Hometown Blues

The greater metropolitan population of my hometown is about 200,000.

There are over 90 bars, all of which serve the same house wine, domestic tap beer and have the same smoky dingy interior. There is one bookstore: Barnes and Noble- also the only free wifi location in town.

The male-female ratio is about 76:100.  Median income is 18,000 and 25% of the population lives in poverty.

The political tone is strongly republican and no one that I've talked to cares that the best gym at the local Y is men only.  After all, I'm such a feminist.

The average driver's age is 59.

There is a local racetrack and 2 movie theaters.  There are no art galleries.

A nurse on U8, one of the few who was interested in more than getting married and having babies, was after me for weeks to get together. Finally, we had a common day off and made plans.

I was thrilled to finally share conversation. She didn't show up. She sent me a text message the next morning telling me how sorry she was but a friend showed up in town unexpectedly.

Now, a week later, she acts as though we are best buddies, girl-flirting with me at work and constantly playing with my hair. I ignore it.  My resentment towards her is minor. Rather I resent that this stifling, backwaters town has so lowered my standards for friendship.  I miss my wonderful, interesting, reliable Seattlite friends.

She asked me if I was going to be sad on my last day next week and I laughed at her.

I hate this town and, now that my family is mostly gone, can hardly wait til I'm gone.

Hovering

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.

'Tis the Season

We are awash with new fractures, new nursing students and bad weather in this neck of the woods. My work days are long and busy.

There was a call in tonight so busy became frenetic. There were the usual culprits of laziness but I was amazed with one of the nurses.

Airyeal* is one of the younger staff members and has always given the impression of someone who doesn't really care about anything outside the scope of her own comfort/pleasure. Tonight though, she was incredible with one of the students. She spent her entire break showing the student the ins and outs of charting, how to find information in the computer and in the chart, and what particulars are important to know as a nurse.

It was awesome and set a really good example for the rest of the preceptors. Watching their interactions totally made my night.

Drink of Choice

It was a very busy day at work tonight. The hospitals in the area are at red alert; maximum census. We traded and juggled patients within our unit and with other floors to maximize bed usage. I'm the one responsible for making sure that, in these situations, the patient's television and meal services follow him/her.

We have different bed models and I have to make sure that the model bed in the room is suitable for the particular patient. Some beds can support the trapezes used by the orthopedic patients, others can't. Some beds can be lowered closer to the floor for the lols and loms who have trouble getting up. With a dozen discharges and admits/transfers, it can get fairly hectic.

All in all, there were dozens of little tasks that needed to be balanced throughout the night. Charge and I, deflected some of the stress fantasizing about paradise. It didn't include 72 virgins but rather several handsome men (we decided that we didn't need as many as 72), tropical beaches and endless backrubs and beverages.

Anyhoo, I mentioned that I don't care for most liquor but that an occasional scotch is divine.

One of the nurse's came back to the desk as I was describing my drink of choice: a rich, peaty scotch with hints of wood, straight up.

It wasn't until she laughed that I realized that it sounded like I was mixing my fantasies up. And so a new euphemism 'sipping the scotch' was born into our unit vernacular, joining, among others: "nasonexing the gift" -another sexual reference whose etymology is convoluted and traces back to the behavior of one of our frequent flyer patients.

Oh the things we come up with....

Tantrums at Work

One of our exclusively elective surgeons is on vacation and so our unit census is low. When this occurs, our scheduled staff rotates either floating to another unit or gets called off.

This nurse arrived, saw that a coworker was floated and proceeded, behind the closed door of the breakroom but perfectly audible down the hall, to shout, slam things around and basically throw a ten minute tantrum worthy of an ambitious two year old.

Why?

Apparently, it was her turn to be called off and she's so sick of other units 'taking advantage of our low census' and 'stealing' our staff.

Wow.

Laziness and Loneliness

I'm lonely.

When I moved back from the west coast to my itty-bitty industrial town, my life changed completely. During the subsequent two years when my time was consumed with caring for my mother, my smart, stimulating and worldly friends across the continent dropped away. I just hadn't the time to nurture our relationships.

I'm trying to create new stimulating relationships but apparently I'm weird.

My nursing coworkers, the pinnacle of education in this working class town, are consumed entirely with creating and raising families, getting married or engaged. We're friendly enough at work but I so miss talking with people about things beyond our immediate sphere of family and work.

Those who read, read Twilight and the Hunger Games. They tease (not maliciously) me about the books that I bring in and I can't find any interest in the antics of Belle or Edward.

