Swine Flu B.S.

(* I found this pic on the internet. LOL)

I have had the sniffles and a sore throat for the past couple of days. I am obviously not feeling well, and as I cruise the halls of the the hospital while working, and encounter other healthcare professionals, I have heard nothing but the following: "You don't have the pig flu, do you?"

No. I do not have swine flu. Stop asking me. But I do have a patient whom we suspect does, and I will go no further than that. But let's talk about the pig flu, shall we? It has, thus far, caused no abnormal symptoms, save for the standard flu symptoms. And while the global death rate for influenza of which we are accustomed climbs into the thousands and thousands, at last check, swine flu has only caused a couple of hundred deaths worldwide. So why are we freaking out?

Well, this marks one of the first instances where we can catch an illness that has morphed from animals. (Not the first. Remember avian flu???) But everyone is in a dither about this. Everywhere I go on campus, there are signs posted on doors, windows, walls, about prevention of the swine flu. Seriously. Even my husband is not exempt. I mentioned that we had a suspected case, and he practically wanted to red-bag my clothes and burn them when I got home. I wanted them off as soon as possible just because I was dealing with influenza, and I have a child and husband at home who have not had the wealth of vaccines I have had due to my position in healthcare.

Maybe it is just me. I don't get worked up about MRSA or TB or influenza. I use precautions when dealing with these patients because I want to protect my other patients and my family by not becoming a vessel of illness. But most of this stuff is just common sense. Wash your hands, especially after touching something that a gazillion others touch, like door knobs, light switches...Make your loved ones and friends throw away their dirty tissues instead of laying them around. Sneeze or cough into a sleeve of tissue, then wash your hands anyway. Stay away from hospitals if you can. We try really hard, but hospitals are full of sick people. Those of us in their employ have someone in infection control to ensure we are protected. We try to protect visitors and patients too, but some people just do not listen. (Case in point: the suspected TB patient who SNUCK out of her room for a smoke!) Do not, by any means, be the idiot who has your 2 year old cruising the halls barefooted. No doubt, they are treading on c. diff and MRSA and VRSA and streptococci and anything else you can think of that settles to the floor of a busy ER.

So why am I not scared, other than reasons I just mentioned? There is not one single part of me that does not believe that I do not have MRSA all over me. If I were to get sick enough that they were to test me, I am sure I am completely colonized with it. I have had my flu vaccine, and I wash my hands before entering a room and before leaving. (That's a lot, for those of you who do not realize what it is that I do.) And in between those frequent washes, I sanitize. When someone is going to be coughing in my face, which is pretty much all of the time, I wear a mask. If I am going to get something on me, I wear a gown. When I get something on me when it was not anticipated, I bag my laundry, and either turn it in to the disinfecting gurus at the hospital or I wash it seperately with peroxide, then wash it again, by itself. And I wear gloves pretty much all of the time. My son and husband do not come to visit me at work. Common Sense, really. All of it.

Quit freaking out over swine flu. Because each year, as we get vaccines for new stuff, there will be other new stuff to emerge from which we are not protected. Viruses and bacteria are a clever sort. The morph and evolve too. Are we going to panic about every single one of them? Really? Calm down, says the Respiratory Therapist soon to have a degree in Molecular Biology. It'll really be okay.

