Not Nurse Ratched

This whole crashing hard drive/using the Mini while the laptop is fixed has been educational for me. I like having a desktop computer so much that I may just keep right on using it. The hard drive is much smaller on the Mini, so I had to do battle with an external hard drive for my iTunes library. I can’t even really duplicate how I finally got it to work. It involved a hellish sequence of consolidating the library and copying things to and fro. I had to restore my entire library and the library database files a number of times, but it finally works. iTunes is a great way to manage a media library, but it’s overly paternalistic, I think. I’d really like to manage things myself a bit from time to time.

Anyway, I obviously didn’t want to copy over absolutely everything to a computer I’d be using only for a few days, and 5 days later I’m finding that I’ve got all I need and don’t miss the oodles of other stuff I had on my laptop. I thought I’d make a list of stuff I just can’t live without.

• NetNewsWire. It syncs with their Web site and my BlackBerry, but I still like the desktop client with the unread dock indicator.
• PandoraJam. Need I say more? Pandora rocks.
• Photonic. I spend a lot of time perusing photos, and Flickr’s pages are hard on the old eyes after just a bit of paging. This is actually a really fabulous program for heavy Flickr users; it’s worth the registration fee compared with the free Flickr Finder.
• Quick Tag. I’m obsessive about my music collection. This donationware app allows tagging so tracks can be grouped with auto playlists into tag collections: fabulous!
• AutoRate. See above regarding obsession. This free program analyzes listening patterns to add track ratings; it works really well.
• Skype. I use this to save on daytime cell phone minutes.
• Mail Act-On. This a free Mail.app add-on that facilitates wheeling and dealing with e-mail.
• Adium. Best IM client out there for the Mac, IMHO.
• Office 2004. I don’t plan on upgrading to 2008; I am attached to my macros.
• Photoshop Elements. I just like to mess around with photos. I actually use iPhoto for most of my photo fixes, and Flickr is now integrated with Piknik, which does a surprisingly good job with quick fixes. But sometimes I just wanna get fancy.
• SuperDuper. This saved my @ss with my hard drive crash and is worth every penny! If you have a Mac, get this app. For real.

Everything else, weirdly, that I thought I just couldn’t live without it turns out I can duplicate with free Firefox extensions or just do without. I should pause to say that the new Firefox is utterly excellent: it’s notably, wickedly, faster and slicker. Most extensions have already been updated to work with it. I have been using TwitterFox for Twitter (replaces twhirl) and FoxyTunes (replaces Cover Sutra).

I installed The Missing Sync for Blackberry, but I hardly ever use it because I use Milk Sync for my task lists and Google Sync for my calendar, and they both sync over the air. I need a wired sync only for contacts, which don’t change all that often.

So there you have it. I hadn’t realized how computing “in the cloud” has changed my digital life. I’ve had a number of hard drive crashes in my lifetime of geekery, and this is the first one that slowed me down not at all, largely because I had everything but my music library somewhere on an online server. E-mail? Settings synced with dotmac. Fired up Apple Mail (with Mail Act-On downloaded) and everything was sucked onto the new computer exactly as I left it. Pics? I copied my iPhoto library, but even without that I had access to all of my pics, AND in an iPhoto-ish interface, through Photonic. RSS feeds? I just synced with the Newsgator Web site and was again left exactly the way I started. I have also now discovered Foxmarks, which lets you sync Firefox bookmarks without dotmac.

Jeez…now that I read all of this it sounds rather complicated, but trust me, this Mini is damn near empty compared with my laptop that died.

After MONTHS of shifts that made me want to shoot myself for giving up a career and spending oodles of time and money on this new one, I finally had a day filled with “oh yeah, this is why I want to be a nurse” moments. I worked my butt off and came home exhausted (don’t know how I’ll make it through today!), but it was a good tired. There was unmitigated chaos all day long. We had admission after admission, and our charge nurse was nearly in tears; everything that could go wrong, did. It was an unlikely day to make me feel good about nursing. Yet a patient went out of her way to tell me she was an old hand at being in the hospital and my care had made her stay much much better than she had expected, and it helped me to remember that it’s not about me. I was happy to see that my burnout has apparently not affected my patient care. I recalled that regardless of how shitty my co-workers are acting (we have all been well behaved lately except ME; I made a bitchy comment yesterday and had to go admit and apologize, which I hate) and so on, the patients still need compassion and good nursing care, and I can provide both. It’s very hard to access that when all I get is complaints and bitchery day after day, so it was nice to get a reprieve from the burnout.

Today could be sadly different, because I simply refused to sit with the violent dude the other day (he’d just broken someone’s nose, and the room was festooned with blood spatters). My boss is back today, and I’m guessing I’m going to get called on the carpet. I may not have a job later today, and I guess that’s OK. Some boundaries are not negotiable, and I’m comfy with this one. I won’t even accept a writeup regarding this situation. Perhaps nothing will happen. I’m hoping for a fast and peaceful day so I can come home and put my sore feet up for a few days!

