The Meeting

We finally had the meeting I have been waiting for for some time now.  The agreement with OHSU has been signed.  Finally.  Hopefully this will be the end of the wild speculation, but I doubt it.

What is being promised is pretty good.  They will take all the clinic staff on without any undo difficulty. We wont be obligated to reapply, submit to any complicated HR process, nor have any of our hours cut.  We will also get 'comparable' pay, which in my own digging around is likely to be somewhat less, but not very much (potentially a few cents hourly), but with the added benefit of an actual sick bank on top of our vacation pay and 6% contributed to retirement (vs. 2.5%).  We will also get some union credit, which will help in trying for vacations and possibly other jobs in the system down the road.  

In the interim though, I suspect chaos.  The nurse I had trained to replace me is offically done as of today (and she was pretty darn awesome), so it will be me and clinic once again....though 4 days instead of 5 (or 3).  Since I still technically am employed by the Park, the big question is how long will I be working in the clinic.  The plan, or at least the most recent itineration, has the Park and Mt. Hood going over in the summer, Good Sam by the end of the year (or early next) and the Creek and my clinic at some point around summer 2014.  If they dont find a way to transfer me (and I am not sure if I want them to or not depending on the day), they will end up with a 4 day a week hole in the clinic that they will not be able to hire to replace.  Also, if the other clinicians dont opt to move along, they could look to transfer inpatient (or in other departments).  Ripples are already being felt as I was the plug for vacations and sick calls at other sites, a service I will no longer be able to provide.  I was asked to 'schedule light' but already we have more patients on next week than we had this week, including a 3 day/5 hour each day hydration for the next month and at least one daily ABX patient.  Scheduling light will be more or less at the whims of the referring physicians and less my own discretion.  It is going to be a bumpy ride.  

On the flip side, at least I seem to be soaking up kudos.  Even the nurse executive is getting in the act.  Going so far as to say it would 'be a loss to Legacy, and a major boon to OHSU!' if I chose to stay.  I am definitely keeping that email to re-read on my shittier days.

We are starting our interviews tomorrow (3 all told) for a new caregiver.  The gal that was supposed to take care of Quinn in the short term will likely not be able to due to health concerns.  So we are a bit in scramble mode at the moment.  We have two centers to visit next week as well.  Hopefully one of them turns out all right.  The pressure is certainly on.  

More to come as always.  I am a whipped pup today.  Time to shut it down.  

36

I have been meaning to blog about turning 36, but then I realized there isn't a whole lot to say about it.  As far as birthdays go, it is fairly innocuous.  I guess, at this age, I figure the 5s are the biggies (35, 40, 35, 50, etc).  Perhaps the only thing notable is that it is a square number and I won't see another one of those until I am 49 (that was for you fellow math nerds).

But, work remains eventful.  The gal I trained leaves next Friday.  They have offered me the full time gig back, but we are going to try to 'compromise' to me picking up Mondays if we can arrange childcare (see later on this post).  They won't post the gig, because they are still very unclear on when the OHSU deal is going down.  Plus, by the time they got the job posted, went through the interviews, and got someone in and trained, it would be months.  My next 'ask' will probably be to switch me back to EH from the Park (I officially work at the latter, though I have only been there a hand full of times since August when I accepted that position).  This would be purely for negotiating with OHSU down the line as I would be 1 of 1 at EH, but the least tenured with Legacy of the group at the Park.

Plus, the latest rumor mill grist is that all the clinics will flip to OHSU at one time vs. the initial staggered schedule.  How this will work (any of it really) is a mystery, but there is more chatter from the higher ups that the signing is nigh.  It is incredibly frustrating mostly because there are no guarantees going forward.  Hard to plan for down the line without any idea of what that might entail.

I also recently got a call back from KP Hillsboro about an IV gig I applied to.  I am unsure what to do with that, as it could be the same crew that did the panel with me and never contacted me after.  I don't know if I would have been a good fit for that job anyway, but it seems kind of dickish to have someone go through the processes and not bother to send out an email saying they picked someone else.  Of course, the call I got was from their front line of defense, who is supposed to filter me in or out before an actual interview.  I will call her at least and see if I make it any further than that.

Tia has her second interview tomorrow with the company out in Oswego.  It is a simulation of sorts, with them explaining the project and her explaining how she would manage it.  Even if it proves awesome, there is still the matter of pay/benefits.  KP is pretty effing awesome in that regard.

Q officially broke up with his daycare today......or we did anyway.  It was one more day of them doing stuff they ought not.  Today they gave him wheat toast and butter.......two no-nos from an allergy perspective, especially since we had not introduced him to them.  They are always giving him tylenol because he is 'fussy' and they still talk of his yelling fits (though we have not seen them in months).  This on top of the fact that he is often half clothed for their diapering convenience.  It was nothing huge, but enough little things to piss you off.  So, the search for a nanny (or ideally a nanny share) begins.  Tia is already making contacts.

That covers it all for now.  IF you get a chance, rent 'This is 40'.  Pretty funny (and somewhat poignant at this age) stuff if a bit overlong and with a few unnecessary story digressions.

Opportunity costs?

I had my review yesterday and it was more positive than I could have reasonably expected.  I guess we are our own harshest critics, but it was nice to hear how your peers/supervisors perceive your work.  As for what it means monetarily, who knows?  Generally it just appears in the next paycheck if there is a raise associated.  I have no idea how that is figured out, nor does anyone else outside of HR it appears.  In the end, Tia and I both got stellar reviews (with Tia locking up a promotion as well) and neither of us has any idea if or what it will mean to our financial situation.

There appears to be a number of opportunities coming up at my job (speculatively), but all with possible drawbacks.

1. We have had a floor nurse out on leave for better than 6 months now.  Evidently her time is up and they are finally able to cut the cord.  However, they envision the position as a pediatric position as well as adults.  It was intimated to me that, were I interested, it would be a position I could move into and that, in regards to job security, it is as secure as it gets.  However, the idea of sticking kids with needles and placing lines in month old babies is off putting in the least and terrifying in general.  Plus, it would mean 4-10 hour days that rotate bi-weekly including every other weekend.  This would mean more days in daycare for Mr. Q.  Well, at least we would have to pay for more days (he would only need to attend 2 days one week and three the next, a next 'gain' of one extra day every 2 weeks).  It would cost us as additional $380/month, but I would more than make up for that with my extra hours and the slight addition of weekend pay.  But I would lose half my weekends with the family and that would be a huge bummer.  Plus it would largely take me away from the clinic.  But Tia could possibly cut back to three days a week then.

