Bob King Diaries; o4.27.2o18 @ 00:27

Bob presents as a charming mix: equal parts Pleasantly Confused Gentleman, and Wiseacre
Neurologist:   Mr. King, are you right, or left, handed?
Bob:    (pause)… Yes.

This takes place during  an assessment following a most uncharacteristic afternoon and evening for Bob. With the only forewarning being a mild complaint of “the sniffles” for a few days, Bob curled up on his bed after lunch, and remained there for several hours. Slowly becoming febrile, then skipping his supper, he became pretty ill in a short period of time, catching everyone (himself included, I suppose) quite off guard.
In fact ~ we realized later that he had become incontinent of urine (a first), and vomited on himself without ever letting anyone know.

IMG_8618Bob’s fever, weakness, immobility, and confusion, ended up buying him a fancy ride to visit The Sisters of Providence.

Settling in for a night of observation.
Spending the night, as Bob does not do well in unfamiliar surroundings.
The only solid info confirmed: +Human Metapneumovirus (a close viral cousin of Avian pneumovirus).
For extra fun, some elevated troponin labs are detected, and a few other things pointing to Congestive Heart Failure.
Bob has asked hospital staff to call him “Robert,” which is totally his prerogative, yet baffling. He has always preferred “Bob,” no matter the setting.

Meanwhile, there was a Potluck dinner back at Chez Blapplegate… heard it was excellent food, delightful company, and apparently HH performed a Sneaky Preview of his upcoming piano recital piece. Something involving Billy Joel.
Was sorry to have missed it, but sometimes the Kristin & Bob King Show needs to take precedence.
(Random side note: I later learn that there had been some Penis P
asta, flown in fresh from Italy. Really? This I miss?)

I was finally able to get some po intake for myself, after the hospital cafeteria re-opened for the Midnight – 03:30 supper crowd. And I must say, it was surprising how quickly the old NOC Shift Nurse in me was revived. I was back in my old element. I still had it in me.

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#fortheloveofbob

 

Bob King Diaries; o3.31.2o18

Apparently, Bob snuck into the shower at an odd hour yesterday. He slipped and fell.
He was completely out of it when I went to see him later.
He appeared to be confused when I told him it was time to walk down the hallway in the Adult Foster Home where he lives to get his supper.
I had to take his hand and lead the way.
I don’t even know what a person does with that. My dad. Sitting on the edge of his bed, not understanding my words.

Bob King Diaries; o3.o4.2o18

Bob King Diaries; o3.o4.2o18
Bob had “too many” visitors last week.
Home Health PT, OT, RN.

Sunday morning call:
Bob: Hello, Apple’s cell!
Me: Heya, Pops! How’s the morning?
Bob: Oh, the usual. Time keeps passing.
Me: Are you accepting visitors today?
Bob: No.
Me: Not even me?
Bob: Oh, you’re not a visitor.
You’re an… intruder.
Me: Oh, I see.
Well, I have some chocolate for you that I got on sale at Safeway. I was going to bring it by.
Bob: Well, that’s another matter!

Upon my arrival, Bob was sitting in his recliner. One of our favorite old movies, Born Yesterday (1950), was on the tele.
I filled his candy dish with Hershey’s Kisses, and plopped down on his bed to watch.
And all was right in our world.

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One nurse’s thoughts about guns…

The time for polite silence is over.

Question:
Nurse Apple, why did you leave your last ‘New’ job?
Answer:
One flippant remark made by the Medical Director of that company about *How Gun Safety Issues in private homes were communicated to Home Health Clinical staff*

That was the tipping point, anyway.
I was still within my 3 month training period with a primarily amazing Home Health organization.
I was giddy with excitement when I was first hired by this innovative, forward-thinking, community-oriented Health Care organization.

99% of the employees were dedicated, passionate, reasonable people. The goals of the company were in direct alignment with my personal and professional goals as a nurse who cares deeply about homebound people with chronic illnesses or disabilities.

People who know me, know various combinations of things about me. But for the sake of a concise answer to the question at hand, I will summarize a few relevant points.

1) I was raised by my grandfather, a WWII army veteran.
He took me along when he taught gun safety courses in a rural community he lived in during his retirement years.

2) My husband grew up with a father and an uncle who were cattle ranchers in the rural SE areas of Georgia and Northern Florida.

3) I *LOVE* my veterans. Most people know this about me.
I *LOVE* serving veterans through my volunteer and nursing work.

4) I *LOVE* to eat animal flesh. I value and appreciate every morsel of beef, lamb, elk, that I am privileged enough to have honorably hunted and killed for my selfish dining pleasure.

5) I do not shy away from “delicate” or “sensitive” social issues. I feel that if we do not discuss and share our fears/concerns/thoughts about issues such as mental illness and gun safety, we cannot move forward and function as a healthy society.

6) I dig seat belts.
I appreciate Ralph Nader.
(Random, I know, but please hear me out…)

7) I have a 17 year old son who has attended public schools in Portland, Oregon since 2005.
He is my only child, he is my world.

8) I vote.

