Wednesday, March 25, 2009


I forgot to come back & report how it was the night we bought Twilight...ooops, sorry about that! There was a line....of about 50 or so people. It moved pretty fast once 12:01 came along. My niece is thrilled...I have yet to rewatch the movie. I am looking forward to the next one that will be in the theaters on Nov 21.

I had a decent week at work. The first two nights were relatively I knew last night something would have to go wrong. It was a bit hectic the first 4 hours of the shift....back to back discharges. I don't mind discharges, but I do mind all of the paperwork we now have to do just to discharge someone. I remember the days of where we would simply write "continue all home medications" & send the patient on their way. Nope, not any more. The Joint Commission of Healthcare now has us writing novels for each & every patient that leaves the hospital. I guarantee at least 90% of our patients either toss this mass of paperwork in the garbage or in a drawer...never to be seen or ever read.

One patient last night....22 pages of discharge information. We give them information on their diagnosis, their new medications, their follow-up appointments, etc. 22 pages. Come on! And this patient only had 4 new prescriptions. I can only imagine how many pages it will be for someone with 10 or more new prescriptions. I think it's kind of overkill...considering they will get information from the pharmacy when they have the prescription filled.

Luckily, I didn't get any admissions last night...just an ICU transfer. He was a sad case....cirrhosis of the liver from years & years of drinking. Now he has a huge cancerous mass in his liver & for some reason - they were talking about putting him on the liver transplant list. I didn't think that was possible due to the fact he abused alcohol for years. He is in miserable condition now & it's sad to see that. Most patients we have are in the hospital because they are non-compliant in some form or another. I am the same way...I don't eat healthy, I definitely don't exercise enough, I probably don't get enough sleep, etc.

I was watching on Oprah about how they are now coming up with ways that we could possibly live to 125 to 150 yrs old. What? Does anyone really want to live to be that old? Supposedly we'll still have the energy & strength of someone much younger...but who knows. I can't imagine it.

I injured myself Monday before going to work....I hit my little toe on a doorway. Ouch!!! It's all bruised. I'm not sure it's broken, but it sure is sore. It hurt to hobble around the last two days. So I'll be trying to rest it the next couple of days.

I was handed our employee handbook or JCAHO readiness book...whatever it's supposed to be & I looked at the names of our "executives" which is neatly placed at the beginning of this book (as if they are the most important people in this hospital - don't get me started!) All of them are new except our CEO. All of chief financial officer, new chief operations officer, new chief nursing officer. And even though we are unable to afford raises, bonuses, etc.....they have created a new position of chief of inpatient nursing officer. I guess it's safe to say that's who is getting our raises & bonuses...her salary. On top of that, the manager of our unit has resigned & left and now I just heard the assistant manager (or whatever her official job title was) has also resigned. This is scary to me..........all new people plus the fact that our managers have bailed completely. I can only imagine the change that will be coming our way now that we have no one to speak for us.

Sure there will be new managers...but will they have the guts to stand up for us when they are brand new in the position? I doubt it. They want to take away our breakroom & turn it back into a patient room so we can have additional patients. They will give us some small office to use as a breakroom.

I'm it like this everywhere else? Are there hospitals that are better? Or worse? Let me know!

Friday, March 20, 2009

Twilight Night

Yes, I will be one of those weird people out at 12 am tonight just for the sole purpose of buying the Twilight DVD for my niece. I am hearing there are going to be parties & events.....this is crazy. It's not even that good of a story, but for some reason it's got this enormous following. I will be back tomorrow to report how it went. Wish me luck!

Thursday, March 19, 2009

Chick-fil-a Thief!!!

My goodness....the hospital has been non-stop busy, busy, busy. As soon as someone is discharged, there is another person waiting to be admitted.'s more than just's being held in the ER until a bed opens up. For those of us that thought it would be a slow season, we were wrong.

