Thursday, April 28, 2005

What part of "nursing shortage . . . ."

. . .don't they understand?

National Nurses' Day and Week are around the corner. Nothing is being done to honor the nurses who work in our facilities - nothing at a corporate level. The following week is National Nursing Home Week, so they will do some special activities then - but nothing specific to honor the nursing staff.

There is an ongoing and growing shortage of nurses in the country. The median of age of a registered nurse is 46. The need for more nurses will grow as the population ages.

Many studies have shown that people want basic appreciation as much, if not more, than an increase in salary and benefits. If you let me know that you think I'm valued and an important part of the organization, I will be more likely to stay with you through the lean times. However, if the opposite is true - you don't make me feel as if I'm worth your time, then I may look elsewhere.

Although there are applications coming into the schools of nursing, many schools cannot take additional students to fill the growing need - the number of nurse educators is dwindling faster than the number of general duty RNs. The median age of nurse educators is 55.

Long term care requires nurses who can look at the resident totally - nurses who can think independently - nurses with experience and assessment skills.

Many nurses leave the profession after less than 10 years, citing long hours, little time-off, lack of staffing, difficult patients, uncaring administration - including older nurses who "eat their young."

I've been a nurse for almost 40 years. For more than 30 of those 40 years, I've been in management/administrative positions, supervising staff and caring for patients/clients/residents. I now manage a department that is responsible for the quality of care for 18 nursing homes.

Lately it has not been easy:

In the last 6 months, my department as been downsized - we did not replace a regional nurse who resigned because the nurse chosen for the position was making 5K/year more than the highest paid regional nurse. So the position went unfilled and the ones left took over more duties.

One regional nurse, very much pregnant, was told that she couldn't park in a "visitors' spot" near one of her facilities - she had to walk up and down a steep hill ( in the winter) to get to the regular lot. She was told, when sick with first trimester nausea, that she shouldn't have worked from home - instead of traveling 100 miles to meet with another nurse - even though her supervisor (me) had ok'd it because the scheduled work could be done by phone and online. One was not allowed one day off for the death of her husband's grandmother. One of the regional nurses didn't get the promised raise - and I discovered that the HR person was spelling her name wrong. The facility directory came out with everyone's email addresses - all except the regional nurses. The afore-mentioned resigned regional nurse was still listed in the directory (and HER name was spelled wrong) - 9 months after her resignation.

These RNs worked for almost 2 years without a raise. All have been offered other positions at other companies and for more money. One month after a raise was given, an arbitrary decision was made to eliminate mileage for the first 30 miles of a round trip to any of our facilities - these nurses travel daily. This decision negated their raise while allowing the company to bankroll the raises of non-traveling employees. The decision was made without input from me or any other of the managers of regionals.

All of these things added together could make one feel . . .like, well . . .like . . .well, that you were not important - not valued - unnecessary to the operation of the company - a nonentity.

Just what does a regional nurse do? Looking at all the regional positions:

The Regional Dieticians (5 plus the manager) monitor the dietary departments. The RAI specialists (6 plus the manager and his assistant) monitor the assessment process and use of therapies. The Internal Auditors (5 plus the manager and his assistant) monitor the business offices and billing. The Regional Nurses ( 5 plus the manager) look at everything else: nursing, pharmacy, social service, activities, environment, quality indicators, documentation, incidents and accidents, provide inservices, orient new DONs . . . .

Just what part of nursing shortage don't they understand?

Just ask me before you make a decision that greatly affects my department and do NOT let me learn about it at the same time as my staff. Do NOT blindside me. Give me a warning and reasons, so I can be on your side - even if I'm really not.

You see, I'm an RN, too.
And there were 12 PAGES of ads for RNs on Not 12 ADS - 12 PAGES.

Just what part of nursing shortage don't YOU understand?

Saturday, April 23, 2005

That Was The Week That Was - April 23, 2005

For those of you under 40, that was the title of a mavelous British-import TV show (many years before we got their reality TV or even "Are You Being Served"). TW3 spoofed the week's real news.

This is my week's real news. I cannot make this up - if I did say it was my fiction, no one would believe that it could happen - that is, unless, it was on an episode of The Office - and then it would be considered satirical. But, no, sad to say, this all happened in Mitzi World this week.

Disclaimer: If anyone from PennMed reads this and wants to fire me for giving away coporate secrets or for discussing corporate goings-on in a blog (as other more well-known bloggers have been terminated), please note the following: 1. I am NOT doing this on company time (unless Saturday mornings are now considered PennMed time). 2. I am NOT doing this on a company computer. 3. I am NOT disclosing any corporate secrets that could be used in the industry (dear goddess, I hope no one else would do these things) and D. Go ahead, make a case to fire me - I'm 57, fat, tired and need a rest - and the publicity - I would love to be the old lady Wonkette.

