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.  

All about Q

We were discussing some friends the other night who swore up and down that they would not be like everyone else and only talk about their baby.  Then, of course, they did.  Their excuse was a valid one however; they pretty much did nothing else.  I am using the same excuse for my own myopic focus.  God knows there isn’t much else going on. 

My mom got to come out to see Quinn.  I was really happy she did, because it will be hard to travel between here and Florida often for any of us.  Hopefully that changes and Quinn becomes more, not less, portable.   But at this moment, the thought of putting him on a plane terrifies me because I can only envision him unleashing his spine shivering scream for hours on end (and I should note here that I also HATE flying…..it is so tight and uncomfortable and unpleasant.  Still, it isn’t like you are going to drive instead).  The hope is that we can return the favor at some point this winter when we are climbing the walls trying to get out of the grey gloom.   Time will tell.

We had our first successful outing in awhile last night.  We made it through both a lunch and a dinner without Quinn melting down.  It takes some cajoling and some work, but it is nice to see that it can, Quinn permitting, happen.  As for sleeping at night, it is happening in fits and starts.  Since he goes through many ‘growth spurts’ we don’t (and generally I mean Tia doesn’t) get a whole lot of stretches longer than 2 hours.  It is definitely one of the toughest parts of being a parent.  Dealing with a newborn is hard.  Dealing with work is hard.  Dealing with life is hard.  Dealing with them all on contracted amounts of sleep sometimes feels damn near impossible.  It is a tough balance to strike, and it will be harder still when Tia goes back to work on the 1^st (just a few weeks from now).   Thankfully Tia is an excellent partner and can pick up my slack. 

Work remains a confusing mess.  They finally hired someone to fill my full time position here (after dismissing every attempt I made to work out something).  My understanding is that she was the only one to show up for the second round of interviews.  I have no idea how she will like the gig, but since she is coming from an ER background; I think she will find it tedious and dull.  There are questions being raised if it isn’t just a step back into the system, but at this point they don’t care overmuch, preferring to have someone rather than no one.  I am, of course, a bit out of sorts that they didn’t ask me to take part in the interviews (or at least fashion some questions).  They didn’t ask anyone from the other clinics either.  So, the two people performing the interview have (had?) almost no clinical knowledge and absolutely no clinical experience.  So, the chances they hired the right person seems rather slim.

Of course, even that hasn’t exactly been well planned out.  She is starting on the 24^th and then spending the next 2 weeks training at busier sites before, ostensibly, I will train her here for 2 weeks.  This isn’t a bad idea, since the 2 clinics she will visit will afford her more varied experiences.  However, I officially will not be able to be here full time starting on October 1^st.  This is something that I have made very well known.  In fact, they knew I was going to part time (or wanted to) around Tia’s 4^th or 5^th month and knew the EXACT day I would need to go to part time since mid-July.  Oh, and I have been transferred all but physically since August 13^th.  My supervisor’s response was”, ‘Oh, that won’t work.’  I love it when a plan comes together!  

Speaking of coming together, we evidently are soon to have a manager.  Just 6 months after the last one was let go.  Also, they still have no found a replacement for the full time charge here who left on the 3^rd of August.  So, most days of the week, we have a charge du jour making planning ahead a near impossibility.  It is truly astounding that we haven’t imploded.  

Not much else of interest going on of late.  After all, it is all about Q at the moment.        

Things are different

Last year at this time: Preparing for my fantasy football draft by reading up on player movement, team rosters, and player fantasy values.

This year: Draft set on auto.  Have no idea what the hell is going on.  Watching videos on cloth diapers and comparing hip snaps and adjustable elastic legs (seriously something is wrong with me!).

Last year this time: Need shampoo.  Buy whatever shampoo is on sale.

This year: Look at baby washes, compare them against the EWG website to ensure that nothing in that supposed 'natural and organic' wash is potentially toxic.  Spend 3 hours online comparing cost benefit for things to wash Quinn with.

Last year this time: Free and clear detergent.  Dryer sheets on sale.

This year: Learned what things like 'optical brighteners' are and how dryer sheets actually prevent static electricity.  Buying detergents like Nellie's and Crunchy Clean and questioning why other detergents have so many ingredients.  Using wool dryer balls.

Last year this time: Buy salsa at store.

This year: Pick tomatoes, peppers, onions, etc from garden.  Make own salsa.

Last year this time:  Happy Hour on the patio.

This year: Well, the pic says it all.

