Day By Day



Showing posts with label Nursing. Show all posts
Showing posts with label Nursing. Show all posts

Sunday, November 02, 2008

Halloween Ghost Stories; Starring Nurses!

Nurses are funny things. Nursing is more than just a job. Nurses deal with life and death of human beings on a daily (and even hourly) basis. So, this tends to make nurses super-dedicated to their profession and their patients.

Nursing is the only profession you can lose your job and your professional liscensure if you call in sick or go home early. Hospitals can legally lock nurses in the hospital if the weather gets too bad for replacements to arrive. Up north, if a blizzard blows in, they send the National Guard out in tracked vehicles to bring in the police and the nurses -- it happens somewhere in the U.S. every single year. It happened in 1999 in Indiana when I lived there.

And the beautiful thing is, most of this is really unnecessary. When the bad weather rolls in, the nurses have already made arrangements for child care and are on their way to the hospitals. When the Hurricane Katrina and Ike and Rita evacuees rolled into town, nurses lined up 7 and 10 deep to volunteer at the shelters.

It's more obsession than profession.

So why are we so surprised when nurses show up at work after they've died themselves?

A good friend of mine, a local author (whose name I won't reveal until he gives me permission to do so) was recently hospitalized at a local county run hospital here in San Antonio. When he woke up after his brief naps, he would have brief moments when, just after opening his eyes, he saw a pretty dark haired nurse dressed all in pink scrubs standing at his bedside tending to him. When he blinked, she was gone.

This happened repeatedly -- even to the point that one time she had several others with her -- and they all disappeared when he blinked. He finally asked one of the nurses about her.

"O, several people have seen her today," she commented dryly, like it happened all the time there. "All hospitals have ghosts."

And it's quite true. The outpatient Dialysis Clinic of the same hospital has a phantom cleaning man who tends the floors night and day. Cleaning staff won't go into the clinic alone after hours. Several of them knew him when he was alive.

The odd part to the story is that this county hospital was built after the old hospital (which still exists as a clinic downtown) began to have so many reports of ghosts and so many frightened housekeepers quitting in terror in the middle of the night that the county supervisors decided to build a new hospital just to keep the peace. So both facilities seem to have their share of eternal staff, it seems.

Another major hospital of a faith-based origin downtown has a medical campus downtown. Originally starting out in a five story building, it has since moved to a larger eight story edifice across the street. The last 24 hour clinical care area at this hospital to leave the original building was the Intensive Care Unit. The ICU moved after several incidents where patients became critically ill or even died when their Intravenous medication lines were all found running wide open, overdosing patients on their medications. When the surveillance tapes were played back, the IV's were clearly seen opening themselves with no staff members present.

That tape is still said to exist somewhere in the hospital security office -- I heard this from an officer who watched it last month.

Since that time frequent noises and voices have been reported from this old 5th floor ICU at all hours of the days and night. It's common to send new officers to investigate these noises without explanation. One officer I spoke with had watched several nurses in old-style white starched uniforms and caps sorting paperwork for 45 minutes from an adjacent floor of the newer building while a rookie searched the old building for these nurses. He even radioed in one time, saying he was in the room indicated, and could see the officers looking at him, but there were no nurses there or lights on -- while the officers could clearly see the nurses.

One of the rookies tells an even stranger story. He was sent to investigate the fifth floor several years ago right after the ICU had moved out. He went up the stairs instead of the elevator and came out to a floor with lights on and a nursing station full of nurses. They looked odd somehow, but he said hello and told them he was just checking the floor, and they smiled at him and told him to go ahead. Each room had patients in the beds, each room was neatly maintained and clean -- each room had the windows open for the clear hot August night.

No air conditioning. Then he noticed there were no televisions either. When he reached the end of the hall at the nurse's lounge he saw an old 1930's Victrola wooden case radio on the desk playing big band music.

He turned and walked straight out of the unit, pausing briefly to say good night to the nurses, who again politely acknowledged him. When he got his supervisor and returned less than 10 minutes later (coming up the elevator this time) the floor was dark, the rooms were locked and stacked with castoff furniture, and the nurses station was piled high with boxes of paperwork.

He was almost fired on the spot. He swears this is true.

My own experience with this type of experience was when I worked at a faith-based nursing home on the near northwest side. As I worked the 3-11 shift and headed home every night at midnight, I frequently saw the nursing supervisor sitting in the nursing station of the adjacent unit reading paperwork. She wore the old-style starched white midi-dress and nursing cap.

A month or two later I heard one of the nurses comment on the "ghost" of the nursing supervisor, and that she was seen on the unit next door where here office used to be. I didn't say anything at the time for fear of ridicule, but made a mental note. Less than a week after that as I drove past those windows I saw her there, stopped the car, and went up to the window to get a better look.