Ring Ring

Seriously?
Okay, peeps. I am busy. Very busy. Picture the busiest person you know and I am even busier than that. Seriously. Well, I slipped. I have managed to work away most of my spring break, picking up extra shifts at work to make up for the deficit in OT while school is in session. After all is said and done, I am human, and so while I can gracefully manage my full-time hours, I do not pile on extra while classes are going on unless someone makes me, and that someone has the power to say I am no longer employed. So anyhow... In addition to the extra work, I am trying to get ready for the next quarter of classes. Buy books. Ensure tuition is paid. Make sure my schedule will mesh with John's and Evan's. I forgot to pay my phone bill. Oops. In a crunch, I give John a wad of cash and tell him to go somewhere and hurry up and pay the total amount due before the powers that be at the phone company decide I am no longer deserving of phone and internet services. I did this once before, so I knew exactly where to go so that the payment would post immediately. I gave my dear husband specific directions on where to take the payment.
So here I am at work last night. It is about time for me to leave. I picked up extra to help out coworkers during our period of short-staffedness. All I wanted was a quesadilla on my way home. I anted to see if John wanted anything. What happened? "The number you are trying to reach is either out of service or is being worked on at the current time." Whaaa?????? My first though was "BUT I PAID YOU PEOPLE A LOT OF MONEY!" Then the confusion turned to panic. I called the repair center from work to let them know that something has to be wrong with my line. She let's me know in a snippy tone that there is a block on my line for nonpayment. She sounds very judgemental, as in I am the type of scum who does not pay my bills. I get mad and tell her I paid my bill and I want my phone turned back on right now. When she tells me I have to wait until the morning, I tell her she needs to quit her job, as she obviously sucks at it. Poor girl. I was so rude to her. So I wake up early this morning, though it is my one day off, in order to send up a flare to the phone company to clear up the mistake. Hmmmmf!
The first lady I speak with treats me almost exactly the same. I explain that we paid. I have the receipt right in front of me, and offer the transaction number. She tells me that apparently there are authorized payment centers and unauthorized payment centers. John took the money to an unauthorized payment center, so we will have to go without a phone for 5 days while we wait for it to post. Then (gasp) she tells me the internet will be disconnected tomorrow if I do not pay. OMG, now they are out for blood. I freak out and tell her that we paid the damned bill. And I didn't pay just what was past due. I paid the entire thing, old and new charges. With my internet now in jeopardy, I demand to speak to a supervisor. She gets very rude, and transfers me anyway.
So the supervisor comes on the line, and I tell her what happened. She repeats what the rude girl told me, that they cannot turn the service back on unless the payment is posted or I go and pay the past due amount at an authorized payment center. I desperately ask if there are any other options. She is giving me directions on how to fax the receipt to her when I blurt out that I am going to make John do it, as he is the one who didn't go to the payment center to which I told him to go. She laughs, and I also blurt out that I am full-time pre-med student, a full-time RT, a full-time wife and mom, and that some things fall through the cracks. That my husband is new to the Mr. Mom role and doesn't always do the best job. This is when she softens up and tells me she isn't going to make me go through the ordeal of faxing her a receipt. She'll turn it back on, but to watch my account to be sure that the payment posts. If I would have been speaking to her in person, I would have hugged her right then and there.
So.....Lisa from Cincinnati Bell: Thanks!

The Christmas Con

So we know I have this kid. He is beautiful and bright and amazing. He is also very, very spoiled and has caused quite a bit of Drama this Christmas. (Capitalizations intentional!)
Let me just say, without faltering, that even when I had no job, when I was a full-time student, when we needed public assistance to buy groceries, I still managed to provide the child with everything he wanted.
My in-laws came in this past weekend because I have the work schedule from Hell and we were sure this was the only way they would be able to see him for Christmas. I had already had a conversation with Evan, explaining to him that people do not stop being sick just because it is Christmas time, and that Mommy has to work. In fact, Mommy does not have a day off of work until January 2nd. Together, we decided that it was acceptable for Santa to come late for Christmas so we could all enjoy the time together as a family. Secretly, I was delighted because this agreement meant that around the time I would have a day off of work to shop, there would be the enormous after-holiday sales. I had it all planned in my head: this obscene display of lavishness where John would get Evan out of the house so Santa could come. Evan would return to find this spread of everything he wanted. Everything! Keep this background information in your mind.

