Ink Master

I know a lot of people eschew television.  I am sure the reasons are varied.  For us, it is the combination of a lack of time to watch it, a lack of interest in watching very many shows, and the prohibitive cost considering the other 2 factors.  If it were, say, $20/month, I am sure we would still have cable and not just use an antenna.  Honestly, I bought the Roku thinking we would use that, and I rarely do.  Thankfully, the cost of the Roku and the cost of the antenna were negated by just one month of not having cable. 

My point, and I do have one, is that in spite of the fact that we watch little TV (wasting our down time on the internet instead), I see some positive effects of it.  Now, I want to be clear, there is a lot of crap on TV that I cannot imagine has any positive effects.  If you glean any life lessons from Keeping up with the Kardashians or The Real Housewives of (insert city here) or find anything redeeming in the Bad Girls Club or Toddlers in Tiaras you let me know.   But, sometimes we just want to be entertained (hello football).  Sometimes, however, it can change how you view things.  

Case in point: food.  I have learned more about food from TV than almost anything else save eating.  I know far more about preparing, cooking, and presentation (not that I have mastered any of the 3) from shows like Top Chef and No Reservations.  From the latter and from Andrew Zimmern, I have learned to try (and I succeed far more often than not) foods outside of my comfort zone.  From this, I have learned to like a much broader variety and am always clamoring for something new and different.  This palate expansion has also expanded (to a lesser degree, but still significantly) Tia’s palate.  I may not like all the things I have tried, but I have tried them because they have been demystified on TV. 

So, in a roundabout way, I can credit (blame?), TV for my new tattoo.  I have long found them interesting, but the idea of walking into a shop and trying to pick an artist or a design was frankly intimidating.  Plus, the actual tattoo itself seemed like it would be painful and bloody.  Ultimately, it was neither (well, barely both actually).  The show, Ink Masters, led me from conceptualization to realization.  It demystified the process in the same way as the cooking shows did.  It gave me some ideas on what to look for in an artist, how to pick a shop, and what the process would be like.  It alleviated my fears.  

So, this past Sunday (nigh 2 days ago) I found myself in a chair with someone jabbing an ungodly amount of small needles into my arm.  It felt less like needles going into your arm and more like they were scraping across it.  The tattoo gun is so rapid that, after the first few seconds, you don’t notice it much more than a tingling sensation with rare blips of minor pain.  Following the tattoo, it feels raw…..almost sunburned (and still feels that way, though less, today).  Evidently over the coming weeks it will dry and peel and then, it will just be there.  For now, it is just a strange site.  It’s as though I expect it to wash off one day in the shower.   But, I am very pleased with the result. Now the next question is, will I want another?

Pic to come once it heals up.    

Random thing to remember on a shitty day: A patient of mine’s sister called yesterday to ‘see I was working today, because they were going to cancel otherwise’ as they ‘had a tough experience the last time in.’ This same patient had already transferred clinics due to difficulty accessing her veins.  I had the good fortune of being successful on my first try.  I am evidently the only one who has had this success.  So, with much trepidation, she came in for her medication and I was able to get her again on my first attempt.  After which she said, ‘I hope they are paying you what you are worth’ and wanted to be certain I would be there on her next apt.  Her sister hugged me and thanked me.  It feels good to have that positive feedback.  God knows if I will make it 3 for 3 the next time though!  

generic update

Trying to tie up a bunch of disparate events with some overarching story line that binds them together nicely like the better episodes of your favorite sitcom, but failing due to a lack of a roomful of writers so I will just go bullet point style instead. 

-          If you aren’t watching Breaking Bad, I am sure you are a lot more heart healthy than I because it feels like someone is sitting on my chest while I watch it.  Utterly amazing.  Both sad that it is winding down and impatient to see how they pull it off.

-          Sun River was a pretty darn successful family jaunt.  Cars = ability to stop and stretch at random intervals.  Plane = cramped with unhappy and very squirmy kiddo (same for dad).  So, while the theoretical 3.5 hour journey took more like 5 hours inclusive of stops, it made for a happy baby and happy parents.  As for the place itself, it was really nice/strange.  An entire planned community down to the stores, trails, and recreation center.  Massive undertaking I am sure, but quite lovely results.  I think Q will enjoy it more when he is a bit older.  For now, he just really liked playing in the sand and probably enjoyed the water feature at Wilsonville Park more than the massive waterpark like SHARC (link) rec area.  He also was not a huge fan of the lava tube.  Dark and cold is not for Q. 

-          Night Terrors = Holy shit!   Quinn got his first one of these and oh my god it was terrifying….perhaps more so for us.  He just screamed for the vast majority of an hour and refused to open his eyes.  Like he was in a trance.  How come there are no such things as night joygasms?  Same reason I wonder why dementia is always negative (people stealing from you, poisoning you, etc) vs amazing (thinking you are drinking cocktails in the Carribbean, thinking your ham sandwich is a perfectly cooked steam, etc). 

-          Work = Same old shit.  Just trying to persist until OHSU takes over.  Though, the most recent negotiating stances are not looking too hot (link).  Will be interesting to follow it from afar, but they are going to a mediator, which is the first time this has happened since the strike in 2001 (which lasted about 2 months). Main obstacle seems to be the retirement funding.

-          Meanwhile at Legacy, they did another survey of the field and are bumping us another 2% and then, in January (should I still be employed by Legacy and not OHSU), another 2% for having my BSN.  And, I ought to be eligible (again, if I am still employed with Legacy) for something when my anniversary comes up in March. None are big jumps and none will certainly put me any closer to my goal of retiring in….well, now really, but totaled they are certainly very nice indeed.

-          Sign I am getting old: I am super excited about a new Mazzy Star record.  Evidently the last release from said artist was 17 years ago when I was finishing up high school.  Sigh. 

-          Sign I am getting old #2: I am way more amped up for 3 books from my favorite authors coming out within 2 weeks of one another than I am about any movie, concert, or show this past year.  Hope this is a geeky trait I can pass on. 

