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Sunday, June 29, 2008

Home Again, Jiggity, Jig

I have been away at a conference since thursday. A fellow advanced practice nurse, from the cardiology practice, and I went to National Harbor, Maryland for the conference and had a wonderful 2 days of great classes. While there, we stayed just down the street from the conference at the Westin with a room that looked out on the potomac. Classes started at 7am and finished at 6pm equalling long exhausting days but we still managed to have fun.

On friday night, we drove to brother #2's restaurant, the Dogwood Tavern, where it was nice to show off my outgoing successful brother. He, of course, took care of the bill for our food and only charged us for drinks. The waitress made out very well - I tipped her what we would have paid... (It has to be good politics to keep the manager's employees happy!)

While at the conference, I made the practice buy me a toy.

It is a palm T/X and has all the medical programs preloaded onto it. I had talked to the docs about getting me a palm treo phone but they balked at paying part of the monthly fee and I wasn't sure I wanted the phone portion. One of the vendors had this and the treo. I compared and found that for the same price of the phone, I could get this with more features and no monthly fee for a cellular internet. This has wifi capability and is awesome. I called the office prior to purchase, talked to a Dr who is realizing how much he misses me when I am gone, wound up with a credit card number, and WALA :)

Meanwhile, I am glad to be home. Gloria is very nice but silence is a foreign word to her. For 3 hours on the ride home she barely took a breath.... I got into my car and thought how lucky I am to have travelled with people and family who are comfortable with quiet times. I walked into the house to a neglected cat, who is asleep next to me. In catching up with all my blogger friends, I found that DragonFly had awarded me with this:

I will share it with Kyla over at The Journey, who is back in nursing school and has some lovely children and Sarah over at Slouching Past 40, who has an eye injury....

Tuesday, June 24, 2008

For The Time Being....

I get to keep my office. The new Doctor will have to share with Dr LR....
Until the next battle, when the office manager decides to use my office for something else and we go nose to nose, again...

Saturday, June 14, 2008

In honor of Flag Day (heard whild driving into work today...)

"I Am Your Flag''

Traditionalists say I was born of a woman's hand -- fashioned from bits of colored cloth by a seamstress in a small house in Philadelphia, a year after the new country was born.

Historians are less certain of my origin. Yet, no one doubts my existence. I was created out of necessity to serve as the emblem of a people whose experiment in nationhood was as unique as the arrangement of my stars and stripes.

I have proved my adaptability to change. I've accommodated growth. I've stood up to time and troubles. I fluttered in the Fall air with General Washington and his loyal French allies at Yorktown. My fabric was shredded by cannonballs from British frigates in the War of 1812. I was carried in triumph by Andy Jackson at New Orleans. The British could see me clearly in the mists of "dawn's early light," waving from the standards at Fort McHenry.

I've witnessed turmoil and bitterness, even lost some of my glory in mid-century in a war between brothers, but I was restored as a nation's emblem at Appomattox.

I traveled West with the new frontier. I flew from the headlamps of the Iron Horse in Utah. I was with the prospectors at Sutter's Mill, with the cavalry against cattle rustlers, with the Rough Riders at San Juan Hill.

I crossed the Marne with the doughboys anxious to make the world safe for democracy. I was with brave GIs storming the beaches at Normandy. I was raised over a shell-pocked hilltop at Iwo Jima and I stood by the grim-faced negotiators at Panmunjom. I was on that last helicopter from Saigon and with the men and women of Operation Desert Storm.

I have been around in victory and defeat. I've seen pleasure and pain. I was raised over the rubble of the World Trade Center and at the Pentagon. I've been folded smartly by soldiers and handed to weeping widows. I've covered the coffins of those who've served country and community.

I also decorate bandstands and concert halls. I am saluted in parades, in schools and at ball parks.

I am part of political campaigns, high holidays and ice cream socials. I fly from skyscrapers and bungalows. I've been to the moon and the ocean floor.

I am everywhere my people are. I am saluted and, occasionally, scorned. I have been held with pride and I have been ridiculed, because I am everything my people are: proud, angry, happy, sad, vengeful, argumentative, ambitious, indifferent.

