5 West Nursing

Growing up I remember fond memories with my mother. Although she wasn’t home a lot because of her work being a college physician, she always made a point to spend quality time with us. I’m sure she’d rather be home most of the time, however, when duty calls, she had to respond to it even at 2 in the morning. This is one of the reasons why early on I decided not to pursue medicine even when my parents wanted me to follow in her footsteps, or be in the medical profession for that matter. Ironically, I ended up being a nurse. At least I don’t get called at 2 a.m., and with a 3 – 4 day 12-hour work schedule, I get to spend some time with my kids.

I’m sure you have fond memories of you mother too. I’m sure you can remember the joys and pains you caused her has you grew up into adulthood. I know she had her fair share with me, and if not for her love and patience, I wouldn’t be where I am today.

So to all you mothers out there I’d like to salute you and greet you a Happy Mother’s day. There is nothing so dear, so sweet, so nurturing as a mother’s love.

Unless you’ve been living under a rock for the last century, I’m sure you’ve seen at least one movie in your lifetime. That being said, we all know that what we see on the big screen is a culmination of weeks, even months, of hard work by a group of people who came together to create that spectacle we call a movie.

Unfortunately for those who worked behind the scenes, all the audience remembers are the people who had the leading role. What most people don’t realize is that, these so called movie stars wouldn’t exist if nobody put them on a pedestal. And although looks and talent may be a big factor in their rise to stardom, it is their fans and the people behind them that makes them look good, an important ingredient to achieving celebrity status.

In the field of healthcare, you can say that the “stars” of the show are nurses. I’m not saying that because I am one, but rather, because it is the way it is. At the end of the shift it is the nurse that gets remembered by the patient, just like a movie goer would remember the star who had the leading role. And just like a movie goer who would judge the actor’s performance as excellent or poor, a patient also makes judgements about the nurses’ performance based on their experience with the nurse.

Don’t get me wrong. I’m not saying that the people who work in the background are trivial… far from it! In fact, it is the people in the background that make or break the performance. Just think about it for a minute…. You can have stunning special effects, but if the actors aren’t talented the scene starts to look phony. Or, you can have great action, but if the music sucks, the scene sucks. On that note, you can have a star nurse, but if the pharmacy doesn’t deliver that pain medication on time, what can your star nurse do? If xray takes 48 hours to get a report to the chart because it is the weekend, who is to blame? If a bloody dressing cannot be reinforced or changed because central supplies failed to stock the unit, would the patient have to wait till the next day?

Regardless of what department you work… don’t get fooled by the cliche, “we are here for the patient”. NO… the NURSE is here for the patient… you are here for the nurse! Hate the idea, but I believe this is reality. Each supporting department is here for the nurse… labs, pharmacy, xray, housekeeping, central supplies, dietary, information services, you name it. Without the cooperation and full support of these departments, the nursing department suffers, and subsequently, the patient suffers. 

I’m sure you work at a hospital where nurses are held in high esteem, where the nurses’ success is everyone’s success, where management treat nurses as assets instead of liabilities, and where departments work together to solve each other’s problems. But then again, it’s a dog eat dog world out there, and for the most part, nurses are fair game and oftentimes get the short end of the stick unlike movie stars who get the red carpet treatment for their life-saving performances… ya. At least as a nurse, I get to go to Walmart without the pesty paparazzi.

We’ve all heard about Obama’s first kill… 3 pirates shot dead. Today the crew of the Maersk Alabama came home to their families… no US casualties, it’s a good day!

For the first time the President did something right… I wonder if the ACLU is going to be on him for ordering the slaying of 3 poor pirates. I hope this sends a message out there that if you mess with America, be prepared to accept the consequences. And although I don’t see how our President is making sense with all that he’s done ever since he took office, I would have to say, “good job Mr. President, you did right on this one!”

Incidentally all throughout the country people are holding Anti-Tax Tea Parties on tax day. Personally I don’t have anything against taxes, after all, Jesus in the Bible said “… Give to Caesar what is Caesar’s, and to God what is God’s.” (Matthew 22:21). I do have a problem with higher taxes, especially when it is used in wasteful spending. If we only gave 10% of our income to the government regardless of how much we earn, and if the government gets spending under control, I believe this will work and will be good for everyone.