The nurse, when she realized I was there, looked up and waved at me, smiling broadly. Startled, I waved back, then got back in my car.

When I looked again, she was gone.

Never saw her again, either.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

I'll give you this one as well, although it's not Nursing related.

When we were looking at cars last year we took a test drive at a Honda dealer at IH-10 and 1604. Behind the Honda dealer is an old stagecoach stop that is probably 150 years old or more that the dealer restored as part of the deal when they bought the property.

The salesman who we were riding with told us that during the restoration process they lost two night watchmen who ran off the property in the middle of the night and refused to come back. Both of these watchmen swore up and down (and independently of each other) that they had seen the stagecoach come in at 3:00am, complete with driver, passengers, and shotgun rider. The passengers disembarked, and the coach just disappeared.

As he said this I looked at the upper windows of the stagecoach stop building (it was about 9:00 pm) and saw a small child looking back at me from the window on the left. I asked him if anyone lived there now. He told me the building had been locked for years, but that faces were sometimes seen at the window.

. . . . Yeah, I figured that part out.



~~JD~~

Monday, October 27, 2008

Why I Was Late Posting Monday

One of the things I like to do with my time is volunteering. You meet new people and get to see places you normally wouldn't. Plus I think it's a good idea to shake up one's own status quo from time to time. As Lenin once said, "A little revolution now and then is a good thing."



This is how I ended up . . . on a golf course on a beautiful South Texas afternoon when I don't even play the game. It was the AT&T South Texas Open, which is a stop on the Seniors Tour.


I have no idea who this guy is. I think he's Fuzzy Zoeller, and I'm probably wrong. But I did get to meet him, and get his autograph, which was cool. That's certainly something that wouldn't have happened if I was sitting around the house. You so infrequently see Fuzzy Zoeller bumming a bottled water out of my refrigerator.


Most of what we did was sit around in an air-conditioned tent watching satellite TV (of the Cowboys game) waiting for someone to come in with (a) a headache, or (b) ant-bites, so we could hand out anti-itch cream or ibuprofen or tylenol, such as the case may be.


This being Texas (and part of the South, y'all) The signs that they hold up when the player is putting say "HUSH, Y'all!"


The bad news was when I volunteered to work the Open, I didn't think I was scheduled to work that night at the hospital. Through a miracle of sudden scheduling, it turned out i was after all. That meant no afternoon nap before work, and when I got home this morning, I was beat. (I'd say "bushed", but I don't want to get angry comments from the Obama-istas in the Comments section. Some of them aren't too bright . . . )

So I apologize for the delay.

More tomorrow.

~~JD~~

Friday, September 12, 2008

Living In The Cone Part X: Ike's Slam

Ike decided to turn slightly north last night, which is not a good thing. While San Antonio is now out of the path of the storm, Houston is now in the crosshairs. Since the Corpus Christi coast (several hundred miles to the south) has alrady been evacuated, this presents a problem. Wher DO you send the Houston refugees now that the shelters are filling, and that you have less than 24 hours to do it in?


Actually, it now appears my old stomping grounds of Northwest Indiana may get more rain than I will. Heh.



Worked in a shelter last night with Corpus Christi refugees. While there was pitifully little to do, I did get to do some really good interviews with unsettled peaople, and solve a few sticky problems. Baptist Child and Family Services (BCFS) an Angel Staffing did their usual fantastic job, and FEMA continues to really impress me with their organization and initiative.

Really!


Nurses; Doing the paperwork that sends normal human beings into a death-like coma from sheer boredom.

Meanwhile, the countdown continues. More as it happens (or doesn't.) Im scheduled to work the shelter again Sunday, but that may be academic.

~~JD~~

~~JD~~

Thursday, July 17, 2008

You May Have Noticed I've Been Posting Less Lately . . . .

Well, just a Bit less, anyway . . . .

Welcome to the Nursing Shortage 2008. Here in beautiful South Texas the economy is thriving and the housing market continues to boom. It's no small coincidence that we have one of the lowest tax rates in the country -- hell, no state income tax at all. So jobs are abundant and plentiful. Texas employers are recruiting all through the Katrina impact zone for construction workers for South Texas. Some road work has even been delayed due to a shortage of trained construction workers.

San Antonio alone has a ridiculous number of hospitals, medical clinics, nursing homes, and skilled nursing facilities. Just by working Temp Agencies like NursFinders a nurse with a modicum of skills can work until they drop. This week alone I've worked 36 hours at a downtown hospital (night shift); then this morning I turned around and started 3-ten hour shifts at my Dialysis Clinic. Then this Saturday I'll work 2 back-to-back shifts at the Hospital.

To pull off this small trick I have to work two of the days this week around the clock. Like today -- I got off the hospital job working all night, then worked all day at the clinic.

I'll do this again Saturday, in reverse order. So if I only post once a dy instead of three times, you know why.

