The lost bar of soap

I think I may have stumbled upon the reason for declining hand hygiene. The loss of the bar soap.

I’ve recently come to discover that washing my hands with some gel or foamy cleanser just doesn’t do it for me. What I long for is a nice, palm-sized bar of soap. A nice fresh soapy smell is good too – no floral, ocean spray or tropical rain forest – just a plain old soapy smell, with the perfectly palm-sized bar that rolls over and over with so little effort when added to water.

I know there was rumor to bar soaps harbouring bacteria, but, let’s be real here – what DOESN’T harbour bacteria?! It is everywhere, we live in a cesspool of bacteria. If the act of rolling that nice firm bar of soap over and over to work up a sudsy lather and then rubbing the bubbles all around improves hand hygiene then so be it.

Long live the bar of soap.

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here again

The birds were up early this morning – 3:30 I think it was. One of the joys of living in a northern climate where the sunrises early and sets late this time of year. Then suddenly at 06:00 it was silent. So silent it woke me – perhaps the end IS nigh, I thought as I pushed the cat out of my face.

A quick review of the news shows we are not in danger of the zombie apocalypse – or indeed, any other kind of apocalypse and I turn to health news.

More Hospital Deaths on Weekends reads the headline. Yes, and I know why.The thin wedge keeping you alive during the weektime admissions – the boss- is absent. Huh?

How on earth, can a group of people who never lay a hand on a patient keep them alive just by being inhouse?

Ok, I know there are a bunch of factors in this really – short clinical staffing, fewer experienced medical staff inhouse, decreased support services along with absent manager, but I am getting a sense that it really is a thin blackline protecting you during the week.

I get to receive all the adverse event reports for two critical care areas. As part of my job I am to review and investigate to determine whether there are actions we could or should be taking to prevent or reduce the chances of adverse events occurring. Adverse event reporting in entirely voluntary in our system and an interesting trend is emerging in the reports – assaults on nurses.

Now nurses have always been in line for some abuse at the hands of patients and families, particularly in the ER and increasingly with the frustrations of long wait times, but what I am seeing is a bit different. I see reports of nurses being bit, hit in the head with the call bell – repeatedly, kicked in the chest, pushed, choked and having things thrown at them. In reading the reports – often very badly written, I’m surprised at the lack of ability to spell by nurses – it seems that they were just doing their job and the patient assaulted them for no reason. But a read between the lines shows something more disturbing.

A recent report was of a man in the ICu who was banging on the side rails to get the nurse’s attention (she wrote this was his ‘chosen form of communication’). She entered the room (read stood in the doorway) and told him to stop banging on the side rails and what did he want. She then reported he just stared at her. So she writes, she told him he shouldn’t bang on the side rails if he didn’t want anything. He then threw a urinal at her.

Fortunately for her, he had been significantly weakened by his lengthy and complicated ICU and hospital stay and his aim was off so the urinal missed her.

unfortunately for him, she still didn’t get it.

So she reported this behaviour, in the adverse event reporting system, where reports of harm or potential harm to patients are to be reported. Many of these reports of assaults on nurses include similar descriptions – a nurse insisting that a patient be turned when the patient didn’t want to be turned results in being beaten off with a call bell, a nurse telling a patient and family, “we don’t do that here” after they ask for a pen and paper so he could communicate and the nurse later being pushed by the patient…what it comes down to is nurses treating patients as tasks to be accomplished, deliverable, the patient is alive at the end of the nurse’s shift.

I blame the profession of course. The biggest mistake we ever made was eliminating the hospital based training schools and move the training into the university. Nurses are no longer trained, they are educated and as a result they arrive, freshly scrubbed and polished on the ward with no idea of what the work of a nurse entails. Oh sure, they get the theory – nursing theory, mind numbing inane – but they have no or little practical experience to draw upon when dealing with ill, frightened, frustrated people.

The nurse is also frightened and frustrated because they now find themselves in a terribly threatening environment where admission of lack of skill, competency or confidence signals a weakness and the pack will turn on you and tear strips of flesh off you each shift until you either grow scars or flee.

