So. How have y'all been? Everything good in the Midwest? Y'all finally into fall? It has come to the reservation and although there aren't nearly the colors of the Midwest, it is still beautiful in its own way. Even the sage brush turns from a green to a silvery color with greay (my version of can't decide between grey and gray) tops. Lots of yellow leaves, but not the bright orange and red back home.
So what have I been doing since July, you ask? Good question. Not posting to the blog site, for one thing. No particular reason, except every time I tried, I just wasn't in the great mood y'all deserve. And no particular reason for the moodiness other than periods of homesickness, lots of hours at the office, and just plain old tired, but not exhausted. That's the good news. Okay, maybe a couple of times. I'm mostly thriving on the work and enjoying it immensely. I feel as if I'm growing a fledgling business: slightly imperfect, not very efficient, but lots of promise to work with. I want to give you rundown from today back to 7/19/18. Exercise my short term memory cells--they go so fast!
The week of 10/22 was a very busy one with home visits on Monday AM, three patients in the afternoon, surprise reports due before Tuesday evening, patients to see Tuesday AM, DM class Tuesday afternoon, meeting Wednesday AM, National Bus Safety event at Ganado School District on Wednesday 9-2, surprise meeting said surprise reports were for on Wednesday late afternoon, Mass Flu Vaccination/Student Day on Thursday and Mass Flu Vaccination/Community Day on Friday for a total of 1,412 people for flu shots and 150+ for A1c tests. Lots of very long days with the HIM supervisor breathing down my neck for and sending nasty grams to my boss for charting on the three charts from Monday afternoon. Not a good week for neck breathing.
The annual National Bus Safety event at the Ganado school bus garage was first for me. So glad to have Herman Kee, CNA and veteran event person with me. He made sure we got through the day with enough incentives (giveaways) for the kiddos, teachers and others. All elementary kids from pre-K (so cute!!!) to the 8th graders (not so cute!). Along with Sage DM Services they had EMS, GFD, Magan B., 2017-18 Miss Western Navajo Teen. I'm not sure how the young ladies are chosen. This young woman was very pleasant. The woman standing next to her is her mother and a very proud one, rightfully so. The little kids loved Magan. Oh, and the kiddos got to see the equipment used to service the buses and see the bus engine which is at the back of the bus ala VW bugs.
Next, a birthday shout out to Razen Mae, one of my modular mates. Her b-day was Friday. There was a surprise impromptu party Thursday night with lots and lots of good food. Roselle, another modular mate is a fabulous cook. Cooking his her therapy. Roselle did a wonderful job as well as Hazel. I contributed leftover ham and bean soup. Not very birthday like, but it was very short notice! The birthday girl. Not a great picture since she is a beautiful woman.
This weekend I'm house and dog sitting for the physical therapist and her identical twin. Aimee and Stacie are off to Albuquerque for 36 hours. They pick up and short term foster the rez strays, getting them to no-kill shelters and fosters that will give these animals a better life. They are awesome ladies and helped me with Sophia (AKA Lil Momma) and her brood. That story is coming up. At any rate they picked up Carley, a very sweet, gentle collie mix. They couldn't get her to another foster before they left. I couldn't keep her at my place. So, I got to stay at A & S place which is a cute little bungalow with three bedrooms, a tiny kitchen, bigger bathroom than I have, tons of storage, a deck, big laundry room, the description of which is making me sound covetous. I am. The girls will be back tonight. Carley's next stop on the foster dog line is today at 1:30-2P at the intersection of I40 and State Hwy 191, so I'm making the transport. It's only a 45 minute drive one way and a nice one. Great day to do it.
I was supposed to go spinning today meeting a new to me group, but I don't know where the place is. As it happens, one of our NPs is the niece to the lady that hosts the spin in. I'll ask Melanie on Monday and go next month. I need some spinning muses. I want to, just not doing it.
Back to October happenings. I'm finally fully staffed in the DM Service dept. if you don't count that I'm not permanent. Angelita Mina started 10/1 and Pepper Morgan 10/8. These ladies are Patient Care Coordinators. The position means they do tons of clerical work, may give injections, do VSs, events and DM teaching at a paraprofessional level. Hopefully by the end of the year, they will be fully oriented and ready to take on the f/u folks. We will also be able to schedule additional patient visit time. right now we do Monday afternoon, Tuesday and Thursday all day. As the RN, I'm to do the hospital and new patient referrals as well as the in home visits.
September is a bit hazy since I went on vacation the last week of it. Maybe I need to work on long term memory cells as well. I was able to take a week and fly home for a haircut, (thank you, thank you, thank you, Cascea Garner, for taking away from your family time to make time for Tom and I.) Then Tom and I got in the car and drove to Marion, IL for the night. Sunday we drove to Gatlinburg, TN, one of our favorite vacation spots. We had a lovely cabin (Check out Jackson Mountain Homes for the best choices and rates) with a hot tub and jacuzzi. When Tom and I go on vacation, we plan to spend some time sightseeing, but we also plan for down time as well. He brought books to listen to and DVDs to watch. We had basic, and I do mean VERY basic cable so that only goes so far. We rode a mountain coaster twice and did a mountain glider. There is video and pictures, but I've not saved them to my hard drive apparently. I'll do that another time. I got to hit the Smoky Mountain Spinnery not once but twice so there is new fiber and yarn (no surprise there!) We bought jams and jellies of which only three made it to Ganado. What a mess that was. Three or four bottles of wine! Don't tell the Navajo Nation. A new mug, of course. We had seven days and nights in the area. We really relaxed and enjoyed ourselves.