By the way, if you know a teen-ager looking for a career, recommend Nursing.

Please.

~~JD~~

Sunday, June 15, 2008

Democratic Delegate Stuns Party, Shuns Obama; Gets Boot in Butt

Today is Sunday, June 15th; 121 Days to the General Election, as we watch the Wheels come off the Obama Bus; and, alternately, who's been thrown under the wheels of that bus today.

Little Green Footballs has a story of a Democratic Party delegate who's made her decision -- she'd rather vote for McCain than Obama. And, my, aren't the wheels on the bus pretty from underneath!!!

Democratic Delegate Stuns Party, Shuns Obama

Sun, Jun 15, 2008 at 2:34:01 pm PST

A Democratic delegate from Wisconsin is about to find out what happens to apostates from the party.

Washington - As an avid supporter of Hillary Rodham Clinton in the Democratic primaries, Debra Bartoshevich is not alone in her frustration over Clinton’s defeat. And she’s not entirely alone in saying she’ll vote this fall for Republican John McCain instead.

But what makes her unusual is that she holds these views as an elected delegate to the Democratic National Convention in Denver this summer.

“I’m sure people are going to be upset with me,” said Bartoshevich, a 41-year-old emergency room nurse from Waterford in Racine County, and convention delegate pledged to Clinton.

Joe Wineke, chairman of the Democratic Party of Wisconsin, reacted with disbelief when first told Friday afternoon that one of his state party delegates is now a McCain supporter. “Not a delegate? To the national convention?” said Wineke, who was getting ready for the start of the Wisconsin state party convention Friday in Stevens Point.

“We have a Clinton national (convention) delegate who says she’s voting for John McCain?” Wineke repeated, for clarification. “I’ve never heard of such a thing.”

Wineke said “almost everybody I know who was for Hillary” is solidly behind Obama now. As for Bartoshevich, he said, “my suspicion is she doesn’t know what she’s getting into” because “the delegates to this convention will be very upset.”

UPDATE at 6/15/08 2:39:21 pm:

Well, she was right -- they certainly were upset. Delegate Stripped of Position After Pledging to Vote Republican.

The Wisconsin Democratic Party has stripped a woman of her position as delegate to the Democratic National Convention.

Last night in Stevens Point, state party members held a unanimous vote to strip Debra Bartoshevich of her delegate status and appoint an alternate for the Denver Convention.

Yeah, yeah -- that's the ticket boys! We don't wanna have no dissent in the Democrat Party. How can we have Diversity with all this damned dissent in the ranks?!?!?

Hat Tip: Little Green Footballs

~~JD~~

Monday, May 05, 2008

The Darker and Brighter Sides of Medicine

The very fact that physicians are beginning to consider the triage of of the dead and dying in a pandemic is more than a little frightening. It acknowledges that the idea of a pandemic itself from SARS and other flu-type diseases has begun to enter the zeitgeist of the masses.

Curiously, the article fails to make any connection between a doomsday scenario where "'everybody will be thinking in the same way' when pandemic flu or another widespread health care disaster hits . . . to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way" and the implications for the socialized medicine that the Democratic Candidates are advocating.

The Associated Press (via Yahoo News) brings us this glimpse of Doomsday:

"If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing," the report states.

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won't get lifesaving care, the task force wrote. But the recommendations get much more specific, and include:

_People older than 85.

_Those with severe trauma, which could include critical injuries from car crashes and shootings.

_Severely burned patients older than 60.

_Those with severe mental impairment, which could include advanced Alzheimer's disease.

_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also "a political minefield and a legal minefield." The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.

If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said.


A "political and legal minefield???" How about Ethical? I'm struck by the similarity of this list to the list of those elegible for Concentration Camps under Nazi rule in WWII. "Mental Defectives?" Those who "present a drain of limited supplies?" I work at a Dialysis Clinic. In case of a pandemic, do we just shut down the dialysis clinics as "a drain of limited supplies" and let millions of people die?

And at what point do these rules kick into play?


At the polar opposite of this scale is Wal-Mart, who has decided to take it's much heralded program to bring inexpensive medications to the masses and expand it!

Wal-Mart Stores Inc., the world's largest retailer, announced Monday it would expand its discounted prescription drug program to offer 90-day supplies for $10 and add several women's medications at a discount. It also said it would lower the price of more than 1,000 over-the-counter drugs.

With the expansion, the company began filling prescriptions Monday for up to 350 generic medications at $10 for a 90-day supply at Wal-Mart, Neighborhood Market and Sam's Club pharmacies in the U.S. Almost all the prescription generics in the company's $4 program were included in the expanded $10 offer, said Wal-Mart senior vice president John Agwunobi.

In addition, the company will add several women's medications to its list of prescriptions available for $9, including drugs to treat breast cancer and hormone deficiency.


