Friday, June 30, 2006

Saturday Sun

I feel lazy and vaguely put-off by the thought of having to go to work tomorrow.

I usually don't feel like, "Yipee! Work!" but tonight I'm really wishing I could just call in sick tomorrow. But I won't, because I don't have a valid reason to, other than I've had a bad headache for most of the evening, and I just don't feel like being a nurse tomorrow. It's really impossible to have a lazy day at work when your job entails taking care of sick people. And did I ever mention how demanding sick people can be? I'm not complaining, but as I was buying some hummus as Trader Joe's today I was wishing I could job-share with someone with less responsibility, like a grocery store clerk, or a graduate student.

Hey, why don't I ring up potato salad and Oscar Meyer hotdogs or write a paper on the Dead Sea Scrolls, and you go hang two units of blood on that hypotensive, crappy 'crit guy, plus fluid bolus him later on because his pressure still isn't holding, plus start him on a Cardizem drip because his heart decided to go into rapid afib just for the hell of it.

I'll be fine once I get to work, but eck. I don't want to! Just feel like being lazy tomorrow, and possibly finding out where they're hiding their Indian restaurants around here...

Runaway Train

So, I am a bad dog parent.

I left my apartment door open and got busy doing something else, and the dog sneaked out of the door.

The bad part is, I didn't notice, and probably wouldn't have for hours except that some kind soul in my building noticed him running around--in the parking lot! the fool!--and took him in, and then called me.

The good part is, little dog ID tags work!

I have him microchipped, too, but that's for Big Guns Serious Runaway Antics, such as he gets himself incarcerated in a pound (which he did once, before his High Tech Pet Retrieval System days).

The problem with Piper is he's so quiet I barely notice he's around sometimes, and with the vacuum cleaner going, I definetely didn't notice him gone. He also rarely runs out the door, so I must have been seriously delinquent in closing the door (I'm sure whatever psycho killer is reading my blog is going to make a mental note to figure out where I live because of what a stupid easy target/victim I make.)

He's back now. I haven't a clue where he is, but the door is closed and locked, and last time I checked he hadn't grown fingers and an opposable thumb, so he must be here somewhere...

Holi[crap]day!

Man, this place is like a ghost town today. I'm not sure where all these people work, but it must be somewhere you can get a week off during a major national holiday.

Therefore, I conclude they probably don't work at my old hospital, where they let veteran nurses quit rather than give them a week of earned vacation, and hire in their stead new grads with subnormal IQs who are so retarded they end up in Orientation Limbo for what probably seems like years to whatever poor RN III pissed off management and got stuck with the scutwork. (I heard one of the new grads spent an entire day "orienting" not with a nurse, but with a unit clerk, and by the end of the day still didn't know how to page a doctor.) Go hospital!

Any hoo, I don't mind working most major holidays, because when you get right down to it, holidays are really annoying. People mysteriouly decide that instead of staying home, reading a good book and taking a nice nap on the couch, that they have to Go Somewhere and Do Something. What they end up doing, however, in their vain, delusional effort known popularly as Having Fun is simply to mob places and fuck up traffic for people who actually live there.

I would say this lemming-like collective drive towards insatiable consumerism, clogged highways and attendant disappointment and frustration is deeply ingrained in our souls, an ironic national quirk much like French people hate cow's milk, but invented moldy cheese for consumption. Ergo, our national psyche ends up enduring hours of pointless holiday traffic jams, milling around aimlessly amongst a stinking lot of tourists who are lost and can't seem to drive worth shit. Ironically, if predictably, this American pasttime of pointlessness ends traditionally with a sense of blunted rage and misgiving because damn, look at all these scores and scores of stupid ass tourists--I can't see a friggin' thing!

Me, I'd rather work and get paid time-and-a-half. Work is somehow more relaxing than the idea of taking a holiday along with everyone else.



Outsourced

I was thinking the other day of all my loan debt, and how stupid and shortsighted it is for a first world country not to have higher education better subsidized, so that in order to get a graduate level degree, one doesn't have to sacrifice years of creature comforts while in school and then--if the degree-seeker is lucky to get a job at all without having to omit on her application the degree that overqualifies her--be committed to decades of staggering loan installments equivalent to everyone else's 300K monthly mortgage payments.

Meanwhile, people like Britney Spears make millions of dollars in a mere two years by wiggling around half naked on stage lip synching forgettable canned pop rock and retire at age twenty five to live up to their true potential of barefoot-and-pregnant. Except they get to gestate in Club Med resorts as opposed to their white-trash counterparts, who waddle around WalMarts giving themselves PIH and gestational diabetes with their non-Academy of American Certified Nurse Midwives prescribed diet of twinkies and McDonald's fries.

Any way, as a country, I think we've shot ourselves in the foot. Now we're even outsourcing tele-customer service jobs to India, so when I call a bank in New York, my call gets rerouted to New Delhi, and I end up talking to Deepak Singh who insists his name is really Harold Goodtree and asks me repeatedly how my your day is ("It was better before they started routing customer service calls to third world countries") when he can't seem to find the right troubleshooting prompt in his English for Customer Service Banking manual.

Pretty soon I'll be told they don't need American nurses any more, because they've found Bosnian refugees can teleport themselves into the hospital and will do the job for a dollar a day, and who cares if patients will never see a real person during their hospital stay.

For the record, I'm not knocking foreign labor as such. The people who answer the bank's phones are doing a job that most Americans are probably too lazy or proud or undereducated to do (how many white Americans know how to speak Hindi and English?)

I'm just saying the cheap Nazi corporate bastards that run this country are driving it into the ground, and if they don't watch out, pretty soon we'll be the ones sewing soccerballs for five cents a day and shipping them to places like India so that Deepak's grandson can practice for the day he grows up and goes to a British university on football scholarship, as per Bend It Like Beckham II.




Thursday, June 29, 2006

Unsolved Mysteries

What day is it?!

I get that way when I have a four-day holiday in the middle of the week, even when I haven't been freebasing or binge-drinking.

Just kidding.

But seriously.

A couple of random observations:

1) I seem to have some kind of weird measles-like rash on my chest. Okay. What the fuck is that all about, please? Why must I turn into Stan Shunpike over night?

2) The middle aged guy on the plane smelled like stale beer. I was actually wedged between Old Guy and Middle Aged Guy, and I couldn't properly figure out if it was Old Person Smell, or Stale Beer Smell, or both. But it was vaguely naseauting.

3) Goofy looking pudgy teenage guys shouldn't go around airports--or anywhere for that matter--with teeshirts that say "Cure Abortion." It makes people who own their own uterus kind of pissed off, because uh, when teenage boys can pull basketballs out of their noses, and subsequently clothe, feed and send those basketballs all the way to college, then those teenage boys can wear whatever stupid Christian Right teeshirt slogan they wish. But until then, limit silkscreened statements to those regarding your own reproductive organs, thank you very much.

4) I read an article in one of those badly written airplane magazines that Danish people smile a lot. I guess the article was about how Denmark is full of toothy, grinning people who are either very, very friendly, or wolves in their grandmothers' Skyggejakke
. Any way, now I want to go to Denmark. Damn suggestive travel articles.

5) I also want to run away from my country, to a nicer country. Specifically, one that isn't full of motherfuckers, and one where it's cheap to live, and tasty food is everywhere, andpeople decide to make me honorary queen and my subjects bring me lots of pretty yarn to knit and evil hospital CEOs to flog publically.

6) Libraries are a big huge turn-on for me. I have been neglecting my inner geek (although not my outer geek, as evidenced by multiple bruises on extremities of which I cannot explain the origin) lately. So when I went into a modest branch library this week, I could barely contain my book-lust. I have to admit I'm somewhat of a literary whore, though, flirting with every genre that comes my way. (I also have a bad habit of reading books--especially philosophy books--in random order, like flipping to page 27, reading five pages, then flipping to the end, and reading the last page etc.) I also confess to the menage a trois approach to reading, wherein I read bits and pieces of various media simultaneously.

Really, I should just out myself with my literary ADD and call it a day.

7) My dog was an ostrich in his former life. He likes to "hide" under my bed, except with conspicious parts showing, like half of his butt and tail, or a random paw. Sometimes he's really lazy about it, and he might as well not even try to fake playing ostrich. I'm all, "Piper, I can see you, you know. Just because you can't see me doesn't me I can't see you." This statement gets a paw drawn slowly under the bed. For about five seconds. Then it slowly inches out again.

Bottom line: The dog could care less what I think.

8) Does any one remember those Monchi-chi monkey dolls? Any one?

9) Dammit. I thought I turned off my stupid overhead fan five minutes ago. But I didn't.

10) Why do people have children? I don't get it. I'm not trying to be an ass, but it seems counterintuitive to me, other than from a purely biological/biblical imperative standpoint. I mean okay, I get that sex can be fun, but we have birth control nowadays. The really good kind, which runs contraceptive rings (pun intended) around your grandma's "Not before marriage, dear" line (did that line ever work any way?)

And then there's pregnancy, which doesn't sound like a barrel of laughs, and then there's labor and delivery, which definetely sounds like hours of intense pain and screaming, and then you have this mini-you running around, which seems ever so vaguely creepy, if you think about it from a genetics-as-philosophy standpoint.

I'm sorry for sounding so dense. I mean, I get why bunnies have babies; foxes need something to eat, and Jamie enjoys having the lop-eared ones around to nibble her computer cord as she blogs. But then, what eats people and makes pets out of them, other than one Hannibal Lector?

