thinkers and dreamers we are

And just in case I have not been paying attention to what’s in the news in and around the Central Valley over the last couple of weeks, I have acquaintances to remind me…especially if it is news that might indirectly affect me, is indirectly about me or what might be important to me…bonus points if it is perceived to be news in a negative light.

Aren’t some acquaintances and friends good for things like that?

Yeah.

In the news recently here in the Central Valley was a recent article that suggests certain hospitals in the Valley are price gouging. Of course some people I know want to know how do I feel about being a price gouger?

Um…

Because while caring for critically ill babies, I am jacking up the prices of the care and services that I provide?

Here’s the thing, even the authors of this recently released study concede that they are not including discounts offered for care and services to the uninsured and insured patients. Factoring in these these discounts would have had a significant effect on the cost-to-charge ratio reported, and therefore the implications of the study’s results. Which goes to show you that one can not and should not just accept a study, any study as valid and absolute truth based on its conclusions…“Dr.” Wakefield’s study linking autism to vaccinespatients’ perceptions of nurses with tattoos and body piercings immediately come to mind.

For what it’s worth, as a nurse at the bedside, I am not setting the prices for the care I give, the medications I deliver, the equipment I use while doing my job. I’m too busy saving lives, providing healing care, providing education to my patients’ family members of their babies diagnosis, condition along with how the medications I administer and the care I give will help their baby and how to take care of their own baby while in the NICU and after discharge.

My workplace is the only hospital in the community of Modesto and Stanislaus County to provide care for everyone, regardless of ability to pay; that’s millions of dollars of uncompensated and charity care provided rather than charged. My workplace employs over 2,100 people, contributes well over $250 million to the local workforce annually as well as contributes over $3.7 million in local taxes every year. Our hospital and employees this year have provided over 50 educational seminars for local schools and community groups, participated in more than 70 community events and regularly contribute to over 50 local non-profit and charitable organizations.

Thinkers. Dreamers. That’s us.

It is what drives us all to serve our community the way that we do at the bedside directly and in and around the community and out-lying areas. It is being thinkers and dreamers that inspires us every day to do what we do and even do it better.

Our hospital continues to receive top grades in patient safety including our overall performance on safety outcomes, including preventing errors, accidents and infections. The unit I work in has had more than 6 years of ZERO CABSI incidents. It was thinkers and dreamers in our unit who dared to imagine that it was possible to have absolutely no catheter line associated bacterial infections. Such strong work has been recognized nationally and even within our hospital as the staff who cared for my darling husband talked about what we are doing in the NICU and how they are hoping to implement the same. Lucky for them, and other local agencies in the valley, one of my colleagues will be providing education next month on our journey to zero and how it is possible. Fellow employees at my workplace provide the type of trauma, stroke and cardiac care that is literally the Gold standard of care here in this Valley which Silver and Bronze awarded local facilities strive to emulate…something I am proud of and most definitely thankful for, you know, since they saved my darling husband’s life.

Yes, one study might contort and twist and suggest less than favorable things about where I work but, dear acquaintances and friends quick to point that out, I would counter do your homework and check the facts especially when you decide where you want to be when you need to be in the hospital. Me, I’m choosing a place with thinkers and dreamers who are providing the very best of care and often times making the impossible possible.

not even a wordless Wednesday: the nurses week edition

Yes, it’s that time of year again. It’s Nurses Week. Of course as a nurse I am celebrating and enjoying the well wishes from my co-workers and the parents of former patients and anyone else out there because it is kind of nice to have a week of recognition; which we share with teachers. The irony that two of the most thankless professions most days (as in if there is a problem it is, of course the teacher’s or nurse’s fault) share a week of national appreciation and recognition.

I took the time to send a note of thanks to Daniel’s teachers today. Actually I sent them a note and email about concerns about him not understanding the current chapter in his math class and his parents not understanding at all because what the hell is up with Common Core…and then I thanked them for all that they do to help support, encourage and teach Daniel…as I do every single time I send them a note, or email them, or talk to them on the phone, or face to face because Daniel has some pretty wonderful teachers and I can’t thank them enough.