The difference here is that these "Pandemic Planners" are anticipating a worst-case scenario with apocalyptic implications. Wal-Mart, on the other hand, believes in the empowerment of the people with reasonably priced medications to do the right thing and take care of their own health.

Which appeals to you more?

(Take THAT, Wal-Mart haters!)

By the Way: If you want more information (such as a List of these inexpensive medications), CLICK HERE.

~~JD~~

Friday, May 02, 2008

Unauthorized Human Testing Department: Man Regrows Severed Finger

This story alternately horrifies and fascinates me. A scientist working for the Army on methods of stimulating tissue regeneration offers a highly experimental compound to his brother (who accidentally lost the tip of a finger in a model airplane accident) and has the fingertip regrow, according to the London Daily Mail:

The dust, actually a collagen powder derived from pigs' bladders, appeared to provide a suitable "matrix" or framework, stimulating regrowth of the tissues and division of the cells, to enable Mr Spievack's finger to grow back - in just a month.

And not just a stump - flesh, tendon, skin, fingernail, fingerprints and all.

It is an extraordinary story because, if it can be confirmed, it will point the way to a breakthrough in one of medical science's greatest problems: the inability of humans to regenerate lost tissue.

One organisation with a keen interest in tissue regeneration is the U.S. Army. Military researchers are reported to be working with University of Pittsburgh scientists who developed the pixie dust to find a way to allow injured soldiers to regrow lost fingers, skin, and even whole limbs.

With hundreds of U.S. soldiers coming home injured from Iraq every month, such an advance would be leapt upon by the Pentagon.

Dr Stephen Badylak of the University of Pittsburgh is the scientist who developed the pixie dust. It consists of a mixture of protein and connective tissue which is already used by surgeons to repair tendons.

The U.S. Army has invested millions of dollars in regenerative medicine, and Dr Badylak - and Mr Spievack's brother - could become very rich men.

The powder, he has said, "tells the body to start the process of tissue regrowth".


Odd that this didn't appear in an American paper. Hmmmmm . . . If it's true, it has amazing application for re-designing tissue growth process as we know it. Burn victims, especially, may be saved from a life of deformity and pain.

But I'd still like to know how an experimental compound NOT approved for human testing made it's way out of the lab and onto a hobbyists finger. I smell a security breach.

~~JD~~

Wednesday, April 16, 2008

I'mFairly Sure Medicare Wouldn't Approve THIS Expense . . . .

. . . however, knowing how powerful the AARP lobby is in Washington, I wouldn't bet against this legislation. I'm just wondering if this constitutes a Consult; or Rehabilitation Services.

Or maybe an approved Home Health Service? (Hey, if Medicaid will pay for a housekeeper if you're disabled, can this be far behind?)

(Sigh) Well, one more reason for the Muslims to be angry with Denmark. From Bloomberg.com

Call Girls at Nursing Home Fuel Debate in Denmark
By Christian Wienberg; April 16 (Bloomberg)

When a male resident at Kildegaarden nursing home in Denmark made an indecent sexual proposal to a member of the staff, the home's director, Inger Marie Kristensen, told a nurse to telephone for a prostitute.

``There was a considerable change in his demeanor after the escort girl had paid him a visit,'' Kristensen said in an interview. (No, really???) Nurses arranged visits by call girls three times in the past three years.

While Welfare Minister Karen Jespersen says Denmark's 98 municipalities are free to let nurses call prostitutes, some lawmakers are stepping up efforts to pull women out of the profession, which has been legal in the country since 1999. ``I don't want to contribute to keeping this industry in business,'' said Mie Bergmann, an elected official with the Social-Liberal Party in Skanderborg, who led a failed vote to end prostitution at Kildegaarden. (Politicians don't like prostitutes; too much competition!)

In a poll posted last week on the Web site of national broadcaster DR, 46 percent of 1,982 readers said nursing home staff should be able to organize visits by prostitutes, 45 percent were against the practice and 8 percent were undecided. A margin of error wasn't given.

Denmark's Society for Women started a campaign in March called ``Take a Position, Man'' urging men to sign up at a Web site to protest against prostitution. (Really? What position? Missionary? Doggie-Style? Kama Sutra?)

The Copenhagen-based Danish Sex-worker Association was established last month in a bid to protect the industry. The leader, who gives her name only as Susanne on the association's Web site, said prostitutes ``often'' visit Danish elderly homes. `To forbid vulnerable customers from obtaining the services of a legal business is discriminating, both against the sex workers and the people who need help to get the services,'' Susanne said in an e-mailed response to questions. (Why did I not suspect the "Danish Sex Worker Association had a Website???)


Ouch. Ouch. Laughing too Hard. Ouch. Hee hee hee hee!!!

~~JD~~

Thursday, April 10, 2008

Friday's Feast!