I know. This should be a no-brainer. However, I didn’t use Mail.app with Gmail for a long time because Mail.app created strange labels in my Gmail Web interface and, most deal breakingly, refused to delete my messages but instead kicked them into a new label or back into the Archive label (depending on the option I checked in the Accounts –> Mailbox Behaviors –> Trash section). This meant that I had deleted messages scattered all over Gmail and a bunch of weird labels that I didn’t want. (Please, no comments on “why would you delete anything from Gmail, with those gazillion gigs of storage?”…I really don’t want stored copies of notifications that my credit card bill is available! I can stagger on without it!)

Invariably someone is wondering, “WTF is IMAP?” There is a complete technical explanation about POP and IMAP here. Basically, you’ve got your Web mail, which is what you see when you get your mail through your Web browser; your POP mail, which downloads a copy of your mail from the server to your local computer (through Eudora, Thunderbird, Mail.app, or another mail client; the fate of the original e-mail is to remain undisturbed on the server or to be deleted); or your IMAP mail, which syncs your e-mail between the server and your local computer. Why care? Because if you, like me, have various labels or folders with which you organize your mail, it’s a pain in the ya-ha to keep them spic and span on your local computer and then just have a messy inbox in your Web mail. I want it the same no matter how I approach my e-mail, and Google is nice enough to provide free IMAP. IMAP is not for folks who don’t have always-on Internet connections. No connection = no mail.

Now I will make another brief digression because undoubtedly readers will wonder why I would not want to solely use Gmail’s fabulous minimalistic Web interface. It’s OK. It’s way better than Yahoo! Mail. I use it without flinching too much if it’s convenient. Still, I like Mail.app because there are no ads, because it’s easy to include photos, and because I like the data handlers. I use Mail Act-On to assign keystrokes that deal with my mail more intuitively than Gmail’s. I additionally like the integration with Apple’s Address Book and the fact that custom pics for people show up in their e-mails (hey! eye candy is A-OK!). I can also now report that dotmac does effectively sync all the settings and accounts for Mail.app. Cool.

So. If this all sounds good, head over to Gmail and read their instructions for setting up IMAP with Apple Mail, except when you select Gmail in the accounts pane and then go to Mailbox Behaviors –> Trash, tick both options (”Move Deleted Messages to the Trash Mailbox” and “Store Deleted Messages on Server”). This is important as it directly counters Google’s directions. Finally, close out of the preferences, saving everything, and head up to the MAILBOXES section in the top left of your Mail.app window. Click the arrow next to “Sent” and then when it expands click once on “Gmail.” Head way up to your menubar and click Mailbox –> Use This Mailbox For –> Sent. Do the same thing for “Trash” (only pick Trash instead of Sent, obviously). You can use this same sequence to use your Gmail Spam folder for Apple.app junk if you have selected “Move it to the Junk Mailbox” in the Junk Mail preference pane.

Voila! You do not have sent and deleted mail all over the place: only in the “Sent Mail” and “Trash” labels in Gmail. Good times for everyone.

Fortuitously, my MacBook spectacularly died earlier this evening. Happily, I had everything all backed up on dotmac and SuperDuper clones. And I have AppleCare and a spare Mac in the house (a Mini). I’m up and running without too much trouble and will call AppleCare tomorrow…one doesn’t like to have to test backups, but I’m pleased to report that all this stuff works!

I read a ton of Mac-related and geeky RSS feeds and listen to a handful of tech podcasts, so inevitably I’ve been thinking on the recent WWDC announcements. Google WWDC if you missed all of this, but in short (1) there’s going to be a 3G iPhone, which will be subsidized and have GPS but which will jack up the data plan prices, (2) there are a lot of cool applications being developed for the iPhone, and (3) dotmac is getting the axe, to be replaced by Mobile Me. I don’t have an iPhone, so the first two points shouldn’t really be on my radar at all, yet still I have some ideas that I’ll blog about later. Mobile Me is another matter.

After much head scratching and bitter complaining about the cost, I bought a year subscription to dotmac after I bought my MacBook. I wrote a post against dotmac at some point but am too lazy to link to it. I found my own arguments compelling but coughed up the dough anyway because of sheer laziness; the services can be found elsewhere for cheaper, but you have to tinker with way more stuff and babysit the processes. I want my tinkering time to be spent elsewhere. I really like the automatic sync, and I love the iDisk. I have a super simple Web page on there—very adequate for me. Even so, I was planning on ditching dotmac, but now I’m thinking I’ll continue my subscription (apparently you can buy these on Amazon at a discount! Who knew?), after considering arguments both pro and con.