-          Not missing TV yet.  Still able to catch Breaking Bad online along with my current favorite (or at least currently airing favorite) reality show Ink Master.  At least until Top Chef returns.  Plus, throw in Parks and Rec to complete the TV set.  Other than that, don’t really follow anything else.  Feeling more and more like a cultural nomad. 

-          Psyched for Sunday.  Will see if I feel the same way after. 

Fees fees fees

The thing about money is that it is highly confusing.  The more you have, the more confusing it gets.  Or in the words of the immortal Jay-Z, "Mo money, mo problems."   Of course, I would love to know what kind of problems the amount of money he has might be.    

When I was really young, it was making sure I had gas money and maybe something to go out.  If I didn’t, then I went nowhere.  As I got older, it was as simple as balancing my checkbook and making sure bills got paid on time.  Then, when I got married, it was trying to figure out how to balance 2 differing views of finances (thankfully not wildly different), putting money into retirement, and shuffling multiple accounts to pay bills.  Now it is all of those things plus money for Quinn’s college and trying to oversee our investments, you know the ones we pay someone to oversee.  It starts to feel overwhelming and things start to fall through the cracks some.  Mostly it is the investments. 

What we are learning is that our advisor did a good job getting us to pull together all our debt and investments, make sure we had adequate insurance coverage, and had open discussions about our finances.  What she was poor at, was actually investing our money.  Our returns have been pretty much flat and the fees wiped out what monies we might have made.  Those ‘fees’ end up being somewhere north of $3000K annually without any real clarity as to where and why.  We just kind of assumed it was standard practice…and are only now finding out that isn’t necessarily the case.  Sadly it took something as innocuous as Tia filling out an online survey that has led us down the path of changing with whom and how engaged we are with our finances (In the survey in question, Tia just mentioned that Erin had forgotten to do things on occasion that she said she was going to do and it turned into something much much bigger than it should.  This also explains why we have no interest in continuing with Ameriprise, even with a different advisor).  Truthfully, it feels like one more thing on an already growing pile, but I suppose we will need to carve out the time somehow.   It is kind of important after all. 

So, now we sit on the precipice of another meeting with another advisor where we will try hard to explain our position, monitor an active toddler, and decipher the financial speak that permeates but rarely seems to find permanence in my mind.  And hope that this time it works out better.  At least we didn’t figure this out many years down the road. 

Speaking of down the road, it is looking more and more like moving will occur sometime down the road too.  The reality has been eye-opening to say the least.  Ultimately, there is no ‘inexpensive’ place to live in Portland and the surrounding areas.  The property taxes and all the addendums to them that Portlanders love to support (hello Art Tax) are onerous, but not much more so than elsewhere.  You are still going to pay about $1000-$1100 per $100K in home value.  And the homes are all about the same as well, save a few pockets where premium prices predominate (and those aren’t areas we live in nor can or want to afford to live in).  West Linn, Milwaukie, Oak Grove, Eastmoreland, Tigard…and on and on, are all about the same.  If you want 3 bedrooms, 2 bathrooms, and somewhere near 1500-2000 sq feet, you are going to pay between $250-$350K.  And, if you are near the bottom of that price point, it is likely the house is going to need updating, so you might as well not bother.   Sigh.  For now, it is looking like private schools will be the way to go.  Though thankfully we are many years from that.  

Work is finally (at least theoretically) going to slow down some.  We officially disengaged ourselves from the Park, and the Hood on Tuesday.  They are now in the hands of OHSU.  As for this clinic, still no word.  Maybe eventually…maybe not at all.  All possibilities remain in the air.  In the interim, keep showing up until I hear otherwise. 

Quinn is starting to enter his ‘shyness’ around strangers phase.  It is kind of cute really, since it generally involves him running to either Tia or I to ‘hide’ or be picked up.  Big change from his usual social butterfly self.  Will be interested to see how long it lasts. 

Off to work another day.  

Sitting waiting watching

Feeling particularly strange at the moment.  Had one of my 'flash migraines' earlier, took some meds and fell asleep (while Tia mercifully took Q out somewhere).  Now I feel spacey and kind of hungover.  Actively tossing around the idea of a 'sick day' tomorrow, though this one might actually be justified.

Spent the last 2 days up at SC in Vancouver filling in for sick calls.  At least that clinic is comparably close and I get to go against traffic both directions.  Plus, it is nice to work with other people.  I worked with a gal the other day who seems to be having a rough go of it with the charge up there.  It is a bummer, because I really feel like she is a nice person (though Tia says she no longer will take my opinions of anyone at face value because I get along with most everyone).  I admit that, much like the charge at MP, I completely don't mind working with them because they are competent and skilled, but I also would hate working for them at their sites because they adhere to zero patient standards (ambulatory and ability to self care are requirements) and let doc offices trample/bully them.

While I was working with the nurse in question (Julie) she was telling me she worked with a float (Diane) I worked with out at Mt Hood who, after what was evidently a rough day, apparently told Julie that "Bryan would just tell such and so patient/doctor to find some other place to go."  And it is true.  I also hear that from my direct supervisors who would love nothing more than to have me run the other clinics scheduling for that reason alone.  While I worked with the float at Mt Hood, I refused to perform a phlebotomy on a patient who couldn't transfer with even a 2 person assist.  I also have turned away patients who are otherwise inappropriate for the clinic, fired patients who neglect to show up or call 3 times, and tell doctors and their offices repeatedly that I cannot take their patients when I feel it is unsafe.  None of these things make me belligerent or fall outside of the parameters of what we SHOULD be doing in our clinics, however, most do little more than take the patients and deal with it.  Which is why I would have HUGE problems working at the other sites under those charges.  The big difference is, I would make it known instead of just dealing with it.  I am not big on brooding in the dark for long.  I prefer to eventually just have it out and deal with it.

