Respect

A quick review just in case you haven’t been around my blog since it’s inception, or taken the time to read my archives- shame on you for that by the way- but in just one of my previous careers I taught childbirth education classes and worked as a doula for laboring women. Those facts are in part one of the essential reasons that I like my current job so very much as it puts me into an environment that I am very familiar and comfortable with.

There are days that I struggle though, because I am constantly walking through hospital corridors filled with laboring women. Some make their presence known in a much louder way than others. I am drawn to those closed doors, and at times I have to force myself not to enter. Working with laboring women and their partners gave me great fulfillment. My role as a doula will always significantly define who I am, but now it is not my place to enter until after the baby arrives.

In many ways I have experienced a love-hate relationship over the years with providers and staff who take a more medical approach to labor and birth. On the “how to proceed with labor spectrum” there are many viewpoints- from technological, intervention-filled medical management of labor to those who may choose a completely unprepared route. I fall much nearer to the home birth and/or minimally managed labor and birth end of the spectrum. I also firmly advocate for informed choice. I admit to some negative biases regarding medication and surgical delivery, and other procedures that occur during labor. I also know that providers and nursing staff have their own biases (often positive according to their views) toward these same things.

I have shared with you just how much I enjoy the staff at the medical center where I work. They are funny, they are friendly, they will answer any question or concern I have. They are patient and they respect me for the job that I do. My eyes and ears are always open. I listen and watch, even though I cannot be in the birthing room anymore. I know that this staff is open and interested in giving parents the birth experience they desire while they work within hospital guidelines.

Today I found myself listening once more and came away awestruck by what I heard and by the staff that I work with. Three of the floor nurses and the charge nurse were all brainstorming techniques to assist a mom during labor. They were not immediately tossing out the word cesarean even though her labor had slowed due to the babies position.

Shannan, our charge was reviewing options learned during the staff classroom experience with “Spinning Babies”.

The other nurses were discussing positions already tried with mom to encourage baby to move (hands and knees) and tossing around options like a modified Trendelenburg position to disengage baby from the pelvis- such as this-

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Image courtesy of Quizlet

 

and then a modified Sims position taught by Spinning Babies to encourage it to settle into a more favorable place in the uterus- sort of this, but with more drop to that hanging leg-

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Image courtesy of Pinterest

They knew that this mom was willing to try these techniques to avoid complications and interventions typically seen with prolonged labor. They were advocating for simple techniques that, if successful, could mean the avoidance of a cesarean delivery.

I could hardly contain myself when I heard them deciding, as a group to present these ideas to mom, and then if she agreed, work together as a team to encourage mom and help her accomplish these moves.

I was overjoyed! I wanted to clap my hands and give fist bumps all around! Then I realized that this level of professionalism is something that these nurses strive for everyday. I wasn’t see something new, something that they had only just now decided to try. I was witnessing a team using their skills to assist a woman in labor to have the birth experience she wanted. I gained a new level of respect for these professionals today.

It was also a good reminder that these nurses, my nurses, nurses in general- absolutely ROCK!

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A Quiz

How many male construction workers does it take to stand aimlessly and stare into a hole?  Apparently, in the case of the sewer workers who have been blocking my parking space since I arrived home at noon, the answer is 5.

This hole was dug last week. My parking place was blocked for an afternoon then. Our building was informed of this planned sewer work last Friday. I was okay with that so when I drove up today, asked how long they thought they might be and was told “just a couple hours” I decided to utilize my neighbors empty spot. I knew she wouldn’t mind. She’s due home soon, and street parking around here is heavily restricted.

We’re now going on 4 hours later, the main job is finished- I believe- but the majority of the crew is now just ambling about, on occasion putting things into the hole, or taking things out, but mostly standing with their hands in their pockets chatting, laughing and having the best time.

There’s one female on this crew. Guess who’s doing most of the work?

Accomplishment

But first… a disclaimer. WordPress offered to let me try out the “new editor feature” that is coming to everyone soon. I had no idea this was happening, but thought I’d give it a try. If this post looks like a garbled mess once I publish it please just chalk it up to the “new editor” and my lack of understanding what all the new features are about.

Since we’re all about being thankful at this time I will add mine. I’m thankful for days off. Days off from weekend work at the hospital. Days off from caring for the girls. Days off from obligations, especially ones that happen when you’d really rather be doing something else.

Saturday at work was a zoo and I came home after 71/2 hours with a headache. My own fault on that. I was wearing my cheap readers to do my paperwork and to run my tests. A few hours with those are fine, but not 71/2 hours. I’ve decided to start bringing my computer glasses to work. Needless to say, I wasn’t much into anything but sitting and catching up on TV when I got home. I don’t need my glasses for TV.