Sunday night wasn't too bad. I sat down for report & the nurse immediately says to me "This patient is discharged, but let me give you report on her." If she's discharged, then do the discharge paperwork & send her home. So I ask how many prescriptions are written....we look...there's only 2. I then suggest "rather than taking the time to give report to me, why don't you just do the discharge paperwork so the patient can get out of here." Makes sense, doesn't it? As I have 4 other patients to still get report on & if you leave the discharge to me...the patient is there for at least another hour or more. The nurse agrees....but later tells my clinical leader that I refused to take the patient. It ends up taking the nurse another 90 min to discharge the patient because she is so slow. Normally if the discharge orders just came in around shift change, I would have done it myself....but they knew this patient was being discharged all day. She didn't even have the heart monitor on when I was there at 6:30. So for this nurse to hold off on discharging the patient until shift change....and then having to stay an extra 90 min, far as I'm concerned...that was her problem. She should have discharged the patient at 3:30 when the doctor filled out the discharge paperwork. the rest of that night went fairly well. Monday was a different story. I only had 4 patients that night....3 who were stable...thankfully. But that 4th one...I spent the first 5 hours of the shift trying to stabilize her. She was 92, had a lap chole (gallbladder surgery) on Saturday....went into respiratory distress that morning....but by 3 pm, the doctor had written discharge orders. What???????? She could barely breathe this morning & he's ready to send her home? What?????? Then he changes his mind and decides she should be downgraded to med/surg status. The cardiologist agrees. What??????? Hello, she could barely breathe this morning. And on top of that...they give her 40 mg of IV Lasix with a potassium level of 3.3 & no replacement.

So I show up & her heart rate is in the 140's. I'm told it's because her family is there agitating her. Ok, that happens sometimes. Only it was still happening after the family left. This patient won't stay in bed either & she only speaks spanish. Not a single word of english. I decide a posey vest would be best to avoid her falling on the floor. She wasn't crazy about the idea....but I knew if I didn't do that, she would end up on the floor. I kept hoping she'd calm down, get some rest & her heart rate would get back to a normal rate. That was wishful thinking, but didn't happen. I check her oxygen sat & it's about 84% on 5 liters. Ugh...not good.

I call our respiratory tech....I don't know why I keep hoping that one day one of them will stop & take the time with the patients to make sure their O2 sat rate is ok....even though it never seems to happen. So she walks in, checks the's still 84%, she bumps the oxygen up to 6 liters & leaves. Ummm...are you going to come back & recheck her????

Even though I have the posey vest on my patient...she weighs like 70 lbs total & is like Houdini Jr. Somehow she was able to get to her hands & knees in bed....this is not supposed to be possible with a posey vest on. She wanted to get up & walk around. These are all big clues that something is really wrong...the confusion & restlessness. At this point it's a little after 10 pm & I put a call out to the cardiologist because the heart rate has now gone from sinus tach to onset of a-fib that is. I wait 20 min, call the cardiologist's answering service again because I haven't heard back from the cardiologist. I wait another 20 min & still no call back. I call again. By this point...I'm ordering things I think are necessary - even though at this time I have yet to get the official orders. I got an EKG, the potassium level...which dropped to 2.3 and ABG's. It takes the nursing supervisor calling the cardiologist to get her to call me. She finally does & I give her all of the info. She starts the patient on Cardizem & starts to give me orders to titrate. I was like "yessssssssssss".....because we are not allowed to titrate Cardizem on PCU & that means she has to be moved to ICU. So I tell the doctor this & she gives me the order to ICU......only my clinical leader is right there whispering to me "We have no beds available in ICU." What????????? So I tell the doctor this & she tells me not to titrate the Cardizem, just keep it at 5 mg/hr. Darn it! She also tells me to call the ABG results to the pulmonologist because they are so crappy. I also start to replace the potassium. I had a feeling the low potassium level was the reason for the a-fib.