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| Us at the Huck Finn Catfish Emporium our first night in Gatlinburg. This is one of our stops when we come. I don't know why I cock my head like that in pictures. Looks kinda dumb really. |
September started off with Labor Day, litterally. Pun intended. I picked up a stray and got her in the car to take to the Gallup Humane Society on Saturday of the holiday weekend. Got all the way there and they were closed for the weekend AND full, so they wouldn't have taken her anyway. I made my quick trips and got her back to Ganado. Then I figure out she's VERY pregnant. Should have been able to tell that during the two weeks I was watching her since she was so skinny everywhere but her belly! Seriously. I didn't really think about it until I got her into the house. Hazel was pretty sure she was very due. Sure enough, she went into labor around 9:30 pm Sunday night and had 7 puppies. I'm now officially a canine Douala. Not a very good one, though. She labored until Monday night when she delivered three more puppies, but stillborn. One would not have made it, but the other two might have if the first had not blocked the way. Enter Aimee and Stacie who brought food for Lil Momma and graciously looked for someone to take her and her babies, not to mention get them to the foster.
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| A pail of puppies. Had to get them out of the whelping box so I could clean it up. |
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| Sophia aka Lil Momma before birthing. |
Now we're into July. I've told people separately about the things that transpired 7/19/18, but not all of you in one fell swoop. So if some of this is old news, please be patient. Of course, as some of you know, my first contract here was up 6/23/18. Honestly, I wasn't sure I'd make it that long. Up until mid June, life in my department was barely tolerable. Than it changed. Suddenly. Not sure if it was the arrival of my now administrative assistant, Maghan or something unworldly, but the office became fun to be in. I felt accepted AND wanted and not just being tolerated. My then boss was asking me to pick some add'l responsibilities, which I gladly did. We had lost one of the original group I started with when Bebah left to go on to bigger and better things mid-June working for IHS closer to her home and we had been working short. We acquired Maghan as a student worker through her chapter. She was to be with us until the end of July. Maybe having someone closer to her own age in the office helped Shaiyaia to be more relaxed. At any rate things were better and I was glad to renew my contract, but guardedly. July 19th dawned like all the others. Just kidding--couldn't help myself to add dramatic effect. I found out early in the day Emma had tendered her resignation effective the end of the month. I won't divulge the reasons she gave. There are always three sides to every story: hers, theirs and the truth. At any rate, by 2pm, Shaiyaia had tendered hers as well to be effective by the end of the month. Lots of drama ensued. By 4pm that same day, both were asked for their keys and badges and were escorted out of the hospital! Alrighty then! There is now no permanent staff in the diabetes office. None! And, at the time, only Dorothy in the Community Health Nursing department as Karen had returned to the main floor being done with her temporary spot with the department. I spoke with Ernasha, my immediate supervisor now, advising her I was happy to help in anyway I could. How hard could it be...only Maghan and myself in DM and Dorothy in CHN? Was I in for an eye opener. Ernasha spoke with administration and my recruiter and by Thursday afternoon, I was the interim supervisor and my contract extended to 12/29/18. Queen of all I surveyed! Yikes!!!
Now I won't bore you with all of the details, but I must tell you about one that was the biggest PIA. Shaiyaia had gone through the entire DM filing cabinet, (which holds some 300 folders I discovered later) and sent appointments via the mail to everyone! Everyone!!! I started calling them the alphabet people because we could tell who had made their own appointment and who didn't since those who didn't were in alphabetical order. The first three weeks were chaos. And only minimal control. On top of that, Maghan was to end her time with us. In an effort to keep hair on my head and me sane, Ernasha wisely asked administration to emergency hire Maghan to help me. But, alas, Maghan had plans she had made knowing she would be done. So, most of the first week, I was alone with assist from Dorothy. I had to make up a postcard-like notice advising those who had been sent appointments their appointments were cancelled. If those folks wanted a new appointment, I asked them to contact us. It was a lot nicer than that, but you get the drift. Then a new schedule had to be made to reflect having only one educator and one nurse to make home visits. Karen graciously agreed to come back in August to resume her temporary spot in CHN. All things said and done, it went better than expected. We only had a couple of appointments slots get double booked. Also, by doing what was done, we discovered, sadly approximately four of our folks had passed, several more had moved and some just didn't want us! That was embarrassing. Many apologetic phone calls were made and lots of egg wiped off my face, but Maghan, Dorothy and I made it through that first two weeks without all of our staff. I'd like to say I sailed through graciously, without doing or saying anything stupid. Not sure that happened, BUT I didn't get fired. Maghan has been a lifesaver, taking on projects and tasks that three other people would have done. Dorothy saved my bacon more than once in July and August by telling and showing me how things were done to run events that we were committed to attending.
