madshutterbug: (c)2004 by Myself (Self RN HardAtWork)
To Florence.
madshutterbug: (c)2009 by Myself (RN Florence)
Been at a day-long thing today. Can't really call it a meeting. Several different presentations all short. It's called Leadership Conference for the Nursing Dept. leaders/managers. I qualify now. Scary thought, that.

Now, one of the most interesting bits that was announced is ... smoke. Hospital is a major teaching hospital, affiliated (not part of) a major university and the medical sciences center of that university. Hospital is building a new structure (we open, in fact, in 100 days) across the Road from current structure. Pertinent to the discussion, at least a wee bit, is that new South Tower is on property owned by Hospital Parent Group. The old structure (North Tower) is on property owned by University. In fact, the original structure (it's been expanded, significantly expanded, over time and much of this during my tenure here) was once owned by University.

Hospital Parent Group already restricts certain aspects of Internet access. Specifically, such things as would not appear congruent with a facility dedicated to health, healing, trauma and cancer care, etc. So I can not, for example, go web surfing to the sites of either firearm manufacturers or sellers. I can surf to sights which provide information about firearms such as ballistics, calibre, tissue damage from bullets, and such. That latter is, after all, part of treating trauma.

Inside of Hospital, and even inside of the University Health Science Center has been 'smoke free' for a decade or so now. You want to smoke? You go outside to designated smoking areas. Inpatient, outpatient, visitor, employee, you go outside to the designated smoking areas. Part of the reason the limits extended only to the doors is University did not commit (other than here at the Health Science Center) to smoke-free.

As of Day One Opening of the new South Tower, Hospital (BOTH buildings), University Health Science Center, and the campus grounds around them will be tobacco-free.

You want to smoke or chew? Head a half-mile (more, actually) up the road.

Oh, there will be means and interventions for those patients who need; these will not include smoking or chewing or snuff.

Apparently, University will be promoting a tobacco-free campus elsewhere by a specified date next year. We here at the Health Care Places will start earlier.

About. Damn. Time.

And now, I go home.
madshutterbug: (c)2009 by Myself (RN Florence)
I've now seen at least one episode of two different new Televideo shows about Registered Nurses: Nurse Jackie and HawthoRNe. Interestingly enough, within the past three days [livejournal.com profile] slave2tehtink passed me a link to a piece published, at least on-line, by the New York Times (link follows http://well.blogs.nytimes.com/2009/07/01/nurses-helpers-angels-or-something-more/ and I didn't need a login to view it...), that discussed the image of Nurses in the media. I'm not sure if this is going to be a rant. It will contain elements of being a review. No major spoilers, I'm sure, if you happen to be someone interested in either show.

But it might get long... )
So.

Nursing, according to that NYT article, hasn't fared well in most medical dramas. None of them, to date, truly show what it is that Registered Nurses do for you when you need them. Gather data about your problems. Analyze and assess that data into information that leads to a Plan, to correct those problems to the best of the patient's ability. Implement that plan, which involves both direct Nursing actions and a whole lot of other people called the Health Care Team. Then do it again, to be sure it worked. Change as needed. Rinse and repeat. It's not Medical Diagnosis and Treatment; that's what Medical Doctors do. Yes, they order treatments and medications and then RN's administer those treatments or medications. That is, if something else in the patient's condition doesn't contraindicate it. Or change suddenly, which your M.D. won't see as they aren't at or near the patient bedside 24/7.

All that said, the two shows remain programmed for the DVR to record. Another one of my very good friends told me in the last 12 month, 'You're non-judgemental. That's a very good thing in your profession.' Yes, it is. Fixing those problems rather requires that non-judgemental aspect, and that is one reason why the two shows remain on the DVR schedule. Also Herself rather likes at least one of them. Still, won't be many more of the first one discussed that I'll watch if things don't change rather quickly. Only saw the one of the second one discussed, so there's at least two more viewings in my future.

And that said, I'm not hopeful.
madshutterbug: (c)2009 by Myself (RN Florence)
Hippie Birdbaths, Florence Nightingale.

And a Happy International Nurses Day to all my Nursing colleagues. Read the part a bit down the page at that link about the ceremony at Westminster Abbey.

And now, back to work.
madshutterbug: (c)2009 by Myself (RN Florence)
I am.

