Monday, March 19, 2012

Oh Brother

Sometimes, my oldest brother has a way of making me feel as small as a flea. I love him desperately; he was even more excited about my first acceptance to school than I was. I can remember the look of thrilled shock on his face when I told him. Everyone should have someone to be so genuinely, unselfishly happy for them. I’m fortunate.

That said, he’s a freakin’ type A, control freak, micromanager with so-not-his-business. Argh. I called him today to chat. We take turns calling and so usually talk several times a week. I mentioned meeting an aunt for coffee and visiting our maternal grandmother in the afternoon.

Gram took great pleasure in reliving some of my “stubborn little pip” anecdotes. She and my aunt laughed at memories of me, a naked 4 year old interrupted from a fight with her brother, claiming that “Just because little girls are staying with their grandma, doesn’t mean that the grandma OWNS them.” Apparently, I was aware of my civil rights even at age four. I blame my mother.

I gave him quick updates on several of our cousins then mentioned finding sprigs of pussy willows on a walk. I have bouquets of willow shoots, winterberry and dried hydrangeas, pretty, easy to maintain and much much cheaper than fresh flowers. He’d always admired my displays when visiting.

Anyhoo, I also mentioned that when I went to the market I noticed that sashimi grade tuna was on sale for 7.99/lb and splurged on a filet ($5.28). I was excited to indulge myself on this weekend off.

His temper exploded and he ranted. How I can’t expect to pay for school, our shared mortgage etc, if I can’t budget my income… blah blah blah.

Now. I. Am. A. Freakin’. Penny. Pincher. I can satisfyingly squeeze a week’s worth of meals on a $30 budget with some creative use of spices and inexpensive staples (quinoa, eggplant, cauliflower etc.). I am also a master of the free/cheap entertainment: volunteering with the zoomobile for a free season pass to the zoo, free city wifi and no cable TV, forgoing downhill skiing for cross-country in open parks. I haven’t seen a movie in the theatre in years. Other than a few pairs of (clearance-no grey’s anatomy for me) scrubs and my interviewing suit, the only clothing I’ve purchased in the last 2 years has been socks and underwear.
I don’t mind. I’ve always been pretty low maintenance, but hell if, at 31, I’m going to be explaining every little purchase to anyone. I told him so. It escalated. Dammit. He’s just like our father; careful, loving and thoughtful but rigid, old-fashioned and by-the-book.

I remember being a teenager and chafing against my father’s restrictions. It was the primary motivation for my moving thousands of miles at eighteen to work for national parks. Every time that I jumped out of a plane, hitchhiked to the rodeo, climbed a difficult mountain or pushed myself past things that scared me, I thought “so there!” to my father.

Right now, I’m garnishing my tuna in a lemon wasabi remoulade (less than $1.50 to make- even with locally raised free range and hormone free eggs) sipping a glass of prosecco ($2.25) and thinking “so there!” at my brother.

Addendum: My brother, bless his soul, sent me an apologetic message a few minutes ago. He and my (favorite) sister-in-law have been under unrelated stresses and he didn’t mean to take it out on me. * sigh * How can I maintain my rebellious angst (damn you! Camus and Morrissey) when my family is so bleeping awesome?

Wednesday, March 14, 2012

Quality of Life

We have a patient on the floor, a social admit. Adorable. She’s completely independent, mobility-wise, and wanders the floor constantly, asking that her ever-present Styrofoam cup of prune juice to be reheated. She flirts with all the men, telling them they’re the spitting image of Clark Gable, sugar lips and all.

From the desk, I see her make her revolution around the unit. She pauses next to the room with the moaning confused man with a hip fracture. I see her raise her hand to the doorframe. She makes no move to go in or even peek. But her hand trembles and she’s obviously affected.

She continues on to the end of the hall, looks out the window at the pitiful view, then returns to the desk and asks me to heat up her prune juice. As far as I can tell, she doesn’t actually drink the stuff but promise her a new fresh cup and she beams.

She makes several rounds, pausing outside noisy rooms and staring out the windows at the end of the corridor. This time of year, the trees are naked and the sky is grumpy. She’s riveted though. She always comes back to the desk and chats with me. It’s the same short conversation throughout the night. She doesn’t feel like doing the dishes. Can they wait until the morning? She’s tired and wants to go to bed.

Despite her fatigue, she makes another rotation. Whenever one of our staff passes in her in the hall, they call out her name with a bright hello. She beams and tells them that they’re the spitting image of someone famous. I look like Ann Margaret. Preeti looks like Pocohantas and Aimee’s Linda Blair.

We talk about patients and quality of their life. This lovely special little old lady has been able to affect the quality of life of everyone on this unit. Talk about giving back. We’re blessed to be a way station on her journey.

Tuesday, March 13, 2012


So my nurse manager has been present on the unit later than usual these last few days. He’s interviewing graduate nurses for our summer influx. Between his interviews, he hovers around the desk. I think it makes the nurses nervous, but I used to work for an honest-to-god narcissistic personality disorder with an impulse control problem. Mauro used to chase us down the restaurant screaming and spitting in front of the guests, just to make sure we dropped a check in a timely manner. He was CRAZY. Hovering Nurse Manager (HNM) is easy-peasy in comparison.

It’s actually been great. I think he’s finally seeing how busy our shift can get. Yesterday, the phone was ringing nonstop, the call bells dinging and two of our surgeons were piling their charts haphazardly across half-wall of the nurses’ station. BAM! Two of the charts fell and exploded like ticker tape flutter across the floor.

