March 24, 2009

14 Minutes and 58 Seconds

Several have asked if I'm still enjoying school. (The LPN to RN program.)

For the record, YES, YES, YES.

My motto continues to ring, "Bring It On", but perhaps not quite so fast. ha ha

I'm getting pretty tired and would enjoy a little break sometime!!! We don't get a spring break, but every 15 weeks, we get one week off. My next week off is the last week in May. I do get every Friday off from class or clinicals, but it seems that day is so packed with catch-up things to do that I'm busy from morning till night too.

This week I've been stressed more than usual. I've had test in every class AND a couple papers to write that required a lot of time and effort. I also did a photo shoot on Sunday that was a blast (baby Jack), but wore me out - even though I had help carrying all the camera equipment. I still have to get those pictures ready, but the photos look so cute! I can't wait for Jack's parents to see them.

Today, I had my mid-term evaluations at clinicals (nursing home), and I worried about that one so badly, it almost made me sick. (It turned out excellent!) The last test of the week (dreaded A&P) is about 12 hours from now.

I tend to get anxious with test-taking, but at least I didn't end up in the emergency room with heart palpation's this week! No. Just feeling stressed mentally and worn out physically.

Most of all, I really miss my boys who live too far away to visit very often. (It's been a couple years since I've seen my boys!) We talk most every week, but I don't bother them during the week because they're busy teachers.

Today I mentioned to my angels that it sure would be nice if one of my boys would call. After a flurry of 55's coming and going during the day (most of you know what that means), I got the call from youngest son about 4 p.m. He asked how I was doing!!!! (It's usually catching up on the boys that takes up most of the conversation.) We chatted about ME (mostly) while he drove home from school, and now I feel SO MUCH better!

That brief moment in time (14 minutes and 58 seconds, according to my cell phone), made all the difference.

Thanks PC! You made my day happier and lighter!

Always remember, the moments you 'give' to someone may mean more than you know! Make them worth it.

(Picture) A favorite photo of my boys, Billy & Philip, taken about 30 years ago, sits on my bedroom dresser where I see it first thing every morning and last thing at night! (I don't care how badly they needed a haircut.)

Take Care on the Journey,
~Linda/"Mom"

Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com

March 16, 2009

New Posting at My Coupon Blogsite

Hope you didn't miss the new posting at my coupon blog CLICK HERE called, Shopping For Seven Sisters.

Take Care on the Journey,
~Linda

Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com

March 11, 2009

There's A Mousetrap in My Med Cart

(I thank my hubby, James, for suggesting the theme for this story and offering ideas. He has listened to many of my nursing stories over the years and can relate to my feelings.) This story, as posted at my blogsite http://dustyangels.blogspot.com/

There’s a Mousetrap in My Med Cart

As some classmates in our RN nursing program gathered around in a small group this morning, I sided up and listened to a story that quickly carried me back in time when I was a newly licensed practical nurse (LPN) just learning how to manage my time as I passed the early morning medications.


The law requires that all meds be given within one hour before or after the medicines are due, and this often creates a lot of stress for busy nurses. For instance, the 8 a.m. meds can be started at 7 a.m., and the med pass, for however many patients you are assigned to, must all be given by 9 a.m., or the facility you work for is out of compliance with state regulations and subject to censure.

Many of my classmates have recently gotten their LPN license and are now RN students. They have not had experience with passing medications or time to learn some tricks of the trade that come with years of ‘working the med cart’.

The story this morning was told with tears streaming down my classmate’s face that expressed more than words could ever tell of how disappointed she was, as a student nurse, to have not completed the assigned task of giving meds to her 17 patients in the two-hour window of time.

Ah yes. I had to turn away as I could not keep my eyes from swimming with empathy while my heart filled with understanding.

Her story will be repeated every day by many nurses, especially LPN's.


I call it, “A Mousetrap in My Med Cart”.

My fingers are burning to tell this story in hopes that other nurses will feel better knowing that many of us have felt the pressure of that ticking mousetrap in our carts!

…Wishing the tired, sleepy, night nurse would hurry it along, I heard report on my patients just like I did at the start of every shift at the nursing home where I worked 7 a.m. to 7 p.m. three days a week.

