Not Hitting the Snooze Button

Instead of sleeping in on a Saturday morning, I followed up on an invitation from a friend to attend an in-service hosted by Central Florida’s Case Management Association.

The focus was Heart Health: The Latest in Thrombosis Care, Exercise Impacts on the Heart, and Heart Healthy Eating

I’m a heart patient.

My work history includes Workers Compensation Case Management.

And this free in-service included, can you believe it – FREE, included breakfast and a gift basket raffle.

How much better can it get?

Well, let me tell you…

Hospital Case managers, insurance case managers, case managers that worked in Rehab settings, some in Home Health agencies — a melting pot of healthcare professionals linked by their chosen specialty.

Around me I could hear everyone discussing the topics, sharing ideas, and, of course, having some good old fashioned fun when the Exercise Impact speakers had us all up out of our chairs and stretching. (I wore heels. Bad choice.)

I may not do Case Management anymore, but attending this in-service, learning, and just as important, seeing the camaraderie among the people in attendance, made me happy I started my Saturday the way I did.

Now tomorrow…I’m gonna sleep in : )

 

A Very Good Read

This is the first time I have reposted something since starting this blog four years ago.

I have a good reason.

While walking through Barnes and Noble, I noticed this book pictured below. I read it a year ago.

That little gold sticker on the  right reads, just in case you can’t  enlarge it, here, let me help you,

Finalist for Pulitzer Prize

____________________________________________________

I don’t look for these books, they find me, Death Be Not Proud, Before I Go, Being Mortal, and now When Breath Becomes Air — stories that don’t glorify death, only bring to light the questions intersecting life, death, and meaning.

When Breath Becomes Air crossed my daughter’s path (a lover of Hiaasen and Palahniuk), not mine, she mentioned it to me in the same easygoing manner she would share her yoga schedule. Little did she know how much of an impact reading this book who have on me.

Atul Gawande and Carol Cassella are the only other physician/ writers of who’s work I’ve read; Gawande —philosophical and earnest in taking his own experiences and finding the common threads we can all relate to; Cassella , in my opinion, a master of upmarket fiction  who creates stories with characters and themes that jump off the page and hold you captive.

Kalinithe’s memoir, completed by his wife when cancer took him, is a lyrical retelling of his entrance into residency, the day he learned of his diagnosis, and how the blending of his calling and his cancer gave him a perspective he was driven to share until the very end. Kalinithe explained early on that he chose neurosurgery because “the brain is the crucible of our identity and medicates our experiences of the world.” Little did he know that lung cancer would spread to his brain and be one of his last teachers.

I don’t have a fondness for stories about people dying. I am a hopeless romantic who could watch Rob Reiner movies all day. It could be the “doctor becomes patient” thing I find intriguing. William Hurt did this well in a 1991 movie, but, it was fiction. While reading When Breath Becomes Air there is no getting up and categorizing the plot as a well-crafted or full of witty dialogue you want to share with friends.

I feel blessed to have gotten to read this book. Right after “courageous” the word “generous” comes to mind, courageous not because Mr. Kalanithe pushed hard to keep working, keep helping people, courageous because he was willing to put his fears and insecurities on paper and leave them for all to read.

And generous, that’s self-explanatory once you read the book.

Make It Count

I was going to stick with one of my usual themes and share last week’s fine moment of when a patient’s daughter came stomping into our area ranting that the surgeon had given her permission to observe in the OR (didn’t happen) and now we weren’t letting her in PACU.

A conversation with someone of whose opinion I hold dearly encouraged me rather to share my thoughts on a news event I’d been following.

Long before I was a nurse, I was a gymnast, and it’s because of that I followed the news accounts of the trial of Larry Nassar, MSU and USA Gymnastics doctor. Me, I had an idyllic experience in the sport.  Mr. Nassar has just been given a sentence of up to 175 years for child pornography and his sexual assault of over 150 girls in Michigan and Huntsville.

The other reason I’m posting is this: I have an appreciation for women who are standing up for each other, not tearing each other down. Rachael Denhollander, the first victim to speak out (August 2016 / the Indianapolis Star), worked with investigative reporters to give a voice to all abuse victims. Nassar, for years, had been preying on young girls obedient to the love for gymnastics. When injuries occurred, he assaulted them under the guise of what he described as ‘medical procedures’.

