Posts Tagged ‘nurse’
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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Posted in health, humor | Tagged: nurse, nurse practitioner, student nurse | Leave a Comment »
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
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Posted in health | Tagged: nurse, technology, telehealth, telemedicine, telenursing | Leave a Comment »
Posted by Sean on September 28, 2011
Tick-tock, tick-tock. I don’t know about you but my entire day at work is ruled by the clock. Everything from the medication I give to the procedures my patients have to every ‘timed’ care event that we perform.
Everything in some way shape or form is on a ‘timer’.
Lately, my timing has been ‘off’. I can’t seem to get a leg up and stay ahead of the 8-ball. The other day I clamped an NG from wall suction after giving a med, and lets just say the tube remained clamped for the better part of my shift (thankfully it was only a couple of hours). I realized that looking up at the clock to see the time and calculating my next ‘event’ was just not cutting it. So here are 3 tips that I think are going to help me, and I thought I’d share them:
A Watch
Now, before you go poking fun. I’m not just talking about a standard time piece. I’m talking about a watch that has a timer, an alarm and possible a stop watch (if needed). I own one of the traditional ‘Ironman’ triathlon watches that has all the above. I’m starting to used the ‘timer’ more frequently, especially after the NG episode recently. Set your timer to whatever interval you need to remind you of your next ‘event’ (a timed med, unclamping a tube, your next blood sugar, etc.)
The IV Pump
Most IV pumps these days are quite advanced. I sometimes think they are a lil’ too much, but the advancement has definitely increased safety and decreased the likelihood of simple human error. This suggestion really doesn’t utilize those ‘advancements’. The next time you have a med to give, or a blood sugar to check (Q 1 hr. on Insulin gtts) set the volume of your infusion for one hour or whatever time you need. That way, in 1 hr., your IV pump will (annoyingly) alarm ‘low volume’ which will require your attention. You can reset the volume to the next desired interval to keep you on schedule.
A Smartphone
This last suggestion is only if you already own a smartphone. No need to go buying one just for this purpose. My iPhone and most smartphones have a pre-installed timer, alarm clock and stopwatch. If yours does not, there are million and one ‘apps’ you can download for free, or for a small fee. My iPhone is always on my hip now since I utilize it more for medication references as well as medication calculations (and just about everything else), so if I forget to wear my watch I utilize my phone. Heck, there are times when I use both my watch and my phone to help keep me ‘on time’.
Care to add any suggestions to this list? What do you use at work to keep you ‘on time’?
Another post over at Scrubs. I really gotta get in front of that 8-ball.
Three on-the-job time saving tips | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles
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Posted in health | Tagged: nurse, time, work | 2 Comments »
Posted by Sean on September 24, 2011
Nursing school checklist
The beginning of the school year is when I do a mental checklist to make sure I have what I need to start this semester and last through the entire school year.
Interested to hear: Do you have anything to add to my list, or recommendations on certain brands?
- Book bag : Check their condition. Yes, I said their. I have multiple bags I use depending on the day and depending on the class. I’m a ‘backpack’ kind of student, but I also have a messenger bag. I need to make sure the bags are gonna make it through the semester. Have you ever had the strap of a bag just ‘fail’ on you in the middle of transport? Yep, my books and supplies went everywhere. It was not a pretty sight.
- Planner : This is almost a moot point these days with the popularity of smartphones and tablets, but I still carry around the traditional calendar planner. I think these days I use it for carrying papers and documents, but I still utilize the calendar in addition to my trusty iPhone.
- Printer & Accessories : Ever run out of ink mid-print? I always take stock in what I have, and what I need prior to the start of the semester. I’ve noticed I print a couple ‘forests’ worth of paper in the beginning. Everything from course syllabus, outlines, assignments, course schedule, book list, etc., gets printed out for each class. I need to determine what I have and what I need. This includes printer cartridges & paper!
- Supplies : I try to envision what I do and what I need on hand while I’m in class as well as what I utilize when I am studying (at home and on campus). Everything from pens, pencils, erasers, white-out, sticky-notes, highlighters, bookmark tabs, scissors, stapler (and staples), paperclips, etc. This list is usually pretty long, and I almost always forget something.
- Storage : How do you store your documents? Where do you store them? Do you use or utilize jump drives? It’s a crazy thought, but some of us still use discs to store data. Do you utilize online storage (in the cloud as they like to say)? Is your online storage maxed out? Is it a paid membership? Is it free? Do you need to clear the clutter out of your storage device to make room for the new data?
- Study : How do you study? What do you utilize? Do you record lectures? Is the device you use to record operational? Do you need extra batteries? Is it digital – if so do you need to clear the memory for the new data?
- Notes : How do you organize your class? Are you a spiral notebook kind of person? Or a loose-leaf paper and binder kind of student? Do you utilize folders or tabbed organizers? Make sure you have ample supply of whatever it is you utilize. I have my binders and paper ready to go.
