Nurses: Changing your first ostomy bag

You want me to do what?

They did what do someone’s colon?

A what? A stoma? I don’t know what that is, but it doesn’t sound good.

I remember looking at the appliance thinking to myself… ‘that does not look right’. I mean there was an orifice where there shouldn’t be one! (my apologies to all the brave folks out there who live with an ostomy, forgive me. I was very naive)

I started at the stoma within the appliance. Then I stared at the stoma and the bag….


Wait a minute… why does that bag look like it’s going to explode? Isn’t there you-know-what in that bag? And you want me to disconnect that thing?!


And that smell!? Oh man, oh man, oh man.

I was just like everyone else. I remember the hot mess I made trying to change my first ostomy bag. Wow. It wasn’t pretty. In fact… If memory serves me right… I had to ‘change’ the bag three times before I stopped making a bigger mess than the time before.

I mean …. Stool. Was. Everywhere. I lost count on how many times I apologized to that patient. This is one of those skills they do NOT teach you in nursing school.

The best piece of advice I can give every nurse out there… is to pin down your in-house wound care nurse and have them show you the ropes. They have magic hands, they really do.

As for the throwing up part… (see pic above)

You might wanna master the art of the mouth breathe….

Image source: Scrubs Magazine | Our 5 favorite nursing memes on Tumblr this week.


Ideal Coffee Time??

Whelp.. I’m pretty much on track. Although I’ve been known to drink coffee all the way through the day except for lunch.



Reference: The best time to drink coffee according to science – I Love Coffee.

10 things to never say to a nurse


NewImage Via Yeah that sums it…

This came across my screen a while ago.. and I’m just getting around to sharing it.

Care to add to the list?

Behind the doors of a nurses’ mind

Here was a post over at Scrubs Magazine taking a comical look at how my mind as a nurse works sometimes. Am I alone?

A nurse’s subconscious mind

There are just some things non-nursing folks will never understand. It’s not a ‘knock’ against those who are not a nurse, really it’s not. What I’m talking about is how your brain gets ‘re-wired’ once you become a nurse. I don’t know if it happened over night? Maybe it happened gradually over the past half a decade? What I do know is my mind thinks and processes things SO differently than it did prior to being a nurse. I wonder… am I brain-washed??

Here’s what being a nurse can do to the mind:

  • At the restaurant, we silently hope that the person choking at the table next to us doesn’t need assistance – yet if they do we’ll be the first to run to their side.
  • Walking through the fog of a public ‘smokers break area’ – we all want to reach out and smack you. Do you want to die breathing through a tube?
  • While phlegm doesn’t normally bother (most) us at work – the sight or sound of you hacking up a ‘lung’ in public really does bother us. Especially when you don’t cover your mouth!!!
  • Public restrooms. Yes – there is nothing sanitary about them most of the time. What we can’t stand is witnessing someone use these facilities and then walk out without washing their hands!!! (How am I supposed to pull the door open and exit the bathroom without contaminating my hand??)
  • For some strange reason – we can never look at another persons arms the same ever again. Every time we see a good vein – yep, you guessed it, we think to ourselves, “wow! I could start an #16 gauge needle there!” Sorry.
  • We continue to micro-analyze anything on TV or in the theater that has a shred of health care related activities. “Oh yeah, THAT would happen” has echoed through our minds one too many times.
  • To this very day, I think we all have been cursed with measurements. We subconsciously measure how much we have urinated, how many CC’s of fluid we have drank and of course how many carbs were in our meals.
  • While on vacation – no matter the geographic location. We somehow ‘notate’ and remember where the closest emergency room and hospital are located.
  • I’m not sure if it’s just a nursing thing, I think paramedics share this curse. We still to this day have a spare set of scrubs stored in our vehicles, along with old ‘not in use’ equipment like stethoscopes, pen lights and scissors.
  • We still shake our heads at those wonderful ‘blood pressure screening stations’ located throughout the supermarkets and discount stores. I think we are more troubled by the fact that the public believe these measurements to be accurate.
  • We still (often) forget that it’s not common practice to talk about blood, bodily functions, and bodily fluids as a discussion topic during a meal. Again, sorry.
  • Yes, we find humor in the most disgusting and disturbing things sometimes (OK, all the time). I’d like to think it’s our defense mechanism for making sure we don’t drive ourselves crazy and burn out.

This just scrapes the surface of what goes on behind the doors of our minds. I continue to convince myself that I’m not brain washed, but that I have been trained and educated to always ‘be prepared’, but sometimes you have to wonder.

(That was a joke folks)

A nurse’s subconscious mind | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

The alphabet soup of nursing care

This post over at Scrubs pokes fun at what we nurses consider normal conversation.

Nurse jargon feels like alphabet soup

I rather like the ‘You know you’re a nurse’ blog posts. It definitely pokes humor at the unique nature of our profession. While Acronyms sure aren’t exclusive to the nursing profession, we sure do see our fair share of them! Heck, I’d dare say we see too much of them!

This is one of those situations where you really cannot understand or appreciate the humor unless you happen to be a nurse or a health care professional. The following paragraph is something that we might actually write, read or say nonchalantly during a typical day on the job. You know you’re a nurse when you can understand this jargon:

44 YR male. History COPD, CHF, HTN, CAD, AFIB. Previous surgeries of CABG X4, R TKR, L THR. Also history of MRSA, VRE. Pt c/o of CP, SOB. JVD also present. Admit from ED for possible PE vs MI. Have not R/O PE or DVT. Labs: Trop, CBC, BMP BNP pending. Scheduled for CT, MRI probable. Cardiology consulted for possible TTE after EKG with numerous PVCs, PACs. No VTACH, but widening QRS and questionable prolonged QT. No U wave noted.