Then I found some of my favorite nurses-related memes and cards that I pinned on Pinterest to remind me on the days when I am feeling especially tired, exhausted, thankless or covered in the most disgusting yuck that I am afraid to enter the Big Top for fear of spreading it. I laugh. I cry. I think. I give thanks. Then I am ready to put the scrubs on again and do what I do because I do love what I do. So in celebration of me, some of the smartest, funniest, loving, hard-working people I get to work with and who have literally saved the lives of some of my circus act, most recently the darling husband; I give you some laughter and some deep, heart-felt thoughts on what I do.

and one more because, yes, this has actually happened to me at least three times in my 25+ year career…true story.

Happy Nurses Week!

Thank a nurse. Hug a nurse. Buy a nurse a cup of coffee…a massage…lunch…maybe some sleep.

Bound by paperwork, short on hands, sleep, and energy … nurses are rarely short on caring.” — Sharon Hudacek

parenting NICU style

Wa-ay back when I was a nursing student, one of my professors shared a cautionary tale about patients and medical abbreviations. A nurse, preparing to assess her patient, sets down her clipboard. While she is carefully assessing her patient, the patient spies his name on her clipboard with the word “SOB” next to it. What followed, the professor shared, was more than awkward for nurse and patient.

In case you didn’t already know, “SOB” is a medical abbreviation for shortness of breath. The nurse’s patient had emphysema and indeed was struggling with shortness of breath. He might have also been an SoB too…then again, he might have been an all around nice guy. Who knows?

There were many takeaways for us to learn from that scenario that the professor shared. For me, the biggest one was to not let my patients or loved ones see my shift notes. I keep them in my pocket.

This lesson came to mind the other day while reading through one of the micropreemie parenting forums I participate in. A parent shared her frustration of over-hearing her baby’s nurse share with the nurse taking over her baby’s care that she had been crying. Not understanding what that had to do with anything, she vented that they should not be worried about her because their job is to take care of her baby. Who cares if she was crying? The NICU nurse in me wanted to comment as to why the nurses might have been talking about her during their hand-off report. The NICU parent in me knew that she just needed to vent because for many micropreemie parents, there are few, if any, safe places to vent off some of the tears, fears, pain, frustrations and anger that is life as a parent in the NICU.

As a parent in the NICU, I know too well that feeling of being watched over, scrutinized even. In the NICU where Daniel was, where I also worked, parents had access to the bedside chart and were more than welcome to look at it. It was not uncommon to see a note or more about Bill or myself visiting Daniel. Weird to be under a microscope and analyzed in that way…especially because we already felt intense pressure from social workers, family and friends who questioned our motives to want to be Daniel’s family. Stir in the fact that a number of my own colleagues were against our plans (and quite vocal about it) and my being called into my manager’s office a couple of times because staff and administration had a number of concerns about my wanting to adopt a patient in the unit because something like this had never happened at that hospital before. “People might think we are ‘giving babies away at Good Sam’!” 

The horror of such a thing! 

Not fun it was.

If only there was a forum like the one I participate in thirteen years ago!

With most NICUs in the US focused on Family-Centered Care and many hospitals keeping an eye on overall patient and family satisfaction, odds are families are going to be right there during change of shift hand-offs and rounds…unlike the “old” days when I was a baby NICU RN and the unit was closed to family visits and calls during change of shift so that we could focus on the hand-off of patient care.

Being a parent in the NICU is hard. Other people seem to know more about your own baby than you do. They tell you when you may touch them, when you can hold them, feed them, change their diaper. You feel guilt that your baby was born early, that you can’t be at their bedside 24/7, that your other children need you, that your husband needs you, that everything else going on in your life is being ignored. You deal with questions…questions all the time as to why the baby was born early, what did YOU do to cause that, what’s going on currently with the baby, why isn’t the doctors and nurses doing what your co-worker’s nephew’s baby had done to her, why aren’t you at the hospital right now, why aren’t you spending time with your other children because they need you too….and on and on and on. Doctors and nurses and staff either seem to act as though you’re not even there or are hovering not giving you just a quiet moment alone with your baby. And god help you if you break down and cry or yell and scream in the NICU, at home, in church, at the school drop-off, in front of your parents or your in-laws.