Before I go any further, let me be very clear, my coaches were an amazing husband/wife team, both Christian athletes, who put  their life savings up in order to create an atmosphere girls like myself could learn and grow as gymnasts. I always felt safe. They were mentors, not just sports mentors, but life mentors. They garnered the trust of my parents. Years later, I was honored when they allowed their young son to be my ring bearer.

‘Finding your voice’, it sounds so good on paper. You envision high school students embracing the arts, theatre, painting or more literal avenues like Debate in order to sculpt their character as they prepare to step out into the world. Don’t we say this all the time to the next generation? There’s a flip side — when using your voice brings on the loss of friends, your church, and your privacy, you weigh each word to ensure the cost is equitable to your motive.

Rachael Denhollander paid the price for speaking up, but still chose her impact statement in court to not be a self-righteous rant, but an opportunity to remind MSU and USAG how they ignored the attempts to expose the so called ‘world class doctor.’ Administrators said they “Didn’t know” because they “didn’t believe”, “reports weren’t handled correctly” and “…weren’t reported to the right person.” Enablers – she didn’t use the word, but you get the point. She outlined all the steps she’d taken to enlighten authority figures and their lackadaisical responses. She reminded everyone in the courtroom how individual girls were treated when they themselves filed their claims. With the help of investigators, she persisted for two years.

As an ex-gymnast, a nurse with general respect for practitioners, and a writer with growing understanding of the power of words, I was overwhelmed with admiration for the clarity and completeness of her statement.

Prosecutor Angela Povilaitis later commented. “[Nassar] is possibly the most prolific child abuser in history.”

Rachael Denhollander just brought him down.

She is not just a survivor; she is a powerful force as a human being.

https://www.nytimes.com/2018/01/26/opinion/sunday/larry-nassar-rachael-denhollander.html

http://www.detroitnews.com/story/news/local/michigan/2018/01/24/denhollander-seeks-maximum-sentence-nassar/1061719001/

Coming Down to Earth

“Remember this patient yesterday? Say’s there’s $10 missing from their wallet.”

What?

“Well, yeah, I remember her. She was a total knee replacement case – had several family members here with her. They took her belonging bags…”

I’m not perfect when it comes to having families fill out and sign the personal belongings sheet. It’s not a high priority thing to me on a busy day. It’s a piece of paper in the back third of the chart behind consents, lab results, the patient history, etc…

“They asked for the manager. She’ll be in shortly.”

Sh*t! Did I fill out the belongings list? Yesterday was a blur. Oh, man…

I was riding high on recently learning my abstract on a Process Improvement project was accepted the National ASPAN conference. Now I’m free falling off my cloud into a counseling session about remembering to complete ALL the paperwork.

An hour later, my manager came back from visiting the floor where the accuser (on day two from her knee surgery) was recovering.

“Was the belonging list completed?” I tried not to sound stressed.

“Yes, it was. But I still want to spend a few minutes with everyone.”

Hmmm

I’m only partially relieved.

Ten minutes later, she came out of her office and prefaced her critique by letting us know that the patient’s family had asked the concierge in the waiting room to watch the bags while they went to lunch. This morning, being uncertain about the amount of money she thought she had in her wallet, left the concierge, and me, in the vulnerable position of being considered possible thieves in the eyes of the patient.

“So, you all need to have the patients check the amount of money in their wallets and write it down on the belonging list.”

Listening to the lungs, reviewing lab results, checking blood sugars, and checking medications for any that should have been stopped or might interact poorly with anesthetics – Well ! Have to stop doing one of these silly things!

Seriously. What a way to dumb down nurses roles. I had one of those rare why am I doing this? moments.

Early Christmas Gifts

As I left bay #5, I almost bumped into what I thought was a visitor, and she was, but she was more.

“Hi, Remember me? I was here a few months ago. You took care of me.”

I didn’t recognize her face or name, but  I recognized her genuine smile.

“There is something …, but I can’t put my finger on it.”

She waited for a sign of recognition. “You must meet so many people, I’m so sorry. I’m here supporting a friend. ”

I really wish I could have remembered her name. I think what I remember was her fear.

“Oh,, please, don’ t apologize.”

” Susan, I just  wanted to tell you everything  turned out well. They did wide margins and got all the cancer out!”

