Lesson of the Day: Change...Embrace It!

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I have been in the throes of hard-drive preparation for another assignment. There’s no easy way to describe the period of time in which the window opens for another assignment. It requires patience, perseverance, and trust that you’ll end up

• in the right place
• with the right people
• doing work you enjoy.

In the back of my mind, I replay the thought that I am really going to miss this assignment. I have made such good friends and enjoyed many new experiences. I have spent one of the best years of my life here. But I’m just not ready to settle down and go "perm."

Here’s how it works.

My recruiter sends me a list of the openings in the locations in which I am interested. I want to see if there were openings near my parents in Missouri/Kansas and also in northern California. The list reveals no current openings close to Mom and Pops in the Midwest. One option down, I concentrate on California.

My recruiter submits my information to several skilled nursing facilities (SNFs). It takes time.

This is when patience is a virtue. Some managers are on vacation; some SNFs are interviewing other travelers who have submitted their backgrounds before me. There are days in which you think you will be interviewed, and then days in which you think you will have an answer.

Then you don’t!

After 10 days of cat and mouse, I've made a decision.

Where Am I Headed?

I will travel three hours north and west of my current location and settle in a small fishing town right on the Pacific Ocean!!

The harbor, minutes from my new place...

I am thrilled! I have always wanted to live near the Ocean…

The beautiful Pacific close to dusk

and they want an OT who can start a new program.

I am their girl.

This appears to be a SNF that hasn’t had an OT for a long time, if ever. The thought of that generates all kinds of questions in my mind. Will they be open to what it takes for me to build a program?

I ponder these questions while sitting at the Fish House overlooking the Bay eating a hot cup of clam chowder and watching the fog set in.

Surreal. Sitting on the bay under the bridge at the fish house...

....and, then, instead of worrying about the "what-if's," I take a deep breath of the cool, salty air and simply sink into the moment.

Change...embrace it!

Lesson of the Day: Quit Perseverating About Your Illnesses!

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I arrived at work to find a full caseload plus 3 evaluations....(shuffle, shuffle, shuffle my schedule...okay, I can make this work...)

My first evaluation was Rick, barely 60 years old, who could recite every little illness he had ever had. I was amazed at how enthusiastically he recounted every ache and pain.

About Pain

A pain scale assesses intensity of pain on a scale of 0 to 10. These scales are at times accompanied by the continuum of smiley-to-grimacing faces. If you have a patient with cognitive issues, you can point to a picture of the faces and ask, "How do you feel?" They are more likely to be able to point to a face than rate their intensity of pain with a number.

If you have no pain at all, you're sitting at zero.

If you...

• Think you need to go to the ER
• Are unable to suppress a scream
• Are writhing in pain or spasms

you're sitting at a 9 or 10.

In between is "hurts a little" to "hurts a whole lot."

This guy, like many of my patients diagnosed with chronic pain syndromes, demonstrated absolutely no nonverbal signs of pain. He was smiling and talking nonstop when he rated his pain at 8/10, then,
...6/10 in another area,
...5/10 in another,
and...9/10 in another.

In my 15+ years of experience, men generally rate pain higher. (Am not sure why, but I'm thinking, "Could they ever make it through childbirth?")

So, I want to say two things...

First, I acknowledge that for each patient, their pain is real. Whether we as health care providers believe the intensity or not, it's real to the patient.
Second, there's a line of thought that says:  What you think about, you manifest into your life. If you think about illness all the time, if you think about pain all the time, you are more likely to experience it.

What do you believe? 
And what would you tell your patients? Or your family members? 

Let me hear from you...

Make Your Day Sweeter...

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Last week, I walked into a new patient's room. His lovely wife had set up the most beautiful tray to brighten his day... a china cup and saucer filled with coffee and cream (nearly unheard of in a skilled nursing facility except maybe in the doctor's lounge). Beside it was a china plate holding the most enticing sweet! I asked what it was.