My week:

1. There was an interoffice memo from the president of the company via the HR department that no one is to place oversized coffee mugs in the dishwasher. I guess the company president couldn't fit his mug into the dishwasher one day.

2. A facility administrator said a "tall woman" told him to use different colored paper in the clinical records for each month of the year- for example: December's documentation in a resident's chart would all be on red paper.

3. The raise that regional people (the ones who drive to the facilties almost everyday) received the beginning of this month will virtually be negated by a change in expense policies: you cannot charge the first 30 miles on your expense report. At 40 cents a mile that comes to 12 dollars for each trip. I guess the price of gas is coming down soon - not to mention the price of tires, car insurance and general wear and tear on our nerves when we drive daily.

As an addition to the above, one of my regional nurses called me (as I was stuck in traffic trying to get back to the office where I can't put in an oversized mug into the dishwasher - even if I HAD an oversized mug) to tell me, that the raise she was supposed to get in this paycheck had not yet arrived. I called my office - from I-78 around Lenhartsville, already in single-lane before the construction and placed on hold for-ev-er. A full bladder, single-lane construction, worry about her department does not make for a happy camper. I told dear Olivia that I would just wait on the line until Willette (HR person who put through the raises) could be tracked down.

For anyone from PennMed who may be reading this: No, I did NOT get to the office Friday afternoon - I drove right home and arrived there at 4:15 - 15 minutes prior to my regular quitting time. But then, I did leave at 7:30 AM - one half hour prior to my regular starting time. But then, I didn't take lunch. Let's see 30 minutes minus 15 minutes equals - 15 minutes owed to me plus the 30 minutes for no lunch equals 45 minutes owed me. Hmmmm . . . 45 minutes minus 30 miles. I think I need a calculator - don't worry, it's my own calculator; I'm not doing it on PennMed time; it IS oversized (so I can read the numbers), but I won't put it in the dishwasher.

Wednesday, April 20, 2005

Where do you get your ideas?

I think that's the question I hear the most when someone finds out that I write - short stories, long stories, novels, poems, and . . . well, blogs.

The answer: I don't "get" my ideas - they appear to me - like Lennon's man on a flaming pie - they just materialize, without warning, without premeditation and sometimes at the most unlikely, and unwanted, times.

Let's take a for instance. Last night I had to have dinner with my supervisor, some regional administrators, my regional nurses and owners of the pharmacy company - the one that I think needs more work to make it nurse-friendly. I was NOT looking forward to it - I was tired, not hungry for rich food and just wanted to veg in my jammies and watch mindless TV. But I was a good corporate girl and made my regional nurses be good corporate girls and we went.

It was not too bad - thanks to the company at my end of the table. Dina, one of my regional nurses, lives in a funeral home - her husband's business. Of course there are lots of stories around a funeral home (hence A&E's "Family Plots"). But Dina also has lots of stories about her family, husband Brian, son Sam, dog Quincy (for Quincy, M.E.) and cat Nedley (I wanted them to name him Jordan, but I had no say in it).

Now Nedley is a black cat - but not just any ordinary black cat. Ned looks like a Siamese that was dipped in a pot of black paint, sleek with large ears. Ned also has the Siamese's intelligence. Not that other breeds aren't also bright; but, the Siamese are legendary in their intelligence (google Lillian Jackson Braun or KoKo and YumYm and see what you find).

But I digress. I've heard many Ned-stories.: paw prints on top of the ceiling fan, ambushing Quincy and jumping on his back. Cat stories - cute but uninspiring - until last night.

Dina told a simple Nedley story. There is a door between the family quarters and the funeral home and one day, Ned tried to scoot through that door and into the casket viewing room.

Bells went off in my brain. A bright neon "Tilt, tilt, tilt" appeared over my head. I heard Bob Barker yelling, "Come one Dowwwwwwwn." We have a WINNER.

And here is how a writer's brain works. My latest heroine (Elizabeth Peacock, ertswhile reporter of paranormal goings-on) has a best friend who is a funeral director. I can work in a scene with a black cat hiding in a casket and then someone opening the lid and . . . cat jumps out.

I had the germ of a scene, a scene that could be humorous, a scene that could be pivotal - I needed to get a character in the funeral home for a legitimate, plot-driven reason - I already had Elizabeth driving the old hearse because her own car had been impounded.

Throughout the rest of the dinner, as the nurse-part of my brain played corporate person, the writer-part of my brain was busy with the new scene.

