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The Bleeing Edge

This Netflix documentary was released the week I was at Big Stuf camp. I had quite a few people ask me if I had watched it yet. I finally sat down and watched it two days ago. I wish I could say I was shocked but I wasn’t, as most of it I already knew.

It’s been almost four years since I was a work and someone said Rachel Dr. Veronikis is calling from the OR and wants to talk to you. First of all Dr. V rarely calls anyone, much less from the OR so I went totally paranoid and figured he was going to yell at me. Instead he said I want you to go in and talk to my patient in 16. We had just moved to our new unit and I had to figure out where that room was. So I walked into Melynda’s room and said something like hi I’m Rachel and Dr. V told me to come talk to you. She had mesh removed by a doctor in California and was here for reconstruction with Dr. V. She shared her story with me.

I must say not only was she super nice but she was super smart. She had one of the Johnson and Johnson mesh put in. It wasn’t the small piece that supports the urethra but an entire thing that lifted the bladder up and had arms. She told me they knew when it was brought on the market their would be some lawsuits so they set aside a slush fund to cover them. There were no trials or studies on living women. The mesh had gotten approval through the 510k process. If a new product is similar to one currently on the market it is approved without trials or research. Physicians were trained over a weekend using cadavers. That’s dead women. Some physicians were also given kickbacks for every sling they placed. I have seen enough of Dr. V patients that had mesh placed that never needed it, to know this is truth. I am sure everyone involved would deny it but actions speak louder than words. Melynda added me to a Facebook group with all kinds of links to mesh articles. I read as much as I could and joined a few of the public groups to stay informed and keep up with what is going on.

So I started the show knowing full well I would be furious, but it was way worse than I imagined. It started with essure, the coils placed in tubes to prevent pregnancy   Again very little training and doctors were told if you missed the tube just put in another one. One lady had five of them floating in her uterus. These are made of metal so it only seems logical people would react to these. The trials they did were rigged. Some of the gals responses were changed right in front of them to make it say they had zero complications and one hundred percent satisfied only because they weren’t pregnant. It was taken off the market in every country except for the United States. However, right before the documentary aired it was announced it would be pulled from the market at the end of this year. I guess the greedy company wants to get a little more money while turning a blind eye to all the people they have harmed.

I have never been a fan of the daVinci (robot) machine. After watching this I would not ever encourage anyone to use it. They state it’s less invasive for hysterectomy. However the least invasive is the vaginal approach. The robot makes a blind stab for the first incision and most of the time that works out fine. However when it was developed an eight month training period was recommended. However again greed knew no one would buy it or invest so it was cut to a much shorter time period. And the show says a doctor practices and then had another physician watch him for two or three times and then he can perform on his own. This is accurate in my world. They had four different women end up with their intestines falling out of their vagina. I say no thanks.

So many people have been injured, maimed and have had their life ruined and yet the greed continues. Profit before people seems to be the motto these days. The FDA 501k process is broken and the loophole needs to be closed. When some of the FDA scientist attempted to be whistleblowers they were either terminated or had their job eliminated.

I don’t have the answers except to do your homework and don’t let anyone implant anything in you without extensive research on your part. The latest greatest doesn’t always mean safest or best.

 

Mole Moral ~ Melynda found her mesh on eBay, purchased it and gave it to Dr. V at her six-week check up. It makes you wonder just how easily any untrained physician can get their hands on it and implant it into unsuspecting people.

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Own it, don’t dismiss it.

A few weeks back my music switched to cycling through everything on iTunes, instead of just my play list. I usually tolerate this until one of the kids nasty worded rap songs comes on and I switch it back to my Christian music. After I saw Rob Bell two years ago I downloaded some of his first pod casts and it so happened number seven popped on. I had heard it before but I had a feeling I should listen again. I believe he called it the tapes in your head. The word tape kind of shows our age since I’m pretty sure they no longer exist.

