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Friday October 30 2020

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Morning

Work went well yesterday, no one answered the phone so it went quickly

Talked with the case manager at rehab, she says dad will likely be discharged a week from Sunday as he's progressing rapidly.  Bit sooner than we thought, which is good.  Just some weakness and balance issues to work on.  No cognitive deficits 

Only potential sticking point is that, for the first week or two he's home, they want someone with him, just in case.  The case manager suggested private duty nursing, which is pricey.  Though dad's LTC insurance would probably cover it.  There is also the possibility his ladyfriend could stay with him.  He'd need transportation services too because they want him to wait before driving again

I talked with dad last night, he sounds normal.  He said we'd talk about the discharge plans once I go over there on Saturday.  I guess he has a plan, or at least his own ideas on it.  Texted with my sister too, she was supposed to call last night but didn't.  Will  text her today and ask her to contact our cousin who is a social worker for the elderly for some more ideas

Work should be OK today.  Going to try and get a haircut, going to try a new place, local.  

Sleep is improving, still waking up a bit early but less of a problem than before

Weather is pretty much the same, rain holding off, mostly in the 40s

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Morning-

We're getting our first snow of the season.  It shouldn't amount to anything.  It will be back in the 60s next week.   Today is my telemedicine day.  It's nice to work from home 1 day a week.  I have 21 appointments today, which is pretty normal.  Fiance continues to interview, but no permanent position yet.  I'm hoping his consulting work doesn't dry up.  DD is working about 20 hours a week at my practice.  I hope she can find something full time or part time to get to 40 hours a week.  She has another 18 months before she'll get kicked off her father's health insurance.

Joe-I'm glad your father is doing so well.  I hope you can come up with a good plan for when he's at home.

Gotta get back to work.  Hope all are well.  

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Joe, good to hear your father is going to be okay and going home soon. 

BC, SNOW??  

We're having above average warmth.  Apparently yesterday in Tampa 17 people from a Trump rally were sent to a hospital because of the heat.  Odd because it was "only" 87 degrees.  

4,000 covid cases a day here in Florida.  Our rate of positivity is higher but still below 5% in my county.  We started the month with 60 covid patients in our facilities and are now up to 85.  And so it goes.

Had a nice walk this morning, will do some cooking and laundry and go to the gym.  Pretty routine day.

Stay well.

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Yup, Tweety, snow!  There's about 2 inches on the ground now and it's 29 degrees.  It's too early.  I still have flowers blooming.  A few years ago we had a Halloween blizzard that left us without power for 4 days.  That's won't happen today.  It's supposed to stop by 5 PM.

It stinks that Covid is back on the rise in most states.  I tried to volunteer for a vaccine trial but I'm too old, apparently.  They were only taking volunteers up to age 55.  

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Good Morning-

BCgradnurse -We got snow, too! There's about 1/2 inch on the ground, enough to cover the lawn and trees. The walkway and driveway don't have snow on it, though, which is good. Seems like you have a busy day at work today. Hope it remains "Q" for you.

Tweety - It's good that your area's positivity rate for Covid-19 is relatively low. Hope it remains that way. Enjoy your well-deserved day off from work.

Joe - It's really nice to read that your father is improving, and that he might go home sooner than later. 

Tonight starts the 1st of four 12-hour shifts in a row. If at any time I'm offered to be On Call, I'll take it! Sunday night, I'll be playing the role of Mr. Shift Director. The full-time Shift Director pleaded that I work for her Sunday Night. She has important appointments to make that are in regard to the process with getting a kidney transplant. So, I pleaded with my co-workers to switch nights so that I can get Sunday off as Mr. ICU Nurse in order to play Mr. Shift Director. Thankfully, one of my co-workers made the switch. So, I'm working her Monday night shift, making it the 4th 12-hour shift in a row.

