If You Take Care Of Your People, Your People Will Take Care Of Business

A long, long time ago, in a city so very far away, I was an afternoon shift nursing house supervisor. In the course of my shifts, I would receive call offs from midnights, and attempt to discern that point at which nights would be short, and I would have to attempt to backfill their staffing.

One such evening, I had determined that nights would, indeed, be short. I started on the unit that was short, and called up. The first nurse I spoke with was the recipient of my stock spiel.

“Ms. Smith, golly, have I got an opportunity for you!”

She was amusedly skeptical. “Oh, you do? What sort of opportunity might that be, Mr. McFee?”

“Ma’am, I have the opportunity for you to make eight hours of time and a half, right this very night! What a deal!”

“What might I have to do, to earn this time and a half?”

“Why, simply keep your same assignment, and ride home in the morning glowing in the satisfaction that comes from a job well done!”

“Suppose I don’t have a ride home in the morning? I carpooled with Ms. Diaz, and she is completely uninterested in OT.”

I had an answer to that problem. “In that case, I’ll trot up there with a cab voucher for you!”

She was surprised. “Can you do that?”

“It certainly appears that I can, as I have the cab voucher right here in front of me!”

“But, I did not bring anything to eat later!”

“No problem. What would you like? We have KFC, pizza, Burger Biggie, and others not so far away.”

“But, I did not bring any money!”

“Who asked you for money? You’re working over, I will be sure that you eat, and have a way home. Any other concerns?”

“But, who is going to pay for the food?”

“Not you. Beyond that, not your problem!”

She sighed. “OK, let me call my husband. I’ll get to keep my assignment tonight?”

“Yep! I will so advise the night supervisor!”

“Thank you, Mr. McFee!”

“Ms. Smith, you are welcome. Thank you for being flexible!”

I caught up with the security supervisor, and asked him if one of his officers could make a chow run. I handed him a $20 dollar bill, asked for my change and the receipt, once Ms. Smith had her food.

The next day, I took my receipt to my boss, explained how I had negotiated coverage for night shift, and presented the receipt. She wrote out a petty cash voucher, and sent me to the cashier to get reimbursed.

Cross Country Adventure

So, TINS, I was NOT FDASL. Rather, youngest brother and I were driving a rental truck full of my mother’s earthly possessions back to The Un-Named Maternal State. She had died, and we were consolidating her possessions so as to end paying rental on a storage locker, once we had each kept a few items as keep sakes.

In any event, we had departed early in the afternoon, and therefore were NOT going to make the trip in one go. Gotta admit, the allure of driving through the night, well, had faded with the years. Neither of us were thirty, anymore.

As it started to get to about midnight, Youngest Brother had searched for, found, and reserved a room at a hotel something on the order of 1/3 of our way There. This hotel was described as “near the airport of (fairly large city)”. Now, I have flown a time or several, and have some expectation, expectation that I feel is not unreasonable, that there would be, ya know, SIGNS, announcing the presence of something as large as, oh, gosh, I don’t know, AN AIRPORT. Signs, no less, on the adjacent interstate highway.

Notwithstanding my expectations, I managed to drive a considerable distance past (fairly large city), and began to wonder out loud where the freaking airport, and, with it, our hotel, might be. Youngest Brother did a bit of internet searching, as well as phone map application searching, before he announced that I had managed to drive past it.

Score, ME!

So, we reversed course, and drove back, finally observing a sign announcing the airport, set way, way, way back off the side of the highway, obscured by shrubbery. We only saw it, because, unlighted, another vehicle’s headlights momentarily illuminated it.

I guess that these folks believe that if you do not know how to get tyhere, already, you don’t belong there in the first place!

Once we arrived, Youngest Brother entered, and registered us, obtaining a pair of key cards. We trundled our crap up the elevator, and found the room. This hotel used proximity key cards, and (I supposed) placing the key adjacent to the door locking mechanism would trigger the door to unlock, and we would stumble into sleepy time bliss.

Or not. The lock blinked a persistent red, and there was no whirring as of, say, unlocking, to be heard.

Youngest brother returned to the desk, there to explain the problem to the clerk and elicit a replacement, functioning, key card. He returned to report the following.

He told the clerk that the cards did not function at our lock.

The clerk asked him, deadpan, “Did the light turn green?”

