My Strong Medicine

The adventures of a male nurse navigating through life, staying fit, surviving the journey.

Posts Tagged ‘nurse’

ANA & Medicare participation terms | RNs & APRNs

Posted by Sean on December 29, 2011

The ANA also expressed support for the following CMS proposals that directly affect nursing practice and patient care for the roughly 60% of U.S. RNs who work in hospitals:

• Allowing the nursing care plan to be part of the interdisciplinary care plan.

• Expanding the use of standing orders and protocols for nurses to give medications.

• Permitting patients to take their own medications under certain circumstances.

• Deleting the requirement for verbal orders to be signed within 48 hours.

• Allowing flexibility for infection control programs, which nurses often lead.

To see the current CMS Conditions of Participation for hospitals, visit http://go.cms.gov/uKSLVy.

via ANA supports changes to Medicare participation terms | National Nursing News.

It’s a slow, long hard battle, but it seems to  be happening one piece at a time. Read the entire post over at National Nursing News.

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My Interview Part 2

Posted by Sean on November 30, 2011

As I posted earlier, Kim (from Emergiblog) over at Masters in Nursing interviewed me. Here is part 2:

Keep your eye on the prize.

That’s what I told myself during my marathon BSN program.

But there is no prize unless you start the process.

In part 2 of my discussion on graduate nursing education with blogger and Nurse Practitioner student Sean Dent, we talked about the difference between graduate and undergraduate education.

How does grad school differ from undergraduate education?

Be sure to follow the link and read the original post…

Talking MSN: Desire and Discipline | Masters in Nursing Blog

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I got interviewed!!

Posted by Sean on November 28, 2011

Kim over at Emergiblog has recently started blogging for “Masters in Nursing”. She approached me for an interview concerning my thoughts, experiences and views on pursuing an advanced degree in nursing.

In this installment of the interview, we talked about Sean’s motivations for returning to school, the type of program he chose and the characteristics that he found important in choosing his program.

Why did you decide to return to school?

….follow the link below to read the entire blog post!

Talking MSN: Sean Dent | Masters in Nursing Blog

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What nursing education can learn from medical education

Posted by Sean on November 5, 2011

 

Is nursing school built to “break us down” rather than “build us up?”

This past week was my first week with our physician preceptors. As a nurse practitioner student we log many clinical hours with our physician preceptors. This week was learning about the ‘patient presentation’.

It may sound odd, but nurses are quite familiar with the concept. The patient presentation is when a provider ‘reports’ or ‘presents’ their patient to the physician. This could be for a consult, a new admission, or for the coverage hand-off between colleagues. While we nurses are familiar with this concept, it’s a whole different ball game when you are the one presenting.

It was another ‘pressure cooker’ situation. Something we are all too familiar with. We build up the scenario in our minds to be the end-all-to-be-all. We picture ourselves making every mistake in the book and of course we envision the physician as this mad-hatter like tyrant who will bark at your every word.

It of course was the complete opposite.

Throughout the entire process the physician was receptive, pleasant, and absolutely empathetic to our newness. She was an active listener and gave great feedback in such a positive manner. At no time during this experience did I feel ‘put-down’, inferior, or guilt-ridden. I could sense that our physician preceptor was making every attempt to level the playing field and teach us, not torture us.

My clinical preceptor brought up a very valid realization after this experience. He asked us if we noticed how much our physician preceptor tried to ‘build us up’, not ‘break us down’. He wanted to know if we have had similar experiences in our previous nursing education and training..

I honestly can say 90% of my nursing education and experience has been about ‘breaking us down’. Sad, but true. I can remember many times nursing preceptors ridiculing students for not performing well or making simple mistakes.

Our physician made it well known she expects us to make mistakes, and that the mistake made now will help save lives later. “It’s not about being wrong, it’s about not being prepared”. Being afraid to make a mistake is not the same as carelessness.

I think nursing education as a whole could learn a thing or two from physicians.

I find the professional relationship and their respective professional curriculum between nurses and physicians to be polar opposites, and I can’t understand why? Barring from the obvious difference between a nurse and a physician, how do two professions with the same goals arrive at their destination in two very different ways?

