Saturday, November 30, 2002

Yawn. Slept in today, watched a bit of the Travel Channel's feature on the hotels of Disney World, and leafed through the latest issue of BUST. The Music issue. Always a treat.

Tonight we celebrated the arrival of the Better Half's parents into town by going into Carytown, eating at Nacho Mama's, then coffee at Bev's and a late evening showing of The Tuxedo at The Byrd. Mr. and Mrs. BH bought us Byrd dollars. The movie was pretty good, and Carytown is all good, as always.

I heard recently that a couple of Baheads flashed the other night at the bar. I don't know who, or the details of what happened that night. The only reason I bring it up is because this week's Entertainment Weekly has an article by Joel Stein about riding along during the making of Girls Gone Wild. The maker of this video, Joe Frances, has two quotes in this article which really say a lot. Mainly, "Man, this guy's an asshole!"
The first: "Christ could walk into the bar [where women were taking off their tops and bottoms for the camera] and start performing miracles and no one would notice. They'd say, 'Oh, another Jew is here.'"
The second: "Girls [strip for free because they] want to get wild. It is a liberating thing for them."

Okay ladies. I'll level with ya here. I don't flash my naked tahs in public because a) I don't wanna, and b) I feel it would disrespect my man to jiggle the twins in the faces of other men. But I don't think I am better than those who do. I don't disrespect the Baheads who disagree with me. But I want you to think before you flash. Do you really want to give an ass clown like Joe Frances and guys like him the privilage of seeing your breasts? If the answer is yes then at least settle on tit for tat. Let these guys drop drawers. C'mon liberated. I promise I won't giggle too loudly when it's too small. :)

Friday, November 29, 2002

Last night was great. The cheeseball was a moderate hit. Our group of sixteen had skimmed down to thirteen, as my sister's friend didn't show up, Kristen caught the flu and Uncle Bobby decided to stay home and take care of her.
My greataunt Da made a mean Tom Collins (more gin than actual Collins) and I had two glasses of wine. Combine that with the cheese, I could only muster up enough stomach room for two plates. My Betta Half's cranberry sauce was really good. The turkey was perfect, despite a near mishap in which the basting pan failed and dripped turkey juice into the bottom of the stove and onto Nanny's floor. The big to-do was the pumpkin pie. For a couple of years now, the pumpkin pie was missing at our holiday because the rumor was started that no one liked it. Not true. I LOVE pumpkin pie. Unfortunately if you don't sing a food's praises 365 days a year, my fam tends to forget. So this year I whined in the way that only the oldest grandchild can successfully whine, and my aunt Tricia, my Godmother for good reason, made a pumpkin pie. I got free run on it, since no one else but Da touched it, and got two huge pieces. My family was amazed. "She really does like pumpkin pie," Da exclaimed.
(I guess, after that story, I should explain how Da got her name. A lot of people when first introduced to our fam, mistakenly refer to her as "Di," as in Princess. It's Da. As in the sound that baby Tricia made when she saw her. The name stuck.)

After the Dallas Cowboy game, which my mother and father watched gleefully as Dallas laid the smack down on Washington, my Grandfather grabbed his big remote control and began flipping channels. My Papa is a treasure. He's been through a lot, having lost two brothers in their thirties to heart attacks and a battle with booze. He's been sober long before I was born, and his addiction now is sports. Papa is a walking encyclopedia on sports. So for a Christmas present a few years back, my mom and her sibs and their spouses chipped in and got him a satellite dish, complete with The Sports Package, with about eighty gazillion sports channels broadcasting games at all hours of the day and night. But tonight, he stopped at a movie. "You ever seen this movie?" he asked me and the Better Half. "This is a Harrison Ford movie called, uh, Witness. Man, that Harrison Ford is a good, good actor." Turns out my Papa is also a fan of Kevin Costner and Tom Cruise.

Papa leads the prayer each fam function. We do the standard Catholic blessing (Bless us, O Lord, for these Thy gifts...) but Papa usually improvises at the end. The improv is usually the same theme, but we always love hearing it:
"And Lord, I just want to thank You for health and my wonderful family. People often ask me how I get my family to go to church or to come and visit. I have no answer, but I know there is a lot of love here. Yesterday there were six people here, raking leaves, setting the tables, moving furniture, so that they could come and sit together tonight. And that is just wonderful."

I couldn't agree more.

Thursday, November 28, 2002

Thanksgiving has always been great fun for me. It's my favorite holiday: stresses togetherness, lots of great food, and without that pressure of buying presents. My contribution to the Thanksgiving dinner is the famous cheeseball. The Better Half, being The Better Cook, has made chilled cranberry sauce, a recipe that he got from a friend's ex-girlfriend. I sampled a bit, and reassured him that my finicky fam would love it and if they didn't, I'd eat it all. The Better Half cooked French toast, and hot cocoa.

