people are such evil little witch-hunters. what is it about the public at large trying to find new and engaging ways to hate healthcare? i feel like i'm screwed before i even walk in a patient's room because now everyone is "educated" and thinks that they know more about my job than i do.
i got talked to by management yesterday because a patient's granddaughter complained that i didn't wear gloves when i touched him. i'm sorry, i missed the memo that i was no longer able to touch another human being without a protective layer. apparently granddaughter missed the issue of Reader's Digest that explains that gloves protect ME from YOU and not the other way around. so if i want to use my bare hands to check radial pulses STEP OFF ME. you just watched me wash my hands like a good little solider, what else do you want from me?
and then i came home and read this, which pissed me off even more. you, ryan from buzzfeed, are a hater, and from the tone of your article you would think that this doctor took pictures of dead babies and put them on her newsfeed. it's obvious to me that this doctor is frustrated taking care of people that are rude and entitled and is only putting up with this patient so her next baby doesn't die.
and was it the smartest thing to go there on facebook? no, probably not. but that doesn't mean that she should get fired and stripped of her license and burned at the stake like all the internet crazies are demanding.
not to mention the fact that these weirdos who are so worked up about "HIPAA violations!!" and "breach of patient privacy!!" have taken a story that would have stayed local and plastered it up all over the internet, greatly increasing the number of people who know all about this woman. except, of course, for the fact that ALL WE KNOW ABOUT THIS WOMAN IS THAT SHE HAD A STILLBIRTH AND IS CHRONICALLY LATE.
but maybe i'm a little sensitive on the subject. because i've been there. a few years ago one of my coworkers posted a quote from a patient when we had a bunch of prisoner patients on the floor. the little old man kept seeing officers walk by his room, and asked the nurse "is this a hospital or a jail?". i commented back saying something about how half of our patients come from jail, and several days later ended up getting hauled into HR and read the riot act.
keep in mind that i do not have any affiliation with my employer on facebook, and that i did not say anything about a specific patient, and that this was not even on my profile.
yet this cost me 6 months "in discipline" and will sit forever in my file. because my comments were "unprofessional and people reading them could think that you would give this patient population poor care".
three years later, and i am still livid. having and voicing frustrations and opinions does not make me evil, and it doesn't make Amy Dunbar evil either. you can bet i've learned never to say a word about work on facebook again, and i think that we can all probably assume that Dr. Dunbar has learned the same.
so move along, healthcare haters. move along.
Wednesday, February 27, 2013
Sunday, February 24, 2013
if you love him, let him die.
when your 86 year old father/grandfather starts to say things like "i'm going up there" while staring at the ceiling and "it won't be long now", it's time.
when he has been in the hospital for almost 2 months without signs of recovery, it's time.
when nothing we do makes any difference, it's time.
when he starts to swell with edema because his protein is so low, it's time.
when the deconditioning becomes so bad that he can't bend his legs, it's time.
when he's being kept alive by TPN and antibiotics, it's time.
it's time to let go. it's time to let him get to where he's going.
and it's hard, this i know from experience.
but the TPN and the physical therapy and the labs and the scans....you're not doing it for him. you're doing it for YOU. he wants to die, this i have heard from his lips more than once.
so let him. let him go.
if you love him, let him die.
when he has been in the hospital for almost 2 months without signs of recovery, it's time.
when nothing we do makes any difference, it's time.
when he starts to swell with edema because his protein is so low, it's time.
when the deconditioning becomes so bad that he can't bend his legs, it's time.
when he's being kept alive by TPN and antibiotics, it's time.
it's time to let go. it's time to let him get to where he's going.
and it's hard, this i know from experience.
but the TPN and the physical therapy and the labs and the scans....you're not doing it for him. you're doing it for YOU. he wants to die, this i have heard from his lips more than once.
so let him. let him go.
if you love him, let him die.
Wednesday, February 20, 2013
goodbye to good care
i haven't ranted about the state of the unit lately. be prepared.
what is wrong with people!?! seriously. would it kill management to staff us appropriately? it is just ridiculous. 5 of the past 8 days we have been short. we only have 4 nurses on the schedule for PMs this week. and those of us who are left are killing ourselves.
we all sit there charting an hour after our shift ends
patient care sucks
no one has time for anything
people are unhappy.
i have 5 patients and am precepting and am charge and am taking the admits whenever i can because i'm afraid that if i give them to these people who are so ridiculously stressed they will either start to cry or quit.
they will quit, like everyone else is quitting. and can i really blame them? no. who wouldn't want to go be a nurse who lasers hair off people's legs for more money and way less stress? is it any surprise that we've lost 2 more nurses this week alone?
no. it's not. do you know why?
