Tag: RN

I Got Yelled At

  • People in the hospital are rarely happy (ok, maybe in the maternity ward). I’m generally not seeing people when they’re at their best. I accept that and knew it going in. I understand if someone gets a little snippy, or forgets to say thank you if you go above and beyond to do something for them when they’re in significant pain. This week however, was a special low point when it comes to patient and family behavior. It started with a schizoaffective patient constantly screaming at me to stop playing mind tricks on them, and then having to be brought back by security after running amuck through the hospital hallways. That’s a mental illness, so I don’t take it personally. Then there was a family member accusing me and anyone who came in the room of not caring about the patient and ignoring them and their needs. Constant very passive aggressive loud muttering about everyone having their heads up their asses and waiting 30 minutes after pressing the call light (it was 5, our system shows us exactly how long it’s been). Sigh… deep breath, their family member doesn’t look to have a good outcome. I’ll cut them some slack.
  • But then there was the real humdinger. A patient and family member who were both serious meth-heads, combined with a rainbow of other illicit substances, with no money, resources, or insurance, who were there for a trauma. For two days straight the patient yelled, screamed, cried, manipulated, and generally behaved like a flaming asshole to anyone unlucky enough to go in the room. The patient was getting enough pain medication to tranquilize a horse, yet screamed and cried that we were inflicting intentional torture. The family member would show up, hear this, and begin the litany of demands to see everyone from the charge nurse, floor supervisor, hospital president, and city mayor. The family member would then announce they couldn’t take their level of anger and had to leave before ripping someone’s head off. They’d return an hour or so later and it would begin again. This pattern repeated all day long. Any attempts to engage, refute, or otherwise point out they were being unreasonable only resulted in additional yelling, just at a louder volume.
  • Twelve hours a day, for two days is a lot to take of that sort of behavior. I was pretty angry and frustrated each night when I got home. Upon reflecting on those days, I think I’m most angry at myself for putting up with it. At the time it seemed easier to mostly ignore it. All three scenarios were verbal battles that I wouldn’t win. These were not people who’s minds were going to be changed. It’s often less stressful to simply nod and say mmm-hmm and get out of the room as fast as possible so you can get on with the thousand other tasks you have to get done. But I didn’t realize how much the cumulative impact of continually taking the verbal abuse would affect me. On the drive home after day two I briefly thought what the hell am I doing? At my age I don’t need to put up with this crap. But I still like the job. It’s rewarding in many ways that working as an engineer for mega-corp never was. But it seems like the hospital population is more and more the mentally ill, the indigent, and drug users who are not capable of dealing with life in general. The bad behavior has become so common that when receiving report on the rare, “nice”, patient a nurse will make a point of letting you know, “you’re lucky, he/she looks like a normal person”.
  • I’m not sure what the answer is. I could move to a clinic of some sort, but just taking blood pressures all day would be like watching paint dry. Besides, I’m in a spot where I have the perfect schedule. It would be hard to replicate it working on a different floor. I think I’m going to try an experiment. For the next few weeks I’m going to be a semi-jerk. There will be no shit taken from anyone. You want to be an asshole? I’m going to be one right back. Of course, in a professional manner. This may make my day more difficult (and certainly the charge nurses – people LOVE to escalate any perceived wrong at the drop of a hat), but I’ll be curious if my mental health will improve? Will I have an overall better outlook if I go home knowing that I didn’t accept any crap from people? Nursing is such a hard balance. How do you continually be compassionate for people in a bad situation, yet not let yourself become a doormat? If you know the secret, please let me know!

