Is Nursing a Talent?

18 September, 2015 § Leave a comment

The Washington Post published “Is nursing a talent? You can bet your life on it.” The article is very well written and it confirms what many of us already know: it is a skill that we continually work to keep sharp and update.  In some ways, it is a lot like many of the other talents that were displayed in the Miss America pageant. We juggle a patient load, orders, varying degrees of patient acuity and needs.  We move so quickly up and down the unit that we often feel like we are on (and sometimes need) roller skates.  We have sung to our patients. We have read poetry to them. We tell them jokes. We often work magic.  Indeed, we have many of the same talents as pageant contestants, but we also have so many more talents and skills that are necessary to be a Nurse.

Since the jokes made by the hosts of the View, I have used my skills and talents as a nurse to perform CPR, stabilize a cervical spine with my hands until we were able to place a collar, managed the trach of patients so that they may continue to breath, placed an IV so that a patient could receive live saving medications, comforted and calmed scared and confused patients, decreased someone’s pain, increased someone’s hope, and gave families peace of mind that their loved ones were in good and caring hands. That is only a small fraction of what I and my 3 million colleagues have done.

Lateral Violence and Bullying in Nursing

24 January, 2014 § Leave a comment

JoAnne, RN has written an excellent article about lateral violence and bullying in nursing and how we can deal with mistakes in a way that builds the profession instead of tearing down our fellow nurses and ancillary staff.  Take the time to read the article here, it is worth it.

Sadly, I have seen lateral violence among nurses and bullying from nurses to ancillary staff, luckily this was mostly in nursing school and environments outside of work.  Sadly, I have also been on the receiving end of said lateral violence.  Nursing is not the only profession that this happens in and before I was a RN I was a clinician in the mental health field.  I imagine this exists in any place where there is a power dynamic at play.

In my own experience, I am pretty good at standing up for myself and when I have been the victim of lateral violence and/or bullying, I immediately called them out on the behavior and justified why I did something based on my professional opinion.  I am always open to constructive criticism, both when I worked in mental health and as a nurse, but outright ridicule or remarks said to others, in a loud manner, that is meant to demean or call into question my abilities, is never acceptable.  I admit, there have been times when I did not always do this, but at this point I try and I hope my fellow nurses do the same.

When we, as nurses, see bullying we must also make it our reaponsibility to stop the bullying immediately.  Just as it is not acceptable for it to happen to us, it is also not acceptable for it to happen to others and we must attempt to end it when we see it.

Now here is the hard part: fixing mistakes and stopping violence and bullying while not engaging in the same violence and bullying ourselves but by coming from a place of compassion, understanding, patience, and teaching.

Have you ever been the victim of lateral violence or bullying? Have you witnessed lateral violence or bullying? What did you do? How can we, as a profession, address this issue?

-Anthony

A very important nursing skill

28 July, 2013 § Leave a comment

Prepping for my daily caffeine bolus

Prepping for my daily caffeine bolus

One of the most important skills that a nurse can have is the ability to put together a quality cup of coffee.  Okay, I know what you are thinking:

Anthony, this is a a very bad stereotype.  People already believe that Nurses just get coffee for the Doctor!

Please people, I am not talking about getting coffee for a Doc, they can get their own coffee from one of those $0.50 machines where the coffee comes out tasting like cheese.  Besides, I am not sure if they can handle my nurses brew.

I am talking about making a good cup or three of coffee to power us through our day.  We can not afford to get that end of shift slump like our office faring brethren, no it is usually near the end of shift that we must be our most alert or Murphy’s law will ensure we are there long past our punch out time.

I have a Keurig for when I need that emergency cup STAT, but truthfully I love the coffee that comes out of my French Press.   The Keurig is nice but it is almost blasphemous, but when coffee is needed immediately we must improvise. My press is nothing fancy.  I picked it up from my local grocery store for about $20 and it works great; the end result really is all in the coffee and the water anyway.

