Phlebotomy licensing

I finally sent off portion 2 of my phlebotomy licensing paperwork today. Been procrastinating a long time on that, partly because now that I got into nursing school, I doubt I will need the license, partly because of starting the new job as a med tech and just feeling really busy.

I took the licensing exam in December (4 1/2 months ago now)... was a little confused about what the next step was, and whether or not I had to pay more to NCCT (national center for competency testing) to get my national certification. Turns out I didn't. I paid I think $100 to take the initial test, and that served as my national licensing fee. Then for the state application, which I just sent off, it cost another 100. Plus I had to make copies of various certificates, order some official transcripts, and include two more passport photos (the national cert took 1). Hoops and more hoops to jump through but I think I dotted all my i's and crossed all my t's.

So, the plan is to keep that license up as a "just in case" fall back. Just in case my current job doesn't work out (I just had a positive 3 month work review), just in case nursing school has problems, just in case at some point I need to work as a phlebotomist for whatever reason. And it will probably be a good resume boost when I'm applying for nursing jobs in a couple of years.

Achoo!!!

So...about 5 weeks ago, I got a chest congestion/cough thing that had been going around through my work (both staff and residents). Then, just as that was clearing up (and it took about 3 weeks), I got another cold that started with a sore throat, then went into mostly head congestion, which evolved directly into a sinus infection. Then I finally got myself to the doctor for some antibiotics.

I had one of those ultra-vigilant, if I see a speck of green in your mucous we're calling your allergist for antibiotics kind of moms. Bad for antibiotic resistance, very...but I don't think until this point I had ever actually experienced a full blown sinus infection. Oh man, I was miserable. It felt like my upper row of teeth on the left side was being pushed gradually out of their sockets, my cheeks hurt, my ear hurt. All of that on top of the feverish, low energy, nausea from snot dripping down your throat kind of feeling that goes with your average cold. I was not a happy camper.

I've taken only 3 days off of work during this 5 weeks of yuck. I don't get any sick pay yet, plus we're short staffed, so it's difficult to take the time away. The worst of the sinus infection his during my two days off, then I took yesterday and today, and I'm planning to go back tomorrow, for what will be a 2 day week. Whew.

I'm exposed to everything that goes around at work. I'm exposed to everything that goes around my niece's preschool through her. But I'd like to think my immune system is decent; I eat fairly well, exercise, get a good amount of sleep. I need to wash my hands more, I guess, and be ULTRA careful about not touching my face EVER at work.

We don't have those hand sanitation stations around the building like they do at hospitals. I should probably carry hand sanitizer along with me (in addition to gloves) to use in between residents, and then wash my hands for reals on top of that every time I come in the wellness center. And I don't know what can help discourage me from touching my face...maybe if I put on some lotion, so my skin doesn't feel dry, and keep some tissues with me too, in case my nose or eyes are bothering me.

Gotta get these germs under control!

A little bit sad today.

Switching over from "independent" living to "assisted" living, I knew I was going to be exposed to death more often, but today is the first time it happened since I started the new job.

I had yesterday and today off, but I went in today in the afternoon for a work meeting. Two people had died since my last work day and another had a major cardiac event and was in the hospital.

The woman who died, I think I am at peace with. She was in her upper nineties, her health had been failing for a while, she knew it was coming soon. Some of the caregivers at my table during the meeting were talking about the process, how the tissue in her extremities had started turning blue and dying, and how she was scared to be by herself. I had a hard time listening to that, but I guess it is stuff I need to know. The signs I need to be aware of.

The man who died, he was the one who really got to me. A tall, lanky guy, fairly independent still, who all of a sudden went downhill about a week ago. I saw him every day, multiple times per day, but he was never asking for anything for himself, always just looking after his wife. "My sweetheart needs her anxiety meds." "My lady is in pain." He was very selfless. It is sad to see his wife left behind so sad and alone. Her family is with her now but they won't be forever.

The man who is in the hospital with heart problems, my coworker thinks will be back again. I was surprised to hear he'd had an emergency. He's pretty feisty.

I got a little teary eyed finding all this out right off the bat. I got some ice water and had some time to sit outside by myself before the meeting started.

I've never really believed that people "go to a better place" when they die. I think some of the comfort that comes with that thought would be nice right now.

I got in to the RN program!

I got a letter in the mail last Saturday. I'm in!

I start August 20th of this year.

The new job as a med tech at the assisted living place is going well. I've got a good reputation there, among the residents as well as the staff. It has been an adjustment, being on my feet all the time, but I'm doing ok with that as well.

I will write more soon. My cat recently used my keyboard as a scratching post and tore off several keys, so the typing is a struggle at the moment, but I do have a lot of new stuff to share.

Kind of disgusted.

I went to my first monthly all staff meeting at the new job. They announced the "employee of the year" (last year's) and I had a feeling I knew who it was going to be, I've heard other people talking about it, but I was hoping not.

See, there's this one girl on staff who has been there a few years now, longer than my current supervisor, and she, although she is a favorite of the managers because she'll always cover a shift or fill in where needed, is a total thorn in my side. And I'm not alone. Even our supervisor has talked about her being rude to the public, and how that's not a good thing. She's the leader of this little click with two other girls, and they always sit around and make fun of the other staff, and many of the residents. She is especially mean when it comes to new people on staff. The last new person before me she (and her click) make fun of for being *too sweet*. Because she works hard and has a good attitude.