So this past weekend, they come into town. They are armed with cash to spend on Christmas gifts for Evan. We visit Toys'R'Us, where Evan is to pick out what he wants within his budget. Evan rattles off the list, and we start to fight the most insane crowd you could imagine in a toy store the weekend before Christmas. One of the items on his list, like every other kid in America, is a Wii. I had planned on buying one for him. But despite the crowd and the demand for the game system, they actually had them in. His grandma explained that if he chose the Wii, that would be it. Instead of getting a large quatity of cheaper presents, he would just get the one big one. He was fine with that. I was as well, thinking that it would be better for him to get it now while they had one in. I just planned on spending the same amount of money on accessories for it, which can be pricey.

John's sister comes up with the idea of taking Evan down with her for a visit this week. Yes, it is Christmas, but I will be working anyhow. We all agree that it is fine. It sucks that my son is not going to be here on Christmas, but neither will I. It is better for him to have some sort of celebration with family. We pack his stuff and when they make the return trip to Southern Kentucky, Evan goes along.

Now here we are. Evan is with them until Saturday. After a heated discussion with John's mother, it is revealed to me that I apparently spend no money on my son, that he is deprived. I cannot believe this is being said about the child who wears nothing but designer clothes. The child who has a room that looks like a toy store, whose mother works 60-70 hours per week to provide him with a private education because public school was not offering enough of a challenge. I am completely dumbfouded and have to step back from the situation for a minute to even think of a response to this. After a minute, I call his mom back and ask where she could possibly get an idea like that.

Where did she get it? From Evan. From my poor underpriviledged, malnourished, neglected little angel. You see, one day Evan had asked me if Santa could fit through the little fireplace at the new house. It didn't seem like too illogical of a question. The fireplace in the living room is small, and Santa is fat, right? My response?

"Well, Evan, Santa has magic on his side. Even when our house didn't have a chimney, Santa still found you, didn't he??? So Santa will find you."

Apparently this got twisted just a bit. My angel went and told John's family that he was told that Santa couldn't fit through our chimney, therfore no Santa this year. As a result, John's mother and father have gone and bought a whole new batch of presents for Evan to open down there on Christmas to make up for his alleged non-Christmas here at home.

Originally, I felt shocked and sad that my baby actually believed I was not going to get him anything for Christmas. But then I stopped and thought back through all of the conversations we have had about Christmas. I made it clear that Santa was going to come. I even made sure Evan understood why he would come late so as not to upset him. If he didn't understand, I would've found a way to celebrate on Christmas and not late. If this were some other child, I would feel like I had failed. This isn't any other child!

This is my gifted son. This is the child who knows exactly how to manipulate others to get what he wants. He has a memory like you would not believe and he knows what was said. This is not miscommunication or confusion. This was a lie. I know my son better than John's family, apparently. They got played. He knew what he was doing all along, and it worked. They got upset and felt badly. Despite the fact that he already got wonderful presents from them this past weekend, they went back and bought him more out of sadness for the poor little boy without Christmas gifts.

I do not know whether to be mad at my son for the conniving way he played them, or angry at my in-laws for not seeing through it. I think it should be a combination. One look at Evan shows anyone he is not deprived. They have seen his bedroom. They have seen the clothes I buy for him. They know he is in private school.

I have not decided what I am going to do about this. I am tempted to not buy him anything for Christmas. I don't know if that is a good enough lesson. I think he needs to learn about true deprivation. I cannot decide if this should mean that he will need to personally box up all of the extra Christmas gifts and physically hand them over to charity, or if I am going to take him to a soup kitchen and make him do some age-appropriate task for them so he can see what it is like. That while he is throwing around these statements and ideas, there are others without food or shelter. There are children living on the streets, with no warm clothes or hot meals. Heaven forbid the Wii was his only Christmas gift fro his grandparents.

Don't Watch

Yep, I stole that pic from the internet. But notice the lovely PB 840 Ventilator in the lower left corner??? By far my fave!

