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Thursday, June 12th, 2014
2:53 pm - Seeking nurses willing to discuss LEAN/Six Sigma

[Hoping this is acceptable to post here; if it's not OK, just let me know. I don't want to cause any problems for anyone. Thank you.]


I am an academic researcher and author who is currently working on a project
about the effects of LEAN and Six Sigma in various types of workplaces, but
with special focus on the health care industry, including hospitals,
inpatient and outpatient clinics, etc.

If you are:

-Currently employed in this industry, preferably as an M.D. or nurse (but
other positions/titles also OK)
-Have direct experience (as an employee, *NOT* an administrator) "adhering"
to LEAN and/or Six Sigma


-Would be willing to participate in a brief interview regarding your
experiences, thoughts, and opinions on LEAN and/or Six Sigma, please contact
me at packedby776 at gmail dot com.

If desired your identity will be protected and confidentiality maintained.

Thank you.

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Tuesday, February 4th, 2014
1:03 pm - Patient Care... Even if Only the Resident Sees It

Dear LTC Middle Management,

As much as our wonderful corporate bean-counters would make any right-thinking nurse sick, basic infection control and patient care should still take place even if the big bosses aren't inspecting the facility at the moment. I know, crazy, right? What, you think the owner of the for-profit LTC making six figures a year is made of money?

If a dressing is on a Stage IV is ordered to be changed every day, it should be changed every day. Even if the patient doesn't get visitors and has aphasia and cognitive impairments, preventing her from complaining to the bosses. I shouldn't come in for my shift and see a filthy, wet dressing barely holding on, not even fully covering the wound and dated three days ago and the patient grimacing in pain. No, not even if the treatment nurse is friends with the DON. Not even if he's friends with the Pope. Not even if the treatment nurse kissed every butt that ever sat in a manager's chair (which he has).

No love (and hoping this other place calls me back for an interview soon),


current mood: bitchy

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Wednesday, January 15th, 2014
10:10 am - Shift report -- Grrrrrr!

Dear she whose name shall not be mentioned,

There's a reason that I hate giving you shift-to-shift report...you can't seem to stop talking long enough to listen to ANYTHING I have to tell you! You're constantly interrupting report to chitty-chat with folks whom you're going to be seeing ALL FREAKING DAY, for Pete's sake, as well as interrupting me to ask a bazillion questions, all of which WOULD have been answered, anyway, if you'd have only just freaking shut up long enough to listen to what I had to tell you!!

No Love,
Your colleague who can't stand giving report to you

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Monday, December 2nd, 2013
10:41 am - Seattle nurses

Anyone here from the Seattle area?  I've lived here for 6 months and work in one of the hospitals on First Hill. I don't know a lot of people in Seattle and my only fellow nurse friends here work in my same hospital.

I am thinking of trying to move to another hospital but don't have anyone to ask which might be better.  I'd hate to give up a tolerable, but not great  job for something I end up hating.  Anyone have opinions on which places are best to work in the Seattle Metro area? Any opinions or advice welcome. 

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Friday, June 14th, 2013
1:48 pm - [29] A little help please.

Hi everyone. If you have time, please check out this fb page. It is about different diets, if you think it can really help or not please do comment on it. Like the juice diet. I think that is not a good one since it spikes your insulin making you tired after all that glucose was consumed. If fluctuations of insulin continuously happens, do you think it could lead to diabetes? What do you think? A patient of mine tried to argue that it is a good diet, she tried the one with fruits and a little bit of greens which I think is wrong because fruits have a lot of sucrose...

This is the fb page. Thank you.

current mood: hopeful

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Wednesday, February 27th, 2013
11:40 am - Long time, no post...

A little common courtesy is a wonderful thing. Too bad that certain people seem to be lacking in this very desirable trait. For example, if you want somebody to act as a "reference" of any kind for you on an employment application, don't you think it would be courteous of you to ask first if that would be OK? Honestly, I would! I'd do it, if for no other reason, than to feel reasonably assured that the reference said person would give would be a good one, even if courtesy WEREN'T a priority in my life!

