Watch out for WOLFS

It's been another weird weekend over at the hospital, y'all. As I've probably mentioned on here before, weekends are the time when all my nice, normal, elective joint replacement patients are not there. So weekends are when I am either floated to another unit or I stay on my own unit but we get atypical patients there (OB-GYN issues, medical problems that don't involve bones, etc.)

Last night I got sent to another unit to do a one-on-one with a very large, schizophrenic patient with a history of methamphetamine use. I'll just let that sink in for a few minutes, shall I?

I spent 8 hours in a hospital room alone with someone who, on paper at least, I would normally sprint away from.

And boy, was it an unusual night.

As I soon discovered, my patient had quite a fascination with "wild animals". Since my patient was a little edgy, I took this person on about eighteen million walks around the floor to try to burn off some nervous energy, toting along the IV pole with us each time. On one of these jaunts, a framed poster of a baby animal that looked like some sort of canine caught my new friend's eye.

"Oh, is that a hyena? Look at him! He's so nice and symmetrical. I've never seen a hyena. One time I saw a wild animal that was like a bobcat or a wildcat or a mountain cat. I saw it walk by the window here too [note; we were NOT on a ground floor level]. One time I saw an Orca whale in a lake. They don't usually live in lakes, so I took a picture of it."

This proved to be a fruitful topic, so my patient thoughtfully provided me with more tidbits throughout the evening:
"If you were by the woods you might get picked off by a wild animal. Like some wolfs. Or mountain bobcats. You should really be careful. If a wild wolf comes out of the woods, you give it a cookie. If it takes the cookie, it'll just, like, go back into the woods. If it doesn't take the cookie, point to the lake. It'll go jump in the lake. I saw that happen but then the bobcat got eaten by an orca whale. In the lake. The whale just ate it all up. It was weird."

My patient had the flattest affect during all this, and consistently called wolves "wolfs" very clearly. I checked in with a nurse at one point to find out if perhaps this person was messing with me, and nope, the nurse said this patient was a bit of a 'frequent flyer' and advised me not to laugh at any advice or stories the patient told me.

We made it all through my shift just fine. Then tonight, in the cafeteria, I saw another CNA who works that unit. She said that my wild-animal-expert patient was pacing the floor, ranting, and attempting to get dressed in all sorts of things because the patient believed it was time to leave.

WHEW! I dodged a bullet there, didn't I? So glad I got floated last night instead of tonight!

I'm on it.

I'm off training and working on my hospital's orthopaedics floor regularly now, and I LOVE IT. Love, love, love it. I love that no matter what the problem is, there's always someone there for backup. Not sure how to use that whatchamacallit? Ask someone. Need a bariatric-sized something or another? Ask the unit secretary to call for one. Patient getting combative? You can always call security. We never run out of the basic stuff I use to care for patients (gloves, linens, hygiene supplies) and I'm never left completely on my own to just deal with a situation. It's great. That's the benefit of being at a facility many times over the size of the GreatRep, with all different sorts of staff available.

I've also gotten to see some pretty amazingly gross stuff, like the patient who came in with the complaint of "My toe is missing. I think maybe the dog bit it off". Sure enough, the whole thing was missing, and I could see the bone right in the middle of that toe stump. I get a lot of darling little old ladies who are getting hips repaired or replaced and who are just delighted to have a young lady being the one who helps them to the bathroom. We don't get all that many amputations, which is kind of too bad because I think those are really neat and I want to see how people get back to their regular activities after one (but that's more of physical therapy/rehab deal).

All in all, I'm being exposed to a lot of new conditions/procedures/equipment and the nurses on my floor are quite nice and pleasant to work with. I feel so lucky that I happened into a floor where patients (usually) go home happier and healthier than when they came in - it makes for such a different dynamic than I've experienced before. And I have health insurance! For myself and Mr. Polly both!

NKOTB

I've started training on my actual floor of the hospital, caring for real live patients. I've learned how to use (most of) the equipment there, including my first ever go-around with electronic charting and fancy-schmancy vitals-taking machines. I have yet to have a patient accept my offer of a bed bath or a shower, so maybe these people just like to be dirty or maybe they're too high to move or maybe they just don't wanna get even a little naked in front of me? Hard to say.

