Saturday - November 9th, 2013 - Good Morning!

  1. Good Morning!

    It's 4:14 AM (EST) here.

    Well. . . I tidied up my happy music studio! I purchased a bookcase to put stuff on and threw out lots and lots of stuff that I don't use any more. I still have a closet full of electronic equipment which I'm either going to sell, donate out or throw away (if broken). This includes a 24 channel/8 bus mixer which is in great working condition, an ADAT recorder and various other audio and video devices. For now, though, they're safely tucked away in the closet. Also, got the car back! Almost $1,000 worth of wheel repair and new tires was put into it. (Ouch!) But, that's what overtime is for! LOL! (I really hate to see Amy work so hard! Oh, I'm just kidding! I don't mind her working overtime at all! Again, just kidding! LOL! )

    (Just to be clear, I'll be the one doing the overtime. LOL!)

    Sabby_NC - You have to do what you have to do, as I'm sure you know. Although I could be very wrong, my gut feeling is that his "yawning" is more than just being tired and needing CPAP adjustments. Maybe I'm projecting my own issues into the case but I've kind of been in his shoes in the past during a job I used to do. It's a long story and one that I'm not necessarily proud of, but let's just say that I quit the job and resumed my working life as a staff-nurse.

    Joe - I don't get migraine headaches but I do get "lack of caffeine" headaches! If I go about 16 hours without a cup of coffee, a headache and irritability it guaranteed! Glad to read that you had a relaxing day yesterday. Hope your day, today, is a pleasant one.

    cardiacfreak - Hope your car isn't as costly as mine ended up being! (Yikes!) Seems like you had a nice day without the car, though. Lots can get done, that's for sure! (Reading novels, cleaning studios, etc. )

    aknottedyarn- Seems like you're slowly getting things in order. I hope your friends and extended family are OK! I haven't checked the news yet so I don't know that status of the Philippines. All I know is that there was a whopping storm headed its way. Not good. (I hope such storms don't become the norm. )

    EMSnut45 - My day, yesterday, was productive! LOL! Seems like yours was, too! Your dog will eventually forgive you for taking her to those "not nice places"! LOL! Have fun with the walk for the AHA.

    Steph - We have something in common! LOL! We're both procrastinators! LOL! Glad you're ain't gonna judge me for my shortcomings! (Why do I think that there's a cryptic message by you to me! LOL!) Hope your on-call weekend is "Q".

    dianah - Curious. . . any gigs coming up? Any more albums being recorded? Just wondering about your wonderful musical life. I enjoy listening to your band.

    Well. . . it's now 4:37 AM (EST). I'm going to check the news. I'm worried about the all the people in the Philippines and the damage to life and property from that dreadful typhoon. All I know, now, is that it was to be a HUGE storm. Not good.

    Hope all are safe and sound. . . everywhere. . . and to all who visit here.


    Edited to add:
    Oh my. Link to news about the Philippines:
    Last edit by Ted on Nov 9, '13
  2. 11 Comments

  3. by   Joe NightingMale
    Morning Ted, I saw the stories about the Philippines too.

    Work went OK yesterday, the meds worked, no migraine just had a bit of a caffeine rush in the morning. Was busier than I thought but I got a bunch of stuff done.

    Came home and took it easy, had a glass of wine and watched a movie. Or tried to; I ordered "The Pink Panther Strikes Again" from Netflix but the CD was cracked. Fortunately I also have Amazon Instant Video so I watched "A Shot in the Dark" instead, which is almost as good.

    Going to go out riding today, was thinking about tomorrow but I think it will be colder and more windy then. Going to see my dad today too.
  4. by   Sabby_NC
    Good Morning Ted and all who decide to pop in for a natter,

    Ted so happy you got your music studio sorted out, I knew you could do it. LOL Ouch that is a long of $ but we need safe and durable cars so good for you.

    I had a frustrating day yesterday and one that I now feel sick over, I phoned hubby who happens to be the Director of Patient Services and S's boss. Informed him I do not want to have him with me next week, nothing I do or say is getting through to him.

    The icing on the cake so to speak was when I had a pain crisis of one of my patients, I informed S he will handle this. (Now remember he has been a Case Manager for over a year). Got to the home and the guy was rolling in agony. So S goes ahead and does the ^&$%$$$ vitals before giving anything for pain. Gave Morphine, no explanation of the medication, adverse effects, how this may make the patient feel etc THEN goes back to documenting with his back to the patient. I end up doing all the education to relax and know that the patient was being cared for. Never had Morphine before and he was scared.

    I am slowly fuming here, no conversation with the patient nor caregiver, no reassurance no nothing. Patient needed to use the bathroom so S takes him there, places him on the commode and goes back to documenting. This is a patient that fell off the commode a couple of days ago that S knew about. I just looked at him and said this patient fell off the commode just a couple of days ago. Oops he darts back to stay with the patient.

    Brings him back and is trying to give the patients words to say about his pain and pain score, leading him by saying 'now your pain is about a 5 now isn't it?' Ummmm no the patient went from 10/10 to 8/10 after first dose of Morphine so he asks me should he give another dose. (we have orders where it can be repeated one time in 30 mins if no relief of pain) Well duh what do ya think it is 8/10! Brings it down to 7/10 after 30 mins.

    Patient has an acute abdomen, asymmetrical with no bowel sounds, S looks at me as if what he should do now. OK I am fed up, phone our hospice home, report what is going on, get EMS and have him transported there for symptom management. Phone Onc to inform him of what is happening.