9) I pay taxes. Nurses are well-paid. I pay *lots* of money in taxes. #Happily

10) My son will be a freshman at MSU in Bozeman, Montana in the fall.
The dorms at MSU have gun lockers available for students living on campus who want to have guns available for sporting and/or hunting use.

11) This one might be less well known:
I enjoy archery, and gun target practice.
But both my son and I have been struggling with some depression over the last couple of years, so my husband and I have *DECIDED TO NOT HAVE GUNS IN OUR HOME AT THIS TIME*

Now, back to the pivotal moment that cemented my decision to leave a new-to-me nursing job that I loved:

The setting was a meeting about how, and if, to proceed with the Home Health care of an individual who was known to be struggling with both debilitating physical, and mental illness.

A Nurse Practitioner (also a newer employee with the company), had called an emergency Ethics Committee meeting to develop a strategy for how we, as a Home Healthcare Team, were going to approach this individual’s care.
It came up *as a side-note* that it had previously been noted that there “might” be guns in the home, and that “perhaps” we should have a Two-Caregiver Buddy System protocol set up for visits to this particular home.

A bit of context:
The general approach to Home Health Teamwork, is that visits are made by individual solo members of the team (Nurse, Social Worker, Physician or Nurse Practitioner, Chaplain) in order to maximize the time and attention that each patient/family receives from the Home Health Team.

I learned, approximately 2 hours before I was scheduled to go meet this patient in their home for the first time, about this “possibility” of guns on the premises.

I requested that we backtrack the conversation a bit, as I was new to the situation, and this issue had not come up yet in my orientation or training.

I wanted more information about what I was heading into, and wanted to discuss the company’s policy for sending employees into homes with guns.

I was silenced.

Apple,” the Medical Director said, “we have the Second Amendment in this country. We have no way of really knowing which private homes we serve may have guns.”

We cannot sterilize every home we go into.”

Stunned, I managed to reply that I had grown up with guns, and that that was not my concern.

What I wanted to know was how my new employer addressed the issue of gun safety for their employees.

Another person in the meeting, a member of the administrative staff, not part of the clinical team, picked up my line of questioning:

What is our policy for disseminating this type of information to clinical staff?” she asked.

This person, also, was silenced.

We were informed that this was not the purpose of the meeting we were having at that time. There was apparently “another committee” that was working on formalizing the organizations policy on safety issues.

I should clarify that there were other concerns I had about the organization I had been newly hired into.
But all of those concerns were related to a pattern I was beginning to see of serious problems with communication.

That one dismissive comment, in that one specific meeting, was the tipping point for me. I was offered another position the next day, and I jumped on it.

I basically fled that job like my hair was on fire.
Not because I am uncomfortable with Veterans, or people with mental illness, or the possibility that I, as a Home Health Nurse, might be entering into homes with guns.

It was the refusal of a person in power, to pause and communicate about people’s concerns. My concerns.

I was fortunate. This is not lost on me.
I’m an experienced nurse. I can work anywhere.

I felt unsafe, and unheard, and unprotected.
I left.
And my heart aches for people who are not given that choice.

Thank you for reading this.
With love, Nurse Apple

Bob King Diaries; o1.31.2o18.

Like clockwork.
Nurse Apple books a trip to remote Idaho to see her best gal from Nursing School.
There are 2 precious weeks left b4 Crabby CrabApple starts her (next) new job.
She hasn’t seen Nurse Angie, aka Malheur County Public Health Goddess, for… for far too long.
They book rooms at Frozen Dog Digs Bed & Breakfast in Emmett, Idaho.
Like clockwork, Apple’s phone rings.
Bob has had another dizzy spell. Nay, lost consciousness, taken a wee fall.
Bob knows. Bob does not like it when his daughter leaves town.
Bob always knows.

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Preaching To The Choir

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I find myself reminded of why I had to pull out of the fray of Social Media after the election last year.
Without too much replay, but to provide context… I was witness to people I care about, along with complete strangers, tear one another apart over the topic of:
Vegan vs Non-Vegan.
Everything from the ethics of eating eggs from your own backyard hens, to wolves in National Parks, to breastfeeding, to Economy-Ecology-Ethics.
I stepped out for a half day to think, and then in a moment of insomnia, came back with my final reply:

Woah.
I need to Peace Out on this one.
Fucking take some breaths, people.
My departing advice, as a passionate RN, who has learned some hard lessons about Prioritizing and Politics, Policy, and Procedure…
1) Look at what HAS to happen vs what you would PREFER to have happen.
2) Prioritize. (*This is often much harder than it seems)
3) Think about what you can change, and what you simply cannot change.
4) Focus your energy where you think it will have the most impact.
5) Ask yourself if you think action “X” will really lead to desired change “Y.”
6) Before you jump to action, think first: “Will this really change the long-term outcome?
7) Who am I arguing with? Am I turning away someone who is basically in, or near, my camp? Am I effectively searching for common ground?
(Grammar Police, help me; ‘Am I being effective in my search for common ground?‘)
8) If I want to achieve some long term change, how can I learn how to get people with opposing views to engage with me, and actually consider where my thoughts are coming from?
9) Am I at risk of letting my passion cloud my message?
10) Is my behavior respectful to, and of, the people I am trying to engage with?
And lastly, it is a cliché, but nonetheless, a Solid Gold Cliché:
PICK YOUR BATTLES CAREFULLY.