Here is the deal, peeps. We do some things that are uncomfortable for a patient when in an ICU. The list is numerous: chest tubes and a-lines and don't forget intubation. A tube made of polyvinylchloride is not a pleasant thing to have jammed into your airway. But we do it out of necessity. Not rosey and cute. But required. Then occasionally we have the patient who is having trouble breathing and we try to intervene on their behalf to actually avoid intubation. Whatever unpleasantness I could be up to is nothing compared to days of mechanical ventilation, I assure you. What am I getting at? Well here it is:

I know the patient I am taking care of may be your sweet mother. I completely understand that. I had a mother once before. I know you do not want to leave her side. Your presence at her bedside 24/7 is as much your way of ensuring we are giving her adequate attention as it is for tou to assure her with your presence. But when I come into an intensive care room, it is a sign that sweet Mom is just not breathing so well on her own. She needs some sort of help, whether that be in the form of aerosolized meds or oxygen, bronchial hygiene or mechanical ventilation. But please know that I am good at my job, even if that job is not all sunshine.

So you are at Mom's side. Great! But when I tell you I am about to do something unpleasant and encourage you to leave the room, please follow my advice. The most recent situation was the nasotracheal suctioning of an elderly lady unable to speak, and unable to adequately clear her airway with cough. DO NOT insist on watching me thread a catheter up her nostril, through the pharynx and into her trachea. She is not going to like it. She will cough and gag, and naturally try to fight me, at which point I will have to firmly insist she stop. I need to do this. I do not want the process to take so long that she becomes hypoxic or starts to brady down. That would be bad ju-ju. What I can say is that, while unpleasant, she will feel better when I am finished and have removed the nastiness from her. She may hate me, but she will feel better.

Please do not watch me, then get angry because I upset dear Mom. I am not concerned with Mom being upset with me at all. My job isn't to have tea with her or to convince her that I am worthy of her adoration. My job is to ensure that her respiratory function is intact. Making her mad is just a side effect.

If you can't handle the heat, stay out of the kitchen? More like if you cannot handle the unpleasantness, stay out of the ICU (other than for standard visiting hours, of course.)

Lot Stalkers

In other words, @#$%^&*! I hate Lot Stalkers! They have been plaguing me since I started my new job back in July. They have always been present at Wal-Mart. But since it is cold out now, and also Christmas time, it is getting worse, as it does every year.
WTF is a lot stalker? These are the drivers who will circle the front row of a parking lot, waiting and waiting for someone to move their car. You know you've encountered them!

So picture this: You are in the store. You have just come for a gallon of milk, a loaf of bread, and some Diet Mt. Dew. You have a Veruca-Salt-ish little boy with you. He wants/ needs/ will die without everything! I swear, one day I was in the pharmacy section to get some Advil, and he even managed to throw a fit there! Over what? What could a 7-year-old boy want in that area? Fricken Ironman band-aids! He would even throw a fit for an enema if it came in a colorful box!
So you make your way through the store. The three items you came in for in the first place? You did manage to actually pick them up, but you wouldn't know it by looking because they are at the bottom of the shopping cart, buried beneath the box of cereal the kid had to have (Hey, no added sugar, so it is good for him and you just cannot say no.), the shampoo you forgot you were out of at home, the packages of socks that were on sale, the book that looked too good a read to resist, and much, much more. There is a cart-load of generalized crap. You have heard "BUTMOMMYINEEDTHISFOR_______" so many times that you are contemplating just exactly what you were thinking in the first place when you decided to reproduce. The love of your life is with you, your partner in this fine mess. He is no help, because he alternates telling the kid to shut up in a tone you just know will result in a call to social services by an onlooker who has not had the priviledge of navigating a store with a kid, with asking you if you really need whatever you have absentmindedly thrown in the cart most recently. (Yes, John I really do need the tampons!) You get to the checkout line, and Grandpa Moses is running the register and manages to comment on every single item the 500 people in front of you in line are buying. You absolutely cannot wait until it is your turn (so, do you find that Super Plus is really all that more absorbent than Super?????). And the beauty of it is this: You are at your wits' end. You are about to kill your loved ones. You really need a cigarette because, at this point, it be worth the risk of lung cancer. The old man at the checkout is taking forever, and this is where they put.......wait for it.............The CANDY! The BUTMOMMY's go into overdrive at this point. By this point, you are at the register and pay $300 for the three items you need that should have been about $10, but is not because the list grew. The kid demands his own bag for every little thing he wanted, so between frayed nerves and telling him to just be quiet, you have to make Grandpa repeat the total 3 times so you can pay him.