2.  The new RN I trained, who is excellent btw, is evidently going to relocate back to Texas.  And this is going to happen very soon as she is turning in her notice on Friday.  This of course could mean that they will need a new full time staff person there (assuming they replace the position) and that I could slide back into the clinic.  This would be a better reassurance that I will have a position and that it will stay very local, but would necessitate that Q go to daycare M-Th every week (definitely not ideal) or we could look to a nanny, which would be better than daycare but a LOT more expensive.  Plus there is always....

3.  The clinic buyout which has been rumored and speculated upon since last summer is still lurching its way forward like one of the Night of the Living Dead zombies.  The rumor mill still has much grist to grind upon, with the latest being that all clinics will flip over at the same time vs. a few at a time.  So, the clinic position might not buy me any additional time in Legacy.  But, perhaps this is a good thing?  There is the possibility that the move to OHSU would be a positive one.  Though it is likely to mean a pay cut of some degree (though I doubt an overly large one), it would afford me the opportunity to learn chemotherapy regimens and get certified as an oncology RN.  I have no particular interest in that, but it would make me much more hire-able should we relocate.  Plus, it is likely the benefits and retirement are at least on par with, if not superior to, the ones offered at Legacy.  There is also the possibility that it will be a game of musical chairs with more RNs than positions available.  If that is the case, I have the least seniority of any of the clinic nurses.

4.  The possibility that, if the buyout occurs, they will likely offer a take it or leave it deal.  Meaning, they will come to the affected staff and say "here is the offer to go to the new clinics or you can take a buyout (generally one week of pay per year of service)"  This would allow me to (at least based on past instances from co-workers) collect unemployment and take Q out of daycare completely.  The downside to this is that it also may make it harder for me to get back into the field down the line.  Also, can I handle being a full time stay at home dad?  Plus, Tia would then need to go back to work full time (an option she is mulling presently anyway).  I might also finally be able to take a fair amount of time off and fly out to Florida to visit my family (though the idea of flying with an infant is terrifying.......I might need a sedative)

 So, while all speculative at the moment, it appears there will be much to consider in the coming month(s).  Should be interesting.

Q is starting to rock back and forth in an effort to crawl.  Mobility is imminent.  This will surely be novel, but we will have to keep a sharp eye on the little fellow.  He is continuing to get more and more, dare I say, fun to be around.  He still takes every bit of energy you have, and it is crazy difficult on the days you aren't feeling up to snuff, but for the most part these aren't problems related to him so much as they are things about me.  I certainly try my best and it is getting easier than it was.   It is fun to watch him grow and change and play.  Now if the weather would just shape up a bit and warm up so we can go outside and enjoy it!

I better finish this and eat before Q awakens and I lose the opportunity.  Going to try to take him to the soaking pool today.  He loves it!  It isnt the pool part that concerns me, but the to and from really.  Wish me luck.

Well played Mr. Q. Well played.

Dare I jinx things horribly, but things have been pretty darn good with Q of late.  He still wakes up WAY too early and naps too infrequently, but he is a much happier dude altogether (and hence are we as well).  He is still bothered by an infrequent and unproductive cough, but otherwise has been healthy. Plus, he is finally topping 15lbs.

Speaking of Q, he continues to be very very HIGH energy.  When the MA at the doc's office (a pediatrician who sees kids all day every day) brings in other MAs to meet him because he hams it up so much at the office, you know he is different (and in a good way).  He has such joy for everything.  I wish I could be half as excited and happy as he is when he wakes up from a nap, let alone a long night of sleep.

Today we took him to a pool near Multnomah Village that had a water slide (he is unfortunately still too small) and some spraying water jets and a nice shallow end perfectly sized for his stature.  It wasnt nearly as warm as the Kennedy School soaking pool, but he still had a blast.  Then, he passed out in the car on the way home and had a nice nap before we wandered out to a local 'fruit stand' which also turned out to be a mini grocery with an array of house made sausages, home baked pies, and other delicacies.  We capped it off by trying Lardo sandwiches for the first time while Q actually played and entertained himself enough to let us both eat at the same time!  (As a sidebar, they had on tap one of the best/strangest beers I have had in a very long time (ever?) called Sweet Heat by Burnside brewing; sweet and spicy with a really nice flavor.  Thumbs way up.)  When we got home, Q ate and then, when Tia stripped him for his bath, he peed all over her pants and the rug.  While she went to take off her pants, he then took a shit on the same rug!  It was effing hilarious and ridiculous all at once  :)  Now I am trying to type a blog with cats draped all over me.  I don't know what tomorrow will bring, but I will definitely try to remember today when days don't always go so well.

No new news from work.  Trying to figure out the next move while possibly keeping a step ahead of any changes that might be coming down the road.  Have my review on Tuesday, should be a nice chance to finally chat for a bit with the new manager.  Still working everywhere while they try to figure out what to do with me.  I guess for now, until rumors solidify a bit more I will just try not to speculate too much and keep showing up until something actually comes along.  More to come as always.

2 foot tornado, Euro hotels, and how you know when you are old

We have started calling Q the 'two foot tornado' now as he has a penchant for utter decimation of any area you put him in.  Whether throwing around toys, smashing whatever he can on any hard surface, and projectile spit-up, he leaves a swatch of destruction in his wake.  It should prove interesting when he can walk.....I might need to start child proofing now.

Q has also recently learned the 'bah, gah, and dah' sounds.  He repeats them over and over.  It is actually pretty funny because there is never any context for it.  He just kind of starts babbling when the mood strikes him, wherever that may be.  Also, he is really developing a funny laugh.  Still runs at 110 mph when awake and flails his entire body about like he is on methamphetamines.  Probably why he crashes out so hard when he naps.  Nighttime sleep is still irregular.  Mornings still begin anywhere between 5-630 (usually closer to 5).  Night sleep is pretty consistently around 6.  It is remarkable to see him evolve from this little crying lump over the past half year.   

Tia and I (thanks to my mother-in-law) actually managed to have 24 hours baby free.  It is funny what things you revel in after their absence.  Things like eating a hot dinner at the same time, going places that are decidedly not baby friendly, having dinner at 9pm, and reading the newspaper while having your second cup of coffee.  It was a wonderful escape.