So the nurses bully the patients, each other and the residents. The residents bully the medical students, other nurses and each other. The management either bullys or acts as a behaviour filter while they are there, which disappears the first long weekend.

The whole health care system is circling each one looking for vulnerability in another, watching for the weakest to throw under the bus…which shouldn’t really be surprising since they are only human and humans have behaved this way since before they climbed down from the trees.

Which really doesn’t help me find a solution or even a bandaid to cover the wound and promote healing.

Last night

You would think, that given a belief that May 21st is rapture day, the last place you would spend your last night on earth would be the Safeway store on 102. Those of us who will burning in the hell fires come Sunday needed to get some milk and bread, maybe a little probiotic yogurt, the righteous didn’t have other plans for last night?

It’s all rather odd of course, anticipating the end and poking fun at those believers. Few people ever believe their end will occur, imminently, but this, prediction, based on convoluted calculations derived from a badly written, compilation of various authors with atrocious editing, well, it reminds me of The Fetch and his insane ramblings of Isis and Zions and who knows what. I believe he predicted the end too, only based it on some other obscure calculations that everyone else was simply too stupid to understand.

Walking out of the Safeway and into the warm spring evening, it was like winter had never been. The cold, dead grip winter had on the city miraculously gone and once again, those long twilights of the northern gods spread out over the city. Warm smell of  may trees mix with the perfect quality of the air and the best sunsets ever. How could anyone think this would end tomorrow?

But for a good time read the twitter rapture pick up lines at #RapturePickupLines

I wonder, as I drive off enjoying the evening, if a sudden decrease in world population by 200 million true believers would bring the food prices down – cause that was just ridiculous – a loaf of bread, liter of milk, 3 containers of yogurt, tea, coffee = $50.

Now that just might be a sign of the apocalypse

Livin’ the Dream

It’s been a busy week. Driving back from Alabama last week through hell’s weather on earth, trying to get cleaned up and unpacked before work Monday morning, bin Ladin’s assassination, 800+ email to plow through, J back inside Afghanistan, lawn clean up, and planning Mother’s Day brunch; oh and Election Day! The world has become such a tiny place.

I’ve just returned from grocery shopping where I discovered for some odd reason that the cart token I purchased from the store a couple years ago sudden didn’t fir into the cart. WTF?! Checking that I was indeed in the correct parking lot and had the correct token in hand, I found an unlocked cart and headed for the so called, Customer Service desk.

“Did you get new carts?” I asked the gentleman behind the counter knowing full well this would not go well.

“wha??” was his response. He had the same look as the anime-barrista in Vancouver when I asked for a lactaid latte.

Stepping closer and speaking slowly and a little louder I asked again,

“Did you get new carts? My token suddenly does not fit” and  provided a visual demonstration of how the token is suddenly too large.

“No, No!” he exclaims and rambles off some other comments of which I cannot understand,perhaps in another language, but he does offer to give me a loony back for my token. Then suddenly he says the words, “new carts”

“So you did get new carts” I say. “And the tokens don’t fit?”

He shrugs.

“Are they coming out with new tokens”, I ask.

A negative. I hand in my token and get a loony back. Outstanding.

Now granted this is a minor inconvenience to me, but I can’t help noticing that it is typical of our culture. Change something, anything and someone will have missed a crucial component of how that change will impact on the end-user.

Now I like change for the most part. I think most of the things we have in our lives are improvements over the old way. I have a horror of outdoor toilets, can’t imagine communication without computers, cell phone and truly enjoy central heating in January. In fact, change is what gives me my pay cheques. But, any change bring consequences, desired and unexpected. Think it through, down the line to see how it will impact at the pointy end of the spear.

On another topic, but yet similar, I understand from the elctorial map of Canada I live with the fightened hipsters. I’m not entriely sure that is a correct assessment, and I am willing to bet the clown who labeled us as such has never been to Strathcona. Hippies, yes, but hispters are rare except on Saturday mornings when they drift down from their luxery lofts and mummy & daddy’s basement to clog the Farmer’s Market and sip Carmel Macchiatos on the sidewalk seats of the Starbucks. They don’t vote here, and are in all likelyhood, too emo to been step behind the cardboard divider.