Welcome to the Twilight Zone - A.K.A, Santa Rosa

Being Sunday and my third day of work, I had decided to sleep in a little, since I know where I am working, I could push the envelope and wake up as late as I can..but still get to work on time with a coffee in hand. I stayed up way too late finishing my book, so I was excited when I set my alarm for 0600. At 0530 my phone rings...as a PPMC this always meant that Kora was calling me off!!!!! YAHOO!! In Santa Rosa, it means something different. The voice on the other end said she was from the staffing office at Santa Rosa Memorial and that I would be going to their Acute Care Rehab at the Fulton location. In my sleepy state is say, "OK where is that?" She said on Fulton Rd. I said OK....and that was it, as if I knew right were Fulton Road was......a few minutes later I realized what this meant. I then remembered that the voice on the other end said, "It should be a good day, there are only three patients and you guys have three nurses, one is on light duty, so I have to send you there. " It is all setting in now. I realize that I am going to Santa Rosa's equivalent of 4K. For those of you who work with me, you know how much we all love floating to 4K!!!! And for only three patients?!!?!? What the heck? With three nurses? I quickly realized that this was going to be the longest day of my entire life. I then realized that I had no idea where this building was located. Thank God for the Internet and Google maps. I was on the computer at 0540, looking up the directions. Which by the way were totally different the what the voice on the other end of the phone was muttering during the sleepy conversation earlier. So I got ready and headed out to the Fulton location. PPMC nurses reading this, be thankful that 4K is in the same building as the rest of the hospital. At least you can escape and have lunch in the cafeteria and see your friends from your home floor. If you are floated to the Fulton Campus....there is nothing. Their meals get delivered from "The Big House", which I soon learned was the main hospital...not jail..contrary to my initial assumption. There isn't even a place to get a soda! Nice I thought. And three patients and three nurses...nice! Now these nurses live and die by their paper charting system. I was forced to carry my clipboard/MAR around with me all day. No computer anything. Every med...you initial beside the time. I don't think I have done that since nursing school....in 1999. These nurses also live and die by what is written on the KARDEX! If it says..."Mobility: PT" there is no way these nurses are going to get the patient up. I clearly learned that when I was giving verbal report at the end of the day and was telling the oncoming nurse that I got my patient up to the commode. She said....."WHAT? We aren't supposed to get her up." I replied, "Well I didn't know that, and she did ok with the help of two people. She was a little unsteady, but she did well with a pivot transfer with two." In a normal setting, the nurse would say, "Oh, ok. That's great! She must be improving." And move on! But not here in the Twilight Zone(TZ)/Santa Rosa Acute Care Rehab....We had to have a 30 minute dissertation on how and why it was written on the sheet of paper...numbered 2000002...that she couldn't get up without PT. Well again here in the TZ, PT doesn't work on Sunday. So that means that if the patient's mobility status is with PT....they aren't getting out of bed at all on Sundays!!!!!!!!!!!!!!! What the heck???? I was the only one questioning this. I tried to argue that as a RN I have pretty good nursing judgement whether a patient can get out of bed to the commode or not. Or wait, I forgot where I was, when you cross into the threshold of Acute Care Rehab in Santa Rosa....all your nursing judgement is checked at the door. Again for those of you who have worked with me you all know well that I follow all the rules, and never speak my mind....NOT. At about the 31st minute of the small dissertation this RN was giving me on why I should haven't gotten her out of bed...i said, "OK. Well, please write me up then. Can we move on?" I immediately thought....oh CRAP I am going to get deported back to Oregon, loose my contract, etc. But by this time I really didn't care. I wanted to get out of that place and forget this little place even existed. I wish I could have just taped this interaction and posted it on my blog here. Because the look on her face when I said...."just write me up, can we move on?" It was priceless. She was shocked that anyone...especially a traveler would take that tone with her. Again, those of you who have worked with me know, this tone isn't new for me. I really didn't care. LOL. The patient was safe and proceeded to thank my for the rest of my shift for getting her to the commode. I may not be saving lives down here, but I sure am making patients happy and pissing off some of these regular nurses. Who by the way have been in the same job since the year I was born....1976! The other funny thing that happened today, was with another RN working at the rehab place. The charge nurse and I were talking and I was telling her that I used to spend a lot of time on a telemetry/cardiac floor. And she said, so you know what QT elevation is right? And I said yeah. Thinking this was a trick question. She said so if someone has QT elevation they should be looked at right. I again thought....where am I...what RN doesn't know that any EKG change should be looked at by a cardiologist???? Well come to find out the third RN that was on that day was having a little "heartburn" for two days. And she couldn't really get rid of the "pain in between her shoulder blades" for two days. And her "jaw was hurting now". And she just "felt funny" she "couldn't describe how she was feeling". So she had RN number 2 run an EKG on her. Well everyone can run EKGs here, but does anyone know what they say? No. Hence the QT elevation question. As I pieced this puzzle together, I told the nurse with the chest pain, shoulder blade pain, jaw pain, etc....to fricken get the hell out of there (before I was running a code on her sorry ass) and get to the Urgent Care that was luckily located in the same building! Turns out they shipped her off to the "Big House" for a complete cardiac work up...imagine that! The charge nurse, very sweet, but not all there, looked at me and said, "Man, I am glad you were here today. What whould we have done without you?" Again, where am I? The Twilight Zone?

I know this is a long entry, but the moral of my day is...if you ever have anyone needing rehab of the acute kind.....don't send them to the Santa Rosa Memorial Acute Care Rehab! Please I beg of you! It is the Twilight Zone disguised as a rehab facility.

That's all I have for you all today. Thanks for reading. Miss ya all!
-bev=)