PEOPLE CAN'T WORK LIKE THIS!!!!
it makes me feel like there is a forest creature in my chest trying to claw its way out. CONSTANT phone calls. ignoring my coworkers who are asking for help because i'm drowning myself. getting 3 admits called at once and having to give them to people who are so far behind that they're already in tears. running all day just to do the bare minimum. always hearing that this score is low and this form is not getting done, and wondering how on earth i'm going to squeeze even one more thing into a day. and then telling this to management, and having them just stare at me with blank looks like they can't even fathom what i'm saying.
when i punched out tonight, i left one of my nurses with all of her charting left to do. i asked her why, and she told me that she felt so bad about the care that she gave yesterday, that she had to really focus on the patients tonight and worry about the charting later.
that is not ok. NONE of this is ok, or safe, or the type of care that i would like to give people.
it's not ok to walk into patient's room and find them with teeth that obviously haven't been brushed for many days. it's not ok to find undocumented, hospital-acquired pressure ulcers. it's not ok to turn a patient and find a dressing that hasn't been changed for a week. yet these are all things that happened yesterday alone.
and can you really blame people? yes. but when you only have so much to give, what matters most? when acuity is ridiculously high and resources are low and expectations are unrealistic, what are the things that you skip? what are the corners that you cut?
because the corners ARE being cut.
it's the only way to survive.
and that is just sad.
what is wrong with people!?! seriously. would it kill management to staff us appropriately? it is just ridiculous. 5 of the past 8 days we have been short. we only have 4 nurses on the schedule for PMs this week. and those of us who are left are killing ourselves.
we all sit there charting an hour after our shift ends
patient care sucks
no one has time for anything
people are unhappy.
i have 5 patients and am precepting and am charge and am taking the admits whenever i can because i'm afraid that if i give them to these people who are so ridiculously stressed they will either start to cry or quit.
they will quit, like everyone else is quitting. and can i really blame them? no. who wouldn't want to go be a nurse who lasers hair off people's legs for more money and way less stress? is it any surprise that we've lost 2 more nurses this week alone?
no. it's not. do you know why?
PEOPLE CAN'T WORK LIKE THIS!!!!
it makes me feel like there is a forest creature in my chest trying to claw its way out. CONSTANT phone calls. ignoring my coworkers who are asking for help because i'm drowning myself. getting 3 admits called at once and having to give them to people who are so far behind that they're already in tears. running all day just to do the bare minimum. always hearing that this score is low and this form is not getting done, and wondering how on earth i'm going to squeeze even one more thing into a day. and then telling this to management, and having them just stare at me with blank looks like they can't even fathom what i'm saying.
when i punched out tonight, i left one of my nurses with all of her charting left to do. i asked her why, and she told me that she felt so bad about the care that she gave yesterday, that she had to really focus on the patients tonight and worry about the charting later.
that is not ok. NONE of this is ok, or safe, or the type of care that i would like to give people.
it's not ok to walk into patient's room and find them with teeth that obviously haven't been brushed for many days. it's not ok to find undocumented, hospital-acquired pressure ulcers. it's not ok to turn a patient and find a dressing that hasn't been changed for a week. yet these are all things that happened yesterday alone.
and can you really blame people? yes. but when you only have so much to give, what matters most? when acuity is ridiculously high and resources are low and expectations are unrealistic, what are the things that you skip? what are the corners that you cut?
because the corners ARE being cut.
it's the only way to survive.
and that is just sad.
Monday, February 11, 2013
Friday, February 8, 2013
just when i thought i had seen it all...
so tell me, how do you keep a straight face:
...when your patient seriously wants you to ask the doctors to harvest sperm from her boyfriend who has been deceased for 2 days so she can get herself pregnant?
...and when you hear that they plan on burying said boyfriend in a flat brimmed baseball cap that says "NayNay love you boo boo"?
...or when her mother, in response to the sudden need for $600, states that they're going to get the money no matter what, "even if we gotta go out there and sell booty"?
i. i just. i can't. i just can't. there are no words. i can't even believe the things that i have heard out of this group's mouths this week. i thought i had patients who were hood before. but these folks...there is only one word, and it is ghetto. they are just ghetto.
they are nice people. friendly and personable. they aren't entitled, they aren't disruptive, they are supportive of the patient and help her with her cares. they are respectful to me and i like them a lot.
i was trying to settle the patient after her surgery one day and was literally tripping over babies in car seats, massive balloon bouquets, and giant stuffed teddy bears wearing baseball hats. one of the patient's cousins looked at me, smiled, and said "you probably ain't never seen nothing like this before. this ghetto". i smiled back and told her that i've seen a lot of things.
and i have.
but sperm requests, "selling booty", and having to postpone PT because my patient is getting a full weave put in...
the cousin was right. i AIN'T seen nothing like this before.
