Finding the silver lining

Yesterday was a bad day.   Not bad as in someone got hurt, or bad as in something awful happened... just a bad day from beginning to end.

Before I get into the day itself, let me tell you about the disappointment of the snow blower.  We used to have a small snowblower that was a god send when my father was alive.  We loaned it to a 'friend' several years ago and he just kept it when he moved.  For the past few years my brother and I have shoveled the driveway clear... mainly my brother.  With the job this year, I knew that my brother would be doing far more than his 'share' of the duty, so I figured the least I could do was to buy a new snowblower.  We don't need a big one, and frankly after the holidays I only had the cash for a small one.  I found the perfect one right in my price point on Monday, but where the website said this store had it in stock for local pickup... they didn't.  I had to order it online and it should be here next week.  Then we got about 8 inches of snow.  With my luck it won't snow again all year.

So... the day started off like any other... coffee, web, television.  I did have to leave early for work though as the skies opened up and dropped many inches of snow.  I normally like the snow, but having to drive an hour to work in a car that's scared of the white fluffy stuff is no fun at all.


I left for work about a half our early.  The first annoying thing was Fiona.  For some odd reason her 'intelligent access' feature stopped working.  I still have the push button start, but the doors won't unlock by simply gripping the door handle.  Hope demanded that I stand outside of my car, freezing my butt off gripping the door handle and waiting for it to just work.  No beans there.  I had to fish out my keys to hit the unlock button on the fob.  I know, I know... cry me a river, my special little feature didn't work.  But it was just the beginning of small little things adding up to make this just a horrid day.

Getting out of the driveway was a pain.  Fiona's traction control is just a nazi when it comes to laying down the torque.  The wheels barely spin, and then reduce all power making it impossible to plow through inches of snow.  I have to lay of the gas, wait a moment, and then try again.  And again.  And again.  Driving on the road wasn't much better.  When I finally got to the main road I was offered up a new problem; exiting a snow covered street through the drift that the snow plow deposited there onto a main thoroughfare with quite a bit of traffic.  Like in the driveway, Fiona kept me from making good progress.  Unlike the driveway there was enough snow to STOP all forward momentum, requiring me to actually reverse the car and try to build up some steam to plow through with.  Of course I'd only have time for one or two attempts before traffic would make me stop.

It took about 10 minutes just to cross that intersection.

All of the surface roads were the same.   Traction control made every start a slow deliberate process and every stop tested the anti-lock brakes.  The highway itself wasn't bad, but it wasn't clear sailing either.  I topped out around 45mph.  When I eventually pulled into the parking lot, I was greeted with it's beautiful unplowed visage.  There were plenty of tracks from previous cars going in and out,  but no 'clear' path. I got up enough speed to throw Fiona into a spot without crashing into anybody, but I knew that I was in for some trouble getting her back out at the end of the day.

The trip took long enough that I arrived just in time, which I was very grateful for.  At every job I've been at, it's been understood that if you are late, you simply don't get paid for the time you were not there.  Maybe you'd get 'written up' but if it was for snow or some other 'valid' reason, it was more or less just brushed under the rug.  No harm, no foul.  Well the state has a different take.  It seems that if I'm late, I have to use some of my annual leave (heh... spell checker wanted to make that into 'anal leave'!) to make up for the time.  Frankly, I'd rather go without being paid.

I get into the clinic with the other nurse coming on duty and we looked over our scheduled appointments.  At first blush this was going to be an easy or even slow day.  I had two call outs, she had five, and there was no way that the state was going to be transferring inmates when the roads were so horrible.

The offgoing nurse gave us report with the only relevant part being the inmate currently seeing the doctor.  He has a history of asthma, but currently doesn't' have an inhalor.  He had an attack last night and another just before we got there.  The doctor came in a few minutes later with an order of breathing treatments (at the clinic) every four hours as needed, and an immediate shot of some corticosteroids.  Not a huge deal, but I haven't given this particular shot before and it's not a standard shot.  The steroids have to be mixed properly beforhand and this is one of those shots that burn going in.  The benefits are worth it, but no one likes getting a painful shot in their derriere.  Beyond the shot, writing up orders for him to return every four hours as needed isn't exactly easy.