I was so happy I almost lunged at her with a hug.

______________________

Christmas gifts are everywhere.

 

Community

I’ve been nominated for an award by a young nurse who’s sharing her journey through nursing school and other aspects of what I’d call young adulthood. (I can say that. I’m twice her age J  )

She writes with an authentic voice and is not afraid to reach out to readers and ask for advice.

Oh, if I were to have had this much courage at her age. Check out her blog!

https://bethssmilinvibes.wordpress.com/

Here are my answers to the questions posed by Beth:

The first thing I do on Christmas Day is give thanks for my daughter.

I would like to visit Victoria Falls in Africa.

The biggest role model in my life, other than my parents of course, is Maya Angelou .

My favorite quote: “People may not remember what you said or did, but they will remember the way you made them feel.” Maya Angelou.

I love sunsets better than sunrises.

My New Year’s Resolution – Make less lists!

My go –to comfort food: French Fries. If stuck on an island in the ocean and only able to have one thing – French Fries!!

And I’m nominating:

https://freshscrubsblog.wordpress.com/

https://thewordstrucksoul.wordpress.com/

My questions for these bloggers:

What was the last book you read?

Four 12 hour days or five 8 hour days – what’s your preference for work?

Your favorite quote?

Your favorite cartoon as a child?

Pick five people you’d like to sit and have dinner with (living or dead).

If you were told to start a second Blog, what would be the theme?

More info about Liebster Award:  https://wordingwell.com/the-liebster-award-the-official-rules-my-first-blog-award-and-a-few-personal-secrets-revealed/

The Rules:

• Thank the person who nominated you, and post a link to them on your blog.
• Answer the questions about yourself, which will be provided to you by the person who nominated you.
• Nominate blogs that you feel deserve the award.
• Create a new list of questions for the nominees to answer.
• List these rules in your post.
• Inform the people/blogs that you nominated that they’ve been nominated for the Liebster Award and provide a link for them in your post so that they can learn about it.

 

 

Emotions

Long day at work and still grocery shopping to do, I wandered through Publix getting more than I needed because, well, I was hungry. Cart full of the requisite fresh healthy vegetables, other perishables, and of course my gluten free honey mustard pretzels, I rolled to the checkout lane.

TIME – SPECIAL EDITION – THE SCIENCE OF EMOTIONS

It caught my eye.

Nestled in the corner rack next to Star and US magazine (fodder for gossipers everywhere) the cover was a picture of father and toddler daughter, she in midair, father’s arms outstretched, ready to catch her. I grabbed it and threw it in with my groceries. So what if I was already over budget. I rationalized it as being good ‘Nurse’ reading. We are in a profession expected to have skills coping with all ranges of patients emotions. Plus, I’ve always been intrigued…how much emotion is physiologically derived.

There is reference to Emotional Intelligence, Hedonistic adaptation (adapting to whatever we think will make us happier and taking it for granted), and the brain’s amygdala (the area responsible for emotions, survival instincts, and memory.) Little of the writing was scientifically driven, but then, it was TIME, not The American Journal of Medicine. So I read on. Here’s a summary of my favorites:

The Upside of Bad Moods by Susan David: My favorite quote: “Negative moods summon a more attentive, accommodating thinking style that leads you to really examine facts in a fresh and creative way.” Yeah! So there, I don’t have to be a Pollyanna all the time.

Natural Mood Changers/ Subtitled How Six Mainstays of Modern Life Tweak Our Neurochemistry, By Kate Rockwood: Here are the six: Alcohol, Marijuana, Caffeine, Orgasm, Sugar, and Exercise.

Essay by Jancee Dunn, Instagram Envy, Tamed: She tells you right off the bat she understands that posts are curated and edited. It still doesn’t stop her from deleting a pended post she determines not to par amongst peers posting Bermuda vacations and completed half marathons. Her life seems to ‘pale in comparison.”

“We have taken our relationships online, and with a need to present our best selves, we edit. We look to social media to validate what we want to believe about ourselves.”

When she referred to social media as a fluff fest, I guffawed. She nailed it on the head. Her advice, “Either get away from it or get behind your posts 100%. There’s more to you than pictures of the smoothies you made this morning.

So, here I go.

 

Matchmaking: This’ll make sense in the end.

