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!

Studying: it works!

I think I mentioned recently that after finding out that my employment at Father Sainty's is no longer such a gigantic helping factor in getting me into nursing school, I decided I needed to pull my grades up. I was getting a B in Anatomy and Physiology and an A- in Bio. That B in A&P was sort of tenouous, though, since I'd gotten a B- on my most recent exam.

I studied like crazy for my most recent exam on bones, and got a 90% on it! If I continue to study this hard and do that well on my remaining exams this quarter, I should be able to get my grade up to an A-, I think. So that's my plan.

Too bad I don't love muscles the way I love bones. I even had dreams regarding specific bones (I was in a butterfly garden but the butterflies were sphenoid bones that were flying around, and I was delighted!).

So while it may be tempting to put work first, I need to remember to put school first. That means if I have to sleep less to study more, that's what will happen. If it means showing up at work exhausted rather than after napping, then that's the deal. If it means eating dinner in the cafeteria instead of cooking and packing my meals, that's okay too.

After this quarter I only have to do A&P II and microbiology. I think I can technically apply to nursing school even with one class left to finish up, so maybe I can apply for admittance next Winter quarter and take microbiology in the fall before it begins?

Either way, I plan to stop working at the GreatRep once I'm in nursing school. That 10-hour workday is just too much time lost. If I can take out loans, i'll do that to compensate for the lost income. I know how incredibly lucky I am to be going to school for free right now, and I know that won't continue forever.

More and more the idea of goign for my LPN and working in a skilled nursing facility or inpatient rehab sounds appealing to me. If I'm going to work and go to school, part of me thinks that work should be the best-paying I'm able to get.

Either way, I'm back on board with school!

And here's a visual for anyone wondering about my dreams: they're a cross between this



and this

Best of Both?

I had a rough, rough shift at work last night. Was working with a nurse that is new to our floor, and coming from a floor that's notorious for having RN/CNA conflicts up the wazzoo. So I made time to sit and catch up with NewNurse when he came on shift halfway through mine. I already had 13-14 patients of my own, and the way we have it set up, all the call lights come to the CNA's first. If we don't answer, then they are forwarded on to that patient's nurse. So you can imagine how busy I am on these nights. Of my 13-14 patients, I'm likely to have at least 5 diabetics who need their blood sugar checked before meals and at bedtime. Another 2-3 who are confused/fall risk/non-English speaking. And 4 or 5 who are fresh post-ops, which means they're in a lot of pain, bed bound, and possibly needing to be strapped in and out of devices to move or steady their joints.

NewNurse got pissed at me for two things, one of which I think was valid (although I had no way of knowing about it) and the other which was absolutely not; one of our regular floor nurses scoffed at NewNurse when she heard him getting angry at me about it in the nurses' station.

Anyway, everything turned out fine, all my patients were okay (although one did give me a terrible scare, then when it became clear that my fear had been because of one of the machines giving a wrong reading the first time, the patient asked "Are we in trouble? I'll cover for us. What should I say?" which made me laugh despite how upset I'd been).

But I'm now mentally comparing that to my shift last week when I filled in over at the inpatient rehab unit (physical rehabilitation, not drug or alcohol rehab). I had such a mellow night, I was able to cover most of the unit by myself. And if I got tied up with something, the nurses were aware of it and went and did things for their patients themselves. I even had time to help a very sweet older lady get her Kindle working again, which delighted her!

It was more like a nursing home, in that it's lower acuity and the patients are there for longer periods of time. But it's a smaller unit, so that makes teamwork easier. And it pays at the rate of the hospital, not at the rate of a nursing home.

Is inpatient rehab the best of both worlds? Less stress, more time with patients, and the same pay and benefits?

Could be...

Mountain, not a molehill

Today I'm feeling like I've bitten off more than I can chew this quarter. I'm taking Anatomy and Physiology I, and an online bio course, so that's 10 credits total. I'm working full-time, 3 shifts a week at the hospital, and one at the Dementia Facility.

On a typical day, I get up at around 7:30, get ready, catch the bus to school, get home from school at around 11, and then study/eat/nap until time for work at 15:30-23:30. I try to get to sleep by 1am, then do it again the next day. And lord, am I tired. I've fallen asleep on the bus, nearly fell asleep in the bathroom at work last night (the auto flushing toilet woke me up with a start and I LEAPT to my feet!) and in general am just so tired and feel so behind on everything.