P.S. Does any one remember Robert Stack's Unsolved Mysteries? Someone needs to get Robert Stack back on the air, and do a special Unsolved Mysteries on Missing Monchi-chis: The Untold Stories of the Russian Toy Mafia of the '70s and '80s.



An Affair to Forget

So Financial Aid Death Match, Round 2 commenced today. I have gotten more Zen about the whole process as in, "Die, motherfucker, DIE!"

Suffice it to say I called to figure out what the hell they were talking about in the first place and a) never figured it out, somehow and b) spent half an hour getting screamed at and insulted.

So then I called my loan consolidation company, whose employees were much nicer, but became politely puzzled when I tried to explain to them that the financial aid office was so horrific I couldn't manage to get a) the name of the loan b) the amount of the loan in question.

Any way, the whole conversation was right out of an absurdist play. I kept expecting some angry Julia Child clone to burst into the kitchen with a burnt omelette sounding like the Swedish Chef, followed by dubbed Iron Chef commentary, with the token clueless actress judge saying, 'Hai. This sauce looks really modern, doesn't it?"




Sunday, June 25, 2006

If it ain't fixed, don't break it

One of the nurses on my unit starts out report with a little synopsis I always find amusing, "Well, we broke the guy in room twenty, but we fixed a couple of people, but then we broke one of them again."

It's always a good feeling when you help to fix someone.

Like yesterday, I had a guy, two days out of CABG surgery, with a massively lousy 'crit and hypotension to best anyone's syncope diagnosis. We had d/c'ed his chest tubes, only to figure out we'd given him a pneumo in some random lung space and so he had to have another one placed, and his vein graft incision site was oozing (and had a bandage on it that looked like... well, I'm guessing a nurse didn't do that dressing, that's all I'm saying).

So we transfused him yesterday, I got him all washed up and his incision dressed properly, and today, he was like almost brand new.

His wife even brought me kimbob, which is kind of like Korean sushi. And I had been craving sushi all week long. She said they really liked me and thought I was a good nurse.

I was thinking secretely, "Then you must not have been watching real carefully when I accidentally backprimed some of his unit of blood into the saline bag."

Well, not all of it.

Any hoo.

It's so rewarding to see my patients get better,and get up walking around whereas the day before they were so tired and weak they couldn't get out of bed. It's so much better than running around frantically for twelve hours, trying to get somebody, anybody to care that your patient is dying, and then watch them die any way because no one except you appeared to care, and you couldn't do anything about it.

Even Foley Bag Guy couldn't ruin my day. I helped fix a patient. I helped them get better. It's what I got into nursing for (that and the chance to steal used foley bags, of course)! Too bad I had to wait an entire year to feel this way about the profession, isn't it?

The Foley Burglar

In a funny way of greeting, one of my patients, an elderly gentlement that has a predilection towards the cantankerous, said to me accusingly: "We're YOU the one that stole my foley bag yesterday?!"

I had to surpress a laugh--not to mention look of utter disbelief--and simultaneously conjured an image of myself as The Infamous Mid Atlantic Foley Bag
Burglar, notorious for spiriting home patients' used foley bags and storing them in my closet. I then imagined myself hurrying home to my piles of used foley bags, having a nightly ritual of cradling each in my arms, whispering deliriously to myself over and over again "We loves them, precious! Oh yes! We needs them! Nasty hobitses... we won't lets them near the precious, no we wont! Evil hobitses, trying to take my precious away, but we won't let them, will we, precious?! We must kill the hobitses, vile, loathsome, evil hobistses! My precious, my love..." And later, me, screaming into the darkness: "The lambs, Clarice! The lambs! Can you hear them now?!"

Of course, the imagery wasn't as amusing at 6p.m. as it was at 7a.m. for by change-of-shift I'd already had about fifteen pointless conversations about his stupid ass, discontinued foley bag which we could not replace and yet he kept insisting we should.

Logic. They should teach it in school. Or give geriatrics seminars on the topic, to prevent brain rot.

Friday, June 23, 2006

Calm Blue Ocean. Calm Blue Ocean.

I must think good thoughts. I must think good thoughts.

Okay, so I will think mutinous thoughts, and curse and smite thee, mine insidious and unworthy opponents.

Incidentally, one of my favorite Psalms is 109, in the Latin Vulgate. Because I'm a huge geek, I enjoy muttering this maliciously under my breath when cursing someone (I learned this by heart long before ever taking Latin in undergrad, again, because no one has figured out how to save me from my general intellectual uselessness to the world):

Dixit Dominus Domine meo:
sede a dextris meis
donec ponam inimicos tuos
scabellum pedum tuorum.

The Lord said to my Lord:
sit at my right hand
and make the heads of thine enemies
thy footstool.


Now, at the risk of alienating more pious readers from my blog (the readership of which is at what, a staggering four now?!) I just have to say that my friends, was a time when God was God, all kicking arse and taking names. None of this namby-pamby turn-the-other-cheek-pansy-assed-kumbya-New Age-Christian shit, just shut up, sit down, and hold on to your butt woe-unto-thee whup ass. That was God in his Homie Don't Take That Shit, Niggas shining incarnation!

Which makes me lament all the more: Dude, why can't our modern day God be more vengeful and choose sides (namely, mine)? He was like that before.

Stupid garbage ass-ho Christianity, fucking up all the good bits of having Yahweh on your side.



Repeat 100 times: I will not make fun of stupid people.

Oh, who the hell am I kidding, of course I will.

The funny thing about Ivy League employees is that they universally hate the students whose tuition pays their undeserved wages. I don't wholly blame the employees for their miserable attitudes, as most of the students I ran into outside of the school of nursing tended to be snotty-nosed prats. It was the only institution I ever went to where you'd say "Hi!" to another fellow student in the hallways, or wherever, and get a silent glare in return.

Well. We Novo Collegians were a smelly, granola-ish lot, but we were, by and large, quite friendly, happy-go-lucky kids.

I was just talking to a good friend of mine on the phone today, when I realized Ivy League School of Doom was the worst financial, and possibly life, decision I've ever made.

I incurred a whopping 50% of my student loan debt in one and half years of school there. It makes me cringe to even think about it, and to tell you the truth, the thought that I might actually have some other random loan out there I didn't know about makes me want to hop on the next plane to Costa Rica and live the life of a sea-side mammacita, insisting my name is Rosita Perez when questioned by immigration authorities.

I still think Financial Aid Office is full of shit, since they think I'm deliquent on their Perkins Loans (this makes me think that I should send everything return-receipt-required, so they can't claim they didn't get the damn documents) and I'm patently not, and also, don't you think it would be nice if the school like, you know, let you know you had extra loans with them, rather than spring it on you all smug-like when you least expect it?

If I were a Marine, I'd insert a big long string of suitable cuss words here. So imagine I'm a Marine for a moment.

Ah. I feel much better now.

Any way, I was all calm and happy before the ugly tentacles of that horrible school reached out from its miserable skanky retreat and tried once again to latch on.

Bastards! Scum! Vermin! For now I have to fly home, rummage through my stuff, find proof I've been paying my loans all along, and send a big long snotty letter back detailing the whys and wherefores of my long-suffering past year committed to giving one third of monthly wages to clothe and feed the already fabulously rich academically well-endowed.

Fucking bastards!

No child of mine will ever darken their doorsteps! Nay! I shall defy those evil fuckers, and my children shall go to community college and then on to a decent public state school, or maybe even vocational school if it's the last, loose-meat sandwich-on- bleached-flour-Wonder-Bread blue collar thing I do with my life.

Boo! Hiss!

One year of Nursing in Hell has changed me, for the worse, I think, in some ways. While I can now enter Crisis Mode at work with fair aplomb (unless my patient's crashing and no one gives a damn; then I regularly fall to pieces, but wouldn't you?) I now have an even shorter temper than I did before.

For those of you that know me well, you know that this Isn't A Good Thing, as I am a real nasty piece of work when I get angry. Lately when pissed off about something, I have very little control over the Bad Words that come out of my mouth. It's a bit like being Linda Blair, except without the head spinning like a top (yet).

For those of you who (thankfully) haven't been subjected to my Evil Emotional Twin, and have only encountered the SuperFakeyNice Jamie (coined from Mason-Dixon Knitting, which is a funny read even if you don't knit) you'll probably not understand how Bad this kind of thing is for me.

I've always been highstrung (read: make coffee nervous) but a year spent in Nursing Hell has refined the fine art of a tantrum. Mostly, I have minimal tolerance for incompetence; once I scent it in the air, I become a right royal bitch. It ain't pretty.

For example, today I was on the phone with a board of nursing employee--who, in her defense, appears to be literally the only employee at the board of nursing that processes license applications, as every one else I've been talking to for the past two months keeps saying, "Oh, I don't know. You'll have to talk to Penelope about that." [Note: names have been changed to protect the guilty].

Any way.

I've sent two transcripts to the board of nursing, who keeps claiming "they don't have it." So I call to check up on whether or not they've finally figured out where the transcript was filed (because I sent two of them in May you understand). At this point, I'm beginning to think somebody used the transcript as toilet paper, or an oragami project for their kid's third grade World Geography project.

First
, I am informed that the Royal We "keeps getting mail sent back marked undeliverable." I'm wondering if "they" bothered to let their fingers to do the walking and pick up the phone and call the phone number on the application to see why. I mean, come on, this is the twenty first century, isn't it? Phones aren't a newfangled concept in the state capitols of mid-Atlantic states, are they? I didn't somehow open a portal into the 17th century when I sent in my application, did I?

