Medical care today

 I expect people to do their jobs no matter what that job is but when you work in health-care, I'm going to scrutinize you a little closer because I know the field inside & out and if you mess up I'm going to complain. I would expect nothing less if I were taking care of you & you were not satisfied with My care! 

Today I had to make such a complaint at a Facey facility in porter ranch because I felt there was some racial bias going on there or maybe they just didn't like me & my husband who happened to be black & mexican & I saw them treating white patients differently, so you tell me🤷‍♀️ this was the second time it happened too. So not a first event. If a place has a pattern of things, chances are there's a reason for it, just saying.  I made a complaint to the office mgr but I know how the system is & there may or may not be anything done about it so I'm gonna cover all the basis to make sure my displeasure is known because its Not okay to treat patients & their families that way & I will not tolerate it. I won't let that medical asst take care of my husband again thats for sure. 

Patients have the power, you just have to be willing to use it 😎 and I am!

The pharmacy debacle

 On July 29th I picked up my prescription from CVS went home & opened the bottle & was immediately concerned because these pills didn’t look right, this is a medication I’ve been on for 16 years and it’s never looked different!

I called the pharmacy and they said “well this is a different manufacturer “ I said well first of all Why did Caremark allow you( local cvs) to fill this when they usually mail it to me and they have my records and know this and my medication has always looked the same so it must have always been this “Amneal" manufacturer listed on my previous bottle? He had no answers, in fact he actually said, he was unsure why they were filing it through them also. He said “you can try it and if the effectiveness is not satisfactory we can request another manufacturer for you", I said “ Are you out of your mind, are you looking at my file, do you see my allergies & sensitivities to medication, I'm not going to just try anything, I once had an allergic reaction to a medication that lasted 6 weeks, took 3 visits to the ER to reverse cause they had to try 3 different medications to stop it, don’t tell me to just try anything.! I know my body.

My next call was to my customer service at cvs Caremark and I have to explain to these people my allergy situation just as I did the pharmacist and they tell me I have to get my doctor who prescribed the medicine to write a letter saying I can only have this medicine dispensed by this particular manufacturer, cause I absolutely refused to take this stuff I had in my hand. I was also told that once they had that letter and a new prescription, they would email me a mail tag so I could send this medication to them and they would send my new meds. The medication in question is a schedule 2 type medicine, one that they monitor so they of course want to make sure I’m not just stocking up 🙄 which is offensive, but I know I'm not a liar so anyway, I email my doctor and he says okay, I will do it.

A week later, still not done, long story short, 4 more calls & 3 more emails to my doctor, its done, He even had to spend an hour on the phone with Caremark to get it straight, I get an email 8/11 saying prescription is in process. To my dismay, a week later 8/18 I get an email saying it’s too soon to fill your prescription, it will be processed 10/1. Being a nurse, I know exactly what they are doing, its because I have the current pills that I won’t take, so I decide, you know what, no more calls cause the last one went back on the mailing label and said they couldn't take it cause the mail order pharmacy is different from the local pharmacy and even though this was their mistake by letting my prescription get filled by the local cvs instead of the mail order cvs like it usually is, when its the Dr who put it in electronically they wouldn't take the meds back.

I looked up the headquarters of CVS Caremark and they are in Rhode Island and I found the name of the CEO then I looked her up on Twitter and there she was, I sent a tweet to her saying I need help my meds are preventing me from being able to attend my cardiac rehab, which is true, sent that 8/24 an answer came 8/25 for me to private message them with my name and info to the customer service cvs Twitter, I answered but also stated the reason I contacted the CEO is because I’ve spent a month dealing with my own customer service people and gotten nowhere so if this is more of same it will not help me, and I attached a screenshot of a letter with all the details of the ordeal cause I had already typed it and included it in the bag with the pills I mailed to the mail order pharmacy on 8/24 .

I received a call from a rep named Umekia the next day 8/25 and we talked about it all, she listened and said she would call back in few hours. She called back by 2pm and said my medication would be to me by Saturday 8/28 via UPS and she would follow up to make sure it arrives. She did and I asked her also about the $10 co-pay since I paid for the previous meds too which I sent back to their pharmacy to destroy, and she refunded my $10. This lady was a true professional. (3 days from call to meds in my hand)

I’ll admit a few key points that I think made the difference, my letter included to the CEO, I clearly pointed out the mistake was Not mine but theirs or my doctor, but either way, I should not suffer, then I stated how I felt my medical condition was being discriminated against due to the nature of the medication that people with adhd often are judged just because of the meds they are on and thats not right, then I pointed out how I needed my meds to counteract the side-effects of my heart medicine which makes me so tired that I couldn't wake up and go to physical therapy, which was my #1 reason & frustration. Of course because when you have to take it this far, you use everything, I even added this, I bet I wouldn't be treated this way if I had a ppo and was rich, but I'm not, I ‘m poor and have an HMO and am black.