Growing up here, I was the lonely little girl in the tree with a book fantasizing about evading the trolls below. When I left at eighteen, I discovered a wonderful world full of fascinating curious people who read, traveled, explored cultures, food and art, fought for environmental preservation and human rights. They celebrated their own uniqueness and seemed to appreciate mine. I swore that I'd never return to this area.

Then dad got sick and mom got sick and I again was tethered.

I know that the end is in sight; I'll be leaving in a few months and re-entering a world of more curious people.

This last year has been brutal though. Those who have applied to medical school probably remember how demoralizing the process is. You basically rip your life and history apart, present the pieces to anonymous adcoms and wait for them to decide that you're lacking. With the deaths of my parents and my relocation thousands of miles and several time zones away from my friends, I lost all of my social and emotional support.

Every time that someone I work with asked why my applications were failing, I withered away a little more. Trying to explain the immense competition involved came across as just defensive and it showed in their expressions.

Emotionally, I'm hibernating now. The acceptance that I received validated me in a way that I could have never predicted. My intellectual loneliness isn't so severe now that I know that it's finite.

I don't feel defensive anymore when people insinuate that I'm lazy because I don't plan on working through medical school. I can just wait a few short, yet impossibly long, months and I'll be with folks who'll understand that I'm not lazy.

I'm grinning now in anticipation. I know that I'm leaving an intellectual desert to conquer an ocean of knowledge. It'll be hard, I know, but it'll never be as hard as the last few years of dehydration. It can't be.

Outrage

It was a busy crazy day at work. I’m usually the only one on the desk on evening shifts; the charge nurse takes a group of patients. This week, the patient who will not be named was here again so I worked with Charge in that room and managed the desk.

We’re implementing a new rounding system next month and so I was also responsible for logging all patient call bell requests in preparation for the new protocol.

There was a water line rupture in the unit next to ours and the shut-off affected some of our patient rooms, public bathrooms and other facilities. I needed to contact Engineering, itemize the affected plumbing, and make other arrangements for patients and staff.

We also had a stroke response on one of our post-ops. I had to monitor the call, STAT orders, arrange for CT, and, afterwards, restock the crash cart. The house staff was going to send the patient to telemetry and I arranged the transfer between the units.

In the meantime, we received 2 contact precaution admissions from the ED and, with no available isolation rooms, I had to rearrange the already admitted patients, inform the nursing staff, direct the aides, contact housekeeping to clean the rooms and then admissions to confirm the computer transfers.

While the stroke response was occurring, the nursing supervisor arranged for a transfer of someone already downgraded to medical from telemetry to make room for our unfortunate patient.

It soon became apparent that our patient belonged in intensive care and not tele. I began those arrangements.

Despite the alleviation of urgency, the other unit decided to send up the transfer, walking! before we were ready. I scrambled to find somewhere for her while her room was prepared. Argh! Her meds hadn’t been hung and she was due for pain medicine so she complained the entire time while I tried to juggle everything. Her new nurse was still dealing with the stroke situation.

Finally things settled a bit and, ten minutes before shift change, the supervisor called about a non-urgent transfer from intensive care. “ICU only has two patients, can this wait until morning?” “No, this patient needs to start PT first thing in the am.” “Sigh, alright.” I HATE moving patients around at 11 pm. I think it’s hard enough for them to get sleep without the jostling and noise from rolling squeaking beds and housekeeping carts. But I took down the details, another iso-room needed! and began rearranging our patients.
The aides grumbled but they moved the patients. The call bell system erupted from all the newly awake patients. “I have to use the bathroom.” “Am I due for pain medicine?” “Will you call my family to let them know about the change?” etc..

11:10 One of the nurses from ICU called to give report. I told her that we weren’t ready yet. Our nurses were just starting report themselves.
“NO! I need to give report NOW.”
“Um. No you don’t. It’s a non-urgent transfer and I know that your shift isn’t over until 0700”
“We’re just starting an in-service. I want to give report before it starts. I won’t send the patient up for a while.” Sigh.
“Jackie would you mind taking report now? She’s insisting.” I rolled my eyes and handed the phone to an incredibly patient nurse. Jackie gets report and says that the patient’ll be up between 12 and 12:30.

11:15pm. I track down the housekeeper just before he finishes his shift and beg him to clean the room for our transfer.

11:17 ICU nurse calls with update on the transfer patient. I tell her that the nurses are in report and that Jackie will call back when she’s ready.

11:19 Housekeeping is still in the room cleaning. The elevator door opens and our patient steps off, white knuckles grasping his walker and the aide carrying his belongings. !!!!