After you have paid for your load of crap, and you head to your car. You manage to get the kid into the car and get the heater going for him so you can load up the crap without giving him a nasty case of hypothermia. You try and smoke your cigarette while you load the crap into the car because you cannot smoke in the car. The cig may be worth the risk of lung cancer to you, but never ever for your baby. You are taking your time because, though it is raining/ snowing/ sleeting/ cold out, it is quiet out there. You are at peace for the first time since you pulled into the parking lot 2 hours earlier. You casually turn your head, and you see it! The string of traffic, backed up by some woman who must wait on you to empty your parking spot because it is all-so-much-closer than the empty one two spots down! You really want to teach her a lesson and lean against your car with folded arms until she gets tired of waiting, but you feel badly for the mom in the mini-van stuck behind her who just had the same experience you did and wants nothing more than to get the hell out of this parking lot and get home. So you have to hurry up and finish what you are doing, run the cart to the corral to save the brand-spanking-new beemer parked beside you, and get in the car. Find the keys that you just had in your hand, resulting in emptying the contents of your extra-large purse, only to realize that you are so frazzled that you didn't even know they were in the ignition in order to allow the child to have heat. You try to navigate your car out of the spot with the 2 feet of room the haeffer has given you to back up. You are on your way and turn the corner to leave the lot, when you end up getting stuck in yet another string of traffic waiting for yet another spot to open up.

I have many problems with this, but I'll address that in a sec. These lot stalkers? They are at work also. I came outside from a grueling night shift. I was tired, as I had just finished my 72nd hour for the week, and it was freezing out. Whetever was falling from the sky was a mix of snow and little ice balls. My car had been in this for 12 hours, so my windshield was encased in ice. I have no gloves yet, and have managed to forget to put the ice scraper in the new car, so I have no choice but to wait for the front and rear defrosters to work so I can at least have a 1-square-inch window through which to see. Cue the Lot Stalkers! Follwed by the string of traffic behind them of drivers who just want to pass and find a spot that is open anywhere or drivers who just want to leave that God-forsaken place after a night similar to mine. I have no choice but to wait until I can actually see to drive. I need to find my phone in the bottom of the bottomless purse so I can charge it. I need to find some hardcore tunage to keep me awake for the drive home, which means I have to find the IPod and then find the adapter and plug it into the stereo. And I am being rushed by these #$%^&* people.

So here is my problem: I am fully aware that everyone covets that spot near the front. This desire is 10-fold when it is cold or raining or snowing. I also fully realize that some people cannot walk well, and need a spot close to the front of the lot. But those people should have handicapped parking permits, and thus should have the good spots available to them. I also realize that people are in a hurry to get done whatever task is on their agenda. But is waiting that long for me to leave really worth it when comapred to the 2 seconds it would take you to pull into a spot that is only 2 feet away and already empty?
Don't get me wrong! I don't exactly relish the idea of walking across a vast parking lot after the trip to the store described above, or after a long-as-hell night of saving the world. But I look at like this: I have spent hours walking by that point. What's a few steps more?????

So.....I guess the moral of the story is this: Do NOT be a lot stalker, lest my wrath be upon you!

Idiots Should Not Breed

(Please excuse the numerous posts for today, but there have been several things I have come across in the past week or so that I wanted to blog about and could not. Now is my chance!)

WARNING: This Video contains some female nudity! Don't report me!



Okay...I do not even know how to start this post. I am completely flabbergasted by this. John and I were watching television and we surf through the channels and find this documentary on "freebirthing". I am intrigued, as is John. We stop here and watch the piece.

Women, discouraged by either unsatisfactory prior birth experiences or by those of friends or family, are deciding to give birth at home. Completely unassisted by any medical personnel. Yes, women went through this daily in ages past. But do we really need to do this now?