The first compelling argument AGAINST doing so is the name. Mobile Me? WTF? Doesn’t Apple have enough money to pay a creative team to come up with something better than this? Like I really want a me.com e-mail address. I mean, dotmac e-mail sucks @ss anyway (I logged into it today and could not reach buttons on the page because it was not scaled to fit on my MacBook…argh), but I’m just talking hypothetically. The second argument is that many of the improvements are directed solely toward the iPhone, which, as has been established, I do not have.

However. They’re doubling the storage space to 20 GB with no price increase, and I can make use of some of the push syncing (notably iPhoto and Address Book). It’s nice to have a backup in “the cloud” (this is the new buzzword, in case you missed that), after all. Once I thought about it, if I get the $80 subscription from Amazon, that’s about $7 per month for effortless backup and synchronized data. That makes me feel better about not having to babysit another backup service or, worse yet, back up manually. Argh! Not that! The photo galleries and Web pages are just gravy. I use them since they’re there, but I probably wouldn’t pay extra to get them elsewhere.

There is little doubt that Mobile Me will really change the iPhone experience, and I wish it would work with the BlackBerry. On the other hand, my Gmail arrives instantly on my BB as it is, and I don’t keep photos on it. Calendar is the only thing I need a cable for. I guess it’s not that big of a deal. If only Gmail would enable two-way sync as Yahoo! has…but that’s a topic for another day.

Finally, I changed my Twitter username to not_ratched so as to be a bit more consistent, so if you are following me and experience sudden pangs of loss without tweets from wizardchimp, fear not! I seem to have been effortlessly ported over to the new username without any hassle, for which Twitter is to be highly commended.

Much is made of the Patients’ Bill of Rights displayed at hospitals and nursing homes, but I wonder if similar rights exist for nurses (or health care workers in general). Yesterday I experienced my second day at work during which I was genuinely afraid that I was going to get hurt, and this time I WAS hurt. I ache all over from being hit and clawed all day long and from having to wrestle with a patient far too big for me to have a reasonable chance of controlling safely (for either one of us).

I brought this up multiple times throughout the day, and no one paid any evident attention either to the fact that I was in physical danger and was in fact being roughhoused or to the fact that if the patient decided to take off and happened to fall there was very little I could do about it. After 8 hours a male aide came from another floor to take my place, but I’m not sure whether this was because my desperate pleas were heeded or because they needed me on the floor. Anyway. This combined with the previous experience I had with the crazy family member (who I thought was going to hit me but didn’t) has given me a definite dread and actual fear of going to work. In what other profession would I be expected to be repeatedly hit? I am often hit or kicked as a one-off deal, and I don’t mind much because the patient usually doesn’t mean to do it and there is no way it can really be predicted or prevented. But in this case EVERYONE knew this patient was going to be violent.

So what about my rights? I hear a lot about patient rights and patient safety, and those items are indeed near the top of my priority list at work. However, my own safety is right up there as well, and that philosophy does not appear to be shared by my employers. It started me thinking. DO nurses have the right to a safe workplace? I don’t think I have ever heard this proclaimed. Obviously they should, but I’m wondering how common this kind of situation is.

I’m pretty much thinking that no job is worth being hit while no one does anything, so the next time I’m assigned to sit with a patient known to be violent I am going to refuse the assignment unless security is also in the room. I have too much respect for myself to allow that to happen again, and if I am fired for this caution then I guess this institution just isn’t a good fit. Am I insane to be bothered by this? Other aides were appalled and several said, “I wouldn’t have sat in there,” but is that true? I’ve never OBSERVED anyone refusing to do things like that. And the night nurse yelled at me before I even went in the room because her aide had said it was an impossible situation (”It’s your JOB,” she said). That didn’t really start my day off very well.

It was a bad day for everyone. Several of us were about to just walk out because of all the impossible situations that kept occurring. If it weren’t for my previous experience, I would write it off as a bizarre exception, but apparently this hospital has a habit of discounting its employees’ need for protection from violence. I’m not in to that. I want to help people and be a good nurse, and I am willing to accept the reasonable risk that one accepts to work in a hospital; however, I did not sign up to be a punching bag.

Even though I have a houseguest sleeping in my office (my dad was gracious enough to come stay with us so the recently hemorrhaging boyfriend isn’t left alone while I work), I find I still have to get up a little early and drink coffee before I can face my day. Yesterday I tried just getting up and going to work, and I felt off kilter until about 10:00. Apparently I require both caffeine and RSS feeds to wake up. Who knew?

I have been listening to a great podcast that I recently found through another blog. It’s called Buzz out Loud and can be found at http://reviews.cnet.com/buzz-out-loud-podcast/. You can subscribe through iTunes. It contains geekery, but they branch way out to discussing cars and all kinds of stuff. The podcasters are hilarious. My friend L recently said, “What’s a podcast?” I will have to blog on that later since I have only 8 minutes before I have to get in the shower and go to work.

