What Happened to Arlene?

I know I've been off the blog too long when I have to enter my password!

I had intended to join the morning teaching events on Hilltop this weekend, but didn't show up.

I got sick! I was starting to sniffle and sneeze and blow my nose the 17th & 18, during our teaching weekend on Tacoma's Hilltop; then took off Oct 19th and 20th from work for the anniversary of the Birth of the Bab; then Oct 21st for our second anniversary.

About 4 AM the 22nd it hit. High fever, really not feeling well. But I was scheduled to work a twelve-hour shift Thursday, so I did, going through a box of tissues and a container of that horrid alcohol gel which I applied after every sneeze and nose blow, getting sicker and sicker. After whining about my schedule and being assigned to work this weekend so I wouldn't lose my house, I ended up taking this weekend off anyway. I still have a fever but the running nose is now only jogging, and the sneezes have stopped.

I tried to go to the Doc-in-the-Box today but they wouldn't take my insurance, which is one of the major companies. I have Peach, they only accept Mango. I thought they were pretty much two sides of the same coin, but not according to their contract. So I decided since I'm not dead yet, I'll just wait. I'm not working until Tuesday, anyway.

I'm watching videos with my daughter.

Business People

Saturday while we strolled through the Hilltop neighborhood, I was partnered with a gentleman from Bellevue and I asked what his wife does. After a thorough explanation, my previous observation was confirmed: the strong possibility exists I am just not intelligent enough to understand business. I've already proven I'm not smart enough to understand Stephen Hawking. But I'd rather try to explain a quasar than any aspect of business.

Years ago I used to walk along the Tacoma waterfront on Ruston Way, trying to figure out my nursing career which was always crashing and burning. I was watching for rainbows and trying to manage my weight [ha!] I used to see them on Ruston Way: Business People.

They trade their spike heels for chic walking shoes and glide out from their offices in pairs, crisp in black business suits, sliding narrowly past the stroller pushers, dog walkers, and fat, desperate housewives. The speak a staccato dialect from another planet, possibly B9 Business 1138.

I want to approach timidly in my Birkenstoks, "I come in peace." But I know they live and work and have their being in a different world from mine.

Love and Compassion, Part 2

The Bab said that people ought to love God because they love Him, not out of fear of hell or desire for paradise.

He also said, "The path of guidance is one of love and compassion, not of force and coercion." The Baha'i agenda is not to coerce people to seek God out of fear; it is to attract people's hearts which are already yearning to connect with their creator. I think the sea change I sensed this weekend in the Hilltop neighborhood is that, when we use the language of community-building, people sense the love and compassion and the lack of coercion, so there is no reason to feel threatened.

People we approached were friendly; I was fearful because at heart I am a hermit. I am always attracted in two directions: to associate with people and enjoy the fellowship, love and friendship, and to seek solitude and rest.

This weekend was very convivial, gathering in homes to pray together, team up and go out into the world to meet people, return and share out stories. Every year there is an event called the "Black Men's Gathering" where, being neither male nor black, I can only guess that they get together and enjoy being black men together. Anyhow, they came to participate in our teaching event this year. We also had visitors from Boise and from Salt Lake City.

Sunday morning there was a devotional meeting which included the people from the Black Men's Gathering, bringing drums and music and we had stories from the early days of the Baha'i Faith, more prayers and music, and it was fun and moving and enlivening. Then we ate waffles. After the devotional gathering I went back to the house where the teaching was going on, and joined the friends who were staying there and praying.

The whole weekend was social, convivial, joyful, full of friendliness, fellowship, love and unity. I was exhausted. I came home at 6 PM, crawled into bed and slept until 2 AM.

Love and Compassion, Part 1

I associate activities intended to save souls as having a coercive agenda. This is because at heart, Christianity as currently taught by some Christians, involves the doctrine of original sin. As I understand it, there were two people in the Bible, Adam and Eve, that failed to follow the commandment of God, and for some reason, some type of twisted genetics, everyone else who followed [being their offspring], inherited the quality of being inherently sinful.

The corollary to this situation, the way I have been taught by some Christians, is that since humanity are all sinners, we are all automatically consigned to the flames of hell unless we are saved.