Then Penelope starts sounding harrassed and defensive, which is odd, because I haven't accused her of being a bad state employee (yet). "This is a really bad time to be applying for a license you know! New grads and everything!" she says, in a distracted tone that sounds much like a sleep-deprived mother of seven very unruly spoiled children.

I ask her again about my transcripts, and for the third time in thirty seconds, she absent-mindedly asks if I've had my name changed. (I'm thinking, "Not unless I'm Liz Taylor."

"Oh well," she says, finally procuring the transcript from god-knows-what-bureaucratic-cubbyhole, "Huh. A master's degree... Hey, are you applying for an nurse practitioner license?"

I'm about to start drilling spikes up my fingernails to distract me from the frustration of this conversation, when I start thinking, "I'm so glad I pay my taxes and everything, because it's so worth it to have such knowledgable, fine state employees lose track of every single piece of paper I've ever sent them."

The good news is, I finally have a valid license (as opposed to temporary permit) in the state in which I currently practice nursing.

And it only took two months of holding on the phone, getting transferred, hung up on, and accused of being stupid enough to dare apply for a license at the same time as new grads.

Then there was the Bitchy Phone Conversation with the Evil Mistress of Financial Aid at Nefarious Ivy League School of Inadequate and Impotent Intellectual Balderdash, who snottily informs me that I haven't been paying my student loans that the Royal We has been so kind and generous as to bestow on my weak chinned, knobby-kneed Oliver Twist-like form.

I explain, quickly losing my patience, that I filled out paper work a year ago when I became a nurse to defer the Perkins loan, and as far as I know, I'm not deliquent on any loan.

I hate it when the claws come out, but out came the talons, and in a voice seething with contempt and loathing, a response cracks across the phone line that they've been sending things to my address and all have been returned.

Here again, I silently wish that people who are being paid slightly over minimum wage for petty office clerical duties would kindly get off their fat arse and pick up the fucking phone and call me when such troubles arise, rather than act as if I'm the problem.

Apparently, however, this bit of common horse sense is way too much of an intellectual reach for people who have a job that barely outstrips the intellect needed to ask "Would you like fries with that order?"

Sigh.

I suggest icily that they send it to my parents' home instead, from where mail does not magically boomerang, and am informed, in a tone that suggest I am the one with a mental deficit, that "We'll need an e-mail in order to do that."

This is where Jamie Loses It.

"WAIT A MINUTE? YOU'RE SAYING YOU CAN SIT HERE AND TELL ME OVER THE PHONE THAT YOU'VE BEEN TRYING TO REACH ME FOR THREE MONTHS OVER THESE SO-CALLED DELIQUENCIES, AND YET NOW THAT YOU HAVE ME ON THE PHONE, YOU CAN'T CHANGE A STUPID ADDRESS THAT OSTENSIBLY YOU HAVE IN YOUR DATABASE ANY WAY?!"

"Yes." replied the self-satisfied and overly smug answer on the phone.

"FINE." I spat, viciously, "IF THIS IS THE WAY YOU PEOPLE CONDUCT BUSINESS, THEN NO WONDER YOU PEOPLE DON'T GET YOUR MONEY."

Click. I hung up the phone in high dudgeon, out-of-breath and feeling as if I'd just been through a hellacious pissing match with a lazy attending who doesn't care his patient is bleeding copiously out of his urethra.

I think the reason I lose my temper so quickly with situations like this is because it reminds me of my salad days in nursing, when crappy situations would be left to fester and fester and fester, and then everything would get dumped on me, the nurse, and then when I'd try to fix it, I'd get blamed for whatever it was, and intellectually insulted for good measure.

Sometimes though, I overshoot the mark and go from assertive This Bitch Don't Take That Shit, to Psychotic Bitch on the Rampage. I rather hate when I lose my temper, because it ruins my otherwise serene day.

And by the way. Those kids, running around like assholes outside on the landing? I hope they trip, fall four flights down the concrete steps, knock out a couple of teeth, and cost their parents a passel of money for a pedi trauma admission, and on going cosmetic dentistry bills.

I really, really really am highly displeased with other people's ill-behaved genetic misfortunes they call "their children." Children like that should be placed in a cage, and watered and fed once a week, twice at most.

Grrrrr.






Picture Pages

I was just thinking, if I wrote a book for popular press, it would have all of my favorite things in it:

knitting, Westies, knitting, bunnies, yarn, knitting, nursing, music, food, pretty photographs, art, knitting, references to other books, philosophy, and knitting.

Hmm. I must dwell on this idea.

But later, after food, and of course, more knitting.

Men Who Knit

I was just lurking around on the Mason-Dixon Knitting blog
which contained a link about boys knitting.

This reminded me of a blog I came across somewhere in Sphere O' Blog that roundly denounced Men Knitting, and considered it a waste of her time to devote any blogspace to such trifling, insignificant matters. The blogger didn't clearly articulate her reasons, but I suppose it's her blog, and I doubt many men read it any way.

Of course, this male-exclusive statement reminded me of Mary Daly, an ex-Roman Catholic nun turned feminist theologian. It turns out she doesn't interact with men at all. She doesn't even look at them or acknowledge them during her lectures. There's some whole background story to this life approach, but I frankly didn't find it very convincing the first time I read it seven years ago, so I wouldn't be able to tell you exactly what she's thinking, other than that she seems very angry about Bad Things That Happen and spends a lot of her time blaming men When Things Go Awry With the World.

I can't even begin to figure out how this strategy helps people learn to be better human beings and get along with one another, but I suppose that's not her point. And honestly, I couldn't tell you what her point was, because I was so turned off by the first few pages of her Beyond God the Father that I stopped reading it properly, and only skimmed it for my paper (I hope my old theology professor isn't reading this blog).

While the devil's advocate in me can see this life commitment to ignoring men as having limited potential for amusing moments (eg telling some poor bewildered male clerk at the drug store, "I'm sorry, I don't interact with people like you,") I also didn't really get it. I mean, it's not particularly practical, and it seems like a shortsighted strategy, because not all men are Evil Patriarchs, are they?

But back to the main idea of this post, which was about men and boys knitting. I doubt many people realize that in Iceland, or somewhere, knitting was traditionally considered a male activity. I don't know if their knitting sessions included some kind of ritualized sword fighting with huge broomstick-sized needles, or something, but in some communities, knitting was so synonymous with maleness that woman weren't allowed to knit. Or it was considered shameful if womenfolk did pick up the needles, especially in public, or something silly as history is known to provide us details.

I am totally for Equal Knitting Rights, myself.

When I was in Nashville, eight year old boys would come into the shop with their moms and sit and knit with them. I think I even remember giving one of the lads a knitting lesson a ime or two.

In fact, if I had my druthers, my Custom Made Dream Guy would knit, and knit avidly and voraciously. Then we could go yarn shopping together, and compete in Most Fabulous Sweater of the Year household championships during world cup playoffs, or something.

Then again, my Dream Guy would know that the way to my heart would be to coo little sweet Kantian antinomies in my ear, so I'm not exactly holding my breath, or anything.

Pack rat

There are things done during periods of duress that are good, like ditching a job that's killing you, literally.

And then there are things done during those periods that are lamentable at best, and downright foolhardy at worst.

When I moved from Nor'eastern State of Doom, I had to make decisions about What To Bring. I threw a lot of stuff out: old orientation manuals from school and my last hospital, of which I'm sure an entire acre worth of trees were felled in the making, weird doohickey things I couldn't figure out why I'd kept all that time, random pieces of string... and well, more expensive pieces of string.

In retrospect, the expensive pieces of string (yarn!) I must now properly lament, as in the Old Testament breast-beating and wailing tradition (or breast beating were that I had a real bosom to speak of. Perhaps I should find a tunic to render instead...)

I don't know quite what I was thinking; it would have been a mere one more box of stuff. Surely one more box of stuff would have fit in that spacious moving van that came to collect all my worldly possessions for the long south-bound haul that was my destiny?

Alas, and anon (for good measure).

Here I am, wishing I had just one ball of the good old stuff (I did keep a few paltry special skeins, but not enough to knit what I want to knit now, dammit). I think my rationale was either a) can't. pack. another. fucking. box. or b) I can always buy more yarn.

Note that rationale b) is a hugely self serving one, as dumping all your old yarn means you get to have fun buying new yarn. But somehow, it just didn't work out properly, and turned out to be more of the wrongheaded thinking involved wherein a well-meaning but ironically insensitive friend buys you a puppy dog two days after your venerable canine companion of fifteen years has gone to Dog Heaven.

Sometimes, I'm just a big fat idiot. A big fat idiot that finds herself at the local craft store, shelling out more money for yarn she had in her stash but donated instead of hauling along with her like a good pack rat.

Error of packing judgment; I will never make thee again, I do so solemnly swear on my beat up copy of the venerable knitter's guide Elizabeth Zimmerman's Knitting Without Tears (well, I would swear on it, but it's in storage right now).

Moral of the story: yarn is your friend. Treat it well, keep it near you at all times, and most of all remember: don't get rid of what you've got, because if, heaven forbid, you don't have the yarn you're looking for, why(!) you can always buy more.

As a postcript: Turd. Why must I get my charity-knitting-second-wind one week before the due date of several charity deadlines? And furthermore, why must I insist on starting a blanket before said deadline?

These questions and more, answered, next after these messages from our sponsor.

Thursday, June 22, 2006

My Right Foot

It still hurts, dammit!

I've tried stretching, cool packs, hot packs, and magical incantations.

