We nurses sometimes forget to separate our personal lives from our work ones.

For some reason, we tend to socialize with the very same people we work with (or used to work with), or we socialize with fellow healthcare professionals (Docs, EMTs, Medics, RTs, etc.).

It’s neither good nor bad–until we’re not around them but continue to act like we are.

Here are some tips to keep in mind this holiday season:

Refrain from talking about work at the dinner table

Yes, contrary to what you may believe, there actually are people out there who cannot talk about bodily fluids, blood, and drainage while shoving food in their mouths. Call me crazy, but slurping down cranberry sauce while discussing bloody wounds is not what most people call normal. Besides, you’d rather be enjoying your time off from work than resuscitating a family member who fainted.

Try actually tasting the food

Try not to eat your meal with the same “hot-rod racing style” that you do when you’re at work. Most of us don’t get a full-fledged traditional meal break, so we eat on the go, on the fly, or while we are still moving. Some of us inhale our food so fast, we forget what the heck we ate. I’ve uttered the phrase, “I’ll taste it later.” This is that rare occasion when you can eat at a normal pace, so give a try!

Cutlery improvisation

Whatever you do, I mean, whatever you do–if the supply of utensils is low, please do not break out the tongue blades, urimeters and other equipment to aid in your feast. Once again, it’s not normal to eat your food with a piece of equipment used to examine the back of the throat, or drink from something that normally collects a bodily fluid. Please refer back to family members fainting.

Native tongue

This goes right along with the bodily fluids topic. The minute you start speaking in medical mnemonics, you’re more than likely going to get that glazed over stare and be asked to explain yourself. Play it safe and avoid them altogether.

Maybe I’m the only one who has had to follow these tips? One thing’s for sure, the holidays are always entertaining when there’s a nurse around.

via What NOT to do this holiday season | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles.

A post from over at Scrubs taking a humorous look at nurses and the holidays.

8 crazy things nurses do during flu season

As nurses, we get very comfortable with our obsessive compulsive behaviors.

During the flu season our OCD-like nature gets ramped up simply because of the obvious – more people are sick.

Whether it’s from a new strain of the influenza virus or maybe the idea of people refusing (or plain neglecting) to get the vaccine, here are ways to take some extra precautions to ensure we don’t get the flu….

1. Pay with credit or debit

Can you imagine the filth and germs hanging out on that paper money… or those coins? We all took microbiology. We know what can hang on!

2. Avoid mass transit transportation

Everything from the subway, bus transit, planes, etc. (Please refer to “taking the stairs”) Who wants to be huddled up next to someone with a snotty, runny nose? You have nowhere to go!

3. Take the stairs

Elevators are a no-no. What if someone sneezes!! Seriously?!

4. Personal stash of disinfectant wipes

Who knows when you may need to use a public telephone, a public computer, or worse yet… have to pull open the door to exit a public bathroom instead of pushing the door!

5. Wear long sleeves everywhere

For that one time you use a public bathroom and you have to pull the door instead of push the door to exit. Need I remind you that not everyone washes their hands after they’re finished? (Oh, you know I’m right.)

6. Avoid salad bars and buffet meals (including family ones)

Some people forget how the food is actually made and prepared. Yes, those employed by a business establishment wears gloves. They are required by law, but what about your family? Or your friend’s football party??

7. Refuse and/or deny any requests to borrow your cell phone

I’m pretty sure you can figure out why.

8. And of course, this is a given: We wash our hands. And then we wash them again. And again. And again.

What do you do to avoid the flu?!

Another post from over at Scrubs. Crazy is as crazy does…. right? LOL

8 crazy things nurses do during flu season | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

Eating on the go: Product review for nurses

 

*Disclaimer: This product and containers were provided free of charge. The blogger is in no way affiliated with balanceddaylunchkit.com. All opinions are of his own, and is under no obligation to promote or defend the product in question.*

As everyone knows, I’m a commuter student with lunch-packing challenges. (Read my previous post here on ‘Packing my bags‘) I noticed in the Scrubs Magazine fall 2011 print edition a page on getting organized (page 16 if you’re interested). We also have a page dedicated on our website to ‘The Organized Nurse‘.

I read about the product ‘Three Squares in One’. They have a ‘lunch bag’ of sorts they call the ’12-Hour Shift Bag’. I found it so intriguing I contacted the company to see if I could try it out. The were nice enough to provide me with the bag as well as the food containers that fit inside! Needless to say I was acting like a kid in a candy store.

I have always promoted healthy eating. Bring a lunch and leave the money at home. So I’ve been trying to find a lunch bag that can do that very thing, but can provide me with meals over the course of the day. So the 12-Hour Shift Bag seemed like the answer to all my woes.