Regardless of what you are celebrating today whether it be the return of the Maersk Alabama crew or the beginning of Tax reform in the US, I hope this day was a good one. I know I had a great day today… spent all afternoon at the Houston Space Center together with my daughter and her 3rd-grade classmates, part of a 3-day field trip. What could be better than that?

It’s official, the “war on terror” is over. Our president in his infinite wisdom suggests that calling it the “war on terror” offends people, so, to show the whole world how weak America has become, we call the “war on terror”, “overseas contingency plan”.

That’s sad because growing up, my perception of America was this big brother with strong shoulders who fought for freedom, coming to the aid of those who are too weak to defend themselves, fighting those who threaten to destroy what America stands for. So much for calling it the “land of the free and the home of the brave”. If the president himself cannot stand up and call evil by its right name, who will?

How about you?

There is no doubt that we are living in tough economic and political times. Most experts are saying that we are headed for a depression. Others say, we’re headed towards socialism. Yet most say it’s all Bush’s fault. Regardless of what you believe, I believe there is no greater time to be a Democrat.

You see, Democrats have had control of Congress for the last 2 years and much more now since the last presidential election. With all the proposed spending, our president, with the bidding or the speaker of the house as well as other interest groups that helped him get into office, has clearly shown us that he is ready and willing to drive the country into the ground blaming the previous administration for the mess we’re in. It’s like blaming the last shift nurse for not doing their job. Nevertheless, to be a Democrat, you need to master a few things. Here are a few fundamental core values of being a Democrat:

1) When things go well claim all the credit. When it doesn’t just say “we’re all in this together” because it’s about America.

2) If the proposed solution clearly wouldn’t work or is void of common sense, blame the Republicans for not coming up with an “alternative”.

3) If Republican’s proposes an “alternative” that could possibly work or solves the problem, just reject it and remind them who won the last election.

4) If Republican’s reject a proposal, just tell them they are “un-American”.

5) Don’t work hard. The government will spread the wealth around.

6) Don’t pay your taxes unless you’re up for cabinet appointment.

7) Democrats are perfect… it’s always someone else that makes a mistake.

Now if everyone was a Democrat, wouldn’t you think we’ll be living in a perfect world?

As I come to work today someone had told me that our big boss (aka director) is a patient on the 7th floor. “No way” I said. “You better believe it” said my co-worker. I did a quick search and sure enough, her name appeared (HIPAA, what HIPAA?).

It turns out that our boss was going for some type of sugery in the morning. Hmmm I hope she doesn’t end up in the ICU. But then again maybe she should end up in our unit… after all, she runs the place and maybe, just maybe, she’ll find out for herself the frustrations we as nurses have to go through. I could only imagine it right now…

Boss patient: “Nurse I need my pain medication STAT.”

Nurse: “Sorry boss, the pharmacy hasn’t profiled it yet. I already called 3 times and the Pyxis doesn’t have it. Don’t worry, it’s only been two hours since I scanned the order, they usually have it after the third hour.”

Boss patient: “I want a bath.”

Nurse: “Sorry boss, you’ll have to wait, we didn’t have towels and wash cloths when we started our shift. The morning shift used it all up and didn’t bother to replenish them. Do you mind if I used pillow cases or top sheets instead?”

Boss patient: “Nurse, my dressing needs to be changed.”

Nurse: “Ok boss, but can that wait until the morning? Our supply room is lacking supplies. Apparently the morning shift used up all the 4×4 gauze, abdominal pads, and tape without replenishing them. The hospital central supplies department closes at 5 p.m. Besides, no one has bothered to order supplies for the last 2 days, oh yeah, it was the weekend. Actually, the supplies did come, but they just stack the boxes instead of stocking the selves. Do you mind waiting a couple hours while I search for them in those boxes?”