2 weeks

It has been nearly 2 weeks since my last post.  Seems both impossible and very very likely.  Honestly, it has been a hectic couple of weeks.

Quinn is still up and down depending on the day (and the time of day).  He has 'colic' very likely, but that isn't much of an actual diagnosis.  Basically it just means he is fussy and there is no medical reason why that is.  All they really know is that it goes away around months 3-4.  They sell a lot of treatments for it, and we have tried them, but none have any proven efficacy and none have worked for us.  He likes the treatments a lot though because they are mixed in sugar.  Everyone has their own suggestions as well, from putting him in a car seat on top of a running dryer to placing some karo syrup in the bottom of his bottle.  In all cases it 'worked for them'.

While we certainly appreciate the ideas, like grown people, babies are unique and seem to sooth in their own ways.  We have found that Quinn likes to be almost violently bounced in a manner that would appear downright abusive from afar.  He also needs to be burped far longer and more vigorously than I would assume is normal.  We have also tried hard to zero in on his cues which are still sometimes mysterious, but we are gradually translating them.  Worst case, only a few more months and this should pass.  God knows what comes next though!

As for work (I always circle around), it remains as much a jumble as before....perhaps more so.  On a positive note, they have placed an interim director and they are committed to getting us a manager by mid September.  There are many possible reasons why it has taken this long, but the most likely reasons are: A. They were paying our old manager a 6 month severance so they did not want to 'double pay' for the position and B. Evidently 6 months was the period of time they could not hire someone for the position without risking a potential lawsuit from our previous manager (I have no idea on what grounds this could be, but because they 'eliminated' her position as a means of removing her, they couldn't 'un-eliminate' it and hire someone else immediately).  Why all of this was necessary vs. just sitting down with her and letting her go for whatever reasons they decided it needed to happen is beyond me, but I can't say I see the bigger picture.  

As for my position, that is less clear.  They haven't yet found a replacement for me.  Of the 3 interviews they arranged, 2 accepted positions elsewhere prior to the interview date and the third neglected to show up at all.  Evidently they are going to try another round of interviews at the end of this month.  Somehow this is better/easier than allowing me to work part time and filling in the spots with a co-worker who already is assigned there every Wednesday and using an on-call or floating from another site (which they often have to do anyway due to census issues at peripheral sites) whatever other day they would like (I am malleable).  In the interim, I have 'accepted' the other position and been transferred per HR.  So, every time I clock in at my current job, I have to clock in as a float or else they will charge my time to the Park......you know, where I supposedly work.  In the meantime, I have been here there and everywhere and most definitely full time.  Just this past week I worked 2 days at EM, 2 at the Park, and one at our Vancouver site.  It is boggling.

They have yet to find a replacement for my supervisor as well, which is leaving the one remaining supervisor (she works 3-4 days a week) a LOT of time to catch up since there is no consistency to who is handing off to her.  Plus, it means we are often short on the floor.  It is every bit as awesome as it sounds.  

And finally, they are evidently working with another local hospital to create a new company that is likely going to swallow up all the clinics within the next year or 2.  This will create a myriad of concerns ranging from how patients are seen to how it will work for us as employees.  I won't bother trying to get into it here, as there is not enough information at present to bother with it, but you can imagine the complications of trying to mash together 2 different systems complete with their own physicians, nurses, charting, and procedures.  Most of the Park's staff are very concerned of course, but since there is little that can be done about it (and it is yet unknown if it might actually prove to be better or worse), there is little reason to fret about it in my opinion.

Quinn is calling.  More later.

rock, paper, scissors

Being back to work is difficult, and not just for me.  It certainly puts a HUGE onus on Tia to take care of Quinn.  She is responsible for him during work hours of course (including getting ready in the morning and travel time, that means she is on duty with Quinn from roughly 8-6) and then she has responsibility for the night shift as well since I have to be somewhat coherent and clear headed to deal with the medications I infuse.  I am therefore generally little to no help after 11 either.  I am sure that it cannot be easy.  There are no scheduled breaks, no real downtime, and no uninterrupted lunches.  Of course, I don’t exactly feel like dancing around after a day at work either, especially when I am still readjusting to it so it is difficult to walk in and want to take full responsibility for him when all you really want is a few minutes of peace to unwind.  In summation: we are both really effing tired.      

All would prove infinitely easier were Quinn to adopt an even semi-regular sleep pattern.   As you can imagine (if you have ever been around a newborn) it isn’t happening as yet.   From what I am told, it might be awhile before it does too (rumor has it 3-6 months).  Of course, by then we will both be working outside of the home, which will create its own obstacles (I foresee a lot of ‘rock, paper, scissors’ matches in the middle of the night).  

