Don't Curse the Nurse!

Sharing support with stories & humor

Say Hello !

Nikki from Fort McMurray Canada is a nurse who’s started a blog and I recently started following her after reading a post she did on Intention.

Her sincerity is appreciated in a time when lots of nurses are using various platforms to only vent frustration.

Go check it out! Meet her family. Show some WordPress love !

https://mymommylife.family.blog/

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I broke one of my rules, but it turned out okay.

” Could I get you a warm blanket? Our pre-op area is kind of cold.”

I had her husband ready to go, Discharge teaching initiated and prophylactic antibiotic started, there was nothing left to do but chart the medication.

“Sure, that’d be nice.”

When I returned with the blanket, I noticed, as I have before, this was one of those couples that struggled when required to sit together in a place such as pre-op where there is no T.V, computer, or gaggle of children to fill the space. The wife with her shoulders stiff, moved her eyes everywhere but toward her husband. He stared straight ahead.

“Did you two have far to drive this morning?”

“No,” he said, “We live close.”

“Good, you’ll get home fast and you’ll both catch up on whatever sleep you didn’t get last night.”

I had just put my head down to make sure the consents were flagged for the surgeon when the patient asked me a question.

“How long have you been a nurse?”

“Thirty-six years.” Sometimes I can’t believe it’s been that long.

“Our daughter’s in a Nursing program.”

Thirty-six years gives you a lot of opportunity to meet family members of someone in Nursing school, but this was different. My patient’s wife, her mouth turned down the second he shared that fact.

Before I could stop myself, I did it. I broke one of my rules. I made the conversation about me.

“I’m working on the first draft of a book for young nurses, kind of a Self-Help book.”

The wife cocked her head thoughtfully.

“Oh, what kind of advise would you give?”

What I said came from a place deep down in the center of my soul.

“It’s important to remember, your patients, they’re the ones in pain, not you. They’re the ones grieving — it’s not yours to carry. Forgetting that is self centered and also brings imbalance to your life outside of work.”

I don’t know if the wife’s dour look triggered my response. I held my breath when she started to speak.

“That’s really good advise.”

She turned to her husband and continued.

” We should tell her that.”

I need to finish the draft.

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COVID – The Sorting Hat for Nurses

Because I arrived a day late to the National Association of Perianesthesia Nurses conference last week, I missed the Keynote Speaker Mr. John Perricone.

The title of his lecture: Developing a Philosophical Identity

                        Subtitled: Professional Development for Nurses

I was only twenty-one when I started nursing. My philosophical identity was not as layered as it is now. The career choice itself, over this last thirty-six years has driven the development of my philosophical identity. Cherished mentors and my faith sculpted it futher.

This is from his web site:

Mission Statement

“We often witness, in times of crisis, the best of our humanity rising to the surface (complete strangers shielding or coming to the rescue of others, etc.) It is my fundamental belief that every human being has an inherent desire to live their life at the best expression of who they are, but this deeper self (or their “true self” if you will) is often buried under layers of what might have been a toxic upbringing, addiction, familial or societal expectations, etc. The goal of my work is to attempt to use my voice to bring this “best self” to the surface — where it can hopefully become the predominant expression of a person’s being, rather than the exception.”

                                                                        ***

Before even looking up his name to reach his web site, I had said to a family member, “COVID seems to me, to have been the Sorting Hat for nurses; some took advantage of the rise in pay for travel jobs and left places they’d worked for years, some retired early, some buckled in and have held on.”

I’d like to think my sorting experience was similar to that of Harry Potter’s ( Books by J.K. Rowling).

The Hat struggled when placed on Harry, whispering Slytherin, and Harry, mentally pleaded Gryffindor, please, Gryffindor.

I still wanted to help people prepare and safely complete their surgeries with all the education they need when home recovering.

I just needed to be in a different ‘house’

Changing to a setting where I could do that and also be more available for my family and address my health needs — a perfect sort for me.

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What Does This Mean for Nurses?

The day after Christmas in 2017, A Tennessee nurse did an override from an electronic medication cabinet and gave an anxious patient (about to have an MRI) Vecuronium, a strong muscular paralytic, instead of Versed, a sedative in the same family as Valium.

The nurse admitted her mistake quickly, but also pointed out she was distracted by a trainee.