If the order was for treatment every four hours, it would be simple... write up the order to come to the clinic at these particular times.  But it's the "as needed" part that gets tricky.  I need to convey to the correctional officers in his unit that he can return to the clinic any time he needs, so long as they aren't more frequent than every four hours.  It took me, my supervisor and HER supervisor putting our heads together on the best way to write that up without conveying too much protected information on the order.

At that point my supervisor asks me if I have time for a few extra assignments.  I of course tell her that I can handle anything, so I get to call out two inmates for later.

Just as I was about to call him in, we heard over the radio that someone had fallen in his unit.  As we got everything together to go provide help, we heard who it was.  This particular inmate is an elderly gentleman who is doing anything he can to get transfered out.  He wants to be sent to the prison hospital, even though he has no problem warranting it.  In other words... he fakes things.  Often.   So we had to trudge all the way across the yard to his unit (in -10 degree windchills) to offer aid to someone who doesn't need it.

As soon as he saw me and the other nurse, he got a pissed off look on his face.  He knows that neither of us tolerate bull shit and that he wasn't even going to be going to the clinic.  Understand... if anybody honestly needs our help, faker or no, we give the help.  That's our job.  But when there is nothing wrong, we don't coddle or encourage the behavior.  We did an onsite assessment and of course found nothing wrong.  Even the details of his fall were suspicious... no one saw him fall, and he just so happened to 'fall' in a place where a CO couldn't have seen it.   When we found nothing wrong we asked if he could make it back to his bunk and he stood up without problem and marched to his bed without any hesitation or problem whatsoever.

Faker.

So we get back to the clinic and I call in my patient for his shot.  The shot alone would have put me behind in my two call outs, but heading out to the unit made me way behind.  It's not as though being behind was bad for me... but it means that the patients that I have to see are sitting in our small holding area waiting for far longer than they want.  So any hope of having them in a good mood (and a good mood goes a long way in making it a good appointment), is blown away.

I give the shot and the orders to the patient and then send him off to his unit.  I get my other two guys in and out, and it looks like the day is about to quiet down.  Hah.... as if.

We did get some transfers in... from the other side of the facility.  Technically it's not a transfer, but since we have separate health clinics, they still have to go through that part of the transfer.  This of course pisses them off and makes a simple yet time consuming process a pain in the ass.  To make matter worse, the other clinic sent t hem over without their charts or their meds.   So I go out and give them the 'welcome talk', get their paperwork started, and call over for their meds and charts.  It seems that the other facility is having a hellish day too and they tell me that they'll get the stuff to me when they can.

Just as I'm wrapping these transfers up, an officer comes in with two boxes of meds and charts.  Are they for my guys?  No.  They're for the seven OTHER transfers.  It seems the state could care less about the roads, and transferred us seven inmates from another facility.  Four of these guys don't have charts.  Two don't have their meds.  None of them have good will in their hearts.  So I trudge out again to give another 'welcome talk', and tell them that I'll be bringing them in individually for their entrance interview.

Just as I head back into the clinic to get their paperwork started (and finish off the paperwork from the earlier 'transfers'), we get a call from one of the units.  It seems that our asthma patient is having trouble and we need to go get  him.  Grr.  We head back out into the now -15 degree windchill this time with a wheelchair in tow and find him standing at the officers station.   He probably could have made it on his own, but why walk when you can be wheeled?  To make matters worse, he was standing there in his jacket without anything to cover his mouth with.  He was told earlier that in his condition he shouldn't be going out into the cold without some sort of mask.  Now, there aren't just masks or scarves that the inmates can use, but they are told that a clean shirt or an extra hat can be used.  So we have to wait for him to walk back to his bunk (note that he walked back without any problem), find a clean shit, and then come back to sit in the wheel chair.

We get him back and do a preliminary assessment.  Yes, he still has wheezes in his chest and we know that we'll be giving him a breathing treatment (it's been five hours since his last one), but since the doctor is still there we immediately call on him for another assessment.   The doc agrees with our assessment and we give the treatment.  With the inmate sitting there breathing in his albuterol, I get down to getting our transfers ready.  After his treatment the doctor comes in to listen to the inmate's lungs and says that he should be fine to return to his unit... but the inmate disagrees.  He says that he's felt like this before and even though there is reduced wheezing in his chest and his oxygen status is in the 'damn near perfect' range, he knows (KNOWS) that he is going to have to go to the hospital.

