Views From Kennewick

Saturday, February 04, 2006

Prodigal Son

The prodigal son returns tomorrow. He’s been away for two years, but is in transit and will be here tomorrow afternoon.

It’s difficult to imagine how my life is about to change...again. Empty nesters get comfortable with that empty nest mighty fast. There’s freedom, a little less work, a little less worry, a little less to do.

I like empty nests; it means you’ve done your job as a parent. But, things change, and sometimes the fledgling returns with a flurry of activity, and endless chatter.

I know about the endless chatter. This young man was talking non-stop pre-birth.

And he hasn’t stopped since.

Since moving to Kennewick a little over a year ago, I’ve had the luxury of peace and quiet, probably for the first time in my life. Coffee on the deck, watching wildlife, listening to the sounds of the river, contemplating color and painting, letting my imagination run’s been wonderful.

That’s about to change, at 2 p.m. tomorrow, my oldest son returns. He’s moving here and will be living at home for a while. Mind you, I love the young man, he’s a great soul. I just hope I have the energy and the patience to keep up with him.

We’re joining a gym...

I can feel the burn as I type. Please ignore the groans.

Friday, February 03, 2006

Hunting Season's Over

It's almost imperceptible. There's a calm in the air that hasn't been felt since November 1st.
Hunting season came to an end February 1. I'm certain the ducks and geese are very grateful.

During hunting season the air is filled with the geese honking, day and night. On the first day of February, all is quiet, calm, and peaceful. The boat ramp across the street seems different as well. Instead of hunters, fishermen are claiming the parking lot.

I'm not sure if it has to do with the calmness fishermen have, they're quiet when they launch, when they're on the water, when they come in, and when they leave.

Conversely, hunters are a noisy lot. I'm sure they're good and quiet when in their blinds on the islands, but they're raucous when they're in the parking lot, or loading their boats.

It reminds me of cowboys. How inwardly calm they become when working with horses. A quiet confidence, as if their souls are standing still, listening for that undeniable communication between horse and human.

It's magic.

Wednesday, February 01, 2006

Nursing Tip Of The Day

No matter how you look at it, most people are under a tremendous amount of stress. Add to that an illness or disease, and it soon becomes a vicious cycle. Believe it or not nurses deal with stress all the time, their patients stress.

In home care, we often see patients that have just returned from the hospital, and are now coping with a different level of health, or lack thereof. Even though they are happier and more comfortable at home, their stress levels are quite high, measurably so.

A patient just released from the hospital may be confused about the change in medication, treatment received when in the hospital, how their spouses or loved ones are coping with the situation, worries about long term care and the possibility that they may never get their good health back.

A frequent problem is side effects of medications and or chemotherapy. Nausea can be a formidable opponent when a person is trying to heal from injury, surgery, or chemotherapy treatments, among other things.

Often, a prescription to relieve this unpleasant side effect is given. Another pill to add to the pile of pills. Surely there's a better way.

And, there is. Make good friends with your ice pack. If you don't have an ice pack, you can easily make one with ice cubes, and a doubled zip lock bag.

Are you ready? Here's the nursing tip of the that ice pack right on your stomach, not where you think your stomach is, but up high, where the inverted "V" of your ribs is, where they come together. In about 5 minutes your nausea will be relieved.

Not bad, eh?

Tuesday, January 31, 2006

Yesterday, Today, and Tomorrow

Talk about nursing shortages...we have two nurses out of the office. One resigned, the other had surgery and will be off work for 6 weeks. They hired a new nurse, but it'll be some time before she's through with orientation. Therefore, we're short handed.

At my Home Health agency, I work weekends and holidays, and I'm on-call Friday night through Monday morning.

Believe me, it's a good way to avoid office politics.

My boss called yesterday and asked if I'd pick up the two nurses' on-call nights. At the time, I politely declined.

Then I realized I really do need the paltry fee they pay me to be on-call. A whopping $2.50 per hour. Yippie Skippie! So, when my boss called about another issue this evening, I asked her if she found coverage. The other nurses are pretty spoiled now that I'm on board. They're not fond of being on-call overnight, then putting in a full day.

Hey, who can blame them? Certainly not me.

The boss had to schedule rotating coverage, as the nurses weren't jumping up to volunteer. So I said I'd be on call for the next 6 weeks. It's not that big a deal, usually.

But wait! There's more! Sometimes the phone goes berserk, with patients calling from anywhere within a 50 mile radius of the office. Most of the time, the problem can be triaged over the phone.

Admittedly, shamelessly, I am a delegating-triage-hair-on-fire wild woman.

There is nothing I dislike more than going out in the cold, in the snow, in the dark, and trying to find a patients home. Of course, whoever happens to call does not have a clearly marked address on their house--ever. This would be against "the rules."

"The Rules" patients use for the Home Health On-Call Nurse is:
1) Call anytime of the night, your RN never sleeps.
2) Call when you know how to take care of your problem
3) Call to change an appointment with the case-manager RN at
2:00 a.m.

and so on.