I’m not the type to use the race card, but one thing I do know is the medical field & key words that make executives nervous and you know what, just do your job and make sure people have what they need and think about how your mistakes affect people's lives. Never accept a mistake and think there is nobody you can talk to about fixing it, when you have talked to more then a few people at a company, its time to go to the headquarters of that company.

Everybody has a boss, don't be afraid to go to them to seek a solution, but know what solution you seek.

When a Dr. wears his jeans too tight

 We had this one admitting doctor that would come down to the ER all the time wearing jeans that were so tight you could see the outline of his ‘junk' 😳 😂 the nurses would talk so much crap behind his back to each other cause we weren't sure how to address it. The patients even brought it up sometimes cause he would stand at the side of the gurney & well what do you think was eye-level 🤔, awkward much 😂.

He wasn't a friendly type so I decided how to handle it, we had a complaint line that could be anonymous, so I called it & the next week he started showing up wearing a long white lab coat over his jeans & from then on that’s what he did! 👌👍Nursing has had some awkward funny moments.

#missionaccomplished #nomoremooseknuckle

A life so small & in trouble

 ONE NIGHT I'LL NEVER FORGET....

A life so small, handed to me by a parent when I was a new ER nurse & working triage, I was outside the front door in the lobby & the parents came in and said the baby wasn't breathing, I took my stethoscope, quickly listened, heard nothing, I tried Not to look as Terrified as I felt inside as I grabbed the 9 day old baby & turned to go inside with the parents, took 3 steps to the counter where Dr B. was & laid the baby on counter & said I don't hear anything & he saw the fear in my face grabbed the baby went to a gurney & we called the code white & began CPR😳.

At the bedside we made the parents comfortable as possible, then the team got started, IV access couldn't be found so we had to do IO, which is in the bone, then we started IV fluids for blood pressure to stabilize the baby & we did save baby in the end & transfer him to a big hospital ICU somewhere else but it was so scary. Turns out the baby aspirated milk (meaning it went into his lungs)given by a dropper because this was what someone told mom to do if the baby wouldn't take the bottle 😥thank God mom knew something sounded wrong when baby was gurgling & to rushed to hospital. I'm so glad the baby survived, of course a part of me always wanted to know what happened after but thats the bad part of ER, you don't get to know the ending many times & you get use to it, but sometimes you end up hearing, mostly not.

My coworkers talked about the look on my face for a long time after that, cause thats how we cope with stuff, tease each other about how we handled the last tragedy, yeah I know sounds warped but its ER Nurse stuff. But there's those cases you never forget, you may not remember the name or all the details but it stays with you forever.

It's ok to say No to your doctor

 I did a “take home” sleep study test to determine if I had sleep apnea because my doctor was trying to discover the cause of my migraines several years ago & I was skeptical but I went ahead & did it anyway. The test required me to sleep in an unnatural position, on my back which in not normal for me, as I’m a side sleeper and the results were mild to moderate 40% sleep apnea but I only slept 4hrs, so this is what they based putting that diagnosis in my record on.

So nothing was done about it & I blew it off & said I don’t buy it anyway. That was 2018, fast-forward 2021 my cardiologist is bringing up that “sleep apnea” diagnosis as a reason for problems with my current issues with “POTS”, so I say hey, that test was bullshit, he says well maybe you should re-do it & see a sleep doctor so I do it over & guess what?🤔 this one shows No sleep apnea. The sleep specialist explains the more advanced test doesn't require sleeping on my back so its more accurate & natural and then when discussing results he says,” if you really want to be sure you can do the study in the lab.” 🙄 “I said, No, I am sure, I was sure the first time that your test was wrong & simply came to prove with this second one that I was right to begin with-that I don’t have sleep apnea. I don’t need a third test to convince You of anything! Im satisfied, now take it out of my chart.”

I told him going in the bottom line is this, even if I had it I’m not the type to wear anything on my face at night when I sleep so cpap is out, surgery is out, only a mouth guard would be an option & that’s not a good option for mild so I knew where I stood going in & didn’t waiver. Knowing your bottom line helps. Be your own advocate in your personal healthcare, your doctor works for you. Not the other way around, he may have the medical knowledge but you have the knowledge of what you want to live with or without in life to be comfortable. If a doctor doesn't respect your views, it's time to get a new doctor.