How do we get "saved?" By reciting words to the effect that, "I believe that Jesus Christ died on the cross to save me, and I repent from my sins." Something like that. Now this, as any child can see, is a no-brainer. If the clear choice is to go to hell or to recite whatever you think God wants you to recite, why not recite the words?

The trick, as I figured out as a child, is to be sincere. How can you know you were sufficiently sincere to keep you out of the flames of hell?

Coming to a Neighborhood Near You

Baha'is went out in the rain and sunshine Saturday and Sunday to meet people in the neighborhoods and facilitate involvement in community-building activities such as devotional meetings, holding children's classes in their homes, and assisting middle-school age youth to devote their energies to their communities.

Personally I was never receptive to having religious people approach me at my house because experience has proven that they are almost never receptive to hearing what I truly think and feel, their agenda is to change me and save my soul, and they are never receptive to the message of Baha'u'llah.

On the other hand, when I meet people in their home or on their porch, I am interested in them, and I have no interest in changing them.

Surprisingly the people in the neighborhood of Hilltop in Tacoma which we visited were friendly, approachable, and receptive to having people stop by. Whether or not they were interested in what we had to say, they didn't seem hostile or alienated in any way to have us in their neighborhood, and many people were very receptive to meeting us.

Be Thankful In Adversity

Things to be grateful for:

a glorious sunrise
onions
a framed copy of a picture I admired, by & from a friend
Feast
a wonderful gathering at Gig Harbor Saturday
doing two admissions and still getting off work on time because there are two of us
apologies accepted
pressure cookers
having an efficient way to cook beans [at last] [see above]
people who care whether I attend events
still having a daughter
Baha'u'llah
Enayat's hands and heart and voice and spirit
liking my cooking better than the average restaurant's
having someone to clean the kitchen for
having a chance to revise my lifestyle while I still can

A Unity Bhajan

October 11 on Baha'i Views there is the most exquisite Unity Bhajan by Vivek Nair [a video of a song.] It looks as if it is performed at possibly one of those large conferences that were held last year all over the world. I only discovered it this morning before work. With 12 hour schedules I get behind checking my favorite blogs.

This is incredible. My husband showed up just before I got home from work tonight, talking about being approached in the Burger King for resembling a Sikh in his bushy beard, which reminded me again of this performance, which we watched together.

I can't get enough of it. I will ask my daughter if it is possible for me to load this in my iTunes. Also planning to see if there are CD's of this performer.

What Do You Chart When . . .

Mr. Fizzel might actually be or have been a nice person, socialized to treat other people with respect, and understanding normal boundaries. Currently it's difficult to tell, with his dementia. He has been continually entering other residents' rooms without permission, seeking the exits in the facility, and taking what the staff considers an unreasonable amount of attention to redirect him. He is not very redirectable. He sometimes requires one-to-one monitoring, and the staff for that is not readily available.

The other night, the medication nurse approached me in a rather excitable state and described Mr. Fizzel attempting to place his hand on another resident's breast. It was clear to her that the destination of his hand was mammary gland, and only her physical intervention prevented this purported grope.

This type of situation is very difficult to deal with in a politically correct manner. The professional is wrong no matter what you do. It feels like moving through a swamp.

All staff members who witness an event where there is any question of suspected abuse or neglect are considered "mandated reporters" who are required to call "state," the 800 number provided to initiate an investigation. But we are cautioned not to call state unless we have a plan for intervention. Confusing.

Also confusing are the guidelines for charting in these situations. I charted that Mr. Fizzel's hand was outstretched, palm open and fingers extended in the direction of another resident's breast, and that contact was prevented by the nurse. The director of nursing removed that page from the chart, making it necessary to chart again according to her guidelines. The use of the word "breast" was objectionable, and the assumption of the destination of his hand was objectionable, although, from the nurse's description, any fool could see what was transpiring.

The bosses were friendly about it. I emerged from an hour-long meeting [sleep-deprived] more confused than when I went in.

The usual rules of charting are clear: be specific. I love to chart about wounds. Describe the dimensions of the wound, the color of the wound bed, describe the wound edges and surrounding tissue, the color, consistency and [sorry!] odor of the fluid emerging from the wound, and the treatment, all in full living color. Wallow in it.

Rules for charting an interaction between patients: vague. "The resident reached in the direction of the other resident's left upper trunk." Period.

Argh!

