Fun And Games Off Duty · Fun With Suits! · School Fun And Games

Hazards of Immobility







So, TINS©, TIWFDASL©, working full time and going to Nursing school full time when not in the firehouse. Oh, and sleeping. When I could.

As you may have surmised from the foregoing, I was acutely-on-chronically sleep deprived pretty much entirely through school. I have previously revealed what the director of the program thought of my first pass resolution of that problem, wherein I skipped lectures and slept in, however briefly. (Review: NOT MUCH!)

Therefore, I showed my happy academic ass up for every lecture, and attempted to take notes and generally avid snoring and/or drooling. In order to assist with my camouflage, I typically sat around 2/3 of the way back in the lecture hall, and about 40 degrees off axis from the lecturer’s line of sight. One particular failure of my strategy still stands out in my mind.

The subject was “Hazards of Immobility”. Unfortunately, one of the hazards of immobility, that the instructor did not enumerate and then explain in PAINFULLY elaborate detail, is somnolence. For those sleep deprived, as I was very much so in those days, sitting still was nearly a death sentence. I was wedged into my seat, and getting more comfortable, and more comfortable, and finally felt my pen slip from my fingers. I woke up at that, and retrieved my pen, again settling myself into my wedged-upright position.

I shook myself kinda sorta more awake, and resumed taking notes. Sleep crept up on me, again, until I heard our instructor asking, “Perhaps Mr. McFee can tell us about calcium and immobility. Mr. McFee? Won’t you join us?”

Without opening my eyes, without moving, I responded, “Well, patients who are immobile long enough, began to mobilize calcium from their bones, and excrete it via their kidneys. This places them at risk of both renal lithiasis, as well as pathological fractures.”

I heard the pause. She sounded surprised. “Mr. McFee, I was convinced that you were completely asleep!”

Still eyes closed, still unmoving, I cleared things up for her. “Ma’am, I understand how you might think so. In contrast, I find myself in an advanced state of relaxed alertness. Ma’am.”

I managed to stay awake enough to take notes for the balance of that hour.


Fun And Games · Fun With Suits! · Having A Good Partner Is Very Important! · Pains in my Fifth Point of Contact

“Little Mary Sunshine is NOT a Force Multiplier!”

Once upon a time, long ago and far away, I was nursing in an ER in a medium sized city. For some reason, I was unable to evade being placed in charge.

Lord Knows that I tried! While I have established that I can be reasonably effective in a supervisory role, I really do not like it. For one thing, it places me in overly close proximity to Suits. I do not enjoy proximity to suits. Hell, my Suit Aversion Disorder led me to work midnights, in the first place! (well, that and shift differential, as well as seven-on-and-seven-off scheduling, to be honest.)

For another, I get subjected to all the bullshit from other departments, which, invariably, appears to consist of interacting with slothlike souls who manifest only one burning desire: skate through their shifts, while expending as little effort as is needed to maintain their receipt of a paycheck. Notice, I did not attribute to these chuckleheads the desire to actually do something resembling their jobs. That wuld be different.

Finally, when in charge, I get to cope with all the malignant and ill considered decisions regarding staffing the aforementioned cursed suits have enacted.

So at this point I was working in a relatively urbanized area, with a sixteen bed ED, in a town with three total Eds of various sizes. We had been short staffed for an extended time. This, of course, made me oh, so very happy. Or, not. I had been bitching, complaining, protesting and generally making known that not only was this sort of staffing insufficient, but, into the bargain, was considerably short of their own goddamned published staffing parameters, written by the goddamned suits themselves, and for which I would be written up should I let someone go home leading to staffing short of these parameters.

Well, as it developed, one of the Junior Suits (our assistant director) was compelled to show her smiling face up to work some of the short midnight shifts. She was, let us say, “entertaining”, to work with. She would “help out” by triaging. Well, when you triage someone, it is helpful if you (1) obtain and record vitals, (2) ascertain, and document allergies, medications, medical history, as well as (3) history of present illness, typically elicited by asking something along the lines of, “So, Mr./Ms/Xr X, what motivated you to come out in the dark of night to join our happy little party?”. You did notice how much fun I seemed to think it was, to, ya know, DOCUMENT, the aforementioned items, right? Sort of like that was, oh, I dunno, a GOOD THING, or something?