There was a new admission in Room 5. The patient in Room 10 had fallen during the night and would need vital signs and neuro checks every two hours. Room 11 had ants crawling along the window that would need spraying today. There was a new patient in Room 13 who wanted pain pills more often than she had them ordered.

Time was ticking, and I knew the mousetrap of time would be set in my med cart on the dot at 8 a.m. I wanted to have my blood pressures taken before I started my med pass. I hoped I would have time for a quick check on each of my patients by then too.

As I prepared my cart and checked for supplies, a tiny little mouse scampered beside me when I ran to answer the phone from an impatient doctor who wanted to leave orders ‘with the medicine nurse’. ...At least the patient in Room 13 could have her pain pills more often now.

I had 19 patients this morning, and the first patient had to be wakened from a sound sleep.

“Why do they wake you up to give you sleeping pills?’ she grumbled.

“I need my pills crushed in applesauce,” she said in a more agitated voice as she almost threw the pills back at me.

Back at the med cart, I was somewhat confused because two of the meds were enteric coated, meaning they should not be crushed. I wondered what the other nurses were doing about that. Maybe I could convince her to swallow them whole if I did some patient teaching about enteric-coated pills.

In the next room, my patient was sound asleep, but I did not have to disturb him because he had a gastric tube (G-tube) and was on constant tube feeding. My problem was that his powdered medication would not dissolve in water! I stirred and stirred. I added warm water. Maybe it would dissolve while I did a placement and residual check of the tube. But no, the powder continued to float on the top of the water. Finally, I just poured the mixture into the tube syringe – and it promptly clogged up!

Just then his wife stirred from her sleep in the chair and said, “You have to mix it with hot water first.” Why hadn’t someone just written that on the medication record? Now I had to spend several precious mousetrap-ticking minutes unclogging the G-tube!

“Please help me to the bathroom. I’m going to mess this bed if I don’t get to the bathroom,” my next patient begged.

By law, the medication nurse isn’t supposed to be helping patients to the bathroom while passing meds. But tell that to someone who’s holding the back of their gown and slipping off the edge of the bed. I turned on the call light and felt that mouse getting bigger as it ran down the call light string toward my fingers.

Due to a sleepy, slow-voiced, night nurse who took 45-minutes to give report, I hadn’t had time to check any blood pressures, and my next patient had a medication that was certain to lower his blood pressure very effectively and quickly. I would not give this med without checking to see if his blood pressure was already low.


Shucks. It was 80/40. Too low for the medication. Too late, I realized I had put this pill in with his other meds, and now I had to figure out which one it was AND make a place to chart the low blood pressure because no one had done it before now. I also had to chart why I didn’t give the medication. And, I had to do another patient teaching about this medication to the patient when he got upset because I held the med.

Already it was almost 9 a.m. and the mousetrap in my med cart was rattling around every time I opened a drawer. I could smell the sweet cheesy odor on the trap, and I could feel the mouse allusively nearby!

Patient seven had more pills than Carter has liver pills – as we like to say about patients who take more than 10 pills at one time. This one had 20 pills that had to be laboriously checked and rechecked against the medication record. I put a dot on each space on the med record to indicate each pill had been accounted for. I would put my initial in each space after I gave the meds. I hurried into the room almost tripping on the fast-moving mouse as it ran ahead of me and dashed under the bed.

“Now what are these for?” asked my patient as she dumped the pulls onto the sheet for a re-count and explanation. Several small white pills slipped silently to the floor and rolled out of sight under the bed.

Do I chance getting bit by the hungry mouse as I get on my hands and knees and peer into the darkness? All I see are two beady eyes reminding me that the trap is still set. If I don’t find the pills and discard them, housekeeping will report the pills to the supervisor, and she will be sure to match them against who was suppose to have given them. I brave the mouse and return to the cart for new pills.

A half-hour later, in Room 14, my patient is asleep on his left side with a pillow stuffed against his back for support. There is a trocantor pillow strapped between his knees – a sure sign of a recent hip surgery. I cannot turn him by myself. We need to use the log-roll method of turning to prevent injury to his new metal hip.

Locking the med cart, closing all the med books, and covering any evidence of confidential patient information open to public view, I kick at the imaginary mouse under the cart.