Song of the day: Twisted Sister – We’re Not Gonna Take it (Extended Version)

Death By Jingle Bells

  • Time of death was 1735. Ten and a half hours into the shift. The Christmas music loop playing over the hospital loudspeakers had just begun the forty seventh repeat of Jingle Bells for the day. He was found slumped over his desk, eyes rolled back, drool pooling in the corners of his N95 mask. The charting system was open and his last known note had not yet been saved… “Patient observed laughing while on phone call. Patient informed this nurse that pain was 10/10. This nurse provided education on pain medication schedule and alternative pain relief strategies. Patient was observed yelling obscenities at staff members. This nurse will continue to monitor patients pain levels closely….”
  • Thank god we finally have some diversity at the highest levels of government. The media proudly gushed that Pete Buttigieg will be the first openly gay cabinet member. Pete himself made a point of saying this during his acceptance speech. Apparently Richard Grenell as DNI doesn’t count because, well, he was appointed by Trump. And he even though he’s gay he probably secretly hates the gays. And he’s a racist obviously. Does it worry anyone else that Mayor Pete, who couldn’t even get the potholes fixed in South Bend, is now in charge of Transportation? Optics and symbolism are clearly what’s most important.
  • 8 inches of snow overnight. I’ve got stuff do this morning, so the first downhill day will have to wait until tomorrow. We’ll get some skate skiing in with the hound this afternoon.
  • The backlash over Jill Biden insisting on being called ‘Doctor’ has been hilarious. Reviews of her dissertation have not been kind. Tucker Carlson’s skewering of her academic prowess was pretty damn funny. You didn’t really think, after four years of being called racist, and trashing the first lady, folks would just magically unite did you? Silly rabbit.
  • Remember the days of riots, looting, and police officers being shot over the tragic police shooting of Breonna Taylor? Well, it turns out when someone does actual journalism (remember that?) reality doesn’t match the mob outrage. Poor miss Taylor doesn’t seem to have been the innocent bystander she was portrayed as. Will the media report on this? Nope. It doesn’t fit the narrative and we wouldn’t want to upset people with minor details like the truth.
  • While a bit long, this thread is worth reading. It asks some interesting questions about the flu and why it’s been nearly non-existent this year. It shows how little we actually know about Covid and if our myriad of strategies for dealing with it are even doing anything. You know, science.
  • Magically after the election, Twitter returns the retweet button back to its original functionality. All is well, nothing to see here folks, move along. Twitter will add a “fact check, disputed claim” to a video posted by a conservative. They don’t when the exact same video is posted by a liberal account. If you’re an honest, thinking person this should bother you.
  • I don’t normally read James Bond type books, but I’ve been hooked on the Gray Man series by Mark Greaney. Been binge reading. I’m on book 8 of 10. Good stuff when you want an easy escapism read.

Song of the day: Beastie Boys “Root Down”

Yo Hippy, Get A Haircut!

  • Everyone has a chore they hate doing. Dusting, mowing the lawn, cleaning the inside of the microwave, organizing the Tupperware, everyone has something they dread. For me it’s getting a haircut. Don’t ask why, I just do. Maybe in part it’s because in my head I’m convinced I’ll soon look like Brad Pitt in Legends of the Fall. The reality is closer to greasy Appalachian trailer park resident. The same with facial hair. Any day now I’m going to have a Jack Murphy beard. Reality is… well not that. So my cycle is let it go until it’s embarrassingly long and I’m coating it in major amounts of hair goop to keep it out of my face (or wear a hat every day), then shave it all off. And every time I cut it I swear I’ll schedule a haircut every five to six weeks like clockwork. At my age I guess I should just be grateful I still have a full head of hair to worry about. Anyway, today’s the shearing day.
  • Speaking of hats, an update on the surgical cap. I don’t particularly like it, but it’s doing the job and saving the tops of my ears from the surgical mask ear loops. It’s clear that even though they say “unisex”, they were designed for women. I ordered something that’s more like a doo-rag to see if that works better. Stay tuned, part two.
  • The injury update – I have a bruise that goes from my hip almost to my knee. It looks gruesome, but doesn’t really hurt. When I landed on the key fob it created a tennis ball size hematoma. All that blood has to go somewhere. It looks like I got hit by a truck.
  • So Project Veritas manages to secretly record CNN editorial calls for months. It shouldn’t surprise anyone that CNN is nothing more than a propaganda machine for the left. I’m sure secret Fox news meetings would be similar. Never air anything that hurts your political agenda. These are not news organizations. I’m not sure we even have just straight news anymore? For me the most humorous part is CNN “referring this to law enforcement” when they have no qualms about doing the exact same thing.
  • I was going to make a joke about the woman who “lured” a 14 year old boy to her home and had sex with him. I suspect my sarcasm wouldn’t be appreciated by the outrage crowd, so never mind.
  • I had a patient go AMA last night. For those who don’t know, AMA stands for “against medical advice”. The patient had a fall a week ago, finally came in and had an unstable vertebral fracture. The neurosurgeon ordered bedrest until a rigid clamshell brace could be fitted. The patient completely ignored the bedrest orders and spent the day walking around the room (complaining of pain) despite everyone’s attempts to describe the potential for further injury. At the very end of the shift the brace arrived and the patient took one look at it and said hell no I’m not wearing that, I’m leaving. After spending the better part of an hour (and ignoring all my other patients) trying to convince this person to stay and wear the brace, printing paperwork, explaining the consequences of leaving AMA (the massive bill insurance won’t pay), etc… the patient packed up to leave. Several minutes later he hit the call light so he could ask where his pain pill prescriptions were? I informed him that if you leave AMA there are no more scripts. Cue the lengthy, expletive filled rant on how we don’t care about people and do we not understand he’s in pain? Oh, and can I help him get his shoes on because he can’t bend over that far. Is it any surprise that I’m becoming very cynical about the human population?