I was created to serve a people in struggle and a government in change. There are now more stars in my blue field than there were in the beginning and, if need be, there's room for more.
But, those red and white stripes remain as they've always remained: clearly visible through the struggle -- the symbol of the "land of the free and the home of the brave."

I am your past. I am your future. I am your flag.

by Bob Nelson

Friday, June 13, 2008

Just When You Think You Are Having a Bad Day!

Just when you think you are having a bad day, you meet someone like Laura. Laura is a 28 year old, who was diagnosed with metastatic non small cell lung cancer in January. It all started as a bad cold that progressed to pneumonia. When the pneumonia did not clear up with antibiotics, her family doctor ordered a chest cat scan that revealed a large tumor in the right lung. She was taken immediately to surgery and found to have metastases to her lymphnodes, bone, and kidneys. She has never smoked, had rare second hand smoke exposure, no exposure to any known carcinogens, and no family history. It is a case you rarely see nor want to.

Laura started chemotherapy and radiation right away but the cancer was already advanced (stage IV) when diagnosed that it had little effect. Her oncologist had followed serial cat scans to evaluate progression of the disease and last week noticed some fluid around the heart. It was decided that she would come in this past wednesday for surgery to drain the fluid but on tuesday, she became acutely short of breath and was rushed to the emergency room and ultimately surgery one day early. Surgery was sucessful but her shortness of breath remained. I was consulted to see her for a possible pneumonia and what we found was that the cancer had narrowed her airway and nothing more could be done. A decision was made to discharge her to her childhood home with hospice.

This morning I recieved a page asking me to see Laura immediately. She had become increasingly short of breath overnight, was now on high levels of oxygen, recieving morphine with little relief of her distress, and was experiencing quite a bit of pain. We met with Laura, her family, and our palliative care nurse- a final decision was to provide morphine and allow the inevitable to happen at the hopsital with her family at the bedside. As I walked out of the room, she asked if she could see her cats. My heart broke because if I were in her position, I would want the same thing. We arranged for her husband to bring the cats to my office and then we brought them up the back way to her room. They simply curled up on her bed at her side. She died at 3:53 this afternoon with her family and cats by her side.

Please keep Laura and her family in your prayers. Her family, understandably so, is devastated.

Wednesday, June 11, 2008

Transformers (the movie)


Big Bad, Frustrating Week from Hell....

This has not been a great week.
And it is only wednesday.
It has to get better.

Dr W (GSW) was long call this past weekend. Long call involves covering 2 hospitals during the evening and night of friday, saturday, and sunday. It also involves covering Lankenau Hospital during the weekend days. Lankenau is a city hospital. Paoli is a busy hospital but on a smaller scale. GSW is not one for new experiences and change. He hates covering Lankenau and begins to stress about his weekends of long call, at least, 5 days prior to the event. We spent last week with GSW in such a funk that I almost purchased M1dol for him.... He now has been working 10 days without a day off. All work and no play makes Greggy a crabby boy... I started this week and realized that this was the week in which if I said black, GSW would say white. Day 3 and I am offering electric shock therapy to the man!!

Every morning, I have entered my office to find a significant pile of patient issues that need my attention prior to starting seeing my patients in the hospital. Yesterday, GSW inquired if I thought I might be able to make it up to the hospital on time because it slows him down (BITCHY!!). I would like to mention that I smiled and mentioned that the delay was caused by what he had left for me to do... "Regardless, I need you in the hospital on time. You simply need to come in earlier". Alright, no problem- I am already working 48 hrs a week but I can add a couple more hours, no problem! (Asshole).

Finally, Donna (the woman who plays at Office Manager 2 days a week) has decided that she would like to use my computer and office in the mornings when I am in the hospital. This really is not an option. These girls have destroyed every computer in the office, except mine and the doctors, with viruses from their web surfing. I refused and managed to keep my cool when I explained that my office was off limits and that simply because I was an RN did not mean that she had free reign. My office had the same limitations as the doctors. She argued and I won. However, when I mentioned this whole exchange to Dr L (HTL), I was suprised to learn that GSW is considering giving my office to the new doctor joining our practice in July. I have yet to hear this from him. The discussion with HTL revealed that the new doc will be working part time and splitting days with Dr R (LR). So the logical explanation would be to share an office with LR. Apparantly, it would seem that LR is too much of a slob to share an office with and Donna suggested that, rather than suggesting that LR clean up her act, I give up my office. Another option would be that the new doctors office be the conference room that we never use. It has a door, it can connected to the hospital system, and it is a nice huge room!