The good news is that none of this is unusual.  No matter who you talk to, every parent has been through it and all are happy to regale you with their experience.  It makes you wonder how anyone comes to the decision to do it a second time (or a third for that matter).  Aside from trauma induced amnesia, copious alcohol, straight up prophylactic bursting accidents, or unadulterated sadism, I can’t fathom how it happens.  Certainly with the first child you can disregard the tales, feign utter ignorance, or go forth incredulously believing you will somehow avoid the pratfalls of others, but with the second you have the luxury of your own experience.  One would assume your only response when asked about having another child would be emphatically stating ‘Hell no!”, punching the questioner squarely in the nose, or curling up in a fetal ball bawling loudly like a vet going through PTSD.  That isn’t to say the whole experience is bad, it just isn’t necessarily something I can imagine wanting to go through again.  I am sure there will be a time that I will look back wistfully on these days through the blurry soft-focus Vaseline coated lens of time, but for now I would trade it for a kid that could communicate his wants and needs in manner other than screaming.  

As for work, well that is moving forward in the lurching stop motion fashion of a zombie caught in a strobe light.  I heard today that they called off their ‘on-call’ help at the Park this week because they were told (as was I initially) I was going to be there starting today.  I also heard they are interviewing for my position here tomorrow.  As you can see, communication is a strength.  Hopefully things start coming together soon, because ideally it would be nice to transition over slowly allowing the new person the time and opportunity to learn, ask questions, and feel relatively comfortable before being here by themselves, but honestly as like as not they will just be thrown in the deep end to see if they can swim.  Because, god forbid we think ahead.  

  

Offer accepted (?)

Life is kind of a blur at the moment. 

I have returned to work and today Quinn is officially 1 month old (and -3 days old compared to his theoretical due date).  Though I feel fortunate to have been able to spend so much time at home with him to start (I was only planning on 2 weeks initially for financial reasons) and though it was far more difficult and exhausting than I imagined it to be, I can’t help but feel some guilt for not being there now.  I feel guilty that I am not there for Quinn of course, but mostly I feel guilty that so much is now being put on Tia shoulders.  I feel worse when I hear that it hasn’t been the best of days. 

Yesterday Tia told me she didn’t get lunch until 230 nor shower until after that because Quinn was fussy.  I ended up bringing home dinner, emptying the dishes, taking out the trash, doing laundry, cleaning up the kitchen and spending time with Quinn.  I don’t feel that Tia should have gotten to these things or that she was somehow deficient by doing anything other than existing and ensuring that Quinn did , I just feel terribly that I am not there to take some of the burden from her during the day.  Of course, after I am at work all day, I am tired too.  But, I fully understand her position.  It is a different kind of fatigue and stress when you can never have time to untether yourself from it. 

There isn’t much I can do about it of course.  On the one hand, it would be great for us both to be home taking care of Quinn and trying to help prop one another up.  On the other, it would be great to have the money to pay for food, shelter, and transportation.  Unfortunately, I haven’t found a way to accommodate both simultaneously.   So we split the difference presently: I work for income, Tia to keep Quinn alive.  At least through October anyways, when things will change once again.   

As for work, a curious thing happened while I was checking our online job listings; I evidently ‘accepted’ the position at the Park.  I did this the end of July.  This is, of course, is what we had hoped and worked towards.  However, I have never actually been officially (or for that matter unofficially) offered the position.  I also have only a vague idea based on some general thoughts from the staff there about which days they will want me to work.  Also, when will I start at the Park?  I have heard as soon as next week, but I nothing definitive.  And, of course, no one seems to actually know and there really isn't anyone definitive to ask. 

Additionally, they have yet to hire anyone for my present job(?) and when they do it is unclear if I or someone else will train them (and if it is to be someone else, they will need to train elsewhere as there is no one here besides me that can do that) or whether I will be asked to come back to do that.  I know they have 2 candidates they are interviewing and those interviews are supposed to happen about the middle of next week.  I know nothing else.   

The hope is that tomorrow will clarify things at least somewhat.  Hard to really say though.  My charge nurse returns then anyway, and she puts together the schedule.  The other charge nurse, of course, had her last official day last Friday.  In between, there have just been fill in staffing.  The same as they have used in the clinic.  This helps us all subsist on a day to day basis, but does little to engender long term stability or functionality.  Because, as you all know, there is less buy in when you are temporary and less you really need to be aware of.  For example, when you rent a car, you will put gas in it as required and try not to damage it lest you have to pay for it, but you certainly aren’t taking it in for oil changes, closely evaluating the cause of the pinging sound coming from the engine, or worrying about the tires, filters, et al.  You don’t worry about it because it isn’t your job to do so.  Your job is just to return it in the same condition you rented it. 