So, it develops that Little Mary Sunshine did not document (or even obtain; it was difficult to sort that one out) vials, allergy/med/history, or present complaint information, at least, not consistently. In addition, it seems that an ED physician with, say, a dozen patients, really, really gets petulant if these items are not there in the chart to be found. Slows him/her down, considerably.

Then, there is the part about both bedding the patient, as well as noting such fact on the greaseboard, as well as reporting off to the the nurse who would, oh, I don’t know, maybe BE CARING FOR THAT PATIENT.

Finally, it was established practice to start the needful IVs, collect the blood, and send it to the lab, along with a requisition for the bloodwork the physician was going to be desiring to see. None of which had penetrated Little Mary Sunshine’s cranial vault.

She was no more helpful as a “floor” nurse, Which is to say, she would half ass do things, not tell anybody at what point she had grown disinterested and wandered of Ghawd alone knew where, let alone document anything that she, by some miracle of random happenstance, completed.

As my partner, Andy, opined, “Ya know, she is not really a very effective force multiplier!”

Much more nicely phrased than the tsunami of profanity that was boiling away, waiting for me to spew forth as my OWN opinion of her “efforts”!

So, visiting as she was from the warm climate of Daytime “Suitworld”, Little Mary Sunshine was chilly most of the time. (she might have been warmer, had she been moving about as briskly as the rest of us, but, then….) Andy, once again demonstrating the situational awareness that made him a fine nurse and great partner, noted this fact, and brought it to my attention one long, long night during a missing Mary moment.

He implemented a plan based upon this observation, and turned the department thermostat down to around 60, from the typically balmy 70 where it normally rested.

Well, time passed, Mary Sunshine wandered around, fucking things up, and soon the HVAC system equibrillated at the new set point. Mary zipped up her sweatshirt, and began to complain that it was cold.

Nice of her to notice.

Shortly thereafter, she loudly opined that “You guys seem to have things under control. I’m gonna go back into my office and do some paperwork. Call me if you need me!”

Once she was safely away down the hall towards her (independently heated) office, we returned the thermostat to the baseline setting.

The rest of the night passed as the typical clusterfuck of shortstaffed jackassery, fortunately not exacerbated by halfwit half assed managerial fumble fingering.

Fun And Games · Fun With Suits! · Pains in my Fifth Point of Contact

Random Thoughts

Random Thoughts, Accumulated over a couple of weeks

(1) I know I have led a bad life (Ask The Plaintiff!). Therefore, I know that I’m going to Hell. If Dante Alighieri was correct, those of us going to Hell will experience our own personal, customized Hell.

Several times, it has occurred to me that, in my own personal Hell, I will be the clinician in Hell’s urgent care. There, I will spend endless shifts packed with trivially ill souls, who will take protractd periods of time to NOT answer my questions.

(2) I used to carry a can of CS teargas in my hip pocket, Back In The Day. Department regulations prohibited carriage of a firearm, so, what the heck, tear gas was First Runner Up in the self defense sweepstakes. So, one day I was in class, pursuing paramedic certification, and the top of the can, “safely” packed in my hip pocket, broke off. That left a puddle of corrosive tear gas in my seat. Curiously, there were no tears, which had, let us say, interesting implications for it’s efficacy as a self defense tool.

What there WERE, were sizable second degree burns on my asscheeks. That made for entertaining runs, as my ass slid to and fro while my partner drove our ambulance to emergency responses.

(3) This one time, I was working this one place (Hey! How about that RIVETING! Intro? Huh?) and they staffed the two provider clinic with two folks to work the floor, meaning they had to room patients, make appointments for followup, register and discharge patients, make referrals, answer the (incessantly ringing) phone, do procedures (breathing treatments, perform EKGs, take x rays, perform in house tests), and answer questions from random folks who walked in to ask questions about their bills or try to get their blood drawn (which happened at the lab, two doors down).