He was talking about the way you talk about yourself in your head. So he launches into a scenario where he is playing kickball with you and you catch his ball but you trip and fall and run a spike through your chest. So he cuts the spike loose and halls you to ER. I had a hard time getting past playing kickball with Rob and not calling 911. Anyway you arrive to ER and they stat page a doctor to your room. Do you want your doctor to play this in her head? I’m not really sure about this. I graduated last in my class. There are so many doctors that are better than me. Or would you want her tape to say I’ve got this. I know exactly what needs to be done. I have the skills and the team to accomplish this. Another thing he spoke about is not owning compliments but rather dismissing them or downplaying them.
Three hours after I listened to this I walked into work and my boss was talking with another gal I had never met. The unknown called me high energy and my first thought was no I’m not. And then it was if my head shook and cleared my brain and I was like I think she’s right. So I’ve been thinking about how my life does indeed reflect high energy.
For starters my job reflects this. I am scheduled eleven am until seven-thirty pm to come in and take all the new admits. They include surgeries, direct admits (straight from home or doctors office) ER patients and moms who just had a baby that ends up in NICU. This shift originally started because for a few years the hospital did away with having people on call and we were not allowed to staff for patients who weren’t there at the start of the day. On big surgery days (10 or more) this could be a nightmare with every nurse being at max capacity and yet more surgeries needing to come. I worked three to eleven back then so a lot of times they would call me to work early. So anyway I now come in at whatever time they need me. This may be as early as eight thirty or as late as three. I sometimes have all five patients within three hours. The recovery room loves me because I almost always take report when they call and have taken back to back and say send at same time I’ll make it work. The only time this is a nightmare for me is when the patients were not given adequate pain medicine during surgery and are out of control upon arrival. This keeps me running for the first few hours. Our unit is huge and really spread out so on a crazy day I can easily hit ten thousand steps in eight hours. And to think my husband likes to harass me and say all nurses do is sit around and eat chips and dip.
My activity level screams high energy too. I walk almost three miles every day for my coffee and then around the back neighborhood. It’s also my time to play Pokémon. I’m still running and always training for something. Last years fifty mile runalone says either high energy or belongs in an insane asylum.
At the end of the same day I had a patient and her husband thank me for being the kindest nurse and person they ever met. My first reaction was to dismiss the entire compliment and then Rob popped into my head and the love dare. I remembered one of the three things Brian said he admired about me was my willingness to do whatever I could to help others. And I must admit they were right. They were of a different culture and I respected that and incorporated it into my plan of care. Plus they were Heartprint patients which will always have a special place in my heart.
So over the past three weeks I’ve been trying to own it, instead of dismissing it. I must say this is a lot harder than I thought it would be. My head tape likes to go immediately to the negative and the worst case scenario. I guess I have something to work on.
Mole Moral ~ If the tape is negative, eject it, and replace with a positive one, you deserve it!
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Time Really Does Fly!

On this day thirty years ago I graduated from Deaconess College of Nursing with my diploma in nursing. So much has changed since then that it is almost impossible to believe. For starters there is only one diploma school left in the area and that is Lutheran School of Nursing. Every other program is either associate or bachelors in nursing. The diploma schools had the most clinical hours back in the day and were usually associated with hospitals. In other words free labor.

I recently looked at my scrapbook to figure out which day I graduated on. I was very surprised to discover I graduated on Uncle Larry’s birthday. I would have thought I would have remembered this but I guess this is why I scrapbook. Things you think you will remember forever you quickly forget.

I must say nursing school has not changed at all during this time. It is still the most stressful time in a person’s life. I swear they do everything they think of to get people to quit and weed out the weak. I mean if you even think about applying they start quoting wait lists and GPA’s and drop out rates. It is just ridiculous. I can honestly say I would never go through it again. One and done.

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I thought I would list some of the changes over time. Please feel free to comment any others.

  1. All white with a nursing cap. Scrubs started around 1989 and the caps were gone by the time I started working at Deaconess
  2. No computers at all. All charts were paper and kept at the  nurses station.
  3. Medication carts with narcotics on them. Now my friend Gena who works at a small hospital still has them. I haven’t carted one up and down the hall since 1990 when I went to the burn unit.
  4. Gloves were only for sterile procedures. You carefully cleaned up people and emptied foley catheters.
  5. It cost money to watch TV and there were only seven channels.
  6. Smoking occurred anywhere in the hospital. Patients were placed in rooms based on smoking preference.
  7. No scanning medications or automatic times placed in charts. Also the medication records were hand copied by night shift every four days.
  8. All pain medications were given IM. There was no IV push pain medication.
  9. Darvocet was not a narcotic. It no longer exits as it was taken off the market years ago.
  10. Two nurses had to count narcotics at shift change. No one could leave until the count was right. If you forgot to sign out a narcotic it held up everything.
  11. LPN’s were phased out of mercy at least five or more years ago.
  12. There were no twelve-hour shifts.
  13. There was no straight day shift. You could work straight evenings or straight nights but days were rotated with either evenings or nights.
  14. People were admitted the night before for tests now done outpatient such as cardiac cath, upper and lower gi, stress test, etc.
  15. Nursing boards were a two-day event with a six-week wait for results. Small envelope you passed, big envelope you failed and they were only offered two times a year.