While I won't go into huge details regarding the person I'm irked at at the present time, said person was a former co-worker of mine at a previous place of employment. Yes, I liked this person personally, and he did good work while he was at my former place of employment. Unfortunately, he left under less than "professional" terms -- actually called in and quit, minutes before his scheduled shift was to begin, leaving us in one hell of a bind, and his attendance, while he was there was, to put it kindly, was less than stellar. Imagine my amazement when I got a call from one of his current prospective employers this morning (the dude's in the job market again -- imagine that!), asking me to talk about him -- when not a word was said to me previously that he was even THINKING about using me as an employment reference! And no, folks, I wasn't evil and DIDN'T give the person inquiring any negative info...I begged off, telling the person that I'd worked all night, was in the process of getting ready for bed (which was true), and asked for a number which I could call back at a time which was more convenient for me. Needless to say, I then programmed that number in my cell phone to go straight to my voicemail (just in case they call me again), and hopefully, I won't be bothered by these people again!

Unfortunately, I'm in one of those peevish moods this morning (in spite of the fact that I had an excellent night at work with pleasant co-workers and great food -- management fed us well last night!), and I'm still irked at said person's audacity. I made the mistake of giving a decent reference to a former co-worker once previously, and feel that I seriously risked my reputation in doing so. Said person apparently hasn't been able to hold down a job for more than a few weeks or months at a time since, without being fired! The fact that I did give THAT person a decent reference (because she WAS a good worker when I knew her and I was sympathetic to the reasons she quit the job I knew her from), I feel, reflects somewhat badly upon my professional reputation, and I'd hate to go through the rest of my career thinking that my word and my recommendation is worth nothing, simply because I might have given too many good references to people who didn't deserve them! So, with that in mind, I've been VERY careful in recent years in deciding whether or not to act as a reference for ANYBODY looking for a "new" position. And, the idea that someone (even someone I liked personally and considered a "friendly" co-worker) would assume to use me as an employment reference without even asking me first, just sticks in my craw...honestly! One would think, if one wanted to use a former co-worker as an employment reference, one would want to make certain that his/her work (AND work habits!) were such that I'd WANT to recommend him/her for the position. As I said previously, I've been at this for too long and have worked too hard to have my professional judgment mean nothing -- and therefore, I WON'T be giving work references willy-nilly, even if I DO like the person in question!

This isn't the first time that I've been called out of the blue for a work reference on someone who's never discussed it with me previously, but I'm old enough and bitchy enough these days to be completely honest the NEXT time something like this happens! Grrrrrrr...and yes, this is probably much ado about nothing, really. But what can I say? I'm an old, peri-menopausal woman who's accomplished more than her usual share of bitchery in recent weeks :-(

current mood: bitchy

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Friday, December 7th, 2012
11:14 pm - I think I am exhibiting "exit seeking" behaviors.

So work is horrible lately, and not in that, "its flu season so we are in perpetual gridlock and everyone is bickering over having to work the holidays but it will get better soon," kind of way but in that, "this place has gone to shit due to a series of terrible decisions by upper management and there is no light at the end of the tunnel," kind of way.

They decided our floor will be taking all the vent weaning candidates in our region. These patients tend to be an extremely heavy workload. They have trachs, continuous tube feeds, often a variety of ulcers from being bedridden for so long, limited mobility, and a whole slew of psychosocial issues. They usually are on our floor for months before being discharged, if we cannot successfully wean them, which is going to be the case for a certain percentage, they will be on our floor for up to a year awaiting placement in a complex care facility.

Somehow, the powers that be decided we would take these patients on with no additional nursing staff, and a REDUCTION in patient care techs (to the tune of half of what we had before). So far it has been going splendidly, we constantly have nurses on leave for back injuries, long timers are jumping ship either transferring to other units or getting new jobs, they are paying out a shit ton of overtime because no one is getting breaks anymore, and the place constantly is so effing filthy (trash on the floors, dirty linens in piles in the hall) I am embarrassed to work there.