Brother’s answer: “Nope!” (while thinking, ‘Of course it turned green, you idiot. The door popped open, and right now my brother and I are sitting on the sofa, eating our dinner!’)

I suggested an alternative answer. “Yeah, it turned green. And I looked all around, and never did see the butler who is supposed to open the door, turn down my sheets, and unpack my luggage! What sort of low rent establishment are you running here, anyhow?”

We did, in fact, receive a new set of keys, which worked.

THE WISDOM ASSOCIATED WITH HINDSIGHT!

So, the other day, My Best Man and I went to the range together. He had recently acquired a Garand that he had not yet shot, so, by way of introduction, I brought mine, along with some other guns that merited airing out. A good time was had by all, as range time = good times. “Group therapy”, so to speak.

My friend is a bit of a raconteur, so the stories never end. He told several tales regarding the CEO of his employer, and these stories revealed a soul steeped in the tradition of leading from the front, and taking care of your people = taking care of business, which equals, in our line of work, taking care of patients. Well. Taking care of them, well.

From him, with our history, these were tales of high, high praise, indeed. (He is the originator of the observation that “Little Mary Sunshine is *NOT* a force multiplier!”)

Eventually, we had shot everything that we had brought along to shoot, and noted that it had clouded up, with occasional rumbles of thunder to draw our attention. Therefore, we safed the weapons, packed up the ammunition, cased the firearms, and paraded to our vehicles.

Once everything was settled into our vehicles, well, the skies opened. We were at my conservation club range, and so I got the opportunity to exit my vehicle, unlock the gate, open the gate, exit the gate, and relock the gate. This, of course, required that I exit my nice, warm, dry truck, wade through the slough that our driveway had become (soaking my feet in the process. I *HATE* cold, wet feet!), fiddle with the lock, fiddle some more with it as I fail to correctly recall the combination, fiddle with the damned thing YET AGAIN, finally opening it. In the downpour.

As my partner exited the gate, I ran to my own truck, entered it, and realized that I had a poncho therein. I donned the poncho, and attempted to close my door.

As it developed, my truck will *NOT* exit park, and move, until the driver’s door is secured. That required me to remove the poncho from the door, and attempt, several times, to close the damned thing. Finally succeeding, I moved my truck through the gate, and re entered the cataract in order to re lock the gate.

It occurred to me, right about then, that donning my poncho (as well as, oh, I dunno, FREAKING BRINGING MY FREAKING FIRE BOOTS) might have gone a long way towards allowing me to open the gate, close the gate, lock the gate, and then return to my vehicle, without being, you might say, soaked to my damned skin.

Ah, the wisdom associated with hindsight!

Sometimes, The Pucker Could Squeeze Diamonds

So, TINS, TIWFDASL at an urgent care out in Flyover Country. It was a typical afternoon, featuring a parade of sniffles, coughs, and poison ivy. Our clinic was on the south side of the road, east of Middling Sized City, and the Big Time Big Deal Hospital And Trauma Center. In other words, to get the the BTBDHATC, one would exit our driveway, and turn west (that is, LEFT!)

Abruptly, the registrar summoned me. My MA and I walked over, to behold a limp toddler. Very Not Good!

The MA escorted the male carrying the child to an exam room, and began to collect vitals. I examined the child, discovering a heartbeat (Crom be Praised!) and spontaneous respirations. The registrar collected demographic information, and I asked the adult what had happened, prior to arrival.

“Well, he started shaking, and then he stopped. He just wouldn’t wake up, so I brought him here.”

Well, the “wouldn’t wake up” part was still descriptive of the child, and I noted that I would have to call an ambulance immediately, because this could have several causes, none of them good. Indeed, “floppy child” is right up there in my Triage Catalogue Of Very Bad Things.

The adult male paused at this. “I don’t want to send him by ambulance. I’ll take him myself!”

I was surprised. I noted, “So, you *DO* realize that several of the things that caused this, could reappear, and he could stop breathing or his heart could stop. EMS is trained and equipped to deal with those things, should they occur. You, while driving, are not, right?”

He persisted. “I’ll drive him myself”.

We directed him to go there immediately, with no delay nor detour. We explicitly directed him to exit our driveway, TURN FREAKING LEFT (that is, west), and not stop until at the ED.

He stated that he understood, and would do so.