Kind of demanding, right? Well, somebody took a minute to call the office manager, suggesting that stuff either wouldn’t get done, or would get done incorrectly due to the pressure of multiple competing demands upon staff.

Her reply, as reported, was priceless. “Clinical medicine is like Zumba! You just have to keep up!”

Fun With Suits! · School Fun And Games

“School Daze, School Daze, Dear Auld Golden Rule Daze!”

My parents had moved from one of the suburbs of Da City, to Some Unnamed Eastern state. Once there, they met the neighbors. One of whom was married to a meteorologist on Da TeeWee.

He (the meteorologist) found himself, from time to time, changing jobs, and this generally involved moving to an altogether new city. Of course, once they had moved, the children would have to be registered in the new school system.

I have, previously, suggested that not every functionary associated with our public schools is, shall we say, the best and/or the brightest. Indeed, from time to time I have wondered if some of these folks are alumni of The Short Bus.

Mrs. Meteorologist told a tale that supported this theory.

It seems that, after one move, she was undergoing the interrogation customarily associated with registering one’s children at the public school. The clerk was presenting questions, and my mother’s friend was answering them.

“Name?” asked the clerk.

My mother’s friend responded with “Name (whatever)”

“Address?”

The response, “(Address)!”

“Telephone number?”

“(Telephone number)!”

“Mother’s occupation?”

“Home maker.”

“Father’s occupation?”

“Meteorologist!”

(Clerk, without missing a beat, steadily typing away:)“What hospital is he on staff at?”

“(Huh?)”

Fun With Suits! · Pains in my Fifth Point of Contact · Sometimes You Get to Think That You Have Accomplished Something!

Hospice Nurse Midnight Shift Call Off

A long, long time ago, in a galaxy not so far from here….

No, wait, that is not quite right. Well, anyway, after I had departed Da City’s EMS, and started working as an RN, my father took ill. Years previously, he and my mother had moved back to The Megalopolis, and resided in The Maternal State, nearly half way across the country from me. My brother the contractor did not seem well suited to the demands of helping care for a sick elderly man, so I volunteered.

As it happened, while I was helping Mom take care of my Dad, I was working 12 hour night shifts in various EDs around The Maternal State, receiving my assignments from this or that temporary staffing agency. The money was OK, and I was able to keep up with my house payment, my car payments, and all that stuff.

Things progressed. My father was dying, and there was no stopping it. I was glad that I could take some of the burden off of my mother, who was nearly overwhelmed in any event by the looming demise of her husband of decades. You do that which you can do, correct? Around this point in the process, my father had been admitted to hospice, and his care needs had escalated to the point where Hospice supplied a nurse to care for my dad around the clock.

So one morning around 0900, I arrived home from work, and went to bed. I was awakened for a phone call around 11 am, to find that the agency was informing me that my shift that night had been canceled. I mumbled affirmation, and stumbled back to bed.

Around 1400, I was again awakened to learn from the Hospice case manager that they were unable to find a nurse to care for my dad overnight that night. “I don’t know what we are going to do!” she apologized.

I wasn’t all that wound up over it. “So, it looks as if you have a nurse, then.”

No, I don’t. I have called, and called, and I cannot find a nurse to care for your father tonight!”

Yeah, you did. Me.”

You cannot care for your father overnight!”

How come? You need a nurse. I’m a nurse. You need somebody who will be reliable. I flatter myself, that I am reliable. You need somebody here. I’m gonna be here, nurse or no nurse. Looks like I know what I’m gonna be doing, instead of watching late night TV!”

Are you going to be able to do this? Can you handle that responsibility?”

Do you have a better idea?”

She admitted that no, she did not.

Well, then, it certainly looks as if I have to do it, and have no alternative to handling it, doesn’t it?”

We agreed, and I returned to bed.