The transition has settled down and we have resumed a routine. I've been to more meetings than I every thought I would. I've been looking for ways to bring the department up to "code" so to speak for not only being AADE accredited, but for the annual SDPI application. AADE=American Association of Diabetes Educators. SDPI=Special Diabetes Program for Indians. The first is not Native American. The second part of the Indian Health Services. Every year we are responsible for making a new grant application for close to $500,000 for our program. This grant pays for all of the salaries and supplies of the program. It's a huge deal! Oh and there is one more thing.
During this time, we had not one but three administrative leadership changes! You heard me. Three. The CEO and COO who were here when I started were removed and a new CEO was brought in the beginning of the summer. Things seemed to be changing in a good way for about six or eight weeks. Then, 8/31/18, Razaghi Medical Care's contract with the Navajo Nation Health Foundation was not renewed! New interim CEO was in. Then, the former CEO and COO were brought back, no longer Razaghi employees, but Sage. I don't know about other people, but I felt a bit stressed and unsure what was going to happen. I was sure my contract would be ended at the end of the year, simply because I'm an agency nurse and we tend to be pricey.
My goal before I leave Sage is to leave a legacy of sorts regarding the DM/CHN departments. I may be just bragging, but I'd like to have them accredited by AADE. I'd like for them to stop double and triple charting with standardized charting that will cover AADE and SDPI. I'd like for a new curriculum in accordance with AADE to be in place by 2019. I'd like a DM support group set up out of the old DM class structure. I'd like to have 2019 DM medications in the formulary (we've already disposed of the 1/2", 29 gauge pen needles and syringes that were being given out and added 6mm, 31 gauge) and add at least five more DM related medications for better options for our people. I'd like for my two new patient care coordinators and myself to be certified for foot care. Those are the short term goals!
Ernasha assures me I'm doing a great job. And, if I say "good", she corrects me to "great." She likes that I'm organized and structured. She likes my ideas for the department as they have aligned with hers (I didn't know until we shared.) She sent me to the annual AADE conference in Baltimore, MD the 2nd week in August. It was very nice to network with like minded and hear the latest and greatest. I'm sorry to say, when I left SSM, I left behind many diabetes related management and education tools. I wasn't going to do DM anymore IF I remained in nursing at all. I miss some of those things now.
I've been attending a monthly meeting for the area Public Health Nursing departments and trying to get a handle on PHN/CHN so we can improve Sage's CHN. It isn't bad, but could be better as far as serving the community. Ernasha has given me the go ahead to get another nurse in to allow Karen to return to main floor nursing. There's also a trust issue from a previous CHN nurse who left Sage 3/23/18. She had been here 15 years. She was very capable, coming out of retirement at the age of 65+ at the request of someone in administration. That person left. The CHN became even more opinionated, rebellious and...blunt as time went on. Even I blush at some of the stories I hear. And her time here did not leave a good image of the department for the community or administration. Lets just say it was so bad, one of the administrators has someone contacting him/her to let him/her know when our vehicles are seen doing something that might be frowned upon. Such as stopping to go to the bathroom at a convenience store or restaurant. More on that another day. I'm working very hard to improve the image and restore trust in the CHN and DM departments.
For all of those in my past who didn't think I was supervisor material, I wasn't. But if nothing else has changed in the past four years since my unhappy demise from SIU, HAMP and SSM, it's been enlightening, aging and growing. I hated most of the past four years! I was demoralized, shot down, stabbed in the back, and generally folded, spindled and mutilated of a sort. But it was a learning and growing experience. I don't cherish it. I don't want to do it again. But I'm through it and have come out on the other side only a bit scorched and crispy, but better. I am a supervisor and damned good at it, I've discovered.
As an ending to this long, long catch up: I've lost 28.5 pounds since coming here in March. I'm no longer depressed. I'm in better shape than when I got here although not necessarily great shape. No leaping tall buildings, hiking canyons or lifting heavy weight. Most days, just getting out of bed is the heaviest weight I lift. I've hennaed my hair again and am loving the color. Someone told me there is a redhead in me trying to get out. I've been asked to teach knitting. That may happen after the first of the year. I've seen my beleaguered spouse three times counting vacation and he's coming for a visit for the long Thanksgiving weekend to cook me and some other folks a traditional turkey dinner. There's something historical about that, I think...Seriously, though, he's been great at keeping the home fires burning. My quick trip into St. Louis was less than 18 hours total if I count the haircut, driving out of St.L and driving back in long enough to stay overnight and get on a plane the next afternoon. Even one of the cats didn't get used to me in time. Winfrey stayed in the basement most of the time. But Tom has stayed constant through it all. The job isn't done yet. Ernasha has assured me I'm here longer. My first year with AB Staffing is up in March. After that, I'm not sure what will happen.
Love and hugs,
ckb
It certainly sounds as if life is really good for you now and I'm very happy for you. I'd love to see you back in STL, as I'm sure your husband would, but for now, you're in a good place. Hooray for you! Enjoy it!!
ReplyDeleteTeresa (2catlady)