My clinical leader makes the ICU clinical leader aware of the situation. They both come in & assess my patient & decide she needs to be moved to ICU. They did have a bed available...the "code bed".....but decide it's better to move this patient before she codes. It's at this time also that she is switched from nasal cannula to 100% non-rebreather as her PO2 level is 45 on 6 liters.
The only bad thing though...I don't have an order for ICU because I was told we have no ICU beds available. I'm confident the pulmonologist will give me the order...if/when he calls me back. I wait 30 min after my first call....on the second call I don't even mess around. I say "Can you connect me directly with him?" Luckily that happened. I don't like calling this particular doctor as he can be rather snotty....but it was my lucky night as he had no attitude with me at all. I got the order for ICU along with a bunch of other orders. I gave report to ICU & got my patient over there by 1 am.

Now I had not done any charting at this point except on the patient I transferred. My clinical leader was understanding & told me....go chart & let me know when you are caught up. Two hours later she is calling me. I told her I was caught up, but I would like to take a break. She said that was fine, but I'd be getting an admission when I got back. I figured as much. I don't usually even take breaks, but I definitely needed one that night. All I wanted was a few minutes to drink a coke & to finish the chicken nuggets I bought at Chick-fil-a earlier in the evening.

I go into the breakroom & notice that my Chick-fil-a bag is not on top of the fridge where I left it. Hmmmm...not good. I think "Ok, maybe someone thought it was from dayshift & thru it away." I glance over at the garbage can & to my dismay....I see my Chick-fil-a bag and the container of my chicken & gone. Someone ate my food!!!!!!!!!! Who does stuff like this? I was so irritated. I mean really.....if you want chicken your own! I told my co-workers about it & they all started coming out with stories about how they've had food that was taken too....didn't matter if it was all wrapped up & had their name on it...the food thief came along & ate it. What is wrong with people that they have to steal other people's food at work?

The rest of my night went ok. My new admission was easy to care for. I was able to leave work on time. Tuesday night I was floated to a different floor & it was me working with four other nurses....who were all males. That was different. My night was pretty good. I kept busy, but at least nothing critical was going on.

On a good note...I taught my dog Shay how to speak on command last night. She is a fast learner. She has taught me that she will only speak on command when I have a dog cookie in my hand. Ahhhhhhh! Smart dog!

Thursday, March 12, 2009

No End in Sight

What did I get myself into? What was I thinking? Spring cleaning? Remodeling? Ahhhhhhhhhhhhh!!!!!! How in the world did I end up with so much stuff?

No kidding....I must have thrown out at least 8 or more bags of garbage and have made 3 trips to Goodwill so far. I still have a ways to go!!!!! I am not buying anymore stuff for my house except food & laundry detergent....seriously!

My bathroom is still a work in progress. We gave up on removing the wallpaper as it was more trouble than it was worth. Instead my brother plastered over it. My mom tried to give it some textured design. We're waiting for it to dry for a few days & then will see how it looks with paint. I'm hoping I like it. We haven't even started on my bedroom. I want to see how the bathroom turns out first...before tearing my bedroom apart.

I return to work on my projects will be delayed a bit. My focus now is still on getting organized & getting rid of more stuff. I think I have enough candles to last the rest of my life & I'm not kidding. I love candles though. Notebooks on the other hand...why do I have so many notebooks? And pens? I could open up my own office supply store.

On a good mom, aunt & cousins are planning a trip to Aruba in December. I asked my mom if she needed company (meaning ME). She has to check with my aunt, but hopefully it will work out because I've never been to Aruba before & it will be nice to have a trip to look forward to. December is a ways off, but I know it will be here before I know it.

The lunch on Tuesday was wonderful....we were there for 4 1/2 hours! Our waiter was a guy & he definitely did not understand how we could sit & chat for as long as we did. He must have come by no less than 15 times to see if we were ready to order. I love these monthly lunches with my family. My sister-in-law is going thru chemotherapy after having a double mastectomy. She is the bravest person I know & her attitude is just amazing. The outlook is good....supposedly all of this treatment she is going thru means she'll have less than a 2.5% chance of cancer reoccurring.

Ok, I need to get some sleep. Have a good weekend everyone!