He scooped the child up, and exited the building. I sat down to chart, as well as call BTBDHATC, in order to provide them with forewarning of the sick, sick, sick child coming their way. That is, until my registrar called me, excitedly, to report that this sunovabitch had turned EAST! (exactly away from the hospital) upon exiting our driveway.

WTAF!

I had the clerk print a face sheet, and called emergency dispatch. I related the above information to dispatch, along with my concern that a critically ill child was *NOT* being taken to the ED. I provided the street address we had received, as well as the contact information.

I next called the child protective services emergency number, to report the above. I was assigned a report number, which I charted, and my own name and contact information was taken.

Several hours later I received a telephone call, from a gentleman asserting he was from CPS. I asked him to confirm the report number, the child’s date of birth, name and address of our record. He did confirm all these details.

He queried me about the particulars of the child’s presentation. I supplied the requested information. I asked how the child was. The worker paused, and said, “Well, I am not allowed to provide information regarding an ongoing investigation, particularly one where the child in question has been hospitalized. I’m sorry. “

My response? “Yeah, it’s too bad you couldn’t tell me if the child had been hospitalized or anything. I understand. Thank you.”

Interview Skills

A long, long time ago, in a Galaxy not so very far away, TWWWBTP (The Woman Who Would become The Plaintiff) had graduated LPN school, and was starting her LPN-to-RN studies, and I was seeking a change of employment. I was looking to add ICU to my resume, since the grad school I had my sights on required it. This one hospital was recruiting, and proclaiming that nurses who accepted positions in their ICU, would receive a $10,000 sign on bonus.

I investigated, and learned that one half of this bonus would be paid upon completion of one year of employment, and the second half would be forthcoming after completion of the second year of employment. Sounded good to me, and so I arranged an interview.

Since TWWWBTP, at that point TDW-Mark I, thought that it would be problematic should I accept a job requiring me to drive halfway across the state, as this position would, perhaps she should investigate employment (and schooling) opportunities there, as well.

Sounded good to me.

On the appointed day, she and I arrived for our interviews. I learned of the position, and they told me, “You do know, don’t you, that we require a two year commitment from nurses in order to qualify for this bonus, right?”

I acknowledged that I did, indeed, comprehend this aspect of the arrangement, and stated, “Yep, I expect that I can wait two years before going to grad school!”

They acknowledged my comment, and we proceeded.

So, we concluded our interview, TDW-Mark I and I, and we sat in the lobby, awaiting their offer(s). We were summoned, and received the news: TDW-Mark I was offered a PART TIME, LPN job. As for me, well, I did not receive an offer. They informed me, “We are looking for nurses who want to come here, and settle down here, in our community. With your grad school plans, well, you do not appear to be a good fit for that sort of longevity.”

Cool story. We drove home, TDW-Mark I composing her “Thanks but no thanks” letter in her head, and I remarked, “Ya know, honey, I believe that I have figured out what I did wrong!”

She replied, with some side-eye, “Oh, really? What was that? Other than being truthful about your higher education plans, I mean?”

“Well, you see, I should have walked in there, paused just inside the door, and, James T. Kirk like, spread my arms in an all encompassing gesture, slowly turned, taken in a deep breath, and declaimed, “I…I..feel, I feel as if I have come….HOME! I….I want my children…to grow, TALL, under these…these Blue ! Skies!…I want to spend my days….Breathing! This! Clean! Air! I…I want…my..bones, to rest…to, REST…beneath …these green hills! I…I feel as if…I am…at..HOME!”

I looked over at my bride. She smiled, and responded, “So, you are telling me that you should have lied your ass off, right?”

“Of course, right!”

RANDOM THOUGHTS, INSTALLMENT NUMBER VIII

@The other day, my MA gave me the typical “thumbnail” report of my next patient. “(sick person of some sort”), (vitals), ….And, you know, he’s older.”

This particular soul was born TEN YEARS after I was!

@ROBOCALLS: I receive telephone calls, from time to time, from unknown numbers. Almost every one is from some computer dialed bullshit. My practice is to say “Hello”, and then begin to count ten seconds. If there is no human being on the line by then, according to my (it’s a robo call: I’m not particularly patient) timer, I hang up.

If there is some human on the line by then, they have, maybe, ten or fifteen seconds to convince me that I have any interest whatsoever in speaking to them.

