Friday, September 30, 2011

The "Overdue Day Off" Friday Random Ten

I was working yesterday-- in the midst of my third double of the week-- when I realized that I'm not actually done with my training despite the fact that I'm pretty much working as a dialysis nurse at this point. My unit is so short of people that they're trying really hard to accelerate training so they can get us on the floor working. Not a bad spot to be in. I like the job a lot; it's interesting and I work with a lot of nice people. And it sure is nice knowing I'm helping people in the process of making a living.

I was on overtime after about five o'clock yesterday, so I got a day off today. I used some of the time to catch up with an old friend on the phone, some of it to catch up on my errands and some of it to rest. It wasn't until I actually rested that I realized how exhausted I'd been; new job, tons of new skills, lots of hours. I still have a bunch of stuff to learn and skills to master. But I was showing a co-worker/trainee (who has himself shown me better ways to do things on many occasions) an easier way to put a tagaderm dressing over a catheter and had a moment where I suddenly realized what I'd done. I realized that I was doing things that I never would have believed I could have done just four years ago. I am trusted to set up a complicated and expensive machine and attach peoples lifeline-- their blood vessels-- to that machine and give them treatment that they would otherwise die without. It kind of blew my mind. And made me feel like I'd done something beyond making sure that I'd get a nice paycheck next Friday. And damn that's a good feeling.

And I have to admit that the financial aspect is something that's been satisfying. I have a nice little pile of debts that'll need to be taken care of in the next six months or so, and it'll get taken care of. But today I actually felt confident enough of my financial future to add internet listening-- at the cost of $2.99 a month over the cost of the basic service (which is $12.95 a month) to my Sirius/XM satellite radio. I got even crazier and signed up for the free trial of the New York Times on my Kindle; I anticipate being able to spring for the $19.99 a month for the service after the free trial is done in two weeks (it also allows me to have unlimited access to it on the computer). After four years of sweating about money, it's nice to be able to ease up a bit. And after 17 years of worrying about where my son's college money will come from, it's nice to stop worrying about that.

1. Twistin' the Night Away- Sam Cooke
2. Why Me?- The Planet P Project
3. It Isn't Gonna Be That Way- Steve Forbert
4. No Feelings- The Sex Pistols
6. Golden Slumbers- The Beatles
7. Time To Kill- The Band
8. I Hate Rock and Roll- The Jesus and Mary Chain
9. Pack Up Your Sorrows- Richard and Mimi Farina
10. Door Number 3- Steve Goodman

1. This song always makes me think of the movie "Animal House."
2. A nugget from the early eighties
3. Forbert had a hit with "Romeo's Tune," but has a bunch of other great songs, including this one.
4. God, that one and only Sex Pistols album still sounds great, doesn't it?
5. Great almost-instrumental from 1974 (there's a chorus by The Three Degrees at the end). "TSOP" is "The Sound of Philadelphia," and "MFSB" is "Mother Father Sister Brother." The Three Degrees would later have their own hit with "When Will I See You Again?"
6. From "Abbey Road," the last Beatles album (Though "Let It Be" had been recorded earlier and shelved, it was released later)
7. From the great "Stagefright" record
8. I always have to crank this song to "11" whenever I hear it.
9. Mimi was Joan Baez' sister. Her husband Richard was killed in a motorcycle accident on the way home from the party to celebrate the publication of his book "Been Down So Long It Looks Like Up To Me."
10. Goodman wrote this comic take on "Let's Make a Deal" with his friend Jimmy Buffett.

Monday, September 19, 2011

Seriously, Let's Get A Grip, People

In the last couple of weeks, there's been a big hullabaloo over Netflix raising its prices. Let's put it all in perspective.

First off, to continue the plan I've been using, the ten buck "one disc out, unlimited streaming," will go up to 16 bucks. Okay, yes, that is a 60 percent increase. But let's put in perspective. I went out running tonight and ran 40% further than I ran last time. This meant, in reality, that this fifty-year-old ran 16 blocks instead of twelve. Sounds like a lot more when you say "40 percent," but in reality not much more. The fact of the matter is that at 16 bucks, my plan is still a great deal. My kids stream their South Park and scary movies and I stream my documentaries (many of which are only available this way), old television shows and artsy movies. And I can get my one disc at a time-- usually classics and more arty movies. And we can watch different shows at once, on our big tv connected to the Wii, on most of the household computers and even on our ipods.