Looked at in greater detail I could add lots of things to that. ... ready to go home (only can't yet). ... enjoying working on photos even if not everything is going to be shown (some is just practice, and sometimes I'd rather practice with things I like even if I can't show it). ... needing time off.

Well, that last is coming. Another week plus two days and I've got a week plus one day off. It will be bittersweet time, though. Time off as originally planned started this Friday, for the annual hadj to AORN Congress. Which will be next week.

For the first time in 13 years I will not be there.

This, more than anything else, is an indicator to me of where our economy stands. I can keep the roof over our heads and the Land under our House, the food on our table including for the livestock and pets. Our connections to the Grid and Communications remain active, we can still get about as well with fuel and transport. In that last is where the bitter choice came in, as Sydney SubaruOutback needs work done, and the funds to cover that in the timely manner needed, as well as go to my professional association meeting, do not co-exist.

I started off this post with my current default icon, these days being Houdini & I. It is now RN - Florence. It's not simply that I could save money trimming my trip to cover only the days of the conference, rather than as I usually do extending the time a bit afterwards to photograph things in other places. That would conserve funds, yes. And still the equation will not balance.

Decisions made in the near past, Voice raised in our representational government process, all made and done knowing that indeed we, as a population, are not facing difficult financial times, we are in the midst of them. Doing what could be done to help with that because that's what people should do, much less Nurses. Yet still the impact comes: How Bad Is It?

It is bad enough that I am not able to go represent our Patients who need the advocacy, or my colleagues who are also unable to go, to see to the future of a Profession and a People.

No, Toto, we're not in Kansas anymore. And I don't think the ride is over yet, either...
madshutterbug: (c)2009 by Myself (RN Self Hard at Work)
LJ's 'Writers Block' today is:

It's the 20th anniversary of World AIDS Day today. From clean needles to safe sex, the fight against AIDS has touched everyone's life. How has it affected yours?

My professional career started before the first news of the unusual disease which affected peoples immune systems came out. There is a great deal more as to how this affected my practice than this one story. A lot of things changed because of it, and since I am a Registered Nurse, it is something which affects me every time I take care of a patient.

One of those patients - I went to check her in and assess her before surgery. This back shortly after I'd transferred from the NICU to the OR, and I still wore a beard. She was blind because she'd been born premature and got caught by another of the risks premies are vulnerable to; too much oxygen will affect retina development, leads to separation and blindness. Fascinated by my beard she ran her fingers through it. She also tested HIV positive.

That she got because of another, early vulnerability, that the tests for donor blood couldn't detect the virus. She'd received transfusions as a premie.

And, her history showed her to be a Frequent Flier here at Hospital. Reviewing her record, I determined that yes, indeed, I could be the Registered Nurse who gave her that transfusion. I wouldn't of known at the time, couldn't know after the fact, and am not alone on the list of people who gave her transfusions.

Still... put that in your bag and contemplate, Oh My Children.
madshutterbug: (c)2009 by Myself (Expostulation)
The last speaker at the FCORN meeting provided a very good presentation on menopause and related issues. What I most liked, though, is that I know her. Met her at Hospital when she was doing her OB-GYN residency, and really liked her then both as a person and a Doc. She's good people on that count. She didn't remember me, which I expected for several reasons. I didn't work with her directly (NICU rather than L&D, even with us going over to L&D for high-risk deliveries to assess and often admit babies). Also, in those days I wore a full beard. And much longer hair. In fact, much more hair, at that. However, after jogging a couple memories we shared a nice little visit.

Arrived home after a mostly uneventful trip. I say mostly for a couple reasons. Started the drive home by staying on A1A north as far as Port Canaveral, then jogging over to I95. It's been more than years since I drove that stretch along the coast. Much changed. I'm not surprised by it, actually I'm not sure how I feel.

Several cruise ships in port, all three of the lines in fact that use that facility, Carnivale, Disney, and Royal Caribbean. However, I'm not going anywhere with them.

Onto I95 and heading north, more of the boring interstate highway trip which is I95. Just south of Daytona traffic northbound slowed way way down, and FL Highway Patrol when whizzing by on the right shoulder lights flashing. That pretty much confirmed my suspicion a traffic accident occurred ahead. Getting up to it confirmed that status, someone (probably southbound but no way to really tell) had flipped their car into the median. Apparently no one was injured, and the car wasn't even much damaged, though still upside down. A wrecker was already on scene to remove the vehicle, plus both that FL Trooper and the local county mounty.