💟Why I loved triage nursing

I worked as an emergency room nurse for over 14 years before I retired in 2019 and I spent a large majority of the last 7 years or so of my career mainly doing triage. When I worked in the ER, sometimes I would be assigned a room assignment, meaning 4 patients, or to be float nurse, to help everyone, or triage or 2nd triage(which is the one who would get vitals or ekg's). When we were short staffed or after 12am there was just 1 triage nurse. I was even at one point relief charge (which I hated)😡😂 definitely not my thing, so I avoided that like the plague lol. Triage was my strong suit though because my personality fit there, I was able to control the waiting room no matter the chaos & help regulate the flow of patients to my team in the back.

The biggest thing I feel that served me well, especially because I worked nights was my attitude, I had an aggressive attitude when needed & was not intimidated by yelling pts or family members & in fact would yell at them if need be, this kept people from getting out of hand & worked in my favor. I also could decipher between a loud mouth & a sick pt cause the loudest isn’t always the sickest! Being sick is awful, having family sick is worse but acting a fool is never acceptable & its not gonna help the pt for you to act that way in the ER. I’m a huge pt advocate & believe me if a pt is truly sick & has something serious going on that needs immediate attention, I’m the First one to act!!

I remember a woman came up front to the hospital when we were remodeling & I saw commotion outside the lobby door, I went out & its a child on the ground in a diaper, another nurse from the hospital is checking him, I say what happened, mom says he was in the pool when she found him & pulled him out, unknown time, I yell to my team call code white (kid down outside), but I pick him up with help, he’s 2y & kinda big, breathing but gurgling, I decide, screw this, LETS RUN, so me & mom run to the ER in the back of hospital cause I didn't like the way this baby looked😳. I get almost to door, the ER doc meets me in hall we stop I tell her story. Hand off kid to our emt cause I’m out of gas now 🤪 and we go to room and start code, the kid had poopy diaper too, so I had to get new scrubs from housekeeping cause I could smell it on me 🤢 but hey at the time, all I could think was get that kid to the doctor👍. Because it was a near drowning, police had to be called & they came & child was admitted in critical condition. You never know whats gonna walk into triage or show up in front of triage.🤷‍♀️

Always scary with kids involved, and there’s no script, sometimes you just react. I had a kid who had a panic attack come in screaming at the top of her lungs “I can’t breathe" and the parents in full melt down too, they almost couldn't handle that I was totally ignoring them, I bent down & looked at the child took her hands & said calmly listen to me, do what I do, copy me, etc, and in a minute or 2 she was taking slow breaths and calm, then we got her vitals. Ironically, I have a great way with kids, they always respond to me, I often had just a lil purple in my hair, maybe that helped 😉.

Then there is the drama 🙄 I called a male pt in his 20's and he walks to the triage door with his girlfriend & falls down right in front of the door & she starts screaming at me, “do something” so I said “get up you were just fine & you were just walking, now do you wanna be seen or not, stop playing with me boy and get in this chair" she says “you're mean what kind of nurse are you?” As he gets up and gets in the chair. I said “one that knows my job now have a seat, I’ll bring you in when he’s in a bed, I don’t need you in here for this.” I had no problem putting my foot down when it's needed, cause too many people just wanted to act a fool in the ER & that was My house & I was running it😎 if you were sick I got you but don’t play no games with me.

We didn’t get a whole bunch but whenever a child abuse case came in, that was a 1 to 1 case just cause of the documenting that needs to be done & all the phone calls & time & because I had done it & was comfortable with it the charge nurse usually put me on those when they came in, it also kept the pt from having to repeat it to multiple people because I usually was the one triaging them, but even if I didn’t they would give it to me once the complaint was known. Those are tough cases, my hospital was not one that did the whole exam so we kept them there for the police to interview and did the child protective service report then the police would pick them up & take them to the SART(sexual assault response team) hospital and they do the exam there. People don’t realize its only certain hospitals that do those exams, but yeah its true. It’s easy when the person bringing the child in is not the person suspected, but if the Dr or nurse suspects them & has to make the call, that’s a whole different story.