Song of the day: Nena “99 Luftballons (Live 1983)”

Do You Smell That?

Cool things, random thoughts, advice, and independent thinking from someone who’s been around the sun a few times.

  • We came home last night to an odd smell and a bathtub full of, well, sewage. I’m no expert, but that’s not normal. Our main sewer line to the house was completely clogged. This is where you realize that one of the most important things for you to acquire as an adult is to “have a guy”. A trusted mechanic. A handyman. A snowplow service. And, of course, a plumber. I firmly believe that the truly powerful people in life, from entrepreneurs to politicians to mobsters, got that way because they cultivated a rolodex of “guys” who can get things done when needed. Feminists please don’t get your panties in a bunch – I’m using the stereotypical “a guy” as a figure of speech. Yes I fully realize the “guy” you need may be a woman. For example, we stumbled upon a trusted decorator that’s done some great work for us who’s a woman. Wait, men can be decorators as well. Shit, now I’ve stepped in it. What was I saying? Oh right, we now have a plumber who did great work at a fair price added to our rolodex of non-gender specific trusted servicepersons.
  • Things that smell part two. Did you see the Trump campaign’s press conference yesterday about post-election lawsuits and alleged voter fraud? I don’t blame you if you didn’t as probably only two networks covered it. This brings up two points. Ok, three. First while I personally think most of the allegations will fizzle out, I do think there’s enough smoke to warrant serious investigation. Second, you cannot credibly claim the press is unbiased. Just like the Hunter Biden laptop, this is a major story and needs to be covered. The intentional choice to spike stories that don’t fit the media’s group think narrative is probably the single biggest reason Trump lost. And third, as he’s done for most of his presidency, Trump continually harms his message with his choice of messenger. Independent of the message or strategy being accurate, Giuliani is a horrible spokesperson for the campaign and should have been relegated to behind the scenes work a long time ago.
  • Update to the sore ear/surgical cap crisis. I’ve worn the silly wannabe do-rag bouffant cap for a week now. My ears are much happier because the mask ear loops are connected to cap, not my ears. My self esteem lost a few points, but at my age I don’t really care.
  • As California moves from stage Saffron-Yellow to Crimson-Burgundy, the governor announced a state wide 10 PM curfew. More keys to solving the Covid puzzle! Turns out the ‘rona is a night owl. As long as we stay below five feet, only go out during the day, and only dine at ungodly expensive restaurants – we’re going to be ok.
  • Started watching the Netflix series “Challenger the final flight“. Very good so far. I still remember exactly where I was when this happened. Working at a ski shop watching a tiny little TV. Didn’t have a single customer all day (wasn’t ski season) and no such thing as a cell phone yet (can you imagine?). I watched solitary all day with nobody to interact with until I got home. Was a very strange feeling.
  • Speaking of Netflix, proof of what I dork I am. Recently a friend asked what I was doing that evening. Mrs Troutdog was traveling so I said “Netflix and chill“. I had no idea that was actually a euphuism for sex. Awkward!
  • While I don’t think it will happen, the mere suggestion by the Biden team of cancelling student debt is enraging. I completed college working and without loans. Please explain how I’m going to be compensated for that. Otherwise, it’s not fair… and isn’t everything today about participation trophies and fairness?
  • A guy who drinks champagne and reviews pine cones.
  • And finally, some kick-ass outdoor sports footage by people wearing weird teletubby onesies. No, really. Worth the watch.