That isnt to say I don't think I am a very accommodating nurse/employee.  I absolutely try to get my patients in when I have the availability.  I also take very good care of my patients at all sites.  It is a big of a brag, but I hear it often when I visit other sites how much the patients like me (this little old lady thanked me for being so nice just the other day and I got a heartfelt thanks from a pt at MH who I worked with a few times over the months who told me how much he appreciated my positivity and listening to him).  I take considerable pride in that connection with the patients because it isn't like they are visiting a hair salon or a restaurant, they are seeing me for medical conditions that are at times debilitating.  I feel like, as such, they deserve nothing less than skilled care, a positive attitude, and any measures I can provide to make them feel comfortable and at ease.  It is the thing that I feel separates the good nurses from the mediocre, and that is remembering that patients are people and not just a series of hurdles you have to cross to make it through the day.  Hell, I know I even forget that at times.  

Not much else on the horizon at present.  Spent the last few nights at various parks around us listening to summer concerts with Q.  I have to post my new favorite current pic of him running through the water feature during the last show.  Also took him to the children's museum, for the first time today.  Total blast!  He spent most of it between the toddler area and a room full of dump trucks and rubber 'dirt'.  Can't wait to take him back.  

We tried

Having a small child certainly makes it hard to blog.  Honestly, I am only writing now because he is out with his momma (meaning they will be home any minute).  On to it.

We continue to try to find a place in Milwaukie.  We have had to kill off the idea of building or splitting a lot for the time being; too expensive.  Plus, too much time that we just don't have.  We found a lot that was dividable, but it turns out that means you need to get approval from the city planners.  They would need to issue a variance (which costs money) and could be even more expensive if they ask you to make improvements.  Then you have to contact water, gas, electric, etc and have those hooked up.  That costs money.  Then you will probably want to have, you know, landscaping, fencing, and some means of getting from the road to your house.  You guessed it, more money.  Long story short, even splitting a lot and lowering our overall cost by about a third still put it pretty much beyond reach.  So, back to the drawing board.

One of the main reasons we wanted to split a lot with Tom and Diane was an effort to try to create more of a communal/familial vibe.  Help each other out and work collectively on the land itself.  I am not writing the idea off completely, but it clearly is going to have to come about another way.  

Shifting gears, we are currently waiting on lab tests for our kitty Dexter.  Based on his initial lab work, they think he might have cancer.  Chemotherapy exists for cats but it is both expensive and of little value in extending the life of your pet, so it isn't on the table.  They can pretty much offer him steroids......and I haven't read more yet in an effort to 'keep positive' because I am going to break the eff down when I lose him.  Still hoping it is something simpler and correctable.

So much for floating less at work.  They changed the schedule after my meeting with Vicky to make it so I don't float near as much.  Well, they at least made it so I don't float as much through advanced scheduling, but I am still all over the god damned place when sick calls come in.  I spent a day at the Park and a day at MH last week.  I got a message to go to SC (in Vancouver) tomorrow and then I am scheduled for the Park again on Friday.  In theory this kind of shit should happen less once the other clinics go away in September (then it will leave our department with only my clinic and SC), but it seems like an interminable wait.  Maybe I should just be 'sick' tomorrow too.

Not much else of note.  Quinn has learned the pleasures of spinning until he loses his balance, climbing into his toy box (and any other box), making pretty much everything into a hat (including his actual hat), and generally just being a silly goof.  He is (98% of the time) a lot of fun.  He will wear you clean out, but we still laugh every day with him.

Cutting the cord

Well, it is official, we are cable/satellite free.  How long we will be is the question as I cannot recall ever not having cable.  Even in college, it seemed a necessity of sorts.  And yet, in the past 2 weeks (well, close to anyway), it has not been missed.  I still have a satellite dish to take down (it is evidently 'ours' as Direct TV will not remove them nor accept their return) and an antenna to install in it's place, but for the past few weeks we have been using the ROKU and watching TV online, if watching anything at all.

Now I won't profess now (or likely ever) to be anti-television.  I still have shows I really like and will try to find online (Breaking Bad, Game of Thrones, Parks & Rec, Top Chef) and will want to watch at least some live football, but I honestly think I can find those shows through other means and for far less than the nearly $70/month the second year of our two year deal was costing us.   In fact, paying that much for as little time as we spent watching TV seems patently absurd in retrospect.  Like all other things, it comes down to cost/benefit, and the cost was outweighing the benefit for now.  I hope it stays that way for awhile.

Work is at least somewhat better now that I don't float as much (thanks to my manager for intervening on my behalf).  I have 2 more float days this schedule (3 total over 6 weeks), but it is less than half what I was originally scheduled to do.  The last few days (and most of the last week honestly) things have been really slow with a pretty incredible 'no show' rate.  Even my float out to Mt. Hood yesterday resulted in little more than a few PIV placements and not much else.  It has been a nice lull, but it makes the days and weeks seem so much longer than they are.

We are in the contemplation stage regarding moving......again.  This time to Milwaukie.  The idea is that the schools are better, the houses somewhat less expensive, and we could procure some more space for Q to roam about.  The reality is that it will not be easy to do.  But, if we find the right fit, maybe.  Per our Realtor, and with what we are seeing around us, our house has appreciated quite a bit since we purchased it over 2 years ago.  Something in the neck of 20%.  This is somewhat astounding to me, but also pretty awesome.  However, that is happening around us as well.   So, Milwaukie homes are not proving to be all that much cheaper.  The taxes are also about the same.  Oh yeah, and Q won't be going to school for another 4 years and, in the interim, we will both be losing our easy commutes, proximity to Parks/restaurants, and our house which we both really like.  So, again, I think it will have to be a near perfect storm.  But, it is fun to look in the interim.

Gotta run.  Q will be awake again soon enough.

1 year

Quinn is now 1 year old.  1 year removed from that night that is still seared into my memory for its general confusion, borderline hysteria, and a gnawing fear that we wouldnt all make it out okay.  Mercifully we all did. 