Honestly, our patients are a good bunch and I have them well trained.

If they really need me, I'll be there. If it's something that can wait, then it has to, because our corporate headquarters gripes and whines if perchance we make an "idiot visit." An idiot visit is one that could be handled by the case-manager RN during normal business hours.

You see, they have to pay me an extra $0.50 per hour if I go out when on-call.

Do we see a pattern here? Do we see why nurses leave the profession?

You betcha.

Monday, January 30, 2006

The Problem with Nursing

Any nurse can tell you that the profession is rewarding, stressful, challenging. There's always new technology to learn, or new guidelines, and always, more paperwork. Patients are sicker, the job gets tougher by the minute.

Supposedly there's a nursing shortage. I can tell you why that is, it's not that there are too few nurses out there, it's because hordes of them have left the profession, yet they keep their licenses current. Some call it a sabbatical.

I call it "Runs From Paperwork." It's atrocious. In todays litigious society, everything you do as a nurse has to be documented. A few years ago, nurses charted by exception. If for example, a patient had a fever when vital signs were checked at 7 p.m. this was noted. Other things like administering medications that were ordered, were considered the norm, and therefore not charted.

But, that's when life was sensible.

RN Tip Of The Day

The old saying, "it's all in your head" is often true! More often than is realized, symptoms and illnesses can be controlled by what you think, and how you think about it.

A positive outlook, even in the most dire of circumstances, helps tremendously with the outcome of the disease process. If the patient maintains a positive outlook, which isn't always easy, and manages to keep a sense of humor, symptoms will be greatly reduced. This in and of itself, has proven time and again to not only keep the patient focused on a good outcome, but in fact, can contribute to healing.

The mind controls the body, always. That's not to say that the mind can cure all...or can it? I don't think that health care professionals have delved into this aspect of care with nearly the vigor that it needs to be addressed.

For us average mentality folks, it is said that we only use a small portion of our brain, the rest lays there, doing little. Imagine, if we used the power of our minds, what effect that could have on our health.

Can you think your way to wellness? Yes, I do believe you can.

But it can't be done with just one thought, it has to be a focused, relentless attention to the problem. Like a tape recording on a feedback loop, keep in your mind the solution to the problem. It can be something as simple as, "I will NEVER have a cold or the flu again."

People doubt me when I tell them I did that 23 years ago, and have not had a cold or the flu since making that declaration. But it wasn't just the declaration. I focused my mind and in my head repeated that single sentence perhaps a thousand times. 23 years. No colds, no flu, and I'm around people with both almost daily.

You decide. Then do it.

To your health!

Sunday, January 29, 2006

Quiet Days and Chinese Food

Some days it just doesn't pay to be a nurse. Literally. Other days it pays handsomely, if not in dollars, in gratification.

I'm not sure what kind of day it was today. There were no calls from the answering service till a few minutes ago, and then it was just my boss requesting information. Since yesterday was call after call after call, it was a welcome relief.

I'm not, never have been, don't wanna be...a pediatric nurse. So what's with all these little kids coming on service lately? No idea, stuff happens, and in Home Health, you just have to play the cards you're dealt.

When in nursing school, I knew I didn't want to be a pediatric nurse, or an OB nurse. Giving meds or performing procedures on kids isn't my idea of a good time, nor is it theirs. Don't get me wrong, pediatric nurses are a special breed of angels. Uh, I'm not one of those angels.

Give me a geriatric patient any day. At one time I'd have thought "Geri's" were not a particularly fun group to work with, but I was wrong. There's so much strength, and humor, and fun working with elderly people, I can't imagine enjoying this job as much as I do, with any other age group.

Today, I had a 3 year old and a 73 year old. Guess which was more enjoyable. Overall, the weekend went well, and I'm glad it's almost over. With any good luck at all, the answering service will be quiet tonight.

There's a Chinese Buffet right across from the office, their parking lot is always full. I'm not overly fond of buffet anything, since I'm a light eater. But Chinese food sounded excellent, and I didn't resist.

The food was quite good, but in all honesty, the ambiance in the place is...non-existent. I managed to stuff myself, and of course, hit the dessert bar. They do make some mighty good cream puffs the size of a miniature muffin.

Which reminds me of a time long ago. I must have been 5 years old. My sister, RuthAnn eleven years my senior, was still living at home. It was the 1950's and as I recall, she had her auburn hair up in her signature French twist, a dress with a full skirt, and she decided to make cream puffs.

That woman can yell when she's mad! "I TOLD YOU NOT TO SLAM THE DOOR! The cream puffs will fall."

Um, ok. Sorry about that door, Sis. I remember this event, RuthAnn does not. I wonder why?
I do remember those cream puffs were luscious though. Light as a feather and made with real butter.

I can't tell you if they fell or not, they seemed just fine to me.