Pt became confused in ED. SPO2 89%declined fast. No history of CVA. Desaturated. Pt intubated. ETT placed. Vent setting AC 12, TV 450, FIO2 50%, PEEP 5. SPO2 95%. EEG will be ordered per PCP’s CRNP. Covering MD also notified. On call PA-C present.

If CVA confirmed, possible EVD placement.

I &O recorded. No BM.

OK. OK. Now my lil paragraph there doesn’t make a great deal of sense for those of us who understand the jargon (take it with a grain of salt please), but you get the idea. I spit out that ‘mock’ scenario in 5 minutes using all those acronyms from memory. If I sat here long enough I could keep adding more. The list is really endless.

Just imagine how the layperson feels whenever we talk to colleagues or fellow health care professionals in our native tongue.

Alphabet soup | Scrubs Magazine

Classroom Concentration

Another post from over at Scrubs Magazine. Any tips on keeping focus in the classroom??

I need help with concentrating in my nursing school courses. More specifically, I need to tackle the sleepiness factor. I am of course referring to physical (and mental) alertness during a class. How does one stay ‘awake’ and focused when all your eyelids wanna do is close?

It’s not that the material isn’t riveting and key to my education *cough *cough*. Nooooooo. Not. At. All. My mind is not wandering due to boredom or due to attention challenges.



Ever happen to you? Never happens to me.


So here’s my question.

How does one stay focused on the material being provided in class when your eyelids don’t wanna cooperate? I know that we’ve discussed the NOC shift and tricks of the trade for staying awake, but this is a different sort of animal.

I find a heavy sense of irony when you put a nurse in a classroom. Here you have a professional ‘doer’ — someone who is constantly moving (running most often), never stays in one place or area for a very long time and always has an overabundance of stimuli coming at them from every direction.

So where is the one place you should not place this creature?

That’s right, in a quiet environment where there is only one source of stimuli (the presenter/professor/instructor). While you’re at it have them sit in this environment for very long and extended periods of time (I’ve had classes that are 4 hrs. long).

Most 2nd degree nursing programs and those RN-BSN programs are all structured the same way. They are trying to meet the needs of the busy full-time RN (not a bad thing at all). They understand that they are working full-time, usually have a family and many other responsibilities outside their work and home. So they try to minimize the amount of ‘time’ commitment by offering classes that meet only once a week for a large chunk of time, as opposed to the traditional college coursework that involves meeting 2-3 times per week for 40-50 minutes per class. Same amount of ‘total’ time to get your degree, just a lot less ‘relative’ time spent on campus.


Back to my original question at hand.

How does one keep the laser-sharp focus and mental alertness in the classroom when all you wanna do is take a nap?

I myself seem to be chewing a lot of gum right now and sipping frantically on bottled water, but as you can guess from me asking the question, my methods aren’t very effective?

Any suggestions??

I need tips for concentrating in class | Scrubs Magazine

Patients that are ‘outside their minds’!

My latest post over at Scrubs Magazine. Care to add to the list?

Don’t get me wrong, I love my job. I truly love my job. I think I’m one of those nurses that actually enjoys what I do – the good and the bad. I don’t view our profession through a pair of rose colored glasses (at least I try not to). I keep it realistic. There are good and bad days, good and bad jobs, good and bad patients.

Sometimes you wonder what gets into our patients. I completely empathize and understand that we see them at some of the worst times of their life. I also can appreciate the level of fear and anxiety they must endure while they are recovering – but sometimes…. I mean… sometimes… our patients must be ‘outside their minds’!!! (sorry, yet another movie quote)

Here are some things (and some patients) that just blow me away:

  • The patient who thinks that the hospital is really a Howard Johnson hotel/motel. I’m a nurse not your personal assistant. This is a hospital not a bed and breakfast.
  • The patient who all of sudden loses their ability to pick up a glass of water that is within arms reach. There is tired, then there is just down-right laziness.
  • The patient who thinks I won’t figure out they have been smoking in the bathroom. What’s that I smell in the bathroom? No, someone isn’t burning leaves outside your window. Nice try.
  • Honesty truly is the best medicine. Lying will only make you feel better – not get better. When referring to your version of your alcohol use, and I can smell it on your breath – don’t tell me it was mouthwash. C’mon. Seriously?
  • The pain scale is not open for interpretation. Telling me your pain is a 15/10 will not get you your medication any faster. Especially when (according to you) the pain medication I bring you (and that was ordered by your physician) is not strong enough.
  • Oh, along the same lines of the pain scale example, referring to your pain medication as ‘Percs’ or ‘Vics’ or your ‘Oxy’ does not help the situation.
  • By the way, the nursing staff does talk amongst each other. When you tell me, “that other nurse said it was ok / that other nurse allowed me” do you really think I’m going to let you have something to eat when you’re NPO.

There truly is a method to our madness, I promise. We don’t have it ‘in’ for you. We nurses are here to help you get better, get healthier and get the heck out of the hospital. But we can’t help those, who can’t help themselves.

(Please be sure to notice the heavy sarcasm and humorous tone of my sensible nature)

Some patients…|Scrubs Magazine