“The room’s not ready! Why are you here!”
“Oh. I just came on. They told me to bring him up.”
“You have to go back down. We’re not ready.”
“I can’t go back down; They already stripped his bed, we don’t have anywhere to put him”

Seriously? I lead them down to the room and pull a chair out into the hall for the patient.

Following the aide back, I laid into her.
“We told you folks several times that we weren’t ready! This is inexcusable. You didn’t even bring him up in a wheelchair!”
“I’m sorry, I just came on. I’m just doing what they told me to.”
Sigh.
“I know that it’s not your fault but this is ridiculous!” Grumble Grumble.

The aide leaves and I go back to the room to get the patient settled in. When I come out, the nurse from ICU is yelling at Jackie.

“How dare you yell at my aide! Blah blah blah, miscommunication that’s all your fault.. blah blah blah..”
I could feel the hackles grow across my shoulders like the hump of a grizzly bear. I’m outraged and start to jump in but a nurse grabs my arm and I pause. Jackie diffuses the confrontation by apologizing and the ICU nurse righteously storms off.

I’m told that the ICU nurse is something of a barracuda, is always right and never lets things go. After she leaves, the nurses gather and complain about her unjustified behavior and how awful she is.

It’s now five days later and I’m still stewing over the situation. It makes me so mad when people like that ICU nurse get away with laziness, superiority, inconsideration and recklessness because people are afraid to call them on their crap.

In hindsight, I know that if I had gotten involved, the confrontation would have escalated. It wouldn’t have been fair to the night crew to spark it and then leave when my shift was over.

But I HATE that someone else gave an apology for my behavior. If my behavior calls for an apology, I want, I NEED, to be the one to offer it.

In this situation, though I cognitively recognize Jackie’s motivation to diffuse the situation, her apology stabs me viscerally. I know that I should just let it go but I’m so outraged.

The Catheter Interrogation

First thing this morning, a urologist came to place a supra pubic catheter bedside. The patient had been retaining crazy amounts of urine and neither his nurses nor his orthopedic surgeon could place a foley in him. So urology was consulted.

The doctor had called in a list of supplies that he'd need bedside by 0530. Apparently he was rather rude to the evening secretary about it, saying 'everything better be ready", in a 'you people always mess up' sort of way. But I know the evening secretary is something of a sensitive whiner, so I took her report with a grain of salt.

He arrived examined the patient and then decided to try his hand at placing the foley first, giving me and the patient's nurse a new list of supplies. We have coude catheters in different sizes and foley kits stocked on the floor so much of his list was immediately manageable. But he wanted Urojet (lidocaine) syringes too. We don't have them in our McKessen so it was a short process to get them up to the floor. He needed to write an order, I faxed it to pharmacy and then immediately ran down to pick them up.

He was NOT HAPPY.

Though it took 10 minutes tops to get them (5 of which were taken by him arguing about writing the stupid order), he was incredibly put out. I heard about how ridiculous we were, how he doesn't have time for this stupid delay.. etc, eye rolls and disdain galore.

Fortunately for the patient, he was able to successfully place the foley. Whew.

A few minutes later, I stopped in the room to check on the patient and I noticed that his collection bag had over a 1200 cc in it.

I remembered reading somewhere that draining the bladder too quickly can cause the patient major discomfort so I pointed it out to his nurse. She was busy doing her end of shift med pass and instructed me to ask the urologist if she should clamp the catheter.

So I did.

I thought he would attack me.

He completely lost his temper and flayed into me.

"That's the stupidest thing I've ever heard! Why do you think to clamp the catheter? Why?" and then he waited. It took me a moment to realize that it wasn't a rhetorical questions but that he actually wanted a response.

I tried told him that I had read somewhere that it could hurt the patient if the bladder emptied too quickly but as soon as I started talking he restarted his rampage.

I was mortified. I tried to explain that I was just an aide and the messenger for the nurse but he kept at me. I can't remember everything that he said; I was flustered and just trying to escape. I remember him saying that they don't teach nurses to be doctors and thrusting a new order at me, written in block letters as though I were in grade school, DO NOT CLAMP CATHETER. It was the only completely legible order he'd written thus far.

He ended up staying to yell at me for longer than it took him to place the foley.

So much for his valuable time....


I'm totally re-writing one of my evil book characters in his honor and he's (the character) is going to suffer.



.

Impatience.