"A florentine!" she said, and proceeded to tell me which boulangerie she had visited that morning. (Love the bakeries in northern Cal!)

The florentine she brought her husband was actually rolled with a light cream filling inside. I couldn't resist. Yesterday, I walked over and picked one up at the bakery.

It was...melt-in-your-mouth delicious!

So, imagine this:

http://allrecipes.com/recipe/milk-chocolate-florentine-cookies/detail.aspx

rolled and injected with a cream filling...

Yum! 

Lesson of the Day: Mr. Charlie Taught Us to "By-Grab-It!"

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Have you ever had a week of days where it's a victory just to get through each day? Last week was just that...No one who works in healthcare can consistently feel compassionate, patient and giving all the time.

During those hard-to-take moments, when we really wish we could go home, take a walk, eat a pint of sorbet or just take a nap, all we can do is

"By-Grab-It!"

Do any of you know what that means?  I tried to define it on Google, and all I come up with is a description of some new technology. My family members know what it means.  Whoa, do we know what it means!

A crusty, old WWII vet tobacco farmer in my home state introduced this word to my 6 siblings and me; he turned out to be one of our greatest life-lesson teachers.

MR. CHARLIE.

Mr. Charlie was the sole survivor of his company during the Battle of Normandy, shot full of shrapnel. In what we thought (in our youth) was a ripe old age, he stood 5'2" tops in his bib overalls and  flannel shirt. And he moved faster than most men a quarter of his age.

The man was a machine!

If you needed something done, Mr. Charlie had it done before you could blink. He finished his tobacco harvest long before all the other farmers and headed out to help his neighbors.

We were lucky recipients of his time and wisdom, though, at the time, we didn't necessarily see it as such!  You see, he always seemed to show up late in the evening, 10 or 15 minutes before it was quittin' time. Right before we planned to head in to the house to finish homework.

The dogs would begin to bark. The slice of headlights would light the starry sky in the otherwise black night. His truck tires would crunch down the snow-covered, quarter-mile lane.

Mr. Charlie would hop out of his truck as if he had downed a double espresso. The door to the stripping room would fly open. Now, what do you think that means?  Sound naughty?  Well, it's just the place tobacco farmers call the place they remove the leaves from the tobacco stalks.

We'd turn to greet him as we stood in line at a long table covered with tobacco plants, stripping cured tobacco leaves off the stalk, grading and separating them by quality.

"Well, Byyyyy-Grab!" he'd exclaim, closing the door. His weathered and whiskered face taking in the sight of us. His wide smile revealed shiny, pink gums. Not one tooth. "It's a good night for strippin' some tabaccer!"

Inside, we would groan, knowing it would now be at least another hour, or two, until we'd feel the warmth of the house and be able to sit down to finish our homework.

What's with the "by grab?" we'd ask each other early on. We never asked, and he never told.

But...what happened over time is that it became a verb.
           -
verb \bi-'grab-it\  sink your heels in and don't look back. Just get 'er done. As in, "You're just going to have to by-grab-it. Tough it out!"

Then, it morphed into an adjective.
                   -
adjective \bi-'grab-it\  an attribute characterizing perseverance, strength, initiation and reliability all rolled into one. As in, "He's a real by-grab-it kind of guy. He gets the job done!"

Today, 9 years ago, Mr. Charlie left this earth. When I attended his funeral, I was struck by the impact this sprite, tough, little man had on our lives. He still comes up frequently in conversation and so does his life lesson.

Mr. Charlie taught us how to keep on going, even when you want to quit:

Continue to put one foot in front of the other, even on the worst of days...

Keep moving...

Keep your head up...

Look only to the next step so you're not overwhelmed...

Keep going until you're DONE.

Nike said, "just do it!" Mr. Charlie said it even better.

Every day last week, that seemed to last 120 hours each, when fatigue and impatience were itching my skin, I thought about Mr. Charlie.

I sunk my heels in...

....and just By-Grabbed-It.