She was fired a week later.

The hospital settled with the family within five months post the incident. Not speaking about the event was part of the settlement.

One article I read, reports that the hospital did not report the error to state or government officials despite it being mandated by the Health Data Reporting Act of 2002.

This revelation resulted in threats to suspend funding. 22% of Vanderbilt’s funding is via Medicare reimbursements. The hospital submitted corrective action and that possibility was put to rest.

Eight months post the fatal error, an anonymous tip brought this case to the attention of the district attorney’s office. In December of 2018, penalties and criminal charges were only placed against the nurse. She initially plead innocent to all charges.

Miss Vaught immediately lost her license.

In March of this year, a verdict of gross neglect and negligent homicide means Miss Vaught could spend anywhere from three to six years in prison. The sentencing is on May 13th.

Everything I’ve read has been sympathetic, especially a review from the Institute of safe medicine practices. At one point in the article, this nurse is referred to as the ‘second victim of a fatal error’.

However, see, there’s this thing: The Five rights of medication administration (Right patient, drug, time, dose, and route)

It’s Nursing 101.

If we start using automation and computerization as excuses for errors, we are in big trouble.

Jailtime, No. It is a shame it’s come to this.  I think the Tennessee court, unsure what to do, is overextending on this case. The criminalization of medication errors is scary.

 With that being said, some journalists that are reporting this outcome as a concern to the already ongoing crisis of nurses leaving the profession, eh, that has to stop.

Let’s get serious about the job. Let’s get serious about all Healthcare jobs and focus on quality, not setting goals in terms of productivity and cost cutting.

https://www.ismp.org/resources/tn-board-nursings-unjust-decision-revoke-nurses-license-travesty-top-tragedy

https://www.tennessean.com

https://www.npr.org

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Cheeky, but Somewhat Brilliant Idea

As I walked by two Recovery room nurse that were sitting at the desk and chatting, warm blanket in my hand for my Pre-op patient, I had a thought:

Why don’t we focus on making salaries for Nursing school instructors more competitive? ( I know they’re not because I peered closely down this path a year ago.)

Why don’t we reward people that are willing to take responsibility for teaching future nurses? I’m talking about more than the little extra you get if you can put preceptor on your end of the year work evaluation.

Articles have been out for a while about the diminishing interest / increased difficulty in filling positions in college nursing programs.

The U.S Board of Statistics has an interesting graph that shows the projected departure rate of nurses. It’s divided by RN’s, LPN’s, Practitioners, and Anesthetists.

RN’s are leaving by double the rate of the others.

These are our clinical nurse, the bedside nurses.

How about we go back to the beginning where it starts, in school, and reassess what is being taught and what tools nurses are starting out with.

And I’m not talking about stethoscopes.

https://www.bls.gov/careeroutlook/2020/article/careers-for-nurses-opportunities-and-options.htm

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Patient with a giant personality / Repost

We didn’t see his type often.

He walked in, chin up, thick belly, arms cocked at his side, gave me a smile, a mischievous smile, and I thought , oh well, every now and then, you gotta take care of someone you know is going to be different.

“Hi David, I’m going to be your nurse. We need to get your weight and height right over here.”

He gave me a ‘You must be crazy’ look, but he did comply. I jotted the numbers down and led him along with his female escort to his pre –op bay.

Paperwork completed, I closed the curtain, giving him privacy to change.

A small adult cuff fit his arm, Yay!, the O2 saturation probe picked up fast, and I thought things were going well until the woman with him asked for help.

“Susan, we need to find a channel he likes, like fast!”

I started pushing the channel up button as quick as possible. I didn’t want a meltdown on my hands. He started to scowl. His face turned red. I flipped to high channels then back to low one. Panic was making me inconsistent. Why does the hospital need sixty-eight channels? I just passed a really hard test. I can’t believe how nervous this is making me.

Finally.

Channel 18.

The cartoon channel.

Crisis diverted.

Four year olds are cute, but I’ve changed my mind about being ready for grandparenthood!

 

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Words of Wisdom

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Your Words / Your Voice

All the way back to the 1700’s with political colonist Thomas Paine and the Common Sense Pamphlet, we’ve been using the spoken or written word to express opinions on matters that we care deeply about.