I know I am forgetting so many things but there are many others I will always remember.

  1. My first patient that passed away.
  2. My preceptor, Lisa from my first job.
  3. My ten years in the burn unit including my first really critical burn.
  4. How hard nursing school was.
  5. How I learned to never date a patient the scary hard way.
  6. Why I transferred to Women’s Health.
  7. Being pregnant and vomiting in the trash can during a feeding tube insertion.
  8. Taking care of my first Christmas Angel.
  9. Leaving a code to go the bathroom to avoid peeing in my pants.
  10. The class I had to take to learn how to use a computer mouse.

 

Mole Moral ~ As I look at my picture I think dang I had a nice figure and yet if you would have asked me back then I would have told you I was fat. My body image disturbance isn’t just a nursing diagnosis, it’s a reality!

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Mercy Heartprints

I rarely blog about work because with HIPAA I do not want to be in violation and potentially lose my job. However I feel this subject will be safe because it really has nothing to do with a specific patient of circumstance.  A little over seventeen years ago my nephew was born and it was apparent he would not survive so the decision was made to take him off of life support and have his parents hold him until he passed. I was there and it was the most difficult thing I had ever been through. Prior to this I had worked in the burn unit and been with my patients when this was done. I thought it was easier because there was no hope, however I discovered that although your head knows it’s the right thing to do, your heart is broken into a million pieces. After this happened my sister-in-law was transferred from the mother/baby floor to the gynecology floor. I had been thinking about leaving the burn unit for a few months and after visiting her there I knew it was time to transfer.

Mercy Heartprints is a program for families who experience the loss of a baby through miscarriage, ectopic, stillbirth or neonatal death. It is run by a wonderful lady who has been in charge for longer than I have worked on Women’s Health. (At some point the name of our floor was changed from Gynecology to Women’s Health but I cannot remember when.) We have an open visitation policy so if the mom wants to see her baby again before she leaves, we do that for her. I remember when I was in my labor and delivery rotation and our instructor called us in to see a twenty week loss. She was touching the baby and I remember thinking that I would NEVER touch a dead baby. See how that word bites me every single time I use it. Sadly, I have touched more than I ever could have imagined. I used the word sad because every baby is a loss for a family.

Most people wonder why and how I can do this and there are two reasons for this. One, if I could go back in time and hold my nephew even though he had passed I would. I do not want any of my patients to ever have that feeling. Two, I know it is the last time they will see their baby until they themselves die and go to Heaven. For those of you who are wondering we do indeed warm, dress, and wrap the babies in blankets. All of this is then given to the parents to keep.

My mom taught me how to crochet when I was really young. I’m thinking maybe eight or so. I even made clothes for my sisters Barbie dolls. I never played with those stupid things. Shocking I know. I always wanted to learn how to do granny squares but no one I knew could make them. I bought a book with the instructions but I might as well have  been reading Chinese. So when I had Emily, an aunt made her a granny square blanket. It was beautiful and I will always treasure it.

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Brian took this photo all on his own when Emily was three days old. You can see the blanket in the picture. Finally about a year ago, I thought I bet there are You Tube videos on how to do granny squares. Sure enough there was and I finally was able to do make them and then the Chinese directions actually made sense. So I started a pinkish one and then the girl who does my hair was having a baby so I made one for her but she was having a boy so I had to switch yarn colors. Then my other friend was pregnant again with number eleven and I was convinced she was having a boy so I made another blue one. However, about a month before she was to deliver I decided to finish the pink one just in case. When she texted me she had a girl I believe my response was “OMG! It’s a good thing I have a back up plan.” I have since made about three more blankets for other friends that are expecting. I ran out of people to make them for so I decided I would make them for the Heartprint patients. Since most of the time those babies are smaller, I only use one skein of yarn for each blanket. Hobby Lobby has a brand of yarn called I Love This Yarn and all of the colors are amazing. I have currently made twenty blankets (I have been asked if I think I am OCD. That answer is you better believe it) and I see no end in sight. I have a lot of solid colors from past projects so I am doing a solid and then a fun multi-colored one. I feel that if just one blanket brings one mom some comfort and peace knowing her baby was recognized then it is worth making a thousand. My husband did ask how much i was charging for them. I said they are gifts to the Heartprint program. He asked me how I am ever  going to get rich. I said giving them away makes me richer than Bill Gates.

