Time to Heal

Hubby is now in an ortho boot. Thankfully, after an ultrasound and follow up with an orthopedic surgeon, he does not have to have pins placed and his hematomas do not have to be evacuated. He tore ligaments in his lower leg which will require time to heal. So, he's gimping around in his franken foot. It'll be another 4 weeks and then a follow up.
He's not too happy about being incapacitated for such a long time, but that's a chance you take when you ride a motorcycle. Yes, you can clearly see I'm not a fan, not at all.

On the positive side, I get to see him every day. Normally, his career requires him to be gone for 24 hour periods. It's nice to have him home every evening. I figured I would have to wait until after his retirement to have this type of time together. The kids like it too. I'm going to enjoy it while it lasts.

10 Days Post Crash

It's been 10 days since the motorcycle accident.

The following Monday, I called his PCP to make an appointment for a follow up.
They asked the reason for the visit and once I told the receptionist, she cut me off.
"We don't see patients that have been in a car accident."
"He wasn't in a car accident, it was a motorcycle accident."
"Uh, yeah, we don't see those patients."

Before I could say another word, she placed me on hold. Someone else picked up the line and asked me what I needed.

"I need to make an appointment for my husband."
"Well, we don't see patients involved in accidents."
"Okay. Who does he need to see then? He was told to follow up with his PCP. He needs to see a doctor. Dr. *(^&)*^ is his doctor."
"Please hold."

I was not arguing with these people, more like flabbergasted that they refused to see an established patient.

"This is the office manager. We do not see patients that have been in any type of motor vehicle accident."
"Yes, that has been established quite clearly. What I am trying to find out is who WILL see him."
"Look the reason for this is because we do not get involved in disputes between parties about which insurance will cover what medical bills."

Ahh, so it's a money thing - always a money thing.

"There was no other party involved. If I call his medical insurance company, the one you have on file and they say they will cover the visit, then can he see the doctor?"
"Yes."

I had to have my husband call the insurance company because they said they had to talk to the patient directly. Sigh. Once that was all hashed out, I called back and got an appointment for later that day.

I went to change his road rash dressing and my heart sank as I took the bandages off. He had a massive infection that would need IV antibiotics. Shit! Now I had to call the doctor's office again and speak to the nurse about my assessment. She said she would call me back after informing the doctor. I waited, then waited a little more. I called back and wouldn't you know it, they were at lunch.

I wanted to kick small kittens and puppies at that point.

I guess once their lunch was finished, she called me back and told me that she would cancel the appointment and to go to the ER. I was already on my way, had texted my charge nurse that we were en route and she had saved a room for him.

What a cluster%^&*.

Ultimately, he got the antibiotics, his arm was improving the next day and I still had to make a follow up PCP appointment.

I saved that for another day. Small animals stay away from me!!!!

The PITA Patient

I looked at the patient and knew he was going to be a pain in the ass.
He was in a motorcycle accident and fell onto his left side resulting in road rash to the left forearm with a deep laceration, shoulder pain, and left lower leg pain.

I got some pillows and ice packs for his leg and arm. While I was elevating his leg, he exclaimed, "Urrgh! That hurts. Leave it alone."
"You need to elevate it. Of course it hurts, you were in an accident."
"Seriously, leave it alone."
"No, let me do my thing. Stop being so prissy - I know you're in pain."
He made a stern grimacing face at me.

When he returned from radiology, I had some things together to clean up his arm abrasions before the doctor irrigated the laceration.
"Okay, this is going to hurt," I stated.
"I know. Stop saying that."
"Saying what?"
"That it's going to hurt. You keep saying that."
"Well, it is."
"Ya know, your bedside manner sucks."
"Do you want to do this yourself?"
"No."
"Then be nice. Seriously, you're kind of a sucky patient."
"Fine."
"Fine."

I cleaned the area and it hurt - Just. Like. I. Told. Him.
I gave him some pain medications beforehand, but it was all raw, exposed skin.

After discharge, I rolled a wheelchair into the room.

"I don't want to be in a wheelchair."
"You can't walk on that leg. Just sit in the chair and I'll roll you out to the car."

He made a sigh and a grimace trying to get into the chair.
I drove the patient home.
I swear, my husband is going to be such a pain in the ass through this whole ordeal.
I hate motorcycles.