Only once did I have to do distraction techniques until the police arrived with a family because they were going to remove the kids right there in the dept. It was stressful but clearly needed, a broken bone that was obvious abuse on a 7 yr old, & there were 3 other kids with them there but 3 other kids at the house so they coordinated grabbing all the kids at once. This was evidently not first event or complaint. Never forget that. Nursing is rewarding but you see the worst & best of people, you get to help & hurt people for ultimately good reasons but if you choose it for the right reason, you will never regret it. I had to retire because of my heart & not being able to physically work but I am still a nurse & will always be. I keep my RN license current & active & read journals & latest info, because I worked so hard to obtain my license and I don’t intend to let it expire even if I can’t work again. I am very proud to be a Registered Nurse. 🙂👌

Advanced healthcare directive

 I know most people don’t like to think about this topic much less actually write out plans, but believe me if you do it, you will save yourself & your family members so much heartache that it will be worth the time. I can tell you on more than one occasion in the ER with family there during a cardiac arrest that the Dr knew he should stop because it was too far gone & the pt would never recover or be brain dead,😔 but if there was no DNR (do not resuscitate) order & the family asked us to continue we would & sadly sometimes we could get them to revive on machines but not any quality 😥 so a life of no substance & bedsores, just my personal opinion, I think its cruel. That’s why I say discuss it with your family, make your wishes known.

My father was very clear about what he wanted, when he had his stroke he actually recovered quite well & fast but he was clear, no surgery, no feeding tubes, nothing, his words, “if its my time it’s my time, I don’t want all that shit.” So 5 yrs after his 1st stroke I believe he suffered a second stroke, cause he couldn't swallow & we went in to my ER, they did some tests & kept him overnight but the dr said if he didn’t get a feeding tube he would die, and he said “send me home”. I told the doctor to set up hospice & I’d be there to take care of him and my dad died 2 days later at home, with me by his side, after my son came by with his great grandson so he could see him & he visited via Skype with my daughter & other grandkids. That was what we had talked about before he got sick and I asked the questions “would you want this or that?” Donate this or that?, cause its the persons choice and you have to choose someone strong enough to do what You want, not what they want. If it had been my mom & he started to die at the house she would have called 911 🙄 cause she had no respect for the process, thats why he put me in charge of his care. I’m like my dad & won’t want delay of game, interference or nonsense when it’s my time & have it all written down! 😎👌

There are plenty of versions that are pre printed and you can easily edit to choose the options you want, just search “advanced healthcare directive” CA or whatever state you're in & talk to your loved one about your wishes, its the one thing you can’t do when the time comes 🤷‍♀️let them know where you stand on the important decisions, some people would never want to be keep alive on a machine for years, others would? Where are you? What if you had no chance of waking up? Does that change your mind? 🤔 talk about it, it matters! Don’t let the ER make this decision for you.

When I medicate a patient

 From the very beginning of nursing school I can remember how much importance was placed on learning how to perform medication calculations & researching the medication of our patients the night before our clinical rotation days, This was to ensure we knew everything about the medications the patient was taking, including the side-effects, possible adverse effects, allergic reactions etc, and you better know if your patient had any allergies to it or contraindications 🧐 because the instructor was probably going to ask you in the morning & you didn't want to look like a fool. I was one of those students that was Not gonna be caught off guard & worse yet Not be able to answer the patients questions about the medicine, to me that was unacceptable, so I took it very seriously & carried that with me into my career.

As an ER nurse there were many times when a patient would ask me why is the doctor giving me this med? I would explain in detail because I felt patients have the right to know exactly what they are getting & why & decide if they want it. Of course I would make the case for it if it was necessary to help them choose wisely, but I never pressured anyone to take something they didn’t want. I also discussed side effects known & possible unknown as listed in literature, as is my duty, that's what’s called informed consent, I never gave something without explaining it first, of course unless the patient was unconscious, drunk, or a violent psych pt we had to take down & we were restraining them or we were saving them in a code blue etc. If a patient decided against it, I explained the results of that decision based on their condition at the time also, that’s how nursing works, ultimately it’s the patient’s decision. On a few occasions the doctor would have a patient sign a form called AMA against medical advice, if a patient decided against a medication that the Dr felt they needed to save them & they might die without it & the pt decided to leave, they would be asked to sign this form that states the exact risks of not following the medical advice, but that happened about a handful or so times in my career.

My goal was always to educate my patients as well as care for them, I tried to empower them also by teaching them about their conditions & what questions to ask their doctors when they go to regular appts, in hopes that they would follow up, they usually just came back to the ER but I tried. 😁 As a nurse one main goal is to do no harm to our patients, just like doctors, so I personally would never give anything I didn’t research & explain risks & benefits of to My patients. I wonder if nurses of today can say that? I am glad I became disabled due to a heart condition & retired in 2019 because I would have never given what I’ve researched to people, just my opinion, I’d quit first.

