Wednesday, September 28, 2011

Ding Dong, the Witch is Dead

This is in very poor taste, but remember the guy who was threatening to come to my facility and kill his wife (and anyone who got in his way) and then himself?

He's dead!

He had a heart attack. Not that surprising since he kept checking himself out of the hospital AMA in order to go back home and threaten his wife and family and us some more.

I know, he was probably once a nice guy, and obviously was suffering from some kind of mental illness. But he refused help over and over again. And I think it's fine that I want someone off this planet that is wanting to come and shoot one of my demented little old ladies.

And now he is. I'm not sorry. It's a huge relief not to have that hanging over my head at work anymore.

Wednesday, September 21, 2011

Floundering

I had my face-to-face interview over at Father Sainty's yesterday morning, and it went really well. The unit manager was the one who interviewed me, and she told me that I did really well and (with the prioritization scenario) answered it "just right". I should find out at the end of this week or the beginning of next week whether or not I'll be offered the job. I'm thinking I will be, which is wonderful - I can work 24 hours a week instead of 36 and make around the same amount of money. I'm going to need that extra time for homework if this week has been any indication ...

Going back to school hasn't been as smooth sailing as my professional life has been. First I found out that my financial aid wouldn't cover my Bio class (deadline was 0800 to register for it, but I'd been waitlisted and so I went and got the instructor's signature at the first class session at 1100. Too late). I freaked out until I realized I don't even need that Bio class. WHEW! The prerequisite for me to take Anatomy and Physiology I next quarter is Chem 121, which I'm in right now. Thank goodness it's my only class, because I'm woefully behind in the math.

We did an 8 problem assessment quiz in class to see how well prepared we were and I didn't even know how to do any of the 8 problems. Algebra was in high school, which was a long time ago. Instead of bursting into tears and running out of the room, I stuck around for the lecture, and then did the in-class group exercise (conversions using the dimensional analysis method and significant figures). Since this was new to all of us, I did fine with that. I just don't know how to write things in scientific notation, but my textbook should be able to tell me that, as soon as I go buy it. I stayed after and spoke to the instructor, who told me that if I'm willing to work hard and use the extra online resources, I can learn the amount of math I need in order to complete this course.

So I'm doing that. And trying not to freak out too badly.

But if I struggle this hard with every class, I can't imagine taking more than one per quarter, which means I'll be at the community college for a looooooong time.

Sigh.

Wednesday, September 14, 2011

Interviews

I just finished my phone screening (pre-interview) for a part-time job at Father Sainty's. I feel like it went really well, and should find out soon if I'll be called for a face-to-face interview or not.

I'm applying for a part time 2nd shift position on the orthopedic floor. The base pay over at Father Sainty's is almost $4 more per hour than my CNA pay at the Great Rep (and $2 more than I make as a Med Aide there) PLUS they have shift differentials for evenings and weekends, which is what I'd primarily be doing.

The lady I spoke to was cool, and we built enough rapport during the phone interview that I felt comfortable asking her my big question:

Since Father Sainty's just implemented CNA's, were any nurses let go in the process? What about LPN's?
I wanted to be sure I'm not walking into a situation where they've fired 3 RN's and hired 10 CNA's. The remaining RN's would start off hating me and all CNA's. Which is not good news, because they're going to be my direct supervisors. Or if they used to have LPN's and decided to do away with them in favor of all RN's supervising CNA's; that would be sticky too.

But they're actually going from an all-RN model to adding some CNA's. They never did use LPN's. And had they fired any RN's for this change?

She said no, that wasn't the case, and that while they had let some people's contracts expire without renewing them, they mainly freed up the budget by letting nurses retire. I hope that's the truth. I should try to get the scoop from my next door neighbor, because she's an RN over there.

Anyway, she didn't seem to be put off by my asking that, and answered as though it were a very reasonable question, which I think it is.

Now I just have to hold my breath for a couple of days to find out if I go get interviewed by a panel (!!!) at Father Sainty's. If I'm offered the job, I need to get details about their health insurance and how much it costs for employees, and then tally up whether I can afford to work part time there with benefits or if I need to stay full time at the Great Rep without benefits (which I'm currently paying the entire premium on).

Wish me luck!

Tuesday, September 13, 2011

Simplicity of success

After 3 long shifts as a med tech at my facility, I went and worked my once-a-week evening shift caregiving, and for the first time, it felt like a relief. We've got multiple residents on a lot of medications right now, many of which would normally be PRN's and therefore not my department. However, one of the nurses wrote them in our book as nursing orders, so for the first time we're giving medications that absolutely must be given at a certain time and that is really stressful with this population. You just never know if or when these people are going to cooperate with you.

So anyway, we've still got the Darth Vader Choker running around. He's a reasonably nice guy a lot of the time, but when he gets combative, it's scary. He's a big man (and remember, he lifted one nurse clear up off the ground by choking her). During report today we were told to "keep a close eye on him" and perform "frequent checks" because he's been peeing everywhere. And housekeeping is getting mad because he peed on the drapes and it's expensive to clean them. I'll file that under "not urgent". If it's that expensive to clean the place when he pees all over stuff, how about NOT ADMITTING people that we KNOW ahead of time are going to freak out when toileted and have a pattern of voiding inappropriately? Duh.

Anyway, Mr. Vader has been on a streak of bad days lately. So when we spotted him dozing on a couch in the hallway after dinner, I suggested to the other aide who was assigned to him that we go try to put him to bed right away, before his meds wear off. We got a wheelchair, because he was all zonked. We gently woke him up, told him we would help him get to bed, and plopped him in the wheelchair.