 

What followed was 4 months (plus probably a few weeks) that remain somewhat fuzzy in retrospect.  Did I really stay up nights until 330 in the morning with him?  Did we really sleep as little as it seems?  Was it as bad as I remember?  All I can be sure of is that it wasnt pleasant and at times, perhaps much of the time, it seemed like it wouldn't ever end.  

 

And then, slowly at first and then with increasingly alacrity, it did.  The 'formula' that changed everything.  Yes there was still reflux.  Yes there were still times of screaming with seemingly no cause, but it was less and less and much more manageable because of it.  He started putting on weight and stopped needing to be bounced up and down trampoline style following each meal.  The world began to be more or less 'right.'  

 

Since then things have rarely been easy and have become constantly different.  There is no more 'sleeping in' on the weekends.  There is no such thing as a 'quick run to the store' nor a few hours spent going from place to place.  Our house is always 'messy', even when it is not.  Our pets, our yard and our house are much harder to maintain for lack of time (and often fatigue).  Alternately, there is a lot more smiling and laughing.  A lot more adventure.  A lot more experiencing the world in a way I havent since I was a kid myself.  Plus it is fascinating to watch him 'become' a little person.

 

As for whether or not we will opt to repeat this experiment, I still have no idea.  I would say I lean heavily towards 'not a chance in hell', but that would be disengenuous.  Honestly, I don't know.  And, even if I did, time has a way of blunting the edges of resolve.  3 years ago (hell, probably closer to 2 than 3), I would have said that there was not a chance in hell we would have Quinn.  And now I can't imagine it any other way.   

Warehouse deals and at least all kids are pretty much the same

Who doesn’t love a bargain?  Clearly pretty much everyone does or there wouldn’t be so many ‘sales’ going on all the time (I am looking at you Macy’s).  No one wants to pay retail.  However, with something like a shirt, it is hard to really compare the prices, especially when companies sell their own brand(s).  As such, I am claiming my love of Amazon Warehouse Deals. 

For reasons that defy easy explanation (at least to me) Amazon sells ‘used’ goods for as much as, if not more than, 50% off.  I have purchased quite a few things through that service and, thus far, the discount is almost exclusively due to damaged packaging.  Buoyed by my recent spate of small purchases, I decided to go all in and buy something I have had my eye on for some time, a Dyson vacuum.  I know I am a bit obsessed by vacuums (much to my wife’s chagrin), but am starting to see them the same way I view shoes.  You can buy a few pair of cheap shoes or one pair of really good ones and, over the long term, the good pair will outlast the cheap ones and eventually save you money (even if you were reluctant to spend 3 times the price of the cheaper shoes at the time). 

I waffled a lot on my vacuum purchase.  Reviews (opinions) are like assholes after all, everyone has one.  So, for every few glowing reviews on (insert whatever vacuum), there was a scathing one.  No matter if you were talking about a $70 basic vac or a $1499 Miele (I shit you not, they literally can cost that much).  After visiting a vacuum store and nearly convincing myself and Tia that we needed something in the $700-$800 range (though we didn’t want to spend more than $500), I opted for the Dyson because of the availability of expansion tools,  the cost of those tools, the certification from the asthma and allergy foundation, and the low maintenance costs (no bags, reusable filters). 

Dyson’s are not cheap, the retail price was $470, and you can pick up a refurbished model (something I did with my Ipad, though that was through the manufacturer) for about $350, but that cuts the warranty from 5 years to 6 months.  Or, you can buy a ‘used’ model that comes in the original packaging (albeit damaged packaging), unopened, with full warranty for about $320.  Since this isn’t an action figure and I have no intention of displaying it and keeping it ‘in mint condition’, the condition of the surrounding box is of little consequence to me.  So, in summation, the box that the Dyson comes in is evidently worth about a full third of the cost of the machine, or around $150 dollars.  Gotta love Amazon Warehouse!  

I am super excited to use the vac (I realize this is pretty lame but honest) and will write more once I get the opportunity to use it. 

To kind of liven things up, I am compelled to write about an experience we had this weekend with some friends.  They have 2 kids (there was another couple with a child there as well), the oldest of which is their 3 year old daughter.  We all met up at a park for a picnic.  In the middle of the park is a large fountain that, I would guess, no less than 30 kids were running through.  After our picnic dinner, the kids all went to play in the fountain for a bit before this exchange:

Dtr: “I have to go poop”

Parent: “Okay the bathroom is……

Dtr: (pulls bottom of swimsuit down and poops on the concrete next to the fountain). 

I am sure it was mortifying (they seem like really good parents), but I told them they needed to write it down because it will be something to absolutely laugh at later on.  Really puts in perspective Mr. Q taking his dump on our living room floor (and this morning urinated on the hardwoods in his room in the minute between cleaning up his dirty diaper and getting out a clean one after I set him on the floor so he wouldn’t fall). 

Vomit and shit oh my

 Being the proud owner of 3 cats (all of which sport long hair) I clean up a LOT of vomit.  Far too much of it really.  There is nothing appealing about it, but at this point it has become frequent enough that it no longer fazes me in the least.  It is just like any other crummy task that has to be done.  I will say this though, the spot cleaner I purchased for just such occasions has been WORTH EVERY PENNY (and then some).  

Being the proud father of a little boy (or a GI tract with legs) I now have intimate experience with shit as well.  Lots of it.  Many times daily.  It is my least favorite part about being a parent.  I am able to suppress, for the most part, my gag reflex, but I have never quite gotten over my disdain for all things fecal.  Still, it is all part of the job and frankly there is no way around it. 

Being an IV nurse, I see a lot of blood.  Occasionally, I get to collect urine and feces as well (thankfully not a common task).  I used to dislike dealing with blood, but I have come to see it as no better or worse than any other part of my job.  

So, despite my rather intimate and frequent dealings with bodily fluids, I am still not totally inured to things.  Case in point, yesterday Quinn learned how to make himself vomit by jamming his hand down the back of his throat.  Once could be qualified as a fluke, but I watched him do so 3 times.  Then, later on, when I went to get him out of the car seat on one our trips out of the house, he was also covered in vomit (very likely the same reason).   This isn't necessarily a problem, yet, but it is disconcerting to watch.  He isn't upset about it either...it more or less appears like he is amazed at this new ‘skill’.  More updates if it keeps happening. 

