Shooting at the range with one of my 80% homemade ARs. This one is a gorgeous rifle. Anyhow, this rando comes over and asks to see it. Not unusual, so I show it off. Then he asks me to sell it to him.
Uh, it’s a homemade rifle with no serial number. Not for sale.
He keeps trying to pressure me. I finally had to get firm with him.
My paranoid side says “Fed” or possibly “informant.”
The last time we talked about my grandson’s progress was December 1. For those who don’t know, four and a half months ago, my grandson was hospitalized with an unknown illness that was later determined to be viral meningitis caused by the enterovirus. He spent weeks in the intensive care unit. There was a time when I was unsure that he would survive, although I would never have told my daughter that.
I posted about his illness on this blog, and many of you told me that you were praying for him. Well, it seems that those helpful thoughts were successful, because he is doing better than I had hoped. All of the things that he used to be able to do, the things we all take for granted, he has had to learn all over again. He had to be toilet trained all over again. Walking, reading, writing, speaking, feeding himself, all of it had to be learned again.
He now walks and runs nearly like a normal, six year old boy. and is no longer in a wheelchair, although he does occasionally wear leg braces. He relies on the braces less and less as time goes on. He even returned to ice skates two weeks ago. One of his favorite things to do was play youth league hockey. He still isn’t back to that, but he is pushing himself.
He still doesn’t have the fine motor control he had, but he can write (sloppily), His speech is still stilted and somewhat robotic, but also improving. If you want to read his entire story as posted on this blog, click here.
The care that he received was second to none. My daughter’s boyfriend works at a different hospital in that hospital chain, and the nursing director of his hospital personally made the drive to the hospital where his stepson (my grandson) was, so that he could visit and deliver gifts that included gift cards, food, cash, and stuffed animals. The entire staff of the hospital where he works was wonderful. They offered to care for the other kids, cooked meals for the family, and even came over and cleaned the house. What large companies do that anymore?
My wife bought our current home 5 years before we met. It’s still deeded in her name only. When we move, we want to convert it into a rental.
The problem is this: That house has appreciated by $200k since she bought it, and unless we sell within 3 years of moving out, we will have to pay capital gains taxes on that $200k.
My position on this, is that we should sell it and use the proceeds to buy a different rental so we can reset the tax basis. My wife is vehemently opposed to this and wants to keep it. She remains convinced that there must be a way to avoid the capital gains taxes.
I have an appointment with a tax attorney this week, but my own research says that we either sell within 3 years of moving, or we will owe the taxes when we eventually sell, even if that sale is 15 years from now.
As I said last month, we are searching for a new location to be closer to my wife’s job. I am also tired of things where I work:
So I also want to change jobs. Career specialists say that you should change every 2 to 3 years, so I think now is a good time to do so. I think we are close to answers on both.
We found a builder that will build us a 5 bedroom, 4 bath, 2900 square foot house for less than $190 a square foot. The place is gorgeous. Here are a couple of pictures from the model:
Construction should take a bit. In the meantime, my wife’s job is moving in the fall, so if the house isn’t done by then, she will have a 45 minute commute. We are negotiating terms now.
On the job front, I just negotiated with a potential new employer. I spoke with people I know who work there, and they say it’s a good place. It looks good:
The downsides are twofold:
The new hospital has sent the offer, and I have conditionally accepted for an August start date. (when the wife’s new job location starts) I should get the actual contract to look over some time in the next week. If it looks good, I will sign on. Hey, closer to the new place, less workload, and more money.
Explanation of the importance of patient/nurse ratios:
For those who don’t know, each patient needs to be assessed at intervals, plus needs medications, tests, and other related things coordinated. For “routine” patients on a medical floor, a nurse can handle as many as 6 or 7 patients at a time. The more things that are wrong with the patient, the more time it takes to care for them, so task loading becomes an issue- a nurse can only do so much without increasing the risk that they will miss something important, or make a mistake because they are pressed for time and rushing high risk tasks like selecting and dosing medications. For this reason, the sicker the patients, the fewer that a single nurse can effectively handle.