Some other day, I will write more about my own experiences as a vegetarian (never a vegan), the people I managed to piss off rather than impress when I was a 17 year old vegetarian-living-on-a-farm-who-had-all-the-answers, When/Why/How I started eating animal proteins again later in life, and other meaty nuggets of conversation. (Meaty, get it? Meaty Nuggets. Which reminds me that my childhood BF Chrissy used to call McDonald’s Chicken McNuggets Pinchin’ McKNuckles)

For now, at the hour of 0200 Portland, Oregon, time, and in the interest of being neither a constipated Meat Eater, nor a Constipated Writer, I shall end this run-on sentence and hit that Publish button. Cheers!

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Bob King Diaries; 1o.13.2o17

A week away from Bob: Preparations & Communications

Papa Bob tends to not do so well when I leave town.
Last November, I drove HH up to Canada to experience “American Thanksgiving at UBC.” It was our first college campus visit: a chance for American high school students to visit The University of British Columbia while UBC students are in class, and American kiddos are on break.
The timing worked well for our family; Mr. Blitch has been obligated to work the days before and after Thanksgiving for the last 20 years.
I had recently settled Bob into a new Adult Care Home in Portland, and had a free window to travel with HH.
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However, Bob was not feeling as settled as I had imagined. Per report from his primary caregiver, Bob had become confused during the 3rd night of my absence. He decided to shower at around 4 in the morning. He slipped and fell. Miraculously, he did not seriously injure himself, and his caregiver was able to wait a few hours to call me with the unhappy update.
It happened again recently when I was in Seattle for several days for my INELDA (International End of Life Doula Association) training. Bob had what we have affectionately started calling “one of those episodes” and fallen in the dining room after breakfast. Again, not an emergency, but enough to trigger my guilt for not being there for him.
Currently, I am in Pennsylvania with HH, visiting Swarthmore and Haverford Colleges.
And throwing in a visit to Bryn Mawr ~ where, as my mother describes, I was “hatched.”
Bob seems to understand the reason for the college campus visits, but the interest in visiting my birthplace has thrown him. In our conversations prior to my departure, Bob confused my birthplace (where I did not grow up) with Northern California, where I attended Jr. High and High School.
I prepped Bob as best I could for my time away.
I bought him some new socks, as he had become convinced that some of his older socks had “gone missing” (read: in Bob’s mind, stolen by other residents).
Sadly, I observed that not only did he not try on the new socks, but had also worn the same pair of old, grey, socks for at least the last 5 days that I was still in Portland with him.
I brought a bag of Hershey’s Miniatures Mix three days before I left. They were gone within 48 hours.
I restocked: Halloween Reese’s Peanut Butter Cups, HERSHEY’S® KISSES, some plain milk chocolate bars from Trader Joe’s, and some honey roasted peanuts. All of these items were purchased On Sale. It would be a tremendous sin to pay full price. Even for these essential staples.

Coping Strategies

Bob tends to change the subject when he’s feeling uncomfortable.
He asks me if I have my “device” with me. Can I look something up for him?
Me: Sure thing, Dad. What’s up?
Bob: Look up “City. On the edge… of Forever…”
Me, pleasantly surprised:
        Oh! This! Yes, we loved this episode! Remember you had it recorded on a VCR tape. It had Joan Collins in it!
Bob, satisfied: Ah, yes. I was trying to remember her name.

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Check-in Phone Calls

I reminded Bob that coordinating phone calls might be a bit challenging with the 3 hour time difference. In theory, he understood this.
The day of departure, Mr. Blitch drove us to the PDX at 0430. Needless to say, a long day of flying, rental car pick up, and driving for the first time on the Pennsylvania Turnpike.
I tried to ring Bob up in the evening: bedtime in PA for the exhausted travelers, after dinner hour for Bob in Portland.
He did not pick up. Not alarming, as he may have been in the bathroom, or elsewhere,  unable to answer the call.
I fell asleep, assuming it would be acceptable to call the next day.
Next day: Afternoon in Pennsylvania, late afternoon in Oregon.
Bob picks up on the first ring.
Bob: I thought you were going to call me to let me know you had arrived safely!
Me: Oh, Papa, I did. I called once, but didn’t reach you. I’m sorry if you were worried.
You know, you have my number– you can always call me too!
Bob: (long pause) … I’m not sure that I can…
Two days later (October 13th):
Me: (Newsy chatter about Swarthmore, Haverford, and Allentown) then,
Dad, how’s your day going?
Bob: Oh, about the same as yours. 60 minutes in each hour.
Me: Funny guy! Hilarious as always.
Bob: So… you’re coming home on the 11th, then?
Me: (gulp) Um, actually we’ll fly in late on Monday evening. Today’s Friday, so we have the full weekend and part of Monday, then we’ll head home. I’ll see you in person on Tuesday.
Bob: Well, wonderful! I’ll look forward to that.