work issues

*this is not my usual mommy blog post, and I used lots of jargon-I will be happy to explain anything to my regular non-medical readers.

I don't usually write about work, there are lots of reasons for that. I have never hid the fact that I have a blog from my coworkers, and I worry about revealing too much about the patients I take care of.

Things are changing in the hospital that I work in. This is the only level one trauma center in our state, we have 1000+ beds, and 11,000+ employees. It's a teaching hospital and a small city all by itself. It seemed like the best place to start out as a new grad, that I would be where the action was, see a lot and learn a lot.

In the five years that I have worked there, upper management (president/ceo/director of nursing) has changed drastically, it feels as if no one is in charge, like the rules are being made up at will. We have had three incidents of wrong surgery site in the last year. Every week there seems to be some new policy, or procedure, or extra piece of paperwork that the nurse is responsible for. From Christmas on the pace seemed to just pick up until it was at a pace that was not possible to keep up with. All nurses where routinely staying an hour or more after their shifts to be able to finish their work. Extra beds were being placed in rooms that only had one oxygen and suction set up. We recently lost 6 good nurses. Smart, good common sense, experienced nurses. People who just decided they were done, it was time to move on.

Suddenly now we have had a huge drop in patient census. Odd since other area hospitals are not having the same issue. There is no overtime, units are being closed, including MICU, and step downs. Due to this it was decided that medical floors like mine would begin taking long term vents. Traditionally these vents would go to the RICU, but they are so full of "stable" vents that they don't have room for new patients needing beds. Apparently at some point in the past medical floors did take vents, this was before my time. I don't have an issue with learning how to manage a vent patient, but I don't think it is too much to ask that we get some training. Little things like, how does a vent attach to a patient, what do I do if it malfunctions, what do the alarms mean, what do the settings mean. It was agreed that some training would occur before we got a patient, and that the patients were to be placed near the nursing station so that we could monitor them more closely.

Of course this weekend we got a vent a patient, of course we did not get any training, of course the patient was placed as far away from the desk as possible when there were empty beds right near the nurses desk. Of course when we came on shift saturday morning we were upset, of course the nursing supervisors didn't care, of course the patients family was upset they were on a floor that didn't have the knowledge they needed to care for this patient, and wanted to be in the RICU where they always go. As we are talking we find out the patient does not have an ambu bag at the bedside, and did not travel with one to our floor, as they were told they didn't need one. So something like 10-12 hours later before that one was caught. We also did not have the appropriate trach size in the hospital. Luckily the family had brought one with them.

Long story short we had a nurse on the floor with some previous step-down experience (however brief) and the supervisors felt that she should be given the patient. She objected as she had not worked with a vent in years, got yelled at and told she had to. The nurse who the patient was actually assigned to was offended that the patient was just being taken away from her, and while the whole supervisor thing was going on went ahead and contacted the doctor and managed to get the patient moved to RICU as the family wanted.

I'm feeling that this hospital is in a decline, and I'm nervous because all of my work experience is in this hospital. I chose to work here because I thought it was the best place to be, that it meant something, but now I'm starting to worry that it will be perceived as "that hospital". I wonder if this is just cyclical, and it will pass, I hope so. In the meantime I wonder if i should make a change, or just stick it out.

quick post

today i am spending just about 800.00 to fix a car that's not broken, it needed an oil change, then it needed it's 30,000 mile tune up, now it also needs front breaks, oh well at least we have the money right now! 6 months ago i would have had to say no.

i'm supposed to be cleaning but i'm blogging, ( i will keep it short though) little boy undies don't wash themselves.

i felt better after the gym yesterday but it didn't really last, i was just tired all day, but went to bed early and have been better today, still tired but not cranky at least! alright whiney three year old says i'm done blogging!

cranky

hubby came home from work vomiting, baby was up twice last night, woke up to hubby standing over me looking for shorts to wear to work ( works construction) damned if i know where the entire bag of his summer work clothes went last fall-it has to be the basement, went to the basement covered in saw dust and insulation and completely blocked by tools (barefoot) to look, nothing, will having a temper tantrum from the time i opened my eyes to the time hubby left, now it is 7:17 i feel stuffy and tired and cranky and i'm supposed to be at the gym at 8:30, had to drink my coffee with milk cause we ran out of half and half, haven't had a shower in days....

maybe i'll feel better if i just hop in the shower and go do a little sweating? here is hoping...

our week in pictures!