Sad to say, only the magical incantation seems to be having the slightest effect on my foot at all, in that I feel so silly it takes my mind off of the pain in my foot.


FYI: DIY and KISS

So I went back to the book store

As I headed up to the cash register to ring up my purchase, I saw a book brilliantly entitled "How to Get Pregnant."

It was then I realized I'm in the wrong career, and that I should be writing books on patently obvious topics for stupid people who can't grasp the concept of "insert tab A into slot B" kinds of mechanics.

Really, I should write a book entitled "How to Get Addicted to Cocaine" or "How to Spend All Your Money On Stupid How-to-Books."

Damn Magic 3D Mystery Pictures!

Okay, I thought of number 11:

1) Try as I might, I cannot see the secret whatever in those 3D mystery pictures... you know the ones that you're supposed to stare at until you feel you're the dude in Munch's The Scream, and then see a picture. I feel like such a failure, although I'm convinced it's a genetic thing, like the ability to roll your tongue; completely useless, but very depressing if you're seven-years-old and all your friends can do it and you can't.

Ten Things I Like About You

Because I am suffering from random memory loss of the young adult, I can't remember where I saw this in passing (but I think it was a blog somewhere in the blogosphere) but I kind of liked the idea. It was entitled "One Hundred Things About Me."

As you can see, I'm living in the eighties like there's no tomorrow, what with the self-centeredness.

Any way, I thought I wouldn't bore myself (or rather, come to the horrible conclusion that I'm not interesting enough to think of 100 independent statements describing myself) and start out with ten.

Let's see:

1) I am a nurse.
2) I like Westies and small flop eared rabbits.
3) I am a knitter.
4) I always said green was my favorite color, but now I think it's blue. Or red, maybe.
5) If I could have a Super Power, it would be invisibility. Or maybe being extremely rich. Wait. Is that a real Super Power?
6) I read Kant's Critique of Pure Reason in undergrad and managed to retain none of it. Thankfully.
7) I am craving sushi right now.
8) I am not craving a bean burrito, because that is what I had for lunch today and yesterday.
9) I am an insomniac, but would prefer not to work night shift.
10) I think naps should be mandatory for everyone.

Nw Cllge Graduate

Yes, I am!

That's what my new Florida license plate says, any way, because the stupid car dealer logo on the license plate holder masks half of the words, so instead of New College of Florida, it looks like it says N w C llg f Fl rid.

So much for college pride.


Failure to Thrive

Okay, I'm not sure God isn't going to strike me down (or give me a really crappy assignment when I go back to work this weekend) for that last post, but just in case, let's bless our rosary beads and kiss our St. Judas Patron of Lost Causes medallions, yes?

So I bought that book Because I Couldn't Wait Two Weeks for amazon.com's super saver shipping (say that three times fast with a spoon up your nose, I dare you) even though I could have had two books for the price of one.

Whatever.

Next on the list: I must grouse about this newly found appetite thing. The way my body is reacting reminds me of how the Allies, when they found starving concentration camp prisoners, immediately gave them all of their rations, including chocolate. Naturally, it was too rich for the dying concentration camp prisoners, and their bodies were too weak to handle it, so it ended up killing them faster.

I think my body is doing the same thing. It's like, "Uh, Jamie?! Uh, this food thing?! Can we talk about it? No? Well, fine then, suffer the GI consequences!"

So basically whether or not I eat, my stomach makes certain I only absorb about twenty percent of it.

Lovely.



Bad Jesus

I'm glad God never chose me to be Jesus, because I would have made a lousy divinity.

You know that part of the gospel when Jesus goes into the desert to fast and pray for forty days, and then Satan comes to Him and shows Him all the Cool Stuff He's missing out on, like first century equivalents of iPods (whatever they were) and free passes to Cirque du Soleil (whatever that was)?

Well, see, if I had been Jesus, I'd have switched alliances in a heartbeat. I'd be all, "Smell yah later, God!" to paraphrase one of my friend's favorite allpurpose expressions.

I kind of wonder if Jesus didn't go over to the Dark Side, and maybe that's why God got Him crucified, because it pissed Him off royally. Any way, I don't know, if God made me fast in a desert for forty days and had torture and crucifixion in store for the end of my life, and then some dude claiming to be the Dark Prince came along and was like, 'Hey, I can give you an entire city if you just bow down and swear allegiance to me!" I might be entrepreneuring enough to accept, especially if he threw in free books, music and knitting supplies whenever I wished them.

The only reason I mention a theory as heretical as Jesus becoming Darth Vader's stoolie is because well, He was supposed to come back imminently (well, imminently for way back then any way), wasn't He? And did He? Did He?!

You see, this is where conventional Christians and myself part ways, because they keep claiming He's coming back, and I say, "Yeah, prove it."

This is the part of Christianity that completely lost me right around the time I figured out Santa Claus was really mom and dad staying up really late trying to figure out toy assembly instructions written in Japanese and searching vainly for D batteries in order to make Christmas magical for their kids.

I'm talking, of course, about the complete suspension of reality necessary to "believe" in the whole Jesus story. It may have made sense to some backwater Aramaic speaking Jewish guys back in 34 CE, but I'm not sure the story tracks in a world where we have running water, electricity, and routinely pooh-pooh time-travel Michael J. Fox movies of the great caliber of Back To the Future for space-time-continuum plausibility issues.

I guess I'm saying I like my religion without historical conundrums like, "What about the people who existed before Jesus did? Do they get automatically grandfathered in on Judgment Day or something?"

Any way. I can't believe I went to divinity school, to tell you the truth, as I was surronded by people studying to be ministers who earnestly talked about stuff like What Would Jesus Do?, except in a more formal, pseudo-intellectual way. I always thought that was vaguely creepy, actually, going to school with ministers-in-the-making. Especially since so many of them turned out to be lushes with dubious moral character more befitting of a slimey DC politician.

Rather than religion, I like the idea of creating a What Would Jamie Do? ethical set up. First, it's completley self-centered and relativistic, so no real need to speak of a "community of believers." Second, it basically means I can do whatever I damn well please, with no pesky saintly intercession or other heavenly correspondance needed.



Wish List

I'm usually very indecisive when it comes to asking for gifts, mostly because I think this kind of behavior is reserved generaly for people under the age of fifteen.

But this year, I feel differently. Mostly because I'm pretty broke right now, and as it happens when I have no money, I feel the need to Buy Everything, Right Now.

Instead, I'm going to make a list of Stuff I Want For My Birthday. Now, I don't want people to get all huffy about this, the way they did on Michelle Au's blog
when she added a link on her blog to an amazon.com book list for her infant son, Cal.

Wow. Talk about backlash.

She then had to explain to outraged and miffed readers (patiently and graciously, I thought, given the fact that one doesn't really owe complete strangers explanations about your blogging activities) that you know, she wasn't soliciting gifts from strangers, thank you very much, but rather intended the link for those good friends and family who read her blog too.

Beware, gentle readers, for the power of the blog to divide and conquer is great.

But back to Selfish Me.

Year after year people have asked, "What do you want for Christmas/your birthday?" and I've been too brain-dead or modest. to give a proper answer.

This year, I've decided to be selfish. I want stuff, namely yarn and books. Gift certificates from amazon.com, knitpicks.com, and patternworks.com will do nicely. And I want a new stethoscope, even though I don't really need one, and have grown fond of my Littman Classic II with teal tubing. I want the Littman Cardiology III, the bad boy of stethoscopes, in my opinion, even though I couldn't distinguish a grade I from a grade II murmur if you threatened me with going back to my old unit.

I don't really need it, though, so I'll probably wait until Christmas time for that, because they are quite expensive, stethoscopes. And like I said, there's some weird relationship you develop with your stethoscope; it's kind of like a talisman of sorts. You never quite feel the same using someone else's stethoscope. I know this sounds cultish and bizarre, but I assure you it's true.

Any way. Must rummage through cupboards for dinner. I didn't have an appetite for an entire year, and I"m not sure what to do with the one I have no, except to feed it.

Margaritaville

I think I've figured out I'm not as creative when I'm happy.

Bummer, that.

Any way, having a pleasant three-days-off. Yesterday I ran errands in sweltering heat (the only downside to living here is that it's hot in the summertime. I don't do well in hot weather. Then again, I do worse in cold, so I suppose I'll take the hot summers and snowless winters and shut my mouth.) As I was trudging up four flights of stairs with groceries I was thinking, "My, for a skinny thing working on a cardiac floor, you're sure as hell out of shape."

Alas. The days of my 3-5 mile runs (oh! my knees!) are done. Very sad, and Tuesday at work I suddenly felt my right foot arch get all painful (hey! I'm not an ortho person, okay, so kindly keep your snotty guffawing to a dull roar). It feels like I tore something, or at the very least, strained something, and it hurts to bear weight on it. I probably should be applying warm compresses followed by cold compresses, but being a crappy nurse, I haven't done anything but gimp around on it pretending I don't have three twelve hour work days ahead of me.

Other than that, I'm having a good time being a lazy ass. My only complaint is that the margarita flavored wine coolers I bought yesterday don't taste a bit like margaritas. I'm not sure what they taste like--maybe alcohol-flavored battery acid, but they don't taste like margaritas, no matter how much salt I put on my tumbler glass rim.

This sidebar brings me to a funny (okay, mildly amusing) postcript in the annals of my life. The postscript being I am almost thirty years old (I staunchly refuse to believe this is true, and shall hereforth refer to it as my "second twenty-ninth birthday) and am still carded on an alarmingly regular basis when trying to purchase alcoholic beverages. Once, mortifyingly enough, I was with my parents at a restaurant, trying to order a margarita (with my mother) and the waitress asked for my ID. I was, you know, with my parents and so I didn't have an ID or anything, because I wasn't driving. Short version of the story: they wouldn't let me have a margarita, and I had to make do with taking furtive/clandestine sips from my mother's margarita.