After using (and abusing) it for work and school over the past couple weeks I’m ready to share my findings. It definitely touts a large capacity for storing any and everything. It has two main compartments that are individually insulated. So you could potentially have one ‘hot’ and one ‘cold’ meal. It actually has the two sides labeled ‘One’ and ‘Two’. I initially found that entertaining, but then I utilized the labeling more than I ever thought I would whenever I would go hunting for my food.

The containers they provided fit perfectly (as they should I guess). They had a nice seal-locking mechanism on them that ensured your food’s freshness. Something I really liked. Especially with the wear and tear I gave it. My food never spilled.

I loved the little zippered ‘compartments provided on each ‘flap’. You could store napkins, utensils or even pre-packaged snacks in those nifty pockets. And once again they were still insulated. Within each ‘side’ there were small elastic Velcro straps provided. I later realized these could be utilized to secure containers as well as secure and cooling device you may utilize (like the blue ice cooling blocks). In addition there was also an additional compartment with a magnetized flap for additional storage space.

It definitely held up to the rugged wear and tear. I swung that thing over my shoulder and across my back numerous times throughout a single day. The adjustable strap was key! And the straps were attached to the main unit by metal clasps, which was nice. This way the strap doesn’t tether away from the main unit.

Space was not an issue. There was plenty of room to bring just about anything. The two main compartments, the zippered pockets in the flaps, and then the additional zippered outside pockets on both sides made for easy portability.

While it was a large bag, it seems that you could compress or collapse one side of the bag if you wanted to, if you were only needing one side for those shorter days (or shifts).

Here are my bulleted highlights of this product:

PROS:

• Ample storage space with deep pockets
• Well compartmentalized
• Zippered flap for utensil storage
• Individual insulation is great for bringing hot & cold meals
• Ability to secure items within the compartments
• Option to collapse one side to only utilize half the bag
• Strong and sturdy adjustable carrying strap
• Aesthetically pleasing for both men and women
• Labeling of each side compartment

CONS:

• Very bulky at times to carry
• When fully pack – can be quite heavy

Overall grade: A

I don’t think there is a ‘perfect’ lunch bag out there, but this comes about as close as you can get. It has enough options available to suit just about any and every need for those nurses looking to pack their meals for the long shift. The name of the product says it all. I highly recommend this product.

I would like to extend a special thank you to Kathi Blackwell from Balanced Day Bags Inc. for her generosity in providing this product.

*Disclaimer: This product and containers were provided free of charge. The blogger is in no way affiliated with balanceddaylunchkit.com. All opinions are of his own, and is under no obligation to promote or defend the product in question.*

Eating on the go: Product review for nurses | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

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

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

The ideal rotating shift?

I just read a new study that claims that ‘working rotating shifts is not as potentially unhealthy as it used to be’. What? Is there such a thing?

I wonder if those who conducted the research have ever worked a rotating shift in their life??! It seems that there is now a more ‘ideal’ formula for rotating your day and NOC shifts. Instead of working 2 weeks of days and then 2 weeks of nights this article ‘claims’ there is now a trend to work day-day-night-night then five days off in a row. I like the adjective they used in the article I read though. They called this trend of rotating shifts more ‘humane’.

I must admit, I’m glad to see research is being conducted on ways to minimize the detrimental effects of shift work. I don’t think they will ever eliminate the health risks involved with ‘flipping’ your circadian rhythm.

When I read the word ‘humane’ I immediately blurted out ‘Darn right!’. Working a NOC shift has got to be a warped zombie-apocalypse training scheme in my book. I don’t know about you, but working ANY type of NOC shift turned my brain into much and pretty much guaranteed all my autonomic bodily functions would short-circuit. I couldn’t see straight, I could stand without swaying and stringing more than two words together to form a comprehensible sentence just wasn’t possible. I remember feeling like I had the ‘flu’ every month when I had to do the shift ‘flip’. My hats off to those that can ‘flip’ with minimal damage.

It probably didn’t help that I have chronic insomnia and I am such a light sleeper. So much of light sleeper than a kitten walking on a newly installed carpet woke me from my sleep (true story). When I would work nights every trick in the book to help you sleep would not work for me, since the wind blowing outside would wake me up.

*sigh*

This would explain why I don’t work nights anymore.

…

I’m still chuckling at the word ‘humane’.

Article of interest:

Modern Shift Work Patterns May Be Less Harmful to Health

My sarcastic post over at Scrubs. Am I alone on this one?

The ideal rotating shift? | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

Doctoring the ‘Doctor’ title?

There has been much scuttlebutt throughout the online health care community. The divisive ‘physician versus advance practice nurse’ debate has gained quite a bit of steam thanks to a recent article by the New York Times titled: When the Nurse Wants to Be Called ‘Doctor’. A great big thank you and ‘shout out’ to the NY Times. I think this conversation needed to continue.

Over the course of the past several days I have been keeping a log of responsive articles (please see the end of this blog post for articles of interest). I have taken an interest to this particular debate, since I am a current Nurse Practitioner student who will eventually hold a Doctorate of Nursing Practice (some years down the road).