Soo, my plan is to get the heck out before this place crashes and burns. A lot of our core staff who can easily transfer to greener pastures have done just that. I am thinking grad school. Masters of nursing/NP can be mine in 2 years if I go at it full time. Problem now is which program do I want, should I just get the masters without the NP component? If I do decide to go for the NP do I want to go with Acute Care or Primary Health Care? Or if I don't get in I will look for another job, just not at all sure where. There are a few jobs for nurse educators that I may have a chance at which would then help me pay for my masters which ya know, is nice. So many decisions, the only thing I am sure of is I cannot stay long term on this floor anymore, not working under these circumstances. Anyone got any commiseration, suggestions, advice?

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Friday, November 16th, 2012
10:27 pm - Nurse fail

Dear Clinic Nurse colleagues,
It's not acceptable practice to NOT assess the site of an infection you are treating. No matter what part of the body.  If indeed the pt refused assessment, cover your arse and document it!

no love

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Wednesday, September 12th, 2012
11:19 am - UK nurses

Looking to find a forum for UK nurses or a UK nurse who can help me with some info. I'm an RN in Canada, with dual UK/Cdn citizenship, also RGN in UK. I'm thinking of moving to England in a few years, looking for contacts, forums to learn more about nursing jobs in England.

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Sunday, July 22nd, 2012
10:54 pm - OK I LOL'ed


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Sunday, July 8th, 2012
10:05 am - areas that need nurses?

Hi all,

I'm a new grad with a BSN living in Portland OR.  Unfortunately in my city, there are 8 schools that graduate new nurses, 4 of which convey BSNs.  There are of course several hospitals, clinics, nursing homes, rehabs, jails, etc. But the applicant pool is pretty big at the moment.   Although I'm only one month into the job search, and not being picky about positions,  I have only had one phone interview that went no where.  I graduated Magna cum Laude, have 4 years acute care experience as a CNA and have done several community health and other types of volunteer work.  I think that I may be looking to relocate.  

I'm just curious if you live in an area that seems to need nurses?  Or if you know of a city/region that is less saturated than the Pac. NW?  Any advice or online resources you can direct me to would be hugely appreciated.

(x-posted to nurse students.)

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Monday, July 2nd, 2012
11:21 pm - UGH!

Some guy was hitting on me on Facebook telling me that he wants to role play in my Scrubs. Yes cause my job is SO SEXAY OMG!

I responded UGH NO before I could even think.

EEEeeeeeew C. Diff and MRSA.

Should I block him?

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Sunday, May 27th, 2012
5:31 pm - Weekend gripes

Dear Patient ,
Yes, you have to get your arse off the couch and come and sit where I can (a) see the wound and (b) work without getting onto your filthy floor, or have your obnoxious dog crawl all over me. I know it's not what the other nurses do, that's their problem. Not sorry that you missed a whole 10 minutes of an old movie on TV. Don't expect me to want to come back again.

no love

your nurse

Dear fellow nurses,
Please consider, not booking patients who don't need daily visits on the weekend. I was asked to do other visits, but had to turn them down, as I had 10 visits and a lot of driving to do. It would also help if supplies were (a) available in the home or (b) organised so that I didn't have to dig through several bags and boxes to find the right stuff. It would also help tremendously if you could document wound size at least once in the last month, so I can do my job correctly. Reading, not measured for weeks at a time isn't helpful when I need to assess if the wound is healing. I know I'm covering for your day off, but I like to provide at least adequate care.

no love
your colleague

Dear Supervisors,
Get it in your head. I am not killing myself driving all over a huge area to do extra visits, when I am already overloaded with visits. Hire some more nurses. Can't find them? Well maybe it's time you raised our wages.

no love

an almost dead nurse who you need to work tomorrow

current mood: irate

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Saturday, October 1st, 2011
3:27 pm - Thoughts and opinions welcome

Dear cynical nurses:

I am in the final year of my BSN program.  This term is Leadership/Management outcomes and of course I have a big APA paper to write.

We are to address a healthcare topic with policy, practice and economic implications.  It is to be analyzed from a nursing leadership/management perspective.   I am thinking of talking about the practice that many hospitals seem to be adopting of mandatory vaccinations for healthcare workers, particularly flu shots.  Its seems timely, especially in October.  