Next quarter, I'm going to only take one class because I can't afford to cut back on work and I want to really learn this stuff and do well in my classes.

There's all this weird drama in the nursing program at my Community College, where the previous director of the program just finally "stepped down" aka got fired, and a new one is taking her place. The new one is my academic advisor, and I like her quite a bit from what I know of her in that context, so hopefully she can turn this ship around. Right now the nursing program's retention rates and NCLEX pass rates are very poor. So in many ways I might be better off going to a different community college, but Father Sainty's will either help pay my tuition at my current community college or at the University. If I want to go to the University, there's a couple of extra prereqs I need to take (including Chem 131 - yikes) and it would be a long commute to take classes there all throughout nursing school.

Anyway, all of that is something I shouldn't be worrying about this early on. If I don't focus on the present my grades will suck so badly I won't be able to get into school.

Work is going pretty great though. I just (belatedly) had my 90-day evaluation at the hospital with my nurse manager, and it went quite well. I got some nice comments on my peer reviews including "Pollyanna is soft spoken and calming to patients" and one about how I'm pursuing my education and always happy to share new things I've learned. So those both make me feel really good!

I feel so, so lucky every day to be working on the floor I'm working on. Our charge nurses are awesome, the floor nurses are easy to work with and appreciative, and the majority of our patients are motivated to work hard toward their recovery goals and get back to their lives as soon as possible. I like being able to help them with that.

And this week in A&P we're going to start studying the skeletal system, which I'm very very happy about since I hear the terminology at work all the time (about fractures and where they are and what type and so on) but don't understand it. So I cannot WAIT to put cell respiration behind me and move on to something that feels more relevant to real life!

Code: Disaster

Winter kicked my little town's ass this last few weeks. I know, everyone jokes about how we are such wusses about snow in the Pacific Northwest, but the thing is, we are never ever prepared for it. We don't have the infrastructure in place to handle it well. It's not just the snow, or the unplowed roads, but the fact that we have approximately 8 trees per square foot* and a lot of them fall down during storms and knock out our power.

So this last week was a special week at the hospital, as a disaster code was called. That meant all staff on premesis was not allowed to leave. People were mandated there for 30+ hours, sleeping on the floor wherever there was room for a short respite after 12-16 hours of work.

AWFUL.

I wasn't there during this, and had no way of getting there, which suited me just fine except that I felt so badly for my coworkers who were carrying all that load understaffed. In spite of this, they made it, and did well.

The thing that I found most touching was that we all got these desperate emails begging us to come and donate blood, because obviously all the regular blood drives out in the community weren't able to happen. Much as I hate needles in me, I wanted to go and do this, but again, had no way of getting to the hospital.

The other day I got an email from some muckety-muck about how that turned out - the big hospitals from the nearest Big City had some donors (3-10), one of the local Big Companies, had around 20 donors, and our hospital had 70+!! By far the most of any facility that did the emergency blood drives. And this was all from employees that couldn't leave. The email referred to us as "the little hospital that could".

And with that, my heart grew three sizes and I vowed to donate the next time the van is on campus at my school.



*scientific and accurate. Totally.

Ahhh, Winter Break.

Tomorrow I'll be back on campus, doing Anatomy & Physiology I, and also doing Bio 100 online. Winter break has been so, so nice. Just working gave me time to catch up on things like cooking, making gifts for my family members, going and helping out my Grandma with cleaning her apartment, etc. I'm almost sad to go back to school even though I know I need to. I expect this quarter to be really hard, because I'm doing 10 credits and working full-time (75% at the hospital 25% at the dementia facility).

I'm hoping to have at least one classmate from my chem class in my A&P class to study with, since most of us were on the prenursing track. But all the ones I talked to at the end of last quarter were going into a different A&P class, dang it. We'll see. It's just nice to have a familiar face around.

