22:00.002-06:00

I was in Mrs. A's room last night. She told me Mrs. B was confused. She thought she was at home and wanted to go check on the horses. She said she had told the nurse and the nurse said they would come and evaluate Mrs. B.

"I can evaluate her for you right now," she said. "Cuckoo."

Why not take them home?

2010-11-18T08:08:00.002-06:00

I sometimes wonder why some of our residents are in the Nursing Home at all.

We have family members who never seem to leave. While this is great, and the resident seems to love it, why not just bring them home? If they have time to be there all the time and diddle around making arrangements to have other people come in and be with the resident, why not do this at home where it's cheaper and the resident will be happier and more comfortable?

I think it's great when the residents have lots of visitors. I'm glad we have family members who check up on us and make sure we are on our toes. But if they have time to be with the resident 12 to 16 hours a day, they need to take the resident home and arrange for home health care to come in and assist them. It's a healthier and less stressful environment for the resident and it's healthier and less stressful for the family members, too.

Between and Rock and a Hard Place

2010-11-15T20:46:00.005-06:00

UTI's are the bane of my existence.

I know what we're supposed to do to prevent them. Toilet the resident's regularly, do proper perineal care, offer them a drink at every opportunity, yadda, yadda, yadda.

But what do you do when you have a resident on a fluid restriction? I know from personal experience that keeping yourself clean and voiding regularly don't work very well if you can't drink enough fluids to flush out your bladder. Granted, these folks are usually on a diuretic of some kind, but it still seems like we're constantly poking antibiotics down some of them. No sooner do we get one infection cleared up than we have another one in the works.

I realize that this could just be the result of their other diagnoses (immobility due to hip fracture, diabetes, bowel incontinence, Multiple Sclerosis and other neurological conditions), but it's still frustrating when you try to do everything right and the resident gets sick anyway.

I suppose it's up to the physician to determine the optimum fluid intake that will allow the resident to remain UTI free and also out of danger from CHF. Still, I'd like to have a meter that tells me that the resident is properly hydrated without the guess work. Maybe I'll invent one after I create that teleporter that allows me to just show up at work instead of having to drive there.

Last Night in a Nutshell

2010-11-12T10:36:00.003-06:00

I walked out of Mrs. A's room to find Mrs. B standing at my med cart with her hands on my pitcher and water dripping down her chin.

"Rita Lee! Did you just drink from my water pitcher?"

"Yes. Heh, heh, heh."

"Well, here's some more," I said as I handed her a cup of water before rushing back to the kitchen to wash my pitcher.

Funny how we get conditioned...

2010-11-08T11:40:00.002-06:00

...to a thing and then react the same way regardless of what is actually happening around us.

***Whiny post warning!***

We've had several DON's since I began working at the Nursing Center. I usually refer to inservice as our "bi-monthly flogging". This is because the other DON's used it to tell us everything we had been doing wrong and to generally make us feel like we were the worst Nursing Department to ever exist.

I'm not saying that this never happens now. When it does, it's usually the Administrator running it. (Can I say that I don't like her and I'll be glad when she moves on to bigger and better things?) But, generally, when the current DON is in charge, it's more of a discussion of things we could do better than a "Hey, you losers, this is everything you've done wrong for the last two weeks" kind of meeting.

And yet, I still cringe when I have to go to inservice. In fact, I have often thought I would gladly give up my Medication Aide certificate just so I could be working the floor instead of sitting in there with my head bowed.

The worst is having to go to inservice on my day off (like today). It cuts my day in half. I spend the first half fretting about what's going to be said to us and the other half wondering why I keep going back if nothing I do is right.

On the bright side, I will get paid. And then I can grocery shop, which I LOVE to do. And if the DON is running it, I might actually get a suggestion for something I could do better instead of lash marks across my back.

Backhanded Compliment

2010-11-07T10:14:00.002-06:00

Conversation at supper yesterday:

"Well, you look neat," Mrs. A said to me.

"Thank you," I replied.

"She always looks clean. She must shower," said Mrs. B.

I wish I could have thought faster. I would have said, "Yes. Once a month whether I need it or not."