Feast One Hundred & Seventy Nine (from February 15th, 2008, one that I missed -- no feast this week, "The Chef is Busy!")




Appetizer: Name one thing that is unique about you.



I can sleep on demand for prolonged periods. I've slept through construction, traffic, and a Scud raid in Saudi Arabia. I can also conversely stay awake for prolonged periods when I really want to. I attribute it all to being a Nurse.


Soup: Fill in the blank: My favorite _________ is __________ but I like _________ too.

My favorite food is lobster, but I like steak, too.
My favorite pets are cats, but I like dogs, too.
My favorite ice cream is mint chocolate chip, but I like vanilla, too.
My favorite TV show is "Battlestar Galactica", but I like "Flip That House" too.
My favorite time to sleep is an afternoon nap in the sun, but I like nighttime, too.

Salad: What type of wood do you have for your home’s furnishings?


Hey -- I live in Texas. Everything's Oak here. That's just the way it is.

Main Course: Who do you talk to most often on the phone?

Nobody. The only time I use the phone is to communicate with my wife or son, or to get work from my Nursing Agency. I can let a telephone ring for hours and never feel compelled to answer it.

Dessert: What level of responsibility do you have in your job?

I'm responsible for the care of 12 patients at a time, and the supervision of the three dialysis technicians who care for them. So, mid-level management with hands-on aspects.

~~JD~~

Tuesday, March 25, 2008

Man Declared Dead Feels 'Pretty Good'

Sometimes I can't improve on the title of a post. I've had a couple of these things happen to me in my twenty-some years of nursing, where a patient I was caring for woke up and remembered me talking to them. It's always weird when it happens, and it doesn't happen often -- but it does reaffirm your faith in hope when it does.

I have to admit, my mind is awash with straight lines after reading this article. (I'll try to limit my responses, though . . . ) From the Associated Press via Yahoo News:

Man Declared Dead Feels 'Pretty Good'
Mon Mar 24, 10:09 AM ET

OKLAHOMA CITY - Four months after he was declared brain dead and doctors were about to remove his organs for transplant, Zach Dunlap says he feels "pretty good."

(Like "six beers later" pretty good?)


Dunlap was pronounced dead Nov. 19 at United Regional Healthcare System in Wichita Falls, Texas, after he was injured in an all-terrain vehicle accident. His family approved having his organs harvested.

(Six beers later and an ATV ride and your organs get harvested. Sound like Saturday night in South Texas to me.)

As family members were paying their last respects, he moved his foot and hand. He reacted to a pocketknife scraped across his foot and to pressure applied under a fingernail. After 48 days in the hospital, he was allowed to return home, where he continues to work on his recovery.

(Ah, don't we all.)

"I feel pretty good. but it's just hard ... just ain't got the patience," Dunlap told NBC. Dunlap, 21, of Frederick, said he has no recollection of the crash. "I remember a little bit that was about an hour before the accident happened. But then about six hours before that, I remember," he said. Dunlap said one thing he does remember is hearing the doctors pronounce him dead. "I'm glad I couldn't get up and do what I wanted to do," he said.

(A Monty Python moment flashes across my brain. "No, I'm not!")

Asked if he would have wanted to get up and shake them and say he's alive, Dunlap responded: "Probably would have been a broken window that went out."

(Or broken up a Doctor and put him out!)

His father, Doug, said he saw the results of the brain scan. "There was no activity at all, no blood flow at all."

(And . . . that was different from every other day . . . how, exactly?)

"Just makes me thankful, makes me thankful that they didn't give up," he said. "Only the good die young, so I didn't go."


And on that note . . . . . .



~~JD~~

Wednesday, March 19, 2008

New Blog Alert!


I discovered a new blog today at Digital Doorway. Keith is a Registered Nurse who (like myself) practices mindfulness mediation and nursing (of course.) I'm adding him to my daily reads, so give him a look.

An interesting post here called The nurse as Ogre should interest those of us in Health Care. Take a peek and leave Keith some feedback.

~~JD~~

Tuesday, March 18, 2008

Health Provider Predicts Big Loss; Unions Blame Everyone Else

The Boston Globe reports that all is not rosy in the people's socialist commonwealth of Massachusetts. A new law there requires all hospitals to render care to the uninsured, but only reimburses 70% of the costs.

The result, as you might guess, is diasastrous; or as the Cheif Administrative officer of one hospital put it, "This would be catastrophic."

Health provider predicts big loss
Hospital alliance cites impact of reform law; Could cut 300 jobs, suffer $25m shortfall
By Jeffrey Krasner, Globe Staff / March 17, 2008

Health Alliance, a key part of the Boston area's healthcare network, is facing a potentially "catastrophic" loss this year and is looking to eliminate up to 300 jobs, or about 9 percent of its workforce, in an effort to stabilize finances. The alliance, which includes Cambridge Hospital, Somerville Hospital, and Whidden Hospital in Everett, says it is being hit hard by the state's new healthcare reform law, which has left it responsible for providing free care for those without insurance while reducing the hospitals' compensation for such services.