Tomorrow I'll have 8 patients to care for, then for my last day of training I'll have the full 10 (my normal load).

And so far, no more fainting. Not at the blood bank, not after chugging up all the flights of stairs in the "tower", not when someone was admitted with their toe already missing, not any fainting at all. Yay me!

Now if I can just navigate the whole time-management aspect and deal with nurses who are unused to delegating anything at all, I'll be golden.

Whew!

First week of hospital orientation

I finished my first week of hospital orientation, which translated into multiple 8-hour days of class, basically. Seriously, I finally got a tour of my unit the last day, AFTER everything else (except restraints) had been covered.

And how was all this class, you wonder?

Pretty cool, for the most part. We're the pilot program of them implementing CNA's at Father Sainty's, so every single one of the CNA's for my floor was hired and trained all together. So it feels like we're a graduating class together after all these days of orientation classes together, which is neat. Dayshift, swing shift, and noc shift all got trained and oriented together for the pre-floor stuff. We learned new things (bladder scans!) and slung each other around using the overhead lifts in the patient rooms. Good times!

Now for the humiliating news: I passed out. Cold. In front of every single other CNA on my floor, two nurse educators, and one of my managers. It was AWFUL. We were in the classroom and I have a needle phobia.

I do okay when someone is actually in front of me bleeding or has an IV inserted or whatever, but that's because I can move around to keep my BP up, and because I know I'm responsible for them and cannot faint. I've cared for someone through a compound fracture and been okay. But when it comes to the classroom setting, when someone verbally starts describing blood draws or the like, I get woozy. Even if I'm listening to a nursing podcast and they get too graphic, I have to change it or I'd be a danger on the road.

So not only do I have a crazy phobia, it's ridiculously specialized; a DESCRIPTION of blood and needles phobia.

So our nurse educator is merrily telling us how to do glucose checks, and going on and on about it, and about how we may not "milk" their fingertips to get more blood, and I was getting woozier by the second. I trying to hang on as long as I could, then I figured I'd better get out in the hallway where I can put my head down without anyone seeing me. So I stood up and started walking towards the door.

Who can guess how that turned out?


Yep, I woke up flat on my back on the floor, with people over me going "Are you okay Polly? Are you okay???".

So. Freaking. Unbelievably. Embarrassing.

So now one of my managers thinks I'm going to do this while working the floor, and the rest seem undecided. All I can do is prove them wrong. And once I do, hopefully this will become a funny story about way back when I first started working at Father Sainty's.

Oy.

Two Days Left

I've only got two regular days left at the GreatRep, and then my orientation at the hospital on Monday and Tuesday. I'm planning to still work one day a week at the GreatRep, because they'd like me to and I could use the extra income. Today I was looking at my residents and thinking about how much I'll miss some of them.

And then a call light went of because Mr.UberCombative (the one who Darth Vader choked a nurse) was attacking two CNA's with a full size floor lamp and they'd locked themselves in the bathroom to get away from him then hit the call light for rescue. And then while I helped the remaining CNA from that wing hunt down our charge nurse (he ended up grabbing the DON and the Administrator to deal with that fun situation) I found the charge nurse, who pulled me into another bathroom to help hold up a 103 year old woman while she digitally disimpacted her and avoided her resulting mule kicks as she screamed "That was HURT!" at us all. Poor baby, I bet it really, really did! She was waaaaaaay backed up.

And then I hustled my butt over to where I was originally supposed to be doing what I was originally supposed to be doing (helping the less able residents drink their ensures for snacktime).

Whew.

I don't expect the hospital to be a cakewalk. But I do expect to be assaulted a lot less regularly.

Cross your fingers for that, anyways!

A few minutes after all this, I saw our maintenance man walking down the hall, having confiscated said floor lamp. He looked PISSED. I wonder if he has a special room where all the furniture that's been used as weapons goes for "time out" the way I used to put toys that the kids were fighting over in "time out" for a while to let them all calm down?

