Me

I am on night shift for the next 10 weeks. Getting used to this is a bear. If any of you have noticed my posting quality dropping off, that’s why. They have me on the 4 pm to 4 am shift. The extra $6 an hour in shift differential is nice, but it’s been awhile since I worked nights and is taking some getting used to. I’m just getting to bed while the wife is getting up to go to work. I worked on Labor day, which gets some good bonus money. Time and a half, plus the $6 an hour for shift differential. Still, tired.

Since I have been dragging, I didn’t get a lot of time for researching the news today, so instead I will tell you what’s up in emergency medicine. This week, we saw some interesting stuff. Here are some of my more notable patients:

• A guy complaining of abdominal pain and constipation. He had a large blood clot in the main vein that runs from the digestive system to the liver (Portal Vein). It was 85 percent blocked. Because he was so big and the clot so large, he got the largest loading dose of Heparin I’ve ever given- 10,000 units.
• A man who came in with groin pain. We had to let him know that he has testicular cancer.
• A woman with congestive heart failure. She damned near died when her lungs rapidly filled with fluid. She was joking with me and fine. I left the room and 10 minutes later, she was gasping for air and needed BiPAP, a nitroglycerine drip, and Lasix. At one point, I thought she was going to code.
• A guy who did code. Wasn’t my patient, but a code is all hands on deck. He used the bedside commode, passed about 1 liter of blood, then went into cardiac arrest.
• A woman who stabbed herself 10 times because “I was sad.” She remembers feeling sad, and said the next thing she remembers is seeing the knife on the floor and being covered in blood.
• A woman who took some penicillin and had an anaphylactic reaction to it.
• A woman that had been trapped in a burning vehicle who had a hoarse voice and a cough.
• Interestingly enough, I didn’t have any COVID patients this week, but other nurses did.

We have been mostly at 3:1 nurse:patient ratios until 9pm when the mid shifters leave, then we go to 4:1. That means I see anywhere from 10 to 15 patients per day. One thing that gets me is how grown adults who are covered in tattoos can be afraid of needles. I’m talking people in their 30s, 40s, and 50s who cringe, and even cry when you start an IV on them. Three of my patients in one night were actually SCREAMING at the top of their lungs because I started an IV on them. In one case, a woman’s heart rate went from 90 to 150 while I was getting her IV.

Anyhow, since my work week is done, I now have 5 days off in a row. That means I have work to do around the house.

When I got to work yesterday, we had a significantly larger number of COVID positive patients in the ED than usual. Usually, we will see somewhere around 2 or 3 percent of our patients testing positive for COVID. Yesterday, it was hovering around 12 percent.

One of my patients was a 20 month old who came in because she had what her father reported as a seizure, the third one in the past three months. Apparently, no one before had tested her for drugs. I asked the Doctor for a urine drug screen because the entire family smelled like weed. Her urine came back positive for Cannabis, Fentanyl, and Methamphetamine. When we called DCF, they weren’t surprised. Apparently, this family is well known to them. Go figure. Because of having to wait around for DCF, I wound up working 14 hours yesterday.

My patients yesterday? Two homeless people demanding to be admitted (I guess looking to ride out the storm in comfort). A couple of broken feet from falls, a dude with chest pain that he got while clearing debris ahead of the storm, two drug seekers trying to score some pain meds, a 20 year old with nausea, and a woman in heart failure, you know the usual. We were 4 to 1 yesterday, which is better than my old hospital. I think I treated 15 patients overall.

I retired from the Fire Department back in 2011. After a brief journey to grad school where I majored in Physician Assistant Studies, I left because I couldn’t handle the leftist professors telling stories about how Ronald Reagan deliberately engineered AIDS as an attack on women and gays. You can read about this nutcase here. I highly recommend reading it. It’s enlightening. Anyhow, the liberal indoctrination and constant bullshit made me want to leave, so I did.

