Saturday, October 27, 2007

Boring hospital politics, part 17

There is a return to the SuckySoftware drama and the CNO. My availability was requested of me by the CNO last week because she'd like to meet with me for a half hour to discuss SuckySoftware. This meeting hasn't been scheduled yet, but I bumped into her one day last week and she cheerfully asked me about my vacation, wants to meet with me and "thinks I'm very bright."

You'd think that should be flattering, but all it did was put me on my guard and thickened my walls. She wants something; I just don't know what it is yet. I respect her. She's an exceptionally smart and classy woman, has been published and is very active not only in the community, but the state. I would like to trust her, and ....the truth is I don't. I cannot put my finger on why this is.

I can't decide what I think about this yet.

And. What's so weird to me is that....

I mean. WHO CARES? Who the fsck am I, anyway? Nobody.

Why does this shit happen to me, and happen to me all the time, and seemingly when I put so little effort into stirring things up? I don't do this on purpose; or at least, I don't think I do.

There's something else. MyInstructor is very careful during CCclass to ...she will critize something genuinely stupid about SuckySoftware, and will be right about the software being wrong. But she will backpedal and be careful to say, "I'm not against computer charting and I am confident the subcommittees are working on it."

Lots of furtive looks my direction. Either to read my face or because she's afraid somebody's gonna "tell on her", I can't decide. Why would I "tell on her" for saying shit I agree with? Why would I hang her out to dry for telling the truth? Why would I "tell on her" to someone I don't respect (meaning Director)? And what is this sense of paranoia all about? Are we not professionals?

...The other thing wrong with MyInstructor's statement is that R tells me yesterday that the subcommittees are stalled. The only movement we got on positive changes was days after my email went out. Nothing has happened since. I could see the steam coming from R's ears the other day as she told me this. I think she wants my help again to get things moving, but we couldn't talk freely.

(And why can't we talk about this stuff freely? What is the big fscking deal?)

MyInstructor says, "It's so difficult to get everybody in HospitalSystem to sign off on changes, that it takes a LOT to get changes done. I mean it's mindboggling how complicated that is" Except that that is wrong, and we are the beta test site, and the rollout is incomplete across the system. Now is our best opportunity.

Why is this such a charged thing? The software is shit and we need to fix it. Where's the fscking controversy in that? Nurses! They are so unlike people in the rest of the American working world. Why are we more concerned about hugging and kumbaya to nebulous Powers That Be (and who ARE these people? and can I sit them down and talk to them like reasonable people?) than in being effective at treating our patients?

I feel like I'm in China in the 1960s. A lot of people seem to be waving little red books, and I don't know who is doing so only to avoid being dragged into a stupid meeting so that a very small person can fume and try to intimidate them...and who isn't. And I've got a meeting with Mao sometime next week. Cos Mao thinks I'm very bright.

Is that terrible for me to say? Probably not. But it's possibly terrible of me to post on a blog.

Work politics. Boring. I'm not actually a socialist or social democrat, I'm a libertarian.

Know what that means?

Time to go be a consultant again is what that means. I am working on some things up my sleeve in that area. I'm not stupid and I'm not tied forever to whether or not MyHospital ultimately resolves its SuckySoftware drama. I will do what I can to help; I will do my best to help.

But at the end of the day, SuckySoftware will remain sucky. Hopefully not as sucky, but it will be sucky. There are stellar individuals and I'm lucky to know many within my hospital. But organizations and the faceless mass of people within them are mediocre. The only constant among all large organizations is mediocrity.

I'm not leaving MyHospital; I have things to do here. Chief among them is actually learning ICU and building my skills. I also meant what I said that Director is not on my Christmas list, and if I need to step on her toes again to help improve things for nurses who do have my back....I will step on them with enthusiasm that didn't exist before she tried to smack me around.

We'll see what happens I guess.

Right now, I have about three hours to come up with a Halloween costume.

Critical care class, weeks 1 & 2

This summer my world was all about the social life. It's fall again, and focus is back on work. Quite a lot goin on at the moment.

Critical care class is going fine. I'm with six others: an pediatric OR RN with 5 yrs experience there, an oncology RN (brand new OCN) with eight? years experience, a med-surg RN with two years behind her, an ortho RN with 8 years ortho/med-surg behind him, and two new grads.

Love hemodynamics. LOVE IT. It's new stuff to me, and I'm getting it and my brain is actually working again! Love it! Twelve lead stuff,'s not new, but my understanding of it's always been superficial. I'm getting some more depth to that, and that's fun, too. There's a lot to 12lead, so I'm looking forward to taking the class proper. This is the good stuff about CCclass.

However. Because we have to start as if everybody's a new grad, I'm bored half the time. I've had so many people tell me how ass-kicking this class is....and I really shouldn't be this cocky halfway through. I'm just used to measuring troponins and know the heparin nomogram, and know what adventitious heart sounds are. That kind of stuff.

I'm not always at the top of my game. Doing the drip calculations my instructor's way caused me great pain. She uses something she calls "a magic number" to calculate drip rates and she is unable to do the calculations the long way. The ortho RN and I both needed it proved to us, so we put our heads together and over a period of two hours, figured out why the shortcut works. Others in the class just accepted the shortcut and were okay saying that they use a "magic number" to calculate a lifesaving drug drip factor for a critically ill patient. My father is an engineer. Math is NOT MAGIC.

I'm anticipating that once we're out of cardiac and into other body systems, I'll be working harder. There is SO MUCH that I don't know about ICU nursing, and my critical care class should be harder on me than it is so far. In a real ICU, I would get my ass handed to me and I know it. I'm a little nervous that I'm not worrying yet in this class. Again, maybe I'm being cocky and on the exam, I will get my ass handed to me.

But certain comments my instructor makes give me pause. Me, "Instructorperson, will we be going through the clotting cascade and stuff when we do livers? I don't know a lot of that stuff." "Yes, we'll be going through that when we do DIC. Probably not deeply enough for you, but we will be going through it." And what is that supposed to mean "not enough for me"? I'm sorry, am I bugging you?

Saturday, October 20, 2007

Possibilities on the Horizon

So I'm out drinking with one of my girlfriends (another ICU RN) last night & she tosses out a very interesting idea:

Why don't we travel together for 6months or so in Europe? Apparently, there is a need for non-military RNs through some non-military companies to work on American bases in Europe. (This is important since she speaks three languages fluently and I speak one and confidently mangle two.) They pay to move you. Her dog could come, my cats could come. They'd even move your car (though in American standards, my car is small and practical and is the size of a Cadillac by European standards.) We'd have our own spaces, but we'd have each other in a country where neither of us might speak the langauge, plan our schedules to make some three or four day weekends and we'd invest in Eurail passes. And during the week, wall to wall grateful American servicemen. Two single ICU nurses in Europe with no cost of living, and still making a good salary with no taxes.

In what way does this not sound like a riDICulously fantastic adventure?

The only snag I see is vehicle and the fact that the Euro is so much stronger.

It's a thing to think about. It's a thing to seriously think about.

I am fighting the great fight on my unit; I really am. I care about those people...the ones I work beside, mind you. (Not necessarily those I work FOR.)

But this hasn't been the world for working in the same place to get that fancy watch after 50 years of service for a long time. And my career has been full of winging it and bouncing through different contracts and having adventures. I have been to Toad Suck, Arkansas and Surfer's Paradise, Australia. Toronto to Tijuana. That is what I'd done, what I'd made for myself.

I can do it again.

It requires some plotting, several months of it. I plan to embark upon this plotting, oh, today.