As a side note, to all my fellow nurses out there. Physicians are misinformed about our educational system and standards. I guess I automatically assumed physicians understood the requirements and curriculum progression of our profession. We took a great deal of time to explain how a nurse ‘becomes’ a nurse (RN, BSN, LPN, CNA), and how a nurse is trained for specific specialties (critical care, emergency, oncology, etc.)

I’m still amazed at how much I learn every day.

Another post from over at Scrubs.

Is nursing school built to “break us down” rather than “build us up?” | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

Posted in health, opinion | Tagged: , , | 6 Comments »

Tattoos & Pain…

Posted by Sean on October 27, 2011

 

Another nursing urban legend: tattoos and pain

So the other day I got my flu shot. Yep, I get it every year. Regardless of the folklore out there I’ll take every little bit of help I can get when it comes to fighting off any bout of the flu.

I was in line waiting my turn. I could hear the nurse give the ‘warning message’ each time she administered the injection, “A pinch and a burn…”. I honestly didn’t think anything of it.

My turn. I sit down, fill out the proper documentation and roll up my sleeve. Subconsciously I’m waiting to hear the warning message, but instead she pauses. She leans towards me and says, “Oh. I don’t have to warn you do I?”

Now I immediately thought she meant, oh you’re a nurse. So you know what I’m about to do.

No.

Instead she goes on to say with a sarcastic chuckle, “This shouldn’t hurt a bit with all the artwork there. Right?”

She was referring to my tattoo. I have one on each of my upper arms.

I politely responded, “No, I’ll be fine. Thanks though!”

I walked away chuckling.

You’re probably wondering why I was chuckling? I walked out of the room thinking of a very popular urban legend in the nursing world:

There is an inverse relationship between the number of tattoos a patient has and their tolerance for pain.

So, the more tattoos a person has, the less tolerant they are of pain. Any pain. Or, put it another way, the more tattoos the more they whine (sorry for being so blunt).

Like you, I used to scoff at the mere thought of this. But then I worked in the PACU. I took care of many patients post operatively. I then continued to take care of surgical post-op patients during my time in the ICU, something I still do to this day. Let’s just say I’ve taken care of my fair share of patients who have had surgical procedures. As time progressed I noticed there was a sliver of truth to this urban legend. Maybe even more than just sliver.

I’m not here to dispute the definition of pain. I know that a patient’s pain is what they say it is, where they say it, when the say it is. All I’m saying is when we nurses see tattoos, we can’t help but wonder.

What do you think?

Another one of my posts over at Scrubs. Any thoughts on this urban legend?

Another nursing urban legend: tattoos and pain | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

Posted in health, humor | Tagged: , , | 3 Comments »

Nurses? Catty?

Posted by Sean on October 12, 2011

 

Nurses go clique-ety clique

Heard at the lunch table on campus the other day, “I sometimes miss working in the mill”.

This spawned quite the conversation, I must tell you. The conversation topic involved the ‘pulse’ of the nursing profession and its  sometimes palpable cut-throat atmosphere. I think you’ve heard it before. Nurses can be ‘catty’, and cliques seem to be a very common occurrence on nursing units.

“We need more men in nursing”

(I must say I wasn’t expecting this statement). When I inquired as to why we need more men in nursing, the response was not what I expected (or hoped).

“Most men confront you when there is conflict. They tell you how they feel right to your face. They speak their business and move on.” “Women do just the opposite”

Catty: Subtly cruel or malicious; spiteful (Free Dictionary)

As you can tell this was quite the venting session amongst a small group of nurses. It seems that a lot of nurses feel that the majority of nurses are following a horrible stereotype. Apparently most women can be quite mean?

As you can see I’m writing this blog post with a lot of question marks. I’m wondering just how true these opinions really are. Or should I say, how common are these feelings outside of my lil’ world of nursing?

I have to bashfully admit something though. I found great humor in this conversation. Mostly because I’ve heard this before. But more specifically, I found it highly entertaining that I was the only man in this conversation.

I for one think that there is a shred of truth to these thoughts, but I’m not so convinced that they are gender specific. I’ve met a lot of cruel men and women in my professional career thus far. I don’t think the ‘meanness’ trait has some strange exclusivity to the X chromosome. But it sure makes you wonder.

So folks, what do you think?

Are most nurses catty?

If they are, why? And what the heck can we do about it?