 

Mole Moral ~ Often in this world, we never know how one-act of kindness can make a difference to just one person.

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CPR can KMA

This May I will have been a nurse for thirty years. I can still remember taking CPR for my first job. That year they had these fancy mannequins that recorded rate and depth on a strip. You had to get so many right to pass. I managed to pass it just fine, but many others did not. They didn’t have to retake it or anything either. Two years later when it was time to recertify they had changed it and no longer required a passing strip. So it was much easier and way less stressful. Two years ago I took one of the last old style classes in which there were instructors and real live people who checked you off. This year it was online with learning modules and then you go into a room and perform on a mannequin that is hooked to a computer that will only pass you if you do it perfectly.

Please keep in mind that I am old school. When I went to nursing school, computers did not exist. I mean there were some a frame type computers but personal computers were not around and everything was typed on a typewriter. I went to class every day and listened to lectures and took notes. So this online stuff is not really my way of learning. I have had numerous people ask me why I don’t go back to school and become a nurse practitioner. One, I have no interest in leaving bedside nursing and two, I do not want to write papers and do group projects to earn a degree. So back to CPR. I did the online stuff without any issues. It only took about two hours to get through all the modules and the simulation stuff. I managed to forget to turn the AED on every single time before applying the pads. Yesterday I went to the lab for the manequin portion.

I did just fine on ventilating the adult and the baby. I also had no issues with the check off for the chest compressions on both. CPR on the baby was ridiculous. I had to push so hard I swore I was going to break both of my fingers. Then the adult came and no matter what I did, I could not pass the three cycles. In the middle of my attempts I posted on Facebook and someone asked if I was having trouble with the ventilation. My response was “I can blow like a porn star!”, it’s the chest compressions I cannot manage to do effectively. Someone else said you have to do it hard, fast, and deep. My first thought was do I look like a dude? Maybe my husband could give me some pointers! I finally asked for help and the gal came over and gave me pointers but by this time I was so exhausted I was told I had to come back the next day or day after depending on how sore I am. She also gave me the you need to work on upper body strength to which I replied I am a runner and that’s what I enjoyed. When she continued to annoy me about upper body strength until I threw out there that I just ran fifty miles. That pretty much shut her up. Yes lady I am in the best physical shape of my life, this computerized mannequin is stupid.

On the way home I started thinking about one of my many bus rides to Big Stuf camp. Jack Riley was on my bus for my very first camp and he was a freshman that year. Fast forward to the year he was an Obtern and an EMT. We were talking about CPR across the aisle from each other. I said to him “the person is dead so if you screw it up, it’s not like you killed the person.” He started cracking up and knew what I said was true. However the other kids sitting around us about lost it. But I speak the truth, if your heart isn’t beating, you are dead and your chances of CPR working is not the greatest. Now if you heart is in an arrhythmia and you have an AED available then your odds have greatly increased. So here I am all worked up over ineffective CPR on a plastic mannequin. I went up to the floor afterwards and burst into tears. My good friend Amy said what is really going on, there is no way you are crying over CPR. I was like seriously my life is cool for a change. It was only this morning I realized what the issue is. I had forgotten to take my crazy pills for over a week, so I took two right away.

I cannot even think about attempting it today. I forgot to take my Fitbit watch off and it put a nice red mark and bruise on the top of my wrist. My arms are killing me and the palms of my hands are bruised as well. Hopefully I can perform tomorrow or I won’t be working until I can pass. Once you expire, Mercy will not let you work. Now had I been taking my medication properly I would look at it like this “I can’t pass, cool I get a day off work.” But since I am unmedicated I look at like this “Oh look Rachel is such a loser and horrible nurse she can’t even pass CPR.” The second statement is beyond false but the voices in my head like to shout at me and without Zoloft they are louder than my God voice that tells me I am a treasured child and a really cool person. Work has just called me to come in so I will sign off.