Some patients are so sick that they take up all of your time. A patient on a ventilator is one of those. In general, having two patients on a ventilator is all a nurse can handle, because those patients are also usually receiving a list of medications that are high risk, and this combination means spending a lot of time with that patient. This is why the more acute the unit, the lower the ratios need to be. In the ED, patients in general shouldn’t be more than 4:1 to the nurses, unless you want to compromise patient safety by not monitoring the patients closely enough. For that reason, the ICU is usually 2:1, the “step down” unit is normally 3 or 4 to 1, and so on.
This is why the ED usually has a unit called “fast track” where patients are less sick with things like toothaches or broken fingers. In fast track, you will see ratios of 6:1 because the patients require far less of the nurse’s time. Fast track is usually a separate subunit within the ED, usually staffed with a nurse or two and a midlevel practitioner (a PA or a nurse practitioner), and the goal there is to clear out as many low acuity patients in as short a time as possible, thus leaving the sicker patients (who take up more time and resources) for the doctors and the nurses with lower ratios.
My wife’s job is moving. She will be working about 30 minutes farther away from the house than she is now. She wants to move closer to her new work location. I have been working on changing hospitals. If I want to do that, it would be easier if we move. If we move about 30 minutes south of where we are now, it would put us closer to my wife’s work and would make it easier for me to find a new hospital.
So we have been looking at houses. We had a few must haves, and some wants.
So we began looking.
The first community we looked at wanted $400k for a 2000 square foot house. Hidden costs included a $45,000 bond. A bond is an invention here in Florida that requires each owner of a residential property to pay for roads, fire stations, and other infrastructure costs that are not part of the property. In other words, it is a cost of building a neighborhood that is passed on from the builder to the buyers of the homes. This raised the cost of the house to $455k, or about $225 a square foot.
The second and third builders did not have houses and floor plans that we liked. We went to a late lunch out in the country. While we were there, I happened to see a nearby community that looked interesting, so we headed out there. They had 2950 square foot home plan that they think we can get built with custom options for $525k, and no bond. That brings the cost to $178 a square foot. Admittedly, it’s at the upper limit of what we wanted to spend, but it’s a really nice house with a large kitchen. The best part is that it is within a 30 minute drive of 5 different hospitals, which gives me a lot of flexibility in changing hospitals. It’s one of those small Florida towns that only have a population of about 2,000 people, but still have stuff nearby.
The only real catch is the current lead time for construction is 12 months, meaning that we will be in late 2023 or early 2024 before we can move. We are looking at all of the numbers and facts, but we will likely be paying earnest money within a week or two. That means when the school year starts next fall, my wife will have to commute a bit. It also means that I can start looking for new work, expecting to start somewhere in July or August. There is a hospital that is only 15 minutes from the house we are looking at that is a good place to work and is offering a $10,000 bonus to work there. By all reports, the pay is good and I hear lots of good things about them. There are other hospitals that offer larger bonuses, but there is a reason for that.
So change is coming. It will be easier working where I am, knowing that my days there are numbered.
Speaking of expensive hobbies. One of the things that I do to stay busy is work on making my house a smart house. It all began about 8 years ago, when I installed a SmartThings hub. Our house is automated. I use our cell phones as presence sensors, and the house changes modes when we leave, come home, and go to bed.
My wife was very understanding, and has now come to love the automated features of the house. When we go to bed, the thermostat changes to make the house cooler, the lights turn off, and the smart locks on the doors all lock themselves. The landscaping lights change colors depending on the season. There is purple, gold, and green for Mardi Gras; Red, white and blue for Independence Day, that sort of thing. The hot water heater turns off when we go to bed or leave the house. It’s geeky, fun to do, and pretty bad ass.
But 8 years has gone by, and technology is evolving. I have always been bothered by the fact that SmartThings is a cloud based processor. I want local processing, and now that we are thinking about moving next fall, I have a chance to try it.
I am thinking of switching to Home Assistant. I just bought an Odroid N2+ processor and a 128 GB eMMC card to use as a server. Now I am going to learn how to program it and integrate it with all of the devices I am planning on using. So I will spend the next few months playing with it. I am planning on using smart switches that can control scenes as well as individual lights.