Later the same evening, Tia and I generally let him run around naked after his bath for a bit.  It gives him some diaper free time which is supposed to be good.  However, pretty soon that might be an only outdoor option.  He has shat upon the bathmat and on the rug in his room.  Last night, he apparently did so in the living room, and then stomped through it and onto the rug and into the bedroom.  It is not awesome.  Thankfully, he is.  

Motivation

Some people are intrinsically motivated.  I would like to say I have at least some of that in me.  It is important to me to do my job well because I have a particular standard of care that I hold myself to.  I try to treat all my patients well (which is nice because one of my recent patients was a coworker of my boss and evidently raved about her time as my patient J).  However, it would be foolish to not consider the extrinsic motivations as well.  I think we all want to be recognized both monetarily and generally praised when we do well.  I think that is what makes nursing a little bit more difficult to maintain any level of motivation outside of internal standards, a general concern for the well-being of our patients, and whatever level of obligation we feel to our coworkers. 

Nursing in a hospital is like working for the government (so I hear) in the manner in which there is little motivation to necessarily excel.  There is no real mobility.  No promotions.  Raises are based exclusively on longevity.  We get paid well, so I have no complaints on that side, but it isn't exactly motivating to know that, good or bad, we all move forward one spot on the board.  I make the same as employees who show up routinely late or not at all.  I make the same as people who never miss a day and come in extra when needed. 

An example: they recently hired a nurse to work at our MP clinic in Tualatin.  She lives in Washington.  This was an explicit discussion upon hire.  She showed up day 1 in denim jeans (and therefore could not work), day 2 she didn't show up at all.  When she did show, she was evidently curt and disagreeable.   After her new employee orientation, she decided that it was ‘too far’ to drive to MP.  Did they fire her?  Of course not.   They are now going to use her exclusively at our Gresham site. 

Example 2: Gal who runs the Gresham site took a leave of absence because she was upset at the buyout.  She returned for a week and then had a vacation planned (with now no vacation time).  She has decided to extend her vacation by a few days…which now conflicts with other vacations, despite the lack of vacation time and her very recent unauthorized LOA.  Did they fire her?  Write her up?  Nope.  They set her up with a part time gig to stay at MH hospital and are going to keep her ‘on call’ in the department once the clinic transitions in September. 

In the interim, I get to float to her clinic to cover.  Float to MP to cover.  Float to SC to cover.  Because I show up, I get to have the long commutes and work in unfamiliar places.  It is part of my job.  I get that.  And, again, I think we get paid well.  However, it is demotivating to know that were I to say ‘nope, not gonna do that for you’ or not show up at all that there would be no penalty.  Conversely, the best I can hope for if I do everything that is asked of me is to make exactly the same as the people who have the same number of years as I do.  

Speaking of which, I am off to MPH tomorrow to help out.  At least that will stop in September....hopefully. 

So long shots

I had a patient walk in today (it wasn't my patient and I promise no identifying information, so back off HIPPA police!) who came in looking for her provider.  This happens, on average, once or twice a week.  Only, generally, they at least know who they are supposed to see.  I can pull up the patient's info, but it will only show me their appointment if they are seeing a provider in our system, not outside of it.  Most offices in the building are not affiliated with us.  So, I go to pull up her provider for her and, when I ask her the doctor's name she states, "It is some Asian women.......maybe Chinese?"  What I said was, "I'm sorry, but I can't look them up without their name." What I wanted to say was, "Oh, the asian woman doctor.  Of course!  We all know her.  We do, after all, have to make our quota of one."  It is kind of like when I say I went to UF (45-48,000 students when I attended) and people say something like, "Did you know Billy?"  I usually just say, "Oh yeah, I remember him.  He was a huge anti-Semite.  You aren't friends with him are you?"

 

On to the more mundane, things are occurring as I suspected they would at work.  The nurse who is out on the mysterious leave of absence has extended that leave through mid-June at the minimum.  The likelihood is that she is not coming back at all.  This whole situation is made worse because literally all her patients and the staff she shared space with know about it.  And while she supposedly harbors no animosity towards our manager and towards the rest of the staff, her behavior is affecting us, not the people who made the decision to make this joint venture thing happen.  This is compounded by the fact that my manager has been, in her words, working with this nurse to secure a position to stay within the organization.  Why now would you want this person in your organization at all?  

 

What it means for me personally is a whole lot more driving.  As this clinic can, ostensibly, be run by the charge nurse while staying somewhat in the nougaty center of things, that clinic cannot.  So, I am Gresham bound for much of the next few weeks.  I don't mind it per se, insomuch as I don't mind any changes largely, but I hate above most things commuting.  And this commute is a real bitch in the evenings.  At least everyone seems appreciative of it.  And, like it or not, it is part of the job.   

 

Domestically, I am finding things harder and harder to manage.  Between Tia and I working nearly full time schedules and Quinn, there seems to be less and less time to get things accomplished.  I admit I am a bit OCD about things and they bother me more than they should.  But, it irritates me to have a table half covered in bills and bibs.  It irritates me when the bathroom isn't clean and there are bath toys all over the place.  It irritates me that our yard is weed ridden and seemingly always on the verge of going full on wilderness on us.  Ultimately though, I don't know what to do about it.  By the time Tia and I get home from work and get Q to bed, it is generally after 7.  Then, we need to eat something, which means at least perfunctory cooking and the accompanying clean up.  Then the aftermath of Hurricane Quinn needs to be picked up.  Once you get everything roughly done, you are staring at 830 and have the decision of what to do with your free hour..........get that bathroom cleaned up or veg out for awhile because you are exhausted.  I admittedly almost always go with the latter.  