This past week, I tried have my scheduled changed so that I work the opposite week-end that I normally work. This would enable me to help out the full-time Shift Director when she works her weekend (which, for shift directors, are 12 hours long, otherwise they work 8 hour shifts during the week). All three ICU Nurses who work the opposite week-end declined to switch weekend. Needless to say, I'm feeling both frustrated and disappointment in them. One of them actually said she WOULD switch weekends. THEN. . . she changed her mind. (I was pissed when I found out.) I understand the importance of our personal time. I really do. But I was asking to switch weekends to help One of our Own. There are too few Per Diem Shift Directors. I'm one of two willing to work nights. Oh well. It is obvious that the full-time Shift Director (needing the kidney transplant) has a hard time doing 12-hour shifts. They exhaust her. Basically, she keeps her job for the health insurance. So, if/when there is a choice between me taking On Call and her, I'll give it to her. (The staff RNs in our hospital are unionized. The Shift Directors are not unionized. We get first dibs on being placed On Call, which is voluntary, and not mandatory as it is for other hospital systems.)

I'm going to do some chores, then eat lunch, then try to get some ZZZZZs before going to work this evening.

Hope all are well. . . and keep well. . . 

Ted

Edited by Ted

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Good morning.

Glad Joe's Dad is doing well.

Tweety: Maybe some of the people who suffered from the heat came to the rally from a cooler place. Maybe being crowded in 87 degrees, and possibly not hydrating enough contributed too. It is in the 70s here, BCgradnurse and Ted have snow.

Ted: I am proud of you being so considerate to your colleagues.

Yesterday at Trader Joe's a father and two teen sons were planning Thanksgiving dinner. They were, as required, social distancing and wearing masks. They were also loud. They had purchased turkey legs and were planning to wear Renaissance Faire clothes, speak Elizabethan, and eat with their fingers. Apparently the Mom told her "boys" they could do the meal and celebration with just the four of them, I wished them a "Happy Thanksgiving".

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Hi. 

Hmm, Joe, I wonder if he has no cognitive deficits why he would need someone with him and how they can assess that so quickly. And he has the right to refuse. I hope he does not try to leave to early before he has gotten full benefit from his rehab. 

Ted, yes good on you for stepping up. Are there plans for if and when you co-worker is out for transplant? It would seem you would need to be replaced in your ICU role. You and BC can just keep that snow on your side of the country! 

Tweety, yeah, the heat stroke thing is kind of weird, but as Amo says, maybe they weren't used to the temp. I think many people follow the rallies around the country like Dead Heads. Our local hospital has 5 COVID patients out of 220 bed capacity (24 ICU beds). Our case rate is just holding steady, but not enough to progress to stage 3. We continue with masking & distancing, restaurants at 50%, schools starting to open, outdoor sports are starting, churches at 25%.

Weather is cloudy and gusty, in the 50s. The sun may come out tomorrow. 

Not much going on today at work.  I am trying to read about the different drug regimens for TB, but my mind keeps wandering off. I plan to meet dd later this afternoon for a cookie break. There is a nice little pastry shop 3 blocks away that we meet at for a treat and a cuppa. And to vent. She is on the school board and some unsettling things have come up. A local mom killed her 7 year-old twins and herself, the deputy superintendent of the schools got a DUI, and the police department hired a school resource officer who has a history of killing someone. 

Good news, youngest ds got a job working as a health aide for disabled folks and he made dinner last night. My hip and shoulder were really hurting last night and was thankful that he cooked. 

Well, that enough of me blathering on. 

 

Good day all

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Hi nursej22 - Yes. . . It seems that I will be taking her position during the kidney transplant & recovery process. Once she's fully recovered, I will happily relinquish that position back to her.

I'm On Call! Currently working on a "First Snow" video! Hope to have it finished to share tomorrow. (It's very likely to be finished tonight if I don't get Called In.) 🙂

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Joe - have some suggestions for your Dad, hopefully to ameliorate CM/SW concerns re 'safe discharge'. #1) Can it be arranged for some family, friends and NEIGHBORS to all to take turns to stop by for some block chunks of time so he'd not really be left alone while awake? But regularly scheduled.