NICU parents, am I close?

For what it’s worth, speaking as a NICU RN, when we share with colleagues that mom was crying today, or dad keeps asking the same question repeatedly or the family’s only car broke down or almost anything else family-related it is because the care we give is Family-Centered Care. Our role is to care for the baby first but we also are caring for and supporting the family during one of the most stressful times in their lives as a family…until their baby is a moody teenager. It helps the staff to know that mom is having difficulty producing breast milk or that her mother in law doesn’t want to drive her to the NICU anymore or dad just got laid off or little brother is sick with the flu so that we can better address what the family and the baby needs right now…and what they need to be ready for discharge because, god-willing, discharge will happen sooner than a NICU parent can hope to imagine.

What an amazing day that is when your baby is finally free of every single wire, tube and tape that is attached to his body and you pick him up and hold anytime you want to!

It’s a day that every NICU parent and NICU nurse, doctor, respiratory therapist, social worker and unit coordinator looks forward to as well.

Meanwhile, dear fellow NICU parents, cry if you want to, vent away too, but most of all, hang in there. Your journey is just beginning and this right now is preparing you for the weeks, months and years after the NICU.

 

 

for the future important people

This week in my social media:

And one special gem that made me smile and made me cry.

Dr. Carey D. Andrew-Jaja’s joy shines out like a bright beacon in this video. It reminded me of the fact that for the last 25 years I always whisper “happy birthday” to each and every tiny human I have the privilege of greeting on the day that they are born because this day really is a day to celebrate meeting a future important person. Oh, and I am reminded once again that I do have the best job ever shaking the hands of countless important people.

The mother of this one reminded me yesterday that she turned 9 years old. Honestly, it seems like it was yesterday when she and I shook hands for the first time.

 

 

resting can be hard

Moms, remember when our babies were brand new and the well-meaning, but not asked, advice givers would tell us to rest when the baby sleeps and we might have ignored that advice in the beginning?

Remember?!

The baby is FINALLY asleep!!! OMG! I can take a shower and maybe shave my legs and armpits and blow-dry my hair I might put on makeup and I am definitely putting on clothes, real clothes and then I will take care of that sink full of dishes oh and the laundry who knew an 10lb baby could create so much laundry and I will watch all the tv and write thank-you notes and…

WAAAAAHHHH!!!!

There you are, dripping wet and wrapped in a towel. 

Damn!

And after changing the baby and feeding the baby and changing the baby again and rocking the baby, you realize that you might have slept 30 minutes in the last 24 hours and it dawns on you…

You should have taken the time to rest/sleep when that little baby was down for maybe an hour…that same hour that you made plans to do all kinds of stuff that really didn’t need to be done because this tiny new baby never sleeps.

Oh what a blessed hour it would have been too.

You learn…eventually…hopefully…perhaps after the third baby. Then the well-meaning, but not solicited, advice givers will judge you as lazy.

Resting, when we should, can be hard. There’s so much to do. So little time.

About 5 weeks now into my formal half marathon training, which by the way is going GREAT, I come upon an extra rest day. A rest day on a night that I am working in the NICU.

Hmmm…

I always run a quick 3-4 miles before work because I do. It’s part of my getting ready for 12 hours of taking care of tiny humans all night long routine. Last Friday I ran 3½ miles before work and then ran 7½ miles Saturday afternoon with no problem at all. I need to run before work, I tell myself. There is no way I can get through my night with out a little run before.

Then the rational part of me, the part of me that actually listens (sometimes) to well-meaning, good advice reminds me of what Hal Higdon says about rest:

The most important day in any beginning or intermediate running program is rest. Rest days are as vital as training days. They give your muscles time to recover so you can run again. Actually, your muscles will build in strength as you rest. Without recovery days, you will not improve.

But it’s hard!

I need the before work run!

It’s a Friday night.

The census is up.

The acuity is high.

I really need to run.

SIGH!

I need the rest day too. My body needs the rest day. My mind probably does too. Resting IS fitness training.

Fine, I’ll rest.

Apologies to my colleagues if I get all twitchy.

Resting can sometimes be so hard.