June 25th, 2009 by CodeBlog in Better Health Network, Opinion
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Or the other statements, “I could never do this” and “It takes a special person to be able to do this.”
These words are usually uttered by family members who walk into an ICU room to see me calmly managing a patient on drips and vent, hooked up to monitors and other various tubes and wires. I’m sure these words are spoken many many times every day all over the world.
I appreciate hearing it, but it always makes me think of the jobs that I could never do. Sure, there are lots of jobs that I’d simply be unhappy doing, but there are a few that I’d almost rather starve than do.
I could never be a dentist or hygienist. I cannot handle dealing with teeth. If I see that my intubated patient has a loose tooth, I’m done for.
I could never be an exterminator. In fact, I was talking to an exterminator the other day (If you don’t live in California, you are probably not aware that it is, in fact, resting atop a gigantic ant hill). He was friendly and chatty and I myself mentioned that I don’t know how he was able to do what he does because I literally shiver with disgust at the mere PICTURE of a large bug. He then asked what I did and I replied that I was a nurse. He looked at me for a moment and said that the site of blood completely freaks him out. There’s no way he’d ever work in the medical field.
Within my own profession, I can imagine doing almost any type of nursing. That isn’t to say that I’d enjoy it or even be good at it. But there is one branch of nursing that I will never go into. There is one patient population that I cannot even begin to cope with taking care of, and that is burn patients. I don’t know how you can cause someone so much pain day in and day out, even if it’s in the name of healing. Any burn unit nurses out there? How on earth do you work in such a unit?
What are some jobs that you could never do?
*This blog post was originally published at code blog - tales of a nurse*
June 24th, 2009 by Emergiblog in Better Health Network, True Stories
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Well, somebody likes their job, I must say.
Although I can’t figure out why she is smiling.
Her cap looks like conjoined coffee filters!
Conjoined coffee filters that somebody sat on!
Maybe she doesn’t realize it’s squished, and would die of embarrassment if she knew!
********************
The emergency department “regular”.
Every emergency department has them.
A patient can become a “regular” for many reasons. Maybe they are a recurrent cardiac patient. Perhaps they suffer from chronic pain. Sometimes, they become a “regular” because they utilize the ER as a clinic and bring the whole family in over the course of a month. Some regulars are drug seekers. Others are homeless and know they can find respite in the department for at least a couple of hours and maybe get something to eat.
If you work in an emergency department long enough, you will know who they are.
And you will get to know them.
*****
Recently, it dawned on me just how well you get to know them.
I work in a community hospital. It’s one of those hospitals that patients actually request to go to from all over the county. We have our shifts from hell, but it is far from the county-trauma-eight-hour-wait-time environment of the huge medical centers. There is time to talk to the patients, find out more about them than what hurts, what is swollen or what prescription they have lost.
Over time, the conversation stops being scripted and “starts getting real”, as they say.
*****
This particular shift was steady, but not crazy. And almost all the patients I cared for were “regulars”. Easily 90%. For some, it was their usual health issue. For others, something different.
I found out a lot that night over the course of that shift
Someone’s youngest would be starting kindergarten in September; someone’s oldest had just graduated from high school. Someone had gotten into a recovery program and had been clean for a month. Someone had just welcomed their first grandchild, another was mourning the loss of their mom the week before. Someone had lost their job earlier in the week. Someone had gotten married since their last visit. A baby sister was on the way for one of my patients. Another patient had enrolled in the local junior college.
We saw them, treated them and sent them on their way with a wave and a prescription.
Hopefully they left in better shape then they arrived, even if all they needed was reassurance.
All I know is that I thoroughly enjoyed that shift.
*****
I had done all the usual things. Saline locks, blood draws. Medications and re-evaluations. IVs and education.
But I had also congratulated success, commiserated over frustrations and offered consolation over losses. We covered birth and death, struggles and successes, dropping old lifestyles and starting new beginnings.
That shift, I saw my patients in a different light.
*****
The best part of nursing has nothing to do with disease or diagnoses or procedures or prescriptions.
The best part of nursing is the patients themselves.
I thoroughly enjoyed catching up with my “regulars”.
I hope I was therapeutic for them.
They were most certainly therapeutic for me.
*This blog post was originally published at Emergiblog*
June 16th, 2009 by MotherJonesRN in Better Health Network, Opinion
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Do you remember this person? She is a bedside nurse. She walks up and down hospital hallways in her white nursing shoes all day long while caring for her patients. She is trained for active duty. I’m asking you this question because nursing researchers have had an epiphany. They believe that they have discovered something new in the field of bedside nursing.
Over the years I’ve observed that the more degrees and letters that a lot of academic nurses get behind their name, the more out of touch they become with bedside nursing. This came to light once again when I attended a mandatory inservice at work. I was told that we were going to talk about an innovative concept that was going to revolutionize patient care and the nursing profession. Imagine my surprise when the speaker talked about hourly rounds. Did you know that nursing researchers have discovered that patients are happiest when their nurses spend time with them at the bedside every hour, and anticipate their needs? Wow, what a concept. Academic nurses living in the ivory tower of higher learning have discovered through years of painstaking research that patients also want nurses to answer their call light promptly when they need help getting to the bathroom. Holy cow! Hourly rounds decreases the amount of time patients spend using their call lights, decreases injuries due to patient falls, and increases patient satisfaction while they are in the hospital.