This time, around 1500, I was awakened for another phone call (this appeared to be developing into A Thing!, and I was not liking it!). My agency was calling, and the staffing coordinator perkily informed me that she had found me an assignment for that very night! “Gosh, thanks, but, after you called me to cancel me, I made other plans.”

She was aghast. “What? Are you refusing an assignment?”

Nope. I had an assignment as of 0730 this morning, when I left duty. I was sleeping, in preparation for reporting for that assignment, when you called me, to cancel it. Once you had canceled me, I had no obligations to anyone, and I have made other arrangements since then. Now, you are calling me and asking, at the eleventh hour, may I remind you, if I can take a last minute assignment. No, I cannot. I am busy tonight, with obligations that I cannot ignore. I’m not refusing an assignment, I am simply not able to accommodate your last minute brainstorms.”

We ended the call at that point, and I resigned myself to my (sleep deprived) fate.

Mom and I had supper, I made some calls, and wrote checks for some of my bills. Once 2300 arrived, the afternoon nurse gave me report, and oriented me to the overnight routine.

We changed my father’s bedding, and bathed him. As we turned him to his left, I held him for her part of the cleaning and linen change, and he sighed once, long and loud. I looked into his eyes, and watched them dilate. I felt for a carotid pulse, and found none. “I think he’s gone”, I told the nurse. She and I tidied up the bed, tucked him in, and she went for my mother.

The next couple of hours were not etched in my memory. Eventually, Mom and I were alone in the house. We cried, we hugged, and we went to our beds.

Monday I had an assignment. I showed up, happy, in a sort of left handed way, to be doing SOMETHING that did not involve constant reminders of my dad’s death. The charge nurse for St. Elsewhere greeted me with, “We heard about your dad. We’re sorry to hear it. How are you doing?”

I was surprised. She was a lovely soul, cute, smart, professional, and capable (all things that I admire in a woman). She was friendly, and I was very open to that. However, I hadn’t told anyone about my dad’s demise. I was touched that she would make the effort to offer consolation to me, a relative stranger. I had been hoping that I could immerse myself in ED nursing, and not think about my dad for a while.

I offered my response, thanked her for her concern, and asked what pod was mine for the night.

Fast forward a couple of weeks. I received another call from the agency, and another assignment offer. I had made plans to take my mother out for dinner, and therefore I declined the assignment. (Yeah, THIS one I straight up declined.). The coordinator took me to task. “I’m getting really tired of covering for you all the time!”

What the fuck? My query was edited before being spoken. “Huh?”

I said I’m getting tired of covering for you!”

Uh, what are you talking about? Covering for me? When?”

Remember two weeks ago? That Friday night, when you had made other plans? That’s what I’m talking about!”

I was almost speechless. Fortunately, this was a telephone conversation, not one taken across a desk. That fact alone kept me from big trouble. I put as much ice into my voice as I could, and clarified: “Oh, wait! Do you mean the night my father died? Do you mean to tell me that you are irritated that I could not work on the night my father died, in my arms, and you are really, no shit, taking me to task for not working that night? Did you really, actually, just say that to me, not two weeks after he died? It sure sounds as if you did, and I cannot think, off hand, of any other way to take that. What did your supervisor say when you told her you were inconvenienced by my not working that night? Say, how about I call her, right fucking now, and ask her? Gimme her goddamned phone number, please. I feel the need for a heartfelt chat!”

For some reason, she was, well, “reluctant” probably does not fully capture her lack of enthusiasm for me chatting with the manager of the office on a Saturday night.

I continue to be surprised. By humanity in general. And, in particular, that she was such a jackwagon, and that she did not provide me that number.

Although, not giving me the number might have been a good thing.

Fun With Suits! · School Fun And Games · Sometimes You Get to Think That You Have Accomplished Something!

How Adults Roll

Many years after I was FDASL© in Da City, I was a Dad. (In my opinion, my most important job). I had four children with my wife, She Who Would Become The Plaintiff. Our daughter, referred to herein as Brenda, was a lovely girl, but, unsurprisingly, was a typical pre-adolescent.