We didn't go far, both because Q is still unpredictable and also because we didn't want to spend the bulk of our time driving.  We settled on McMinville because it was close, inexpensive, and neither one of us had been there.  The town is surrounded by vinyards and has at least one very notable restaurant (amongst a disproportionate number of them vs. the size of the town) and lots and lots of tasting rooms.  Well, the truth is that the main drag is, as far as I can tell, pretty much all there is to the town. It comprises about 6 blocks along one main street.  It is easily traversed in 10 minutes of leisurely walking.  The hotel was one of the McMenamin's properties, The Hotel Oregon.  We opted for the Euro room vs. having an en-suite bath as the idea of traveling a few feet down a hall to save $40 appealed to me (had you asked me that at 5am, when I was trying to locate my key card so I could wander down the brightly lit hall and pee, I may have reconsidered).  It was all pretty typical, and pretty novel considering.

Our new manager started this week.  I don't know when I will actually meet her though.  I have been running all over the system of late as it becomes more and more evident they aren't exactly sure what to do with me.  I will be out at the Hood tomorrow (in Gresham), and have been to the Tualitan and Vancouver in the last few weeks.  I keep hoping that the deal will finally come through for the clinics, just to see if I would finally have an opt out that would allow me to collect unemployment and stay home with Q.  I have doubts it will happen anytime soon, if at all.  In the meantime, I will just keep showing up where they need me I guess.

Last but not least (and most recent), I realized, definitively, that I am getting old.  I was washing the dishes after dinner and I sneezed.  But, since my hands were wet, I tried to hold back a bit.  This was a bad idea.  I felt a tweak down the left side of my body and a tug in my groin.  Now I am actually sporting a bit of a limp.  This is all utterly ridiculous.  If it gets worse tomorrow I am going to tell people it was a from jumping out of a plane, playing some pick up basketball with much younger players, or really anything that has slightly more cache than what actually happened.

I am going to bed to hopefully prevent further injuries.  More to come as events warrant.

Ah, funny but true.

Credit to: http://theoatmeal.com/comics/minor_differences4

It has been awhile........and will probably continue to be

For years, whether anyone cared to read along or not, I managed to post just about weekly....on average anyway.  This through preparing for nursing school, nursing school itself, boards, new jobs, at least a half dozen moves, 2 surgeries, and Tia's pregnancy.  Then, baby Q.  Then, nada.  The only reason I am writing this today is that I am home sick with Q in daycare (the last month has seen me with at least 2 colds, one course of ABX, and the norovirus; Tia with at least 2 colds and a course of ABX, though she has probably been sick the most frequently the last few months; T with RSV and at least one general cold).

And it isn't as though I don't have the time.  I do.  He falls asleep around 6 every night.  It is just that, from 6 until bedtime, I have so little ability to focus an energy on a task such as this.  Feeding myself, cleaning up from the day, and preparing for the next is just about all I have the energy for.  Even reading is sometimes too much, let alone writing.

What I am learning is this is in part due to the fact that Q is very high energy.  I didn't know this until other parents of little kids point it out.  Perhaps he is just catching up from the months of general discomfort and malaise.  He literally does not stop moving when he is awake though.  Often to quite comical effect.  Once he gets his arms flailing, legs kicking, and starts to unleash his pterodactyl screech of joy, he is truly in his zone.  It does probably explain why he needs to nap as often as he does.  Honestly, I want to nap just watching him.  It can be exhausting just trying to keep him occupied (and woe to the person who does not try......he does not suffer such a lack of effort quietly).  However, all things considered, even when he is waking us up at crazy hours and we are collectively worn out, he is just so infectiously happy you can't begrudge him any of it.  It is certainly a joy to hear him laugh and watch him play, especially considering how far from that we were not so long ago.

Q is finally on the growth curve now as well.  At the 3% side of the ledger, but there nonetheless.  He LOVES solid food.  It is funny just watching him try new things.  He immediately lets us know if he is a fan or not.

My job remains largely the same.  I float around a bit more than usual, though I am still primarily at the main hospital.  There is still no concrete word on the new company taking over the clinics.  Still endless rumor, though all proving false in time.  It may yet not happen still.  It may be next month.  No one in a position to know such things seems to have any idea and, if they do, they are reluctant to share it.  In the meantime, we all just keep plugging along and waiting.  We do finally have a director and, at the beginning of next week, a manager (nearly 1 year to the day from the last one getting fired).  Will be interesting to see if that changes anything.

Tia's job continues to be very busy and, if one of the rather large grants gets funded, will get more so.  She is also looking around when the right opportunities present themselves, but it remains unclear if she would actually jump ship.  There is a lot of frustration there, but a lot of camaraderie as well and the benefits are pretty amazing.  But, she certainly has the capability to do other things and I understand the burn factor.

I have been looking around as well when the right opportunities come along, but have had little success getting so much as an interview.  I believe that if I was willing to look at more general positions (med surg) and less desirable shifts (nights) I could find something, but at this point I don't think it would be wise.  I generally like being home with Q and, though it is certainly not easy, it is getting incrementally better.  I am very much looking forward to the spring/summer (which seems so far away at this point. This is the part of the year we would normally get away somewhere sunny for a week, a proposition not in the cards this year) when there will be much more to do outside and he will be much more capable of enjoying those things.

There is little else to catch up on.  Apparently time passes quickly when you are constantly on cold medication.  I will try, as always, to be more constant in my posts.  I will also likely fail in the regard.

Norovirus?

I am as aware an anyone that the 'New Year' is an arbitrary delineation of time and doesn't mean anything.  However, this has not been a good start.

I was already on antibiotics for a persistent sore throat, malaise  and red//goopy eyes.  Tia has been suffering from the same, only for longer than I (though with less acute eye concerns).  Then, I came home Thursday night feeling like my stomach was displeased with something I ate.  Just mild cramping really.  An hour later I was submerged in a warm bath hoping that that might alleviate the now worsening discomfort.  It did not.

The vomiting started very shortly thereafter.  Then the diarrhea.  Then both at the same time (a marvelous feat of multitasking straight from the depths of hell).  I had no idea my body could even hold so much inside it.  Around 11 or so, I realized I had some anti-nausea meds upstairs.  I made about half the climb and then curled up for a bit.  I next recall slowly lowering myself to the bathroom floor and coming to a brief time later.  Around 1, I was in serious internal debate regarding an ambulance and a trip to the hospital.  Thankfully the nausea pills starting to master at least that aspect of the illness.  The rest of the evening was spent alternating between sleeping, running to the bathroom, sweating, and shaking.  It was awesome!  From what I have been reading, it was like as not the Norovirus.