This is a randomly small list of things I inventory each semester. I find it helps make the transition a little less hectic, because we all know how ‘stress-free’ those first two weeks of class are right? Right? (Yes, insert heavy dose of sarcasm now)
What crazy things to you check when your school year starts? Another post from over at Scrubs.
Nursing school checklist | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles
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Posted in health, random | Tagged: nurse, organization, school | 2 Comments »
Posted by Sean on September 23, 2011
How clean is your uniform?
Isn’t it amazing how our uniform defines our profession? I guess you could say all of health care to some degree. We as nurses love to wear our scrubs. We love to be able to say we wear our ‘pajamas’ to work every day (OK, maybe I’m the only one that says that). But what if the uniform we are wearing is causing harm? Or could potentially cause harm in the form of infection?
It’s not a new concept, but I recently read an article (Dangerous Bacteria Hide Out in Nurses’, Doctors’ Uniforms) on how our scrubs and our lab coats (all types of care providers) can and do harbor harmful bacteria. When I saw the title of this article it immediately brought back memories of the cleanliness of physician’s ties (How Clean Is Your Doctor’s Tie?).
It is no secret that we deal with a boat load of serious disease-causing germs on a daily basis while on the job. It doesn’t matter where we work, it’s what I would call assumed risk for us. This is health care, and we are caring for the unwell.
I guess I’m wondering how often we think about the ‘sterility’ of our uniforms (all of them). I mean, I don’t think I’m alone when I say I wear my scrubs from my home, to work, at work, and then back home. In fact I’m pretty sure we have all run errands before and after work while still wearing our scrubs. What’s that say about our cleanliness? Or our infection prevention? We ALL know how easy bacterial transmission can be (those darn vectors!).
When I worked in the PACU, we had to wear OR scrubs. We could not wear scrubs from outside the hospital. We had to change into our uniform that was provided for us by the hospital. And then at the end of the day we changed and tossed the dirty uniform in the dirty linens to be washed by the hospital cleaning service.
I used to think that was such a pain.
Then I remembered my pediatric rotation in nursing school. All the germs we encountered there. I specifically remember MANY of my classmates getting the sniffles, head colds and full-blown flu during that time frame. We were told to rigorously clean our equipment (pens, markers, clipboards, BP cuffs, stethoscopes, etc.) to make sure we didn’t transport any of the ‘germs’ home. RSV was not our friend. I remember wiping down my shoes with Clorox wipes after each clinical day!!!
I’m still pretty ‘Type-A’ about most of the aforementioned, but somehow I’ve gotten away from including my uniform.
Maybe I’m being too ‘Type-A’, but I wonder how many times we nurses have gotten sick, or we have passed on the ‘germs’ to someone else who eventually became sick, simply by the uniform we were wearing. (See this article about germs on your scrubs, as well).
Things that make you go hmm…
How ‘sick’ are the scrubs you are wearing? Another post from over at Scrubs.
How clean is your uniform? | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles
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Posted by Sean on September 21, 2011
More effective communicator
As nurses we all learn about therapeutic communication. I’m not here to review that. But, does being a therapeutic communicator make you an effective communicator?
I found out this week that it does not. Taking that initial history can be challenging to say the least.
You can listen with the most empathetic ear, but if you cannot effectively communicate AND therapeutically communicate, the conversation you have with your patient will be short and ineffective.
Here are some key concepts that may look vaguely familiar to those who know therapeutic communication skills:
Level the playing field
We all know to always maintain direct eye contact, but also make it a point to maintain the patients eye level. Meaning, unless you can’t prevent it, don’t interview your patient standing over them. Everyone remembers how to communicate with pediatric patients right? Well it equally applies to adults. Be on their level – literally and physically!
Two ears & one mouth
This means you should listen twice as much as you talk. The best communicators are the greatest listeners.
Wide open spaces
I would hope you are within close proximity of your patient. Trying to elicit a meaningful dialogue from across the room is not very effective. Although there can be such a thing as ‘too close’ and invading personal space. Please respect someone’s wishes and be culturally sensitive to their needs and wants, regardless of how you feel about them.
The Doppler effect
Be very aware of the tone of your voice. While we always want to use our ‘inside’ voice, I think we can all admit to raising our voice to speak above the ambient sound of the hustle & bustle of the nursing unit. I honestly would suggest starting with a whispered voice. I haven’t met anyone who gets offended by a whisper, but many will be offended by a boisterous megaphone-like shriek.
Be a N.U.R.S.E.
(Sorry, I learned this new acronym and had to share)
N – notice
- Listen, listen, and then listen some more
U – understand
- Developing a plan of care
R – respond (& reflect)
- Clarify yours and their understanding
S – sympathize
- Validate how they are feeling
E – empathize
- Be objectively aware and non-judgmental
A lot of these suggestions are not new. In fact I think all nurses possess these skills, or they learn them as they travel through their career. It never hurts to remind ourselves.
Another post from over at Scrubs.
