Tabula rasa

Tabula rasa.

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Tabula rasa

TabulaRasa

So here again is the tabula rasa before me. And the self excuses of why I have not continued to add entries to this blog. They are in no particular order:

Too busy – an all time favorite all around. In despair over the state of nursing I picked up a second job with a university nursing program to teach. Actually two programs – one for the critical care certificate and one for the international nurses upgrading to bridge to writing the licensing exam. I figured that if I couldn’t have any impact on the job maybe I could have some pre-job. Jury is still out. However, these two teaching positions required anywhere from 1-3 hours per week per student and I have managed to shepherd 21 students through their learning experience with me in the past year.

Transitioning coach – I have been diligently, and with certainly a lack of patience, assisting in transitioning the significant other to the normal life – you know the one where people don’t go to work with a gun as part of their daily tools. This has involved teaching cooking, cleaning, gardening, laundry, though we still struggle with time management we now have fresh baked bread, slow cooker meals and a grow op in the basement.

Worried about offspring – not the band, my children. While the smart twin and the pretty twin, svarn and flying-kitty-princess all assure me they are fine, I still find time to worry about at least one on a daily basis. Sometimes I will really do a work out and worry about two or three of them.

Worrying about job – well, budget. Need I say more. Well ok, maybe a bit more. I have been suffering extreme deja vu. 1974, 1985, 1990, 2013 – same rhetoric, same actions. We can’t seem to learn. Having been here before and I can read between the lines on the messages to staff from the ceo. Positions will be disappearing and my non-bedside may just be seen as extraneous. More on this.

I’m a little tired – I have joined the Gluten-free cult and still run into things that put me in a coma. Who knew that some cook would put flour in a rice dish? Upside is we don’t eat out so much anymore.

Winter in this place – 5 days to Spring 2013

spring 2013And it is still snowing. I have a firm winter policy that I don’t shovel in March, however this has been challenged this year.

Part of the solution, not the problem – this has been severely challenged more and more. As the adverse event reader for my area I struggle daily with not saying, or even thinking – “Whiskeytangofoxtrot!¬† WHO is responsible for this?” I know, I know – 90% or more are systems errors and not a personal fault, but jeebus save me it is difficult to understand how someone could insert a tube into a neutropenic patient despite the tube use criteria clearly indicating neutopenia as a contraindication, and it not be an individual failing rather than the system. Critical thinking and problems solving skills seem at an all time low in my profession. And instead of bemoaning this and pointing fingers I think a solution is needed, but the problems is much beyond my pay grade to fix. So how to work with what I have…

Adverse event reporting remains low throughout healthcare, and not surprisingly action on the reports that are made are frequently not solutions but more band aids. Is patient safety a buzz word of no meaning? Is it window dressing for accreditors? Words to point to in mission statements and values to show how seriously we take it?¬† When statements get made such as, ‘Patient safety is everyone’s job’, we know that means since it is everyone’s job we scatter responsibility to no one and as everyone’s job, it is no one’s job and things will remain the same. We will continue to have recommendations to adverse events that include ‘create a policy to…’, or, ”provide education on…” – actions that change nothing but make the board feel like something was done and a solution that can be pointed to indicate change.

Research – I have a couple studies percolating in my head. Have even reach the point of getting part down on paper. Definite interest from co-contributors, so something to look forward to going to work for if I can only get work stuff from interfering in my research stuff. I wonder if they would give me a sabbatical…? Poster is off to printers for IHI conference in London, less that a month to wheels up. Very excited to be presenting four posters at the conference.

Ok, so now I get it down perhaps I have a few reasonable explanations  on why I have not been able to write more. Perhaps, in retrospective reflection I set the bar way too high for myself, but I have to keep lowering it at work, so perhaps in response I raise it for myself?

Did I mention that mediocrity is now acceptable? Fodder for next time

zen5Stay out of the hospitals.