Thankfully, as I write this, I am mostly better.  Still not back to normal, but at least moving in the right direction.  My sincere hope is that neither Tia nor Q share in the joy.  Lots of handwashing, bleach, and general avoidance.  One day this year I am bound to feel good.

In other news, nothing to report at work.  Have still not headed to the Park.  This is largely due to the limited patient volumes there and the new gal's need to learn the minute details of the position.  She is doing very well and is extremely competent, but has to learn all the ins and out of clinical nursing and there are so many to cover.  They are still talking about the possibility to adding a second body to the clinic, but it is unclear if that will be an RN, be full time, or be anytime in the nearish future.  Would be nice if it happened though.

Q had his first swim lesson today.  Did not go as well as hoped.  Not for anything that Q did though, it was just WAY too cold.  Tia pulled him about half way through the 30 minute group lesson, teeth chattering and feet kind of blue.  Evidently the temps were supposed to be about 5 degrees warmer than it was.  Kind of a bummer because we really thought he would love it.

Back to resting.  Stay well everyone.

Christmas spirit

For whatever reason, I just couldn't get into the holiday spirit at all this year.  Well, actually I assume the reason is Q.  I know he is certainly why we were too tired to carve out space and take the time or expend the energy to decorate......at all.  We literally put up nary a piece of tinsel.

Still, it was a pleasant enough day (by Portland winter standards that is, which is to say no more awful than any other winter day here), and I didn't have to work, but I guess I am used to the holiday being somewhat relaxing.  We generally go over to Tia's folks and slowly open gifts, eat, and talk.  But, now with a baby, almost all of the time is spent trying to keep Q occupied and happy.  Going up to the store is sometimes difficult, but putting together a string of hours (because he does not sleep well at home, but sleeps FAR worse away from it) is exhausting.  This weekend we really pushed it too.

Saturday night, we went out to a gathering with some of Tia's workmates.  Her boss (who hosted) has two preteen sons who could not have been better with Q, but even with their help, he had a somewhat hard time being up and out past his usual 6pm slumber time.  Then, we had pics taken on Sunday afternoon, for which he was pretty good, though required an incredible amount of cajoling.  Sunday night he was in mostly meltdown mode at a family Xmas party.

I don't mean to frame it as a complaint.  I know that it isn't like he is willfully being a difficult baby.  He just is.  You might as well blame gravity for the rain falling down.  It is just, well, tiresome.  It makes me feel worn and every minute of my 35+ years.  Seeing his very portable and easygoing cousin today just further emphasizes exactly how much more difficult Q is.

On the positive side, he has clearly been really maturing.  He is definitely starting to chatter more and more, play more actively, and interact somewhat.  He has yet to get to a point where he can entertain himself for more than a few minutes though.  Hopefully soonish.

Have been training the new gal at work.  She seems really nice, though not terribly confident about the clinic as yet.  It still remains unclear how long they will keep me with her, but I hope until she feels comfortable.  Of course, at some point they will take off the training wheels.

Have put in some apps elsewhere with the faint hope that maybe one of them will turn up something.  I know it is always 'the grass is greener' but one of the positions would be a return to an area of real interest, asthma and allergy.  Of course, it is with KP, so I assume I have the same odds of running across Obama at the local Whole Foods.  But, we shall see if I manage to keep up my .000 batting average there.  At least I know it isn't personal, with a number of nurses (including the gal I am training) getting not so much as a call back with many more years of nursing under their belts than I.

Tia is sick....again.  Poor thing has been healthy about 7 days in the past 60.  Not enough sleep, too much stress, and of course no real downtime to rest.  An ideal combination for poor health.  Hopefully her current issues resolved quickly.....for her sake and my own.

I hope everyone had a safe and wonderful holiday.  I am overdue for bed time.....or else tomorrow will be very very difficult.  

Gypsy Curse?

I am 99.9% certain that gypsy curses are not, in point of fact, real.  However, just to cover all my bases, I am going to go ahead and apologize to any and all gypsies that I may have given cause to curse myself, my wife, or my child.  Please let us know what, if any, animal sacrifices, ancient blood rites, and or formal letters of apologies are warranted.

You see, I have spent the past week beginning with a sore throat, GI upset, and malaise and culminating in nausea and vomiting (mostly the former which precludes the latter by limiting intake) and of course a overriding fatigue from a diet of not much more than thin soups and white breads.

Tia has been sick for better than a month and never seems to fully recover.  She has had a long term sore throat, hacking cough, and associated fatigue (exacerbated by never getting a full night of sleep).

As for Q, well I have tried to document his struggles as best I can (along with his successes).  Unfortunately, after we thought we turned a corner, it appears we have just run into another corner.  He has seemingly been experiencing even more GI problems.  He is eating less, spitting up more, and seems to be having a lot of discomfort.  Tia has a call in for him to have some perhaps more invasive GI tests to see if there is something physically wrong.  He fortunately has a little room to backslide, but not terribly much.  I certainly fear he will end up returning to the hospital at this rate.

I hope better posts follow.  Right now there isn't much positive to report.

Fat Baby (or at least back on the growth curve)

Though Q is fighting some kind of gastrointestinal distress (as is the entirety of our household, thankfully save the feline members since I would no doubt be charged with clean up), he has made remarkable gains with the new formula regime.  On the 29th of November, he was 10lbs flat.  Now, less than 2 weeks later, he is 11lbs 14oz.  He put on nearly 3 ounces a day!  He is back on the growth curve (granted, at 5%, but still).  The picture above was taken just 2 days ago after 9 days on the new formula.  Seeing is believing.

Have another appointment in a month.  Hope things keep moving in the right direction.  Only downside to the formula thus far is that it REEKS (going in and coming out).  But, we will take it as a fair trade off.

Nothing else to report other than I was watching many hours of a tattooing reality show today while lying supine in a state of near unconsciousness and I learned that people can (and do) get their tongues tattooed.  Just thought I needed something non baby-related in here.

More to come as always.  

Talkin' shit (literally)

As we are officially off breast milk and on formula now and it is making a WORLD of difference thus far.  Things aren't perfect, but they are incredibly improved.  Less screaming.  More smiles.  Less grousing and grumping.  More play.  Nice.  