I for one do not have a solution (sorry). However, I do feel this debate is based on valid rationale that has gone awry.

Yes, I firmly believe we as practitioners should not mislead our patients. The social stigma and public knowledge that follows the title of ‘Doctor’ can lead one to believe they are in fact a medical doctor, ergo a physician. The reality is that not all ‘Doctors’ are ‘Physicians’. We need to remind ourselves that the PhD has been around for quite a long time, and that there are doctorate degrees in many other health care related disciplines.

To quote Dr. Kevin Pho over at Kevin MD:

“Those who earn a doctorate degree, whether it be in nursing, pharmacy, or psychology, deserve to be called “doctor.” Period.”

So in defense of Nurse Practitioners with their DNP, they are not misrepresenting themselves. They’ve earned the title. But it’s the intention in which the title is used that makes all the difference, in my humble opinion.

Proudly conveying your earned title without proper clarification and intention can easily be mistaken for deception and misdirection. In the original NY Time article the NP introduced herself as ‘doctor’ and followed up with “I’ll be your nurse”. No misdirection there.

I think this is the source of the physician community’s angst, and disapproval. If the NP is making an empty attempt at representing themselves as a  physician with their numerous years of education and rigorous training, then yes, I too would be on the defense. Even though I am not a practicing NP (a mere student), I don’t believe there are NP’s out there that would outright misdirect or misrepresent themselves as someone they are not. If they are, then shame on them. They are not only damaging their professional credit and earned title, but they are potentially placing their patients in harms way.

I know in the end, both physicians and advanced practice nurses share the same goal of optimal patient outcomes. Splitting hairs over entitlement and attempting to ‘strip’ someone of a title that have rightfully earned is just a waste of energy and a misuse of vital resources.

Articles of interest:

When the Nurse Wants to be Called ‘Doctor’

Should medical students be introduced as Doctor?

Calling yourself Doctor and what that now means

Turf Wars

Universal board certification can solve the Doctor Nurse controversy

A post over at Scrubs that continues the conversation about the newly controversial title.

Doctoring the ‘Doctor’ title? | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles

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

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

A letter to my former self (the new nurse)

Dear Me:

I know it’s been a while since we’ve talked but I thought I’d check in on ya and see how you are doing? I see you’re head is still circling after finishing nursing school. Yeah, I know, it still seems like a dream… but guess what you did it! You graduated.

Now on to the NCLEX (boards).

While you’re busy studying for that I know you’ve started working as a Graduate Nurse at the bedside. Just when you thought you were done with that ‘learning’ stuff huh? Yeah, you thought nursing school was tough? Now you have to figure out how to survive and eventually thrive as an independent nurse!

Don’t worry, we have all shared the same feeling: Being sure that sooner or later someone was gonna notice that you had no clue what you were doing!

It’s OK. We’ve all been there.

I thought I’d pass on some tips and words of wisdom for you during those first few years, to help you through the tough spots. Yes, you read that right. I said the first few years. It takes, at the very least, a full year to just get comfortable in your new ‘nurse’ skin. It’s only after another year of feeling comfortable in that skin that you finally shake those jitters.

Sorry. I promise it does get better.

Here are some things to keep in mind:

• It’s OK to be scared: We all were and still are to some degree. Remember, not everyone can do this job.
• You are not expected to know everything: Some of us have been doing this for decades, and we still don’t know everything!
• It’s OK to ask questions: the minute you stop asking questions is when we get worried.
• Stop beating yourself up over every mistake : we all make mistakes, and we all continue to make more. The key is to learn from them.
• Yes, things really do move that fast at the bedside: we all learned to walk first, then run. So will you.
• Your first patient death will shake you up: trust me. And there is nothing wrong with that.
• Your first code will scare the living daylights out of you : you’ll understand it better once you experience it first hand.
• Every time you want to ‘run’ force yourself to walk: hurrying through a task will only increase your chances for making a mistake.
• Take the time to learn everything by the numbers, before you decide to adopt a shortcut: just trust me on this one.
• Learn the difference between confidence and arrogance: it will save lives.
• Stop dwelling on how fast you do things: yes, we all did things that slow when we started! Efficiency comes after accuracy.
• Never, ever, ever, ever apologize for calling a physician about your patient : even at 3AM.
• Don’t expect respect until it is earned. You’ve earned the right to be here, now earn the respect to stay.
• No matter where the job takes you, there will always be somebody wanting to break you down: don’t let them infect you.

And last, but surely not least. You have entered into one of the most awesome professions around. Be sure to pass on your knowledge, your skill and your passion to those who follow. It’s our job to erase the old urban legend of nurses eating their young.

Best of luck to you on your journey and your career. You are in for a wild ride!

A letter to my former self (the new nurse) | Scrubs Magazine