Where do I get my ideas?
From a cat on a flaming pie.

Tuesday, April 19, 2005

Alone Again . . .Naturally

I must be hung up on song titles today. Song titles and Seinfeld episodes - the chronicles of today's culture.

Alone again - naturally. This is not a complaint - but an observation. This is not a bad thing. The longer I remain unattached, the more I like it. I may have even used that title in an earlier blog.

Is it blasphemy to say that I enjoy being alone? I enjoy, relish, cherish time alone - to read, to meditate, to pet the cats, to write, to nap. I even love traveling alone. I enjoy planning a day trip on my own - going somewhere new - without worrying if another is happy, content, having a good time.

Sometimes I wonder why I'm not more . . .well, more lonely. Is it the old cliche of faking it until you make it? Did I fake enjoyment of the single life for so long, that now it is my life - a good life, a rich and full life? When did being alone - being a single person - become a liability? When did society decided that "oneness" equaled "badness"?

People who travel alone are asked to pay the "single rate" which is usually several hundred dollars more than other rates. As a single person dining alone in a restaurant, I've been passed over as the wait person heads to the couple, even though I was seated first. There is still the societal discrimination: if you're not married or living with someone, there must be something wrong with you.

But is there something wrong if the person can say that they are truly happy and content?
I don't think so.

I'm entering a new phase of my life that, in many respects, seems to mirror my adolescence. I am relearning who I am, who I can be and who I want to be.

Right now I only have room in my life for me.

"Whoooo Are You . . .Who? Who?"

Apologies to The Who and CSI (the original), but this is the question I've been asking myself everyday as I look at the wrinkling countenance in my bathroom mirror.

As I walk out my front door every morning, I can see the poster for The Beatles at Shea Stadium hanging in the entrance to my apartment. The poster is a reproduction given to me on Mother's Day by my daughter - my 34 year old daughter. I was at Shea that August evening in '65 - just a few days before I was to enter nursing school - a few days before the life I wanted changed into the life I would have.

What happened to that girl, the one who rode the bus to New York to see The Fab Four? The girl who would sit in the basement and pound out stories on the old Royal portable - a Christmas gift from a father who wanted to inspire his daughter - not to be a writer, but to be a secretary. Where is the girl who fantasized about running away to England, to live in the Cotswalds, to travel the British rails? Where is she?

Is she still around somewhere, buried deep within an aging, overweight body? She still pounds out her stories - now on a computer. She still listens to J, P, G, and R - on her CDs. She's been to England four times and is planning her fifth trip across the pond.

She's still around - she didn't know who she was in '65 and forty years hasn't changed that.

Monday, April 18, 2005

That anti-aging face cream . . .

. . . must be working.

Yesterday was a gloriously beautiful day. I spent about an hour at B&N, sipping FF latte and reading (I did buy some magazines and a book). I then went to a nursery and bought plants - pansies, lavender and herbs. Back at home, I cleaned off my patio and potted the plants. I decided I wanted to spend the rest of the afternoon sitting on the patio, reading and sipping. . . what would I be sipping?

I had the urge for a beer. But I shouldn't be drinking a lot of alcohol, so I decided to run to the Giant for some O'Doule's - the non-alcoholic stuff. At the Giant I took my time, meandered around the aisles, picked up pretzels to go with my fake beer. I proceeded to the check-out line where a sweet-young-thing beeped through the O'Doule's and asked for my ID. A tad confused, I thought she wanted my grocery store discount card and handed that to her. "No, I need your ID," she repeated patiently.

I must have still looked wifty, because she motioned to the six-pack and said, "For that - I need ID." I finally got it. "For non-alcoholic beer, you need an ID?" I asked shaking my head. And then it hit me. I started to dig in my purse for my driver's license, thinking that it had been a long time since I had been "carded." I pulled out the license and said, "You mean I don't look like a 57 year old woman?"

A manager must have walked by then, because she suddenly appeared to tell the cashier that there were some people who didn't need to show ID for "cigarettes and other things."

I still couldn't get the idea that I was being asked for ID for non-alcoholic beer. "Is it because there is a little alcohol in it?" I asked the manager. She shrugged her shoulders and said, "Maybe."

"What do you do with mouthwash, then?" I wondered aloud as I picked up my bag and walked 57 year old legs out to my car.

The O'Doule's did taste pretty good as I sat on my clean patio.

Tuesday, April 12, 2005

Technology is wonderful . . .