I come to you to ask if you have any other ideas for topics, as we all seem to have opinions that make us cynical about the healthcare industry.  I would love to hear ideas and/or any resources you might have (URLS you can point me to) if applicable.  

**Please note, I am in no way asking for help with the work, simply your ideas on pressing topics in healthcare that management can or should be addressing. Thank you in advance!

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Monday, September 26th, 2011
2:39 pm - Hell hath no fury...

Dear Emergency Department: Please mind where you put your patient belongings. 'Cause hell hath no fury between a woman and her shoes!!! (And her blood pressure!).

Just sayin!

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Wednesday, September 21st, 2011
12:21 pm - Ego is not a dirty word

I am having many work related issues right now, and i need to vent

Dear Intensivist,
I understand beds are tight, that clearing patients is a bitch BUUUUTTT, I work in the PACU, telling me to BiPap a patient for quite possibly the rest of my shift and or life is not going to work for me. Also saying the nurses are really busy and maybe a bed on the medical ward is better is just plain stupid, it is called INTENSIVE care and HIGH DEPENDANCY for a reason
Dear Orthopedic Reg,
I know you are an Orthopod (Orthogod) but c'mon, you do an operation, you do the op report, you chart meds and orders, it has never been any different, why do you need me to run around after you asking you to do your job?Does it make you feel important? Maybe some mother issues?
Dear Anaesthetist,
Telling me as you stand infront of me that it is your turn to talk ie.flirt with the pretty Cardiologist, cutting my conversation off with her, is not ok! Why is your conversation more important, is it that you are older than me? a doctor? an asshole? I just hope sir, that someone doesn't treat women in your family as badly as you do the women at work.

End of rant

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Sunday, August 28th, 2011
11:24 am - I'll take five of these in red please.


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Wednesday, July 20th, 2011
12:58 am

I work as a home caregiver right now, which basically means that I do housekeeping and meal prep for my clients as well as transportation assist and meds and such. I also work in a state where burning stuff in a barrel or brick well outside your house is legal.

Two words regarding the client I saw Saturday:

Depends. Bonfire.

I won't lie. It was surprisingly awesome.

current mood: amused

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Tuesday, July 19th, 2011
2:38 pm - Lung police

Note: I have been unofficially diagnosed with asthma by a nurse practitioner; given that I've had bronchitis twice in the last 5 months, most recently 6 weeks ago, and it required a 12 day Prednisone taper to stop the barking cough, I'd call her diagnosis of "constrictive airway" a fair call.

Lady, if you're going to ask "Do you mind if I smoke?" and I reply "Yes, actually; I have asthma":


-go on about "ooh EVERYONE says that nowadays, it's like an EPIDEMIC". Yes, I stayed up all night with my brothers and sisters on the Asthma Bat-Phone cooking up the SEEKRIT Asthma Conspiracy: "You, meb21! Make sure none of the people in your patients' homes can smoke! It will drive them MAD and we will finally rule the WORLD!"

-say stuff like "Did you hear they're taking that stuff off the market" and make some vague inhaler-type motion with your hand. What is ThatStuff? Should I ask my doctor if ThatStuff(tm) is right for me? Perhaps if you quit the pack a day of that nicotine stuff you're smoking you'd be better off. But I'm a bad nurse, of course, judging you.

-fondle your lighter and pout for the rest of the visit. You're not even my bloody patient! I'm here to see your aunt! Can you hold off of a smoke for 45 minutes while I assess her?? Or go out on the porch!

current mood: annoyed

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Monday, July 4th, 2011
2:27 pm - Oh, how I love doing home health on a holiday weekend.

I just have to get this out somewhere:

1. Madam, I know that you're fascinated by the Casey Anthony trial and really REALLY want to watch the closing arguments but I really must, must insist on FULL access to the large, open oozing abdominal wound that we've been doing daily dressings on for months now.

2. Words you never want to hear from a patient: "Let's get this wound vac done so I can get back to playing with my chainsaw."

3. You, sir, if you are indeed harassing my patient because she is gay, and I ever catch you, I'll call the cops on you so fast your head will spin.

current mood: hot

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