"Just wait..."
Do you have any Just-Waiters in your life? Perhaps you yourself are a Just-Waiter? Let me explain. Here's how typical conversations with Just-Waiters go:
You: "Gosh, being big and pregnant is no good for my sleep. Couldn't get comfortable last night, and was up six times to use the bathroom. I'm awfully tired today."
JW: "Ooh, just wait until that baby gets here! You won't be sleeping well for the next three years!"
You: "I sure am struggling with my two year old. His tantrums are epic!"
JW: "Just wait! Three is worse than two!"
You: "Man, my four year old is sassy."
JW: "Just wait till she's a teenager! You'll wish she was four again!"
You: "High school is hard! These tests are brutal, and my teacher is no help."
JW: "Just wait! College is way harder than high school!"
STOP.
If someone has trusted you enough to share a struggle, please validate it! Do not make them feel worse by saying that more difficult struggles are ahead. That is in no way helpful!
Better response?
How about, "I'm sorry you're struggling. I brought you your favorite hot beverage. You are an amazing human, and you're doing a fantastic job at life. How can I help?"
Wednesday, October 11, 2017
Wednesday, October 12, 2016
Freeze!
My middle child can be described by many adjectives: intense, passionate, spirited, and strong-willed are just a few of them. I admittedly have struggled at times to parent her in a way that cuts down on frustration and accomplishes our daily goals.
Recently I had a spark of inspiration, and introduced a new strategy. Whenever someone is starting to feel cranky, we holler, "FREEZE!" We then brainstorm ways to get that person into a better mood. This could be a hug, a high-five, a silly dance, a nap, etc.
This strategy works about 20% of the time, but hey, 20% is better than 0%!
I came home from work the other day and shared a story of a coworker who was frustrated with her assignment that shift. Middle Child piped up, "Did you tell her to freeze?"
Recently I had a spark of inspiration, and introduced a new strategy. Whenever someone is starting to feel cranky, we holler, "FREEZE!" We then brainstorm ways to get that person into a better mood. This could be a hug, a high-five, a silly dance, a nap, etc.
This strategy works about 20% of the time, but hey, 20% is better than 0%!
I came home from work the other day and shared a story of a coworker who was frustrated with her assignment that shift. Middle Child piped up, "Did you tell her to freeze?"
Wednesday, March 25, 2015
Advice to Expectant Parents from a Postpartum Nurse
Dear expectant parents,
First of all, congratulations! You'll be bringing new life into this world soon, and that is a big freaking deal. Mostly exciting but a little bit terrifying, am I right?
Here are a couple things you need to know that will save you (and your nurses) a headache at the hospital.
1) Choose a pediatrician or family doctor. Preferably you've chosen one prior to delivery, but if not, you may be required to make your decision before you can be discharged from the hospital. If the physician does not see baby at the hospital, someone else will cover, but we need to know where to send the chart afterward!
How do you choose a doctor? Start with your insurance. Find out who is in-network. Talk to friends with kids. Do they like the doctor their kids see? Call potential physicians to find out if they are accepting new patients. Sometimes the type of insurance you have makes a difference, as some physicians can only accept a certain percentage of private insurance, Medicaid, etc. Narrowed it down to a few? Call the office to ask about sitting down with the pediatrician so you can get a feel for their personality.
This is legwork you don't want to have to do in the 48-72 hours after delivery, so use the nine months prior to get it done!
2) Purchase a new carseat. I love bargains, but carseats are not an area where you should cut corners. Garage sales, craigslist, and facebook are NOT good places to score a carseat!
Carseats have expiration dates (often 6 years after the date of manufacture, but not always). The material in the seat breaks down over time, and the manufacturers can only guarantee the seat's performance for a certain amount of time. The expiration date should be printed on the bottom of the seat.
Did you know carseats need to be replaced after an accident? Even if it was just a fender bender and there is no visible damage to the seat, it needs to be replaced. Car insurance companies should not give you hassle about replacing carseats. The seat has done its job and absorbed the impact, and cannot be relied upon to perform the same way the next time.
If you get a carseat from a garage sale, can you be certain it's never been in an accident?
Don't risk your child's safety for the sake of saving money!
Ok, so you have the (new) carseat. What next?
Read the manual. Keep it in a handy place. Play with the straps on the seat. Figure out how to loosen and tighten them. Practice strapping a doll or stuffed animal into it.
Install the base of the infant seat in the car. Be prepared to bring the seat itself into the hospital sometime before the day of discharge.
If your baby is small (less than 5lbs 8oz at our facility), has respiratory issues, or spends time in NICU, the nurses may need to do special tests to make sure baby can tolerate sitting in the seat, and you won't want to wait until the last minute to do those. Even if your baby does not need the special tests, the nurses will want to see the seat and check the fit of the straps before you get to leave. You do not need to bring the seat into the delivery room, but you will want to have it handy.
Need help installing the seat? Call your local fire station. Find out when a Certified Car Seat Technician will be available there to help you. They are not there 100% of the time, so showing up unannounced at the fire station is not recommended.
Again, during the first hours after baby arrives is not when you want to think about the carseat for the first time! About a month before the due date is generally a great time to get the seat in.
Is there more you need to know and do before baby arrives? Sure. But taking care of these two items will save you so much undue stress, and allow you to put more of your focus where it should be: getting to know this wonderful new person!
Love,
Your Postpartum Nurse
First of all, congratulations! You'll be bringing new life into this world soon, and that is a big freaking deal. Mostly exciting but a little bit terrifying, am I right?