I am undertaking a rather ambitious house renovation/feng shui project at Casa De Jenn. I am finally parting ways with my old This End Up desk that I have had since age 11. I really don't use a desk anymore, and I type on a laptop. The good folks at St. Mary's Thrift are willing to take it, but if any of you guys need a desk, email me, and it's yours for free.

Tuesday, November 26, 2002

Today I went and helped Nanny with the Thanksgiving decor. We raked leaves for the exterior, then for the interior, we took out the Good China, and arranged places at our big table for sixteen. At the end, it was kind of sad, because she told me, "I couldn't have done it alone. I am getting so old." It made me realize she isn't going to be around forever. Part of me looking for another job involves balancing my family and my friends into my life.

Monday, November 25, 2002

I'm in pain. has 8 cashimir-icles for low prices for the holidays.
My sister and mother laughed at me when I looked for some clothes in my closet to pawn.
My keys, which I think were abandoned in the ER the night I fainted, are no where to be found. The Better Half laments that his keys were on my keychain at the time.

l'm ready to gobble down two Benadryls and call it a day.

Sunday, November 24, 2002

I am unemployed.

I fucking hate it.

Saturday, November 23, 2002

I am feeling good today. I am sitting downstairs, listening to the opera Samson And Deliliah on NPR. The Better Half is upstairs in his office. I can hear the strains of Neil Diamond and The Better Half’s off-key karaoke of “Play Me” over my radio program. At my feet are the latest issues of People Weekly, Vogue, and Us. Brain candy.

I realize how much of myself is wrapped up in nursing. Every so often, I need a break, a sabbatical, where I tap into my other interests and I am reassured that I am not one-dimensional. I like rock and roll music, Russell Crowe, F. Scott Fitzgerald, the works of Mary Cassatt and, of course, knitting. I want to take scuba diving and sewing lessons before I get married. I used to consider myself active, although recently I haven’t done as much as I’d like. I get tired so easily now, and after working a twelve-hour shift, all I wanted to do was go home and stay put. With a rotating schedule to boot, I couldn’t ever commit to a class that met at a certain time each week. I realize that working in a hospital just doesn’t feel right for me now, although I needed the experience. Now I feel it is time to move out of that mold.

Whatever this new job is, it will free me up for most weekends and holidays and evenings. I am really looking forward to that.

Thursday, November 21, 2002

So, things went really well today. Job Number One involves a nurse going around the hospital performing admission assessments. They expect ten a day, which isn't too bad. It's Monday thru Friday. The nurse manager seemed really cool. Her name is Linda, she is Master's prepared and she drops in on Saturdays and Sundays to check up on the staff. She seems so cool. She oversees 50 beds. It sounds pretty good. Tomorrow I will email her my resume.

The big meeting with Barbara lasted about 30 minutes. It went pretty well. She was concerned and wanted to know if I could do the job without compromising my health. I reassured her I could, and I really really liked the job and the company's attitude. I almost told her the thing about the bag (see below) but I knew that was going overboard. I realize maybe I shouldn't have said anything about it, but I have a feeling they would have asked sooner or later, if they'd asked Lorraine, she probably would have told them too. Well, basically, we clarified that, and she said between those concerns (which I hoped were clarified) and the upcoming JACHO visit were the only two things that were holding me back from being hired. She said I meshed well with the staff and that I would work well with everyone, and that the two girls I rode around with were impressed with me, so that is good. She said she had no doubt that I could do the job. So that sounds good.

The dermatologist's office is a nice place too. I could do a lot of fun things there: inservices, patient education seminars, health fairs, support groups. Also would operate the photo therapy machine and do some procedures with the docs. It sounds like they need a nurse's touch. There are docs, there are medical assistants, and there are administrators, but no nurses. A nurse on your staff guarantees you have a counselor, pharmacology expert, sympathetic ear, staff therapist, and much more!

Okay, I feel like a bit of a job whore. I've booked 3 interviews today. First I am going to talk with a local hospital about the admissions unit there. It's Monday thru Friday, possibly less since those nurses work ten hour shifts. It's been a recent trend in hospital admissions. It's a unit designed for people who are non-emergencies, so that the ER isn't swamped. People with minor wounds, diabetic issues, etc. Things that are triaged as non-priority in the ER.

Then at one, the BIG MEETING with Barbara from the Home Care place. This is still my first choice. I could totally see myself toddling around Richmond, stopping in at patient's houses, eating lunch with pals in Carytown and getting good money for it. (My mom says I tend to romanticize my jobs a bit...ya think?) It sounds kind of stupid, but the other day I was doing some research in home health and came across an ad for the field bags carried by the nurses. I stared at the ad for twenty minutes. I WANTED to carry one of those bags. Also, since I love purses and handbags, it only seems natural that I want this job!