My first job when I got back put me in a position of working for a boss that was deliberately keeping people sick so that he could make more money. He insisted that we falsify documentation and lie on paperwork. He told me “We are making money, the nursing home is making money, and the patient doesn’t even remember his own name. We all win here, so don’t rock the boat. You want to keep your job, don’t you?”

I didn’t. I wound up being shown the door because I had ethics.

I took a couple of years and enjoyed retirement. That was when I met my wife. She told me that we could do so much more than what we had. We could travel. If only I got a part time job, we could use the money to travel. I was bored sitting around the house, so I got a job teaching just three classes a day. We used the money I made to see the world. We have been to 14 countries and 48 states. During the seven years I was teaching, I went from part time to full time, and realized that teaching wasn’t for me.

Then COVID came along. I went back to health care. That’s how I came to be unretired.

As I rapidly approach my seventh decade, I realize that I can’t work as a bedside healthcare worker forever. I can’t wrestle with meth heads forever. It’s time to start thinking about what comes next. My new employer will pay for my classes and books, so I have decided to get my Masters degree. There are two real choices: Nursing Management, or Nursing Education.

I have already gone down the road of education- I was a high school science teacher, I have also had jobs teaching Paramedic, ACLS, PALS, and other classes. I also don’t have a very high opinion of nurse educators, so I don’t want to do that.

That leaves Nursing Management. If you’re gonna be in the band, it’s better to wave the stick than to carry the big drum. That requires a couple of undergrad prerequisite courses that my previous degrees didn’t cover. Classes begin this week.

My bill came in this morning after I posted about being happy with streaming. I disconnected television service and returned their equipment on July 20. I still got billed for the full $220 as if i had television and was renting all of their cable boxes. I try to go online, and I get stuck in a chat with an automated system that won’t do anything but show you the (incorrect) bill and ask if you want to make a payment.

So I tried to call. Now I know why people snap. There is no way to escape the phone tree, because it texts you a link to the automated system and then hangs up on you. The only way to get through to an agent is to sit there and refuse to respond to any prompts. If you respond in any way, the system sends you a text link to the automated tree. Once there, you are back in the loop where it shows you your incorrect bill and asks how you would like to pay.

So I sat there and refused to answer by voice or push 1 for an agent, until the system put me on hold for an agent. I sat there on hold for 9 minutes before getting an actual person. That guy gave me a song and a dance about how it takes time for the computer to update.

I called to cut the television services on July 10. I made them effective July 20. I returned all of their equipment on July 20. I have a receipt. They just billed me for services from July 21-August 20 in the amount of $222. They are telling me that the system takes time to update and that my bill is really only $87.

It’s quite frustrating. However, the only options in this area are DSL or this one. DSL here isn’t fast enough and has data limits that are too low for streaming. I swear, it’s harder to get out of CATV service than it is to leave a timeshare sales pitch.

So I will wait to see what they charge my credit card. If it is a penny more than $87, I will send a certified letter to their offices, demanding an adjustment. Following that will be a complaint to the state regulatory agencies, and possibly a lawsuit in small claims court.

That’s why I keep copies of receipts and correspondence. When I move, there will be a different internet provider.

Cord cutting is going well. It’s been several weeks, and we haven’t missed CATV at all. Our first night without cable TV, we watched a movie: Where the Crawdads Sing. Great movie. We are saving more than $100 a month by not having TV.

The hospital where I work has an extensive training program. One day a week, I get scheduled to work from home, attending online training. The hospital follows a protocol model, where everyone is expected to follow the hospital’s official guidelines when treating patients. An encyclopedic level of knowledge of those protocols is required in order to comply with this. My last hospital was more of a “come as you are” model, and I actually think that the protocol model is safer and more efficient. Still, that means there is a steep learning curve.

My wife seems to look at this as an opportunity to assign “honey do” chores for me to do, because she apparently hears the “from home” part more than the “work” part. Today, she has asked that I get laundry done, put away the dishes in the dishwasher, and fix the ice dispenser in the freezer.