I told you it was a mortifying story.

Any way, I can't figure out why people think I look like a teenager. In the last three months I've only purchased alcohol once without any one asking for proof that I'm in that sweet demographic of "twenty-one-and-over." The clerks look really embarrassed when they see how old I am, and I suppose it's flattering but Jesus.

Maybe it's the waifishness, and the short haircut, plus the flat-chestedness, and the short stature thing.

[I have to interject--I'm sitting on my couch writing this entry, and the rabbit, who's out of her cage at the moment, is lying on the cheesy faux granite fireplace hearth in front of me, all Kicked Back Bunny Style. The funny thing is she has this random little stare in her eye, which has morphed from "Clueless blank bunny stare" to "Yes, I'm lying on your faux granite hearth... so what of it?" She also has this annoying habit of climbing in the fireplace itself (with the faux logs; she is a very urban bunny, you see) but that's another story for another day.]

My brain is like so much oatmeal, except without the interesting bits added by Quaker Oats. I did go to Barnes and Noble today, to drool over the latest copy of Mason-Dixon Knitting.

I am insanely jealous of one of the co-authors Ann, who lives in Nashville. Okay, so not actually insanely jealous, but I do miss Nashville, and wonder if I'm ever going to live there again.

I then did something nefarious, which was to copy a baby sweater pattern from another book out on a scrap of paper . I am a Bad Human Being. But I can hardly afford $50 worth of books, so I went about my fell deed with a sociopathic conscienceless zeal worthy of the most tightfisted manifestation of my Inner Ninety Year Old. In the same pennypinching vein, I decided to purchase said books on Amazon.com, but later, when I actually have reasonable funds to purchase frivolities like knitting books, as one thing I need like a hole in the head is more knitting books. As I was saying to a friend of mine, knitting is much like a crack addiction; it matters not what you had fifteen minutes ago, it's all about the next fix.

I suppose I shouldn't be talking about crack addiction that way. Then again, who cares. I'm sure I'm the only crack addict reading this blog any way.

[Nota bene to state licensing board, JCAHO, hospital and employer for which I currently work: I'm only joking about the crack addiction. Really. I swear.]

In between pawing through a stack of fifty books tottering precariously on one of those cafe tables--no doubt garnering unheed dirty looks from the poor employees whose job it is to reshelve the books--I also spent a fair amount of time weaving in and out of aisles peering over fresh armloads of texts, very disheveled and Hermione Granger-esque, I imagine. On one of my treks back to the knitting section, I caught a glimpse of a book that I think was called "How to Set A Man's Thighs On Fire."

Don't ask me if that was the whole title of the book or not. I haven't a clue in which genre this book falls, but I supposed it was some Cosmo type get-him-hot-and-bothered stupid thing I don't have time for (because I'm busy knitting like the ninety year old I aspire to be.) But then, the Warped Nurse side of me said, "Geez. That's not very nice. I imagine sustaining third degree burns on one's groin would definetely take the fun out of foreplay, but whatever deviant sex practice floats your boat, I suppose."

Also, I noticed a book michesviously misshelved sex tips book in the knitting section, with a note on the dust jacket illustration that said "Sex tonight, XXOO" in lipstick. I had to look twice, to make sure it wasn't actually some kind of funny, risque knitting book (I'm sad! I know! Stop laughing at me!) . Then I thought to myself, "What kind of cheesy people actually leave notes like that for their partners?!"

I know for me, a note like that on my pillow that would be an instant turn off, and I'd spend the entire day at work looking even more glazed-over than usual as I planned how to get to bed first and pretend to be asleep so as not to be subjected to more of my partner's lame cheesiness. Then I had some random, free-association thought about a teacher's blog I read once, about how some teacher got tired of his students saying, "Motherfucker!" in class and said, mildly, in response, "How about Mater Fornicator?" Then his students thought he was nuts, but I thought it was funny, and now parrot the phrase in my head on occasion (but only in my head, so people don't learn how really crazy I am.)

I know, my thought doesn't quite track. Like I said, the brain hasn't been working properly lately (read: for the past few years).

I was having a sort of Fellini-type day, I suppose, as after my bookstore excursion, I ended up wandering off in the wrong direction in search of a bottled cola product. I passed an Old Navy store with mannequins dressed in the latest ready-to-wear. On my way back (turns out the damn grocery store was in the opposite direction, and I didn't figure that out until I'd walked the entire length of the shopping mall in the sweltering heat) one of the girl mannequin's pants had fallen off. This made me laugh and simultaneously feel vaguely scandalized, for some reason.

Ah well. Back to internet surfing and muttering-to-myself in a manner befitting of one's Great Aunt Edna.





Monday, June 19, 2006

Almost Paradise

Work is good!

All my patients were alert and oriented, pleasant, and appreciative of my nursing care. It was a busy day, but it was also one of those days where I left work tired, but not exhausted, and feeling stressed-out, neurotic, angry, bitter and frustrated with my inability to provide reasonable care.

The day was busy, but steadily so. I keep waiting for the hallucination to be over, and for my patients to turn into some Kafka-esque cockroach nightmare, like they were on the Old Floor.

In fact, work is so much nicer now that I fear I'm going to be spoiled for any other nursing job.

New and Improved Nursing Job--it's a good thing.

Wednesday, June 14, 2006

The Honeymooners

I left work today at quarter to eight o'clock, just like usual.

The difference was, I felt exhilarated when I left, not shitty, guilty, pissed off, angry, or just so exhausted all I wanted to do was have a martini when I got home and go to bed, as per usual at my old job.

So can I just crow and say:

I just had the Best Day Ever at work.

I cannot remember a work day being so good, ever. It was like, if nursing was like this every day, we wouldn't have a nursing shortage; we'd have so many nurses working our ratios would be 2:1 on a med-surg floor and we'd all be content with working for minimum wage, because who can beat the ego-boost and sense of usefulness and purpose?

All my patients were just so sweet and friendly I could have kissed them. Mr. Rapid A-fib, Now Sinus Rhythm s/p CABG X4 Cardizem Push/Cardizem Drip Guy said to us during interdisciplinary rounds (in which nurses present their patients and patients are given the opportunity to ask questions and voice concerns about their own care), "Well, I think my nurse's great attitude fixed my heart."

Awwwwww.

He even gave me his e-mail and told me to write him and keep in touch (he's about seventy seven years old.) He teaches internet skills to senior citizens, is an opera buff (with an iPod!) and surfs the internet. He rocks.

Another patient told me what a great nurse I was and asked if I would say good bye before I left, and kept asking if I'd be coming back tomorrow (he's going for his CABG in the a.m.) and would he end up on our unit afterwards, he hoped?

I also had a cute little lady who was two days out from CABG, had a small left lobe pneumo so we couldn't pull her chest tubes, and was on an insulin drip, requiring practically hourly finger sticks, which she was really really nice about.

On top of that, I also had Nursing Superstar Assessment Moment with her. Around 4:30 p.m. I went in to do her sixteenth bloodsugar of the day, or so, and she said, "I see funny out of my left eye. It's all blurry, but only half of it."

With her CVA history, I immediately kicked into high gear assessment mode, taking a quick set of vitals (stable), making sure her bloodsugar was okay to rule out hypoglycemia or hypotension, and then doing a bilateral hand grasp (equal and firm) and asking relavent history, such as when it started ("At eleven thirty, but it was only a pinpoint then, and I didn't want to bother you."), if she'd ever had this happen before ("No."), if she felt any dizziness, numbness and tingling, ("No") and what happened the last time she stroked. ("I don't know. I was sleeping.")

It isn't astrophysics, I know, but there's that little thing in your gut that develops after being a nurse for awhile, which some call an ulcer, and I call nurse's intuition. When patients say things to me that sound odd or bizarre, I always investigate. Sometimes I have the feeling it could be just neurosis and hypochondriosis, but this was a lady that barely asked for anything at all, and I just, I don't know, had that feeling, just like I had a feeling when I walked into the room of my twenty-four-year-old s/p VSD repair/AVR to assess him yesterday and thought, "Oh shit, he looks like pre-code crappy." I wasn't far off, either.

Any ways, thinking, every-so-professionally, Oh crap, why does it have to be a neuro thing?! I suck at neuro! I ran to find the PA, who comes in to do a neuro assessment, along with another PA. The PA calls the attending CV surgeon, who orders a neuro-consult. Around change of shift, the neurologist comes up; very nice guy, the kind who asks questions of his peers, like, "What does that mean?" in an honest, sincere I-wish-to-learn-way, not in a you-suck-so-I'll-play-ironically-bored-with-your-drivel way that a lot of attendings cop in front of nurses, God, and everybody in between.

After the neuro assessment he comes up to me and says, "I definitely think she's had a small stroke in her right posterior occipital lobe, but it's a very small stroke; only her vision is involved. I'm guessing it's embolic--is she on aspirin?" I asked him if he thought it was likely to resolve, and he said only time would tell (can you tell neuro is not my strong point? Well, it isn't.)

So she ended up buying herself the million dollar work up--MRI, MRA, head CT, etc, etc.

I felt bad for her, because that's really got to suck, and she started crying while the PA was doing his assessment, saying, "I really was trying to be so good." How horrible she blamed herself for her stroke.