So we watch, and I become more and more disgusted by the sheer negligence of it all. After all, as an expectant mother, one is expected to surrender their needs in the interest of the baby's well-being. I, myself, had to make such sacrifices, submitting myself to months and months of preterm labor/ contractions that were excrutiating. I wanted the pain to go away. I was exhausted. I could not afford the medical bills that were piling up before my eyes. But here is the thing: I didn't matter. Evan Robert did matter. I endured all of it for him. Up until the very end, I had the most invasive, intrusive, horrendous pregnancy experience one could have. Even his delivery was not something I would tell around a campfire while singing Kumbaya. I was strapped to an OR table with a suction catheter rammed down my throat to clear out the vomit I was at risk of aspirating. I heard him cry, and my tears started flowing because all I could think of was that they had told me his lungs would be in trouble because of his prematurity. He came out with a big lusty cry, which is very rare for c-section babies. I remember thinking "There is nothing wrong with his lungs. There is nothing wrong with his lungs." Over and over again. Then, before I even laid eyes on him, I heard a nurse tell John "Boy, you sure can't deny this one!" followed by John's laughter, so I knew he looked like his daddy before I even saw him. I remember shouting "Can I please see my baby???" And when I did see him, it was from a distance, a brief glimpse of this tiny little miracle swaddled in a receiving blanket. Not exactly a Mother Earth, One-With-Nature story. Was it what I would wish as my last childbirth experience? Probably not. Was it a smashing success? Absolutely! The evidence of its smashing success is asleep in the next room. He still looks just like his Daddy and still has the most robust set of pipes I have heard.

So these women are deciding they want the romantic version of giving birth naturally. That's great. It is true that medications given to Mommy during labor have an effect on Baby. Natural Childbirth is great if you can do it. Medicated Childbirth is great too. Pick what suits you for that stage of the game. But medical personnel are not just present at births for the Mommy. We are there for the baby just as much, if not more. And when you choose to do what these women are doing, you are making the choice to have no one present with the skills necessary to intervene on your baby's behalf if something were to go wrong. I am sorry to say this and burst any bubbles, but a bystander CPR course does not replace a team of medical professionals well-versed in neonatal resuscitation.

I am appalled by this. I am all for choices. For " birth plans" to give a woman and her family the experience they would like to have. But this should not be a choice. At least have a midwife present during your home birth.

So I start looking at some articles on this ghastly practice. I come across the website of the woman who has been so vocally advocating the practice, and I start reading some of the justifications for this "freebirthing". She actually stated that women have been doing this as long as mankind has existed. Yes, very true indeed. But that is because there used to be a day when we did not have such access to medical care. Cars didn't exist. Roadways were not present. Homes were far-flung. We also used to think that smoking was great for the body and bloodletting cured disease. So I keep reading, and see that she goes on to say, in so many words, that infant deaths have actually increased since hospital births have become the norm. I am not sure where she got her figures, but perhaps she is referring to the dark ages when medical personnel were not as skilled as they/ we are now. There was such a time. Furthermore, when Sally gave birth in her bedroom in a farmhouse way back when, and the baby did not survive, did we really have an acurate manner of keeping such records and statistics? Now, when a woman gives birth, there is this unbelievable string of documentation that must take place, These are just a few flaws in this woman's train of thought that I could pick out off the top of my head.

I think these women should be held accountable. If the child were to die, these women and any one participating in the act should be found guilty of manslaughter. I find this as neglectful as it would be for me to try to deprive my son of food or clothing or shelter. If these women do not want to be held responsible for these actions and accept these consequences, then they simply should not reproduce.

Dog-Tired

I have finally experienced the ultimate level of tiredness. An exhaustion you can feel in your bones, your teeth, your hair.

