Thursday, November 20, 2014

Rainy Days Are Here and I Don't Mean The Weather

Rainy Day Fund

          You all know the phrase "save for a rainy day"? It's something that I practice almost religiously. Along with the unemployment checks for 6 months, it was reassuring that I had saved for a rainy day.

          Since I finally got gainfully employed 3 months ago, there seems to be more rainy days occurring in my life. First was the plumbing problem I had where a new garbage disposal system had to be installed because the old one was corroded. This happened just right after I got my first paycheck.

          Next came the car repair which involved brake pads and rotors replacement, plus a new battery because the old one had 10% charge left. The front brakes had been a problem for several years and I had been putting it off. I had been avoiding driving on the freeway because sudden or hard braking from full speed made the front wheels shake violently feeling like the wheels were going to fall off.

          Then just as winter started, my wall furnace went on the fritz. For the past 22 years, I've been able to relight the pilot on my own by following the manufacturer's instructions. This time the pilot light won't stay lit despite several tries. I called the Long Beach Gas Department and they sent a technician to check it out and he said that there was a problem with the electrical system. So I had to call a heating company whose technician first diagnosed a thermocouple problem. So he replaced that but the heater still didn't work. That could only mean one thing: the price of repairing the heater would get steeper.
         Sure enough, he had a second diagnosis and this involved the generator. He explained to me how the gas, the pilot light, and the electrical system worked. I asked him if he was sure that if replaced the generator, the heater would start working. He said "well, there are really only two parts of this particular heater: the thermocouple that I replaced and the generator". So I asked him for a price quote and again, sure enough, the price more than doubled. Well what choice do I have other than freeze in the wintertime. Unlike the movie Frozen when one of the characters sang "the cold never bothered me anyway", I prefer to keep myself warm because cold bothers me. I had to take a nap before work, so I asked the technician to come back the next day.

          So there you are. Three major rainy days in the past three months of full time employment. The timing couldn't get any better because at least I now have the income to use as an umbrella for the unexpected precipitations. Thank GOD! Oh boy, living in the United States sure is expensive! Too bad my rainy days isn't helping the drought in California.

Update: November 22, 2014 - Well my old Asus Transformer TFT 101 is on its last legs. Sometimes it works and sometimes it doesn't. The thing I like about this device is the 16 hour battery life when attached to the keyboard and nothing comes close to it at a reasonable price in the market nowadays. Time for another rainy day expense to replace it?

Saturday, November 15, 2014

CHLB Center for Mental Health NOC Shift BHW Duties and Responsibilities

          I just finished my 3 month probationary period in my new job as a Behavioral Health Worker, and while in orientation the first couple of weeks, I learned about my duties and responsibilities, which I now list below. Although the list may  be longer than what I had to do as a care manager in assisted living, it is not as physically demanding. At least not yet.

          First of course is clocking in to work, then checking the assignment sheet to find out if I'm assigned to Unit A, Unit B, or the Geropsych unit one floor up. Then all the staff hang around the lobby area between Unit A and Unit B in what they call the huddle. During the huddle a short report is given on the number of patients on each unit, how many possible admissions are expected, and how many are being evaluated in the emergency room downstairs or in other hospitals. Reminders are also given on any special things that need to be done. After the huddle, we proceed to our assigned units to listen to report about the patients from the day shift.

          Then we do our first rounds checking the location and behavior of the patients. We do this every 15 minutes throughout the shift. Next, we check the vital signs of all patients (temperature, pulse, respirations, and blood pressure). We are usually accompanied by a registered nurse so they can also check on their assigned patients. After all vital signs are done, we give a copy of the vital signs sheet to each nurse, then we enter the results in the Epic electronic medical records on the computer.

This is as far as I will write in narrative form. What follows is the list of my other duties:

  • Make sure water container has cold water (add ice from freezer as needed).
  • Assist with admissions as they come in (vital signs, papers signed, belongings; contraband; valuables check).
  • Snacks at 2030, Canteen run to vending machines,  and Contraband time right afterwards.
  • Prepare new rounds sheets for next day. File old rounds sheets at midnight.
  • Break down discharged patients charts & keep dividers in binders. Place D/C chart in cabinet near copying machine.
  • Make admission chart packs after 2300. Put nursing paperwork and admit packs in empty binders for new admissions.
  • Clean tables in dining room with disinfectant wipes. Order staff pantry supplies from Dietary Department as needed (fill out form then fax). Straighten out dayroom, contraband room and donated clothes (in solarium) as needed.
  • On geropsych unit, give a shower to at least one patient in the morning (red key in nurse's station for shower & vending)
  • Continue Q-15 minute checks throughout the shift. Approximately 5:30 a.m., enter patient's number of hours of sleep and sleep quality in EPIC./ Print out vital signs sheet and meal/shower/BM log for the a.m. shift./Serve decaf coffee at 0600.

Admission papers:  BHW - Release of Information, Notification of Patient Admission, Telephone List, Consent to Photograph, Patient's Rights, Valuables List, Rounds Sheet.
                                 RN - Medication consent , Interdisciplinary Treatment Plan (multi page), Physician's Initial Assessment, Skin Assessment, Patient Education Record, Discharge Recommendation.

EPIC for BHW's:
  • Log in. To find your patients: Click System List on left side, Click Units-CMH. Click CMH 4A or 4B or 5. Click and drag Unit chosen to My list on top of left side of screen.
  • To chart vital signs: double click on a patient's name to open his/her chart. On left side of the screen, click Doc Flowsheets. On the tabs on top, click Vital Signs. Enter the vital signs in the designated areas. When done, click File on upper left corner. Close the chart by clicking the X next to the patient's name. Double click on the next patient name on the list and repeat above instructions.
  • To print labels and ID wristband: on the left side where you found Doc Flow sheets earlier, click Form Reprint. Click on what you want to print and enter how many, then click Print.
  • To chart hours and quality of patient sleep: as above, click on Doc Flowsheets, click Sleep on left side, enter number of hours in designated area, click Quality of Sleep, choose appropriate description from drop down list or type in your own comment (F6 key), click File on upper left corner, close the chart by clicking the X next to the patient's name. Double click on the next patient name on the list and repeat above instructions.

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