I did a little holiday shopping with the oldest daughter on Sunday after an easier day at work. That was nice, and I found a little door hanger which seemed to be a better decision versus a large wreath. I just don’t have any storage space. We have a community shed out back that some of us store things in, but I have nightmares of opening up a stored bag or box that I’ve put away and finding large, hairy spiders living in my stuff. This little door hanger can just be tucked into my inside closet when the season is over.

The youngest daughter and I went to see Bohemian Rhapsody after work yesterday. No spoilers, but we both had sort of meh reactions to the movie. I mentioned to blogger Ally that there were no surprises, the music was the best part, and I left the theater just being rather let down and sad, since we already know how the story ended.

Needless to say, I really didn’t get anything done in the last three days and while mostly enjoyable, today-my day off, was a catch up day. I’ve been lazy about my typical cook for the week pattern and had some veggies that had to be used so I got those prepared in a simple saute that I can eat as is, or add some chicken along with. I also need to start a soup, but I decided to break and write this post.

I did make it to the store earlier this morning after stopping by the auto shop to have a window ding checked. I’ve been driving around with that little chip for some time now, and as we have moved into frost weather along with the need to scrape windows in the mornings, I wanted to make sure that I wasn’t going to come out to a cracked windshield one of these days. They labeled it a surface pit, with no need to fill it. That made me smile.

I bought one of those springy-pole-type shower organizer things at the store. I have a window in my shower—remember this place was built in 1959 when they did that sort of thing, and it has a ledge, but all my bottles and shower necessities end up sitting in puddles of water on that ledge. The organizer went together easily and now I have ample room for my stuff and the water doesn’t pool under things. I’ve also managed to knock out 2 loads of laundry as well. Let’s throw in a little cleaning here and there and you have my day off so far. 

It feels so good to check all these to-do items off my list.

The Official Performance Evaluation

You may remember this post in which I pondered the monetary potential I may or may not be entitled to once my employer gazes at the annual performance review now in process.

As I have no more interest in cleaning my apartment today, and as I have already baked and started a curried lentil soup in the crockpot, I thought it would be an appropriate time to share an update.

I was graciously given a head’s up by my supervisor prior to her making the review available for viewing. She clearly began by stating that our corporate system of reviews was crap, that they have no idea at all what we do, that 75% of the rating categories we are being judged on apply only to admin positions, and… that they (corporate) sent along some very specific guidelines regarding what level of ratings we should, and could, achieve.

In other words readers, corporate put a strongly suggested limit on how high supervisors could go with their ratings. On a scale of 1-5 supervisors were told not to give a 5, that even one 4 was highly discouraged (and would need massive amounts of documentation), that 3’s (meets expectations) were really the only acceptable rating, and while not specifically voiced out loud, I would bet that they would be absolutely giddy to see the lowest marks (1’s and 2′) so that they can truly justify their apparent stinginess when it comes to pay raises.

I was also told that it would not be unheard of to find that any attempt to send a well documented 4 rating may very likely just be ignored, or picked apart, thus allowing corporate to overlook a better than average performance and corresponding pay raise. In other words, she may suggest a 3% raise as an example. I may be extremely lucky to get 2%.

I was given 3’s with two categories bumped up to 4’s and documented as to why. I was only one of two screeners who received any 4’s. In the sit down review with my supervisor I found two other categories that I feel (and my supervisor agreed) that really deserved 4’s. As she noted, with a conspiratorial wink of her eye, that in preparation for next year, and given the fact that she is not present when I am doing my job and cannot document herself, that I keep clear and careful documentation which will go a long way in her ability to assign 4’s when next years review comes around.

You can bet that I’m am going to document clearly and professionally when I do something that goes above and beyond normal. I actually already have 3 specific events/ongoing procedures documented that have taken place since the cut-off date for the current review.

Today I had the opportunity to review the draft, add my own comments and sign-off prior to it being submitted to corporate. You can bet that I commented on a few categories in what I hope was an intelligent, professional manner. You can also bet that I tried to tactfully highlight that a hearing screener’s job is not relatable 75% of the time to the criteria that informs the current and very generalized performance categories. I did this by giving actual examples of what we do as applicable to the remaining 25%…not that anyone will care.

Now I wait, until March and the implementation of new pay levels, for corporate to decide that my supervisor overstepped the guidelines when she gave me two 4’s and that, should they decide that I am not worth a decent raise in pay, just how much I am willing to continue to fight. I suspect that corporate may not give a rats ass when it comes down to the next review, but my notebook and I are up for the challenge…

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https://imgur.com/gallery/nJzIM

 

 

Encounter

I should know better. I truly dislike going to the grocery store in the afternoon.

It’s busy. It’s crowded. All the good produce is picked over. Bothersome for someone who eats a lot of vegetables for sure.

Knowing just how much I dislike afternoon shopping unless it’s an emergency, I chose to go to the grocery on Monday afternoon after work.