“I know what time it is, but you won’t get the best of me. I’ll conquer you yet!” I hiss as I hurry down the hall to find help with my patient.

I’m quite aware that the medication is a simple stool softener than could be given at noon when the patient is up in his chair for therapy, but someone put it down as an 8 a.m. med because it’s given once a day. I could skip it and no one would know – except I would know!

Twenty minutes later the patient is positioned up in bed, the pill is given, and I can move on to patient number 15 (of 19).

The clock says it’s 10:00, and I have no more time to finish passing my meds, and still be in compliance. The second hand of the clock looks suspiciously like the long, brown tail of a mouse!

Biting my lower lip to stop the quiver and pushing back tears filling the corner of my eyes, I collect the meds for my next patient.

“I asked for a pain pill 45 minutes ago! Why can’t anybody do anything around here? I called my doctor, and he said he gave you new orders for my pain pills. I want the number for your administrator!”

"I’m so sorry you had to wait. I know you must be in a lot of pain. I’ll get your pain pills right now. In fact, the doctor said you could have two. Would you like me to bring both pills?” I reply in the most tender voice possible, although in a bit of a quandary because I can’t remember my patient's name at the moment.

“No. I’ll take one now and take the other one later if I need it,” replies the patient who is unaware that the request will would require another clarifying order from the doctor, because he ordered two pain pills to be given every four hours.

I’m sure I hear a nest full of squeaking baby mice under her bed as I hurry back to my cart to sign out one narcotic pill.

My last room has two little ladies who are comparing notes on their care.

“I’m suppose to take my meds with food,” one says to the other. “And I had breakfast hours ago.”

“I take three different kind of eye drops five-minutes apart,” adds the other patient as I walk through the door.

I turn back to find some crackers and milk at the nurses station.

After delivering the meds with food, I search frantically through the half dozen drawers in the med cart for the eye drops. I feel faint and nauseated. It’s almost 11 a.m. and that mouse is still dodging my every step and getting bigger by the minute! I’ve been up since 4 a.m. with nothing to eat or drink so far this morning. The prescribed eye drops are nowhere to be found! I strongly suspect that the night nurse put them in her pocket and didn’t check her uniform before she went to bed for the day.

I circle my initials in the space for the missing eye drops and wonder what I’m going to write as my reason for not giving the meds. And, I wonder how my patient will react when I tell her that I can’t give them now.

It’s almost time to start noon meds, and I’ve just finished morning meds – some of which are the same! Do I give them again?

It looks like the hall is becoming darker as it seems to fill with monster-sized marching rats, but it’s only my supervisor who asks how it’s going and offers an encouraging smile and a snack for my break.

I wait for her comments that I’m out of compliance or that I will have to do better if I’m going to work this hall. But instead, she carries a steaming cup of hot coffee hand in one hand and offers me one my most favorite dark chocolate candy bars with the other.

“May I borrow your keys to the med cart?” she asks with some mischief in her voice. “I have some mousetraps to remove."

I would remind my classmates and myself, as new RN's and possible supervisor of LPN's,... May we always remember to remove the mousetraps.

Take Care on the Journey,

~Linda

Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com

March 10, 2009

Finally, Becoming a Nurse

(As posted at my blogsite http://dustyangels.blogspot.com/)

My friend, Buffy, asked me how school was going when I visited her at the hospital on Monday. She had a beautiful baby girl and both are doing well. I met the ecstatic biological parents who were staying in the room next to Buffy, and I got a peek at baby Ava as she slept in her mother's arms.

Yes, I was pleased to report to Buffy that school is gaining strength and moving forward at a very fast pace. Finally, we are off the med carts at the nursing home and, after an hour or so of the backbreaking vital sign taking, we got to review charts, assess patients, work on care plans and learn about the many kinds of arrhythmia's of the heart!

Our classroom instructor showed us some great Youtube sites where we can learn and interact with the video of EKG's and interpretations of the heartbeats on the EKG strips. I'm anxious to go back to the websites and learn more! I already know some basics, but we are starting from the beginning in class.

A very good link is HERE for anyone who might like to see what we do in class. (Music is a big part of it.) It might sound boring if you aren't trying to actually understand it. LOL

For tonight, I have lots to get ready for school in the morning so will close for now.