And, if it’s one of those “we need to speak to you about your computer repair the other day” idiots, it depends: if I’m feeling froggy, I may stay on the line simply to trifle with them and waste their time. If I’m feeling curmudgeonly (which, to be honest, is most of the time), I hang up. In mid word.

OVERHEARD THE OTHER DAY:

Joe-Bob arrives, asking if he could get the work note written for Cletus. The clerk inquired after Cletus’ last name. Joe-Bob did not know Cletus’ last name.

She asked if Joe-Bob knew Cletus’ date of birth? “Nope.”

Cletus’ phone number?

“Nope.”

Cletus’ SSN?

(surprisingly/sarc) “Nope!”

Did Joe-Bob know the date of the visit which elicited Cletus’ work note?

(say it with me, now…) “Nope.”

She wrote down *OUR* phone number, and suggested that, once Joe-Bob rejoined Cletus, perhaps he, Joe-Bob, could invite him, Cletus, to telephone us, and at that point arrangements could be made.

@ Life Lesson: A lesson learned from hard experience: No matter how frequently you look at your watch, in the middle of an awful shift, it is still 3 o’clock!

Thinking About 9-11-01

Please, go to the link.

https://digital.lib.uiowa.edu/islandora/object/ui%3AJan16duffy_37

go. view. weep.

A little bit more heartwarming content for the 20th anniversary of 9/11

Twenty years later, I weep.

Men. Duty. Honorable actions.

May we live up to their examples.

Questions Above My Pay Grade

A long, long time ago, back in Da City, I had left EMS, and was employed as a nursing house supervisor. In the course of my rounds, I stopped by ER. The staff chatted with me, revealed that things appeared to be under control, and they needed for nothing at that time.

One of the staff nurses drew me aside, and murmured, “Check out the ER doc that they sent us!”

I asked, of course, “Why?”, and was told, “Never mind! Once you chat with him, you will know!”

I approached him, introducing myself, and asked how his night was going. I was struck by the fact that he appeared to have several freckles about his face, each with a glint as of metal. Each, in fact, about the size of a pin head. I figured that was odd, concluded my conversation, and moved on.

I subsequently encountered one of the ER nurses in the cafeteria. “What did you make of Dr. Pins?”

“Couldn’t tell you. Never seen anything like it, before!”

So, a little later that night, I cruised through ER, again. (part of my “management by wandering around” strategy). The doc asked me if he could speak to me, in private. That was odd, but, sure, whatev’s.

So, back in the physician’s office, he began to describe a patient. I mean, as in how a resident (or a midlevel) would staff a patient with an attending. He wound up with his query: what did *I* (remember: the NURSING supervisor, with no provider chops whatsoever at this time) think that the patient ought to have done?

I tried not to stutter: I really, really did. I suspect that I failed, but I did manage to observe that other physicians had ordered this, or that test, and not uncommonly had discharged the patient with a prescription for this, that, or the other thing.

The following afternoon, my boss, the afternoon Nursing Director, and I had a chat. A lengthy chat. About Dr. Pins.

The Sunshine Rule, Revisited

As you may recall, my go-to principle is that everybody brings sunshine into my life. Sometimes, that is when a soul arrives……

So, TINS©, TIWFDASL© one sunny Saturday morning, and my very first child of Ghawd rolled his eyes when I asked, “do you have any allergies to medication?”, which is part of my Mark I-Mod Ø interview question set.

My inattentive friend responded, “Of course I have allergies! My nose has been stuffy and runny for a week!”

I tried it, once more. “Do you have any MEDICATION allergies?”

“I dunno”

(sigh) “Are you taking any prescription medication?”

“Yeah….”

“Can you tell me what medication you are taking?”

“Nope. Cannot remember.” (eye roll)

I concluded that further interview would waste my time and annoy this gentleman, further. And so, a surly exam followed.

COMMENTARY: Simply so you know, IDGAF what you are allergic to, nor do I care what medication you are/are not taking, despite your physician’s goading, instruction, entreaties, or hectoring.

I *DO* care, very much, that I do *NOT* prescribe prescribe a medication that will cause your immune system to turn you into a fireball. Similarly, I really, really do *NOT* want to prescribe a medication that, in concert with whatever the (expletive) you are, indeed, taking, will perhaps form a binary explosive in your bloodstream. Because you could not/would not tell me whatever else you are, indeed, taking.

So, to me, this sort of thing is kind of important. Please, try to keep up.