It’s good to have a tolerant wife.
Oddly enough, I posted the other day that I am thinking of changing to a different hospital and that same afternoon, I got two emails. The first was from my job, spelling out that all employees need to be aware that, should we decide to wear a shirt under our scrub top, it has to be white. We also have to wear white socks that cover our ankles. If we choose to wear a sweater or coat, it must be the same color as our assigned scrub color. This seems odd to me, since they can’t find shift coverage and are back to offering shift bonuses most days and are still understaffed.
We are a 50 bed ED, and we had 123 patients the other day. All of the rooms were filled, plus we had 50 patients on beds in the hallway and another 23 patients being treated in the waiting room. But our administration is worried about what color tshirt I wear under my scrubs.
The second email that I got was from a competing hospital chain. They are inviting a bunch of nurses to a free meal where cocktails will be served and we get the opportunity to meet the leadership team and learn about the advantages of coming to work for them.
Dude. Looks like I at least get a free meal out of the deal. I told my wife that I am not working that day, so I think I am going to go and at least hear the pitch.
I worked yesterday. The theme of the day was insane people with mental problems and intoxicant day.
One woman came in with a complaint of constipation. She said that her anal sphincter was too tight, and wanted us to loosen it for her. I told the charge nurse that we should send her to the local bar with a couple of coupons for free drinks, and I am sure one of the patrons of the bar would help her out. The charge nurse actually snorted.
Then I was given a Baker Act. She was being Baker acted for the third time for threatening to kill herself. This time, threatened to get a gun and come back to kill us all after she was discharged. Then she told me that she would look for me when she got out, so she could “fuck me up.” She also said that she would follow me home one night so she could kill my family. I had to get a female staff member to escort the patient to the bathroom. Once they were in there, the patient attacked the female. After that, I couldn’t get a single female to take over my patient. They were all afraid of either being attacked and injured, or being attacked and getting suspended. Since I already was suspended recently, I insisted that my manager call the local cops and filed a police report. My amanger wasn’t happy about that, but I don’t care. I am not going to put up with crazy bitches threatening me. The cops wouldn’t arrest her, but at least it creates a record in the event that I see her near my house. Other than taking reports, cops are largely useless. I don’t know if the threats and her appearing in my neighborhood would be reasonable fear or not, but it can’t hurt. I am pretty sure that, should I see her in my neighborhood, I will call the cops and probably hold her at gunpoint.
Name another job that requires its employees to be physically attacked and put up with threats of being murdered.
Speaking of that, one of my former druggie dirtbag patients decided to perform a home invasion, and got ventilated by the homeowner. He is now fully rehabilitated. I love happy endings.
Then I had to spend the day in recertification classes, doing my recertifications in Basic Life Support, Advanced Life Support, and Pediatric Life Support.
So many bloggers did a 2022 in review post that it was boring. That’s why I didn’t do one. Instead, I thought it would be more fun to do a 2023 prospectus post. List what I would like to accomplish this year.
My wife doesn’t like SCUBA diving, my son no longer dives with me, and I haven’t heard from my other dive buddy in years. As a result, I can count the number of times I have been diving in the past 5 years on one hand. I have about $10k in SCUBA gear that sits unused in storage. The vast majority of my fun money goes into shooting now, and that is a huge change from ten years ago. I think shooting is where most of my wish list is going to go.
I have enough guns that the wife complains and says I have so many that I don’t shoot most of them now. I will grant her that. I have a few favorites, and aside from project guns like the skirmish rifle, I only shoot my favorites. Still, it’s fun to buy something new or at least different. My in-laws think I am nuts for owning as many as I do. Compared to my gun shooting friends, I don’t think I have all that many guns. Owning a lot of guns is a relative term.
Starting in 2020, I began making my own guns from 80 percent lowers. That’s been taken from me as a hobby. If I am going to be a manufacturer, I might as well pay the SOT and start making machine guns. I would do that, but I don’t want my house getting inspected and raided by the assholes from ATF.