Hope everyone is keeping strong and being positive in life.

Take Care on the Journey,
~Linda


Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com

March 8, 2009

Video #2 - Sheba Looks For Billy

A Little Play On Words... Video by Linda Meikle March 8, 2009.
As posted on my website http://dustyangels.blogspot.com

Sheba always perks up when we mention "John" or Billy". Today was no exception as I inadvertently mentioned Billy's name as I was taking this video. She is totally blind and her painful hips make it difficult for her to get up when she's lying down. But, she gets up and 'looks' out the window (patio door) when I mention Billy's name.

Hey Billy, get the hint? We miss you!

Enjoy the part where I couldn't figure out how to turn the camera off. It looks like Sheba is trying to tell me something...

video

Take Care on the Journey,
~Linda

Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com

Undecided

Sheba's "Funny-Bone"

video

Video by Linda Meikle as posted at http://dustyangels.blogspot.com

Thanks, Billy & Colleen for the contribution towards the Flip Video so we can post family fun on our websites!

We purchased our Flip Ultra Video Camera this afternoon (after finding it on sale this week at Best Buy). This was the first video taken while Sheba cooperated fully at first, but fizzled out quickly. I figured out how to add (canned) music, but not sure this is the version I'm posting.

Hopefully it doesn't take too long to upload for you and the sound comes through okay.

Enjoy the moment!

Take Care on the Journey,
~Linda

Home: http://dustyangels.blogspot.com

E-Mail: bestnurse@usa.com

March 6, 2009

President Obama and Our Christmas Tree

We had the pleasure of a brief visit from President Obama here in Columbus, Ohio, this morning.

NBC4 of Columbus reported..."Residents expected some traffic issues near the Aladdin Shrine Temple Friday, before and after the ceremony, which started at about 10:30 a.m...Obama and Air Force One arrived at Port Columbus International Airport at about 10:35 a.m."

I drove by the Aladdin Shrine this morning about 8 a.m., and it could have been a proper funeral service with heavy traffic, police cars, police on horses, various types of official vehicles zooming around, and well dressed people crossing the roadway and entering the building. The only difference was the white-shirted officers greeting a line of guests along the sidewalk. (The 25 graduates. Earlier, it was 26. I wonder what happened to one of them?)

And, an electric highway sign beside the road flashing the message, "Private Event. By Invitation Only."

From what I saw later on TV, everybody must have been in place several hours before the president arrived. I watched his short speech as I was taking down our Christmas tree and changing our living room around so we could open the patio door and allow the warm spring air sniff out the winter chill.

Sheba got nervous and upset at the new sounds, so I had to sit on the floor and rub her tummy awhile. Soon she gave me that quick little wag of her tail that means, "Everything is okay now." (It also means, "I understood what you said, but I still wish I could go with you."

I feel like the day is just flying by! The hour-long clothes dryer cycle seems to be taking about 7 minutes today! I still need to go to the bank and close a photography account that they started charging an inactive fee to in January. It gobbled up my $20 and will be asking for more soon if I don't take care of that little nuisance!

For the record (and I'm not complaining about it), at my RN clinicals yesterday, I took blood pressures and prepared paperwork for a patient who was to be discharged today. They say I shouldn't take life so seriously and that I should 'think about the cup being half full and not half empty', when I complain that I'm not getting the proper training as a RN student, So again, I'm not complaining about all the blood pressure experience I got yesterday.

As a reflection, I still remember the excitement of being a student LPN and going on my first blood pressure clinic and taking blood pressures at a Dayton, Ohio, mall back in 1970. I was so proud to meet the public and explain the normal range of blood pressure as I took over 100 blood pressures that day. I was still on a 'high' when I got back to the Flood home, and I wrote about the wonderful event in my little blue diary.

By comparison, yesterday my back went into spasms every time I leaned over to take a blood pressure and when the patient didn't agree with the reading, they complained and asked me to take it over again. (I think I took one man's blood pressure five times!) (Maybe it was the nice attention he was getting?) When I got home, I reached for the ice pack and had to lie down while!

But, I'm not complaining...