One fine day, The Wife received a phone call from the school, relating that Brenda was failing Science class. We interviewed Brenda, attempting to understand what might be preventing this child from comprehending the material in her class that, to be honest, was not all that complicated. I mean, it was fifth grade science, in a podunk little school district.

We learned, after The Wife had detail-searched Brenda’s book-bag, that she, Brenda, had not been turning in her homework assignments. Oh, Hell Naw! That simply would not do! The Wife and I decided that, since I worked midnights, I would be the nominated for the role of Science Class Homework Monitor.

I phoned the school and learned that Mrs. Science Class was in her classroom yet, and would be happy to discuss Brenda’s failing with me. Off Brenda and I went.

I asked Mrs. Science Class if our appraisal was on target.

“Well, yes. Brenda has not been handing in her homework assignments.”

“Do you have these assignments? I mean, in a form that I, her father, could use to have Brenda perform this homework?”

“Well, yes I do. You do realize, Brenda is not going to receive credit for this work, do you not?”

“Yep. I don’t care about credit. Brenda, here, is going to perform these assignments, and I will check them for accuracy, and completeness. Then, I will check her spelling and grammar.”

Mrs. Science Class informed me, gently, “I do not check spelling, or grammar.”

I smiled. “How interesting. I do. Once I have corrected those items, Brenda, here, will do the assignment over again, until she gets all that correct. Then I will grade for neatness.”

Mrs. Science again offered, “I do not grade on neatness.”

Again, I replied. “How nice. I, however, do, and Brenda will repeat the assignment until she meets my standards of neatness. Then, she will do the next assignment, meeting all those standards, until she had completed every one, in it’s entirety, to my thorough satisfaction. Then she will deliver them to you for final grading.”

Mrs. Science Class looked at me, her head sort of half-cocked to one side, as if she were a beagle watching me cook something in the kitchen, and she repeated herself. “You know, Mr. Stretcher Ape, Brenda is not going to receive credit for all this work, don’t you?”

“Yep, you told me that, and I really do not care.”

“You do not care?”

“Nope. So, Mrs. Science Class, do you assign homework simply for your own entertainment?”

“Oh, no!”

“You have a plan of instruction, and homework is a part of that plan? Homework is part of the process by which children acquire an education, correct?”

She nodded. “Correct.”

I leaned forward, intensity in my speech. “Mrs. Science class, my daughter may or may not get the credit: I really do not care. What I care very much about, and what her mother agrees with me completely on, is the fact that our child is going to get the education. Full stop.”

She leaned back. “You know, I do not have this sort of conversation with parents, very often at all!”

I showed her my wolf grin. “That, Mrs. Science Class, is not Brenda’s problem. If she ever, again, so long as she breathes, fails to turn in her homework, in full, on time, and satisfactorily neat and legible, then every single assignment that she may have, I will correct. For completeness. For accuracy. For correctness. For neatness. For spelling. For grammar and syntax. And, she will do those assignments that I find unsatisfactory, over, and over, and over again, until I am satisfied with them.

Or, she could simply turn in her work, to you, on time and complete, to be graded as you see fit.

You see, I am willing to be Brenda’s problem, for so long as she desires it. She will let me know she desires it, by not doing her damned work.”

For those of you who care, my daughter finished high school, and then worked her way through her baccalaureate degree, working full time, with a child, as a single mother. And worked her way through her MBA degree, working full time, with three children, as a single mother. I take some, small pride in her accomplishments.

But, SHE did all the work. In full. On time. And completely. Because she is an Adult Woman.

Fun With Suits! · Life in Da City! · Pre Planning Your Scene

Alimony

Some back story. When TDWM1 (The Darling Wife Mark 1) and I had met up, she was a single mother of two children, working full time and going to nursing school. And, yes, she was successfully pulling that off. Once it was plain that our relationship was going places, well, I invited her to give up her apartment, move in with me, and let me support everybody. I made as much money in one OT shift, as she made as a nursing aid over an entire week. Or two. I told her, “You can always make a buck. You will not get a second chance to make that grade.”