Podcasting and RSS feeds aside, after today I have three days off to sit around with the boyfriend, making sure he is OK. We are both still recovering from the last few weeks. It is creepy to realize that your loved one (or YOU, in his case) nearly died, literally. He exhibits signs of PTSD, I think. He has nightmares that he is bleeding to death, and he often holds has hand under his nose and starts to choke even though there is no blood. He keeps “forgetting” about these events and then I can see him remember. I hope it’s temporary, because I know this cycle from panic attacks! Pretty soon he will be so afraid of precipitating a bleed that he will not do anything at all. I hope he gets better soon.

I just have to ask: how do nurses handle staying in shape? I am so exhausted the days I work that working out seems completely out of the question. Then it takes me a day after my shifts before I get any energy back. So that leaves 2 days per week for workouts…that isn’t cutting it. Is there some recipe to staying healthy that I am overlooking? Do you guys force yourselves to work out on workdays? Does it produce surprising energy? It seems impossible.

Whew…the boyfriend is still sans hemorrhage, and I made it through my shift yesterday. My dad stayed with the boyfriend lest he lost his entire blood volume again, so I didn’t worry all day long. It was quite a day; I had patients with TB, scabies, and various other scary and very communicable diseases, so it was a day where I felt I should boil myself in bleach when I got home.

Meanwhile, my dad is lingering over the weekend, and the three of us are coexisting while tied to our separate laptops. My dad is a geek (I come by it legitimately) and brings with him enough electronic equipment to rival Best Buy on a slow day, so my office is bristling with cables and antennae. I’m trying to rest up because I am still exhausted after a long stretch of working mixed with sleepless nights and emotional stress. I work Monday and Tuesday so I have 2 days to become restored!

I have been checking out SmugMug for photos and really like it, but I think I’ll be sticking with Flickr. I like that Flickr has feeds from freaking everything, that you can have pictures in several sets at once, and that the groups have an easy way to find recent pictures. The communities on SmugMug make it very difficult to follow along with new uploads, although the forums are pretty cool. Flickr is also cheaper, although the extra $15 won’t break the bank. If only Flickr would have an option to allow anyone to comment on a photo; it’s annoying that only members can comment. SmugMug lets you decide all this.

Anyway, this is me recharging. Nobody pissed me off at work yesterday, and I dare to hope that the in-crowd bickering has ended for the time being. There was evident teamwork for the first time in a while. I feel slightly less burned out for the moment. Now, if I could overcome my physical exhaustion and residual stress, I might start actually feeling rested!

This post is just a short wave to the blogosphere. I’ve had a helluva couple of weeks. I have worked a lot, and the boyfriend has had serious complications from his sinus surgery. In fact, he almost died yesterday from massive hemorrhage from an arterial bleed in his sphenoid sinus. It hasn’t sunk in yet how close he came; I walked in as he flew past on a blood-soaked gurney to emergency surgery. They called a rapid-response team on him. He pulled through and has perked up after 5 units of blood; in fact I wonder if he feels more rested than I do, after working back to back and never sleeping through the night since as a result of midnight ER visits and/or ambulance calls! My dad is coming to stay with us for a week or so to stay with the boyfriend when I have to work and just to help out a little so I can get some rest. I’m about to drop dead. How do people care for family members long-term? I totally get caregiver role strain, and this has only been going on for 2 weeks. Yikes.

Meanwhile I have distracted myself to survive mentally. KU Medical Center provides wireless access, and I was one of many in the surgical waiting room staring blankly at Facebook (which apparently, according to this picture, I don’t need to feel guilty about using, unlike MySpace) and Twitter so I could attempt to avoid freaking out completely about the surgery and situation in general.

I’m really freaking mad at the ER staff here in town. We were there twice, and both times they wouldn’t treat my boyfriend since he had the surgery someplace else. That’s not necessarily their fault, but the second time I called the ambulance myself for direct transport, and they still made us stop here in town and wasted time not treating him. I implored them to give him blood, and they didn’t. The first time they sent him in my CAR to the other ER, an hour away, and he passed out as soon as he got inside; the second time he almost died because when the bleed started back up the dude was out of blood. I know there may be policies I’m not understanding, but the fundamental principles appear to be that they didn’t follow a basic principle (if you are missing a lot of blood, you need some from elsewhere) and they delayed effective treatment by withholding it while preventing us from going to the other ER where they would treat him. I’m trying to let this go, but I’m caught up on the “he almost died” part. You just don’t want to see a loved one like I saw him with scary phrases like “life-threatening bleed” flying around. Those docs looked worried; mostly docs don’t look worried. I’ve never seen one look actually scared, but these did. It was not good. I’m not experiencing warm fuzzies about the local hospital, therefore, and it’s unfortunate that I work there.