 

Last but not least, bad news about my ongoing battle against allergies.  My immune system's hyperactive immune response has won out.  I knew I had a chance at failing the shots (about 25% fail them per the allergist), but I had held onto it as my last prevailing hope to staying functional in this climate.  But, when I asked what my next step was, the doc pretty much just shrugged his shoulders (also, when he looked at my sclera, he winced because it was so red/inflamed.........and it did not feel particularly red or inflamed to me, showing me just how far from feeling normal I consider my 'normal' to be).  My last gasp is to try taking an antihistamine vacation of sorts (claritin twice daily vs Zyrtec in the am and claritin pm) and then re-add Zyrtec and hope it recharges.  I might start looking into other options (naturopathic?) as well, because I am kind of out of options as far as western medicine is concerned.  On the upshot, my PFT (pulmonary function tests) were great.  So, at least the whole breathing thing seems handily under control.  Given a choice, I will take being able to breathe over clear eyes and nasal passages.  

 

I better wrap this up.  As I mentioned, too many other things to do.  Ugh.     

No one wants to be left behind

I think we can all agree that, all things being equal, we would prefer to do the leaving rather than being left behind.  Whether it is relationships of the personal or professional persuasion, we would all prefer to be the master's of our own fate.  We all want to believe we are valuable and are bigger than the whole.

I am seeing that now at work.  The nurse who runs the MH clinic has been doing so for about 20 years.  She has dedicated the vast majority of her nursing career there.  She is very unhappy about the now looming buyout which will: A. move her to a new organization and B. strip her of her charge role.  She is also now on a very sudden leave of absence.  I was there filling in for her yesterday (and tomorrow.....and however many other days to be determined).  The likelihood is that she is seeking other employment.  Her patients said as much to me. One mentioned that it, "never hurts to put fear in management by letting them know you are looking for another job."  I was thinking about that fear.

The 'fear' I think she is hoping to strike is more or less related to what she sees as her value to the organization.  That value is transient however.  Had she done something like this a year ago, it would have carried more weight.  Now, with 3 months until they unload the clinic altogether, it is unclear how much power she actually has vs. how much she thinks she does.

Ultimately, I feel for her.  She has committed herself to an organization that, like the vast majority of all organizations, values not your body of work, but what you can provide in the present.  She is not looking at what opportunities she might have at the new place, but rather what she is leaving behind (though they certainly have not treated that clinic, and in effect her, well.  It is certainly the only clinic that I could actively look down upon compared to my own).  For the organization, the clinics no longer had enough value to maintain them as they were and therefore the staff of those clinics were expendable.  To their credit, they seem to have fought fairly hard to keep positions for everyone with the new ownership (though there may be other motivations).

Part of this is generational.  I don't think that most people in my generation (and those that follow) will have the same kind of careers our parents mostly had.  It will be rare for anyone to start and end their career with the same organization.  This lack of commitment is a two way street however.  We know that we need to keep our eyes open for other opportunities because we are mostly an expendable commodity.  It you are worth more than you cost, you are kept, but if that equation is inverted...well, better you have some lifelines already in place.  So, while I am obviously nervous to lose my built up goodwill with management and relationships, I am also somewhat excited by the opportunity to work with other people, learn new skills, and potentially find an even better situation.

What this means to me and everyone else in the meantime is yet another barrier to staffing.  No one knows when she will come back from leave, or even if.  While she is hoping to leverage her position and skills and show up management, what she is ultimately doing is hurting her co-workers and supervisors who have no power to change anything.  Considering this, she would likely be better off to have her frustrations known while showing up and being a professional.  However, the result is not likely to change no matter how she chooses to behave; change is coming whether you embrace it or you do not.  I just hope she finds something to make her happy and that, if it helps her feel better about things, she can do the leaving on her terms.  In the meantime, I think this summer is going to be a tough one on the rest of us.

Roses and thorns Hawaii

I have been struggling to post anything lately.  Call it low motivation or call it low effort, but mostly it is the confluence of both plus the whole having a baby thing.  Anyway, to the post.

Lets start with Hawaii.  It was, as vacations tend to be, some good and some bad (roses and thorns).

Roses:
 - Q getting to go to the beach for the first time
 - Swimming with a sea turtle
 - Yummy fish tacos
 - Time for Q to spend with his grandma
 - Q laughing most of the day having 3 people paying attention to him full time
 - Boogie boarding
 - A week away from work
 - Paia 
 - Cinnamon Rolls

Thorns:
 - Q thinking sand was food......and delicious food at that
 - Q waking up at, on average, 430am, every day
 - Q having teething pain the last 2 days and screaming every few hours throughout the night
 - Near record high temps for the week
 - Road to Hana = rain rain rain
 - Crazy afternoon winds
 - Losing power in the bedroom/bathroom one night due to a short (and short circuiting our 'anniversary dinner' in the process)

All in all, it was really nice.  I can say I have no immediate urge to visit again anytime soon.  I feel like I can see roughly the same stuff in Florida (and stay with family).  Still, I can't help but feel like I could use a vacation after the vacation (sans baby).  For all the things Maui was, relaxing isn't necessarily the term I would use.  I think we might need to look at a driving vacation or a 'stay cation' the next time around.  Especially considering our yard, after just one week of neglect, looks like we left for a month at least.  Mercifully, the plane ride wasn't really that bad.

In other news, I finally received my offer letter from OHSU.  For all the talk about pay rates, mine will actually go up about 5%.  This will largely be negated by the nearly $80/month I will owe in union dues, but it isn't nearly the pay reduction I thought I would be receiving.  Plus, per their union page, the negotiations are in process for the next 3 year contract (expiring in Sept of this year) and they are seeking an additional 8% each of the next 2 years.  Whether that is likely to occur, or if it is just a negotiating tactic, I don't know, but it is certainly an exciting possibility.  I still have a lot of questions and there are some things that are a bit unsettling (like that we will all be subject to drug tests, background checks, and a 180 day probationary period...all generally applicable to new employees only, not current ones which we supposedly were being hired in as), but overall my hope is that it proves positive.  No idea when my clinic will make the transition though.