Yesterday we closed our store for New Year's day and I went and helped Mr. Polly clean the heck out of it, as well as rearrange some things he'd been wanting to change for a long time. The co-owner of the store is still out of town (taking care of his aging father) until the beginning of March so that means Mr. Polly has free reign to go nuts and put things where he wants them. He was so happy about moving some shelves and file cabinets! And I scrubbed the bathroom within an inch of it's life. I still want to repaint in there - it has rainbows and unicorns, courtesy of the previous owners. That could be okay I guess but it's so "LOOK WE'RE QUIRKY AND FUNNY" and also the bathroom is tiny and dark so I want to paint it off-white and put more lighting in there. I'd rather have a clean-looking bathroom than an "adorable" one any day.

Besides, everyone knows that acorns are the new unicorns.

Happy new year!

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?

Coming soon, Hospital CNA Polly!

I got the job!!!

I start on the 24th, it's about a 30% pay increase, and I get health insurance for myself and Mr. Polly.

For now I'm tentatively planning to still work at the GreatRep one day a week until I get busy taking more classes next semester. I'm very, very excited and nervous.

Coming soon: orthopedics floor Polly!

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.

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!

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.

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.

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!

In over my head

This has been a tough, tough week over at the GreatRep. We got a new admit, and he arrived under less-than-ideal circumstances; his daughter, the primary caregiver, was out of town. His wife brought him in and dropped him off, not wanting to visit because he'd been hurting her whenever she tried to toilet him. He had orders for meds, but had been refusing all of them.

So he comes from living at home with his wife to us, a decent-sized facility (around 65-70 beds) where we expect him to take his meds, use the toilet, and not hit us.

None of that happened. We quickly realized, after he had one of our charge nurses pinned up against the wall, choking her and lifting her off her feet, that he was going to require at least 3 people to change him out of his soiled clothes when he was incontinent.



In a hospital setting, or a psych ward, when a patient does something like that, you can medicate that person by any means necessary. In our assisted living facility, they must agree to take their meds orally (unless they have an order indicating otherwise, which this guy does not).

Things seemed to be calming down a bit after that, and he even cooperated with care in the evening one time, after the nurses began putting his evening meds in his desserts so he would actually take them in.

Then, randomly, on day shift, he punched a female caregiver in the face, and then in the back of the head when she tried to run away. Knocked her down, cut up the inside of her mouth from her teeth. She didn't quite black out and yelled for help, dragging herself to the door. It was awful. If I were in charge, that would have been the point where I'd have sent this guy on his merry way to the hospital with police there to assist the medics during pickup.

Instead, they updated his care plan to require and assist of 2+ people with all care and implemented more behavioral meds.

I was livid.

We had a meeting, and the DON was able to state her case and change our minds, even mine. I swear that woman is tricky as all get out. Plus she personally had been doing his care all day long by herself and will continue to do so, which gained her a lot of respect from the rest of us.

She laid out a specific, comprehensive plan to help him acclimate to our setting, and promised that we are NOT expected to stay in a situation where he'll hurt us, and if that means something doesn't get done, then so be it. I also understand that a gero-psych eval is not out of the question if we're not able to resolve the combativeness in our setting. Okay. Stressful, scary, unfortunate, but okay.

Then the bad news kept coming; another new(ish) resident of ours, "Linda" has a husband who lives independently but within walking distance of our facility. And he's telling anyone who'll listen that his plan is to come to our facility, shoot his wife, and then shoot himself.

This is about the time when I seriously considered just getting up from this meeting and going home.

Apparently Mr. Murderer may or may not be hospitalized right now, but of course he can go home, and then to our place, at any time. The good news is, he can't figure out how to use the keycode to enter the building, even though from the outside, the code is posted right above the keypad. So that gives us a grace period in which to see that he's the one knocking on the door trying to get in and call 911. Unless another visitor is being helpful and just lets him in.

Working in dementia, there's a certain amount of "I'm tough" attitude that comes with the territory - we deal with people who get combative for no good reason. That's just how it is. And usually the benefits outweigh the occasional injuries.

But this week has been so screwed up I didn't want to go back to that place. I don't want to be punched and knocked out, or choked, or shot. And I feel about 88% sure that I won't be. Which isn't really sure enough to make me happy about going to work again on Friday. Ugh.

Day 9 - things that make me go gray

9 - What's something that you worry about for the future?