The Freeze Dried Brain

I worked 36 hours in three days. I have absolutely nothing clever to say. Twelve hours at a time of continual human interaction and information processing. Usually about a third to halfway through the day my brain just sort of goes, "crunch." Suddenly my memory span is very short. I stop being able to process information.

To be fair, a lot of this is sleep deprivation. My car was finally ready after being vandalized, and the best time to pick it up seemed to be yesterday at 8 AM after going to sleep after midnight, so I woke at 0645.

A pharmacy calls to say that such and such medications are not covered by Medicaid. I am unable to hear the caller well enough to understand when she recites the medication so quickly, so she spells it, equally quickly. My ears are hearing but I just can't follow it that fast. I have her talk to the medication nurse. This decreased ability is terrifying.

My head feels as if the strands of my thoughts become tangled. I used to think I was eating and reading at the same time merely because it is soothing. But there is something about that activity that puts my mind in a trance-like state and enables the tangles to comb out again. Even though I have provided myself with ample plant-based, whole delicious foods, I find myself craving candies and natural Cheetos puffs and so forth. Not out of hunger, but out of trying to operate with a freeze-dried brain. And stress.

My plan is to find a way to detangle and unstress my brain in a healthy and efficient manner.

One triumph: I found a setting with the tape recorder at work which is sensitive enough to pick up my voice, so recording report went much smoother last night. Yay.

Days Off

Our first two twelve hour overlapping charge nurse shifts went pretty well at Homeland. Busy, if you read the stories. I stopped by tonight after three days off to get organized for the next three shifts, and one of the new nurses on this side said, "I don't know how you did it all with just one nurse!" I said, we were really jumping.

My first day off I chilled out, bought groceries and did errands, then went to Eatonville late in the day. Early Sunday we went to Baha'i Convention at Clover Park College, Lakewood, at the uncharitable hour of 8:30 AM--kind of rough for people living 45 minutes away. I left my lights on, had to jump-start the car when we left at about noon, then we picked up food at Greek To Me restaurant and went to Wright Park, sitting in the sun at a picnic table.

Enayat always has felafel; I had a "veggie gyro." We shared side orders of their roasted potatoes and their green beans. I wish I had the recipes; the potatoes are soft and flavorful and tender, and the green beans meltingly soft. Enayat fed the seagulls and crows. I said he was encouraging mendicancy.

We drove out to Eatonville in time to spend sunset at my new favorite place: the balcony at the huge barn he refurbished by his farmhouse, surrounded by trees and pastures. There is such a feeling of peace there. Always, in clear weather, a slow and beautiful sunset. Grazing horses, prowling cats, passing small planes, distant gun practice at a gun club, but no traffic noise. If you stay late enough there are bats. A new "happy place" ; >. When we went out to the other barn where we have an apartment, we drove out to Ohop lake which borders the land. Elks were in the field. I called out, "Elks!!" very excited and he thought there was an emergency.

Today I had a quiet day at Eatonville, washing up from the delicious pasta dish I made last night. I had some [unfortunately white] garlic sourdough I used for garlic toast; some whole wheat penne pasta; a jar of Prego with mushrooms; and vegetables--leeks, mushrooms, a small yellow summer squash, garlic, and a bag of spinach. [Yes, in my book, garlic is a vegetable.] Yum! Very filling.

For once I requested a Persian movie, one about a shah being shot in the mosque, as Nasirih-Din Shah was, although they didn't use his name. Which they also made him a nice guy.

Owners of pit bulls, et al, always say "he won't hurt you. He's nice." What they don't realize is that, yes, the dog is nice to them. But not to other people. Kind of like Nasirih-Din Shah.

Stories From Homeland, Part 3

Mrs. Diaphanous went to the hospital with severe atrial fibrillation and an ejection fraction of 18%. Her heart is not working well, and her condition is fragile. She is just barely stable. She is alert and oriented, and walking with a steady gait. Naturally she has agitated to return home since she was admitted to Homeland several days ago, and likewise agitated her daughter.

Returning from visiting her cardiologist, who thought it would be fine to go home, she expected to just pack up her bags and take off right away. However, she is being followed at Homeland by Dr. Wildman, who needs to give his permission for discharge. That's how it works in a skilled nursing facility. Whichever doctor follows the residents here has to give the okay for any orders that consulting physicians give.