Now, I should explain that my office is a cubby hole that has no door due to the fire code and cannot get wired to the hospital system. It would not work as a doctor's office as it has no privacy. I know this and Donna knows this. Donna, however, is GSW's pet and has worked with him for the past 20 years. She can do nothing wrong in his eyes. The office was part of the job offer and is one of the few perks I have. I work long hours, I have not had a raise since I started because in December they started paying for my benefits, and the payroll police constantly harass me about my hours. (They don't like to pay overtime....) Donna dislikes that I am beyond her reach in the office. I am an extension of the MD's and I override her. She is choosing to poke the rabid monkey in the cage (me) and is doing a really good job.

I have to talk to GSW abd HTL about my office but GSW is clearly menstruating and beyond being rational. In the meantime, I may kill Donna....

Sunday, June 1, 2008

Laughed until I cried....

This is an actual letter from an Austin Texas woman sent to American company Proctor and Gamble regarding their feminine products. She really gets rolling after the first paragraph. It's PC Magazine's 2007 editors' choice for best webmail-award-winning letter.

Dear Mr. Thatcher,

I have been a loyal user of your 'Always' maxi pads for over 20 years and I appreciate many of their features. Why, without the Leak Guard Core or Dri-Weave absorbency, I'd probably never go horseback riding or salsa dancing, and I'd certainly steer clear of running up and down the beach in tight, white shorts. But my favorite feature has to be your revolutionary Flexi-Wings. Kudos on being the only company smart enough to realize how crucial it is that maxi pads be aerodynamic. I can't tel l you how safe and secure I feel each month knowing there's a little F-16 in my pants.

Have you ever had a menstrual period, Mr. Thatcher? I'm guessing you haven't. Well, my time of the month is starting right now. As I type, I can already feel hormonal forces violently surging through my body. Just a few minutes from now, my body will adjust and I'll be transformed into what my husband likes to call 'an inbred hillbilly with knife skills.' Isn't the human body amazing?

As Brand Manager in the Feminine-Hygiene Division, you've no doubt seen quite a bit of research on what exactly happens during your customer's monthly visits from 'Aunt Flo'. Therefore, you must know about the bloating, puffiness, and cramping we endure, and about our intense mood swings, crying jags, and out-of-control behavior. You surely realize it's a tough time for most women.The point is, sir, you of all people must realize that America is just crawling with homicidal maniacs in Capri pan ts... Which brings me to the reason for my letter. Last month, while in the throes of cramping so painful I wanted to reach inside my body and yank out my uterus, I opened an Always maxi-pad, and there, printed on the adhesive backing, were these words:'Have a Happy Period.'Are you f------ kidding me? What I mean is, does any part of your tiny middle-manager brain really think happiness - actual smiling, laughing happiness, is possible during a menstrual period? Did anything mentioned above sound the least bit pleasurable? Well, did it, James? FYI, unless you're some kind of sick S&M freak, there will never be anything 'happy'about a day in which you have to jack yourself up on Motrin and Kahlua and lock yourself in your house just so you don't march down to the local Walgreen's armed with a hunting rifle and a sketchy plan to end your life in a blaze of glory.

For the love of God, pull your head out, man! If you have to slap a moronic message on a maxi p ad, wouldn't it make more sense to say something that's actually pertinent, like 'Put down the Hammer' or 'Vehicular Manslaughter is Wrong',Sir, please inform your Accounting Department that, effective immediately, there will be an $8 drop in monthly profits, for I have chosen to take my maxi-pad business elsewhere. And though I will certainly miss your Flex-Wings, I will not for one minute miss your brand of condescending bullshit. And that's a promise I will keep. Always. .


Wendi Aarons Austin , TX