Song of the day: Lenny Kravitz “Are you going to go my way (pinkpop 1993)”

I Had A Bad Day At Work

Cool things, random thoughts, advice, and independent thinking from someone who’s been around the sun a few times.

  • Everyone has a bad day from time to time. For most jobs that’s no big deal. As an RN, a bad day has consequences. Yesterday was one of those days. Nothing bad happened and there wasn’t any one thing that caused it. Just one of those perfect storms of events. Short staffed, a super complex patient, a bunch of last minute discharges and transfers, multiple missing lab results, and some ridiculous bureaucratic decisions from management that make everyone’s life difficult for no apparent reason. The result was that I wasn’t a very good nurse. I barely kept my head above water all day. I’m sure my patients did not have a good experience. I think I stressed out the CNA unnecessarily. My documentation sucked. I was pretty rude to an EMS transport crew for showing up early. I caved in an ate a doughnut someone left in the breakroom (ok, two). Fortunately I have great coworkers and they kept me from drowning. It was one of those days that I drove home almost two hours late due to all the charting I never got to finish during the day, and wondered why I was even doing this job. You start questioning if you even have the skills to be a decent nurse. This morning I casually looked through job openings, wondering if it was time to make a change. Fortunately I have a long break through Thanksgiving to recharge and think critically about what I could have done to make that day go better. I still like the profession… I just worry that I’m running out of the mental energy it takes to operate at such a high focus level multiple days in a row.
  • Shortly after the beginning of the great China Plague, my hospital decided that all employees need to be screened as we enter. At first it was a long series of questions about symptoms, travel, and people you’ve been in contact with. Then they added swiping your badge at the entrance. Next, temperature checks. Now they also have someone entering your name and unit into a database. We’re given a different colored sticker for your badge each day to prove you’ve already been screened. There’s often now a line of employees waiting to be screened so they can get to work. So as a contrarian I have to wonder – with all that cost and effort over the last 7-8 months, has the hospital identified a single employee who may have had Covid and prevented them from entering? Does anyone from management ever ask if the outcome is worth the cost? Or is the appearance of doing something more important?
  • For reasons unknown to me, I’ve become addicted to car crash videos. YouTube collections of crazy drivers and crashes. It’s reinforced several things. First, I don’t trust other drivers. Second, I will never drive in Russia or third-world Asian countries. That’s where 90% of these videos come from. Clearly traffic laws in those countries are merely suggestions. I don’t think you can appreciate the degree to which we’re rule followers in the US until you see how people drive in other places.
  • I’m desperately looking for a news channel. Just plain news. I don’t want opinion, spin, or bias. I just want someone to report the important things that happened in the world today. Why is that so hard? Anyone have any suggested channels or sources?
  • I was talking to a co-worker about food and the conversation sparked a memory from years ago when I lived in San Diego and a favorite post-surf meal. Roberto’s Taco Shop and a Machaca Torta and rolled tacos (hey, I was young and burned a crapload of calories). Research has begun. The quest to make my own machaca has started.

Song of the day: Surf Punks – My Beach (Live at the Whiskey A Go Go)

Notions Of Cool V.018

A random list of things and shower thoughts that an old Gen X dude finds cool or worth pondering.