One employee told me that she requested never to be put on shift with K because K disrespects her. I personally believe she was messing with my walkie-talkie for the first week and a half of my work there so that I would never hear incoming calls...and when I complained about it to my supervisor, she then made fun of me for complaining at the first opportunity.

Also, because she has been there so long, she does most things by memory rather than looking at charts/etc. And there are two instances in the last week where a med error was made and I know she is to blame. In one, she was on shift on a Saturday, and when a resident who recently returned from the hospital asked about her B12 inhalations and why she wasn't getting one that week, K told her that she's not on that anymore and walked out before any further discussion was possible. This was related to me by the resident. I checked her chart and she *is* still supposed to get the B12 inhalation and she did miss it that Saturday.

The second was more dangerous. Some residents get their blood pressure checked early in the morning, and if it is below a certain value, one of their medications is supposed to be withheld so their pressure doesn't go *too* low. This resident's systolic was already below 100. The LVN on staff who has been mentoring me said I should look through the recent treatment records and see if I saw any trends in blood pressure worth looking into, and when I did I came across that record. The instructions there on the treatment page say to withhold metroprolol if the systolic is below 100. I asked the LVN to look in the MARS (medication assistance/administration record) and according to that documentation, the med hadn't been pulled. She and I went to the resident's room together and checked the woman's BP several times. It was quite low (top number around 85-90), and we both agreed that it didn't look like the med had been pulled as ordered.

Together, we told our supervisor about it. She is young, unused to managing people, and close with the employee who messed up. And there have been 4 documented and reported med errors in the last year, and if there's another one it will come with a hefty fine and perhaps further consequences to the facility. She said, "Oh. Hmm. Well I will check with K and ask if she pulled the metroprolol this morning."

I get it that sometimes if it is busy, it is possible that she followed protocol and just didn't document it. But we both saw that the resident's pressure was too low, even lower than it was earlier that morning pre-medicated.

Since I'm on a rant here about employee behavior, there's another instance that is bothering me. There is a resident who is having an episode of back pain right now and has had trouble getting back and forth to the bathroom. Apparently a few days ago during noc shift, she pressed her pager for help, and it took a while for someone to come. The resident reports that the staff was "mean" to her, saying things like, "I don't know what you expect me to do if you can't tell me what you need!", "You should be in the hospital!", and "You need a bedside commode, there are only two of us on the floor." I wrote down exactly what she said, and told her I was sorry that she had to experience that along with her current episode of back pain. Then, as soon as a chance, to related what she said to my supervisor. She thought through who would have been there that night, and said, "No, I can't see so-and-so ever saying something like that. That resident's perception is a little off right now. I will talk to so-and-so (staff member) and see what happened from her side."

I appreciate that she doesn't jump to conclusions when there is a chance her staff has done wrong, I really do. But when she's getting multiple complaints about one particular employee, she really needs to take action on it, even if that employee is her favorite person that she can always lean on.

What really chaps my hide, so to speak, is that two of the reasons that our supervisor wrote that she should be employee of the year are her record of "mentoring new employees" and "doing things accurately".

Ugh.

Middle Fingers and Generous Spirits

It has been a couple weeks since my first day as a med-tech / caregiver, but there were two stories I wanted to share from that day.

First, I was in the wellness center learning what my role and responsibilities would be as a med-tech. I was there with C, an LVN, and K, another med tech. In walks a frail senior lady. "How can we help you?" someone asks. She looks at us and flips her middle finger.

It turns out that she has a chronic crack on the tip of her middle digit that she regularly comes to the wellness center for to get ointment :-) She either has no idea of the significance of pointing that finger skyward, or is doing it ironically.

Later that day, I was in another residents' room. She had been dizzy and needed help back to her room, and I was alone with her helping her put on some new depends. She's going on about how comfortable this particular brand is, how it doesn't sag or bunch...and then she looks at me and asks, "is this the kind you use? You can have some if you want!" Completely serious face. I thanked her for her generosity but said no, I don't use that kind.

:)

Workout at Work

In my efforts to lose weight and get healthy, I have been wearing a pedometer for the last few months, every day. When I was working a combination of the receptionist job and teaching, I would get from 3-6,000 steps per day, generally. Since I started the med-tech / caregiver position, I get more like 10-12,000. The caregiver work (currently 1 day per week of my job) is more physical. Kneeling to put on ted hose and shoes, serving in the dining room, etc. The med-tech is also very physical but a few less steps in the day.

So far, so good. I've been more aware of my right knee, which has been tender for the last several months since I fell on it in late November. I was worried that my plantar fascitis problems would come back again with the increased activity, but so far, so good. I have been wearing my orthotics every day, as prescribed.

I sweat A LOT at work. Part of it is the physical activity, and being a larger gal. The other factor is that inside the building it is at least 75F at all times, and in the resident's personal rooms it can be much, much warmer, depending on their preference. I have been using residents' kleenex or toilet paper to mop my face when needed, but I should probably start carrying a hankie or something in my pocket. Sometimes when I take off my gloves, sweat splashes out of them and my fingers are pruned. I mentioned the sweat issue to another caregiver I was training with last week and she said she sweat a lot at the beginning too.

At one point, I was riding up in the elevator after serving a meal to the residents, and the woman I was working with that day asked me what was wrong. "Nothing, really!" I kept saying. I then understood that she thought the droplets falling down my cheeks were tears. Just sweat, I promise.