We have been busy!!! We got two new bedroom sets which required tearing apart two bedrooms, I'm still not sure where exactly most of my clothes are but they are in random baskets in what will be Ben's room. On tuesday we had a little boy sleep over, and he stayed most of wednesday, thursday we went to the zoo with friends. I worked on friday then did all the shopping for Will's birthday and party, Will turned three on saturday, his party was sunday,(he had a great time running around the yard with his cousins and little friends) I worked on monday.

But today was amazing, I went to gym and did a great hour with my trainer, we all took a very needed 2 hour nap this afternoon, daddy came home, we grilled, ate on the deck, played in the backyard with the boys, did baths and just finished tucking them into their beds in matching pj's. A perfect day, my favorite kind of day, just us enjoying the warm weather and our little family.

here are some pictures from our week:

playing in a cardboard box fort while mommy and daddy to house stuff:

at the zoo with will and his little friend lucy:

opening presents the morning of his birthday, ben loved the paper!

birthday decorations! diego style!

will pulling on the diego pinyata


and tucking away his candy
the diego cake i made myself (thank you nick jr.com)

outside playing with mommy and daddy tonight

that's my week in pics, i will post pictures of the new furniture soon!

big boy bed

i'm not sure how or when or why my house has been so busy but lord almighty it doesn't stop! we have a constant run of kids in and out, places to go people to see, kids to have sleep over, warm spring days to play outside, piles and piles of underwear and pants to pee through because we are far to busy playing to stop and go potty.

we got our new bed a week after the rest of the furniture so we have it all and i love it. will adjusted amazingly well to his big boy bed, a little too well actually...

since he was a few day old baby i have rocked him to sleep, or at least to sleepy, i have sang to him told him stories, joked around with him, and "cuddle-cuddled" i have put my nose into his golden curls and inhaled him, i have tried to memorize what he feels like in my arms.

this little boy will be three on saturday, and of course i have no idea how three years have gone by so quickly, or how much our ( my husband an i) lives have changed in three short years. from a married couple to parents of two.

but back to my point, for the last three nights my not quite three year old has stood up and told his daddy "i'm going upstairs to my big boy bed myshelf" and put himself to bed. at first we thought he was kidding, until he fell asleep without even saying goodnight to us. so now when he suddenly just gets up and goes upstairs we go up after him to at least kiss him goodnight.

did i mention he's not even three?! i thought i had more time to cuddle him and rock him! my girlfriend tells me this is just a phase and soon enough we will be wishing he would just go to bed, but i'm freaking out!

bad mother, bad, bad mother...

what my 7 month old infant does while i catch up on reading blogs:

yup falls asleep standing up, while bouncing...

I"ll take that mother of the year award now.....

projects!

is it just because it is spring time that i find myself knee deep in projects?

everywhere i go in this house there is an unfinished projects staring me in the face, things i either want to work on but can't because the kids need attention, or need to work on but have no ambition to tackle just then.

we bought will a big boy bed this weekend and he has done very well with it, but in the process decided to replace our bedroom furniture as well, so ended up emptying our furniture in a hurry into a big messy pile to make room for the new peices, of course i haven't gotten anything done up there to put it all back together.

the dryer is broken, we got the new drum today to fix it, but i have had to wash clothes here and cart them to my mother in laws to dry.

i have worked two doubles in the last week and i have a sinus infection. oh and my car got keyed while we were out a restaurant for my sister-in-law's bday. will had a tantrum half way through the meal, so hubby took him outside to the car to talk to him, when he got there he found someone had gone back and forth on both of my drivers side doors several times, so now the car needs to be repainted!

our new furniture is amazing though-we don't have the headboard and footboard yet they are on back order, but it is very pretty, very grown-up looking cherry finish, and we got a king! love my new bedroom, don't ever want to get out of the bed! ok need to do dishes and pick up down here and then try to get some stuff done upstairs!

because i am "that mom"

i don't dress them alike to leave the house, as a matter off fact, this is the first time i've ever dressed them alike, but come on...its cute!