 

Mole Moral ~ If you are CR, never attempt CPR unmedicated!

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My mandatory cab ride

Almost two years has passed since one of the most stressful events occurred in my life. It is only now that I can write about it.

I was at work and I had taken a Motrin out of the medication machine to give a patient for pain. The next time I went to the medication machine it popped up that I had a partial dose to waste. This reminder is for narcotics so that they are wasted with a witness. I clicked on it to see who it was for and it was for the patient I had given the Motrin to. There was only one problem, I had not given that patient any morphine that day. I immediately thought who am I working with that would have pulled something out from under my name. I went straight to the day supervisor and reported it to her. She made a mental note and said we’d look into it later. Every time I signed in, the warning would pop up causing me to be suspicious of my co-workers. A couple of hours later one of my most favorite nurse buddies came up to the nurses station and said “there are NINETEEN vials of morphine missing from the medication machine”. I stopped dead in my tracks, my heart stopped beating and then said I have a partial waste on morphine that I never gave. So our awesome pharmacist sprung into action and contacted the director of pharmacy. As the pharmacist left she told me not to worry. This was on a Thursday. No one contacted me on Friday so I figured all was fine.

My next shift was Monday which happened to be leap day, my most favorite day ever. I called at ten to see if I was needed and the charge nurse said no. Shortly thereafter my manager called and said I needed to come in. Alarms, bells, and whistles all went off in my head. I went straight to her office and she informed me we were going to HR. Pure CR panic then ensued. She told me to relax, I had nothing to worry about. I kind of believed her until I saw we were joined by not only HR (thank god it wasn’t CC from the spare me incident or I would have died right there on the spot), but the director of pharmacy, and the director of women’s services (who was my manager at one time). I remember thinking this is some serious stuff right here.

So I spent the next thirty minutes talking with these people. I learned that someone had badged into the medication room about a minute after I left. This was when the morphine was removed. At this time I was in my patients room scanning the Motrin to give to her and could not be in both places at the same time. So the pharmacist told me I forgot to log out which is against policy. Well no kidding but he did admit nurses are distracted with their work phones and constant interruptions. The medication machine is a touch screen so it’s easy to think you have logged out when you didn’t hit the exit button quite right.

Up next was the HR guy who informed me I would need to take a drug test. If I refused I would be terminated immediately. If I took it then I would be sent home until the results were back. If they came back negative I would be paid as if I worked, if positive I would have to use PTO and other things would happen. I swear I said “bring on the pee test”. So off to employee health we went.

Normally I can pee every five minutes, any time, anywhere but not this day. I was so freaked out that it just wasn’t happening. I drank two glasses of water and cursed Dr. V’s sling. But finally I was able to go and then told I either had to have someone pick me up or be sent home in a cab. Because I had completed a for cause drug screen, they could not let me drive home. If I was indeed under the influence and then had an accident they would be liable. I could think of no one because my brain was shut down so I picked a cab and said no Uber. I had just watched Criminal Minds where a fired Uber driver went around killing people. They assured me it would be a cab.

I made my manager and the HR guy sit outside and wait for the cab to show up. It was beautiful that day. I wasn’t in the cab five minutes before I called my mom to tell her the story. I then texted Meg to tell her I was sent home in a cab. She responded I was lying so I took a picture of the inside of the cab. I chatted with the cab driver and told him it was the first time I had ever been in a cab. I told him my oldest had been in plenty. He found the story interesting. I finally made it home and then the waiting game began.

It was late Thursday before I was finally given my negative results and the green light to return to work. I was ok at home for the first day or so and then my imagination went crazy. I thought maybe I had busted up a drug ring and the DEA was going to show up at my door to question me. Nothing like that happened so I returned to work not knowing who stole the morphine. I did know it was not a women’s health nurse because they all worked during this time.

Three months later I was told who it was because the Missouri State Board of Nursing needed to talk to me. I was so shocked and it took a good two weeks for it to process fully. I never saw that person on the floor that day. I couldn’t decide if I should kick the person in the gonads or pray for them. I chose to keep it to myself even after I spoke to the board. Then the wait began for the investigation to be over with and this nurse be charged.