The doctor agrees to keep him around and re-assess him in several minutes while the other nurse and I take off to eat our lunch.  We can't take a lot of time for lunch as we have him waiting back there for us, in addition to the transfers (and we still have to finish off our earlier transfers).

Oh... and I still have those two extra assignments to worry about.  Coming back from lunch I go through everything that I have yet to do and figure that if everything goes smoothly I should be able to finish everything by the end of the shift.

There was really no chance of that happening.

Walking back into the clinic, we're greeted by the doctor.  He tells us that the asthma patient is still assessing fine, but he's concerned that if he does go downhill that it will be at a time when there is very little staff on duty.  If he DOES need to go to the ER it would be very bad for him to wait... so he's going to preemptively send him there for assessment and possible treatment (the only treatment left at this point would be to intubate him and put him on a breathing machine).

This wouldn't be bad, but when the doctor says he is going to transfer the inmate to the hospital what he actually means is that I and the other nurse need to transfer him to the hospital.  So setting that up takes about 20 minutes.  Once it's set and the inmate is handed off to the officers for transportation I jump right back into my transfers.  I mentally cut off three guys and leave them for the next nurse on duty.  I could have prepped them all, but then I wouldn't have time to finish them.

Once I'm ready with four of the transfers, I call them up as well as my two extra guys.  I won't go into all the details, but every single appointment went longer than expected.   In addition to documenting all I did I also had to set up two appointments for myself the next day (one to check on a very odd prescription, and one to find some colostomy supplies).  When all was said and done I left the clinic an hour after my shift ended.

Just as I was about to walk out of the door I remembered that I had already submitted my time sheet and would have to send off an email for the overtime.  They want us to do this via email so they can use the time it was emailed as our 'clock out' time.  I stomped back in (in a very foul mood), sent off the email, and then stomped out.

One task I always do before leaving is to stop by the soda machine and get a cold drink for my trip home.   As if fate hasn't already slapped me around enough all day the damn machine was out of my mountain dew.  And coke.  And pepsi.  The only thing it had was diet soda.  Ewwww.  So I went out to my car knowing that I would have to make a stop somewhere to get a drink.

Getting out to the parking lot I was a little happy as I saw they had plowed.   Of course then I got to my car and saw that in addition to the drift in front it, I now had a drift behind it.  Getting out was much like getting out of the drive way or that hellish intersection.  It took 15 minutes just to get out of my spot.

Once I was on my way I looked at the outside temp and saw that it was 1 degree out.  1.  I've been driving long enough to know that no amount of salt on the roads would keep the snow/slush/water from freezing.  The surface streets were a sheet of solid ice.  I think I hit 25mph once, but most of the trip was spent coasting along around 10mph.  For some odd reason I decided that I was hungry and would get some McDonalds to eat on the way home... that way I could also get a cold beverage and not get out of my car.

Yeah... it never occurred to me that eating while driving on an icy highway would be a bad idea.  The highway wasn't TOO bad, but trying to maintain at least 40 mph on roads that would go from clear to sheets of snow and ice while plowing through some McSandwiches was just stupid and did nothing to alleviate my foul mood.

I finally got home around 1am and crawled straight into bed.

There are a couple things I can take away from this bad day.  First and foremost... nothing really bad happened.  Sure, I was frustrated to no end but no one got injured or hurt.  Sure, I didn't finish with all the day's work, but it's not because of my novice status.... the experienced nurse I was working with had the same frustrating day and didn't finish with her tasks either.

If this happened at another job I would have seriously considered calling in the next day (today).  I had peeked at the next days schedule and saw that I only have two call outs.  There is another nurse on duty and he has NO call outs.  Most Fridays we work with only a single nurse in the clinic, so it wouldn't be unheard of to have only one today.  But you know what?  As bitter and frustrated as I felt last night when I cuddled up under my blanket.....

I still like my job.

I still want to go into work today.

I'm not going into work because I have to, or because I'm scheduled to be there... I'm going in because I WANT to.  No single frustrating/bad day is going to blot out my silver lining or ruin my overall good cheer!