Yeah Buddies!

I got my first Chem exam back, and scored an A-. I'm thrilled by this! The first two chapters, what the test was on, involved me relearning all the algebra I'd forgotten since high school. Plus all the regular chemistry topics we were all learning in the class.

Now that we're past that part, the following chapter on naming compounds, Lewis diagrams, and predicting molecular geometry are way, way easier.

Plus my lab partner is really nice; she's a CNA also, and works at a skilled nursing facility. We were swapping stories about the weird residents and the most horrifying post mortem cares we've done, and it's great because we're both 'returning students' (she's in her thirties) so we're both actually motivated to do well in the class because we've got other stuff to do besides goof off.

Work today was sucky.

One of the CNA's that's been at the GreatRep for a few years was fired this week for getting into altercation with a resident. WTF? I haven't heard any details, so I don't know if she just snapped, but the resident she was yelling at is very compliant and nonverbal, and never combative. Not like it's ever okay to really yell at someone you're supposed to be caring for, but if that person had, say, slapped you across the face with their wet brief and then spat on you, one might understand raising your voice a smidgen more than your heart tells you is right. But I can't imagine that anything like that had happened, given who was involved in this. Bizarre.

And yes, the brief-slapping thing is real and did really happen. Not to me, thank goodness. But the resident who did it is alive and kicking. And told me last week that she would like to "shoot [me] with a gun and make a beautiful mess out of [me]". I just sighed and rolled my eyes. That's her horrible, horrible baseline.

I cheer myself up by talking to the adorable little lady who asks for cocoa by calling it "kokomoko". So cute!

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.

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!

Day 4: Hell yeah I have a J-O-B

Day 4 -Do you have a job? If you do, what is it and do you like it? If not, what job would you like to have?

I have a job or two. Actually, technically I have three: I'm a CNA and a Med Aide at my facility, and I work in homecare on the side on-call.

I like my jobs. My favorite is working as a med aide, although that's the most stressful because I'm expected to juggle a wide variety of responsibilities as I'm doing my primary duties. But it's the most fun, too. My regular CNA days working the floor are usually fine. There's a few residents and coworkers I don't like dealing with, but that comes with the territory, right? And homecare is a mixed bag; it tends to be either spectacularly easy and pleasant (am I really getting paid? Right now?? To sleep in a bed in a waterfront condo and wake up for q3hr turns?? WOW!) or horrible and making me rethink my life choices (I drove all the way out here to BFE to take care of a woman in this filthy scary house and her son is showing me how to stand her up and telling me not to "play with her butt"? I clearly took a wrong turn somewhere in my past to end up here. For the next 6 hours. If I ever survive this and get home again.)

If I didn't want to work in healthcare, other jobs I would enjoy:

1. Vacuum technician at a vacuum cleaner store. I loooooooove tinkering with vacuum cleaners and seeing all the different kinds that exist in the world. I did hours of research before buying each of my (2) vacuums that I've ever owned as an adult. I can change the belts, clear clogs, etc. in no time flat. I'd be so enthusiastic about this job, I bet I'd get tips.

2. Mortician. Turns out I'm not at all afraid of dead bodies. And I'm getting better at telling family members bad news every day.

3. Working for the phone or power company to be one of those people that climbs up the phone poles or goes up in a cherry-picker to work on the transformers and to cut back tree branches that are threatening to knock down the lines. I like heights, and like being outdoors, and would like learning to work with electronics, probably.

4. Police officer. I haven't done any of this, although I did intern at a couple of juvenile detention centers and used to work with frequently incarcerated teenage boys. I can be authoritative and set clear boundaries, and am not one to panic when a violent situation breaks out. I think I'd really enjoy feeling like I was serving and protecting those that needed it, but then again, most people that get arrested are usually really, really annoying - trashy, long-winded, refuse to accept responsibility, etc. Also, just because I can keep calm during an emergency doesn't mean I'm not disturbed by it later. Like when one of my boys stabbed the other through the arm with a fork at the dinner table. Yuck.