I waited twenty months before the paperwork showed up on the state board website. I read it and was in shock and disbelief. This person was only charged with testing positive for marijuana in their urine and then terminated from Mercy. I couldn’t believe they had gotten by with stealing morphine and putting me through hell. At this point I was back to wanting to kill this person but I decided once the actual state board of nursing came out with the person’s name listed I would finally reveal it.

It was this past Friday when the paper came to my house. Almost two years have passed and seeing it in black and white made me even more mad. First of all this person got away with stealing. Second of all it looks like this person is a recreational pot smoker instead of the narcotic stealer they really are. Justice was not served at all. Today I started thinking I wonder how people feel whose family members are murdered and the murderer gets away with it. That has to be a million times worse.

Leap day will always be my favorite day but I will also remember this until the day I die. I tell all new nurses to be very diligent about logging out of the medication machine because you never know who may sneak in behind you. I am sure they all think I am insane but I wouldn’t want anyone to go through the stress I went through or being so mad at the injustice of it all. I have to constantly tell myself God will take care of it in His time and in His way. He really should just listen to me and do it MY way.

 

Mole Moral ~ Those who have nothing to hide, hide nothing. This makes life so much easier.

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The Mole Work Ethic

My mom use to worry that my girls would not have a good work ethic because they did not have a job in high school. Emily’s first job was after her second year of college. She worked in a pharmaceutical factory packing boxes in Fenton. The factory closed before the end of the summer. She worked with a lot of former Chrysler workers and they all encouraged her to finish her college education. The next two summers she worked as a nanny and really enjoyed it. That job was way too challenging in my opinion. My own kids are bad enough, no way would I want to deal with someone else’s. Kayla got a job towards the end of her senior year at Swing Around Fun Town. They love her there and promoted her to lead after her first year. She still works there on breaks and summer vacation. Allyson has been at her job for two weeks now.

Emily is working out in California now as a physical therapist. She was diagnosed almost a month ago with a kidney stone. She is in a small town with only one urologist within fifty miles. She needs surgery to remove this stone but that won’t happen for another week. However, she has gone to work every single day anyway. Some days she lays down between patients and texts me that she is dying. The doctor wants her to take the day off after she has surgery and she has told me there is no way she is dong that and plans to work. It will be interesting to see how that works out. Kayla pretty much goes in extra whenever she is asked. She trades hours with people, stays late, goes in early or leaves early as needed. She worked her last shift before starting Missouri State but then the next day she ended up going in for two hours to help out in the kitchen. So her last day was really her second last day. Allyson has already worked for someone who was sick since she had nothing else going on. So I think my mom was worried for nothing.

They say with kids they really do watch what do and not so much what you say. Brian in all the years he has worked has maybe missed five days because he was sick. He did take two months off after he gave his kidney to his father because I forced him too. With that major of a surgery he did not need to be back at work lifting all of that heavy stuff. I can’t remember exactly when I went to all of my shifts being eleven am to seven pm but its been at least five years. My hours really are anywhere from seven am until five pm just depending on how many surgeries, how many nurses are scheduled and what is going on. I pretty much trade with whoever needs to switch a day. My kids are modeling this behavior but yesterday took the cake and the purpose for this blog.

The charge nurse had called around 11:30 to say she needed me. So I was driving to work talking to my best friend Meg when my mom called. I didn’t answer but when she left a message I told Meg I better get off the phone. My mom had fallen and was pretty sure she had broken her arm. There was another nurse on call, so I called her and asked her if she would go in for me so I could go see what was going on with my mother. The charge nurse decided she didn’t need her right then but needed someone at three to cover the eight-hour shift nurse that was leaving. Amy agreed to go in for me and I would take on call. So my mom did indeed break her humerus right below where it meets the shoulder. They gave her a sling and said she could go home. It was now four pm and I was on call until five so I we went up to my floor to hang out. I did not want to get twenty minutes away from the hospital and get called back in. Well sure enough at four-thirty they paged three unexpected patient’s so I clocked in and my mom hung out in our waiting room until I got off at seven-thirty. She said she took the best nap ever on the couch in the waiting room. I got her home around eight last night and opened all kinds of food and things for her because you can’t do anything with one hand. She sees the orthopedic doctor on Monday.

 

Mole moral ~ The mole kids are either half crazy or have a great work ethic, since they seem to be doing what their parents do.