I go to work Wednesday night. It is not the typical work night, as I usually work weekend nights, so I am already out of sorts. I do my twelve hours, not assigned to the ER, but instead to the Surgical Intensive Care unit. I have vent patients in 3 different units of the hospital and spend the night shuffling from one unit to the next, all while weaning a patient in the Post-Anesthesia Care Unit (PACU). Weaning is rather labor-intensive. As in turn down the FIO2, check a blood gas. Turn down the rate, check a blood gas. Turn down the PEEP, check a blood gas. When you get the settings so low that the vent is doing virtually nothing for the patient, you turn the vent to a mode of spontaneous ventilation and let the patient cruise for a bit. Order another blood gas. Looks good? Extubate. So I do all of this. And once 02:00 rolls around, and I am starting to hit my wall, as I do every night, I start counting down the hours until the day shift people come in and I can go home.

But then I remember. Mandatory Inservice. 6 stations of things we do in our scope of practice, but we do so rarely that it is difficult to stay fresh. This is the hospital's way of ensuring that when I have that rare patient who must go to MRI in the middle of the night, I know how to use the primitive ventilator with no metal in it. This wouldn't seem like a big deal to someone who knows nothing about mechanical ventilators. But a vent is not necessarily a vent. The big microprocessor vents are awesome. User friendly. Easy-peasy. And we are all spoiled with those. We forget the fundamentals of ventialtion. How do you dial in a rate if there is no specific way to set a rate? You want the rate to be 12. That means a breath every 5 seconds. In order to get the tidal volume you want, you had to set the flow and inspiratory time. So I-Time can't be changed or you will mess up your volume. I-Time is 0.75 seconds. So to get a total cycle time of 5 seconds, you need to set expiratory time at 4.25. Because TI+TE=TCT=5. Lovely.

But the primitive ventilator is not the only issue. How do you ventilate (safely, without barotrauma) the 1 lb. preemie? What is the best way to complete a protocol on the acute vs. the chronic illness upon admission into the hospital. There is a difference.

So the inservice is mandatory and only being offered on two days. Wednesday and Thursday morning. I intentionally skipped Wednesday's because why would I drive an hour and a half for that? So I planned to go Thursday morning when leaving from my Wednesday-night shift. Completely forgot all about that.

But wait! That isn't it! I also have to do my anual fit testing to ensure that the disposible mask I wear upon entering a TB patient's room will fit me adequately enough to keep me from bringing home the present of tuberculosis to my family and friends. Keep in mind that I failed this fit testing last time. I just do not have much of a nose, and when I would nod my head, as the tester made me, it would create this enormous air leak. Did that mean I got out of seeing TB patients??? Hells to the nah! I am a respiratory therapist! Instead, I had to wear this hood looking thingy. Ridiculous. And it had this fan that worked with it, to circulate the air, so it made this woosh-swoosh sound. I looked like the Ku-Klux-Klan Grand Wizard meets Darth Vader. I refuse to miss the chance to test again, to get the chance to just wear the disposable N-95 mask and not the crazy hood. So I am tired, but I go. And when it gets to the part of moving my head up and down, as in an exaggerated nod, I keep falling asleep with my head in the leaning-back position. Thank God the tester was the mother of one of the other RT's who works night shift. She brought me a very caffeinated a beverage as I was walking out the door. But I Passed.

So I have maneuvered all of the little inservice stations. I have completed the fit testing that is to free me from the Dork-Hood for at least the next year. Now I have to drive home. One and a half hours.

So I know tired now. The tired in your bones, your hair, you teeth. By the time I arrived in my house yesterday morning (I think it was yesterday!) I had been gone for over 20 hours. Blah.

I Hate Fridays

Nope, not that kind. The actual day of the week, before Saturday and after Thursday. I hate those. That is my Monday. But better yet, I cannot sleep like I should when going into work for one of those long nights. I maintain a first-shift schedule all through the week by keeping appointments, running errands, and attending school functions and meetings for Evan. When Friday hits, and I actually slept like a normal preson the night before, I just cannot close my eyes and drift off. I have tried everything and none of it works for me. Poor John has even tried playing with my hair, giving me massages. Anything to help me relax so I can drift off to dreamland. Perfect example: Here I am now, blogging about the need to sleep on Friday, when I should, in fact, be sleeping. Grrrr.

