A Day in my life!

November is here!  The leaves are falling, the air is crisp and snow will soon be falling!
Here's what I did on the first day of the month.

November 1 fell on a Thursday, which is the busiest day of my week,  It's the day our Dr comes in and does rounds, so I usually end up at work pretty late.

 I arrived at work at 7:15.  This is the hall my office is in.  No one was there yet, except the housekeeping crew.

This is on the corner of my desk; my business cards and a little pumpkin which was painted by some school kids.  They painted a bunch and brought them for everyone to put out throughout the facility.

This is the nurses station on our skilled nursing unit.  It's been very busy over there, so I have been coming a little early to get the am blood sugars on our diabetic patients.

Here's what it looks like in the sitting areas, while I was getting the blood sugars.  Most everyone was still in bed and all was quiet.


Once the blood sugars were done I started gathering charts on the people that were being seen by the doctor.  I had called hospitals the day before so I had discharge summaries on our new residents.  I also got copies of recent labs and blood sugars.  I make notes of anything that may be going on with them, so the Doc is well informed, and clip everything together on the chart.
While I was doing this, I got a call with results from an ultrasound that was done late the night before.  One of our new residents arrived with one leg much more red and swollen than the other, so the ultrasound was ordered.  The results showed a very large deep vein thrombosis in her leg.  This is dangerous, because a piece of it could break off and go to her heart, brain or lungs.  I called the Dr and got orders for some blood thinners, and also to keep her on bedrest for 3 days, until the blood thinners start dissolving the clot, and then called the family to update them.

It was now 9:30, which is the time all the managers meet in this conference room. We review all the orders and progress notes from the day before.  This ensures that things get followed up on as needed.  We talk about discharge plans, any pending admits or any other things that may need to be covered.  This meeting was done at about 10:30.

After the meeting, I worked on my vaccination records.  In October I did flu vaccines on all the residents, and then have been giving them to the employees.  The employees take a little longer because I have to wait for some of them to get in and have the vaccine.  Once they are done, they have to be entered into the State of Michigan's vaccine site.  I also have to enter them into our facility site, so it takes some time.

Our Dr arrived at noon.  We eat lunch together, but it's a working lunch.  We review any questions with people he isn't seeing and he gives me verbal orders that I put into the computer.
When we finish that, he goes over each chart and we go out and see residents, one by one.  On this day we had 3 new admissions to see, and we saw 4 of our long term residents.
He writes notes on each of them, I scan them and enter them into the computer and put in orders.
He left about 4:30.
I then call the families of the people we saw and update them.  Any new orders need to be printed and put into the med book.  I talk to each of the nurses to tell them about the orders, and update a sheet at each nurses station to remind them of changes and what they need to be charting on.  Then, the charts all get put away.
I left at 5:45pm

It was getting kind of dark when I left, but I saw some pretty colors on my way home.

Bob was already home, and had warmed up some soup I made the day before.  (I'll be sharing that recipe on Thursday)

We had a quiet evening, so I've got no more pictures to share!

Happy Birthday Ruby!

Monday is our Ruby's birthday!  She is going to be 4 years old. Life with Ruby is never boring.  We never know what she's going to do or say.
Here's a few funny things just from a couple of weeks ago.
We had the girls overnight last weekend.  After we got them tucked into bed, I was putting things away and getting some things ready for the next day when Ruby called me. I asked what she wanted and she said "Grandma, don't go roaming around at bedtime".
During the night (3am!), she showed up by the bed wanting to crawl in.  I told her she should try to sleep in her bed for a little longer. 5 minutes later, she was back. She crawled over top of me so she could be in the middle of the bed.  She got settled in and all was quiet.   Then -
"Grandma, did you ever wonder what it would be like if the world was sideways?"
"No, I haven't ever thought about that!  We should go back to sleep now"
A few minutes later -
"Grandma?  What if even the floor was sideways?"
"That would be funny!"
Then there was quiet for a while.
At 7am, suddenly the lights were turned on (by Ruby!):
"Grandma, get up!  It's light out!"
It really wasn't, but it was light in the bedroom so we got up.
And that's just one night in the life of Ruby.
Life would certainly be much less exciting without her.  We sure do love her!

Trick or Treat!

I have to share a few pictures of Alaina and Ruby trick or treating.  Laura made them the cutest costumes this year.  They were peacocks!

Don't they look cute?

Each little eye is made of felt, and there are sequins running up each section above the eye.

 Here's Alaina... (The mask is made of felt too)

And here is Ruby.

And here's Ruby after discovering she could get candy by dressing up and knocking on a door.  Laura said they were going to have to explain that she couldn't do it again the next day.  :)
They had such fun!