Everything old is new again

2010-11-06T05:15:00.002-05:00

I'm seeing a lot of familiar faces in this current round of hiring. While I am happy because there will be much less training time involved, I have to wonder why you would leave a place and then come back to it. I could understand if we had a new DON or Administrator, but these are the same folks that were running it when these employees left for greener pastures.

I see a lot of this here. Maybe it's because this is Small Town, America. Maybe it's because the pastures only LOOKED greener and they were actually happier here. Or maybe it's because we're fickle and when we say "never" we actually mean "never, unless I change my mind".

Hit the door running

2010-11-05T09:27:00.002-05:00

I wonder sometimes why people come to work and then get ready to work. Shouldn't you be ready to work when you walk in the door? Granted, most days you actually have time to put your belongings in your locker and your lunch in the 'fridge. But haven't you ever walked in to a resident on the floor or someone being combative or whatever?

So I guess this is a post about appropriate dress at work. Having worked in an office for sixteen years, I can tell you that wearing a uniform every day is MUCH easier.

So, here we go:

Wear your uniform. Don't wear a regular shirt and your scrub pants. Don't wear regular pants and your scrub shirt. In fact, I would say wear your uniform even on "Casual Day". Why would you want to get the Nursing Center (or wherever you work) all over your jeans and t-shirts that you wear at home or out with your friends?
Wear appropriate footwear. These folks that insist on wearing these "Croc" things are just asking to get hurt. I've seen more people fall (including my husband, at home and at work) wearing these things. Yes, they're comfy. Yes, they come in pretty colors. Yes, you can get a pair for about ten dollars. But that trip to the ER is going to cost you a lot more when you land flat on your back and can't get up.
If your hair is past your shoulders, put it up. Pony tails are OK, but I'm for a bun. If a resident is in a hair pulling mood, you won't find yourself on the end of a hair leash if you have your hair firmly secured. This goes for boys, too. We have a young man with long hair that puts his up. Work is not a fashion show. No one cares how you look. We only care how you work.
Going back to uniforms, wear ones that fit properly. When you bend over, your fanny should not hang out. If you're a boy, I don't want to see your boxers and neither do the residents. See the bullet point above.
Make sure you have showered and shaved and put on deodorant. No resident wants a greasy, hairy, smelly aide working with them. On the other hand, don't bother with the cologne. Your residents with COPD will thank you if you just smell like skin.

Did I miss anything? Do I sound like your mother? Or your grandma? Maybe that's the point. Dress like you care about what your momma would say. Someday you might be taking care of her.

More on staying healthy

2010-11-03T11:44:00.002-05:00

So, since I've HAD to go see my doctor several times recently, she bullied me into getting a mammogram and a pap smear. So yesterday, that's what I did.

To all those women out there who have told me horror stories about their breasts being nearly torn asunder and their nipples almost popping off, allow me to now roll my eyes in your direction.

Jeez.

Either all of those women are serious wimps or they had the worst techs in the world handling them. I go through more pain with my migraines every month, and for longer periods of time, than I dealt with yesterday. If every medical test I ever had to have done was that easy, I'd probably go to the doctor more often.

OK. So that's a big, fat lie. But it's a nice thought.

Anyway. Go and get your mammogram done. It's not fun, but I promise, it's not as bad as everyone says it is.

Woo Hoo!

2010-11-02T11:54:00.003-05:00

Sometimes things just work in your favor.

I've been wishing for three days off in a row for quite a while. The last time I had more than two days off in a row was in May when I took my vacation. I try not to ask for too many favors because:
A.) I don't like "owing" anyone anything.
B.) When I really want/need something, I want to be able to get it.

So, I've been trying to tough it out until December when (hopefully) I will be taking 4 days in a row off while my sister is here.

Well, I just had Sunday and Monday off. Today I get a phone call. They're making some last minute schedule changes and wanted to know if I wanted today off.

Yee Haw!!

Of course, I got all my chores done, so I have nothing to officially "do", but that's just fine. I think today will be a good day to bake some bread and coffee cake and whatever else I have the ingredients to make. I'd turn a cartwheel, but then I'd have to go back to the doctor and I've had about all I can take of her for a while.