It was busy. The lines were never-ending. It was crowded. Apparently it was unofficially older-person-using-motorized-scooter day. The produce was a joke. Entire sections of the produce bins were empty. My stir-fry was put on hold for lack of available vegetables.

The worst part though was an encounter in the dairy section of the store. Let me set the scene:

Deb is gazing intently at the yogurt, trying to decide on a brand and flavor. Was it going to be pumpkin? Where were those whipped yogurts that she bought last time? Should she just go with vanilla and move on to the next thing on her list?

Removing her glasses after making her yogurt choice, she popped them back on to check her list because she vaguely remembered something else that was needed from the dairy aisle.

From ten feet behind her, “Ma’am…! Lady…! …GRANDMA!!” 

The male voice behind her was clearly not directing those words to the store employee re-stocking the yogurt. Frankly annoyed, Deb turned to see a man, in a scooter, with a grizzled white beard and sh*t-eating grin looking pleased as punch to have gotten her attention. He rolled up, clearly believing he was witty and charming, and said, “Don’t ya know that there’s no U-turns here. This is a one way aisle.” 

Deb whipped her cart around, narrowly avoiding a collision with both the mans scooter and his leg, and said, “Well, apparently I don’t follow the rules.”

Grizzly scooter man had already moved on, stopping 3 more times as he moved down the aisle to pass on more of his wit and humor to the female store employee, the younger woman reaching for milk, and the middle-aged woman who was clearly cornered next to the eggs.

Typically I am pretty darn tolerant of older people in general. Typically I will let older men have their moment to make what they believe are charming remarks and then just move on. Typically I assume they are relatively harmless, at least in that setting.

Grizzly scooter man was clearly targeting females. This man clearly believed he had every right to speak in any way he chose towards any female he encountered. This man, under the guise of scruffy-old-dude-who-believes-himself-to-be-exceedingly-funny was a creep. It was not his words. From someone else those words might have been taken lightly. It was the man himself. This man, I am 100% certain, has the delusional belief that ever woman he meets and greets in this way is walking away feeling privileged to have been given his attention.

I have no idea what he said to the other women in the dairy aisle, but I walked away imagining this man at 16, or 25, or 40. Plenty of men who are currently in the headlines came to mind as I watched him maneuver his scooter. In the few brief moments that I was near him there was a vibe that made me shudder. I have no idea how many more women he spoke to during his time in that store. I have no doubt that he speaks to women in his own “special” way all the time.

I also have no doubt that this man will never be able to comprehend what a misogynistic jack-ass he is.

Eureka!

Doesn’t it make you feel proud and happy when you stick with something that seems impossible and then the moment comes and you can shout Eureka! because you figured it all out?

My Eureka! moments usually come in connection with something electronic or a technological situation. I had a moment today at work. I’m still pretty happy, hours later.

Everything that happens to/for/with a patient is recorded electronically nowadays. When I complete my screening of a baby, I print a paper record of the outcome and I also chart the results in the EHR (electronic health record). My weekend at work was crazy and while I was charting today I went back to a patients results from Saturday to gather another piece of information. I realized that I had charted a screening result incorrectly for that patient. Try as I might, I could find no way to edit that result.

I sent a message to my coordinator asking how to handle the issue and went off to screen my last baby for the day. She sent instructions, I sat down to correct my error and…no more baby. During the time I was away the baby and parents had been discharged and when they leave the floor, they are no longer available in our patient list.

I enlisted the aid of the charge nurse who walked me through the process to find and then edit a record. My access to patient information is much more limited than the staff access. We work much of the time with a “need to know” access and can be denied certain areas. I wasn’t sure if the path that she was showing me would work but I was determined to give it a try.

Things began well but when I accessed the patient record it looked nothing like the screen that had been available to the nurse. I was missing tabs that she had, my screen seemed to be set up differently and quite honestly I had forgotten exactly which part of the chart she suggested I locate to edit my record. Undaunted, because by gosh I wanted that chart entry to be correct, I began opening tabs one by one, exploring, seeing how far I could go and if anything even vaguely resembled the area I needed.

Ten minutes in I managed to locate two notes that I had written and filed regarding this baby. The downside was that there was no way to edit them from the screen I was in. More searching, more clicking, more exploring and as I came closer to the final few available tabs the screen began to look familiar. Thirty minutes after my search began there in front of me was the Audiology tab and the page with my charting. The best part is that it was able to be edited!

I was so pleased with myself that I whooped in delight and loudly began to declare myself to be amazing and skillful and definitely best at never giving up. Thankfully the nurse in the NICU directly behind me was busy with a loud, fussy baby and missed out (I hope) on my zealous display of pride and fist pumping.

I fixed my error, charted an explanation of the changes and promptly forgot all the steps that I had to endure to get to where I needed to be. I did however, walk out of work with a silly smile plastered on my face, a huge feeling of accomplishment in having conquered the EHR, and the phrase “never, ever give up…” running through my head.