So how do I make a kick ass cup of coffee  for my first caffeine bolus?  Well it is slightly labor intensive, but we are nurses, we are no stranger to putting in some work and we know that anything worth doing is worth doing right or we are just going to have to do it again.

I start with a darker roast coffee, usually French Roast (I swear there is no theme here between my French Roast coffee and my French press) and make a coarse grind.  I have a grinder at home but it needs to be retired and produces grounds that clog the filter, so I buy whole beans at the store and then grind it there.  Yes, you lose some flavor this way and that sucks but it is better than the stuff that has been ground already.  Either put out the money to buy a really good grinder or, if you are like me and go through a pound pretty quickly, just grind it coarse at the store.

So I have my ground coffee, I heat 28 ounces of water on the stove (that is where the water meets top band) and bring it to a boil.  Once it boils I remove it from the heat and let it sit for a few minutes to bring it to about 200 degrees. This is the temperature you want the water to be at, so if you have a way of bringing it to that and knowing the temperature, then go for it, I do not so I just give it a few minutes to cool down once it starts to boil.

Meanwhile, I add 2 scoops of grounds for every 6 ounces of water and I will usually add an extra scoop because I like my coffee strong.  Add the hot water, stir with a wooden spoon or chopsticks, and put the lid on with the plunger up.  Now walk away for 4 minutes and allow it to steep.

Tick tock tick tock.

After those 4 agonizing minutes, slowly depress the plunger and then poor that first delicious cup of coffee.  I also add a bit of sweetened condensed milk because it makes coffee awesome.  I learned this from some Vietnamese friends and the Vietnamese got it from when they were a French colony (okay fine, I see the French theme too).

The whole process takes about 10 minutes and the end result is a better cup of coffee than what you will get from your drip coffee maker and most certainly better than your Keurig.

This goodness flows through my veins.

This goodness flows through my veins.

Now all you have to do is pour it into your to-go cup or sit for a few minutes and enjoy the fruits of your labor.  There is something about the process that is zen like and calms my mind to prepare for the day ahead.  And then the resultant coffee amps my brain up.  I am a nurse and zen gardens and sand rakes can only last so long before it is replaced by a brain that processes a metric ton of information and acts in seconds.

I promise that you will not regret making your coffee this way.

Anthony

Pondering on Pediatrics

18 June, 2013 § 2 Comments

I remember being in nursing school and thinking to myself that I did not want to go into Peds because it was not “my thing”.  I also remember being in nursing school and thinking to myself that I would never work in geriatrics either.  Here I am a year later and I am working in geriatrics and have been considering the possibilities of going into pediatrics.  Nursing, and life, is funny like that sometimes.

I do not particularly like to see people suffer, and when it is children it is that much harder for me to endure, but their spirit is unbreakable and Padiatric patients are often some of the most amazing human beings you will ever meet.  I am amazed at their courage and their ability to smile in the face of darkness and odds that are typically not on their side.  Having a toddler of my own has changed my worldview and has expanded the way that I see Pediatrics.  When my little bugger was born it was feared that he had aspirated meconium

“The inhaled meconium can partially or completely block the baby’s airways. Although air can flow past the meconium trapped in the baby’s airways as the baby breathes in, the meconium becomes trapped in the airways when the baby breathes out. And so, the inhaled meconium irritates the baby’s airways and makes it difficult to breathe.

MAS can affect the baby’s breathing in a number of ways, including chemical irritation to the lung tissue, airway obstruction by a meconium plug, infection, and the inactivation of surfactant by the meconium (surfactant is a natural substance that helps the lungs expand properly).”

The NICU team was called and they worked quickly through some tense moments but our little one was fine after they skillfully inserted the tiniest suction catheter I have ever seen.  Later, he developed severe jaundice, causing him to be hospitalized again, and this time it was a great team of Pediatric nurses that cared for him while he was on their unit. Although just a few of the people involved in his care were told directly how much they meant to my wife and I, all of them played a role in the life of my family that I am forever grateful.