Tuesday, March 10, 2009

Wonderful 40th Birthday

I had a wonderful 40th birthday. Friday night I had a yummy lobster dinner with my family & angel food cake for dessert...mmmmm. Saturday started out a little rough...I got lost going to my friend's house! Yes, see what happens when you turn 40? You lose all sense of direction & memory. I ended up in a town called Viera with 1 gallon of gas left in my tank & no gas station in sight. Luckily I was able to find a gas station after driving about 5 miles...whew...did not want to be sitting on the side of the road celebrating my birthday.

I was an hour late getting to my friend Julie's house. From there we left & guess what....almost got lost again. This time I wasn't driving - so can't blame me. We managed to find the hotel & lost going to the room. Ahhhh, there seems to be a theme to this. Finally made it to the room & then there was a knock on the door!!!! It was my other 2 close friends...what a surprise! I was thrilled.

We went to Rainforest Cafe for some appetizers, then to the pool to get some sun. It was very relaxing....the weather was 80 degrees & sunny. We went to Bahama Breeze for dinner & although we had to wait an hour for a table, it was worth it. We got back to the room around 9:30 & sat around talking & struggled to stay up until 11 We just aren't the party girls we were back in our 20's. We got up the next morning & went to breakfast & then went our separate ways. It was wonderful spending time with my friends though. We rarely get the chance to spend more than a few hours together here & there.

Sunday afternoon my mom came over & we are attempting to organize & remodel my house. It started off well...working on the kitchen....threw away so much stuff. Then we started on my bathroom...tearing down the wallpaper. Boy, is that ever time consuming. I want to paint it...but I have a long way to go with getting the wallpaper off the walls. Next up after bedroom wallpaper. Not looking forward to that project.

Today I'm having lunch with my mom, favorite aunt & my sister-in-law at one of my favorite restaurants...The Olive Garden. The birthday celebration continues...haha.

Thank you everyone for the birthday greetings/comments!!!!!!

Friday, March 6, 2009

Last Day of the 30's

I simply can't believe it. Tomorrow I turn 40. I don't know how that happened. I certainly don't feel 40 years old & thankfully I don't look it either. Still though....40. Aacckk!

I got a call last night from the supervisor at the other hospital that I occasionally work at...saying that I was supposed to be there last night. What??? I haven't signed up for any shifts since the end of January. The manager says she has email confirmation...which is impossible because 2 days ago she was asking if I knew what days I might be available this month. I felt bad that they would be short a nurse....but that's the manager's fault, not mine.

I'm trying to relax a little bit when it comes to my usual hospital. I spoke to someone that works at another hospital within the same organization & she says they aren't having any problems. They just got huge bonuses and raises. It's discouraging & makes me wonder if one of our execs is embezzling money or something. Oh well, I'll ride it out & see what happens. If I didn't enjoy my co-workers so much, I'd leave......but it really does make a difference going to work somewhere when you enjoy the people you work with.

I'm picking up my niece & nephew this afternoon & heading over to my parents house. We have a lobster dinner planned (it's the usual birthday dinner). Tomorrow I'm meeting up with one of my best friends & staying the night at Buena Vista Palace...a hotel by Disney. It will be a nice getaway. Next week I'm hoping to remodel my room and well as fit in other lunches or dinners to celebrate my

We'll see if what they say is true....that life begins at 40. Have a good weekend everyone!!!

Wednesday, March 4, 2009


That wonderful job eval and raise I had a couple of weeks ago....well, the raise has been frozen. Apparently, everyone in our hospital will not be getting a raise. It's discouraging...for a couple of reasons. While I understand the economy is crashing & I should be thankful I have a job (which I am thankful)......we see our "sister" hospitals handing out raises and bonuses ($900 & up bonuses) to all of their employees. Yet we get nothing but aggravation.

It's not enough that they are freezing our wages, but they are telling us the patients aren't satisfied "enough." As if that is our fault. Nowhere do they acknowledge that better staffing or improved nurse to patient ratios could definitely boost patient satisfaction....instead they want to up us in PCU to having 6 patients each and our ICU staff to have 3 all times. This is going to improve patient satisfaction????? Either they have never spent a day or even 10 minutes on an actual hospital floor or they really don't care about patient satisfaction. I'm thinking maybe it's a combination of both.