  • This is a perfect example of what’s wrong with news today. I like to think I’m reasonably plugged in… and I had absolutely no idea this happened last week. 1000+ people dead and 1.5 million at risk of water-borne disease or starvation. Meanwhile, Bob in Ohio was outraged at something someone said. We have a fantastic panel to discuss…
  • A neat video about cycling. I couldn’t do it, but a great reminder that we’re only here once. If you get hit by a bus tomorrow, are you happy with what you’ve seen and done?
  • Speaking of bikes, my town is installing this in one of the downtown parking garages. Yay for bicycle friendly!
  • Jim Acosta is the very definition of douchebag. I get it, he generates equal love and hate traffic. And yes, there are Acostas on all sides of the political spectrum. Sad that this has become the new norm for “news”.
  • I did not hit my weight target this week. It’s mostly meaningless… just a goal. Next week for sure.
  • Bullet Journal update: it went strong for a month, then faded. I still like the idea. I resolve to resurrect the habit.
  • A patient was unhappy with his diabetic menu choices, so his wife brought him Burger King and a supersize chocolate shake. When his blood sugar was 320 he was shocked. He was actually angry and accused us of giving him some “pill” that was making his blood sugar go up. It was a battle to convince him I had to give him insulin.
  • “This will be your favorite patient. Super nice and rarely calls for anything”. Sadly as a nurse, I hear that in report maybe once every three or four weeks. The vast majority of the hospital population are grumpy, sour, demanding people. They’re also in the worst possible health – much of which is due to lifestyle choices. I see a clear correlation between your upbringing, mental attitude, emotional stability, and overall health outcomes. It’s not rocket science, but it’s striking when you see it in front of you every day.
  • My internet went down for approximately 7 minutes today. It was a terrifying vision of the pending zombie apocalypse.

Song of the day: Charlie Feathers, “That certain female”

Notions Of Cool V.015

A random list of things and shower thoughts that an old Gen X dude finds cool or worth pondering.

  • The dermatologist took one look at my sunburned, peeling, self and deadpanned “well, I guess we don’t need to have the importance of sunscreen discussion do we?”. Other than that, got the all-clear. I feel better having been checked out.
  • I mentioned before that I spent a ridiculous amount of time watching YouTube videos on travel bag reviews. Unclear why, since I rarely travel. I had settled on the Aer Travel Pack 2. Anyway, I used a simple duffle bag for this last trip. I realized that carrying stuff on your back sucks. For the little travel I do, I’m going to find a minimalist wheelie.
  • I got my passport photo done. Like an idiot, I let it expire. Renewing it, you know, in case I need to flee the country.
  • I loved this quote from David Goggins. “People ask me how I lost so much weight… I didn’t hire a trainer… I didn’t go to Jenny Craig… basically I just stopped eating so much fucking food.” Made me laugh. It’s simple, but true. People make weight loss too complicated. Speaking of which, unless there’s a nacho blowout I’m about a week away from my weight goal. So there’s that.
  • I gave Instacart a try for grocery shopping. Loved it. I’ll certainly be using it again. I’m a busy guy you know.
  • One of the hardest things I do as an RN is care for a patient who is a truly horrible human being. Spending twelve hours making sure I give the same quality of care to that person that I’d give to a sweet grandmother sucks the life out of me.
  • Rebecca Rusch was the first woman finisher in her first attempt at the bike category of the Iditarod 350. That’s badass. I wimp out after shoveling the driveway for an hour.
  • No further Instagram stories. The Twitter experiment has yielded exactly 2 followers. Good thing I’m not in marketing.

Song of the day: “Im gone, Joyryde”

Notions Of Cool V.011

A random list of things and shower thoughts that an old guy (who still thinks he’s 20) finds cool or worth pondering.