Then at three, the meeting with the dermatologists office. Great job, good lifestyle. Weekends and holidays off. Pay isn't stellar, but right now in my life I could manage it. I realize that this is the time to experiment with career. The Better Half does his own thing and there are no kids, and no real pressure to make the big bucks and be a grown-up. Probably my second choice, as I would function pretty independently, not having to oversee anyone, making my own appointments, and assist if necessary. Also would do education and inservices, which are tons of fun.

I've also thought about what I'm leaving behind. Great benefits. Lots of resources if you get stuck in a jam. Excellent nursing reputation. However, there are the pitfalls, like any job. Snot-nosed residents, bad food, contagious bouts of low morale, increased workload, seeing how managed care can screw over patients. Seeing patients die. I used to think that the hospital was the be-all, end-all. I thought I'd always work there. But I realize that it's time to change. To try something else. To explore. I'll keep you guys posted as to what happens today!

Wednesday, November 20, 2002

Today the Home Health Care agency called me back!!! I am going in to "talk"with the boss at one tomorrow.

Yikes, I am so nervous!

Tuesday, November 19, 2002

So, today I got a call from a dermatologist's office needing an RN to operate the photo light therapy machine. There is other aspects to the job as well, as they need a patient advocate, staff educator and someone to work in coordination with the physicians and the clinical coordinator who oversees the medical assistants. Before I worked in the hospital, I had a job as a medical assistant working in a dermatologist's office. It was pretty neat, seeing all the skin stuff out there. Plus, it's not a job where people really die on a regular basis, and it's certainly not the pace of an oncology unit. I mean, you do deal with melanoma somewhat, but by that time, you hand them over to an oncologist, and you just become a consultant.

So far, I haven't heard back from the Home Care place. I liked it very much, but I realize they have to do what is best for the company. I've also applied inpatient as well. I've applied to a couple of area hospitals that are looking for people in admissions units, mother/infant, and pre-admission testing. Mother/infant was something I never thought I'd consider. But when you look at it, it's certainly not a depressing job. I always sort of liked babies, and there is a lot of education and pain management involved. Plus, no one really dies. I guess seeing teenage moms would be a bummer, but after seeing young people die, or suffer from debilitating mental illness, I think it's small potatoes. Plus, I can tap into my psych background with post partum depression. Right now, I'm getting antsy. As the Better Half said it best: "you're jumping ship with a pretty small raft. You need to hop on that big ship.


United States is a terrible place to die - study

By Maggie Fox

WASHINGTON, Nov 18 (Reuters) - The United States is a cold and uncaring place to die, offering little relief from pain or even sympathy to people in their last weeks and months, according to a report issued on Monday.

"Dying patients and their families today suffer more than they should," Judith Peres, deputy director of the nonprofit consumer coalition Last Acts, which wrote the report, told a news conference.

"We still have a long way to go to improve health care and policy for this segment of the American population."

Although more than 70 percent of Americans say they would like to die at home, only 25 percent of them do. The rest are often hooked up to machines in intensive care units, the report says.

About half of all deaths occur in hospitals, but fewer than 60 percent of hospitals offer specialized end-of-life services. Only 14 percent offer palliative care, which means special care to make sure a dying person is comfortable without working to extend a doomed life.

Hospitals concentrate on extending a patient's life, even if staff know the patient is dying, the report says. It may be kinder, Last Acts says, to allow the patient to gently slip away in as much comfort as possible.

Just 23 percent of hospitals offer hospice care, which is designed to do just this.

"Most states have only fair hospice use, with about 12 to 25 percent of deaths including a hospice stay," the report says.

Most dying people get only a week in a hospice, when 60 days would be much better, the group found.

And fewer than half, 42 percent, offer specialized pain management services.

"In any given state, at least one in four nursing-home residents is experiencing pain for at least two months without appropriate pain management," the report says

"A study of cancer patients in the ICU found that 55 to 75 percent had moderate to severe pain, discomfort, anxiety, sleep disturbance or unsatisfied hunger or thirst."

A survey of 1,000 adults, done by Lake, Snell Perry and Associates for the group, found that 75 percent had lost a loved on in the past five years. Sixty percent of those surveyed gave the U.S. health care system a rating of fair or lower, and 25 percent said it was poor.

It found that 93 percent believed improving end-of-life care was important.

The report notes that many Americans are reluctant to talk about death and dying, so few people have pushed for better policies.

"We want to create a wake-up call," Peres said. "We want to let policymakers and people in this country know that we need better care for people at the end of their lives."

Wednesday, November 13, 2002

Today was my great-grandmother's birthday, so Nanny, Kristen and I went out to her gravesite. While we were there, we decided to visit my other grandmother, Memaw.