#2) Can Dad be 'scheduled' for specific 'siesta' times? Like really plot out times to take a nap or just stretch out in bed or on a comfy couch/recliner to just watch TV? I'm guessing he WILL get quite tired when he gets home, so the siestas will prob be therapeutic & welcomed.

Thing is, the times NEED to be scheduled out and adhered to for visits and siestas to work. And since night-time bedtime should take up a bigger chunk of clock time, if enough folk were to help, then actual assistants  or visitor presence time would be minimized. Now Dad must go to bed for bed time and stay in bed for this to work!

#3) Also might his insurance provide some ready-to-eat meal delivery service? My Aetna offered 2 weeks post hosp FROZEN microwave meals - delivered in dry ice to home address. My refrig is tiny, so I was able to spread out the deliveries. At my convenience. Full 14 dinner meals with all the stuff. I also still rely on Lean Cuisines. Easy, peasy.

#4) Now not the most polite-est topic here, but I suggest that he use a URINAL (if not doing so already). Esp at bedtime. It may only be needed for a short time and would decrease his need to get up fast to avoid 'the fast urge'. (Decreasing falls risk.) I'm speaking from personal experience when I say that getting up to go fast is often TOO LATE for me!!!).

#5) I also suggest using a 'blue pad'/'puppy pad' on the furniture and the nearby floor. Again, prob only needed temp and can be removed while awake (embarrassing!, I know). My Dad did not adjust well using a urinal so the padding helped for 'clumsy accidents'. It avoids the embarrassment of accidents on furniture & carpeting. And I'd suggest doing small freq laundry batches just to stay ahead.

#6) I'm ASSUMING he will have sched PT/OT home services. They usually came on diff days for maybe an hour each. Skilled nsg may even be less visits. Not sure how he'll qualify for a home-care CNA, but that is freq very limited. That also has to be scheduled into a big sched for him. So he's not reallllly being left alone for any long periods if he has some visitors & naps.

#7) Has a therapist come out to the home to evaluate things and make suggestions for safe home care? I know even as being nurses (my sister & I), things became evident that were needed for safe help. Like a fresh pair of eyes - to make things safe & functional for immediate NOW, not to eventually get back to the old ways.

#8) Finally, my BIGGEST and MOST PERSONAL RECOMMENDATION = a medic alert alarm!!! I use a necklace - I figure if my arm with a wrist bracelet were to become pinned in a fall, the necklace would be more accessible.

I hope y'all know about my passionate advocacy for these alarm things. I've posted on Yellow Side several times. My life was saved this past May when I hemorrhaged in the BR - passing out. But that necklace worked for what it was supp to do. And in the past, I have also fallen needing help to get. I got the immed help I needed.

Your Dad's at even higher risk now - increased CVA risk and weakness /falls risk. This recommendation, NOT a suggestion, should be PERMANENT,  NOT TEMPORARY.

These suggestions might help the CM/SW more comfortably accept home discharge as a safer alternative to PD. Because they will document their concerns re 'safe discharge'. So if you have a plan in place, they're happy.

I became an unanticipated expert, thru trial & error, for my home care needs. Hoping these hints help your Dad.

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What great suggestions and thoughts, amoLucia! 

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It's been a rough past 2 years, and now esp since this May diagnosis, I struggle more. This thread has allowed me to just vent about 'things'.

And covid has impacted things unbelievably. Going to my appts ALONE IS THE WORST!!! I'm sooo overwhelmed with sensory-overload from new diagnosis things and logistical planning in advanced. I say this in all sincerity, I've lost a few brain cells with my health my issues. 

So if some of my travails can turn around to help out someone else, I'm happy to help. It's hard to just 'turn off' nsg after 36 yrs for retirement.  Am figuring out things almost daily. I could have written a book for more supplemental stuff for what I posted to Joe.  Been there & done those things.

Joe - Covid precautions may be the biggest impediment to folk coming in for your Dad. But things can be addressed ...

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