Did I miss something? I remember learning all this stuff years ago when I was attending a lowly diploma nursing program. We were always walking up and down the halls in our nursing shoes. No one conducted studies on how to make patients happy back then. A little common sense goes a long ways. The formula to good patient care starts with clean bed sheets and a filled water pitcher, and ends with a connection to your patient. That’s not new. That’s nursing.
*This blog post was originally published at Nurse Ratched's Place*
June 11th, 2009 by MotherJonesRN in Better Health Network
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Life is good. I’m settling into my job at UGH (Undisclosed Government Hospital) and I have a couple of days off from work. I’m using my time constructively. My house looks like hell, but I am doing other important things like writing, reading blogs, and visiting Twitter.
Yes, I’m addicted to Twitter. I started tweeting when I hooked up with Pixel RN and Dr. Val at BlogHer last year. They showed the joys of micro-blogging and my life was changed forever. Twitter is great place to meet people using 140 characters at a time. You can hangout in cyberspace with people like Ashton Kutcher, Lance Armstrong, and Stephen Colbert. You can also hangout with a lot of great healthcare providers. I make new “friends” by putting the word “nurse” into the Twitter search engine. Then I sit back and see what pops up.
Yesterday, something very interesting caught my eye. Dr. Hess, a plastic surgeon, tweeted that nurses were being offered free plastic surgery. I love free stuff, so I followed the link in his tweet, and checked out his blog. He wrote a great post. I also checked out the link in his post to the New York Times. The upshot of the story is that some places in Europe are offering plastic surgery as a recruiting tool for nurses. The story talked about the enormous social pressure that some nurses are under to look good. It’s true. Even some hospitals in the United States are using young and beautiful nurses as a marketing tool to entice more patients into their facilities. Age discrimination is rearing its ugly head. I wrote this post about a nurse who lost her job because she was getting old and because she wasn’t pretty anymore.
I tweeted Dr. Hess. I told him that there wasn’t enough plastic on the planet that could make this sow’s ear into a silk purse. I also told him that I look forward to tweeting with him in the future. He wrote back and told me that he thinks that I’m charming. Just wait till he really gets to know me!
I’m going to Twitter my way through life.
*This blog post was originally published at Nurse Ratched's Place*
June 8th, 2009 by Emergiblog in Better Health Network
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You walk into the unit, put down your backpack, fill your pocket with pen, scissors, and tape, sling the stethoscope over your neck, swipe your namebadge into the infernal timeclock and enter stage right.
It’s showtime!
Get the triage, hook up the monitor, grab the EKG, slam in the saline lock – grab the bloods in the process, hang a liter of normal saline, put up the side rails, hook the call bell to the side rail, throw on a warm blanket, medicate for fever and slam the chart in the “to-be-seen” rack.
Repeat x 30 over the next eight hours.
Feel like burnt toast, look like burnt toast, act like burnt toast.
*****
Where’s the patient?
You know, the person you just triaged, hooked, slammed, hydrated, side-railed, blanketed, medicated and lined up for evaluation?
Oh.
Did it ever occur to you that the reason you feel like burnt toast is because you are so focused on what you are doing you have lost sight of the “who” you are doing it to?
*****
Well, it occurred to me.
Because that is exactly what had happened.
Oh, my physical care was fine.
But I had stopped looking patients in the eye. I was spitting out standard responses instead of listening to what my patients were saying. I was expending the bare minimum of energy required to complete tasks.
I was doing; I wasn’t caring.
And I was burnt.
*****
But I discovered something.
And this is huge.
I was not focusing on tasks because I had burned out, I burned out because I had started focusing on tasks.
Let’s face it. The ER, while seemingly exciting to those outside the ambulance doors, can actually feel redundant to those of us who deal with the same issues every day. The same complaints. The same symptoms. Over and over and over.
So, what makes each case interesting? What makes each case unique?
The patient behind the story. The person under the symptoms.
Lose sight of the person and you lose sight of the profession. Lose sight of their humanity and you lose sight of your own. Lose sight of your own and you become a burnt shell.
*****
You would think that after three decades of this, I’d have figured this out by now.
I guess you never stop learning.
This time, my teachers were an elderly man with a DVT who talked to me about his time on the LAPD, back in the day.
And the young woman who described, quite vividly, how it felt to go from the pinnacle of health to the devastation of a cancer diagnosis, overnight.
Or the 18-month old who tucked their head under my chin and fell asleep as Mom described the terror of witnessing a first-time febrile seizure.
*****
Who would have guessed that sometimes patients are the cure for burn out and not the cause of burn out.
The patients didn’t change, they were always willing to talk.
All I had to do was stop and listen.
That simple.
Go figure.
*This blog post was originally published at Emergiblog*