This happens frequently with people who have fractures. They work with the physical therapist, who remarks that they are doing well and should be ready to go home soon. Then they go out to the orthopedist, who says, "Okay, I think you're ready to go home now." The next the nurses hear of them is when the family member leans up against the counter, saying, "My wife went home; doctor Jointz said it was okay. Is there any paperwork you want me to sign?" "Only the AMA form."

So no one in the facility has done thoughtful discharge planning yet or completed the time-consuming paperwork needed for discharge, and Mrs. Diaphanous expects to go home this minute. I phone Dr. Wildman, expecting to just get a telephone order, but it's necessary to fill out the right paper requesting discharge and fax it over.

In the meantime I fill out discharge instructions and ask the daughter which pharmacy she would like me to phone the medications over to. While I work on the paperwork and wait for the doctor's faxed order, the daughter has approached the desk three times in twenty minutes, asking what we want her to do while she waits.

"Play cards?" I want to suggest.

She cut short my discharge instructions on taking the medications, saying the pharmacist would go over all that with them.

Coda: two hours later she was back, asking to clarify the discharge instructions. "I know you couldn't wait to get rid of me," she begins.

Stories From Homeland, Part 2

Mrs. Mold, it turned out, had a bladder infection, with greater than 100,000 Aphus Glaphusiosa, according to the lab report. Dr. Bludgeon was visiting patients and charts at the Green Wing nurses station, and ordered Gentamycin via injections, dose to be calibrated by Evilgreen Pharmacy. I faxed off the order to the pharmacy, which called me and asked what the resident's last BUN and Creatinine labs were, which reflect kidney function.

Last such labs were done in June. Unacceptable. I pick up the phone and am in the midst of ordering a stat or ASAP lab draw when I remember that Mrs. Mold is currently out with her daughter, Isabel, dancing. I leave a message on her daughter's cell phone explaining the necessity of returning so the labs can be drawn.

A few hours later Isobel is standing at the nursing station counter. "I want her to have a urine dip!" We explain that this is not necessary, as the urine has already been cultured and proven to have this particular bug. "How do we know this was not contaminated?" "Because there is only one species of bacteria, not a mixture of normal flora." "Why can't I have her urine dipped? How do we even know this is her urine, not mixed up with someone else's?"

This is the great advantage of having several nurses present; my negotiation skills are very poor. At last Isobel accepts that yes, this infection exists, and we can move on. We call the lab back and they are now reluctant to come out for the draw, but eventually show up. After the results are in, the pharmacy can set the dose and finally the antibiotic will be started, but not within the usual four hour window of time required.

Intelligent minds may wonder, if the patient was out dancing, how sick is she anyway. In the world of nursing, required to follow doctor's orders unless really contraindicated, inquiring minds will just have to wonder.

Stories From Homeland, Part 1

With the new 12 hour charge nurse schedule, there is no more reporting in person to the night nurse, so the powers that be brought in a new Radio Shack tape recorder with voice activation, for recording report. The first night I couldn't make it work, and left my written notes. Last night I made it work, sort of.

I guess my voice is quiet for voice activation, so I had to hold the machine under my nose and practically shout. With even a nanosecond lull, the machine would stop recording [one can see the wheel turning when it's recording, much like a nurse deep in thought.] With all these technical challenges, my report came out kind of rough.

"Hello, this is Arlene reporting for the evening shift on, hello, are you working? October second. In room 201, Mr. Feebel has a Foley, what the hell, are you on? catheter which was leaking. We changed the catheter and, oh, bloody hell, now what? it has been patent. In Room 202, Mrs., hello, okey dokey then, Rheinland is on Keflex for pneumonia . . . "

Too Many Garbanzo's

Started new 12 hour schedule at work this morning. Tuesday I thought I was working Wed, then having several days off, so I scheduled car repair status post break in for Thursday morning, 7:30 AM. Was up late, woke up at midnight, woke at 5 AM, dropped car off about 8 AM, went to work at 10, just got home. Night of the living nurse.

Yesterday [my one day off, after schedule revisions] my husband showed up at Tacoma, having had an appointment downtown. I had just made some garbanzo beans so he had some. Later we went to dinner with Pearl at the Indian restaurant, Sumay. At the end of the evening, Enayat confessed that he had a dish of garbanzo beans downtown at the India Mahal, then my garbanzos, then more Indian food. We had a good laugh over that.