    In the home over 95 mins, S could not or did not get his documentation all done yet that is all he focused on. Got back to the office and had him fax Transfer Form and do the LOC with direction. Documentation sucked, did not document what he saw, very brief but poor synopsis of what he found. Patient was diaphoretic, sallow, gross facial edema, the only words he placed in his narrative were those he heard from me as above when discussing the situation with the Onc and giving handover to the hospice home.

    Head off to the next patient that I handle, come back to the office, go outside and phone up hubby saying if you do not take him back next week I cannot guarantee his safety with me!! LOL

    I am ticked off, upset, feeling sad and a little bit that I failed although I did my best, educated until I was blue in the face and for what? NOT Case Management or hospice material, can some one tell me how he lasted so long in hospice? Yep at the hospice home he allowed others to do his job for him and what he did not do he left for others.

    This past week has been the most frustrating and aggravating week I have had to endure, I love my patients and families and they deserve so much more than allowing him to assess and care for them. Both the patient and caregiver with the incident above kept looking to me as if to say what the heck is going on? That did it for me.

    Ok rant over I am on call today working with D who I oriented just a few weeks ago and I am so looking forward to seeing her again. We will have a great 24 hours working together.

    Frosty outside, hubby got up very early and got the groceries taken care of. I am about to head outside rugged up so I can play with the dogs and toss the ball for them so they can run and play.

    Hope you all have a most excellent day and I do apologize for my negative post, not like me but I have got it out now and will move forward.
  5. by   Ted
    Sabby_NC - There's nothing to apologize for. You're giving him the best and it's up to him to learn or not learn. However, it seems like he needs help with more than just time management. It seems like he needs help with basic assessment skills, effective pain management and patient safety. Wow.
  6. by   Spidey's mom
    Quote from efiebke

    Hope your on-call weekend is "Q".

    That's funny. I had a dialogue with a co-worker on FB who put up a . . whatever they are called . . meme? . . . . about medicine and the "Q" word. You know what I said.

    Quote from efiebke
    Sabby_NC - There's nothing to apologize for. You're giving him the best and it's up to him to learn or not learn. However, it seems like he needs help with more than just time management. It seems like he needs help with basic assessment skills, effective pain management and patient safety. Wow.
    He right Sabby - absolutely nothing to apologize for and you gave it your best shot. I felt myself getting mad just reading what you wrote and YOU were there!

  7. by   Spidey's mom
    Good morning all.

    I said the "Q" word last night when I got report from the outgoing nurse - not on purpose of course. And my night was quiet.

    Our census is higher than normal though so I expect to be busy this weekend.

    Hope everyone has a good Saturday. I've had my two cups of coffee and now must trudge into the basement and attack that mountain of CLEAN laundry that needs to be folded. (ha ha jnette).

  8. by   dianah
    Mornin all!

    Sabby, how frustrating for you and for your patient!
    Sounds like S does need to be out of hospice, tho'.
    You have given it your best shot.
    Document and move on. He will find another area.

    Ted, wow, congrats on cleaning out the music studio (first, tho, I read it as "hippy studio!! lol)!
    If we were closer, dh and our bass player might go rummage thru the stuff you don't want, and relieve you of some of it!

    Joe, hope you have a good, migraine-free weekend!

    Steph, hope the folding is coming along!

    Slept in this morning (doesn't help that I was awake from 2-3:30ish... :rolleyes ).

    Ted, we play next Sunday from 12-3 at Oak Glen (same place: Los Rios Rancho).
    We played last Sunday, with a fill-in mando player.
    He was fine.
    Sound equipment was the bugaboo.
    As an acoustic band, we usually DON'T use sound equipment. We listen to each other and balance ourselves, thankyouverymuch.
    We singers, though, can't be heard very far (even though we quiet down the instruments), so we need SOMETHING.
    Sound equipment is such a pain to set up, adjust, and I HATE hearing feedback!!

    Dh brought our little amp and four mics.
    The owner later came by and said he'd wanted HIS system used, so a larger area could be flooded with the music.
    We didn't know that, of course, when we set up.
    We did the best we could.
    On the 17th we will bring the big speakers and set up grandly.

    Ted, do you have our Christmas CD?
    It's available on CD Baby, name of the CD is "Gift."

    (or I can send ya one )

    Y'all have a good one!
  9. by   TopazLover
    Good day all.
    Oh Sabby. You have gone above an beyond. I think I would have made him walk rather than mess up the car after I took him out to the woodshed for some education. OK, maybe I would not have done it but I know I would have wanted to. As was said before. Move on. He was unsafe at any speed and your patients deserve only the best nurses since there is no one to correct their mistakes or failure to do.

    I have not heard much from Pinoy family and friends. I believe they were spared the worst. At least that is what the last communication was from them.

    I went out for a while to a yard sale and church sale. I knew it would be hard, and it was, but I have to get comf. with doing things alone and might just as well start with something I enjoy. I bought a small tea kettle. I am looking for the right picture for the guest bathroom. I have my poster of The Weavers with Pete Seeger (1950) and know it will be difficult to find something to go with that.

    All the clothes are gone. The coats and jackets remain. We still need to do the same at the office where the suits and more coats are kept. Some of the sweaters went to a friend of mine who really is happy to have something of SO's.

    Life goes on. Today I am in kind of a funk but am better than I thought I would be.

    Enjoy this day.
  10. by   Spidey's mom
    No folding yet. On the phone with daughter-in-law talking about pregnancy-related pelvic pain related to the hormone "relaxin". She's almost 37 weeks.

    We are going out to the ranch to split wood.

    Laundry will have to sit.
  11. by   dianah
    Laundry will be there when you return!
  12. by   dianah
    (((((((((((((( aky ))))))))))))))
    Good find (teakettle).
  13. by   herring_RN

    Clearly that nurse should noy work for hospice.
    You did all you could.

    Best to you AKY.