October 21, 2016

Social Media

I have a Facebook account.  I used to use it a lot when younger, but my usage has dropped off.   I got too tired of reading all the political and social diatribes.  All I want is to connect and catch up with someone, and instead I have to wade through all of these rants, memes, links, and other junk coming for each and every side and POV just to get to them.  And of course, each believes their POV is the only accurate one.

All I want to see when I get onto Facebook is what my friends are up to...and funny cat videos.  There's always time for a funny cat video.  Or seven.

Another reason is that IMO, it's more fun actually living life than posting about living life.   And as one gets older, one learns that every moment of one's life need not be documented in nauseating detail.  Unless this is your chosen career, of course.

I don't do the whole "must friend everyone I work with."  I mostly wait until after we have parted ways at the workplace to add them.  I have a few current coworkers there because I genuinely like them, between both workplaces, I don't see them regularly enough to keep them in the loop on what's going on, and/or we're playing the same online games and there's perks to having a Facebook friend connected with it.  Sometimes, it's more than one of the above.

So I am more likely to connect with co-workers after we're no longer working together.  However, I am now in an awkward spot:  a former coworker has switched facilities, joined me at Job #3 and is now in a supervisory position over me.  We were peers when we were working together the first time.  But she was ready for a change in her career, and Job #3 made her an offer she could not refuse.

Now, as a rule, I post very little on Facebook that is work-related;  if I do post something, it's either positive as hell or at least neutral.  I also do not post anything too personal about myself.  Nor do I go all virtual-PDA with the better half...seriously, some people wonder if he even exists as I talk about him so little online.  Then again, he talks very little about me, so we both prefer it that way.  It's the little ones that get all our press.

So I'm not worried about shooting myself in the foot about posting something that I should not have.  And I genuinely like her as a person and she likes me.  But now that she's above me in the pecking order, I'm not sure how I feel about this social media relationship.  I'll have to think on this.  I wouldn't go so far as to de-friend her, especially as 1.  I do like her, 2. it'd be awkward as hell, and 3. my days at job #3 will be coming to an end soon, and that will resolve the problem.  If I still feel awkward about it, I may move her to a more restricted list for a while, and at least keep her supplied with pics of the little ones.

Moving on...

I have a Twitter account, but it's strictly professional, as in my real name.  I tried having a Meriwhen one but updating that and this blog was too much.  I tried having a personal one but never found myself reaching for it often.  Plus, Twitter is more geared towards shorter but more frequent usage.  And the fact that Twitter tends to be a lynch mob.   So I just have the professional account.  I use it to share information and network.

And that's the extent of what I use, for all of my web-savvy.   If you really want to find me online, the best place is here or at the nursing forum.

October 14, 2016

Something in psych that I always find amusing:  a patient will dislike, even hate me, with a complete and utter passion...and 30 minutes later, I'm their BFF...and another 30 minutes later, I'm back to being their mortal enemy.   Lather, rinse, repeat.   Sometimes these shifts are due to medications given, sometimes they are due to memory issues, sometimes they are due to the psychiatric disorder itself.  Or all of the above.  

One thing is certain though:  I never ever take it for granted that a patient likes me.  More than once I've found that the patient that was all hearts and flowers and cooperative with me yesterday is defiant and lobbing chairs at me today.  So I approach each day--and often, each and every interaction with the patient period--as though I don't know where I stand.  And I also stand a little further back than I can think they could throw that chair.  It is much safer that way.

October 7, 2016

Some non-nursing stuff

Having settled down in a permanent position, I now have new health insurance.  It's through the same organization.  I'm not too worried about coworkers looking up my info, as the EMR software is very good about tracking such things with employee accounts.  If anything, they'll find out that I'm really not lying about my age.

So earlier this year, I got a physical physical, a psychiatric physical, and decided to address a few chronic problems.

Overall, I'm in good working order.  Labs are beautiful:  total cholesterol is 111 despite my cheese addiction.  Fasting blood glucose is in the 80s.  Blood pressure is well-controlled with my one medication.  I'm exercising about 5 days a week so that's probably helping all those along as well.  I could stand to lose some weight, but that's nothing new.

Psychiatrically, I'm doing well.  Been feeling pretty good.  The medications received a slight dosage tweak, but no major med additions or changes.  The psych NP offered me the option of a seeing a therapist...I declined for right now.  I've done it in the past and have had hit-or-miss results.  Plus I don't have anything going on that I really need therapy for.  I'm coping with my father's death pretty well, though December is going to be hell on wheels.  But I'll worry about that in December.

Most of my chronic physical problems are already as controlled as they can be, so there wasn't really anything they could address.  But there's always one...

Long story short:  sinus problem unresponsive to most treatments and is now playing havoc with my ear.  It's to the point that I've incurred some low-level hearing loss in that ear.  Hopefully it's a temporary loss.  It's an annoyance, because I feel impaired on that one side.   Allergy and sinus meds are not working.  And I've been purchasing so much decongestant from the pharmacy that I'm sure they're wondering if I'm running a meth lab.


The nice thing about going through the same organization as my job is that referrals are easy, fast and have minimal preauthorization hassles.  Plus they can all access my account, so no need to deal with releases of information.  I left my PCP's office in the morning and by the afternoon, ENT was calling me to schedule.

So since then, I've had several visits, several tests including a CT, and trials on several medications.  Nada.  I'm now at the point where I've been referred to the ENT surgeon.   Great, the possibility of surgery.  Right when I've taken the full-time job and become the primary breadwinner.  At least they could do most sinus surgery on a same-day outpatient basis, with downtime of only a week or so.

Fortunately, he's not ready to operate just yet.  I'm on the latest trial of two medications, and at the end of the month I go for another hearing test and re-eval.  Unfortunately...these two meds don't seem to be helping much.  Though my hearing seems to have improved a little.