Warning: Rant!

I do not like this man. I cannot put my finger on it, and in our day of prejudices and stereotypes, I have been very careful to make sure it is not for an impure reason. I am all for a minority to be in the White House. I think our country may need it. We have to move forward and grow, and the next step is someone other than a white male moving into the White House. Yay for progress and diversity!

But this man? He is too slick, too polished. He gives rousing and heartfelt speeches and has the ability to say all of the things the American people are wanting to hear. But where is the evidence backing of all of these la-ti-da plans for change? Who is going to pay for all of the programs he is wanting to institute? Middle class people. Me! I am going to pay for it.

Well here is what I have to say about it: People, if you cannot get health insurance, go out and find a job that provides it to you. If your skiils/ education level do not allow this, then change them. It sucks out there, and I had to do what my family needed me to do. We were poor. We had no way to move up. I sucked it up and took 24 credit hours per semester while helping my husband through school, raising a kid and running a household in order to get a job and credentials that would ensure my ability to have the things I need, and to provide my son and husband with the things they need.

We live in the United States. There are so many programs and resources to pay for vocational training or higher education that you can literally get paid to go to school. So suck it up and do it. If for some reason, you are disabled and cannot work or obtain the education to better yourself, than taxpayers like me will be glad to continue to foot the bill for your medical needs to be met. We have been for years. If for some reason you lost your job, as I did recently, we will continue to provide you with federal programs to get food. But to completely reform the government to provide handouts is unnecessary. I say give people a hand up and the tools they need to provide for themselves down the road. We do not need to create more sponges.

And medicine? Yep, we medical people are sheer evil. We want nothing more than to take your money. We will let you die if you don't have the coverage. No, WRONG! I am on the code team at work. I make decisions in the blink of an eye how I am going to help a patient in crisis. The patient is not wearing a gown with "Uninsured" stenciled across the chest. And honestly the only time I have ever looked at a patient's insurance information is to provide them with the best care. For example, the patient has insurance x and needs a test, and insurance x requires a specific diagnosis or criteria to pay for the test, and the patient does not meet the requirements...the test is thousands of dollars. What would you do? Well patients have the right to refuse or accept any procedure. So you let the patient know "Hey, you need this test for x reason, but your insurance will not cover it. Do you still want the test?" It is a courtesy, not a refusal to treat. Other than that, I do not give two shits about my patient's insurance information.

So are we now gonna talk about the costs of healthcare? Pharmaceuticals take a fortune to develop. So, yes, they are expensive. Healthcare professionals themselves are expensive. Look at me, for example. I had to attend college, to the tune of thousands of dollars. I had to take credentialing exams to the tune of thousands of dollars. I have to obtain licensure in every state in which I touch a patient. That is expensive. I have to attend classes and maintain competencies in my field each year. That is not only expensive, but time consuming. So while I would love to do my job for free, I have a family to support, and it takes time and effort to maintain my legal ability to do my job. So I do not come at minimum wage. They have to pay me to compensate for that. Now consider that my hospital employs over 50,000 people, most of which have some sort of credential associated with their name. Do that math. Then consider the equipment they need to allow us to do our jobs. The stethoscope I use to listen to your breath sounds was $300. The ventilator I run costs more than most houses. And we run several of them at a time, so do that math. Then think of all of the little things we use, and all of the disposable equipment we have to use in the name of sanitation. And the upkeep on the high ticket items. And this is just my department of the hospital. So I guess my point is that healthcare is expensive. There is no way to avoid that. We cannot just go revamping the healthcare system in an effort to change that. It will not work unless we all want to live in poverty to absorb the cost of a publicly-run healthcare system. Because someone is going to have to pay for it. And besides, do you really want a disgruntled governement employee to determine if your child gets the surgery he or she needs? I don't.