As part of this switch to formula, the gastroenterologist wanted a bunch of blood work, a urine sample and multiple stool samples.  For the urine samples they at least gave us a bag that adheres to his skin so there is literally nowhere else the urine could go.  But, for the stool samples, they provided us with 4 plastic 'dixie' cups with lids and asked that we get 'approximately 1 gram in each.'  If a baby eats no solids, they poop no solids.  So, we (and the lab techs we asked) were mystified as to how one might collect such a thing.

Cut to Friday morning.  As I get out of the shower I hear Tia asking for help.  I walk in the nursery to see her holding up what can only be described as a shit covered baby who also has a shit covered baggy attached to his front and she is wanting me to grab a piece of plastic cutlery so that I might scrape off enough for a few samples.  And that is how I ended up spending my Friday morning: using a plastic spoon to scrape poop off my son into a Dixie cup while he was being held aloft over his changing pad.  If that is not the definition of love, what is?

Then, tonight, while I was bathing him for the second time (it was a messy day) he was laughing ang playing until I heard him fart, followed by a few bubbles, and then it looked like an octopus squirting ink while fleeing from a shark.  I couldn't really do anything but laugh until tears came out of my eyes (and then hose him off with the shower sprayer).  

Other than lots of pooping, we got to meet a bunch of our fellow neighborhood gentrifiers at a  gathering for all the new (or relatively new) parents.  There were minimally 8 babies/toddlers there from not more than 10 square blocks around.  It was quite amazing.  Perhaps equally amazing were how many pretty rancid stories there were about each house's history.  Lots of drug dealers, crazies, and even a guy who evidently used to shoot target practice in his basement.  Lets just say the neighborhood is definitely (at least by my definition) changing for the better.  Good to see so many young families in the neighborhood.  Up with families, new businesses, and improved houses.  Down with the whole indoor shooting thing.  

More to come as always.  

Pediatric GI doctor (or how I learned to stop worrying and learn to love formula)

References to Dr Strangelove aside, today we did meet with a pediatric GI doctor for the first time.  This after our Pediatrician (who seems like a really great doctor and a generally good guy) was able to get us in on short notice after seeing him yesterday and finding out Q had gained exactly bupkis over the past 2 weeks.  That failure along with the prolonged screaming fits (mostly by Quinn) and him bowing and arching his back after feeds seems to point to the current regimen being profoundly unsuccessful.

So the GI doc listened to us and basically said she wasn't sure why he wasn't gaining with all the interventions, but did put a plan in place.  Also they want to look at his blood, his stool, and his urine.  Whatever your thoughts are on managed care or HMOs, I have to say that I have been never less than impressed with every practitioner we have met on the pediatric side and adult medicine.  I also can't say that I have ever waited an undo amount of time to see them (dental is another story however) nor have I ever felt like they in some way 'skimping' by withholding tests or therapies.  My experience with Kaiser has been universally impressive, but I digress.  The plan is to switch him to formula only, one that has a form of more broken down proteins that should be easier to digest while we await the results of his labs and work on collecting the other samples.

Obviously, we had hoped to successfully breastfeed longer.  However, 4.5 months is nothing to shake a stick at.  And, there remains the possibility (however slight) that Q might return to it.  That said, if this works and takes care of even 50% of his misery (and ours) I will only question why we didn't abandon the breast earlier.  This might even allow Tia to sleep more (although it will cost me some) because she won't be solely responsible for his feeding.  As with all things, time will tell and I will write about it as we move along.  In the meantime, Q is napping so I ought to do the same.

  

In Diane we trust

There are days when we think we have 'cracked the code.'  Q wakes up, eats, plays, and naps without much fuss and without extensive effort.  He is mostly smiles those days.  However, those moments ultimately prove fleeting and we end up frustrated and utterly exhausted again and again.  We have seen a number of doctors, consultants, and the like without any real progress.  The questions vary, but the answers are always the same: this will pass.  As to when it will pass, well, the answer is pretty consistent there as well: eventually.  But if anyone has dealt with a colicky baby you know that all time is not created equally and a day can seem like a lifetime when he is wailing away and you have no answers left but to set him down and let him do so hoping that eventually he will wear himself out and go to sleep.

We believe that the answer is his stomach or, more accurately, his GI system.  Though he is medicated against reflux and takes probiotics, we are gravitating towards possible allergies.  Or perhaps we are grasping at them.  What is clear is that what we are doing now isn't solving anything.  For every day he is happy and content, there are two where we openly question our decision to have a child in the first place (or at the very least I do).  We knew it wouldn't be easy and that things would change, but we did not expect to be anxious about coming home and hoping and praying that the other one has things under control that day or that moment.  What is true is that we are probably shedding nearly as many tears as Q is.

Thankfully, through all of this, Diane has been there to help.  I wish my parents were nearby as well, because the more help we can get the better at this point.  Yesterday, she took Q for the day and Tia and I got out to see a movie and run a few errands.  All told, we had probably 5 hours on our own.  It was like finally being able to breath again.  We are both so grateful for her help and both so wary of asking for too much of it lest we put too much burden upon her.  But honestly, I don't know what we would do without her.

Speaking of Q, he is stirring once again.   Wish us luck if you've any to spare.

4 months and its dark when I get home

Q just turned 4 months old.  Depending on the day, 4 months seems both infinitely shorter than or further from that date.  I thought I might try to encapsulate the experience, but the task feels nigh impossible and always colored by my own mental state at any particular moment in time.  The best I can muster is something I heard from a patient of mine, “You will experience the highest highs and the lowest lows as a parent.”  A truer statement may have never been uttered.    

I don’t think I have ever felt as tired as I have at points in the last 4 months.  Nor have I so regularly felt helpless and inept.  Raising a baby is very very difficult.  I know that all experiences are different and that some are undoubtedly easier than Q is to deal with (and from working in a hospital, I can see the extreme other side of that coin as well), but for every smile and happy moment there seems to be a an equivalent number of spine rattling screams that sounds (in my head) like a cat in heat getting attacked by a wolverine on top of a chalkboard.  You can’t help but feel badly for the little guy as he is in obvious discomfort (as opposed to just being sadistic), but man alive does that yell cut to the very core of you.  Wine consumption has a very strong inverse relationship with his happiness during the day.        