Introducing....My Recruiter

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So....here's the good guy who made the last year possible for me.

Tony Leber from Med Travelers

Tony has been a recruiter with Med Travelers for two years. Before Med Travelers, he recruited travel nurses for InteliStaf Travel (Medical Staffing Network) for 2 years.  Prior to MSN, he started his career at Martin Fletcher working as a recruiter for permanent placement RN’s.

Here's what sets Tony apart.  He called me on a fluke when I was working an assignment in the Midwest, and he stayed in touch. He never bugged me so much that I avoided his calls. (Once you travel, you start receiving weekly calls from numerous recruiters, some of whose calls you consciously let go into voice mail.)

Once Tony started looking, he found a perfect assignment. An assignment that was not listed. He called companies until he found a location within less than 30 minutes from where I wanted to stay.

He has checked in with me during the assignment. He answers phone calls nearly immediately. I haven't had to call him often, but I know if I need anything, he would be there for me 100%.

Tony has taken great care of me, and I appreciate his professionalism!!

Because I am more than willing to share a good thing....if you're looking for a great recruiter to help you through the process, give Tony a call!

Lesson of the Day: ENJOY SMALL BREAKTHROUGHS

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It is 6:30 pm. I am getting ready to leave work, dead tired. I hear Joan's voice at the door.

"This is it...right here. This is where we're supposed to be."

I swivel around on my stool from the computer where I'm feverishly trying to finish the mountain of rehab documentation that never goes away, and in wheels Joan with Monty in tow. I will stop heaven and earth for those two.

Something amazing happens when the 3 of us are together.

Joan came to our nursing facility when her dementia and other medical conditions became too much for Monty to care for her at home. Monty drives 45 minutes one-way every evening to have dinner with Joan. I don't want to say too much about them because "Mont" has given permission for me to interview him about 'dedication'.

Joan rarely remembers my name, but she will call out to me from 30 feet away. Sometimes I am Mary; other times, Carol. The one thing that is consistent is that she associates me with Mont because I go to the dining room almost every night to tell them goodbye.

So, my plans immediately change. I will not leave work at 6:30. I put Dean Martin in the stereo and sit down. Joan is very communicative tonight; much of the sentence structure doesn't allow for understanding a train of thought, but her affect and her enthusiasm are what is important to enjoy. Monty does such a great job of allowing Joan to just "be." 

Joan lets me clip and clean her nails. I'm the only one, Mont says, who she will allow. We listen to Dean sing "That's Amore."

As they turn to leave from our brief visit, Joan begins to speak in full sentences, reflecting accurate information about her sisters, their age differences, and her early adult life in Germany as a singer for Armed Forces Network.

Then she talks about when she and Monty met. She looks up at Mont and says, "We will be together forever. Really, forever."

Amazing.

Monty and I look at each other, pleasantly shocked!  I lean down to Joan and look her in the eye.

"Joan, you are just wonderful!"

Her face lights up with an expression I really can't describe. What she says next, with a sincere and emotional tone, touches me deeply.

"I love you."

This conversation lasts only five minutes. Its impact continues.

Isn't life better when we are aware and grateful for small breakthroughs!

Photos: What I Love about being a Traveler

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Just back from a great Saturday in Half Moon Bay, California, with an early evening stop in Sausalito as I head home. I've enjoyed the presence of some great friends here I would never have experienced if I had not taken this assignment.

That's one of the many things I like about being a traveler!

My running trail on Saturday....the coastal trail above the Pacific...

When the conditions are perfect, hoardes of surfers hit the waves...

Live starfish in the rocks of Half Moon Bay

Surfers heading home...

This location is my friends' secret spot for a glass of wine and a million dollar view of the base of the Golden Gate Bridge. On clear days, they tell me, you can see colorful barges heading in and out of San Francisco and a great visual of the bridge. Last evening, it was foggy, surreal and, oddly, comfortable...

I've loved this assignment!