She accepted my offer, completed Nursing school, got licensed, and we lived happily ever after. Or, at least, several years, happily (or so I thought).

So, fast forward to The Divorce. Let me admit, early in my tale, that she could have been way, way WAY more wretched than she elected to be. For example, had she alleged (falsely, but nonetheless she could have alleged…) that I had threatened her, well, a personal protective order was routine in such events, and until I successfully proved to the judge’s satisfaction that I had NOT threatened anyone, well, all my firearms would have to find new, happy homes. That is one example of wretchedness that she passed by.

On the other hand, getting back to my story, TINS ©, TIWFDASL ©…well, OK. There I was in a courthouse conference room with The Plaintiff (en route to transitioning from TDWM1 to The Wretched EX), her attorney, my attorney and me. Her attorney had just finished describing one of their demands, that I pay The Plaintiff alimony, and I quote, “So that Ms. Stretcher Ape can complete her Bachelor Degree in Nursing, so she can support her children better.”

I looked at my attorney, and he shrugged. With that signal, I dove in.

“Uh, Ma’am? why does your client require alimony in order to complete her BSN?”

“Mr. Stretcher Ape, it seems only fair. After all, she worked to put you through PA school, didn’t she?”

I contemplated this gambit. “You know, you have a point. I think we all agree that we all want fairness. You *do* realize that, while she was earning her associate nursing degree, I paid all of the household expenses for her, the children, and myself, right?”

Everyone at the table nodded, some more warily than others.

“So, since I contributed $1000 every month from my student loans to the family budget, while I was in graduate school, full time, isn’t it reasonable to expect your client to make a similar contribution toward her own education?”

Again nods, some wary.

“And, since I worked night shifts, 12 hours each, every night that I could, during our month long semester breaks, and every holiday shift that I could sneak in, as well isn’t it fair to expect Ms. Stretcher Ape to do likewise?”

The attorney nodded. I continued. “So, if we review my W2 forms, which I am sure our friends at the Friend of the Court have supplied you with, you can see that I contributed around $30,000 every year from my night shift earnings, as well as another $12,000 from my student loans. Isn’t it fair to expect a similar contribution from your client?”

The Plaintiff’s attorney started to bluster, but I held up a hand. “I’m not done yet. Now, you are suggesting all this effort should be directed toward earning her BSN, so that, as you term it, she could provide better for our children, right? This will add up to thousands of hours when your client could be mothering our children, and thousands of dollars in tuition, books, fees, and associated expenses, money that could be spent to the benefit of our children, right? All so that your client can earn a BSN, and earn more money, correct?”

The opposing attorney nodded. “Well, I, myself have a BSN. I am presently employed as an RN, and I can tell you, for a fact, that your client will earn twenty five cents an hour premium, as the holder of a degree in Nursing at the 4 year level! That means that, conservatively, her education investment will have paid for itself in (mumble, mumble, scribble, scribble) somewhere between ten to forty years, depending upon where she takes her classes.”

Opposing counsel leapt to her feet. “I do not believe that the earnings increase that comes with a BSN is so paltry!”

I leaned back, and smiled. “Madam, you have my pay stubs. They reflect that my employer, the largest hospital system in this part of the state, pays twenty five cents an hour. Most hospitals do not pay any sort of premium for that degree.”

Across the table, they leaned into each other, and held a hurried, whispered, conference.

I interjected. “May I make a counter offer? One that you likely will see again, like in court?”

Warily, I received nods of assent.

“Well, since I am a MAN, and a MAN wants what is best for his children I propose that, rather than spend thousands of hours in academics, hours when she could be mothering our children, and rather than spending tens of thousands of dollars, money that could be spent to the advantage of our children, that your client instead spend that time, spend that money, for the betterment of our children. And, since I am a MAN, and, being a MAN, I want to do what is best for our children, for my part, I will offer to pay her, annually, in one lump sum, in addition to whatever other money I am directed to pay, the five hundred dollars annually that she will forgo should she defer her education.”

I sat back.

THAT was the last I heard of alimony!