I hope this won't be the last post for awhile, but who knows.  I will try to be better at it as always.  Now if I can just get the yard under control.

Life as a single dad.....

....totally sucks.  Honest to god, between work and the few hours that bookend it when Q is up and about, I felt like someone crushed me with an 18 wheeler.  To be fair, Q is teething which added a degree of difficulty (thoroughly unneeded I might add) to the proceedings, but I definitely feel woefully inadequate to the task of being the sole parent while Tia was away at a conference in San Fran.  Had she been gone more than three days, the house may well have looked like something out of one of those post apocalyptic zombie films.  To all you single working parents, I salute you and observe you with the same kind of dumbstruck awe I reserve for well honed athletic achievements, in that I am impressed someone can do something that amazing, but it sure the hell isn't me.  Thanks to Diane for helping me out one night and Tia for coming home at all :)

I got word today that the merger will be forestalled yet again.  The original target was 7/1 and is now not until the beginning of September.  The twist is that they are moving forward with GS along with the Hood and the Park at that time vs. GS going separately in January.  As for my clinic and the Creek, the magic 8 ball is still fuzzy.  It now appears likely that at least one person is going over from the clinic.  I still have my own decision to make.  To hedge bets, I put in my app for staying.  I am still waiting to see what benefit leaving will bring.  At least I should know something soon enough (assuming they furnish us with some useable information that is).  More to come when I do.

Not much else to bring forth at the moment.  I am quite tired of looking at car seats....who knew there were so very many to pick from.  Gods.  And so many pros and cons to each.

   

Information

I like information.  Its why I obsessively research damn near everything.  We call it 'falling down the rabbit hole' in our house and I have fallen down quite a few.  I have read far more than any human being not in the their respective fields about laundry soap for Q's clothes and diapers, car seats, body soap, and mattresses among other things.  Really, you name it, I have probably spent at least an hour researching it as it relates to Q.  Or for electronics.  Or cars.  Or restaurants.  Anyway, I think you get the idea.

So, it may come as no surprise that now that I find myself in a potentially weird position at work, I am uncomfortable with an overall lack of data to work from.  I have read large swaths of the ONA contract, and have tried to extrapolate as much information as I could, but it isn't 'concrete' because I don't know if I will be considered an inpatient or outpatient nurse at OHSU (or if they do not distinguish, via varying pay rates, between then).  From what I could gather, even at 80%, I would be getting nearly 2.5 weeks of additional paid time off (mostly through pay for holidays, which I do not get now, and about $1700 of employer contributions to retirement annually.  All told, it could be a net benefit (gross not take home) of approximately $5500.  Not too shabby.  But, as we do not receive our offer letters until the 24th, it is not a certainty.  Plus, they haven't suggested exactly what the pay will be, just that it will be 'comparable.'  Plus, I don't know the work hours.  Plus, I need to learn chemo.....and soon.

The reason this is a problem is that today they posted my current position at EH.  I have to apply for it by the 15th.  Simple math tells me that is 9 days before the other job offer is presented to me.  Unlike the possibility of moving over, staying at EH is a dead certainty.  It is what I have done for years.  Essentially work by my damn self.  I wont go into the pros and cons (I am still tallying them mentally), but I know there are intangible benefits to staying somewhere you are a known quality.  But, if I apply, do I take myself out of the running to so much as hear about the other job?  And, if I do opt to pass, does my job transfer 'as is' (24 hours a week vs. 32)?  So many more questions than that really, but those two are prominent.  I wrote my boss to ask her what her thoughts were on the subject.  More to come when I hear.  And more to come in general.....what a mess.

All by myself

More and more it is looking like, in the words of Eric Carmen, I will be all by myself once the merger happens.  The more details that come forth from our side, the less likely it appears that anyone will be employed by the clinics when it finally happens.  

At this point, it looks like none of the infusion staff from Meridian Park will be around.  KG, as I mentioned before, will be starting her new gig when she returns from Australia at the end of April.  They had asked for a few extra weeks of her time upon return, but her new department declined to allow it.  KV (the current charge) will be moving into the pediatric floor position at EH as soon as the clinic at the Park officially closes.  MT will evidently be taking the evening position vacated by another RN (48 hours per pay period, 6p -230a) once the clinic closes.  MK is apparently also seeking other employment (not sure where though).  That will leave them 0 for 4.   

 

The good news is they 'control' the transitions of MT and KV in that they can hold them in their present spots until a time of their choosing since they are staying within the department.  If MK leaves the department though (a possibility unless she also wants a night position), it is unclear how they will cover all their shifts unless MT (currently part time) wants to go full time for a few months.  They are already reducing their core staffing to just 2 nurses, which will likely cause a lot of headaches for scheduling.  Since they have also told me to 'schedule lightly' and the Creek and the Hood to not schedule beyond their means, the whole situation is seemingly one RN away from crumbling (like, lets say, a surgery or long term illness) or if anyone from the Creek or the Hood seek outside positions as well (a near certainty).  As it is, I picture an awful lot of shuffling.   

 

As for Good Sam, they are also experiencing some attrition, though I am not privy to exactly how much.  While I dont anticipate actually being the last one standing by the time the merger happens, I have a feeling there will be less than half of us remaining.  This was evidently a concern that has been discussed at length in the meetings for a number of months, however, my supervisor Stuart places a large deal of the blame on OHSU, as they have not been forthcoming with information and, with the meeting about a month out yet discussing more specifics and providing offer letters, they don't seem to have any sense of urgency.  If true, perhaps it was part of the 'deal' from their side.  While they explicitly agreed to take everyone on, perhaps implicitly they did not really mean to do so.  It is just a theory of course.

At the same time, they are posting the position for me at EH at 32 hours a week.  So, in effect, that is what I will be committing to long term.  I suppose it will be a good compromise still, but I am sure it will be a hard one to deal with as Q continues to grow and the weather starts to accommodate more entertaining outdoor options.  

As always, more to come as events warrant.  Should be a lot of movement until the merger though.