Back up to speed and a bit later off the highway for the dual purpose of meeting up with [livejournal.com profile] thaddeusfavour and Himself for lunch, as well as SR 40 through the Ocala National Forrest is the way back home. Pleasant lunch talking a bit about writing and more about various movies and such, then away and back on the road. Over the river (St. Johns) and through the woods and over the river (Ocklawaha) and home again by about 17:30.

Houdini seemed very happy to see me back, as did his brothers. Herself as well, if only to vent at me about how slow the Venerable Old Laptop is, and being bumped off the dialup multiple times yesterday (that would be due to the storm I described arriving on the east coast), and I unpacked things and fed the cows with Houdini's help and then the Bros. Really pretty sure that Houdini was very happy to see me, because every 15 paces or so he'd slam into me and rear up to lick my face.

Ate dinner, hot tub soak, plans to take Herself's PC in to Williston where here is a PC repair place for diagnosis (though I'm pretty certain of the answer, want more extensive info re. other parts). I'll do that on my way to work this evening, as my schedule this week is very dis-normal due to the (hopefully) go-live of the shiny new Plan of Care. Evenings today, short day tomorrow afternoon, then two 10 hour days, and Evenings again on Friday. Yes, that's the Holiday. Yes, I'll be working the Holiday.

That's life in the big Hospital.
madshutterbug: (c)2009 by Myself (RN Self Teacher)
Today's sessions are done. This includes the Business Meeting luncheon. The largest chunk of the CE are presented on Saturday, so some folk won't be here tomorrow. I will be, but that's beside the point.

Winding down now. Got a few things to do before going to eat dinner, and there's a party on the beach starting about 20:00. I'll probably go for a bit. Not a lot else to report.

M Tired

Jun. 27th, 2008 07:47 pm
madshutterbug: (c)2009 by Myself (Expostulation)
However, there's another function yet tonight. The Summer FCORN meeting is when the newly elected officers are installed. Since I's a serving officer, I probably should go. Not too tired, really, but it wouldn't be hard to crash now. Probably wake up way too early though.

Cleanup a bit, then off to see what happens.

Oh. One stowaway. Those to whom it matters will know of which I speak. *G*

Friday

Jun. 27th, 2008 07:02 am
madshutterbug: (c)2009 by Myself (FCORN Secretary)
I am not going to Hospital today, but rather a bit south and east, to the Atlantic coast, and the FCORN meeting. There I shall execute my duties as FCORN Secretary this weekend, while also accumulating some additional Continuing Education. Handy, that latter, because I now start the process over.

That is, I've recently renewed my RN license in the state of Baja Jorja, and recertified my CNOR. The former is good for another two years. The latter is good for another five years, and at that point I may be converting it to a CNOR (Emeritus) as in that five years time I hope to no longer be practicing clinical nursing on anything other than a part-time basis. And that may be voluntary work, as in traveling with one of the various groups which do so to provide health care in areas where it isn't quite so prevalent.

But today, it's travel time. When I leave the Intarwebz this morning it will be to pack (basically an overnight bag, mostly set already), load the car, and depart. There will be Intarwebz where I am going, though I don't expect to be using the access during the day.

Yes, I shall most probably be packing along the camera kit. Not sure what photos may be forthcoming, but if there's no camera, there will be no photos. Which, of course, glosses over the camera in the Treo. So there could be snapshots. We'll see.
madshutterbug: (c)2009 by Myself (Florence)
Today is Florence Nightingale's birthday.

Think about her the next time you interact with a Nurse.

Clowns

May. 8th, 2008 04:28 pm
madshutterbug: (c)2009 by Myself (Florence)
Any of you who are afraid of clowns (those disguised, costumed individuals who try so hard to make one laugh, they really must be hiding something) need not read further.

Clowns are wandering through Hospital today.

This is all part of something called 'National Nurses Week' here in the States. Rather a commemoration for all the members of my Profession, it is held annually and usually to correspond to Florence Nightingale's natal anniversary. I'm not so much afraid of clowns as they are more serving an unpleasant reminder of how much I've come to depend on a wee bit of technology that isn't currently functioning well. Nor is my progress to replacing that functionality progressing well.