I don’t know about you, but we nurses are supposed to be the company’s “front line soldiers” when it comes to providing care and representing customer service. Problem is, how can we do that if support services like central supplies, pharmacy, or even labs don’t back us up. Regardless of who dropped the ball, it is always the nurses’ fault when patient’s care gets delayed. Is it fair? Definitely not! Does it happen everywhere? No!

I came from a hospital that is well stocked, well supported, and well managed. Pharmacy delivers the meds within 15-30 min, not hours. Time lab draws get done… on time, and central supply rooms are always stocked, just like shelves at Walmart. And to top it of, it was a non-profit community hospital to say the least. Here at MMC, we make profit… on the expense of either the patient, or the nurse. I don’t think even the CEO cares about what is going on in the front line as long as the numbers are right. What ever happened to the “Service Excellence” ideals that we’ve heard about during our orientation?

Despite this I can say that in my 4 years of working here, it has been a lot better. I can say that this hospital is a lot better from when I first started here because of the fact that I’m here!

Patients are treated right because I treat them right…

Things get done because I make sure it gets done…

Equipment gets fixed because I make sure it does, and when they don’t, I just write my director up. She’s bound to listen.

Overall, I think this place could improve a lot more and I know it will. How can it not, I’m here! Fortunately for MMC, I’m not the kind of nurse that bends over and take it up where the sun don’t shine. I’m sure you’ll do the same thing. But then again, I’m 5 Wester, and you’re not!

If you’re a nurse, I’m sure you’ve seen one of these… you know, those things that seem to jump out of nowhere when you’re not looking while you make your way down the hall. They’re also known as WALLaroos.  (Little did I know that a wallroo  is actually an animal a little smaller than a kangaroo and a little larger than a wallaby.)

Well, the WALLaroos at our hospital litterally jump out of sight. I came in the other day and all you find are four patched holes on the wall, a tell tale sign that marked where they once were. When I asked a colleague what happened, he told us an interesting story…

As the day progressed, the relative quiet was broken by a crashing sound coming from down the hall. Upon doing a quick survey of the area, they found a doctor, someone well known in our hospital, on the floor, unconscious, with a WALLaroo beside him. He was apparently making rounds and was writing his progress notes on one of those things when he leaned forward and ripped it off the wall, hitting him on the head and knocking him unconscious, according to witnesses. Frantically 5 women nurses rushed to his aide, all of them probably hoping to give him CPR my colleague said. He was then taken to the ER for further evaluation and treatment. I guess in an effort to please the doctor, the hospital took all the WALLaroos out the following day. I wonder if they’d do the same if it happened to a nurse. I’m sure they would, but then again nurses are liabilities, doctors are assets, and therefore, they could care less about the nurse.

I’m just glad these occupational hazards are out of service. I know a few nurses that have been sent to the ER for sustaining minor injuries because of these things, especially when left half closed. It’s just sad that it had to take a “high profile” doctor to get hurt before the hospital decides that WALLaroos have to go. But then again, thanks to this doctor’s sacrifice, the rest of us wouldn’t have to. Way to go doctor… way to go!

“Stupid is as stupid does.” – Forrest Gump

I never knew what that meant. Some attempt to explain it as “the quality of your substance”, or that you shouldn’t judge the book by its cover but by its content. I guess you can say, “if it looks like a duck, smells like a duck, and quacks like a duck, it must be a duck!” Philosophy aside, we experienced what stupid did one night.

We got an admission from the ER at 0600, one hour before the end of the shift. The admitting nurse stumbled upon a vague order as she was getting report from the ER nurse. Here’s what the order read:

“Give small dose of Lopressor and repeat EKG when heart rate is slower”

Surprisingly, this order was carried out by the ER nurse claiming that it was the previous shift who wrote it. On top of this, the patient did get a dose of Lopressor (documented on the MAR) despite the fact that the order did not specify what “small dose” meant or defined the meaning of  ”slower heart rate”. Eventually it was written up as a medication error. I’m sure you’ll agree that the ER nurse should have clarified the order.

What can I say? I guess sometimes we just have to get back to the basics and use common sense. In this case, I think I know what Forest Gump was saying about stupid. It’s a good thing that in our ICU…

“Nursing is as nursing does!”