More effective communicator | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles
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Posted by Sean on September 20, 2011
Kim McAllister just keeps flexing her nursing skills. Here is a recent video interview she did on ‘what it takes to be a nurse’.
What It Takes To Be A Nurse
If you’re wondering “should I become a nurse,” you’re going to want to make sure you like science, have good communication skills, are detail-oriented and can problem solve, multitask and handle stressful situations. In today’s episode, Kim McAllister, an emergency room nurse with over 30 years of experience, tells us that it takes a lot more than caring about people to be a good nurse. Kim shares great career advice and all kinds of information about nursing careers.
…Kim tells us what schooling is required to become a nurse. She advises taking lots of science classes in high school and then, because so many nursing jobs are looking for a Bachelor’s of Science in Nursing, Kim suggests going for the 4-year degree today. Kim spent most of her nursing career with a 2-year Associate’s Degree in Nursing and from her experience believes another great route is to get the ADN to start your nursing career and then, while getting real life work experience, keep going to school on the side to earn your BSN. In addition to this great advice, Kim walks us through a typical day and provides an ER nurse job description.
Way to go Kim! Be sure to check out the original post in its entirety!
What It Takes To Be A Nurse | Careers Out There
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Posted in health | Tagged: career, emergiblog, nurse | 2 Comments »
Posted by Sean on September 19, 2011
Do “new nurses” scare you, too?
Lately I find myself becoming quite the cynic. I’m not a cynical nurse, I’m just discovering things throughout my ‘world’ that are cause for cynicism. Well, not everything in my world. Mostly the new nurses.
Now remember, I haven’t even been a nurse a decade yet! And here I am remembering the “good old days” of nursing. Scary. I know.
I guess what gets under my skin is I’m finding more and more ‘newer’ nurses who think they know everything. OR they think they’ve experienced everything simply because they’ve been a nurse ‘long enough’, to see the ‘same thing’ more than once. Complacency can infect all of us at one time or another. We get so comfortable with repetition that we find safety in it, and then we find braggadocio. I’ve been doing this for a mere seven years, and to this very day, I still learn something new, or appreciate a new concept every day.
I cannot shake the feeling that the ‘newer’ nurses scare me just a little. This hollow, yet inflated, ego is going to get them in trouble. So much trouble that I often wonder if their patients will suffer.
It was handed down to me in a very profound way that it’s our job, as nurses, to expect the unexpected. To think in terms of the ‘worst case scenario’. To prepare for the worst, but expect the best. To always have our ‘game’ face on, and to always play our ‘A’ game. I just don’t see that with these ‘newer’ nurses. Now, don’t get me wrong. I’ve seen plenty of awe-inspiring new nurses, that can and have put me and other experienced nurses to shame. I am humbled by their skills, I really am. But, I can’t remember the last time I felt humbled by a new nurse.
I’m not just talking about whom I’ve worked with shoulder-to-shoulder. I’m talking all facets of interaction (in-person & on-line). So it’s not just my small circle of the world.
Maybe I need a breather?
Maybe I need a change of scenery?
Maybe it’s not me at all?
I don’t know. What I do know is that it’s my responsibility to myself and my profession to continually challenge this new attitude. I’m not saying we need to ‘put’ anyone ‘in there place’, but we definitely need to educate and enlighten those that need it.
Am I alone on this, or have others come across this ‘Bo Jackson’ phenomena of ‘knowing everything’?
I’d love to hear your thoughts.
This was a post over at Scrubs. I was trying to figure out why I have come across so many new nurses who have this trait.
Do “new nurses” scare you, too? | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles
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Posted in health, opinion | Tagged: new grad, new nurse, nurse | 3 Comments »
Posted by Sean on September 17, 2011
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
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Posted by Sean on September 17, 2011
Shrtstormtrooper shares a story over at New Nurse Insanity (link below) that encapsulates why we nurses develop short fuses. Fuses that lead to burnout, angst, anger and all kinds of negativity. Sometimes (some) nurses really need to check themselves before ‘reporting’ a fellow ‘fighter’ to their supervisor. Walk just a few steps in another co-workers shoes.. you might think twice about reporting someone for something you yourself probably forget or miss just as much, if not more than most nurses!
A high five to Shrtstormtrooper.
Priorities, seriously
So I got called into the Boss Man’s office this morning, because the floor wrote me up and he wanted to address the issue.
At this point, my feet hurt, I haven’t peed yet tonight, I didn’t get to eat anything, I have blood on my scrub pants…..
I have poop on my scrub pants…
I haven’t finished charting on that last arterial bleeder that came in….
and my coffee from 7pm is still sitting full on the counter next to my computer. It’s been a rough night.
I got written up because, in all the madness, I missed a skin tear on this patient. One skin tear, out of many. And actually, it wasn’t my patient to begin with,
New Nurse Insanity: The Adolescent Years | Priorities, seriously
Follow the link above to read the whole story. Be sure to leave a comment for her, let her know she’s not alone!
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