Once we had him in his room, I started with "Let's take a look at your feet." because apparently that's how his daughter would start his care. He was a contractor for years and years, and for all I know, he thinks he did it today. So I acted as though he had. I said "We want to make sure you didn't step on any nails or anything. Construction sites can be tricky." he was awake now, and agreed. I took off his shoes and socks. I continued "All right, those look good, no problems there. I think we better check your knees too, make sure they didn't get roughed up at all. Can you stand up?" He could, with our help. He didn't even notice that we were taking his pants off to check his knees, was just glad that his knees were okay. We continued like this until he had everything off, used the restroom, washed himself up with a washcloth, brushed his teeth and laid down in bed wearing only a brief. It was amazing. Such a change from his other days. I think if he could be appropriately medicated, he could be compliant like this all the time - he was aware of what we were doing, was doing most of the work himself, and was pleasant to be around.

It was the most successful moment I've had with this guy since he moved in.

And after all the stress of the last few days, it was a really pleasant change - sometimes it's nice to go back to basics.

Sunday, September 11, 2011

Not a 9/11 post

I don't have anything special to say about 9/11 except that death really really sucks. I feel terrible for people who lost their families on that day, just as I feel terrible for the resident at work who's slowly dying from a series of strokes. She had another one today, vomiting beforehand even though I'd given her an anti-nausea drug by mouth before dinner, and the nurse had given her an anti-nausea suppository after the first time she threw up. She vomited a few more times, and then there was that telltale lean, the inability to control half of her body. A different half than last time. And she was so baffled about what was happening to her, and how could she get to feel better, and there isn't any answer.

This woman is a sweet lady with a devoted family.

And it makes me sad, trying to brush her teeth after she vomits and she cannot control half of her mouth while I do it. And it makes me sad, listening to her struggle to slur out that yes, she wants her daughter to come see her now.

Maybe it's easier for religious people once someone is actually dead - they usually say they're "in a good place now". But I don't know if watching the slow, steady decline is easier with a God around or not. I don't know if anything could make that easier; it's just so, so sad sometimes. And sometimes it's not, and I can't make reason of why sometimes it really gets to me and sometimes it doesn't.

If I do end up getting that hospital job, I'll be hoping that having patients for such a short period of time makes it harder to get very attached to them. A lot of the people I take care of now, I've seen nearly every day for about a year now.

And just to top off my bad mood, I got bitten right before the end of my shift, trying to scoop some non-food stuff out of a resident's mouth that she was trying to eat. I knew (obviously) that it was likely I'd get bitten, but I didn't want her to choke or get sick from this. I really hate getting bitten.

So that's my important thoughts for the day: I hate death sometimes and I hate getting bitten all the time. My sympathies for all of you that are dealing with either one.

Thursday, September 8, 2011

Why Not?

Things have been about the same at work; there's a restraining order against the husband of one of my little old ladies, because the husband has been threatening to come to our facility and kill his wife and then himself. He states that he has a gun and is ready to do so. He lives within walking distance of our facility.

It's been stressful.

The new admit, the very combative one, continues to be that way. Some of it is kind of funny, like how he walked around with his underwear outside his pants for hours the other day. But it wasn't funny that he started shoving away anyone who tried to talk to him or help him change them to inside his clothes. And it's not funny that it takes 3 or more people leaping on him in order to complete any sort of care.

My classes start very soon, the week after next! I can't wait. I'm still waitlisted for one of them, but I'm #2 on the waitlist so it should be fine. I'm just nervous about the delay screwing up my financial aid, but I've been in touch with the financial aid office and they say it should be all right.

The biggest news is that I've applied for some jobs at our local hospital. We'll call it Father Sainty's. Over at Father Sainty's, they'd cut pretty much all CNA positions in an effort to save money, which has been a common trend among hospitals these days.

I don't understand it, because why would you pay a nurse much more money per hour to do something an unlicensed person like myself can do - take vitals, reposition, toilet, check blood sugars, etc.? Maybe it's because administrators assume (wrongly) that nurses can do all that AND do the jobs that only they are allowed to do at the same time. Crazy.

At any rate, Father Sainty's must have figured out that if you expect nurses to do everything, everything doesn't get done or at least not very promptly. And I'd expect that patients were unhappy with that. So they're adding back a LOT of CNA positions, and I've applied for every single part-time benefits eligible job they've got.

I have no idea what my chances of even being interviewed are, but I figured it's worth a shot. It'd be great experience, better pay, and include benefits. Which I don't have now.

I know, I know, all CNA's seem to think they should work in a hospital, as if the change in the type of facility is somehow magical and going to get rid of the worst parts of our jobs. I don't think that. I know it'll be at least as hard as what I do now, probably more so. But I've got a couple of years experience under my belt now, so I may as well try to be paid as much as possible at this while I go to school. And I won't be shocked if a patient tries to take a swing at me, or eats their own poop, or does any of the million disgusting things that I've gotten used to working with my current population. I'd miss the consistency of working with the same residents all the time, for sure, and I do still genuinely enjoy and get a kick out of people with dementia. But feeling actually in danger at work has taken away a lot of my daily happiness at the GreatRep. So leaving there wouldn't feel like as much of a loss as it would have in the past.

So, yep, I'm not holding my breath, but wish me luck anyway!