I know it sounds way, way cheesy, but some of my favorite moments in nursing are the ones when you get to hold the patient's hand and wipe away their tears, make them feel a little bit better and help guide them through the hospitalization ordeal. It's moments like those that make me realize how dependent patients are on our assessment skills (and appropriate response by medical team!) for good care, and I shudder to think the times I've begged docs to care that my patient is swirling-the-drain and got jack for response and a dead patient to boot.)

I also love having a great rapport with my patients--even my confused Alzheimer's patient was a nice guy, who didn't try climbing out of his bed every five seconds, crap everywhere, or swear and hit me. I've had alert and oriented patients who were about a bajillion times more of a pain-in-the-ass. He wasn't a pain in the least--although I did feel sorry for him, because he'd say, "Who am I? I don't know who I am... Do you know?"

And (are you sick of me yet?) to top it all off, after interdisciplinary rounds, one of the manager-type people who does research studies and such came up to me and said, "Are you a committed traveler, or are you thinking about maybe staying? Because you know, we really like you, and we'd love to have you stay."

Awwwww squared.

Some days, it doesn't suck to me. Revelation, that.





Tuesday, June 13, 2006

Same Shi(f)t, Different Day



So Jamie Goes To Work, Part I, went off smashingly well (snarf).

Stupid me, I get to work early to witness my post op CABG patient has gone from a perfect NSR to rapid afib overnight, and 10 mg of IVP Cardizem two hours ago at 0500 did nothing, and meanwhile, another patient is hanging out in the 40s and has a slew of cardiac meds due in the a.m.

Both patients were asymptomatic but it was one of those times you wish you could take tachy guy's HR and brady guy's HR and split the difference between the two, rather than have to get orders to do anything about it.

Be that as it may, it's mighty yucky to watch a post op CABG patient tach up to the 140's-150s sustained.

So Jamie bugged the PAs during their report (probably earning me the moniker "that stupid new nurse") and got to push Cardizem and start a Cardizem drip.

Funny thing is, I didn't think twice about pushing the Cardizem, and it was only two admissions that I realized, 'Hey! My scope of practice just doubled!"

Nurses on my old unit never got to push Cardizem, Lopressor, etc. Only unit nurses could, I think. Now it's just expected we do it, just like everyone on our floor has done an insulin gtt so many times they've got the protocol memorized by heart. Which is kind of cool, because who wants to wait for the PA or HO to come up and do it, but it's also kind of scary, because dude you're pushing some powerful fucking medication there.

This is going to sound lame, but I like my new floor (I'm so much funnier when I'm bitching, actually.) The nurses are wonderful and very supportive and helpful, just like on my old floor (which is a mixed blessing, because it also makes me miss my old floor). My manager actually praised me today for doing some stupid pneumococcal vaccine assessment. I thought I was having some kind of psychotic break, and instantly went into Paranoid Mode thinking: "Wait a minute! Why would she say I did something right? Why is she praising me?! Is she trying to trick me into working night shift or something?" Then I realized what a fucking freak I was being, as my nurse manager actually admitted to us during a staff meeting yesterday that she believes happy staff nurses make happy patients, and was totally into the whole concept of implementing change to make us happier.

Meanwhile, I feel, to quote Dennis Leary's song "I'm an asshole", because today I felt like, well... an asshole. The basic assessment skills of nursing always stay with you (thank God), but paperwork and charting--not to mention finding vented spike tubing that doesn't look a thing like the vented spike tubing you used on your old floor in a supply room that is nothing like the omnicell you had on your old floor--is completely disorienting. Even the med retrieval system is different, and it takes me hours to do a med pass.

At eleven o'clock I was still trying to pass my ten o'clock meds, and I didn't even have my two admissions up yet. (Back at Old Hospital, I would probably just be finishing up my first round of charting for the day). That was before I got s/p cath with 80% occlusion of his left main artery patient (read: pre-CABG patient) with orders to start Integrilin (which the cath lab nurse missed and forgot to mention in report) and day one post op CABG patient on an insulin drip, with chest tubes and pacer wires still intact.

By four o'clock this afternoon I was so tired I was ready to fake charting my meds and assessments (nota bene: I would never.)

Having experienced an inuslin gtt on my own today, I can see now why my old floor doesn't take them. Accuchecks q half an hour = pain in the ass. Accuchecks q half an hour with demented patients roaming the hall = completely unsafe.

Oh well. One day, when I learn what our phone extension is on the unit, and quit wandering around in aimless circles trying to find my patient's rooms, it'll all flow easily. And that day will probably be two days before I leave the unit for good, but hey, I can't complain.

For once.

Saturday, June 10, 2006

Preaching to the Choir

Okay, caveat to general readers: probably only nurses will truly get this post, and understand why I'm so excited and starry-eyed about my new job.

(I can only liken it to happiness and sense of fraternity I assume Trekkies feel at conventions, when discussing dialects of Klingon).

Any way, so I can't gush enough about my new unit. The building, which is entirely devoted to cardiovascular procedures, and contains its own EP, cardiac cath labs and ORs, is only a year and a half old and is absolutely beautiful. I was describing my unit as "huge" to a nurse friend of mine, who thought I was talking about "bed-number." This unit has only four more beds than my old unit, (twenty eight beds total) but is literally at least twice the size of Old Unit--plus only 6 of the beds are cohorted doubles, whereas on my old floor, only four of the twenty four beds were private rooms, usually reserved for "train wrecks" and contact precaution patients. (The same friend said, 'So what's their contact precaution policy?" And I was like, "No idea. None of our patients were MRSA/VRE/C-diff.")

One of the first things I noticed is the lack of noise due to the general systematic approach that my old hospital seems to have missed entirely--namely that we are inhabitants of an industrialized, technologically advanced society in the twenty-first century. For example, at New Hospital, the nurses carry cell phones, so instead of having 50 people trying to call the central nursing stations, they just call the nurses, which cuts down on at least 50% of the noise and confusion of a unit in one fell swoop. (Despite having an intercom system on my Old Unit, we had a unit clerk who consistently just yelled down the hallway at nurses, without bothering to find out if those nurses were actually on the floor, in a room, or even working at all that day.)

There are two nursing stations on New Unit, with plenty of spaces to chart, and about 8 additional computer stations spread out systematically in each of the four hallways. I never once had to give up my seat to anyone, which on day shift at Old Hospital, happened at least thirty times a day.

They have remote telemetry monitors who constantly watch telemetry, and if they see an arrythmia or suspect someone has taken off their leads and/or coded, you get an instant cell phone call, so no matter where you are in the unit, you never have to worry about what the hell might be going on in rapid-afib guy's room, or whatever.

When I went to pull tele strips in the a.m., I asked where we put the strips--in the medical chart or in the nursing notes, and I got a quizically polite look from my preceptor, who said, "Oh honey, we don't do any of that. The tele monitors come 'round and do that for us, and keep the tele strips in this book [shows book kept by monitors]." Bug-eyed, I said, "So you mean, I don't have to measure my tele strip?!"

It wasn't even 7 a.m. and already and I was already ecstatically happy.

I kept waiting for the noise, and the people, and the general chaos of day shift to happen--and it never did. The unit remained as quiet and orderly at 6 a.m. as it did at any other time of the day. No crazy confused patients screamed all shift long nor did bed alarms go off constantly (because every one on the floor was alert and oriented!). The hospital is a teaching facility, but I never saw random interns and residents lounging around at the nursing station doing post-conference at nurse's change of shift, when uh, we need our nursing station, assholes.

Nurses actually do daily rounds with the PA and a CV surgeon, who was a nice, normal human being who said hello to other human beings without acting like some kind of snotty stuck up prig.

I suppose the one significant difference was that people did their jobs. Ergo, I didn't spend my day babysitting every one (including my patients) to make sure their jobs were done.

Techs drew labs and started IVs, and there was none of this constant tugging on my sleeve asking for "help" which half the time is just "I'm too fucking lazy to do my job." If I needed something from them, I asked, but otherwise, people did their jobs. I kept wondering where the hell all the nurses were, when I realized that, just like me, they were in patient rooms, doing real nursing. We had time to teach, ambulate our patients, and I made three beds up just to have something to do with myself.

I never had to call lab to beg for a STAT lab, endlessly page the one poor IV nurse covering the entire hospital for one lousy infiltrated IV, call dietary to bring something up, beg housekeeping to come and clean a bed, ask a PA to put in orders, or call an attending to clarify orders. I just checked the chart for orders, which were appropriately placed, and scanned them to pharmacy, and they came up from Miracle Pharmacy, without having to call them five times.

Speaking of proper staffing:

One of the most amazing things to me is that they have a constant, stable staff of PAs who are dedicated to our floor. No more of this, "Where's PA Y? Did she leave the floor already? What's her pager number?" that happened twenty times a day at Old Hospital.

The crowning jewel came at 7p.m., when I asked, vaguely petrified, "So, uh, what happens when the PAs go home? Who do we call for emergencies and orders?" Again, my preceptor, who must have thought I practiced nursing in a barn or Soviet-era prison system before coming to her unit, said, "Oh, well, the PAs go home at 7p, and while we have two on days, we go down to just have one PA on the floor from 7p-7a. ICU has one overnight, and we have one."

I nearly fell over.

"You mean to tell me we have a dedicated PA at night?! On our floor?! You mean there's no house officer?" I asked increduously, with the Slack Jaw Yokel sign flashing in bright neon-technicolor above my head. "Oh yes," she replied confidently, "It's so nice. And if you have an emergency, and they're off the floor, they'll come right up."