Family Traditions

 

My eldest daughter recently told me she wanted to start a new family tradition now that she has her first home that I helped her purchase, that we would get together every year at one of our houses & start this year at hers. She then said something that kinda surprised me, she said we don't really have any family traditions. 🤔

“Really we don't?” Well, I thought we did, I raised my kids with the tradition of going to church so they would have stability & role models & Pastor Murray came in handy when I needed his help as a male role model for my son, and yes it changed after Cory (my fiance) died in 2001 but in life things change. But church was a big part of our lives for a long time. I also had a tradition of celebrating birthdays no matter what, cause they were important & special as well as graduations, dressing up for them, celebrating in a big way and I stressed how important school was & I thought that would be remembered & carried on🤔. I had a tradition of giving money for Christmas & letting you buy your own gifts & wrapping them so when you opened them on Christmas day there were no complaints 😁remember that one? Guess not🤷‍♀️ yes we had some family traditions but I guess you forgot or they didn't mean the same to you as they did to me, so you forgot about those.

I think my daughter will realize when her kids are grown and all that she is trying to do for them to shape their lives & who they become and all the sacrifices, decisions whether good or bad come back to her in the form of judgment from her grown child, then she will understand. She will understand how I'm feeling now & I will be dead by then but she will at least know for a moment we shared a sadness, mine passed quickly because I know the strength of my mind & stubbornness to overcome what I have, I only hope she inherited that from me. The fact she allowed herself to get linked up with a weak disrespectful man concerns me for her future but as long as I’m alive he won’t hurt her life, well any more then he already has anyway, I only hope she sees him for what he truly is before his weakness and not having any honor or respect of family structure infects her children beyond repair. These things will matter in the end because man who doesn't respect his own mother, whether she deserves it or not, will never truly respect his woman & he’s already shown he’s willing to be disrespectful to woman's mother. This will pass down to his daughter by showing her that its okay for men to treat women this way, & he’s too damn ignorant to realize that he’s setting her up to end up settling for someone just like him. Its a terrible cycle. I pray it gets interrupted. My daughter deserves so much better & she’s much smarter then she knows, but I think this next year is going to be an awakening for her.

Main tradition watch out for each other no matter what!😎

Correcting my birth certificate

   I found out that my dad was not listed on my birth certificate when I was about 12 years old and I remember I was upset with my mom about it because being a mixed female who still looked more black then white, the person listed was white but my actual dad is black. I didn't know what to do about it at the time & because my dad was previously violent towards my mom I was scared to tell him about it, cause I didn't think he could possibly know about it. 

   I became a teen mom and life was complicated and other things became priority so the issue was less of a concern but every now and then I did think of how I could change it without endangering my mom, but there was no solution. So I changed my name after getting married, having kids etc, but even after my parents split up and my dad was living with me and he was sick after his stroke I thought about it again, but then I didn't want to break his heart by telling him, so I didn't bring it up.

   Now I'm getting ready to get my passport & I need my birth certificate and its all coming up again cause I have to look at it again so now I need to figure out how to prove my dad is my dad, and as fate would have it I have a sister who's 20 years older by my dad that I've gotten back in touch with that I can do a sibling test with and establish DNA that way to get the court to change my certificate that way. So its actually a blessing it all came up again cause now I'm back in touch with family I lost touch with, so this is a good thing. My kids now can meet their aunt and cousins too, so it's great. 

   Maybe one day I won't feel angry at her about it or maybe if she had just said hey I didn't know who the dad was and thats how all that really happened, I'd feel satisfied, instead of the crap she told me, cause it comes out the same way, but the fact she never fixed it is what makes me mad. Being a mom myself, I just think some things matter more then your pride, and your kids Correct father being listed should be #1. 

Being a Registered Nurse

I am still licensed as a Registered Nurse even though I was forced to retire in 2019 due to my heart condition, I unfortunately will never be able to work again because I can't stand up much longer than 10-15 minutes at a time so that takes nursing out of the game plan. I keep my license active because I worked very hard to get it & I will not just let it go, I still read to keep up to date on things especially for my families sake if they have issues or questions & it keeps my mind busy. I will always renew it as long as I'm alive & able, its very special to me and a huge accomplishment in my life. 

I was a single mom of 3 when I attended nursing school & managed to complete it and showed my kids that you can achieve anything if you work hard & want it bad enough. I hope they carry that with them & pass that mindset on to my grandkids also. It was not easy but they know it was worth it, hopefully those are the things they remember when I'm gone from this world. I know that there will be many things remembered but my strong stance for doing whats right for my family, I hope is the Most remembered 🙏. 

I feel nursing has lost much credibility lately & I hope those that have no-one to ask things of get the help they need because the medical community has done a disservice to people over the past few years & its a shame. I know I am a fighter & question and read & don't just go along with things but I feel bad for the lay person without medical knowledge,  its shameful what's happened 😒 I don't think people will realize what's really been done for a couple years yet & God help them that couldn't stand firm on their beliefs. We all choose the hill we will die & fight on!