The time change has also managed to kick our collective asses.  Q seems to have the same grasp on it as our cats do….namely that the sun rises and sets earlier than it did, therefore I must do the same.  This would be difficult if he slept until 7 before and shifted to 6.  But, unfortunately for us, he only ever used to sleep until 6/630.  It has been brutal.  By the time I get to work now, I have generally already been up for 3 hours.  His witching hour has also moved up to about 5/530 as he is ready for bed by 6.  We have been trying to keep him up a bit past that in hopes of delaying his AM wake up, but this is akin to poking an angry bear with a short stick in that you will pay royally and pretty much immediately for the decision.  I know this isn’t just an issue for us; all the kids at his daycare are going through similar straights.  I am sure if lawmakers all had little ones when the vote came up, we would all just mimic Arizona and Hawaii and say. “screw it, leave the damn clocks alone!” 

Other than that, my job seems to have finally employed someone to take over the clinic from me.  She starts her new employee orientation on the 12^th (next Monday) and then will take an additional week (or thereabouts) for EPIC training followed by 2 weeks at the Park.  My guess is she will start up here sometime around the first or second week in December.  Then I will train her for another week or two before…well, before who knows what really.  I suspect I will kind of float about as need warrants vs. being exclusively at the Park, but maybe not. 

It is bittersweet really, but ultimately necessary since they don’t have anyone to regularly fill in when I am not here (and aren’t interested in doing so).  Just yesterday when I came in I saw that a 3 year old had been seen in the clinic.  There was an accompanying note to the effect that they are coming next week (and in perpetuity) and that I will need to coordinate this with our pediatric nurse who will have to be pulled from the floor to attend to this patient.  The doctor would be faxing further notes.  I then asked the charge who had run the clinic that day, “So why didn’t they just go to the pediatric clinic?” to which she responded, “We have one of those?”   And that, in a nutshell, is why we need someone here full time I guess.  Between people not knowing how to check orders, make appointments, seeing patients outside the parameters of our clinic, and on and on…we need someone who can take ownership of these things.  That isn’t to cast blame on the charge or anyone else who works the clinic in my stead, they are doing the best they can with limited knowledge and understanding and exactly NO time allocated by management to learn or be trained.  Like building IKEA furniture without directions, you might eventually build it, but it will take a whole lot longer, there will be a lot more mistakes and you are like as not to have a handful of extra parts. 

We finished up refinancing our house recently as well and I think I have never been more confused.   This is mercifully a pleasant confusion.  We sold back points at close so we wouldn’t have to pay as much out of pocket (with the understanding that this creates a higher total payback, but as we have no intention of living there for 10 years let alone 30, this is a minor factor) and had to bring something like $3500 to close plus the cost of the appraisal ($450).  We figured to be out a few hundred dollars when all was said and done in exchange for a lower house payment that would make up that cost within 2-3 months.  Instead, we have gotten back nearly $1000 above what we paid.  It is all HUGELY confusing.  Suffice to say, we are holding on to the money until we can be sure that it doesn’t need to go back out to somewhere.  As I said, it has been pleasantly confusing…with the possibility of aggravating very much in play.  

Other than that, Yay for the country voting against rape apologists and for the rights of women, the underserved, and a shot at a future that isn’t being sold off wholesale in exchange for profits today.  Oh yeah, also yay for feeling optimistic about our government for once (you know, until they get back in session and gridlock reigns again).  

Under

I had written a post about a week ago at work, but discarded it for being too much the same.  I suppose that this might be as well, but dammit it has been too long between posts! :)

I have been under the weather for what seems like ever, but has been less than a week.  I can't quite get a handle on this cold either.  Usually it follows a pattern of general body aches, followed by the full blown cold, followed by recovery (usually indicated by being incredibly hot).  Well, those phases all happened, but instead of recovery I spiraled back down.  I feel worse today than at any other point during this ailment actually.  Stupid colds.

Q is also going through another cold of some kind.  It just means he is extra boogery.  On top of the drool, spit up, urine, and poo though, it is hard to really notice one more leaky fluid.  I just feel badly for him because he clearly has a much harder time sleeping because of it.  It is his second such ailment since starting daycare about a month ago.  Poor little dude.

Q is also still quite a bit under weight.  This is evidently an issue with him not getting enough feeding in when he is not with Tia.  It is something that appears easily fixed though, just up his bottles by about 2/3 of an ounce and up the feeding frequency a bit.  The hard part, obviously, will be Tia producing enough supply to meet this demand.  I know she will try.  Worst case, we augment with some formula.  He is otherwise very healthy and doing well.

Work remains pretty much the same.  They offered my job to a former charge nurse who had applied for it, but she had some child care concerns and told them she would get back to them.  Of course, she never did.  She just fell off the face of the earth.  Not only did she not end up with the job, but now she isn't welcome to continue working as an on call either.  Hard to figure out why you would want to burn your bridges (especially since she has left and returned previously), but she has.  Had she left her current job though, she would have burned her bridge there (my old boss hired her on at that job just 3 months ago).  Some people definitely don't consider the ramifications of their actions.  The end result is the same for me though, still no one taking the gig.  They are evidently going to do another round of interviews soon.  I won't hold my breath.  Of course, all it will likely mean is that I will be commuting much further.

There is still much talk about the 'new' company that may end up absorbing all the clinics anyway...starting with the Park where I officially work.   Based on the meeting I attended, this doesn't appear imminent, despite the stated goal of it happening the first quarter of 2013.  Rather than bore anyone with the details, let me just say they have a lot of ground to cover yet, not the least of which are HR related.  If it were a house, they would still be in the design phase with, maybe, some rough sketches.

Tia's job remains about the same.  She is overworked and trying to manage it without going back to full time (which would mean 10 hour days).  Her job is made much more difficult because her replacement did nothing, meaning she is not only trying to keep up with current demands, but trying to catch up for the three months she was out.  In typical fashion at her job, the offending party is not really getting any real flack for it.  She is just passive aggressively being written out of projects and pushed out to other teams.  So that other teams can evidently deal with her incompetence.  Seem like not a very effective way to deal with problem employees.

My head is starting to swim a bit.  More to come as always.
 

QT (Quinn Time)

Week 1 with 2 days of Quinn all by myself is in the books.  It was a quite terrifying proposition since he isn't exactly a baby who enjoys a long nap.  He doesn't really nap at all honestly unless he is in motion.  And he seems to be acutely aware of the difference between automated motion (ala the swing) and someone holding him and moving.  Obviously, this prevents you from napping with him......or at all.  In fact, it prevents you from doing anything much besides dealing with Q.