It's all right though. I've not forgotten Flo's natal anniversary. Y'all will be subjected to something about that on another day.
madshutterbug: (c)2009 by Myself (Studio 318)
And to (somewhat) commemorate my upcoming hadj to AORN Congress:

For House of Delegates Roll Call, 48th Annual AORN Congress

From Florida to this one destination
We've journeyed across our great nation,
From where Mr. Mouse
Keeps a much larger House
To partake in collegial oration.

And it should be a rousing debate.
Just how shall we nurses relate?
Will it be much more fun
To vote One by One,
Or shall we continue to Delegate?

As we gather now, colleagues, take note,
With traditions, but never by rote,
As Members-at-Large
And by States are we charged,
And from Florida 77 will vote!



And a wee bit of background... )
madshutterbug: (c)2009 by Myself (Self_RN Hard at Work)
Yesterday being a Clinical Day, I spent my time in the OR again. Overall a pleasant day; as I mentioned to someone later, I can haz mad clinicalz skilz... or something. Going over the amount of clinical time required with Herself after getting home, as it seemed to her things are being clinical a bit much, I pointed out two things:

1, we are asked to do two clinical days this month because the Magnet Survey team are here, and
2, hence I scheduled my two clinical days fairly close together

Then I pointed out that using a base number of 40 hours per week (it isn't really, you know, but that's the base number used for calculating salary), which means stipulating four weeks/month, it's 160 hours, and 16 hours (2 days) of clinical is only 10% of that. Most months the requirement is only 5% (8 hours).

Besides, it proved great fun to generate confusion on the part of the old co-workers.

'What are you doing here?'
Working
'Didn't you leave?'
Yes
'Did you come back?'
No, and sort of...

Now, what is this Magnet Survey of which I mention above, you don't ask. Magnet Status is an award presented by the American Nurses’ Credentialing Center (affiliated with the Americn Nurses Association ANA) to hospitals, which denotes to both Registered Nurses and patients/families that this institution goes to some troubles to make the place a desirable place for Nurses to practice Nursing. Despite a certain cynicism on my part (something of a defense mechanism nearly all long-service health care personnel will develop) there is an strong element of truth in their program. In general, hospitals which achieve (and maintain) Magnet Status are able to demonstrate lower turn-over amongst their RN's and LPN's (LVN's some states), and often better patient care outcomes as well, because their Nursing staff are more involved in their practice in the facility.

In a lot of ways, it's like my certification as CNOR (Certified Nurses Operating Room) in relation to my license. I can practice Nursing, and specifically Perioperative Nursing, without my certification. Might (probably) even be quite good at it. Unlike Joint Commission or Federal ratings which affect how hospitals can bill and be paid for their services, which is a might more akin to the status of my nursing license, CNOR / Magnet certification is more of a public statement that someone with an objective viewpoint measures against a set criteria and says, Why yes, this person/facility is pretty darn good.

Anyway, the Magnet Survey team is here at Hospital this week for our re-certification, so all us management types are being encouraged to get our staff nurse colleagues out for those Magnet functions, as the surveyors are more interested in how the Staff feel about the place, are encouraged to take part in the daily/weekly/monthly operations, than about the management.

Which, really, is as it should be.
madshutterbug: (c)2009 by Myself (Self_RN Hard at Work)
The link on the Google page is headed with 'Reuter's Oddly Enough', but to me this is not Odd at all. It's something much in need in the place and time:

China Provides Embattled Nurses with Bill of Rights ... link should open in a new window.
madshutterbug: (c)2009 by Myself (Expostulation)
Got up early on Saturday morning; no earlier than any other workday, but Saturday isn't supposed to be a workday get up early kind of thing. Out to feed Teh Ranch by 07:15, because Herself is off to SCA Trimaris Arts/Sciences, there to compete in the Iron Chef thing. By 08:15 all Birds, Bovines, Goats (including two bottle-baby kids), Hogs, and Horses fed. By 08:45 I'm cleaned up, and on the road for a little daytrip to Orlando.

Off to Orlando for a FCORN meeting, the state-level for my professional association which I cleverly volunteered to fill out a ballot on last year (there was someone running opposite me, I figured them to win. I did vote for them) only to be selected. Arrived about a half-hour late for the meeting due to traffic on the Turnpike in Orlando. Still torn up for construction, even if the workers aren't out there on the weekends. Ah well, a good meeting.