Nurses go clique-ety clique | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

Posted in health, opinion | Tagged: , | 2 Comments »

Telling it like it is

Posted by Sean on October 9, 2011

 

When nurses need to give a “straight” answer

How long am I going to be here? How long does the surgery take? How long do I have to take this medication? How long do I have to wear this thing?

I often get these type of questions asked quite a bit from patients and their families. I get questions asking for ‘time frame’ specifics regarding any and everything about their care. Unfortunately, there really is no recipe for success in health care is there?

If I can, I always answer these questions with a bit of humor. A quick witted, “whenever the doctor says so”, seems to bring a smile to most faces. Yes, it may very well be a sarcastic smile, but a smile nonetheless.

(Oh, c’mon you know you’ve used that one before)

Isn’t it ironic that we constantly require our patients to adhere to a time schedule, yet we never can give them a straight answer about ‘how long’.

After my quick rebuttal to most of these questions, I give the long drawn out speech about how there is no recipe for success in healthcare. A + B does not always equal C. While we always have the best intentions, time is not something we can ‘predict’. Not even in the most ideal conditions.

The ‘real’ answers:

A perfectly performed surgery without any complications can still have scheduling delays. There are always emergent cases that take priority in the echelon of care. You can’t preventing the unforeseen.

Being in the hospital can be as short as 1 day and as long as 3 months (or more). There are a myriad of factors that determine whether or not the issues that brought you into the hospital can be resolved. Most of which we have no control over.

Some medication can be a lifelong venture, some can be taken for a specific time frame, while others are taken until your supply runs out.

What you are required to ‘wear’ is serving a purpose to help aid in the healing process or to probably prevent further damage. So it will be worn until it is no longer needed.

Oh, and don’t think for one second that just because you have a friend or family member that was treated for the same thing means that you’ll get the same treatment in the same frame of time. Uh-uh. No-siree-bob.

I wish I could make up a recipe book, I really do. It might make our jobs a lil easier, and I’ll bet the patients would love it!

Am I the only nurse that does this??

When nurses need to give a “straight” answer | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

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The most powerful healing tool we use

Posted by Sean on October 7, 2011

 

The power of touch

The most powerful healing tool gets lost in the background to the buzzing, beeping, clicking and shuffling. The rhythms of a nursing unit set the pace of the day. An alarm sounding, a timer beeping, and a monitor blipping. Rush, rush, rush to the next task at hand, all the while treating our patients like another piece of equipment. I too am guilty of this sin. I get caught up in the moment. I worry about time. I am mindful of the roar.

Thankfully, I had the pleasure of getting back to the basics the other day at work. Due to staffing needs / wants and census changes at the drop of a hat I was floated to a neighboring unit to function as a nurse aide.

It’s no secret how I feel about that job and the angels that perform their duties on a daily basis (here and here) , so stepping into their shoes was a great opportunity to maintain my perspective.

I was reminded how powerful the art of ‘touch’ can be. During my shift, I lost count on how many bed baths I gave. Most of the bed baths were done at light speed by the end of the morning, but the first few of bed baths I was able to take my time.

During the bed bath I was able to chat with my patients, learn about them, talk with them about any and everything that was on their mind. I was also able to help alleviate many fears and concerns they were having about their hospital stay.

I can’t say I give the greatest bed baths. Heck, I’d be willing to admit I’m actually quite horrible at it (to this day I can never hold the darn hand towel correctly!). What I AM good at is having a soft hand and light touch. It’s a dying art in the present fast-paced world. But, having the ability to move a patient correctly, safely and gently holds more value to the patient than we care to admit.

One of the greatest compliments I got that day at work was from an elderly gentlemen who was making a slow recovery from a life-changing surgery recently. As I was cleaning up my ‘mess’ of dirty linens and tidying up his room he reached out his hand gesturing me to come closer. He took hold of my forearm ever so gently with his frail but firm hand and said, “Thank you. You did a good job”.

I gotta tell ya. I don’t think I’ve ever smiled longer.

I’m not sure he realized how powerful his touch was for me.

Another post from over at Scrubs. I sometimes forget how important the simplest gesture can be.