As a department, we fix our sites more and more myopically on the present and less and less project out into the future.  We haven’t even had a manager since February.  But, we know who is scheduled for tomorrow and I am sure we will muddle through it again.  And the next day and the next. 

As always, more to come.  Maybe I will have 'accepted' the managerial position by this weekend.  Stay tuned!  

  

I think we can

Today was the first day I genuinely thought, "this is doable."  I don't mean to imply that I thought it otherwise before, but today was the first day that really felt like we began to settle in to the new normal that is life with baby.

Perhaps it is a combination of sleep and another sunny but not too hot day.  Perhaps I am writing this while half crocked on Benadryl and accrued sleep deprivation (which plays some pretty amazing tricks on your mind.......I know longer can say with certainty the exact day or time things have happened over the past month).  Or perhaps it was just Tia and I actually getting out without an actual purpose.  We have made it out to baby showers, MD appointments, to pick up food, and to do some shopping, but not until today to just wander.  We took Quinn up to a local cart pod on Killingsworth and had some pretty horrible Teriyaki followed by us popping down to Alberta to wander about.  It was really nice.  Quinn slept in my arms pretty much the entire time.  He generally is very good while we are out, and then lets us have it as soon as we make it to the car.  A fair trade I suppose.

As is the pattern, Quinn melted down as soon as we got home (we have about 2.5/3 hours max between feedings) and after we got him fed and changed Tia took a nap and I took Quinn downstairs so she could sleep since she very nicely allowed me a good amount of sleep last night and he squiggled and squirmed and cried every few minutes for the subsequent hour and a half.  But, maybe I was just high on a full night's sleep, because it didn't bother me.  And, ultimately, it ended with us taking a nap in the hammock together outside.  Very nice.

Now I ought to finish and post this blog quick before I change my mind.  Every day is a new adventure.

Work

Hidden amongst the new baby acclimating that is eating the lion's share of our time and energy is my still festering work-related concerns; will they or won't they put the pieces of the puzzle together before I return to work next Monday?   Well, it looks like they will.....mostly.

While it has seemed for some time that the job I have been opening ogling at the Park would be mine for the taking, it has not gone smoothly.  To surmise briefly, they talked about it since at least February when I initially expressed interest in moving to part time for childcare reasons.  In the intervening months: my boss was terminated, the plans for my clinic vacillated between shutting it down entirely to expanding it to include another part time staff member and everything in between (and landed squarely upon changing nothing at all), and the position at the Park changed from 3 to 4 days a week and then it was rumored that the current charge there might want to take it over herself rather than work 5 days a week (before also landing squarely upon keeping it as initially intended).  Then, when it all finally looked like it just might work out, Tia had an emergency c-section 5 weeks early and exactly 3 days prior to them posting the Park job...a job for which I was no longer eligible to transfer to because I was on leave.

I have tried to get confirmation that the Park gig was mine.  But, due to what I can only imagine are fairly Byzantine human resource driven policies, no one could say anything directly.  Allusions were plentiful, but statements were difficult to come by.  So, until yesterday there was still a lot of gray instead of black and white.  Now there seems to be a plan...albeit one that is subject to many possible changes.

I go back to work on Monday.  I will return to my old job at that time.  It appears that will only be the case for one week, after which I will start my new job at the Park.  In the interim, they are not hiring anyone for my old position, relying instead on floating people from the Creek down (floating down the Creek? :) to fill in as they are overstaffed and have low patient volumes.  This will work for a time of course, until such point as they do not have low patient volumes in which case they will be in a difficult spot regarding the EM clinic.  But, hopefully that will no longer be my problem and may in fact prove to be a unique opportunity to pick up the odd shift.

What remains fuzzy are the hours/days they will be using me at the Park (what is clear is it will be 3 days/wk) and when they will hire for the EM clinic and how I (or anyone else) will manage to be available to train them at that point.  But, rather than look the gift horse in the mouth, the job is mine and I will be starting it sooner rather than later.  As much as we could have used a few extra weeks of full time pay, we are happy to trade it for the part time position that will allow for less child care for Quinn.  

Now if we could just get Quinn to sleep a bit more.