Before healthcare reform took effect last year, Keefe said, Cambridge Health Alliance was reimbursed by the state for the full cost of providing services to the uninsured. Under the new system, "we only get 60 to 70 percent," he said. The reduction is particularly significant for the alliance because its hospitals serve a high percentage of uninsured patients. Despite the state's efforts to enroll all low-income residents in free or subsidized insurance programs, many still do not have coverage.

Keefe said the hospital was especially bruised in its second fiscal quarter, which ended Dec. 31, when the new payment system for uninsured patients took effect. Government payments for free care to the uninsured fell by nearly $14 million compared with the previous quarter, he said.

At the same time, the number of patients admitted to the alliance's hospitals dropped by about 3 percent, while patients kept overnight for observation - a category for which insurance companies do not pay as well - grew by 48 percent. Additionally, the number of walk-in patients, which do not generate as much revenue as inpatients, also grew substantially in the six months that ended Dec. 31, Keefe said.

During a department meeting last month, the chief administrative officer of the health system's physicians' group predicted a potential loss of $25 million to $35 million for the year. "This would be catastrophic," Dave Porell told members of the Department of Psychiatry, according to the approved minutes of the meeting, which were obtained by the Globe.


Prediction: This will get far, far worse before it gets beter. Some chains will actually begin to pull out of Massachussetts before the legislature repeals or severely amends the act. And, of cousre, the lefties will blame the "evil corporations" for not funding healthcare for the poor.

Hat Tip: And Rightly So!

Thursday, February 28, 2008

Ch-Ch-Ch-Chaaaanges!

I've been experimenting a bit; a phrase which should bring abject terror to anyone who knows me personally.

A bit of background; I work Dialysis three days a week (usually Monday / Wednesday / Friday, and alternate Saturdays). I also manage to squeeze in a shift or two a week at Nursefinders when I can; although the Dialysis schedule makes that difficult. But with Ariane full time at Nursing School, it's become more important for me to pick up as much as I can.

Hence, my lack of posting lately. Time is at a premium. I promise to try harder.

So, I came up with a way to maximize my work hours while keeping my days off. But first, a story from my youth. When i was about, Oh, say approximately 10 or 12 years old my mother worked as a Nurse's Aide at Whispering Pines Nursing Home in Valparaiso IN. During the summer we always wanted to go to the lake, but my mom had to work. One day I suggested that she work night shift, and we could go to the lake during the day when she got off.

"When would I sleep?," my mother asked?

Well, I never did come up with a satisfactory answer to that part; but the idea stayed perched in the back of my mind, waiting for just such an opportunity as this one.

So when I was trying to figure out how to maximize my time with Nursefinders while continuing to work my Dialysis job, that old story popped up in the back of my mind; and the first question that came to mind was, of course, "When would I sleep?" Well, let's see -- I only work three days a week (14 plus hours a day -- but only three days a week) so working alternate days would give me up to four days to work for Nursefinders. Ofcourse, that means I lose my days off, too.

So . . . how about if I just work around the clock those three days I work at the Dialysis clinic? Work 3am to 6pm for the Clinic, and 7pm to 7am for Nursefinders? That way, I still keep my days off (which I can take naps through, and still get plenty of rest that night for the next day).

Much to my surprise, it worked very well. I would do my Dialysis shift; then toddle over to some hospital for a night shift; then nap on the couch till noon; then run my errands, clean the house, or do the laundry, as needed.

So I was getting ready for work the next day last Tuesday night, and after packing mylunch for the next day i took some clean clothes upstairs and put them away. After setting the alarm for 3am I was on my way downstairs and had just taken that first step down when i felt something in my right knee go "POP!"

Pain. Sheer, grey, electric walls of blinding pain. I passed out, fortunately.

I woke up an indeterminite amount of time later lying on my back in the upstairs hallway with a bump on the bak of my head. I started to sit up --

. . . and started crying like a little girl. My right knee was twice the size of my left, and I was sure I'd broken something. We went to the Hospital Emergency Room and got x-rays; fortunately it wasn't broken, but it was severely sprained. The inside of my knee looks like a prune it's so purple. My orthopedist has me scheduled for an MRI tomorrow (Friday), but he thinks it;s most likely a severe sprain.

And he's got me on "no-weight-bearing" crutches, which has really screwed up the Nursefinders thing. For some reason most supervisors have a problem with a nurse showing up on crutches. No, I don't know why . . .

The good news is I've found a TON of time to work on my book this week. Expect an excerpt later this week.

