Saturday, February 26, 2011

Who took my pen?

I can be a bit absent-minded at times. Having a variable schedule that involves traveling between three different offices does not help. There's days when the only way I remember what town I'm supposed to be working in is because the clerical staff tells me.

I misplace a lot of things as well. I've lost everything from jewelry to eyeglasses, but ink pens are the most common lost object. (In a job interview, I once responded to the "what would your co-workers say is your worst trait?" question with "I never know where my pen is and steal theirs.") I compensate by collecting pens and stashing jars of them at all the offices where I work. As long as it writes, I'm not picky.

GoodbyeNurse has a different approach to ink pens. I walked into the County Seat RCMH office yesterday to find him sorting all the pens in the nursing office by color.

"I don't know why we have so many nonstandard pens!" he exclaimed.

Due to the lack of caffeine in my system, I was unable to come up with a response to his comment. I just stared at him.

He apparently took my slack-jawed silence for agreement. "I was taught in nursing school that blue and black ink are the only appropriate color for nursing documentation, so I don't know why we have so many different colors of pen."

"Maybe it's because most of this office's communication is via sticky notes. As long as they're legible, no one cares what color the ink is."

(In retrospect, I should have pointed out that all of our nursing documentation is done on the computer, so the color of the office ink pens is a moot point. Instead, I settled for taking all of the "nonstandard pens" and caching them in my other office, just in case.)

Wednesday, February 23, 2011

Just another Monday

On Monday, as I always do, I checked the jail mugshot website to see if any of my patients were guests of the Random County Correctional Center (known around here as "the Country Club.")
Then, I called IntimidatingNurse at the jail to see how Bonnie Parker was doing.

The receptionist recognized me by my voice alone when I said hello and immediately put me through.

"Yeah, Bonnie's a bit of a handful, but she stops talking to invisible people as soon as no one's watching her, so we think it's kind of behavioral instead of mental health-related. Don't worry, I've already got her scheduled for a full assessment with IntimidatingShrink this afternoon."

I never dreamed when I applied for this job that I'd be on a first-name basis with the staff of all the local homeless shelters, psych wards (although I really should have seen that one coming,)
and the jail.

Thursday, February 10, 2011

Proposed changes to the nursing uniform

In my work for RCMH, I travel between three towns. There's County Seat, Village, and Hamlet. My "office office" (the one where my desk and files are located) is in Village, but I work at the RCMH office in all three locations. I'm only at the main office in County Seat two days a week, but trying to find office space there can be a trial. If there aren't any crises, I can usually use the crisis office. But if they need it for clients, I have a difficult time finding another place with a working computer and phone line.

I can theoretically use the nursing office as my "space," but GoodbyeNurse has already claimed that as his office. We've tried to share an office, but expecting two adults with separate work loads to use the same computer and phone line and get things done is a bit like expecting the Marines to not make fun of the Air Force--you can hope it will happen, but you probably shouldn't bet too much money on it.

My boss has been working on this situation, and he made sure to remind me of that at the med staff meeting this week. His professional approach to the problem was promptly derailed by the rest of the med staff.

"I can find you an office with a nice desk if you'll wear one of those frilly white nursing caps to work," Dr. Analytic quipped.

"Sounds fine--as long as GoodbyeNurse has to wear one too!"

Wednesday, February 9, 2011

Chart check quote of the week

Dr. Analytic has a way with words:

"I called ExpensiveDrug pharmacy to order the medication, but they haven't prescribed for the client since 2004. I then called OverpricedMeds, but the client does not get medications there either. It appears I have failed at playing "guess the phamacy." "

Monday, February 7, 2011

Overheard at work

Female crisis worker, talking about a recent patient assessment: "So I said to him, 'Joe, are you seeing anything or hearing anything that you're not quite sure if it's there or not?' And he said 'well, you look really good today.' "

Saturday, February 5, 2011

Chart check quote of the week

"I can only imagine how I would feel if my drums were my most prized possession and my brother stole them for drug money."

Thursday, February 3, 2011

I got a bachelor's degree for this?!

Part of my job as a nurse is to "coordinate care" between assorted agencies. When it comes to coordinating care between the patient's mental health and medical health providers, it can get complicated and very annoying fast. Usually the process looks something like this:

I call the Primarycaredoc office and wait on hold hearing automated messages about "your call is very important to us. Protect the ones you love by getting a flu shot" for at least five minutes before I get a live person, who will transfer me to someone else.
Request the most recent visit note and medication list on Joe Patient.
"I'm sorry, we need a release of information to give you that information."
Check client's computer chart to make sure we have a release. Yes, there is one for Primarycaredoc, and it's been in effect since 2007.
"We need you to fax us the original copy of it before we can do anything."
Find client's paper chart (praying it's not in one of the offices in the other two towns I work in) and fax release to them.
Wait 4 hours.
Call back to ask them to fax the information. The person I talked to before will be at lunch/on medical leave/abducted by aliens and the staff I talk to will have no idea what needs done.
Wait for fax.
Blame Primarycaredoc's office when Dr. Warmnfuzzy wants to know what the patient's medical history is before she prescribes large amounts of psychotropic medications to him.
Receive fax about ten minutes before our office closes.

Today, I called Dr. Familypractice (part of Primarycaredoc practice) for "the usual" on Joe Patient.
A secretary picked up the phone immediately (a real, live person! Squee!) and asked for my fax number, then said she'd "get right on it." Then she asked if I wanted Joe's CT scan results too, or just his most recent laboratory results.
And less than three minutes later, the information I wanted over the fax line! It made my day, which reminds me just how boring my life really is. And that I probably should be nicer to Primarycardoc's office staff.

Tuesday, February 1, 2011

Nursing brainwashing

When I was in nursing school, my professors repeatedly stressed the need to "think like a nurse."

I still have no idea what they meant by this concept, but I will admit that being a nurse has definitely influenced how I view the universe.

For example, most of my co-workers are middle-aged or older. I love working with them, but the fact that many of them have children my age does create a generation gap that makes small talk difficult sometimes.

So it's always nice for my social skills when the bosses fill open positions with people who are closer to me in age. But when you meet the cute new guy at work and your first thought on meeting him is "He has nice veins--I'd love to start an IV on him!" it's pretty obvious that "nursing" has hijacked large parts of your brain.

It does come in handy sometimes. It's a lot easier to say "Auntie, I know this is awkward, but five years of nursing brainwashing is making me ask you if you and your new boyfriend are using "protection" when sleeping together. You both should probably get checked for STDs, because they're spreading fast in your age group" than "Are you using condoms with the new boyfriend?"

I try to pretend to be like "normal" people, but the nursing mindset may be starting to leak through the cracks. My co-workers are starting to notice.

Like yesterday, when the other nurse and I were setting up a client's medications for the week. One of the social workers wanted us for something.

"Hello nurse people! It's like "pod people," but not really--I mean you're nurses...."