I made it a goal each day to get out of the house with Q.  This takes considerably more time than I am used to and some strategic planning.  Quinn eats pretty reliably every 2.5 hours.  The bottles need to be warmed.  I can't make milk, so I am at a disadvantage there.  So the game is to, somehow, get him fed, play with him until he is at least somewhat tired and make sure he is changed and have all the gear ready to go along with another bottle heated up to room temp to take with and then try to get the baby and all his accessories into the car and on the road.  Again, he does not like to be put down much at all, so prepping yourself is a challenge.  I have found that I can do this, but generally something has to give.  That something, I am finding out, is generally eating.  This has led me to the conclusion that drive thrus were not made for the portly and indolent, but rather for new parents who know that going into a restaurant entails WAY too many steps and is likely to wake up the baby and prohibit eating.  Suffice to say, I think I will become well acquainted with them.  Note to Chipotle, please put in a drive thru.  New moms and dads everywhere will thank you!  

The nice thing about staying home with Q is that I get to see his happy moments.  He smiles and makes all sorts of fun noises and is becoming much much more interactive.  He is still a colicky terror in the evenings, so remembering that he does have another happier side is HUGE.  

I learned from my friend Lesa when her little one was much younger that we all become rather entranced with baby poop.  It permeates many a conversation.  So, Lesa, this is for you:

Q had gone 9 days without a bowel movement.  I used my general nursing skills to assess him, but his abdomen was soft and non-tender with bowel sounds.  He was certainly passing gas.  His pediatrician said it was not abnormal for a breast fed baby.  But, inevitably, the day would come.  Our hope was that this would be visited upon his daycare providers.  Perhaps this is mean, but we both knew that it could be a fairly traumatic experience.  Suffice to say, it happened Wednesday when he was with me.  Thankfully, it happened on the way home and not on the way to somewhere (and since I was on the way home from signing paperwork related to a house refinance, it wasn't exactly a good situation for a blow out).  Also, mercifully, the cloth diapers do a marvelous job of keeping most everything in that is supposed to stay in.  Unfortunately, EVERYTHING in that area was completely and utterly covered in baby poop.  I looked every so briefly at his wipes and quickly discarded the laughable notion that a dozen or more would be up to the task.  So, ran to the bathroom and sprayed him down with the showerhead sprayer.  Then I bathed him.  Then I wiped everything down.  It was pretty ridiculous and funny honestly.  I was dumbfounded.  It was definitely a moment when I thought, 'what in the hell is going on with my life?!?!?'  Ah, parenthood.  

Work remains the same as before.  They are filling in the gaps with a hodgepodge of people, so I spend quite a bit of time fixing things from the days that I am not there.  There is some faint hope on the horizon though...my former supervisor who left in late  July to work in mother baby at another hospital evidently applied for the clinic gig when we realized that the night shift isn't for her (and that it takes about 10 years to move to days).  I really hope she ends up getting it.  She will already know most of what she will need to know to run the clinic, and will just need to brush up on the computing side.  More to come as I hear more.  Still no word on a manager though.  

Tia is back to her job and, unfortunately, the woman who was supposed to take over her projects while she was on leave managed to either do nothing at all or make things worse.  So, she is having to pick up on new projects that got funded as well as undo a lot of the mess that was left for her.  I feel badly for her.  They clearly need her there full time and she just as clearly does not want to do that.  However, it seems like she may have to choose between being full time and getting paid as such or staying at 80% with the expectation being that she will work full time anyway.  She is very very good at her job, so she is in high demand, but it inevitably means that more people want her time and effort.  We will have to see how things shake out.  Again, more to come as events warrant.  

I am going to call this good since I will otherwise sit on this for possibly weeks until I find another time and space to write.   

And then she walked out never to return

The subject kind of says it all….in an impossibly vague way.  What I mean is that the nurse they hired to replace me (you know, the one they went through 2 rounds of interviews and landed upon because she was the ONLY one that showed up after NO ONE showed up to the first round) has quit.  By all accounts she managed to make it through a few days of orientation and then 2 days in the clinic in Vancouver and then decided to move with her boyfriend to another state.  This begs the question, why bother applying for a job when you are planning a move?   Why burn that possible bridge?  I think it highly unlikely that the move was a surprise, as moves like that often are not.  It also remains a possibility that she was just not terribly interested in clinic work.  All pure speculation of course; the salient point still being that they now have no one to fill the job. 

What does that mean for me and for this clinic?   Well, much of the same as now I guess, with the exception of being able to use me EVERY day of the week to attend to patients.  I will be here Tuesday, Thursday, and Friday for, at minimum, the next 6 weeks and likely at least marginally longer.   They are opting to repost the position rather than working with my patchwork solution because, though I can cover all days but 2 a month between myself and some other staff, they feel uncomfortable with this because two other staff members are ‘iffy’ at the moment (one has a sick mother and the other has a bad history of absenteeism and appears headed for a leave of absence if not termination).  Though these staff members are not involved at all with this clinic, their likely extended absences will mean the people I could use would be covering for them instead (welcome to the bottom of the food chain).  I have been charged with trying to keep the schedule ‘light’ on the days that I am not here meaning that the intention is once again to have me run the ‘full time’ clinic on a part time basis.  Frustrating for sure, but beats the hell out of the commute to the Park.  I foresee many problems, but I will just do my best with it.  After all, even if we upset the providers by limiting service even more severely than we already do, there isn't a manager to complain to. 

Tia’s last day with Quinn at home today.  I am sure it will be bittersweet.  I know she would much prefer to have the opportunity to have gone back part time a month ago and eased more slowly into it while still getting a lot of time with Quinn, but they couldn’t make that work at her job and still allow her the full benefits.  I know she would also prefer to work 3 days a week instead of four, but that also ran into benefit issues.  At the same time, I know she is itching to get back to her career and to have some break from full time baby duty.    

Speaking of baby duty, Monday will be the first day I am with Quinn all by my lonesome.  Wish me luck.  I am sure that it will not be easy. 

    

Glitter paint

I am sure I will continue to fail at this task, but I am adamant about trying to keep up with this blog.  My hope was that I will have more time to do so when I am home with Quinn two days a week, but based on Tia’s experience and my own, this seems very unlikely.  It actually seems like I will have LESS time, not more to pursue such nonessential exploits.  Oh well, how much can you really write about baby spit-up and diapering anyway? 