Amazing what an extra eight hours of freedom does for your attitude.

On Staying Healthy...

2010-11-01T19:18:00.002-05:00

...or not, as is the case with me.

So far in the last eight weeks, I've had two bladder infections, an infected tooth pulled and a head cold.

Go me.

So, where did I go wrong?

I have a bad, bad habit of ignoring my bladder. It tells me to go to the bathroom and I ignore it until, by the time I get there, it takes me a little bit to get going, as it were. That, in addition to not drinking enough water during the day has sent me to the doctor twice.

Stupid, I know. I have a hard time telling my residents and coworkers "no". Since I don't want to give the Doctor any more of my time and hard earned cash, I'll be hitting the head every two hours whether I think I have to go or not. I don't like water, but I'll be drinking at least three glasses on my shift.

The tooth is more about not having dental insurance until recently. Now I'm burning through my coverage before the year is out. No more visits until January.

The head cold? Probably being sick for six weeks made me more susceptible to the "Staff infection" going around work. We've even managed to share with some of the residents. I'm sure they'll be giving it back to us, mutated of course, so we can all enjoy it the second time around.

So, what do you think is the result of three rounds of antibiotics?

Yup, yeast infection.

Do as I say, not as I do.

Take care of yourself so you can take care of your residents. You're no good to them sick. Especially if you've got something they can catch.

A few funnies before I start the "week".

2010-10-26T23:03:00.003-05:00

My weeks are four days on, two days off. Tomorrow is my Monday.

***

Mrs. A said to me "I think I'm over that disease now."

Knowing her diagnoses and knowing that nothing she has can be "gotten over", I asked, "What disease is that?"

She looked at me for a moment and said, "That disease where you get the book and read about it." (I assume she's talking about the booklets the doctors sometimes give you.)

***

"Where am I?" Mrs. B asked me.

Thinking she was confused, I said "You're at the Nursing Center."

She laughed. "I know. I just wanted to know if you knew where I was."

***

I lack a sense of where my body is in space. I would have made a terrible gymnast or ballerina. Thank goodness I'm too fat for either one of those professions.

Anyway, I tripped over Mrs. C's wheelchair.

"Ugh," I said, disgusted. "That was a nice trip."

"Kick it again!" Mrs. C said.

Returning to the chair, I asked, "Oh, once for you?" and booted the seat.

No Call No Show

2010-10-16T09:23:00.003-05:00

We've had a rash of the old "No Call No Show" lately.

If you can't come to work, even if you aren't planning on coming back EVER, shouldn't you at least call to let us know? This mentality completely escapes me.

I can only think of three valid reasons for a "No Call No Show":

You have been stranded by a disaster, natural or otherwise, in an area with no cell phone coverage.
You are unconscious and no one in your family or network of friends knows where you are.
You are dead and no one in your family or network of friends knows it yet.

If you can think of any other good reasons, let me know. Maybe I'm just not seeing the whole picture or something.

Squeezing Out the Sponge

2010-10-14T14:32:00.002-05:00

Currently, the gal that works first shift on my med cart and I have the same schedule. The other day she commented that on her first day, she's anxious and upset but by her fourth day, she's calm and ready to have a couple days off. I, on the other hand, come in calm on day one but by day four I'm frustrated and ready to explode.

I don't know how to classify her, but I am a sponge. After two days off, I'm squeezed out, clean and ready to go. By the fourth day at work, I'm full of dirt, half chewed food and nasty dishwater and unable to take on any more.

I'm not sure if this is good or not. What I need to do is figure out a way to speed up the turn around time, so I can squeeze out every day and come in each afternoon, ready to clean up.

I've tried all the healthy coping strategies and at least one unhealthy one. Nothing seems to work for more than a day or two. Maybe that's the key. Keep switching it up so that you don't become immune to any one treatment.

I don't have the answer, yet. I guess, like all of us, I'm day to day.

I figured it out.

2010-10-06T10:01:00.002-05:00

I know why I like the mean, nasty residents.