. . . as long as it works.
I just spent an enjoyable morning reworking a Power Point presentation on pressure ulcers. Says that real fast five times. I gave the presentation once and it was a bit . . .well. . .blah. So I added a couple of cute pictures with funny sayings and had one of the computer wizards here burn it onto a CD. Now I can take it to the Medical Directors’ meeting (western facilities) in Pittsburgh Thursday night. I really enjoyed making the slides, etc – I had forgotten how much fun that was. Even if it was on pressure ulcers.

Now onto the inservice on Alzheimer’s.

Monday, April 11, 2005

Lunch time thoughts

My office is small but it has a large window and a glass door that face out onto the building’s parking lot and grounds. This affords me the unique experience of being able to watch personnel and visitors come and go. Today I have glimpses of prospective employees coming for job interviews.
I work for a nursing home management company. The operative word in that phrase is “nursing.” I’m the director of the “nursing” part of management and I have five regional nurses to cover 18 nursing homes. I had six but when one resigned, her position was not filled – a financial consideration. One regional nurse is now on maternity leave, so I’m down to four – temporarily. I’m trying to take up the slack and do my own job. At times it’s difficult and at other times almost impossible. But I smile and nod a lot.
And watch prospective employees come for interviews – for an accounting-type position. I want to say to TPTB, “This is a NURSING home company – not an ACCOUNTING home company. Why can’t I have another nurse?” But I don’t. Like I said – I smile and nod a lot, and watch accountants walk into interviews. The latest one just left, head down, clutching a portfolio - her body language saying that the interview did not go well.
Sitting comfortably ensconced in my windowed office, I felt a surge of compassion for her. After all, I’m a nurse. I can work almost anywhere. I could be hired on the spot in some areas. I just don’t know if, at 57, I have the physical stamina to do the hands-on, general duty nursing job.
I do like my bright office. And a paycheck. And healthcare. So, I’ll keep my mouth shut and watch more accounts apply for positions at this nursing home management company.

Lost in Academia

Recently a lovely spring morning found me sitting inside a classroom at a local college. It was a Saturday and I should have been sipping fat free latte at Barnes and Noble or planting pansies. But nooooo. . . . there I was, old woman on campus, listening to the wise words of the academics: academics with MFAs in poetry or creative writing, academics as adjunct professors, academics as Department Heads.
I looked around and wondered, “WTF am I doing here? I’m JUST A NURSE.” Actually I’m a nurse who’s also a writer. My profession pays a salary that allows me to live as independently as a 57-year-old single woman can live in this country and this economy. If it wasn’t for nursing, I may not have the “grist” for the “mill” of my writing.
But I longed to be a member of the heady elitist class that I was visiting that Saturday morning – the longing going back more than forty years. Unable to go to college at 18, I chose nursing school; three years fulltime education plus room and board for $500 was a bargain in 1965. So my educational fate had been sealed early on in my life.
Oh, I had ventured into ivy-covered halls off and on in the last forty years – taking a class here and there. But eventually I decided that getting my BS in Nursing would cost too much in time and money – I was already making more than any newly graduated Bachelor’s-prepared RN.
So just why WAS I there on campus that lovely Saturday morning? I was there ostensibly because it was a writers’ conference. Actually I was there to support a good friend who happens to be a member of Academia and to hear a popular Irish-born storyteller, the speaker at the luncheon.
I attended three workshops and discovered that I was one of the oldest attendees. I was also one of the few, maybe the only one, who did not have (or at least working towards) a college degree. I was beginning to feel like the clichéd fish out of water. That was until the luncheon.
That was when Malachy McCourt addressed the august assembly of college-types. Multi-published and widely popular speaker, humorist and modern folklorist, McCourt made no bones about his complete and utter lack of formal education. Finally I could relate to someone on that campus – the keynote speaker. I listened to his stories with rapt attention. At the end of his speech, he decided to “finish with a song.” With a clear voice he began the old Scottish ballad, “Wild Mountain Thyme.” It was soon apparent that there were only three people in the room who knew the words: my friend, Juilene, Malachy and a nurse in the back of the room.
Later, when I presented a book to McCourt and asked him to sign it to my daughter, he said, “And you – you knew all the words.”
I wanted to tell him that he had made me feel less like a “fish out of water” on a college campus, but I didn’t. There were others waiting for a signing. But I felt his words were like a bond, a connection, from one under-educated but intelligent writer to another.

Starting Over - Again

Life is not just a journey - it's a series of starts and stops along that journey. My blogging stopped for several weeks and now it's beginning again - if I can just figure out how to do paragraph indentations in this template. I also question why the word "blog" does not appear in this website's spell checker. I mean, isn't that like a "nuh-duh, dude." And how do I get a line break - or is it all a stream of Woolfian consciousness . . . .So many questions, not enough paragraphs.