I've followed Netflix-- and been a customer (as well as getting my folks started on it) for 6 or 7 years now. They've taken a daring business model and improved on it, as technology has changed. And they've actually been able to turn a well-deserved profit; according to Wikipedia, they turned a $283 million profit on a $2.17 billion gross, a healthy 13% profit. As they expand the percentage of their offerings as streaming, they'll absolutely have to pay more. That's the way the world works, kiddies; if they're offering more service, they'll have to pay a little more for it and so shall we. I still consider the sixteen bucks a month I pay for Netflix a bargain.

Friday, September 16, 2011

The "Quiet Night In" Friday Random Ten

I'm in my second month of training to be a dialysis nurse. In the last week, my preceptors have been letting me do most of the treatment. I've finally gotten the hang of setting the dialysis machine up, and connecting the patients up to it. Since most of my patients are "acute care," most of them have venous catheters, but some have "fistulas" or grafts, which entails putting needles in. I've gotten to do that twice in the last week. I don't find it terrifying anymore. I'm realizing that a lot of what I do would make a lot of people faint. It comes with the job.

They've been trying to rotate me through the hospitals I'll be working at so that I can know where equipment is, who I'll have to talk to and work with, etc. I've still got a couple of hospitals to go. Ironically, they're two of the ones closest to my home.

There was a lot of work this week. I had to leave work by 1:30 today, because I'd hit 40 hours; my manager doesn't want us to go into overtime while we're training. After we're done training, overtime will be no problem; we can work as much as we want or can handle. With a kid going off to college in less than a year and a ton of bills left over from nursing school, I'm okay with that.

It wasn't all work, though, this week. My old friend Larry was in town. We met when we were next-door neighbors in a dorm at Eastern Illinois University in 1982. I watched the last episode of MASH in his dorm room (he had a then-coveted color tv in his room). I found myself wishing that I didn't have to get up at 5am the next morning, and that I had about 20 more hours to talk to him. He lives in Connecticut these days and is hoping to move back here to Chicago, where he's from. I, for one, can't wait. He's proof that great friendships are like fine wine, improving with age.

In the meantime, as this week draws to an end, I find a bit of humor. I never thought that an eight hour workday would seem short. I never thought that being able to run a couple of miles without my knee screaming would be so thrilling. And I never thought a quiet night in some good tunes, a glass of Merlot and blogging would be my idea of a great night. But here it is.

1. Magical Misery Tour- National Lampoon
2. White Rabbit- The Jefferson Airplane
3. Breaking Us In Two- Joe Jackson
4. Gut Feeling/Slap Your Mammy- Devo
5. Senor- Bob Dylan
6. Chemistry Class- Elvis Costello
7. Long Time Gone- Crosby, Stills and Nash
8. The Stripper- David Rose
9. I Believe- Joe Satriani
10. I Got You (I Feel Good)- James Brown

1. A spoof of John Lennon composed of actual (and outrageous) John Lennon quotes that was performed by Tony Hedra, who is best known as Spinal Tap's road manager and his best-selling book "Father Joe: The Man Who Saved My Soul."
2. My son and I were just discussing this song last weekend. Love the scene with Benecio Del Toro in "Fear And Loathing In Las Vegas" revolving around this song.
3. This song takes me right back to my life in 1982.
4. From the first Devo record, which still blows me away when I hear it.
5. From 1978's "Street Legal." Not Dylan's best album by any stretch, but it has its moments, including this haunting song.
6. Man, "Armed Forces" still sounds great.
7. David Crosby wrote this after Bobby Kennedy's assassination.
8. I've actually got the 45 of this, which I got from my aunt in a big batch of 45's she gave me years ago. That seems very, very wrong, somehow.
9. Rock critic Dave Marsh, who I generally respect, called Joe Satriani one of the top ten stupidest rockers in his 1981 book "The Rock Book of Lists," but I love this song.
10. One of my earliest memories was being about four years old, at my neighbor's house, watching James Brown sing this song on the television. I was hooked for life.

Friday, September 02, 2011

The "One Month In" Friday Random Ten

Today marked the end of my first month as a nurse. We had three days of classroom training, ending with a final on Wednesday. I got a 93%, well above the minimum 85% I needed to get. I was happy to finally get into the field and work a couple of days as a nurse. I'll be working with a preceptor for the next month.