Pretty

From my 95 year old patient:

"You're kind of pretty for a white girl."

"Umm, thank you."

"I like your white teeth and you have pretty hair. Yup, you're not bad for a white girl."

"I appreciate you noticing. <lol> You're nice looking too."

"I know! I'm pretty for a black woman! But I do like your teeth!"

I smiled at her and said, "Thank you, but I'm not giving them to you."

She smiled a large toothless grin, "Dang it!!! I tried!!!"

Interview

I finally interviewed with the psych manager. She was very laid back and stated, several times, that it wasn't rocket science - the biggest responsibility was to keep the patients safe. I gave her my available days in September which were few because my schedule had already been made for my other jobs. I haven't heard back yet, so I'm waiting. I find it strange that there was such a big rush initially and now no rush. Oh well, I'll wait.

The common theme in the main ER where I work is that the computer charting system is "not conducive to our work." The throughput of patients slowed down to a crawl because of this inadequate system that administration has chosen to put in place. The doctors, NPs, PAs, and nurses have decided to chart and process all orders according to the wishes of the admin. This has resulted in a slow moving ER. They have cross trained several nurses from other departments into the ER and all have expressed their dissatisfaction with the chosen charting system. I find it amusing. I'll be interested to see what admin does or if they do anything. Anyway, I have decided to work minimal shifts here and stay out of all the politics.

We'll see what happens.....

Makes sense....

So I decided to take the plunge and told the counselor from the behavioral health unit that I wanted to interview with their director. He told me what to do to submit my resume to her. I did what I was instructed to do and received a call from HR.
She told me that I would have to put in transfer paperwork and have my director sign it. I said that I haven't spoken to my director yet about cross training to psych and would not quit the ER, just pick up shifts over there.
"Oh, I don't know if anyone has done that before.You were hired specifically for the ER and not the float pool."

Now I know I can because I've picked up shifts in the ICU when I was getting bare minimum shifts in the ER. As a matter of fact, they recently used another nurse in the ICU that way too. What's the difference?

I asked her, "How can I put in a transfer when I don't even know if I have a position over there?"
She said this is how it is done. So....I put in for a transfer to a unit that I haven't even interviewed for or have a secured position and flag myself to my director that I want to spend time on another unit?

Yup.

This has happened to other nurses who get so frustrated with this process that ultimately they leave the hospital all together. So, instead of allowing them to transfer to another unit in the hospital, the hospital loses a good nurse.

Makes sense.

Psych

I recently attended a class which was mandatory training for all ER personnel. It was a CPI class (Crisis Prevention Intervention). The instructor was the director of the behavioral health department. Now I have worked with him many times because he performs the psych intake interviews in the ER when we have a behavioral patient. I did not know he was the director of the department. The class was suppose to be a large one, but only 3 people showed up. Not too good for the first day of this particular class.

The good part was we could go quickly through the material and the instructor wanted a lot of input from us. He surprised me after I answered a few of his questions regarding 'what would you do in this situation' or 'how have you handled a patient like this in the past?" and offered me a job in his unit.
Throughout the class, he heavily recruited me. He offered me the job, training and said he would pay me more than what I made in the ER - all in front of my coworkers.

I'm thinking about it. However, I don't know if psych nursing is a good fit for me. I remember when I was working on my psychology degree, I got a part time job in a residence for children with autism. My assigned child was a kid with severe symptoms who had parents that would take him home every weekend and basically reverse all of therapy during the week by not following his plan of care. He performed self stimulatory behavior every chance he got. When I had him, I was suppose to perform positive reinforcement to stop his behavior. He would pick up pencils, straws, his hands, etc, and flap them in front of his face. I was mentally exhausted by the end of the day. My last day there (I didn't keep the job very long), they had a BBQ outside for all the residents. The landscaping did not have mulch, but little sticks - everywhere. It was a field day for him and a nightmare for me.

I'm wondering if it'll be like that. I guess I could speak to the director and see if I could start training - sort of a trial. The one thing that did concern me was the fact that there is no security at the facility and only 4 staff members in the unit which is a free standing building and not attached to the hospital. My concern would be my safety. I may talk to him about it - I haven't decided yet.