~~JD~~

Tuesday, February 05, 2008

Tales From The Nursing Shortage; Part VIII

Star Trek says that "Revenge is a dish best served Cold," but I think it's more like "The best Revenge is Living Well."

One of the places I work has a State Monitor because the previous administration pretty much ran the place nearly into the ground. As part of their agreement with the State, they are paying an independent "expert" RN to drive down from Dallas and observe anything we do and be a "Resource Person" when we have questions.

With this RN, it's more like completely ignore anyone is not an RN themselves; and God forbid one of the lowly males has a question. I asked her a question one time and after she was done rolling her eyes and making dismissive noises, she berated me publicly for five minutes and followed me around the rest of the day, commenting on everything I did and savaging my work. And that's fine -- she has her opinion, and I have mine (which is almost always backed up by state regulations or Department of Health procedures, as she quickly found out.) But I don't complain, I keep my head down, and I do my work.

So one of the things she got all over me for was re-using a single-dose vial. This is one of the things that's different in Dialysis from regular Nursing. When we give medications, they're almost always IV push. One of these is Epogen, a synthetic hormone to make red blood cells so the patients don't get anemic. (Just one of the many things the kidneys of a Dialysis patient used to do for them, but don't anymore.) Your average patient receives between 2,000 and 10,000 units of Epogen every treatment (that means three times a week.) Epogen costs about roughly $1.15 per unit.

So these patients are receiving anywhere from $2100.00 and $11,000.00 in medications per treatment. So if you think we're about to throw away a single dose vial with thousands of dollars of unused medications in it, you're out of your mind. The CDC agrees, and has given Dialysis clinics a 4-hour window to re-use a single-dose vial.

So this State Monitor came over and told our Administration that "Single-dose means Single-Dose -- we don't re-enter vials!" and they bought into it. I didn't disagree -- I'm just the temp, why make waves? I did bring it to my supervisor's attention at the time, and he told me to just follow her directives and they would double-check on the regulation.

Now here it is six weeks later, and the Vice-Presidents from Corporate were asking about our medications procedures, so they all walked over to my station. One of them asked about dating and timing the bottles when they are opened, and I told them I did, except for the single-dose vials which are thrown out.

"You throw out the single-dose vials?"

"Well, yes, the State Monitor told us to." And I recounted the conversation to them. You should have seen their faces go white as they calculated the amount of money lost in the last six weeks by this idiot Monitor. (Fortunately for them, I had continued to re-use the Epogen vials, so we were only losing about a $1,000.00 a month, instead of tens of thousands a day!)

So they've started an investigation into this State Monitor to see what other "inaccuracies" she might have told the staff as well.

Heh. Life is sweet. Sometimes you just have to wait for it.

~~JD~~

Wednesday, November 21, 2007

Happy Thanksgiving

I heard the announcer on the radio refer to today, the day before Thanksgiving, as "Thanksgiving Eve." When did we get to this place, where we've accorded an almost religious significance to an American cultural holiday?

When I was a child in school, we got Thanksgiving and the Friday thereafter off. Today my son gets the entire week off, while my wife gets only the two days off from University of Texas. Obviously it's not a commonplace phenomena; but it's taking hold in some places. And, of course, in my chosen profession of nursing, it's almost an irrelevancy for most health care workers. I'm working tomorrow, but Ariane isn't because it's her regular day off. I'm covering for someone attending a funeral. The motivation for me to work is time-and-a-half pay, which is a very powerful motivator. I've worked probably half of the Thanksgivings my professional career -- and most of the Christmases.

This is not a complaint. I'm actually Thankful for the work, and for having a steady job. The first Thanksgiving was all about being Thankful to God that they'd made it across the ocean and survived the horrific winter of 1620, as well as rickets, scurvy, and god knows what other diseases.

So, what are you Thankful for?

I'm thankful I have two good-paying jobs, and more work than I can handle. I'm thankful I'm continuing to lose weight, and that my diabetes is under control. I'm thankful for a far better wife than I could ever hope to fall in love with, and a son who is even now cooking Thanksgiving Dinner in the kitchen -- in between studying Chinese, Japanese, or violin. I'm thankful for our new kittens, the dog, and for the Grace of God. I'm thankful for the house we're going to bid on next week when the legalities are taken care of. I'm thankful for two working cars in good condition with good mileage.

I'm thankful I live in beautiful south Texas where it's 65 degrees right now and balmy. Every view is scenic; every person is friendly; and there is work out the ying-yang for somebody not afraid to get tired.

And I'm thankful you're reading this. Leave a comment what you're thankful for.

~~JD~~

Thursday, October 18, 2007

Nursings's "Dirty" Little Secret, Part II

From today's Vidette Times, although I've seen this tory literally EVERYWHERE the last two days as well:

Deadly infection is real, but is it a cause for panic?
Thursday, October 18, 2007 2:10 AM CDT

BY HEATHER AUGUSTYN: Times Correspondent

In 2005, nearly 19,000 Americans died of invasive infections caused by a drug-resistant bacteria, according to a study released in the Journal of the American Medical Association. Even more alarming is that this bacterial infection, known as methicillin-resistant staphylococcus aureus (MRSA), caused more deaths than AIDS.