That sort of is what Pediatrics is about, doing amazing things with amazing people and leaving an impact on the lives that you touch.  Loving and caring for children and, in turn, loving and caring for the families of those children.

Maybe I should not write Pediatrics off as “not my thing”.

Anthony, RN

Sources:

H/T to Nursetopia for posting the video

Seattle Children’s Hospital

The Nemours Foundation

A NICU Experience shows the Art and Heart of Nursing

7 June, 2013 § 2 Comments

Image

Source: Forrest General Hospital

A few days ago I talked about being a smarter nurse and the science of nursing.  Today, as I read a story originally found on The Spohrs Are Multiplying I am reminded of the art and heart (heart?) of nursing in which empathy and compassion are at the center.  Heather and Mike Spohr recount the experience they had in the NICU with their daughter Maddie and the post beautifully illustrates some of what it means to be a nurse.

Sometimes throughout our shifts as nurses it is very easy to slip into sterile, clinical mode.  We speak in a coded language designed to allow us to give reports quickly and efficiently in order to maximize our time and all of this leads to that sterile, clinical nurse that we have all become at some point.  It is easy to do; we get busy, we have medications to give, treatments to administer, doctors to follow-up with, charting to do, and on the most hectic of days we believe that we barely have the time to stop for a few minutes to offer warmth to our patients to let them know that we care.  In my short time as a nurse I have learned how to incorporate and convey that compassion even amid the chaos and have been validated by the kind words of patients and their families.  It is not a big deal to us, it is simply what a nurse does, but those small gestures can be huge gestures to patients and their family members especially when they are scared and hurting.

Mike Spohr discovered just that during the five years that his daughter was in and out of the intensive care unit.  He says

It was in the Neonatal Intensive Care Unit that I first saw how amazing nurses can be…Each morning I called the NICU at seven a.m. to get an update from Maddie’s night nurse about how she had done through the night, and the moments waiting for her to pick up the phone were horrible…she would always tell us about Maddie’s night in great detail despite having just finished a long, exhausting shift.

The simple gesture of taking the time to tell Mike about his daughter in great detail, at the very end of the shift, when there was still, no doubt, much to be done, put Mike at ease.  There are not very many professions where you will find people ready and willing to give you as much time as you need when they themselves have absolutely no time to spare.  I admit, sometimes talking to a family is the last thing that I want to do when there is so much more to be done, but it is something I do with great care because they often have no idea what happened the prior day with their loved one.  Family members can not be there all day, everyday, but we are there so I always make sure that I am careful to give families the time they need to know their loved one is being cared for.  For a family to know that their loved one is being loved in return is a monumental thing.

Mike goes on to discuss the love and humanity conveyed by these nurses

Like the NICU nurses, these nurses showed Maddie so much love, mooning over how cute she was and making faces at her to keep her entertained.

There, sitting on a chair with a single tear rolling down her cheek, was my nurse. Her tear told me that she cared.

His final thoughts in closing

To Nurses everywhere… You should know that you have made a difference to so many people in this world, my family included, and I cannot thank you enough.

Nurses do not get the opportunity to hear this very often.  Our patients come and go and we are not their first, or not even their last provider.  We are intermediaries, helping our patients find better health and comfort and once those goals are achieved they move on and we often move on as well, going to the next patient to provide the same care, compassion, empathy and love.  As a nurse I do not expect a “thank you” or get upset if someone does not say it, I do not even think about it because this is simply what I do, no thanks required.

I have said before, we typically offer something that no other member of the healthcare team offers.  We are with our patients for 8,12, or 16 hours a day so we owe it to ourselves and to our patients to practice not only with the science of nursing but with the heart of nursing as well.

Head over to The Spohrs Are Multiplying and read On the Wings of a Nightingale, you will be grateful that you did but be forewarned, it left a lump in my throat.

Anthony

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