There's a nurse on our unit who come in nightly to regale us with tales of how awful her husband is. She dyes her hair only because he prefers blondes. She can't eat this or that because he thinks she's fat. He won't help her at all. He expects her to support them with her night shift and then take care of everything like chores, shopping, all aspects of child care while he sits on his duff and watches television during the day. She's always so tired blah blah blah.

Tonight's tale was about how he controls all of the money including her wages using direct deposit into in accounts that she has no access to. If he's feeling generous, he allots her a $5 weekly allowance. If she ¡misbehaves!, he'll take the money back.

First, I think she's totally full of crap. I don't doubt that the husband is a total jackass, but I'm pretty sure she stretches the truth unrecognizably.

She comes in with her stories and everyone fawns over her.. "oh he's awful!" "He should be shot for or " "You should kick his ass to the curb" and she preens under the attention.

I usually try to avoid engaging with the more manipulative staff but she put me on the spot and directly asked me what I thought in front of the rest of the crew. I tried to prevaricate but she was a bloodhound, asking me over and over.

I finally turned and told her that I thought she was spineless, that if she had such an issue with his money control to deposit her paycheck into her own damn account. He didn't hold a gun to her head when she signed up for direct deposit.

After that, she answered every phone call with "U8, Spineless speaking." Seriously, how old is she?

I would love to be a fly on the wall when she goes home and regales her husband to all of the stretched stories of how awful everyone is toward her at work.

On a more positive note, tonight was hellishly busy but I was working with my two all time favorite nurses and we totally rocked it. I love how efficient, sensitive and cool they are with the patients. Over the last year, I've learned so much from them about how to work with even the craziest, most difficult patients calmly and effectively.

Around 0300, "Dr. Armstrong" was paged to U7, one of the more dangerous pysch floors. We then heard thumping and shouts in the south stairwell. Unperturbed, Jackie, not taking her eyes off the IV line she was priming, strolls over and flips the lock on the door knob. A "Dr. Armstrong" is the hospital code for a combative patient. Moments after she locked the door, we heard a thud and more yelling.

Later, we discovered from the nursing supervisor, that one of the patients actually kicked in the door of the secured ward and escaped into the stairwell. I only caught some of the details in passing. Apparently, the patient had enough time to defecate on the stairs before pushing past the security guards to escape downtown. He assaulted one of the police officers chasing him and is now in jail. It capped the already crazy night.

New Digs

I'm settling into my new apartment. It's a tiny studio in an old Victorian house with ceilings higher than the room is wide...

I'm using an old refurbished library study table for dining.

I last rented a mother-in-law basement apartment, draped in grapevines and filled with books, that I christened the li-burrow. I haven't yet thought of a clever name for this new place. I'll post some more photos when I finally organize the living/bedroom. It's filled with boxes now and not very inspirational.

We have a patient at work. I'm not able to express the turmoil that this patient throws the hospital into when (s)he is here. I've been on the unit for over a year an this is the second visit. It's an incredibly stressful time for nursing staff, manager and hospital administration. This patient only comes to our floor for reasons that I can't go into without violating HIPAA. I can only say that they're unique and awful. I'm not experienced or clever enough to adequately change the details and still portray the magnitude of this person's effect on us. We get extra staff and the nursing supervisor relocates her center of command to our floor for the duration of the patient's stay. It doesn't help with the stress levels of the nursing staff. My manager hand selects the staff assigned to the room. Though he picks his most reliable, most patient and most experienced, it's not an honor.

The last time, the patient stayed 2 months. I'm not looking forward to another two months of complete anxiety before every shift. Bah.

I received my first med school interview offer. I'm thrilled but my loneliness yesterday was amplified in my hunt for someone to share my excitement. I mentioned it to my coworkers but they were more concerned that this means I may not be there next year. My brother disapproves of my ambition (I'm too old) and my west coast friends couldn't talk last night.

I'm still excited though!!

Disaster

My area is under a state of emergency right now. I worked a 20 hour shift at the hospital yesterday and am looking into another long shift today. The region is devastated, without drinkable water and many homes without electricity. Emergency command centers and shelters have been set up throughout the county.

I'm amazed at how well everyone worked together these last couple of days. The folks who actually made it, driving hours in convoluted directions, without complaint buckled down to work and spirits were remarkably high. We didn't know how long we would be the only ones who would be able to work and so my manager set up a rotating schedule partway through the day so that we could get some sleep.

A rep whose presentation was canceled, dropped the food off on our floor and so we dined. Because we couldn't use the municipal water, our coffee dispenser was shut off (it is connected directly to the water line.) A neighbor of the hospital dropped off a couple of percolators so that we could refuel.