I envisioned my Old Hospital where fellow nurses and myself had suffered literally hours to days worth of paging PAs, attendings, and house officers, begging for someone to come up and give a shit that the patient was bleeding out their ass, in metabolic acidosis, respiratory distress, V-tach, or whatever, only to have them say, "We'll just watch that lethal arrhythmia/whatever."

[At New Hospital, they actually have established, clinical pathways to follow, so even though taking care of postop day one CABG patients sounds like I'm being thrown to the wolves, actually, it's not, because they have it written out for you: this is what nursing/medical goals are for day one, two, three and four (discharge). I asked my friend what the hell kind of clinical pathways we had at Old Hospital, and she laughed and said, "I think we had just one: Do nothing and blame the nurse."]

PAs at Old Hospital work bankers hours, and while they were very nice and mostly very on the ball, they were also completely overworked, had huge patient loads spread over the entire hospital, and were rotated in the middle of the week to another assignment, which meant you never knew who was going to be covering your patient, because it changed from day-to-day. When they left at 5 p.m., you were stuck with a nonexistent house officer, who wouldn't return your pages until at least 6 p.m., due to some metaphysical vortex that occurred during their change of shift. Same thing between 7a.m. and 8:30a.m.--the house officer was going off duty, and couldn't be bothered to come up unless your patient was in serious trouble, which was such an elastic term at HSR that it meant "coding."

Then at night, you'd be playing Who's Patient Is It Any way with multiple house officers, and playing Pager Tag with half of them, because you never knew if the assigned beeper for your floor was working, flushed down the toilet, or turned off. Sometimes I'd have to call three different HOs, all of which pointed the finger at another HO and claimed either not to be covering the floor, or the patient, or whatever. Meanwhile, seconds, minutes, and hours ticked by while the patient needing "whatever" got absolutely nothing.

Another thing that just seemed to make more logistical sense is that nurses work two shifts--period, a day and a night shift. So there's none of this, Jamie is working 7a-7p, but Nurse X is working 7a-11a, and Nurse Y is working 11a-11p, and yet another nurse is working 11a-3p, so now Jamie and three other people have to give up half of their assignment to accomadate nurse Y and Z leaving and coming on, and then at 3p, 7p and 11p have the potential to give up and change assignments, float, or whatever staffing decided to do with you, their personal troll/slave.

The time saved in giving multiple reports alone is worth the simplification of shifts. Around 3 p.m. yesterday, I started getting a funny feeling in my stomach, known as the "change of shift shit-about-to-hit-the-fan" sixth sense, when I made another discovery, which is that there is no such monster on New Unit.

Further, I thought I was going to have a religious ecstatic moment when I was informed that unit policy was to take an hour lunch break.

I had run off the floor to gobble down my lunch in fifteen minutes, and then raced back outside to my preceptor, who said mildly, "That was a quick lunch!" Half an hour later, she said, "Well, you can take your other half an hour now; we'll go to lunch now."

I really must have appeared slow-on-the-uptake, because then she said, "We take an hour lunch here, dear." In fact, she must have thought I was mentally retarded, or something, by that point, because I had to have her explain how an hour break (unheard of at Old Hospital, where the policy was half an hour, maybe, if you could afford it) was possible. She said the unit decided they would like to take their two fifteen minute paid breaks, and add them to the half hour unpaid lunch break, because "we really do need an hour of uniterrupted time to take a rest."

Compare this to the managerial tactics at my Old Hospital, where the hospital policy was to discipline you for being so busy you couldn't take a break, or got interrupted by a desating, hypotensive demented patient and forgot to clock back in from lunch because you had to go restrain him, bump up his oxygen, and suction him, but not before you spent forty five minutes trying to find the PA (also at lunch) to write the orders to do all that crap.

In fact, on New Unit, the nurse manager not only wears scrubs, but routinely stays until 7p.m. with her day staff. She's actually out on the floor for a large portion of the shift, helping out the charge nurse or whomever, and her office door is always wide open except when physically not there. The charge nurse doesn't take patients so she can coordinate staffing, and acts as a resource nurse to help her nurses. And day shift still takes only four patients, which was becoming the standard at Old Hospital Unit, but really at the end of the day it would be more like six to seven patients by the time I was done discharging, admitting, and shuffling around my assignment so that the new shift could have patients to take.

(Incidentally, I feel like calling up my old unit manager and leaving a simple "Ha ha." on her voice mail, as per the thug kid's standard response to misfortune on The Simpsons. )






Thursday, June 08, 2006

ave Caesar morituri te salutamus

Do you ever have the unpleasant sensation that clinicians describe as a "feeling of impending doom?" Usually associated with flash pulmonary edema, acute MI, angina pectoris, and anaphylaxis (among other things), I can think of one other purely psychological cause (at least for me): contemplating going to work.

I mean, okay, I survived a mountain of paperwork related to orientation (including mandatory comprehensive exams upon which employment is contingent) plus hours of mind/ass numbing drudgery related to computer training, but um... will I remember how to be a nurse tomorrow?

Not very likely, given the fact that today at defib/cardioversion training I sat there for endless seconds (along with four other nurses) staring at the LikePak 20 when our fake dummy patient was supposed to be in some pulseless rhythm that required transcutaneous pacing. One of the nurses used the AED function, which was mercilessly pooh-poohed by the clinical instructor. Okay, we get it, we suck. That was only slightly mortifying.

To offbalance my neurosis, however, I've been told that the stepdown unit I'll be on is one of the best in the hospital, and that I have great coworkers and an "awesome" manager. Notice that the adjective "awesome" rarely modifies the noun "nurse manager." The nurse I was talking to couldn't say enough good things about her. This is in stark contrast to my typical conversation with a nurse, who usually roundly abuses and villifies her NM any chance she gets--and it's usually well deserved bashing, unfortunately.

I'm just a traveler, but I'm amazed that I've been asked whether or not I want to work three-twelves-in-a-row or not, and if I have any specific requests for time off. Really?! The way it worked on my old floor was the reverse-psychology method. For instance, if you wanted to work three-in-a-row, you had to say in your schedulng request "Please never ever put me on three-in-a-row, because [insert valid reason here]." This way, you'd be guaranteed to work three-in-a-row. If you wanted to work a permutation of certain days, you had to ask for any other days, otherwise, your scheduling request typically never was honored.

Because normally it's all about treating you like a stupid troll, you see.

Mostly, things have been going well. Initially, it was very scary being in a room full of people I didn't know. But then I forget that on the whole nurses tend to be very friendly, kind human beings, and we all quickly bonded during orientation.

Meanwhile, I have to bolster myself and my sad little ego, and think that if I can survive [community hospital of doom] for a year, I can survive three months just about any where.

I really hope it doesn't turn out that I didn't learn anything at my old hospital, except advanced babysitting techniques and tomorrow I don't get crushed in the shadows of Uber-Nurse coworkers.

Please don't hurt me. I'm small, and probably pre-osteoporotic. It won't take a lot to crush me, or my fragile little ego.



Monday, June 05, 2006

Woke Up This Morning

One thing I enjoy about chronic stress is waking up and dry heaving. It provides such a delightful complement to being bleary-eyed and half-awake at 6:00 a.m.

I never used to be this way, alas, nursing as a career has seriously intensified my vagal response to stress. Score.





Sunday, June 04, 2006

Go Live

Okay, so there are probably other, more morally justifiable things to be thankful for, but I now have wireless internet access of my own! I almost thought about cancelling the whole cable thing, because I watch maybe an hour of t.v. a week (if I'm not at work) and the crap channels--mostly basic network plus some stupid sports channels, like I care--I get for 15 bucks a month aren't exactly rocking my world.

But alleviating myself from the slightly annoying scrounging around for a wireless internet signal, well, that's something worth forking over a couple hours worth of pay, I suppose. I can't really justify the expenditure, really, other than the happiness that a full-signal indicator on the wireless icon gives me (meanwhile, must find a way to encrypt same, as I am a ruthless, coldhearted bitch.)

I also went to see my new hospital today; it takes 15 minutes in good traffic, although I can see bad traffic making the thing a scary hour drive. Incidentally, drivers around here are really pushy about merging into lanes. They don't seem to care if there's a car in the space they wish to merge, which frankly gets a little scary at times, because I started wondering if my car is invisible, or whether they consider out-of-town vehicles fair game. They also seem to be in a big hurry, which is ironic considering the bottlenecking that occurs about every five miles on the Beltway, especially southbound.

Otherwise, people seem generally friendly and polite, and my new hospital makes my old one look like a rundown ghetto community hospital that was last au courant back in 1975. Oh yeah, it was. This hospital is in the middle of a suburb, with modern glass siding, pretty landscaping and oodles of parking. I didn't see any old dime bags of crack on the sidewalks, and no one had burglar guards on their windows, either. If the inside is as nice as the outside, and if management is even marginally better than what I came from, this should be a decent assignment.

At least tomorrow I'll be around people, because staring at the parking lot from my bedroom is starting to make me feel like Anne Frank.

Cape Fear

So I'm already freaking out about my new job, and all I have to do for the next couple of days is computer training.

Being a worry wart, I've spent the last month vaguely petrified that I will somehow screw up and be known as the floor as "that stupid travel nurse" or worse. I keep telling myself nothing could be worse than [community hospital] and if I survived my first year as a nurse there, thirteen weeks anywhere else should be do-able.