Uh, you DO know that my workday begins at 8:30, right?

I am getting annoyed at the new technology trends. It seems like everything that you own, from your computers, to cell phone, and even your car is being controlled by someone else. These endless “system updates” are becoming another income stream for technology companies that are looking to use your connected equipment to make more money. Car companies are charging people a monthly fee for things like using their cruise control and their air conditioning. The air conditioner costs $15 a month, the ability to tow a trailer is $20 a month, and engaging the four wheel drive sets you back $40 a month. Heck, even the seat warmers cost $4 a month. It will cost you $20 a month to use your key fob to remotely unlock or start your vehicle.

Remember when you used to buy software? Now you rent it by paying yearly fees to use the stuff that you bought.

One of the things that I did at my current house was to make it a smart house. I have more than 150 smart devices: I can control ceiling fans, lights, irrigation, and even the thermostat- all with smart devices. The backbone of the system is Samsung Smartthings. It has been great. I started doing home automation back in 2014. Since then, my system has expanded.

One of the best things is my lawn sprinklers. I have a personal weather station on the roof of my house, and the system analyzes how much rain I have gotten, using that to adjust the schedule and amount of water the lawn gets. The lawn looks amazing, and the only effort it requires on my part is some weed and feed every 3 months or so.

When I am out of the house, the system monitors for intruders, water leaks, fires, turns the air conditioning to a more economical setting, turns off the water heater, locks the doors in case I forgot, and even turns lights on and off to make it look like I am home. It monitors my freezer temperatures and the humidity of the gun safe and will alert me if there is a problem. The system feeds and waters my wife’s cats, and empties their litter box. My carpets are vacuumed and floors mopped. All automatically. Until we decided to move, I was going to add robotic lawn mowing to the stable and get rid of my lawn service. I feel like George Jetson. Nearly every household chore is automated, and it makes things very convenient and easy.

Until recently. Samsung has been making changes to their systems so that they are easier for people with no tech skills to use. What this means, is that my devices are getting changed and “dumbed down” to the point where I don’t think my next house will be a smart house. Where I used to be able to write, edit, and change the drivers to my system, it is becoming less so.

It all started with changes to how the system dealt with my Sonos speakers. I once had it set up so that the system made announcements over the speakers: things like “your wife is home” when she would arrive, or “your in-laws have arrived” when they came over, so that I knew to put pants on. Then there was a system update 2 years ago, and the speakers don’t talk to the system anymore.

It’s little things. I used to have the ceiling fans set up so that I could adjust their speed from 0-100 percent. Last night, there was a system update, and now my choices are low-medium-high. If I had wanted low-medium-high, I would have set it up that way.

It isn’t just Samsung. A couple of years ago, Google bought out the company that made my fire alarms. Now I can’t change, replace, or add anything without updating the drivers to Google device drivers and becoming a NEST customer, which will charge me money for monitoring the system.

So going forward, I have a few choices:

• Continue with Smartthings, and keep losing functionality. It will still require a fair bit of time and money to set up the new house
• As long as I am moving, I could switch to Home Assistant, which I have been playing with and will give me a lot of control, but will even more work, a steep learning curve, a good bit of money, and I just don’t know if I want to invest the time and money to do it right now
• go back to having a “dumb house”
• or sharply cut back on what automation I do have, to get what I refer to as “a mildly retarded house” with a lot less functionality, but at low cost and not a lot of work.

There is a lot going on right now, and I don’t know if I have the time for most of the options above.

My mail saga continues. There is a knock at the door today. I open it to see the owner of the landscaping company that mows my lawn. We see him all over the place, at parties, friends homes, restaurants. (It’s a small town) Anyhow, he hands me a package that he found on the side of the road about a mile away from here. It’s addressed to my wife. It looks like its been outside for awhile, as it is pretty weathered.

I look up the tracking number, and USPS says it was delivered a week ago.

Delivered (or not) by the same government that wants to be in charge of delivering your healthcare.