Another aide came in to relieve me around 4:00 this morning and I began my journey home. Only one bridge in the area is functional and so I have to drive 2 hours on a winding path in the opposite direction to get on the right side of the hill/river in order to get home.

I was the only car in the middle of nowhere when a red sports car wheeled in front of me and then over-corrected to go flying into the tree in someone's front yard.

Immediately stopped, I put my hazards on and called 9 1 1. Describing what happened to the operator, I got out of my car to approach the accident. As I'm walking up, the boy who had been driving, stumbled into the yard, turned to look at the car, said "oh shit!" and took off across the road into the woods.

And so I told the operator. She said someone would be out as soon as they can. Considering the area was in a state of emergency, that 'as soon as they can' was 2 hours and 15 minutes. After giving my statement, they let me go and I began the long trek home.

Hurricane Savior

So... tonight wasn't as awful as I had feared. Vile Princess is terrified of the hurricane Irene. She lives on the river and "just knew" that her apartment was going to be flooded. I explained that we're several hundred miles from the coast and will probably have nothing more than some big winds.

She shook her head frantically and pointed to the satellite image. "It's headed right to us!" I grabbed her Mountain Dew bottle and blew, waving my hand behind it. See... wind felt here but stopped by the hills. Hooray for the Appalachians!

Now I'm her new BFF and she was positively sweet to me for the rest of the night. I hope her memory lasts. Wish me luck tomorrow!!

Working Blues

I went to work yesterday refreshed and determined to maintain my good humour but the moods of some of my coworkers were just awful. I was running the desk and so was forced to be the central communicator for nurses, physicians, aides, and patients.

Usually, I get anxious when Dr. Pita* comes to the unit. Her mercurial temperament can be scary to work with. She can go from friendliness to dragon in three breaths. But yesterday, I was so happy that she decided to do all her dictating at our nurses' station. She was there for almost 3 hours which gave me a reprieve from the snipping and snarling of my coworkers. They're always more polite when a physician or supervisor is within earshot.

The girl who cried is one of the greatest culprits of nastiness. A significant responsibility of mine is to answer call bells and then call the nurse or aide needed to the room. I heard "Jesus Christ" (with accompanying eyeroll), "take them yourself-I'm done", "fine-FINE!"(with hand up, palm toward me) and other 'tude responses throughout the entire night.

One of the nurses commiserated with me after a particularly vile comment: "she's like that with me too." Argh. That almost makes it worse; I could almost rationalize her behavior if it was animosity solely directed toward me but that she just indiscriminately spews obnoxiousness...

Well, we're not allowed to police each other and I need to be more 'tolerant' of my coworkers. Bah. Think happy thoughts, think happy thoughts, think happy thoughts.

Tonight I'm scheduled to work with the vile princess and another moody grumpy aide. I'm absolutely dreading going in. (think happy thoughts think happy thoughts think happy thoughts.. )

Night Shift Vacation

I've been working third shift this week. It's amazing how tranquil the small hours of the morning can be on the unit. The lights dim and, as we walk down the hall, the only sounds are those of our footfalls and the occluded IVs chirping like birds chattering in the woods.

Patient interactions are softer, quieter. They raise bleary eyes when I wake them for vitals or glucose testing and immediately nod off afterwards.

During the day, my job is hectic, a continual scramble to stay atop of the endless tasks and requests. At night, I mostly mitigate patient squabbles: she won't turn her TV off, He snores-I want a different room.. etc.

The staff, too, is more seasoned, less gossip-girl petty and fun to work with. The team in general has a perverse sense of humor- befitting a group that works the 'graveyard shift'. Last night, one of the nurses taped little devil horns and paper pitchforks to all of the office supplies (staplers, pencil sharpeners, computer mice) at the nurse's station just to annoy the morning secretary, Anna. Anna's celebrity doppelganger is Dwight from The Office. She's incredibly pedantic. This is great for dealing with time clock issues but she gets worked up over the craziest details.

The nurses on the night shift have developed an art to annoying Anna. It was so much fun to watch her huff around this morning tearing down little paper horns. After about ten minutes, she settled down to organize her desk. She then went to fax new orders to pharmacy. When she lifted up the scanner only to find more horns, she bellowed, bellowed, "Okay, who did this? Paper costs money people! No wonder we're always overbudget! This is ridiculous, Who did this?" She then glared at everyone in the nurses' station as though someone had stolen her purse. It was awesome.

If I didn't know that I would be bored within a week by the routine, I would request a permanent transfer to third shift.