But local doctors and public health officials say that this study may be misleading. MRSA infection rates may be on the rise, but deaths are not. "I do not find an epidemic of death," said Dr. Daniel Smith, director of infection prevention for the Munster Community Hospitals. "MRSA is usually never the cause of death. It's misleading. Death could be from diabetes or anything else. Can MRSA cause death? Yes. Have I seen it in the 25 years I've been here? Not in the last three, four, five years. People have died who have also had MRSA."

Smith says the difference in this strain is the way in which it spreads. "We've had MRSA here for a while and I don't think it's any more resistant than it has been. It's been this way for 15 years, but this strain releases a toxin that causes more skin abscesses. We have seen MRSA cases double or quadruple over the past three years in the community, and so we're seeing an increase in MRSA patients," Smith said.

As a result, Smith says his staff has implemented methods to decrease the spread of MRSA and all infectious diseases. "We place the patient in isolation so the infection is not spread from one person to another, and we emphasize hand washing -- not just with soap and water but with an alcohol gel that kills 99.99 percent of all germs, including MRSA," Smith said.


If this sounds the least bit familiar, it's because I blogged about this six weeks ago HERE. The decrease of hand washing in Nursing is spreading this little bug everywhere in hospitals. The decline in kids showering after gym class is spreading the bug likewise in gym classes and subsequently through schools.

An interesting point I've noticed in this story; I've heard this reported variously that either MRSA "kills more people every year than AIDS" as reported above, but several more liberal news organs (like the San Antonio Express-News) report that MRSA is only "approaching the levels of deaths by AIDS."

Hmmmmmm. Protecting a constituency, are we?

Anyway, the bottom line: Soap - And - Freakin' - Water. Kills the bugs every time -- no bacteria is immune to them, or virus, for that matter. Just wash your hands, nurses -- and for God's Sake, take a shower, kids!

~~JD~~

Tuesday, October 16, 2007

"The Ratchet Line"

One of the nurses I was working with last week coined this phrase -- and I love it. We were talking about the point where a nurse can give a patient care and the point where a patient can refuse -- even though that action will harm or even kill the patient. Refusing dialysis; being noncompliant with their medications; continuing to drink with cirrhosis of the liver; and other equally dangerous practices are frustrating for nurses as we watch the patient literally kill themselves. Yet when the nurse insists or attempt to "do what's best for the patient," they can face assault charges.

The other nurse called this "crossing the Ratchet Line," which means they've "crossed the line between being a good nurse -- and becoming Nurse Ratchett, the fascist witch from hell.

"The Ratchet Line." I like it.

~~JD~~

Thursday, October 04, 2007

Welcome to the Nursing Shortage, Part 99

I worked a double (16 hours) for the patrician Movement Drug Detox Monday, got three hours sleep, then doubled back for 8 more. Then the rat-bastards (who had reserved me for two weeks through Nursefinders) cancelled me Tuesday afternoon.

So I immediately started working full-time at the Dialysis clinic. Worked 14 hours today (Thursday), and I'll work the same Friday and Saturday.

Sunday is a double (16 hours) for an Ortho hospital for Nursefinders.

Thank God I have Monday off. I need the sleep!

I'll catch up this weekend. Must-sleep now . . . !

~~JD~~

Wednesday, September 19, 2007

Politics and Nursing

I get occasional e-mails from Jerry Lucas at Male Nurse Magazine. "Male Nurse Magazine" is an online magazine that deals with nursing issues from the perspectives of male nurses.

They also have a small selection of 19 videos on Youtube (HERE) where Jerry and others discuss topics of the day. This video is about the difference between a nurse and a politician.



If you liked that, check out the other Youtube Videos as well.

~~JD~~

Saturday, September 15, 2007

Great Moments In Nursing, part MXVIIII

Offered with only the comment that somehow, it doesn't surprise me. Considering the rampant liberalism in the Nursing profession, this is the inevitable result of the Free Love Generation 40 years on.


Nurse Charged with Sex with 16 Year Old Boy

Jonesboro, AR - A nurse at the Consolidated Youth Services is accused of having sex with a 16 year old boy.

Laura Elizabeth Newberry, age 32, faces 1 count of first degree sexual assault. Court documents state Newberry has sex with the juvenile in an empty CYS classroom on July sixth. Newberry posted a $1,500 bond Tuesday and has been released from custody. If convicted, she could face 10 to 40 years in prison.


Ten to Forty years? I'll believe THAT when I see it; especially in Clinton-Land!

Hat Tip: Interested Participant