January 31, 2014

So everything has turned out pretty well for my dad so far. It looks as though they got all of the cancer out, and there are no signs of metastasis.  They’re holding off on radiation for now and will give him another scan in 3 months.  He had to go back to the hospital a couple of times for an elevated WBC and to have some more fluid drained from his chest.  One of those visits happened to be on the same day that the city was pounded by a blizzard…considering that the hospital is 30+ blocks from the house, not fun for my mother.  He also has to follow-up with pulmonology frequently:  after all, they did jack almost a whole lobe.
But overall he’s doing pretty good.
I’ve been sending out knit items like crazy to them.  With temperatures in the single digits, they need things made from real wool.  I have to admit feeling disconnected:  the rest of the country is suffering from abnormally cold weather and here I am wearing sandals and short sleeves, with little need for wool socks and hats except in the midnight hours. 
I do miss the snow though.
Anyhow, now that the health crises are over (my sister is going to be fine too), I’ve scaled back on the working.  This will be the first weekend in a while that I’m going to be off.  Next week is 3 days, possibly 4.  I don’t think I’ll be too upset if I am cancelled on that fourth day though.
I also got around to giving HR my BSN transcript…and I was pleasantly surprised to find out that my BSN differential is a lot more than I thought it’d be.  I was under the perception that it’d only be an extra 50 cents or so per hour.  It’s actually a percentage of my base rate, and works out to an extra $2.00 (almost) per hour.  Sweet.

January 16, 2014

Per Diem

One thing about working per diem is that unless you have a long-term assignment--which in the per diem world means going to the same unit more than two days in a row--you don't really get to know the patients.  You see them for a shift, maybe two.  You might do their admission, or their discharge, but rarely will you do both.  You don't get to see the patient's recovery evolve during their stay.  Instead, you step in during the middle of a play scene:  you don't get to see what happened before, nor do you see how their story ends.  You're just there for Act 2, Scene 1 and then it's exit nurse, stage left.

So you don't really get to know the patients.  You don't know their progress, their plans, their goals.  You don't know their background.  You don't know their little quirks.  You don't know how well they play with others.  You don't know exactly how they behaved yesterday so you can anticipate that sort of behavior today.

OK, through the miracle that is known as documentation, you can at least read up on the patient and learn what they were like before you got there.  But what you read on paper and what you see in the flesh can be two very different things.  And documentation doesn't always cover the little things.  You may learn from the chart that they received the HAB cocktail (Haldol, Ativan and Benadryl), but you may not know exactly what the precipitating events were, or how they felt afterwards.

On the other hand, an advantage of being per diem is that you are a fresh set of eyes.  You're not going in there with the presumptions about the patient's history or behavior, and so you're not going to be as quick to draw conclusions.  You may catch things that other nurses may miss because they're so used to the patient.  You may be more objective about things, whereas those nurses who are more familiar with the patient may be more subjective.

Per diem nurses have to be able to adapt to an ever-changing patient population.  You do not have the luxury and comfort of getting the same patient assignments each day.  Instead, you go in there never knowing what--or who--to expect each time.

January 12, 2014

In which Meriwhen wins one and loses one

The good thing about the six day work week was that it did its job:  I was too busy to dwell on things in the daytime, and too tired to dwell on things at night.

So things worked out very well for my father.  The surgery went well.  They removed the tumor though I'm not sure if they got a good margin too.  It didn't spread to the lymph nodes, so that's something.  He lost a chunk of lobe and they had to rewire the bronchi.

He spent Thursday pretty much lying there, all full of tubes.

On Friday, most of the tubes were out and he started eating a liquid diet.

On Saturday, he was eating more though not quite the full diet yet, and talking on the phone with us.  And I'll be damned:  he sounded better yesterday than he had in a LONG time.  Even my better half agreed.

Today, he is home.  He's resting a lot but he's in very good spirits.

Right now, they're waiting for more pathology reports to come back before they decide what to do next.  Radiation may be the next step if they weren't able to remove everything.

So yay!  Life is good and things are looking much brighter.   I'm well aware that my father won't live forever, but at least he'll be around a little longer.

Then my sister called.

She's been having vision, vertigo and numbness problems, and so she went to her doctor.  She's got a whole battery of tests next week, but the doctor's preliminary guess is that this could be MS.  Or a brain tumor...which given that she's already had a pituitary tumor that has for the most part been benign, it's not that far-fetched of a possibility.

Well, damn.

I was on for four days this week, and truth be told:  if the agency cancelled me, I wasn't going to pick up hours at my main job.  But instead of trying to lose myself in work, I'll try to help her out however she needs me to.  At least with her, I don't have to fly to the East Coast to be there.

January 7, 2014


I talked to my parents on Skype today.  Dad still looks pretty good considering.  Mom, not as much...but she is stressed beyond belief right now.  Dad's surgery is tomorrow at 0730.  0430 my time.  At least we'll know what happens fairly early.

I'm working tomorrow so I'm attempting to go to sleep right now.  I don't think it'll be easy to sleep tonight.  I don't think tomorrow is going to be easy in any way...but I'm going to have to deal with it.

January 4, 2014

It's annual training renewal time for me.  Almost all of my annual courses, training and certs are due in January.  The exceptions are ACLS, BLS and How to Tango with Angry Patients, a.k.a. CPI.  That's my summer fun.

So I just completed a stack of courses:  privacy, infection control, waste management, disaster management, risk management, personal safety, workplace safety, medication safety, radiation safety and MRI safety.

I work in psych.  We don't use IV pumps or multiple lines.  The only MRI I've ever taken part in was the one I had for my foot while I was in nursing school.  The last radioactive exposure I had was a chest X-ray at my last annual physical.  Yet every year, I take courses regarding what to do with patients receiving infusions, radiation and/or MRIs.

I do pretty well on these tests too.  I must be the only psych person getting 100s on the radiation course.

Anyhow, I don't argue or complain. I figure if it's in my "Assigned Training" folder, then someone somewhere in my facility feels that I need to complete this.   Though when or even why they expect me to be performing MRIs on patients, I have no idea.