The first shoe drops

And we have our first notice turned in for clinic staff from the Park.  The solution will be to make it a 'two person baseline staff.'  This will work out poorly at least half the time I presume as they ideally would like to have 3 and sometimes 4 staff.  They are also going to tell the Creek to keep their schedule within the confines of what 2 nurses can handle.  This while I am keeping my schedule 'light' as often as possible and Mt Hood was told to not expect any help.

At this point either a LOT of patients will be sent to Good Sam or there will be a shit-fit thrown by the nurse exec or docs at the Park.  I am betting on the latter.  Plus, there are more staff still looking around.

I see the weeds

I love Top Chef.  It is, by far, my favorite reality based TV show.  I only bring this up because the chefs (or cheftestants if you prefer) use the term 'in the weeds' when they are kind of up to their necks, falling behind, and otherwise in a bit of a mess.  I am not there yet at work, but I can see em.

The last 2 days at work I had 2 different staff members from the Park up to help me out.  In those two days I learned that one of them has already all but signed the paperwork for her new job (at the same hospital, but in a different department) and the other has had at least one interview.  She and another nurse (they have 4 total) also are keenly interesting in a floor position soon to be posted.  They have, at present, exactly one nurse who is fairly competent in the clinic that works on call.  She also places central lines which makes her equally valuable on the floor, if not more so depending on who is out sick on a particular day.  There are zero plans to hire anyone due to the restructuring.

So, pulling the pieces of the aforementioned puzzle together, I would say we are quite likely close to being in the proverbial weeds/shit.  This should not be my problem, but based on past history, I know it will be.  I will be here, there, and everywhere while the clinic I work in is closed, barely covered, and otherwise shat upon.  I know this because it has happened in the past and they have said nearly as much.  I am not looking forward to the next few months.  In the meantime, best to try not to think about it too much until it happens.....and then make sure I keep the car gassed up.

Got away for the weekend.  Went to Edgefield.  Quite the drunken revelry going on throughout.  Was a nice 'break' but I think I am coming down with a cold (our first cold since.......well, probably January).    Probably our last getaway before our vacation.  Seems very far away from now.

Lastly, perhaps the most horrible way to treat your ipad (or best use of potty time): I present the Ipotty

 Dont pretend like you don't want an adult version.

All we get is this.  Not nearly as fun.

Crawling/All by myself

We got our first crawl this weekend.  Evidently the neccessary motivation was iphone and puffs respectively.  To be fair, it is more like dragging as it is probably 90% arms, but he is pretty darned thrilled about it and the whining has abated for now.

Q is also working very hard on a vertical lifestyle.  He now walks/dances/spasms his way forward with hands for balance.  He also holds himself up against the ottoman and the couch for 15 minutes at a stretch.  He will occasionally let go and try to balance himself.  I believe, were it not a balance issue, his legs are more than capable of supporting himself at this point.  One of the benefits of being small.

After visiting 2 centers and interviewing 3 nannies, we finally settled on a nanny.  Some of the differences were purely philosophical.  One center didn't believe in having the kids sit or stand with assistance, preferring they not attempt those skills until they were  ready to do so on their own.  While that is a fine philosophy, it is one I fervently disagree with.  I believe it is our duty as parents/caregivers, to provide supports for the child to learn new skills, so long as it is done safely and within the bounds of their physical capabilities.  Another place that touted itself as very eco-minded and nature oriented, refused to deal with cloth diapers because, and I paraphrase for brevity, "they are icky."  What the hell!  The other center we visited was Joyful Noise and they were very impressive, but it is still a center and, for now, I like the idea of one on one care for Q.  Especially since, at this age, the cost difference is pretty damn negligible.

As for nannies, that has its own drawbacks.  Obviously, the idea of a near stranger, bonafied credentials or no, hanging out in our house with our kiddo and pets without any supervision is a bit unnerving.  But, based on our last experience with a center, it seems a gamble worth taking.  Of the three interviews (a fourth bailed due to back issues), only one was a genuine 'no'.  She came with a 20 month old who was, well, a 20 month old.  This would not have been terribly disconcerting except that she would have been bringing her with every day.  We both thought that the divided attention would not be beneficial.  The other two were both good, but the second of the two just seemed a little too low key.  Almost sedate really.  I think it will take more energy to keep up with Q.  Fingers crossed this works out better than our stopgap nanny (who bailed a few days prior to her start with health concerns).

I am now all alone again in the clinic.  It is odd.  Perhaps I will get used to it in time, as I obviously spent most of the past 2 years that way, but it is strange at present.  I will miss having Lynne around.  She was a really good nurse and really pushed me to be a better one.  I would say the advantage would be that I am less likely to float all over hell and gone, but I still think that is likely to happen.  We had a weekly hydration patient (3 times weekly for the next month) who would have required about 15 hours of clinic care every week, who they turfed over to GS because 'we don't have the manpower' and also because 'we will need you to float to other sites to cover vacations.'  So, we turned away an insured patient and guaranteed work for the EM clinic so that we could close to cover vacations at other sites.  Sigh.  Things will really never change.

Speaking of that, I am still an employee of the Park.  The more that the above shit happens, the less inclined I am to not go to the new company as soon as the opportunity presents itself.  Despite the possible drawbacks, the idea of some (any) regard for the clinic would be nice.  Instead the department continues to treat it like an inconvenience at best.  

Lastly, yay we are going to Hawaii!  Still a few more steps to complete the process (there are always so many steps), but at least the flights, rental car, and lodging are all almost done (just the latter to finish up).  We tried in vain to rent a few places without much in the way of follow up (I understand that it is home owners, not businesses per se, but these are rental properties and as such one would think they would, you know, want to rent them) before finally landing on this place: http://www.vrbo.com/455674   Having never been to Maui, I am not sure which place will prove to be the best to stay, or which locale on the island really, but I am pretty damn sure that it will be a lot nicer there than here when we go.

Speaking of going, I ought to do so before Q wakes up if I have any hope of eating.  More to come as always.

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.