So, after taking a certification exam for the second time and NOT passing, I quietly moped. My coworker respected my fragile state of self esteem by not bring it  up upon my return to work. It’s taken three weeks for me to shake the blah feeling off.

Earlier this week, passing the Director’s office ( a very warm person who always keeps her door open), I slowed and in a  deliberately exaggerated way, described the event and my feelings afterward. She stood and walked with me back toward my department. She did what all directors are trained to do, she  encouraged me to not give up, to try a different style of studying. At almost the same time, we both said “shadowing anesthesia”. Ketamine, Succinylcholine, Etomidate – yep, side effects of these meds are on the Nurse certification exam for CAPA.

It  made sense. Hang out with the OR people.

“Susan, I  think you should shadow Hank”

Hank, a sixty-five year old CRNA salt of the earth, nicest and I mean nicest guy, is a recent widow. Yeah, that’ll work, shadow a CRNA that has probably never grumbled at anyone.

Here is where things went wonky.

” You two should meet up for coffee or a casual dinner place and talk.”

What?

I redirected the conversation and  commented maybe on a slow day I could switch to education pay on the time clock as to minimize the cost of extra time at work. Her response was, ” No, I think you should meet outside of work.” That made no sense in regards to being in a learning environment.

We were now at the entrance to my department.  The last thing she said was ” It’d be a shame if you didn’t follow up on that idea.”

I did a great job hiding how uncomfortable I was with the undertone of her suggestion. Widow. Age difference. Coworker. Not playing where you work. Being pretty sure Hank did not appreciate R&B music…

She’s not the first at work  to have an interest in determining the course of my love life.

I just want to do my job.

 

Tomorrow

While you’re wishing for the day to be over, someone else is wishing for another day.

‘Rebooting a plane’

I’ve never thought I was normal. I don’t believe there is a ‘normal’. But on my recent return trip from NYC (to see my wonderful daughter), I laughed at discovering another quirky thing to add to my arsenal of, uh, what I’ll call kind of crazy thinking.

Here’s the lead in:

I get on the 4:46 JetBlue flight out of La Guardia with only purse and book in hand after graciously turning in my carry-on to “help speed up departure.” Comfortable in my window seat, I become so engrossed with my Strands bookstore purchase, I lose track of time until I hear the overhead announcement.

“Folks, we are sorry for the long wait on the tarmac. On the control panel, one program button isn’t lighting up. We are returning to the gate.”

In my world, all the buttons don’t need to be lit. While I pretend to have wings and fly through the clouds on a plane so big they call it an AirBus, that’s a different story. I want those buttons lit, flashing, and sparkling like the KiraKira App my daughter showed me on her phone.

We roll back to the gate. We don’t get up and squeeze back down the aisle made to only fit runway models. We get this instead:

“Folks, we’re going to keep you on, turn the engines off, allow resetting, and restart.”

What?! That sounds like ‘rebooting’. They are rebooting the plane. My daughter’s last email to me, only an hour ago was ‘If there is anything weird going on or any passengers get weird, get out of there.’ Rebooting a plane. That might fit the bill.

Two passengers walked to the front and disappeared. I dug around the seat pocket in front of me until I found the barf bag. Just wanted it close by – no gurgling in my innards yet.

 I pondered Kristen’s advice until they announced overhead the two passengers were Miami bound and connecting flight were located for them.

The roaring rumbling of engines diminishes. Some people stand and stretch.

Over and over again in my head one mantra kept me relatively calm -God has a plan for me. God has a plan for me.

Then it happened, that crazy thing I can laugh about now…I estimated the large amount of trip charges on my VISA and freaked out.

 They would be hanging out there if my flight home was to be my last hours on planet earth. It had to be taken care of. I didn’t want my daughter having to forage around my house to find my password and deal with a giant VISA bill (When I see her, we go big. Mama’s worn out nursing feet demand Uber. The kid picks amazing $$$ restaurants for dining.)

I lurched sideways and scrunched up until I could get my hand down to my purse on the floor and retrieved my phone. Recalling old announcements for people to turn off computers until lift off, I tapped fast. I don’t want my cell phone interfering with the plane’s function! Capital One – Yep – okay – not too bad. On to my trusty bank. Account. Pay bill. Confirm amount. Send.

I feel much better already.

The engines start up and we roll back out to try again.

First flight I didn’t fall asleep on.