Yesterday, I had an experience that made me realize I'm beginning to know what I'm doing. My patient was doing well, then suddenly her blood pressure started dropping fast (we monitor the blood pressure constantly). She told my preceptor and I that she had a headache (a common side-effect of dialysis), and then I noticed a change in her demeanor and pallor. My preceptor, who obviously had a lot more experience than I, noticed it too. We tried a couple of interventions without result, and quickly decided to end the treatment. She quickly recovered. I was happy to realize that I had recognized this event that up until now had been just something we talked about in the classroom.

Today I was working with my first patient of the day, who had only recently discovered he had renal failure; this was only his third dialysis session.

When a patient is either new to dialysis or a temporary patient, we use a catheter to gain access to their veins; it's similar to an iv, but has two lines and is placed in one of the big veins in the neck or upper chest. We try to limit their use because they are prone to infections. This can be a real problem because they can spread infections throughout the body since they're placed in big veins. If someone will be getting dialysis for a long time-- even the rest of their life-- surgeons create a thing called an arterio-venous fistula or an arterio-venous graft. In the first, a surgeon connects a big vein and a big artery in the upper or lower arm, creating a place we can access for dialysis. In the latter, a surgeon uses either a donor vein or an artifical tube to connect an artery or vein. It doesn't look pretty, but it's way safer for the patient, with only 1/7 th infection rate of a catheter.

In any event, my patient was clearly scared and confused. My preceptor and I answered a few questions he had. Later, a young resident walked in and told him that he would go later for an ultrasound to map out his veins for a fistula or graft. As she blabbered, I could see the anxiety and fear level in his eyes rise. I tried as politely as I could, trying not to step on her toes, to suggest that a little "patient education" might help. She completely missed the cue. She walked out, and so I explained to my patient what fistulas and grafts were and why they were beneficial. His anxiety level dropped notedly.

I helped my preceptor set up the last patient of the day. He was obviously diabetic, and had lost a leg to the disease. A son and a daughter. who were in their forties, were there caring for him. The son had to leave for a while. As we were getting ready for the dialysis, it became clear that our patient needed his adult diaper changed. His daughter struggled to change it, and was going to call the nurse's aide. I told her I would help, and showed her how a little easier way to do it. She was very, very grateful. I realized later that she had appreciated not only the help but that I'd helped her father preserve his dignity. Between this moment and the others in the last couple of days, I realized that I was in the right profession.

1. Soul Survivor- The Rolling Stones
2. Baby, I Love Your Way- Peter Frampton
3. Crystal Ship- The Doors
4. Low- Cracker
5. Just Got Lucky- The Joboxers
6. Livin' In a Fool's Paradise- Mose Allison
7. Theme From Shaft- Isaac Hayes
8 You're On My Mind- The Dirtbombs
9. Morning Sky- Chris Hillman
10. Incense and Peppermint- The Strawberry Alarm Clock

1. The closing track on "Exile On Main Street," the greatest rock album ever recorded.
2. Was never crazy about this song, but reconsidered it after hearing Lisa Bonet singing it in "High Fidelity."
3. My son was telling me a year or so ago that he was surprised to discover that the Doors' self-titled first album was not a "greatest hits" package. A phenomenal debut.
4. Just have to crank this one when it comes up on the radio or shuffle. Got one of my top ten favorite lines in a song ever, "Don't you wanna go down/Like a junkie Cosmonaut?"
5. This snappy little single stood out, even in a year full of snappy little singles, 1983.
6. Heard this song a lot as a young guy, but didn't know who did the version I heard. Thanks to Youtube, I was able to figure out it was Mose Allison.
7. Issac Hayes had written lots of hits for others before he finally had one with this smash hit. This song was on the jukebox at the Gingerman Tavern in Chicago in the late eighties through the early nintie; it was played 25-30 times a night, and every single time, every patron (myself included) would shout "Shut yo mouth" at the appropriate time.
8. This was originally done by Ronnie Wood's old band The Birds (not to be confused with Chris Hillman's old band, The Byrds).
9. Hillman's a founding member of the Byrds (not to be confused with Ronnie Wood's old band, The Birds)
10. I never get tired of hearing this big hunk of psychedelic cheese.