True to form, I'm still wigged out, and getting that anxious-tummy, tachycardiac stress-ball feeling back. I seriously have to get over my fear of going to work, and not start prematurely obsessing over whether or not a theoretical house officer I have never met is not going to call me back for hours on a crumping patient I have yet to take as an assignment in a hospital I haven't even set foot inside yet.

Perhaps this is why I look so fondly on my undergraduate and divinity school days, because seriously, even if you screwed up quoting Pelagius or something, it wasn't like forgetting ACLS algorithms in a middle of a code. If you didn't turn in an assignment on time, no one desated to 78% and went into acidosis and crapped out on you.

I can't even remember why I bitched about school, or what I had to bitch about. I'm sure there was plenty, but I seriously can't remember what was so terrible about school. At least divinity school. I still remember what sucked about nursing school, on the other hand.

Best Friends Forever

So I'm sitting here waiting for the cable guy to come and hook up my expensive basic cable, which I probably don't even need, but according to Murphy's Law will if I don't hook it up and cough up the fifty bucks a month. Any way, he's supposed to be here any time between 11a-4p. I wish I had a job that I could just show up whenever I wished. Talk about self-scheduling!

This morning I went on a bunny cage run, and found out that stuff here is more expensive than I'm used to. Florida stuff is cheaper, but then, the wages there tend to suck unless you are a Colombian drug lord, which you just might be depending on where you live. Now the bunny is safely caged, and I can spend more time staring out into space vacantly without interruptions--no need to be ultravigilant about her whereabouts and snack choices now ! (Prime treats lately have been baseboards.)

Contrary to popular belief, rabbits aren't dumb, either.

Lately, the minute she knows something pisses me off, she immediately goes into Bad Bunny Overdrive, thereby drumming up even more trouble. I'm not anthropomorphizing either, although I suppose you have to be indoctrinated into the subtle art of conversing in Lagomorph-ese to get what I'm talking about. For example, you can scold a rabbit, but it generally gets the same results as paging a house officer, which is to say you get a quizzical, why-the-hell-did-you-bother glare from either breed.

Any way, the dog came with me this morning, because it's much cooler up here, and he can stay in the car without becoming Dessicated Dead Dog. Plus, I'm still slightly lonely and need a buddy.

Can I just gush here about my dog, and what a wonderful friend he is? It sounds way pro-PETA, save-the-baby-seals granola talk, but he is.

For over ten years Piper and I have traveled the country together, exploring new and different places practically every other year. We get in the car, he curls up in a ball and goes to sleep, and when he wakes up, we're somewhere else. He's great company, never complains, is always happy to be along for the ride, and keeps himself busy inspecting the new place whenever we get to our destination. He also provides a random alert system, although I think he's so friendly he'd probably let in Ted Bundy (had the State of Florida not executed him) and show him right where I sleep. He is, however, very proficient in letting me know about Scary Tree Noises and normal automobile noise from the parking lot.

Piper and I have been together since my Sarasota/New College days, and he's still the same happy-go-lucky, laid-back dog he was back then, except he doesn't chew on forbidden objects like shoes and table legs anymore (once, as a puppy, he chewed a hole in the drywall when we left him in the bathroom. Needless to say, we never did that again).

I wish that cable guy would get here, by the way. I'll probably get a call from the company at 3:59p.m. this afternoon saying I "live too far away" for service, knowing my luck.


Saturday, June 03, 2006

The Joshua Tree

So yesterday I had one of those random free association thoughts I get when a) tired b) hypoglycemic. Incidentally, at the time, I was looking at houses with my mom and my parents' realtor, all HGTV Househunters style--except my parents are buying, not me, because at this point I could afford a cardboard box under a highway somewhere. Maybe).

Any way the random thought was, "Hey! Where's my Joshua Tree cd, man?!" And then that was followed by, "Hey! Where aremy Dave Matthews cds?!"

This is why I hate moving, because every goddamn time I move, I lose or inadvertantly leave behind important stuff. Like cds. And my passport. Seriously. I think I left it with some stuff that didn't come with me.

Don't ask, and I promise I won't tell how it happened.

Any way, I just got to my travel assignment apartment. It's very nice, with a neat little loft and balcony (I get a swell view of the parking lot!) and while it is nicely appointed (in addition to a fully furnished kitchen, they even have those little French soaps and extras like sample Cascade and shampoo laid out) I just realized I now live about six to eight hundred miles from any one I know on this side of the east coast. Ergo, I'm a little depressed.

I don't even know where to go to get simple take out food, and the stupid git I called half an hour ago for Chinese take out just called me back to say "I'm sorry, you are too far away to deliver." You'd think she'd have realized that little logistical snafu when I called thirty minutes ago, the stupid twit. I'm not aware this town is a metropolis in disguise, but I have a bad feeling I am going to starve while figuring out what mid-Atlantic folks call "too far away to deliver" which, if their crappy rude driving is any indication probably means, "we're next door, but fuck you."

I have no idea where I am relative to anything except there seems to be some storage company in between these and the next set of apartments. I can tell, because I live on the top floor of my apartment building, four floors up (non elevator buildings). I am not complaining, because it is nice and quiet up here, with the sky lights in the loft (which Piper loves, the loft I mean) but four floors of stairs.

Once again, for the record: I am not complaining.

However, I somberly predict that by Monday they are going to find my starved carcass curled up in the fetal position somewhere in this apartment, with a list of about a hundred fast food take-out numbers on my cell phone, none of which would deliver to my apartment because somehow the metaphysical layout of this suburb makes it impossible, for reasons I have yet to divine.

Also, while I'm on the subject, I must add this is a very, very, very nice corporate furnished apartment for the DC area, eg I get the feeling if I weren't a travel nurse, I could only otherwise afford it if I was an ambitious White House intern shagging some Congressman, but apparently he doesn't like me very much, because he housed me somewhere far away from take-out restaurants, knowing how codependent I am on same. Perhaps he is hoping I starve to death before I cause him a career-ruining scandal. Nota bene: for the record, I am not having an affair with any one, Congressman or otherwise. I would however, have a fling with the pizza man if he'd deliver a small mushroom pizza to my apartment, stat. Just kidding).

However, I just left an apartment I love, which was even nicer, and had my own stuff in it, like my books. And now I'm in an apartment with like, two suitcases of stuff and no books.

At least I have the dog, or I'd probably get right back in my car and drive back to my home, because I'm lonely and all sad. You should see me. With the sad face and hypoglycemic twitching and diaphoresis. Maybe after a nap I will try to find food, before darkness falls, and the wolves start howling at the moon, or whatever happens here after sunset.



Thursday, June 01, 2006

I am the cheese.

Thus spake Jamie: I shall never change my state of permanent residency again.

Ever.

Ever.

If I do, would someone please take me out to pasture and put me out of my misery?

Thank you.

So, I broke my lease (it cost nearly two thousand dollars and it burns!), quit my job in the most unprofessional manner I could get away with (and got them to pay FMLA on top of it, hee hee) and I moved my stuff.

Actually, quitting my job was pretty fun, except for the horrible guilt I felt at having screwed over my coworkers, who are already working short. On the other hand, sometimes the ends justify the means, plus when you get to stick it to your boss who once told you that "taking abuse is part of this job" you just can't help but break out into a Machia vellian chortle of evil satisfaction as your plans of clever corporate subversion come to fruition.

Any hoo, now I live in the South, which doesn't suck like the Northeast. This objective, completely unbiased and terribly eloquent statement comes after a mindnumbing month of frantic, hamster-on-meth like activities related to said move. I've also been caught in what can only be described as a Bermuda-triange of metaphysical bureaucratic doom, where the phrase, "You didn't send us X document!" when I patently did too, you blood-sucking lazy ass state employees (!) has become something of typical soundbyte in my daily life.

Interestly enough, as a post 9/11 sidebar: in my new state, I either have to prove I am a) a lawful citizen of the United States or b) a documented illegal immigrant in order to obtain a driver's license. Seriously, the fact that I had a valid, unrestricted license from another state wasn't good enough--I had to present a US passport, certified copy of my birth certificate or naturalization papers (like everybody carries those around in their back pocket). My driver's license from Northeast State of Doom didn't cut the mustard; however, if I could prove I was an illegal documented immigrant--bingo! Incidentally, as a second form of ID, I could have presented my baptism records or family bible records or a baby book. I kid you not.

So do residents of Oklahoma have to prove they aren't interested in blowing up federal buildings in order to get a driver's license these days, but whatever, we'll give you a free pass as long as you were baptized?

(Incidentally, I was strongly reminded of the neuro assessment on the computer-based "charting" system at my old hospital, where option number was "alert or comatose." I always wanted to find a way to hack into the system and change option one to 'alert and comatose' which is how I felt most of the time at that job).

I have one and a half days left in my beautiful new apartment; tomorrow I have to start packing, drive 15 hours to a mid-Atlantic state, and start all over again on my travel assignment. But only for three months. Plus, all the furniture and "stuff" is provided, right down the company linens (which I hope are still in their original packaging, but I guess it could be worse. They could be putting me up in a Motel 6 or something).

And Piper gets to come with me, so it can't be all bad, right?

In celebration of my new, stand-alone, independent lease on life, I'm starting another blog, proudly entitled " The Scutmonkey." And one day, when I become Ninja Master of the Blogger, I will find a way to archive my old blog on this blog. But until then, I shall jealously guard my paper books and keep on the look out for an old fashioned typewriter, the kind without electricity, just in case something bad happens, like I'm ever without constant internet access for a fortnight.

Because the apocalypse is nigh. The Jehovah Witness at my front doorstep yesterday told me so.

Oh, it's so, so good to be back in the South.