Lets start with the aforementioned Mr. Quinn.  He is actually doing better.  Or at least was.  It seems like he is hitting another growth spurt complete with ramped up feeding frequency and seemingly ending grousing.  Thankfully, these are generally short lived.  Regretfully, I suspect this will be a constantly repeated cycle.  But, for all the grousing, he is doing very well.  I am sure it will be good fun when he becomes more interactive.  At least he is throwing out some smiles now. 

As for work, the end of full time is nigh.  This is the last Wednesday that I will be here.  The last week that this is ‘my’ clinic.  It is truly bittersweet.  I really wish something could have been worked out to keep me here in my current role, but there was no compromise available and it is much more important to me that I have time to spend with Quinn and that he doesn’t have to spend the majority of his week in the care of strangers.  I can only hope it mostly goes well.  I know it will be a learning curve. 

The new girl won’t start here for another week +, that is assuming she has started at all.  I have heard nothing and likely won’t.  I won’t meet her until the first day we are scheduled together on the 9^th.    I certainly hope it works out well, though there will always be a part of me that hopes it doesn’t work out too well.  At some point, it is still my goal to return to this hospital and this clinic after all.    

As for the Park, it still seems like I will be elsewhere as often as there.  This doesn’t bother me in the least.  The Park is actually the furthest from me of all our sites.  I told the charges as much.  I would have just taken a float job except that: A. It guarantees you no hours, B. You are always first flexed out, and C. No benefits.  I am kind of going into this job with the mindset that I will pretty much operate as a float, only with a set number of hours and days.  They are also opening up some kind of hybrid position for anyone wanting to pick up shifts on the weekends.  It would be a 5 hour gig (8-1) doing rounds/starts at GSH.  Picking up a shift every couple of weekends could mean a few thousand a year extra….assuming they keep that going.  Of course, as with everything else here, instability is the only kind of stability we know. 

Other than the usual goings on, there is little else to report on at the moment of note other than:

-          We (nurses) get a raise in October of 4.5%.  Awesome!

-          I met a patient the other day (and I meet some doozies) that supposedly injected glitter paint into themselves.   It just reminds me that people have an endless capacity to do themselves harm and that, no matter how long you are in the profession, there is always something that shocks you.  

Daddy's Day Off

On Monday after work I lost my car keys.  I had them, obviously, when I got home.  I changed out of my scrubs and into some athletic shorts and went out to wash my car.  Afterwards I took Quinn for a bit and, since it was during his witching hours I watered the lawn, hung out in the hammock, the rocker, the bed, and pretty much anywhere I could take him that I thought would quiet him for a bit.  Somewhere during this period of time the keys went missing.  That night, I went through the entire house twice, checked behind every couch cushion (I found my cell phone there not to long ago), and under every surface.  I even took a flashlight through the front and back yards to no avail.  I went through the same thing in the morning, with the same outcome.  I knew they were somewhere nearby, just not where that might be.  Right as I was leaving for work after grabbing the spare set I went to put my work shoes on and.....there they were in the left shoe.  I have no recollection of putting them in the shoe, but either I did that or they fell out of my pocket and into them somehow.  This is the result of trying to do a full time job on a part time basis and doing so with chronic headaches from stress and lack of sleep.  That was how my week began.  

By Tuesday I had reached my limit.  So, today I called in sick.  I never feel great about calling in sick, even when I am actually sick.  I still do it when I am well from time to time though because, well, sometimes I just NEED to.  This might be the first time I have done so for spite however.  

I won't belabor the point, but I am not supposed to be working 5 days a week.  I am doing so to 'help' out while they evidently sit on their hands.  As a 'compromise' they allow me to come in only when I have patients instead of the entire day.  This evidently means that they are not obligated to do a GD thing about the clinic in the hours I am not there.  Most of the time this would be fine.  This week it most assuredly is not.

I have 7 unfunded patients currently.  2 of those patients require weekly dressing changes only.  The other 5 need daily infusions.  All have sketchy and largely illicit reasons why they need to do this.  The company that does home infusions refuses to see these patients because they cannot pay.  Our clinics have no choice in the matter.  Since I am only in the clinic in the afternoons (save Wednesdays when I have typically been there the entire day), I have to either find a way to squeeze them all in a relatively compact time frame or send them elsewhere.  However, all the clinics are presently inundated with much the same so there is nowhere to send them.  On Tuesday I had already scheduled 9 patients to come in Wednesday.  Too much for just me to deal with.  I then had to turn away no less than 3 paying patients (a blood transfusion and 2 hydrations) because there was literally nowhere I could put them without displacing someone else.  Were I running it like a business, I would just tell the nonfunded patients, "sorry, your spot has been taken," but obviously that isn't how we run it.

Normally I would ask for help from my manager.  However, if you have been following along, we don't have one of those.  Perhaps I could ask my charge?  Nope, she isn't back until Thursday.  So, I asked the 'charge du jour' if we could contact Candy who wants extra shifts and has clinic experience. She instead opted to ask Brandie, an on-call, who told her 'I will think about it.'  On Tuesday I followed up and was told they hadn't yet heard but that 'I shouldn't worry because surely someone from the floor would be available.'  Which means it would be wholly dependent on them being fully staffed and not being overly busy and, oh by the way, that I shouldn't expect anyone with clinical experience whatsoever.  I opted instead to screw them over.  I could not be more pleased about this.  I am so entirely, completely, and fully done with that place.  I can't wait until they are forced to move me into the position I accepted and was moved to nearly 2 months ago.

And, thankfully, it turned out to be a pretty pleasant day.  Quinn was, until his usual 6-8 foulness, quite good.  We even made it out to McMenemin's Mommy Matinee to see Ted and have some food and a drink.  It was lovely.  Quinn slept through most of the film.  We also managed to get a few other items ticked off our collective 'to do' lists and even fit in a short nap.

In the end, I don't necessarily feel good about putting the rest of the crew in a bad position, but I don't much like being put in one all the time either.  I am already doing a job that NO ONE in my department wants to do, and doing it without any support whatsoever.  I also have a few new orders for patients that I have no idea how to even go about scheduling since I know full well that the only way they can be seen is if I choose to come in early to see them and I am no longer willing to do that.  If only there was anyone in charge to ask.  If only.