Here in the twenty-first century, various social platforms give us a multitude of ways to do the same thing. I have one particular issue.

It stems from an evening that, yes, I went down that Instagram rabbit hole ( must have been there over thirty minutes) and came across some posts from nurses, one in particular that had a significant number of followers.

This same nurse had a handful of rants about staffing inequities, but all in all, when I went to her feed, she had about a ten to one ratio of posts with the former being polished selfies attached to superficial comments and the latter 10% being strong words about the significant staffing crisis and shortage of supply needs in our hospitals.

Now, there are great finds on Instagram: Nurses that post only educational material, Nurse that stick to ‘clean’ humor and cartoon pieces, and yes, the nurses that find the time to demonstrate the use of TikTok in the hospital setting. ( I can’t for the life of me, figure out how that gets done.)

When we speak, we either educate, entertain, or express our opinion on matters that mean something to us.

I think it’s the timing that gets me.

If you’re going to yell about what’s going on, yell loud and long. Do some homework so you have facts to back up the significance of the problem going on. Double check and ask yourself, Am I just venting?

I would have no problem telling the nurses projecting how well their scrubs flatter their figure or are doing TicTok on hospital time that they are doing no service to the profession. Call me an old fuddy duddy. I’m calling it like I see it.

And for anyone who’s reading this and going Hmmm, and your blog… consistent ??? I started this blog over seven years ago. There’s enough material to get the tone of my voice

Below are some nurses that are making a difference.

Melissa Early BSN, RN, QMHP, NHDP-BC, CCEMP-P , Richmond, Virginia Mental Health Consultant – working with multiple hospitals on changing the narrative around mental heath needs for professionals

Schola Matovu, PhD, RN, MSN – through her research is focusing on ways to decrease the health inequities on a global level.

Justin Gill, DNP,ARNP,RN, Washington State / Chair of the Legislative Health Policy council Washington State Nurses Association – working to improve safe staffing level legislation and participant in the COVID Vaccine and Equity Project.

You can easily find these above professionals via their work in American Journal of Nursing, MyAmericanNurse.com, ImpactVirginia.org, or https://rnaction.Org

Thank you for your time in reading this post.

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Versed, Amnesia, and Patients Determined to Tease You until They’re Discharged

Even though I was calling him from the waiting room at 5:30 in the morning, he strode back toward the pre-op area with an enthusiasm uncanny for most of our early morning patients.

With my introduction complete and his date of birth confirmed by checking his armband, I gave my first instruction.

” Here’s a bag to place your things, socks to keep your feet warm, the required blue net cap for entering the OR, and your gown.”

” Alrighty” he said.”

” You can keep your boxers on, but your undershirt needs to come off with your other clothes.”

” But why not my boxers ?”

” Oh Sir, your surgery is on your hand. Wearing them won’t interfere with surgery.”

” But, I want to take them off.”

” Ah, okay. I’m just saying that it’s not required.”

“Well, should I or should I not?”

I saw the corners of his mouth turned up and a twinkle in his eyes.

” That’s totally up to you.”

“But, what do you think?”

Now he had a full fledged grin going on.

” It’s up to you” I said with a smile hard to stifle. ” I’m pulling the curtain shut so you can change.”

In short time, the anesthesiologist arrived and interviewed him. I started his IV. Anesthetists arrived and needed their med boxes filled – I stepped away to help them.

Then the OR team came for my chirpy guy. The first thing he said to them was that I wouldn’t let him take his underwear off. The anesthetist gave him some Versed ( similar to Valium) – a medicine known to cause some amnesia. Then they all left for the OR.

An hour and a half later, I moved to help in the recovery room.

In rolls my pre-op patient ( now post surgery), left hand bandaged, head of bed elevated, eyes open, sleepy looking, but awake all the same. He sees me approaching to get report from the OR team. He nods to me. Then he turns to the OR circulating RN.

” See her, she wouldn’t let me take my underwear off.”

And, then that mischievous grin.

Oh brother. Guess that side effect of Versed doesn’t work on everyone!

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Getting on the playground

” You wear a CPAP anyway…you’ll do fine being intubated. It’s just the next step.”

Even with COVID here, some of the Anesthesia docs still find being facetious funny.

Miss Hill, thanks for the holla! I need to remember that my WordPress family is always here for me ❤

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