Perhaps you already asked yourself why I was taking down our Christmas tree on March 6. It's real simple. Hubby and I enjoyed the sparkling lights in the corner of the living room during the long cold winter. We agreed to leave the tree up until we decided it had been up long enough. Today being the first day to reach almost 70 degrees, we agreed it was time to take it down.

It's also time to get the clothes out of the dryer again and head out for errands before I pick up Jim at the bus stop.

See the local TWITTER here that occurred while President Obama was in town this morning.

Take Care on the Journey,
~Linda

Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com

March 4, 2009

Mr. President. I Have Your Name and Number

Bohecker College - Columbus has a new president as of last Monday. (Yep. I was tempted to hold out on the suspense...) Dr. "R" as I will call him, is considered a "troubleshooter' (that should tell you something) and is an interim president until things are on a more even keel. Yes, our Bohecker-Columbus education experience has been a little rocky, so someone to lead at the helm is more than welcome!

Dr. R brought his nine-member team of staff members with him to the classroom today and introduced each one promising that the administrative employees of our college will "keep their office doors open" for us - something not seen much in the past. He has already (in three days) addressed some issues such as getting a student council started and creating an open network for good communication.

"I'm black and white," he said. "Everything from here on out will be transparent," he promised. (Where have we heard that before?) I was impressed by his good-natured but serious manner, and I believe he will make a difference.

Dr. R and his staff listened and responded to a long list of concerns and complaints from our class today. (We are one of about 15 ((I think)) classes the team has visited). Not once did Dr. R or his staff get defensive but took responsibility and responded with good solid answers.

One of our big concerns is the situation where we are "working' (to the bone!) in a nursing home instead of "learning" in a skilled facility as we should be. He said situations like that "will not continue". He is bringing in a "very experienced person" to work on our clinical situation . He promised that she will not only find more appropriate clinical sites for the school, but will include OUR CLASS in the upgrade.

There's been curriculum problems, book problems, scheduling problems, and even uniform problems. But, I don't need to go there in detail.

Dr . R posted his phone number and email on the board and urged us to keep in touch with him on any concern we have, and he vowed to us that 'things will get better'.

You don't know what a relief it is just to know someone who has the authority to make a difference is in charge, and he respects the challenges we have to deal with. Some students aren't so sure that anything will change and have a "wait and see" attitude. I believe he is seriously here to stay until he and 'his boss' are satisfied that Bohecker is top notch. The college got swamped with extremely fast growth (45 students to over 600 in two years), and I think things get out control and disorganized.

Yes, Mr. President. I have your name and number and will be the first to knock on your door and ring your phone as I expect the change you promise and believe it will happen during my time at Bohecker College.

It might even mean a change in schools for some of us to attend another RETS program near Columbus (Circleville) because it (the school at Circleville) is a nationally accredited school. Especially those who plan to further their education after getting their RN. I don't think I want to travel that far every day (even if the school provides transportation), but I'll keep you posted.

Bohecker College - Columbus is approved by the Ohio Board of Nursing, and that's what's important to me. I didn't expect other accreditations from such a young school.

Take Care on the Journey,
(No matter how rocky!)
~Linda

Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com

March 2, 2009

This and Thats

Greetings from Columbus, Ohio, where the wind chill is below zero and the sunshine is stuck behind tons of gray clouds! Brrrrr

Enjoy another coupon adventure over at my other blog - click - HERE

The semester is going well although everybody is tired of WINTER! Every class let out early today, and my photo appointments cancelled this weekend. I suspect it's somewhat related to the extended winter and cold, cold, weather!

We need warm sunshine on our faces, yellow daffodils in the yard and windows open at night.

Here's a shoutout for my niece, Fee, who successfully and without too much difficulty, had a beautiful baby girl in Tampa, Florida.

The best of luck and birthing blessings to my friend, Buffy, who will deliver baby Ava to her very thankful and excited parents within the week. (Buffy is a surrogate mother.)

Wishing good health to sweet little Tony and angel prayers that he will feel better very soon.

Don't forget to check out my golden coupons site HERE when you get a little break. You might find some new ways to save money.

Take Care on the Journey,
~Linda

Home: http://dustyangels.blogspot.com
E-Mail: bestnurse@usa.com