Thursday, February 7, 2013
projectile vomit, DRAMZ, and the like.
there are no words. but i'm sure i'll come up with something.
Monday: five patients, all high acuity.
1. GI bleeding Jehovah's witness, so no blood. J tube meds and tube feeds.
2. TBI, total cares
3. skeletal traction s/p MVC, having an MI
4. 80+ with ostomy, repos, feeder, oriented to self only (more total cares)
5. GSWs x8 with BLE fasciotomies and family drama
and i'm precepting and charge and we're down a nurse.
badbadbadbadbad
Tuesday:
80+er projectile vomits like 3 feet off the bed with no warning whatsoever, taking probably about 10 years off my life. i actually shrieked. i never shriek. it was emotionally scarring.
then the crazy "auntie" of my GSW proceeded to go on a rampage in the halls, yelling and screaming about how "these MFers expect me to sleep in a RECLINER CHAIR" into her cell phone because she is crazy and entitled. come to find out that "auntie" is a. not related and b. not actually from out of town like she spent the last hour telling me. the only reason she was so graciously provided with a room to sleep in at all was because she spun this sad story about being all the way from florida and coming to support her "niece"...well that and she threw a fit, which will pretty much get you whatever you want. come to find out SHE IS FROM 5 MILES AWAY (yet is here with suitcase packed) and is freaking out because she invited her man friend to the hospital and they can't both sleep in the recliner chair. the highlight of my night was watching security chase her (literally) off the floor.
i'm charge again, we're down a nurse and a tech.
Wednesday:
more drama with the GSW....horrific bedside VAC change with about 32542390 family members and friends watching....keep in mind the leg is down to muscle and they're all just staring at it while trying to tell me how i need to do my job. we have approximately 8 kids under the age of 10 in the room, including 1 crying baby and a three year old having some sort of coughing/URI issue. the doctor finally had to ask that someone take the kid out of the room because exposed muscle was a little "mature" for her eyes. i also found out that the body of the patient's BF (who was killed in her shooting) will be brought to the hospital in a few days and we will be pushing her in her bed to a room so she can say goodbye. not the first time we've done this, probably not the last. it's good for her, she needs closure, but will also be super hard and emotionally draining for everyone involved.
still charge. precepting again. jesus smiled on us and we're appropriately staffed (hallelujah!!).
it's one of those weeks where i'm kind of done, but will just have to suck it up.
so on to the next, may the rest of the week be better.
Monday: five patients, all high acuity.
1. GI bleeding Jehovah's witness, so no blood. J tube meds and tube feeds.
2. TBI, total cares
3. skeletal traction s/p MVC, having an MI
4. 80+ with ostomy, repos, feeder, oriented to self only (more total cares)
5. GSWs x8 with BLE fasciotomies and family drama
and i'm precepting and charge and we're down a nurse.
badbadbadbadbad
Tuesday:
80+er projectile vomits like 3 feet off the bed with no warning whatsoever, taking probably about 10 years off my life. i actually shrieked. i never shriek. it was emotionally scarring.
then the crazy "auntie" of my GSW proceeded to go on a rampage in the halls, yelling and screaming about how "these MFers expect me to sleep in a RECLINER CHAIR" into her cell phone because she is crazy and entitled. come to find out that "auntie" is a. not related and b. not actually from out of town like she spent the last hour telling me. the only reason she was so graciously provided with a room to sleep in at all was because she spun this sad story about being all the way from florida and coming to support her "niece"...well that and she threw a fit, which will pretty much get you whatever you want. come to find out SHE IS FROM 5 MILES AWAY (yet is here with suitcase packed) and is freaking out because she invited her man friend to the hospital and they can't both sleep in the recliner chair. the highlight of my night was watching security chase her (literally) off the floor.
i'm charge again, we're down a nurse and a tech.
Wednesday:
more drama with the GSW....horrific bedside VAC change with about 32542390 family members and friends watching....keep in mind the leg is down to muscle and they're all just staring at it while trying to tell me how i need to do my job. we have approximately 8 kids under the age of 10 in the room, including 1 crying baby and a three year old having some sort of coughing/URI issue. the doctor finally had to ask that someone take the kid out of the room because exposed muscle was a little "mature" for her eyes. i also found out that the body of the patient's BF (who was killed in her shooting) will be brought to the hospital in a few days and we will be pushing her in her bed to a room so she can say goodbye. not the first time we've done this, probably not the last. it's good for her, she needs closure, but will also be super hard and emotionally draining for everyone involved.
still charge. precepting again. jesus smiled on us and we're appropriately staffed (hallelujah!!).
it's one of those weeks where i'm kind of done, but will just have to suck it up.
so on to the next, may the rest of the week be better.
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