Because I'm mean and nasty myself.

Prepare yourself before I tell this story because some of you are going to be offended.

Ready?

The other day shortly after I came on shift, my charge nurse came up to me and asked me to give Mrs. A some pain and anxiety medication.

"Wow, she must really be hurting." I said. This isn't unusual for this resident, but it doesn't happen every day.

"Yes and she's having behaviors. She peed on a Nurse Aide and told her she deserved it."

"Well, did she?" (I'm not sure if I'm proud or sad that this was my first question.)

The nurse made that disgusted sound you make when you can't believe what just came out of the other person's mouth.

"Who was it?" I asked.

"Jane Doe."

First I laughed and then I said. "Awesome. She does deserve it. In fact, we should let a few more residents pee on her."

Yup. I said it. The unfortunate truth is that I've gotten several complaints on this Aide. I've had residents request that she NEVER be allowed to work on their hall again. The sad thing is that she keeps being put on the same hall because she does the least damage there. So, the residents are stuck with her until the glorious day when she decides to quit.

So, now you know. And you young Nursing Assistants out there can start quaking in fear now of the day when I become your resident.

Attitude is Everything

2010-10-02T14:28:00.002-05:00

The attitude you bring with you determines the outcome of your day. You can't control what happens, but you can control how you react to what happens.

Case in point: When a nurse comes up to me and ask "Did you take care of so and so today?" my first reaction is to cringe and ask what I did wrong. I freely admit that I often go with my first reaction instead of just smiling and saying "Yes." More than half the time, they are trying to pass on a resident or family compliment. Yet, I still think that every question that starts with "Did you...?" is going to end up with a reprimand. I think that we are conditioned to feel that crap rolls downhill and, as CNA's, we're at the bottom of the valley.

Do you think that for one day we could go to work with an open mind, a clear conscience, and a brave heart and see what happens? Could we do it for half a shift? Heck, maybe just the first two hours or the two hours during the shift when we feel we're at our best? And if we could, would it make us want to come in with this attitude all the time instead of the attitude of the already defeated warrior expecting more beatings the farther they travel?

It's worth a try. Sometimes we get the treatment that we act like we deserve even if we truly deserve much better.

K. Tree, CNA

Kainolophobia

Welcome to Hell (Slightly O/T)

Just This Once

Happy New Year!!

Merry Christmas Everyone!

Dirty Old Women

First Cold of the Season

Do you ever wonder...

Can you repeat that?

Control

Some Things are More Important...

The Angel Tree

Stuff Seniors Say

O/T: You're in trouble now

Happy Thanksgiving

Body Language

Dating Coworkers

Thoughts

"Selling Buicks" and Other Not So Fun Body Functions

Got Mentioned in a Post

Put THAT in Your Care Plan (NSFW)

Goodnight Sugar

Lack of Activity

Opposite Day

Changing of the Guard... Again.

Honesty

Memorial Book

Nursing Fashion

Parallels

NSFW...

Let Them Smoke

And then this happened...

Sudden Influx of Residents

To My DON

Got Lost for a Bit

Repairs Needed

It's a Zen Thing

Wait, that's not right.

Molested!

Mamas Don't Let Your Babies Grow Up...

Frustration Post

Time Warp

O/T Eulogy for a Good Dog

Dr. Jack Kevorkian

Just Wait

Glad to be back.

I'm Off

Honesty

Today is Pajama Day

Still More on Roxanol...

More on the Roxanol Question

There's a cure for that?

Drawing the line

Rumors abound.

Slightly OT: We're all going to die.

Amazing scenes and nightmares...

Compassion Fatigue?

I'm gonna wash that gray...

How pushy is too pushy?

Step away from the rumor mill.

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

Preexisting Condition

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

Bonus

Back in the day.

In the rush...

Off Topic: Dogs

And so the pendulum swings.

I'm sick...

Been in a work funk.

Care to vote on the quote of the day?

Fashion Police

Fighting Dehydration

Bizarro Nursing Center

Well, I bought new shoes...

And into the trash they went

The Short-handed Shuffle

End of Year Review

How about we reconnect our frontal lobes?