April 22, 2017

My weight loss stalled.  I'm not gaining though, which is a good thing.  But I'm holding steady at the 20-21 lb mark.  My shift in sleeping schedule--and thus my shift in and laxity of intermittent fasting and what I'm eating--is probably the reason behind it.   Plus Easter chocolates.  I've improved on the wake-up bag of Doritos though I did have one this afternoon...I was a charge nurse last night, it was a wild night, what can I say?  My soul craved Salsa Verde.

I'm sure once I'm back on my usual schedule and meal plan, the loss will resume.  I need to get back into exercising as well.

Work has been...work.  I thought about calling out tonight or at least requesting a cancellation.  But given that both the little one and I will have various medical expenses coming up, it's better if I work and get my full pay with weekend diffs than just the PTO at my base rate.

I successfully started 2 IVs in the last couple of weeks, bringing my EVAA (estimated vascular access average) up to around .300.

Acuity has been high on every unit since before the full moon.  There are lots of little changes going on to help prepare us for various site visits.   New staff are going to be starting soon, including a new grad (someone who wanted into psych, no less!), so there's been some shuffling around of who is working what unit, who will be doing what, and what schedules will be changing.

Come to think of it, that shuffling has been happening for a while.  It seems like TPTB are into floating staff around and people are working where they usually don't.  I think part of this is due to new staff coming on board, as well as the budget--they want to fill in the coverage gaps so they don't have to pay people to stay late or come in on OT.

I'm eyeing all of this with a little apprehension and concern.  I thoroughly enjoy where I work and I don't have plans to leave anytime soon.  I'm glad to have new staff come on board.  It'll be nice to have staff more evenly spread so there's fewer gaps.  I'm excited we have a new grad that appears to be want to be here and not just wanting to get their mandatory first year over with to leave for more medical pastures.

But I also wonder with all this shuffling, where I will fit in.  Yes, I know some of this is my well-known (well-known if you've read this blog anyway) anxiety/insecurity.  I know the union means they can't just fire me without cause.  I know they can't change my schedule without my consent.  But I'm hardly on my home unit as it is, so I wonder where I'm going to be stashed with all of these changes...especially since some of this new staff is coming to my home unit.

I'm trying to be Zen about it and take a "wait and see" approach.  See what's going to happen to me--if anything--before I make my concerns known to the TPTB.   It could be that I'm getting rattled over nothing, and everything will be the same as before or better.  Or not.

April 20, 2017


The little ones are on Spring Break, which means I've had to adjust my sleeping schedule.  I now sleep in the evenings, go to work, then stay awake to do things with them.  It's been working out so far...its a nice change to stay up after work, and I'll admit that it's easier to fall asleep when it's starting to get darker out as opposed to brighter.  But this won't work when they're back in school, so in a couple of days, I need to return to my regular schedule.  I may shift back to this in the summer, we'll see.

I've been enjoying the last few days off.  I've caught up on sleep.  I'm spending time with the family.  I've turned down requests for work.  I'm just recharging the batteries, getting ready to once again tackle all of the Axis II that seems to have infiltrated the patient population.

The tough thing about personality disorders is that they are how a patient is wired, meaning that nothing is going to cure it.  Sometimes I do wish it was like psychosis, where a shot of Haldol will make the pink elephants go away...at least for a while.  Alas, it's not.  Medications may help them manage their symptoms, but the patients need some good old-fashioned therapy--usually CBT or DBT--to change how they think and respond.  But because they are wired this way, it's also incredibly hard to effect change.

All the Axis II can wear a nurse out after a while.

I'm debating if dealing with Axis II disorders is more exhausting than working with patients in mania.  Both can be challenging, frustrating, and have medications end up with little to no result.

But a manic patient with Axis II...now THAT'S a hurricane!

April 12, 2017

The mystery of the insurance auth has been solved

The ptosis repair--for both eyes!--was approved.  Clearly, my ophthalmologist's UR office is good.

My ophthalmologist only does surgery on Wednesdays.  Also, Wednesdays is the only day that the surgery scheduling team schedules surgeries.  I called and just missed them.  So I have to wait a whole week before they call me.  Well, I've had this eye issue for this long, what's another week?  And it's not as though surgery will be the week after I call them anyway.

I also need to remind them that if they are going to twilight sedate me, that diazepam will make me turn bright red.  They may decide to use something else.

I'm not sure how to deal with this at work.  I have the sick time accrued for a week off...actually, I have a TON of time off accrued because I never really take it.   I'll only need 7 days off for this.  Maybe 8.

When I schedule the surgery, do I tell work now that I've scheduled it so they can plan around my absence, or do I call them the day of surgery and tell them I won't be around a week per doctor's orders?  I'm guessing the former.  But I'll wait until I schedule the surgery first before I say anything.

April 8, 2017

So I received an automated message from my medical insurance plan, stating that my "requested services" were approved and to call my PCP.   I'm guessing it may have been the eyelid repair.  Or it could have been the testing for Graves' disease.  I got the call at 1800 on Friday.  So I'll have to wait until Monday to call and find out what it is.

In other news, I worked my first double at my current facility.  I ended up being so overtired that I felt wide awake.  I didn't fall asleep until I had been awake about 27 hours, and even then, it took pharmaceutical help to bring sleep about.

April 5, 2017

Back on the wagon

So the theme for the last three days has been Doritos.  Massive amounts of Doritos.  All flavors of Doritos (BTW, whoever invented Tapatío Doritos has my eternal adoration).  Doritos for breakfast, lunch, dinner, and bedtime snack.

OK, not that many Doritos.  But a lot of Doritos nonetheless.  More than usual.

That plus lax eating for the last three days...I'm scared to step on the scale.  The last time I weighed in a few days ago, I hit the "23 lb lost" mark.  I know I'm not going to have gained 10 lb in those three days...but still, I think I'll wait until the weekend--and a few days of intermittent fasting--before I weigh in again.

I just felt like going off the rails these last three days, what can I say?