According to my Dad, she was buried next to a statue of The Grim Reaper. We looked, and looked. It turns out that the Grim Reaper statue was missing its sickle, and it resembled more of a constipated Biblical farmer, as it is depicted in this statue as a man with long hair and a beard stooped over, with a look of horror on his face, not the traditional looking scary Halloween grim reaper with the black hood and robe and sickle on a stick. Nonetheless, we found Memaw's grave and paid our respects. Memaw taught me how to knit. I remember how psyched she was when I showed her one of my first projects, a scarf. "Oh, I'm so glad one of my grandchildren knows how to knit!"

So, John has a conference with a parent. Because the child, a first grader, got an "Good" on her report card in PE rather than an "Excellent." The parents object, saying that their child is active in soccer and is very athletic. John tried to explain to the mother that he grades based on cooperation and sportsmanship, and that she has had to be corrected a couple of times. "Good" is about the equilvalent to a B. The phone call ended with the mother saying she would have to talk to her husband and that they may have to set up a conference, because the child got "Excellent's" in all her academic subjects.

I think about a little girl at my church named Whitney. Whitney is ten, and has cancer. Every week in our church bulletin, there is a "Whitney Update." This is the actual update from this week:
Whitney's bone marrow transplant has been put on hold following the discovery of another tumor in her stomach. She had surgery on Thursday to remove this tumor. Updates will continue as more information becomes available. In the meantime, the family has asked for prayers.

I think I can safely say that I think Whitney's parents wouldn't mind if Whitney's biggest problem was having a "Good" in PE right about now...

(If you wanna send Whitney a card, you can email me. Also, I have the address of the family of Bobby Olive, who recently lost his battle with leukemia. Some of the Baheads attended his benefit a while back. The family is so wonderful, and it may help to hear some sympathetic words. Bobby was one of my favorite patients, and I know I'll miss him.)

Monday, November 11, 2002

So far, I've heard back from some other places. First is another home care agency in the area. I went and explored it, but so far, the other home care place is the one I like better. Also, a local hospital is looking for nurses to work in their cardiac cath lab and their admissions/short stay unit. Both of these would be Mon-Fri with minimal weekends. This morning I recieved a call about another job I was looking at, involving utilization review, which is looking at charts and setting up the patient with the care they need outside the hospital. This job probably would not require a lot of hands-on patient care.

I feel good despite all that has happened in the past two weeks. My fam is happy that it's not life-threatening, but at the same time, they were concerned about my stress levels. They've been really supportive of the decisions I've made up to this point. I am grateful for the oncology experiences, because without them, I don't think it would be so easy for me to be out there, nursing, with just the psych experience I had. I realize that I don't have the personality for hospice or end-of-life care. The practical, applied art of working with dying patients and families is dramatically different from the classroom aspect of it. It really takes a special, patient person to work with hospice and palliative care, and to be successful at it. I realize that wound care fascinates me. I feel like I could tackle a central line while standing on my head. I can stomach most strong stenched bodily fluids, although no nurse really finds them pleasant. I love the idea of getting in my car and being able to move from place to place all day, one patient at a time, rather than having five all at once.

So, I guess I have a lot to think about.

Thursday, November 07, 2002

Not much going on, most of my energies are focusing on finding a job. For the past week, I've been exploring home health with an organization in Carytown. I really like the company's philosophy and it's a very casual attitude. The head manager, Barbara, lets everyone call her Mom, and seems to be really supportive of the staff. Today I sat in on the interdisciplinary meeting, which focused on the upcoming JACHO visit (JACHO is the organization that evaulates hospitals and health care organizations to make sure that they operate safely; screwing up with them means shut down.) Barbara went over a few things to say, and then someone asked her if the company was going to be okay during the inspection. Barbara said, "I know it will be great. You guys do a good job." She seems very realistic and practical, and it's refreshing to see that in a manager. On the way out, I saw her hug and kiss Amy, one of the home health aides. I would love to be a part of that. After the meeting, Barbara sat me in her office. The job is basically down to me and another girl. She told me to take a week and mull it over, and she will too. She says she needs to make a decision sometime next week and get someone on board soon. So far, this job is my first choice, and to be honest, I'm going to tell her next Friday that if she will have me, I'd love to be a part of the company. But I am not going to be unrealistic. I realize she has to do what is best for her company, and if it means not hiring me, then so be it. So for now, a waiting game.

Monday, November 04, 2002

So, I am sending out my resume to a number of places looking for nurses. I realize that I want a Monday thru Friday job, based in the day. I talked to Vicki and gave my notice. She wasn't too pleased. I am glad, however, that my preceptor, Lorraine, does, and she is willing to be a reference for me. There's some good stuff out there. John has been wonderful, very supportive. So, a new adventure begins.

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