The nicer of the surgeons picked up the mess and brought it to me to reorganize. The other surgeon complained to his PA about the cheap folders the hospital uses for charts. HNM whispers to me that maybe he should call another nurse in. I snorted and said that it was calm compared to the previous day and he turned new eyes toward the scene.

The resident, interrupted by her pager and a call from the covering attending, swore during her dictation. As she rushed to the PACU (something about p-waves), she called out a verbal orthopedic consult request to Mean Surgeon. He turned to Lackey PA and snidely commented that she was going to save a life. HNM turned to me and asked if I had heard her swear. I mentioned my childhood with brothers and an acutely developed selective hearing. People swear. There are bigger things to worry about.

As I shuffled through the disordered progress notes, we chatted. I mentioned my love of Nick Drake and the new discovery of Damien Rice’s music and HNM said he totally digs him! How awesome is that? I am a little resentful though that so many people have known about this great musician for so long and didn’t share the riches (Yes, I’m talking to you, Solitary Diner ☺).

I notice that the admission orders for one of the charts being reassembled demands that the patient (admitted last week) be under cardiac monitoring. OOPS. I point it out to Nurse Manager then page Cursing Resident. She calls from, ironically, the telemetry unit. I hear in the background: “GI Bleed-rapid response”. I hand the phone to HNM who takes a telephone order to discontinue cardiac monitoring.

I update the Kardex, manage a new flurry of phone calls and flag down HNM to record a critical labs result. I admit it is nice having an RN at the desk. Normally our charge takes a group and so I’m left responsible for all the mechanics of unit flow. Though I like having my finger on the pulse of the action, it sucks that there’s such limitation to my scope: I can’t take telephone orders, record critical lab results, verify medication orders or ‘waste’ narcotics (verify the use of only a partial dose) for the nurses. I sit helplessly waiting for someone certified to have time to step in.

I often stay late to finish up everything I’m allowed to (checking diets and labs, stuffing charts etc) but it sucks when there are dozens of charts to be checked (hours of work) and I’m on the elevator waving goodbye at the bleak faces of nurses with a longer night ahead of them.

This week, I hope that HNM realizes how much work gets delayed because he doesn’t schedule a nurse to run the desk after 1500. I really think that if the powers that be break it down, it would be much cheaper to eliminate my job and add a nurse to the roll call. Having a nurse at the desk would likely eliminate at least 6 hours overtime every night. That combined with my income minus said nurse’s wage would amount to more than $45,000 saved for the institution every year.

Saturday, March 10, 2012

Laundry Pieces and Admission Oppositions

Laundry had piled up. It had overflowed from my hamper in the bathroom sprawling into the hall. Plus, I was completely out of clean underwear, even the old granny panties formerly buried deep in the bureau. So I spent the morning, and two rolls of quarters, at the Laundromat, armed with two months of un-listened to news and politics blurbs on my Ipod. I am now caught up, sort-of, in a dilettantish way, on world mechanics.

I was listening to the NPR weekend edition podcast “In Today's Economy, How Far Can A GED Take You?” from 2/19 and the closing music was the instrumental of Dar Williams’ “February”. It’s my least favorite song on that album; I prefer “Southern California Wants To Be Western New York”- mostly because I was once (still am? ) a mousy SUNY student composting in long underwear and the idea of being lusted after… a lovely novelty. Still… I love NPR ☺

Also fruit flies that drink alcohol are protected from parasitic wasps who can’t hold their liquor. It’s self-medication of an awesome sort. Courtesy of “Cheers! Fruit Flies Drink To Their Health, Literally” from weekend update 2/22.

I went head to head with admissions last night. Our unit was one patient away from its limit. Our nurses are not supposed to have more than 7 patients (which, in my opinion, are still way too many, particularly with the acuity we often have on our med-surg floor. It’s dangerous). Anyway, we had been slammed with 6 admissions/add-on post-ops, all within an hour when we got the call for the final one: 50yo man 400lbs AMS and oozing cellulitis, combative, infected with everything that you can think of, bacterial and viral. Bah.

I studied the census board and then called down. We’ll need to move these ladies together, transfer that dude to that room and then we’ll put Conan into this bed.

Admissions response? “Just put Conan into bed 36A.” I could hear her eyes rolling through the receiver.

“We can’t put Conan there. The roommate just had a major surgery. You don’t put infected patients in with surgical. Besides he needs to be closer to the nurse’s station. We don’t have enough staff for a sitter.”

She argued.

Jeez. Did she think I was just looking to occupy my time? We were crazy busy on the floor and who would be doing the actual physical transfer of the patients and all of their belongings and update all the computer records, charts, assignment sheets, ADT book and kardexes? ME. All she had to do was enter in a few keystrokes.

More arguing.

I called the nursing supervisor. She came up, glanced at the census and then called down to the admissions office.

She !!still!! argued but, eventually, the lady in admissions acquiesced and plotted the patients.


Tuesday, March 6, 2012


I've narrowed my school choices down to two. One is in a small city just a couple of hours from my family and the other is in one of my favorite metropolitan areas a long flight from home.

Both schools are wonderful, state of the art and awash with opportunities for their students.

This is the first time that I've ever been so excited to make such a hard decision.

I'm tempted to choose metropolis because the program starts a month before small city and I can't wait to get started!!

I'm loving life right now!

I've also fallen in love :)

I know.. I know.. but his voice is haunting.