  • I was fluctuating between 200-205. Hit 173 this morning. With a good poop I might hit 172. Not that I’m counting.
  • Listened yesterday to someone being told that if they continue the current lifestyle choices their lifespan will be measured in months. The response? “What time is dinner?” Hard to fathom.
  • We’re seeing the dimmest sun since 1978. The current solar minimum is trending towards the century-class minimum of 2008. Also, for the first time in 132 years, LA did not reach 70 degrees in Feb. No point to that other than you can find extremes on both sides of the thermometer at any day someplace in the world.
  • A baffling recycling program. Now take this and imagine the rules on medical waste. We have four different tubs that various wrappers and things must be disposed into. Nobody can figure out how to open the tops so all wrappers just end up in the trash or placed on top of the container.
  • No idea why I thought this was interesting. “The International Space Station is passing over the Idaho State Capitol Building on March 02, 2019 at 06:38AM, for 614 seconds.” More importantly, why someone took the time to figure it out.
  • This is my MTB ride. Not sure why I’m thinking about cycling. There’s some kick butt spring skiing pending.
  • I still scan tech blogs. I’m realizing that I still really like systems. I started wondering if I should migrate that way in healthcare? I’m not sure I could give up the three day work week though.
  • If you ever wondered where the US navy is currently operating at any given time, here you go.

Song of the day: Agent Orange “This is the voice”

Notions Of Cool V.009

A random list of things and shower thoughts that an old guy (who still thinks he’s 20) finds cool or worth pondering.

  • As an RN, my day looks like this: Wake at 0500 (or 0400 if working out). Out the door at 0620. End my shift and leave at 2000 or 2030 (8:30pm). Walk in the door and decontaminate and change. Inhale food. Watch approximately 15 minutes of news then bed. Repeat x3 days.
  • The flu season has not yet peaked.
  • The Grand Canyon has a new Junior park ranger. She’s 103. I’ve only seen the Canyon once and it was identical to the movie Vacation. We were driving to Oklahoma in the winter. My sister and I begged to detour to see it. We litterally pulled in, got out of the car and looked for fifteen minutes and left because it was so cold.
  • Netflix is usually a wasteland of straight to DVD films, but we stumbled upon this one by accident. The Way with Martin Sheen. Excellent.
  • I’m in search of a small (pocket sized) penlight that has a low lumen level for eye exams. Every one I’ve used so far doesn’t survive being dropped or dies within a month or so.
  • I’m fasinated by how massive the diet industry is. People literally are desparate for someone to tell them what to eat. And what they seem to really want is the magic bullet – “Eat this super food for 12 days and loose 25 pounds!”
  • I’m not making fun of a sad mental health issue (well, I guess I am), but if you’re going to end it all by jumping off a building… make sure it’s tall enough. The end outcome may not be what you wanted. Pro tip, five stories isn’t high enough.

Song of the day: Kid Rock “Bawitdaba”

Notions Of Cool V.007

A random list of things and shower thoughts that an old guy (who still thinks he’s 20) finds cool or worth pondering.

  • Continuing… The earth has warmed – this is not debatable. The warming has been roughly eight tenths of a degree Celsius. And shockingly, this is more or less what greenhouse gases demonstrate in laboratory conditions. What has not happened is the model predictions of runaway exponential temperature increase. So, change my mind – where is the crisis?
  • The new skis are the bomb. Very happy with my choice. Volkl M5 Mantras. Of course, calf deep powder didn’t hurt. The ski is a touch beyond my skill level, which is a good thing.
  • To the best that I can tell I have been in ketosis. Yesterday’s test was after two fried eggs with cream cheese and avocado, followed by four hours of hard skiing. Ketones were 1.5 mmol/l. (suggested range is 0.5 to 3)
  • As an RN, time management is everything. I’m not good at it and it drives me nuts. I’m going to make a full press effort to tame this beast. The conventional wisdom says to implement hourly rounding. The theory is that if you’ve addressed pain and toileting, you’re less likely to be interrupted by call lights. Hmmm. We’ll see.
  • I can’t find anything I agree with AOC on, but she gets social media. Politicians on both sides need to figure this shit out or she’s going to clean their clocks.
  • For the tech dorks, a great blog on security. In my mind I’m still a tech guy, but most teenagers have surpassed me at this point.
  • It’s shocking to me how primitive vehicles are in terms of software, connectivity and interacting with mobile devices.
  • Hard not to laugh at this meme of Senator Klobuchar emerging from a team meeting.

Song of the day: Rebelution “Inhale Exhale”