Back home via a scenic route, not taking the Turnpike/I-75 because it's been ages since I drove US 441. Which used to be a nice rural drive. Orlando is now grown into Eustice is now grown into Leesburg and even north of Leesburg, it's not much country anymore. All growed up until one nearly gets to Ocala. Still and all back to teh Ranch by 17:30, just in time to feed a couple bottle-baby goats, horses, bovines, and of course the Border Collie Bros and Mamma Mudge.

Then me. I ate leftovers. Yummy beef sausage crumbles with wasabi horseradish sauce, and leftover potato salad. Oh, and before I could eat that I needed to apologise to Mean Old Mary Kitty for abandoning her all day. She felt much put out without any monkey companionship. While I say that sounding (I hope) humourus, there is a serious overtone to it. After Herself's mother died, Mary Kitty lived at that house still for another three months, with sporadic human companionship until Herself bundled her up and brought her to teh Ranch.

Mary likes it here. She terrorises all the KitnzOfApocalypse, and their older brother Raz Mewson, and even Grayling the Wandering Tom who checks in with us on a very regular basis. Grayling defers to Mean Old Mary Kitty; I guess he figures anyone (without front claws) that's willing to take on a tomcat just isn't worth fussing with.

Oh, did I mention the frost on the ground and the frozen rainwater in the tops of the feed barrels Saturday morning?

This morning was nicer, in that it was warmer. No frost. Just a persistant mist all during feeding time, which didn't start until nearly 08:30 because by grumbly I did sleep in today. The sun broke through the clouds by 10:00 though, and Herself arrived home safely around 15:00. She didn't win the Iron Chef, but did bring home some nice baubles which were the consolation prizes.

Tonight, it's Leftover Roast Beast from that very same Iron Chef Trimaris. Should be good.
madshutterbug: (c)2009 by Myself (Self_RN Hard at Work)
Today is National Nurses Day in the U.S.A.; this day starts a week commemorating Nurses, who we are and what we do, and culminates on Florence Nightingale's birthday, May 12. Florence's birthday is also known as International Nurses Day (information about that via the same link above).

My reasons for entering the Profession seemed simple at the time; the shortest path/time between one job through another job to a third job and means to take care of myself. The first job I frequently refer to now as 'Federally Subsidised Tourist' and actually was as U.S. Navy Hospital Corpsman. I opted for the short path/time through the second job (Nursing Student) because I could do it, and also (even though it took some time to work through to this realisation) because I like helping people.

In the words of one of my favorite songs by one of my favorite groups, what a long, strange trip it's been. I've lost count of the people I've helped; some stand out in my mind out of the host. Many of them remember me, and I've learned another lesson in that manner, sort of about fandom as it were. There's one of your favorite (writer/actor/artist/musician/InsertRoleHere), but to them, there's thousands, millions of us. They all blur together given enough time, into one amorphous Humanity.

Along the way, it also came clear to me that being a Nurse isn't a job. Oh, sure, we get paid for what we provide, everybody needs to make a living. Being a Nurse is about how we think, and as De Carte said, "I think, therefor I am." We think like Nurses, therefor we are Nurses. Our licenses, while important, merely provide us the legal ability to provide Nursing care. You see the tip of the iceberg when you receive that Nursing care. You don't see the data gathering, the assessment, the planning, the Educated Judgment that took place leading up to the intervention (the Nursing Care you saw). You don't see the thinking.

Leah Curtin, RN is one of my favorite (writer/nurses/artist/teacher). What I said above applies. I've met her, sat with her during lunch and chatted with her, and I doubt she remembers me. There's one of her; I am part of the Amorphous. She speaks at many professional meetings, has been an editor of several Nursing publications and currently is the driving force behind Curtin Calls. You need to go read that, whether you are a nurse or not. One of her common themes in her presentations addresses the word, Professional. What does it mean? Where does the word come from? And her lessons in that presentation led to this.

I Am

One who serves
New-age samurai
Protector of innocents
Defender of the ill and maimed
Torn-spirit healer
Fireman extinguishing
agony’s flames
Sentinel watch-stander
through dark hours
Lamp-lighter
Hand-holder
Guiding to health
Guardian of wellness.

Standing in the forum
Before my countrymen, to
Profess
I am learnéd in science and skills
I am One Who Serves
I am a Nurse.

September 30, 2002

Oh... and it's also [livejournal.com profile] jehannamama's Birthday. She's a retired Nurse. So how cool is that! Happy Birthday, Nurse [livejournal.com profile] jehannamama.

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