“Change we can believe in!”… that’s what some leaders in Congress are saying as the new $700+ billion stimulus package passed and is on its way to Pres Obama’s desk. Speaker Pelosi praised Obama for acting faster than anyone else to help jump start the economy with this huge spending bill. Way to go Congress… we just dug ourselves into a bigger hole! On the other hand, isn’t it comforting to know that this bill has a 50/50 chance that it might work? If it does, then Obama’s the hero. If it doesn’t, then he can kiss the next 4 years goodbye! What a gamble… I give him props thought. I believe this was a very gutsy move.

After all the usual partisan bickering, Pres Obama calling the delay “inexcusable and irresponsible“, Republicans opposing the bill because of too much “pork”, it’s finally here. Interestingly enough, nobody truly knows what’s in the bill. Incidentally, I received a reader comment on a portion of the bill that touches on healthcare which I found interesting. Here’s the link thanks to Michele.

Speaking of “pork”, have you heard some of the things that were included in the bill? Most of them sound like only a few people will benefit from it… mostly the “rich”, some business owners, and those special interest groups. One of my friends told me that this stimulus bill isn’t an economic stimulus bill at all. With all the “pork” infused in it, this bill sounds more like payback for those who “supported” Obama financially and helped him get into the White House. No wonder they wanted to get this thing passed ASAP! Well what can I say… let’s brace ourselves and hope for the best. What’s the worse thing that can happen at this point? Time will only tell!

I’m sure you’ve seen it all over the news. Congress has been working on a new economic stimulus package that’s going to cost us close to a trillion dollars, a bill which most Obama administration critics call is the end of capitalism and the dawn of European socialism in the United States. I didn’t think that this was going to happen, however, it would seem like we are headed in that direction thanks to the influencial president, er, speaker of the house Nancy Pelosi. Sometimes it makes me wonder who is behind this bill because president Obama is so far removed, it seems like Pelosi is the one that sits in the oval office. I guess that’s what we get for electing a president who spent more time campaigning than actually getting things done in the senate. Regardless, there is no doubt that president Obama is off to a rocky start… yup, blame it on Bush… that’s if you’re a pinhead. (It’s OK, you’re not the only pinhead around! ) Remember, power in numbers!

Talking points aside, I decided to be part of the solution. Instead of having this “I’m entitled to a handout because I’m a victim” mentality I have actually used my noodles to cook up an economic recovery/stimulus package that will solve most of the issues that plague America today. Ready for it? Here it comes…

I present you the 5 Wester Economic Recovery Package!

What is it? It’s a person on a stationary bike, pedaling away to power up the generator which provides a current to charge the massive 110 volt battery which stores energy, which will eventually make its way to electric distribution centers, which will power our homes! Brilliant, ain’t it?!

How will it solve our current economic crisis? Here’s how…

1) Helps create jobs and keep them in America – it will help create millions of jobs (sky’s the limit), and best of all, it cannot be outsourced! Imagine a few thousand of these units that make up the new power plants of America? In the last few weeks we’ve seen companies slash thousands of jobs, one company, 4000, another 6000, yet another 20000 jobs. With the above setup, there is no excuse that able bodied people will be unemployed.

2) Good for the environment – now we can have really “clean” energy production and decrease our dependence on foreign oil. The only waste created is metabolic waste (you know #2), which is environmentally friendly and biodegradable! You don’t have to worry about global warming on this one.

3) Positive health benefits - not only will it help create jobs, keep them in America, and decrease our dependence on foreign oil for energy, it also has positive health benefits which will lower the cost of healthcare. Now burning calories not only benefit the individual, but the whole community as well. It’s a win-win, what can I say?!

4) Applicable to other industries as well – the future of the automobile is not flying cars or alternative fuel hybrids. No sir! The Flintstones already figured this out!

And there you have it, the 5 Wester Economic Recovery Package!

It is so ridiculously simple and radically brilliant, it will never happen in America. I guess well just have to wait for the government to figure this out. In the meantime thousands more will lose their jobs. Oh well, what can I say?

Hmmm… I wonder if I can sell this idea to China. Just kidding!