This is embarrassing, but the idea of global warming makes me so scared I want to go hide in my bathtub with a blanket over me, as if it were a tornado. I know I already do pretty well on not making a gigantic carbon footprint (I'm vegan, drive a low-emissions car and don't travel much, live in a small apartment, walk to most of my errands because I live downtown, and will be taking the bus to and from school once I start classes, and buy most of my clothing secondhand). But it's never enough. If I think about it in depth, I get an overwhelming terrified feeling and get dizzy. That's dumb, I know.

The other thing I worry about often is whether I'll be bitter and burned out by the time I finally finish my prereqs and get to apply to nursing schools. My financial aid/tuition waiver has been reduced from up to 18 credits a quarter to down to 10. So I can take 2 classes a quarter for the next 3 quarters. Upside, this will make working full-time totally possible. Downside, I won't finish all the needed courses in three quarters. So I'll be working and going to school ... indefinitely. I like my job still, but I have days when I think "I'm so glad this isn't what I'm going to do with the rest of my life. I couldn't spend every day forever in here". Or days when I just want to hide from the sundowning residents that are yelling at me when I tell them they can't go home, because home isn't there anymore. I want to keep my drive and keep my enthusiasm. I worry that I'll get worn out before I even get a chance to finish my schooling.

But whatever, right? I mean, worrying about it isn't going to prevent it, and I'm doing the best I can right now. So I'll keep finding those funny moments every day, and concentrate on keeping my GPA as high as I can make it, and suck it up. I can do this.

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.

And on my day off, I talk about ... me!

I've got several friends right now who are online dating, and one who just married a man she met that way. One of these friends is very, very smart and keeps an interesting blog about her process of going from newly-divorced to dating at: Struck by Lightning 2.0. Her recent post about statistics reminded me that she'd previously linked to a really interesting site where you can participate in positive psychology research by taking some inventory questionnaires about your own happiness: Authentic Happiness Tests.

I generally score pretty high on happiness, which probably won't surprise those of you that know me or read this blog regularly. Even though there are some really difficult aspects of my life, on a day-to-day basis I'm very happy. I love Mr. Polly tremendously and have a great time with him, I feel that I'm doing the sort of work I'm meant to do and that I'm taking steps toward being where I want to be (in nursing school), I love the town I live in, and have good friendships. I do have some troubled family relationships at time, worry about Mr. Polly's disease, and am constantly frustrated by our neverending medical debt. But overall I feel that most of that is something we can overcome.

But my positive psychology scores aren't really the stuff I'd put on a dating profile, or anything that I lead with when I meet new people. I just took a Briggs-Myers test again and scored as an ISFJ (Introverted Sensing Feeling Judging) type. Apparently I'm a Guardian Protector type. I don't know if my reserve is actually very obvious to others, but I feel it. I've been at my current facility for 6 months and, although I like a lot of my coworkers, I only have the phone number of one of them, and he's the only one I've considered socializing with outside of work so far. I've gently turned down other invitations because I just don't know if it's worth it to me since nursing homes are often such little drama hotbeds. So I wait a long time to see if I hear someone gossiping or being a jerk before I decide if I want to hang out with them. That's pretty reserved, I know, and sometimes I wish I were less so. But I'm cautious that way.

One of my friends that's online dating has her type on her profile (INFP) so maybe that's a decent way to give someone a shorthand of who you are. I'm partly thinking about this because down the road I foresee some "I want to be a nurse because" essays in my future for scholarships. And no one wants to read "because I want to help people" over and over again. So I could say "because I 'have an extraordinary sense of loyalty and responsibility in [my] makeup, and seem fulfilled in the degree [I] can shield others from the dirt and dangers of the world' but also because I find it funny when old ladies come up and try to hand me a handful of poop and I can look at a stage 4 tunneling wound (and smell it) without vomiting. Give me some money for education!"

That'll go over well, don't you think?

Or "Our premarital counselor told me that even though I seem sweet as can be, I'm secretly made of cast iron."

On second thought, it's a good thing I have a long time to work on these pitches, and it's a really good thing I'm not trying to find a husband online. Although, wealthy gentlemen of the world, if you are reading this right now and thinking "I wish I could marry Polly and pay her way through school then let her divorce me and remarry her own Mister" send me a comment and we'll talk. This applies to well-to-do ladies living in states where gay marriage is legal as well, of course.




Maybe this blog is the best scholarship app/personal ad ever in life. Ha.