It's aggravating having people that are clueless about actual nursing making decisions that affect us. And on top of all that they want to go to uniforms. They want us all in the same color, all the time. They say that will boost patient satisfaction. Huh??? Not only that...they want US to pay for it. I am getting so tired of being micromanaged. Have I mentioned they have even told us exactly...word for to chart in certain sections. Is this even legal? Seriously. Doesn't it look suspicious if every single chart pulled has the exact same wording in certain places? And they are serious about being compliant....we get written up if even one word is different than "their script."

Ugh, ridiculous. I don't know....perhaps this is a sign to really explore the world of travel nursing. I really like my co-workers & that is pretty much the only thing stopping me. We are hoping this wave of administration disappears even faster than the last 3 sets we've had in 5 years. One can dream, can't they?

On a different note....I am really enjoying watching "Ace of Cakes." Does anyone else watch this show? I just researched to see how much their cakes looks like they start at $1,000. Who in their right mind would buy a birthday cake (or any cake) starting at $1,000?????? I guess those of us who are not working in

I traded in my patient assignment from Sunday & got a whole new group on Monday. It was much better.....muchhhhhhhhhh better. Now I'm off for 12 days...yay!

Monday, March 2, 2009

Non-stop call lights

I should have known last night would not go well. It started off way too smoothly. I started with 3 patients and soon got a transfer from ICU.

My first patient only spoke spanish. I speak about 10 words of spanish. This patient was sleeping at the beginning of my shift, but soon woke up & was awake the rest of the night complaining of back pain. I gave her 2 Darvocets & prayed they would make her sleepy. God must have been busy last night, because the pills didn't help at all. She was not only awake all night, but constantly pressing her call light.

My second patient was a 92 yr old woman. She was the most mobile of all my patients. Kinda sad, isn't it? She was 100% with it too. Makes me hope that if I do grow old, that my mind remains intact. I doubt it will though. Because this patient was so mobile, whenever she had to go to the bathroom, it required assistance to the bedside commode. She warned me she'd have to go every 1/2 hour & she sure did. Up, down, up, down...all night long.

My third patient was spanish speaking also, but understood some english. She was complaining to me about how she is expected to learn english, but we aren't expected to learn spanish. That's the way it is, dear. She was also in pain, some type of leg pain. I gave her Tylenol & she seemed to be in competition with my first patient about who could use their call light the most.

My fourth patient was a transfer from ICU. She was confused...totally out of her mind, but came across as though she was of sound mind. I knew something was off when she couldn't remember her dog's name. This one managed to crawl out of bed. That doesn't sound so bad, does it? Well, did I mention she decided to do this after having a bowel movement & crawling her way thru it to get out bed? Yuck!!!!!!!!!!!!!!

My entire night was like that. I felt like a ball in a pinball machine. Not good. So what do I do about it? I immediately make sure I don't get those patients back again tonight...I erased my name from the board & added my name by a nurse who isn't back today & claimed her patients were fine. Hopefully I won't jinx myself, but I cannot take another night of call light city.

What's the other thing I did? Went to the store after work & bought some candy & ice cream & ate it until I felt a little better. Sad, isn't it? Why can't broccoli & green beans be my comfort food? Now that I've eaten 9304234 calories this morning...I'm going to bed. Have a good week everyone!

Off-topic....oh my!

Just when I thought I had seen it all, I watch something even worse. I'm talking about when I thought Toddlers & Tiaras was the most ridiculous thing on tv...heck in the world.........well now there is Little Miss Perfect. Haha....words cannot even begin to describe how idiotic this pageant thing is. I really feel sorry for the little girls that are forced to participate by their parents...or are brainwashed into believing this is what life is all about.

It's nothing like the movie Little Miss Sunshine....but that is something I do recommend. If you haven't seen that movie & have a warped sense of it. Don't watch it with kids around because there is a lot of swearing, but it's still a good movie. The ending is simply the best!