I own pump actions, semi-autos, break opens, lever actions, and revolvers. Shotguns, rifles, PDWs, rifle caliber handguns, and all sorts of other handguns. I don’t want any more long guns for the time being, simply because it’s more of a pain in the ass to shoot them than it is a handgun.
So a handgun it is. I currently have, or have had, handguns from Beretta, Glock, Smith and Wesson, Sig, Taurus, Ruger, and more. Been there, done that. There are two noticeable holes in my current collection: I would like to own a .44 caliber revolver. I have been thinking of buying a Smith and Wesson Model 629 in .44 Magnum. I already own a 629 686 in .357 Magnum, and it’s fun to shoot. Having one in .44 Magnum would also allow me to shoot .44 Special. So there is that.
The other thing I have been thinking about is a gun I already owned four examples of, and found them wanting. The 1911 didn’t work well for me when I had them before, but I confess that I am drawn to the 1911, purely because I find them to be aesthetically pleasing. They are just beautiful guns.
I want to give the 1911 platform another chance. Perhaps I just need a really good one. I am thinking that it would be cool to have a custom Ed Brown Kobra Carry. Sure, it’s a $3,700 handgun and I know that I was against buying them in the past, but I have every other handgun I want (except that .44). It’s a beautiful handgun, and Ed Brown has a stellar reputation. It’s just a hefty price tag.
The problem is that I don’t want to put down that kind of scratch until I can get a reliable 1911 for less and make sure that I am not wasting my money. So perhaps I can start with another Kimber. If so, I would try a Kimber Ultra CDP. They “only” cost around $1200 and would let me try out another 1911 without laying down two weeks’ pay to get it.
The other possibility is a Suppressor for the Skirmish rifle. I am thinking a Dead Air Sandman.
So that’s my list. I don’t know if I will get them all, but it looks fun.
So what do all of you think?
The hospital where I work has all sorts of issues. There is a nursing shortage, there are problems with long waits, patients holding in the ED waiting for space on the floor that isn’t available due to a shortage of nurses. Turnover has been enough of an issue that they can’t keep staff.
There have been multiple administrators that have come and gone, and each of them has addressed it in a different way. One way was hiring contract nurses at $200 or more an hour. That was too expensive. Another administrator tried paying large bonuses to get nurses to work more days per week. Still another tried bringing in foreign workers.
One thing that all of them have had in common was the dumbest, least effective action. They changed the colors of the scrubs everyone wears. When I was hired, you could wear any color except black, denim, camouflage, or pediatric prints. Six months later, the colors changed. Since then, we have cycled through at least four different colors. In less than two years, I have bought at least five different collections of scrubs.
Effective tonight at midnight, we all have to wear a new scrub color. These scrubs have to be embroidered with the logo of the hospital and your job title “Nurse,” or “Doctor,” or what have you. We have to buy them from one approved vendor. That vendor is owned by the wife of one of the administrators. I am not sure how that is legal, but there it is.
So I had to buy two sets of scrubs in the new color, complete with the logo of the hospital affixed to it. I’ve learned not to buy more than that, because we will just have to buy a new color within a few months anyway.
The managers are mostly assholes and treat staff rather poorly, although I can say that I like the ones in charge of the ED. They are mostly cool, and I don’t blame them for my recent suspension. That came from risk management, and wasn’t their decision. Still, this place has begun getting on my nerves.
I am giving serious thought to switching hospitals. I’ve been here for two years now, and one of the nice things about this profession is the ease of finding a job. I know one nurse who shows up to interviews in casual clothes and says something to the effect of “Here is my license. We both know that you need nurses badly enough that you are going to offer me this job. So let’s cut to the chase- what are you willing to offer me? Don’t waste my time with useless back and forth, give me your best offer,” and they present her with her options.
Maybe it’s time for a change of scenery. There are a couple of options:
I think I am looking at leaving this place in June or so, when my wife’s school year ends. I don’t need benefits, because I get health insurance from my wife’s job. Maybe I will take a month or so off, then look at my options.