All in all, I'm happy where I'm at. I never, ever want to work a desk job. I want to be up moving around and using my hands.

I wear a lot of hats. Today, literally.

The funny thing about working as a med aide at my facility is that I do a lot more "side work" (as it used to be called when I worked at Denny's back in the day) than I ever anticipated. My primary job is, and always will be, to complete my 3 med passes per day. But in addition to that, I basically fill in any gaps that need filling. I take phone calls from irritated family members who for whatever reason would rather talk to me than the nurse. I handle all the non-prescription type treatments that need to be done in a day (anti-itch lotion on one lady, mouthwash at a certain time of day for another, etc.). When the caregivers can't get a resident to do something, they ask me to do it. When the nurse can't get a resident to take their meds, they have me try it. And when, like today, someone calls out and we're understaffed, I run around like mad trying to get as much done as possible while still medicating all my old folks.

My notes to myself, on days like today, probably look like I'm delusional.

"Violet can't figure out chair - get urine?" then "UA neg. watch for more hallucinations. No bears this time."

"Confiscated several forks from Sally's pocket. ↑ Aggressive?"

"Spoke with Mildred's granddaughter via telephone from 0930-0950. Same old crap."

"Velma requests I cancel her flight to Copenhagen. Give her paper and pen for anxiety?"

"Beth finished her antibiotics. No luck. Still a mess! Is it her birthday?"

Luckily for me I don't have to file these notes. I distill them into something coherent and get others to follow up on what I actually meant by all that.

Today my main "side work" was to do something we call 'out to lunch bunch' which I think is pretty ironic given that it's a dementia facility. They're ALL out to lunch, permanently, right?

But anyway, now that it's nice weather out, we take a small group (who're able to and will enjoy it) out to the courtyard for lunch every day. Since the rest of the staff is serving/feeding/cueing in the main dining rooms, what the med aid does is start noon pass a little early, then go outside with a cart of food and beverages and serve the meal to the lucky bunch.

It's actually really pleasant, and a lot of the residents do really well out there; they like being outdoors, it's quieter, a smaller group, and I have time to really sit and talk with them as I help them eat their meals. Pretty sweet. The cutest part is that, in addition to sunscreen, we've got all these big floppy sun hats with fake flowers on them (the population is about 97% female at my facility) to also help protect them from the sun. Yesterday one of the ladies didn't want to wear her hat, but she really, really wanted me to. So I did. And when I popped inside to pick up some more milk, my coworkers threatened to take my picture in the hat and post it all around the facility. And the internet. And in our facility newsletter. So I wore one again today, just to teach them all what cool really is.

It's pretty much this:

There. Now you know what cool is, too.

P-P-Pollyface has a P-P-P-Plan

The other day I got to play that dancing game for the kinect at a friend's house, and it is SO FUN. But now I think everything in a Lady Gaga way, which is why the title of this entry is full of P-P-P's like P-P-P-Pokerface. I also have been saying scu-ruh-huh-huh-hubs instead of scrubs.

Anway, the point is I have a Plan. Remember how I said I needed to get my butt into school to be a nurse so that I don't have to work this hard for this little money for the rest of my life? Well, I'm registered.

First I'm going to finally go get my CNA Certification, which will get me a (tiny) raise at my current job, and make me qualified to work in a Skilled Nursing Facility if I decide to leave my current job for a different place. I'll also be qualified to work in a hospital but that's more of a pipe dream; most CNA's would like to work in one, but pretty much every CNA works in long term care instead.

Secondly, I did my admission to our local Community College for fall quarter of 2011 to start doing my prereqs. Yeah buddy! I'll keep working while I'm in school, of course, so I'll probably just do one class per quarter. We'll see. I need to get good grades in them so I can be admitted to that baccelaureate program I want to get into to convert my BA into a BSN. So if I want to be a Straight-A Polly, I should probably make sure I'm also Has Time To Sleep Polly.

Look at me, I'm bettering myself! Not buttering myself. Maybe if I buttered myself, I could join the Haus Of Gaga. But buttering myself wouldn't be vegan. Or pleasant.