The power of touch | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

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A nursing student again…

Posted by Sean on October 6, 2011

 

Clinical rotation jitters

So, it’s official. This week I became a nursing student doing clinicals (again). This week was my first week walking the halls of a hospital system as a ‘Nurse Practitioner Student’. I must say it was a very eerie feeling (to say the least). I felt like I was back in my diploma program! Here I was (again) sweating bullets over every little detail concerning my participation in nursing ‘clinicals’. The really scary part is the NP program I am in is nice enough to slowly introduce us into this new role by taking baby-steps. This week I simply started an observational experience. So it wasn’t like I was actually required to ‘perform’ any role-specific duties… although it sure felt like it!!!

We are told to wear business casual and our lab coat – what do I wear??

Shoes – I need comfortable business casual shoes! I can’t spend all day on the floors in my tennis shoes or my crocs!

Holy crap! My lab coat. I have to wear a lab coat. Call me crazy, but it was quite surreal to wear the long lab coat.

My name badge – what should it say? What shouldn’t it say? Credentials? No credentials?

These are just some of the ridiculous things I think about. Like I said, it’s only going to get more stressful (readers beware -this is my preemptive warning).

It was also quite surreal to rub shoulders with the physicians, surgeons, physician assistants and nurse practitioners. I honestly had to train my brain to step away from the rigors and responsibilities of bedside care (while rounding on patients) to focus on the decision-making and thought processes of my preceptor (a physician). I need to learn how to start thinking beyond the bedside and develop my advanced assessment and diagnostic skills. I probably expect way too much out of myself this early on, but I feel so overwhelmed with fear it’s honestly indescribable.

How in the world do these advanced health care providers do what they do, in such split-second timing is just awe-inspiring to witness first hand. I never really ‘got it’ when I would round as the bedside nurse. I was focused on my responsibilities and my duties as the bedside nurse (not that there is anything wrong with that!). I didn’t have a real appreciation for the bazillion-and-one things that they have to process in order to make the decisions that need to be made.

Did I mention how terrified I am?

My hope is this fear will turn into gnarling dedication to improvement -otherwise I’m going to fail and fall flat on my face (cynically joking) .

I definitely have to not only step up my ‘game’, but I need to bring my ‘A game’ at all times.

This is going to be a fun semester!

Another post from over at Scrubs.

Clinical rotation jitters | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

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Distance Caring?

Posted by Sean on October 2, 2011

 

Tele-what?

You’ve heard of distance learning, but what about distance caring?

That’s the newest concept in the world of health care these days. Telemedicine, telehealth and of course telenursing. They all seem to fall under the same umbrella definition of delivering care from a remote distance.

We nurses are no strangers to this type of care. There are nurses out there who used to deliver their care to their patients over the phone (and some still do). What has changed over the years is the avenue by which this care is delivered…for example, via this lil invention called the internet (have you heard of it?). The ‘net brought enormous technological advancements in health care delivery and health care monitoring.

Everything from Holter monitors to 24-hour pharmacies to the Electronic Medical Health Record has catapulted the way in which we provide care to patients.

We’ve leapfrogged from downloading patient data ‘after-the-fact, to real-time monitoring of an event as it happens. This real-time monitoring has now been taken to the ‘next level’.

Traditionally, patients who are being monitored by ‘telemetry’ (bare-minimum continuous ECG ) are monitored by nursing staff (as well as physicians) who are with the patient on the same unit, the same floor, heck – the same building!

Well, not anymore.

The amazing advancements in our technology have opened new doors (literally). Patients are being ‘monitored’ remotely. The nurse (or physician) is now monitoring patients and their dynamic vital signs from a distance. That distance can be as close as the next floor or as far as the next building. I read somewhere that monitoring was performed across state lines and even across coast lines! The distance threshold seems to hold no boundaries lately.

As a critical care nurse this equally excites and scares the bejeezus outta me. How awesome that would be to have the ability to possibly stop an emergent event from happening from a distance?! But, on the other hand, how horrifically scary would it be to make an error in judgment!

The possibilities are endless if you think about it. There are of course numerous adjustments and accommodations that would have to be made for every instance. Patient safety would be the priority.

I’m not sure how comfortable I would be performing those duties? As a critical care nurse we are always, always, always taught to never trust a monitor and to always, always, always (did I emphasize always enough?) check the patient first. No matter how great the technology may be, I just don’t think anything can replace your 5 senses.

Another post from over at Scrubs. Have you had any experience with this yet?

Tele-what? | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

Posted in health | Tagged: , , , , | Leave a Comment »

 
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