September 28, 2016

Got both my flu shot and PPD done today.  My left arm is about ready to fall off.

September 21, 2016

In which Meriwhen contemplates resigning

Yes, resigning.  Not from my main job--I love it too much to want to do that--but from Job #3, which is per-diem days.

I've been thinking about this on-and-off for a while.  But as I was getting ready to drive 1.5 hours in the rain to drive to the site I'm working at today, I really realized that I'm racking up a lot of 6-day (and even a couple of 7-day) work weeks and that I'm not getting much free time anymore.

It's not that I'm unhappy at Job #3.  I find it interesting, though dull at times as it's more office and telephone work than direct patient care.  It's a great organization that I'm proud to be affiliated with.  I also get the chance to work with amazing people are some of their sites.  But it's not 100% what I want right now.  I was ready to step back somewhat from the bedside and look for something of a slower pace, I would work at Job #3 full-time.  I see a job like Job #3 as the last job I take before I retire.  Right now, I want to remain in the trenches.

Leaving Job #3 would bring me down to having only 1 job (if you recall, I cut Job #2 (the agency job) free about a year ago).  I'm not used to the idea of having only 1 job.  But then again, I'm also not used to working a permanent position, as the last permanent position I had ended in 2011.  Since that time, it's been the per-diem life until this year when I agreed to be tied down to a permanent position again.

So it's not as though I'm working two part-time/per-diem jobs and need the income from Job #3 just to survive.  I don't even need it as an extra source of income:  my main job compensates me more than handsomely.  More so than I originally planned for in my budgeting.  And if I really needed extra money, I could pick up at least 1 extra shift per pay-period, if not more.

As for the free time...there are some things I do want to be working on that I have been neglecting since I've been working a lot.  The better half doesn't mind my working, though with flip-flopping between days and nights, he is concerned I'm not getting enough rest.  Little one #1, however, is starting to mind.  He gets upset when he finds out that I'm working on a day he thought I was to be off.

Little one #2 has no comment.

So here I am, seriously consider dropping my letter of resignation.  I reviewed my calendar and saw that I have a few more days scheduled through the middle of next month.  Since I have to put in my resignation while on-site, I think I will wait until I have honored that commitment, and then drop the letter.

September 17, 2016

Right, crush my spirit

It's rather disheartening to learn that the IV saline lock that I placed--which I thought was pretty darn good--was deemed inadequate.  I hit it on the first stick, it flushed well, no problems noted...but to those that know more about IV therapy than I, it wasn't a good job.  Bah.

Yeah, I know: practice, practice, practice.  But given how I float around a lot, I don't always get the patients who need IVs started.  And it's kind of hard to practice on myself.

I think it's time to take an official IV therapy and phlebotomy course.

August 26, 2016

A little break

After working a stretch on the psych-medical unit, it was a nice break to be floated to psych stepdown.  I spent the last several shifts wrestling with IV machines, suction and oxygen tubing.  Sometimes all with the same patient.  And all the call bells that go off when the bed alarms are triggered!  When there's a restless patient, it seems like their bell never stops ringing no matter how low we set the sensors to.

I have remembered that I dislike suctioning.  Phlegm is my kryptonite.

In an attempt to accelerate my getting up to med-surg snuff, I got a couple of med-surg reference books for my Kindle.  While I will always be a fan of paper books, the Kindle makes it possible for me to have all of my reference books with me while at work.   Plus I love the fact that I can order it and have it delivered within minutes.

I've also started looking at a few med-surg and LTAC CEUs.  I have to accumulate 150 of them by 2021 to renew my certification, and only 51% need to be in psych; the rest can be in whatever I choose.  So I'm going to kill two birds with one stone there.

Anyhow, back to stepdown.

Loads of manic patients.  The mania is very strong in the air as of late.

I generally tend to get along with patients in mania, though just watching and listening to them wears me out.   The rapid hyperverbal speech, the hyperactivity, the flight of ideas as they jump from topic to topic, the delusions of grandeur…it really is exhausting to keep up with them.  Still, it's a nice change from answering call bells.

It’s frustrating when PRNs don’t slow them down at all, especially when it’s the middle of the night and they’re waking other patients up.  I tell them repeatedly that as long as they can keep it quiet they don't have to return to bed (some of my peers do not agree with this strategy.  I am of the mindset that as long as they are behaving or not in danger of being hurt, I don't have the right to force them into their room).  The problem is that they’ll be calmer and quieter for a minute or two.  Then the voice and energy level naturally starts escalating again.  

At one of my previous jobs, we would utilize that energy for good and have manic patients fold towels or tidy up the common area.  Depending on the patient, they might get a broom and dustpan and be put on sweeping patrol.  Of course, this is if the patient is willing, which they usually were since they had all this energy to burn.

But it’s harder to manage at night.  During the evening, when everyone else is awake and active, having a manic patient or three is one thing.  At night, when the goal is to have all the patients sleeping…well, that’s another. Sometimes the PRNs need to be “strongly” encouraged.  While I hate pressuring patients into taking medications, it's better doing that than to have them wake the psychotic patients who would pose an even  bigger problem if THEY were awake.

For all the exhaustion working with manic patients can provide, one of my favorite things is to listen to two manic patients have a conversation.  They will be discussing two entirely different things at high speed and yet still understand each other perfectly.  It's amazing to watch.

But the manic patients are asleep tonight...for now, anyway.  It's the religiously preoccupied and delusional that are awake and roaming.  I've been lectured once already on how I'm going to hell, which is a nice change from just being told that I'm going to hell:  at least now I'm having the why-I'm-going-to-hell explained to me.  I'm apparently holding another patient hostage.  But at least the patients are being so polite and friendly about it with me.