Here are a couple things you need to know that will save you (and your nurses) a headache at the hospital.
1) Choose a pediatrician or family doctor. Preferably you've chosen one prior to delivery, but if not, you may be required to make your decision before you can be discharged from the hospital. If the physician does not see baby at the hospital, someone else will cover, but we need to know where to send the chart afterward!
How do you choose a doctor? Start with your insurance. Find out who is in-network. Talk to friends with kids. Do they like the doctor their kids see? Call potential physicians to find out if they are accepting new patients. Sometimes the type of insurance you have makes a difference, as some physicians can only accept a certain percentage of private insurance, Medicaid, etc. Narrowed it down to a few? Call the office to ask about sitting down with the pediatrician so you can get a feel for their personality.
This is legwork you don't want to have to do in the 48-72 hours after delivery, so use the nine months prior to get it done!
2) Purchase a new carseat. I love bargains, but carseats are not an area where you should cut corners. Garage sales, craigslist, and facebook are NOT good places to score a carseat!
Carseats have expiration dates (often 6 years after the date of manufacture, but not always). The material in the seat breaks down over time, and the manufacturers can only guarantee the seat's performance for a certain amount of time. The expiration date should be printed on the bottom of the seat.
Did you know carseats need to be replaced after an accident? Even if it was just a fender bender and there is no visible damage to the seat, it needs to be replaced. Car insurance companies should not give you hassle about replacing carseats. The seat has done its job and absorbed the impact, and cannot be relied upon to perform the same way the next time.
If you get a carseat from a garage sale, can you be certain it's never been in an accident?
Don't risk your child's safety for the sake of saving money!
Ok, so you have the (new) carseat. What next?
Read the manual. Keep it in a handy place. Play with the straps on the seat. Figure out how to loosen and tighten them. Practice strapping a doll or stuffed animal into it.
Install the base of the infant seat in the car. Be prepared to bring the seat itself into the hospital sometime before the day of discharge.
If your baby is small (less than 5lbs 8oz at our facility), has respiratory issues, or spends time in NICU, the nurses may need to do special tests to make sure baby can tolerate sitting in the seat, and you won't want to wait until the last minute to do those. Even if your baby does not need the special tests, the nurses will want to see the seat and check the fit of the straps before you get to leave. You do not need to bring the seat into the delivery room, but you will want to have it handy.
Need help installing the seat? Call your local fire station. Find out when a Certified Car Seat Technician will be available there to help you. They are not there 100% of the time, so showing up unannounced at the fire station is not recommended.
Again, during the first hours after baby arrives is not when you want to think about the carseat for the first time! About a month before the due date is generally a great time to get the seat in.
Is there more you need to know and do before baby arrives? Sure. But taking care of these two items will save you so much undue stress, and allow you to put more of your focus where it should be: getting to know this wonderful new person!
Love,
Your Postpartum Nurse
Friday, November 21, 2014
Customer Service
This is in response to some blog posts I've seen recently protesting the use of patient satisfaction surveys to determine reimbursement.
I haven't settled my opinion entirely, but here are some thoughts.
As a hospital, we ARE a customer driven organization. If we don't have patients, we don't have a hospital to run.
I absolutely think we need to focus on being the best hospital we can be, with appropriate technology, properly skilled clinicians, and safe care for all.
But isn't that just the bottom line?
Can't we do better?
We are understaffed and overworked.
We are busy saving lives.
We are balancing the needs of many, twelve hours at a time.
But above all, aren't we people taking care of people?
What do my patients want?
They want excellent care, and they want compassionate providers.
I'm busy with a critical situation in room A, and the patient in room B is asking for pain medication? Certainly my priority is to get Patient A stable, but doesn't Patient B deserve attention? Maybe I can't make it to that room immediately, but I can ask another nurse to pass that pain medication for me, or ask an aide to explain to the patient that I will get to them as soon as possible.
No matter where we work or what patient population we serve, we are a team. We have to work together to provide the best care possible for our patients. We have to look out for each other and recognize when our coworkers need a hand. We have to talk each other up instead of sniping about the shortcomings of another unit or provider. Even though I might not work directly with Dietary or Environmental Services, patients view all of us as a unit: The Hospital. If they hear me grumbling about how Pharmacy never sends my meds on time, or how ER always sends up my patients dirty, or how that night shift nurse always leaves extra work for me, it reflects poorly on ME, and on The Hospital as a whole. What's that cheesy saying? Together Everyone Achieves More.
Let's work together and achieve greatness, shall we?
(And in the meantime, lowering nurse to patient ratios sure wouldn't be a bad thing! Ahem, administrators. Each patient is not my only patient, but they deserve to feel like they are!)
I haven't settled my opinion entirely, but here are some thoughts.
As a hospital, we ARE a customer driven organization. If we don't have patients, we don't have a hospital to run.
I absolutely think we need to focus on being the best hospital we can be, with appropriate technology, properly skilled clinicians, and safe care for all.
But isn't that just the bottom line?
Can't we do better?
We are understaffed and overworked.
We are busy saving lives.
We are balancing the needs of many, twelve hours at a time.
But above all, aren't we people taking care of people?
What do my patients want?
They want excellent care, and they want compassionate providers.
I'm busy with a critical situation in room A, and the patient in room B is asking for pain medication? Certainly my priority is to get Patient A stable, but doesn't Patient B deserve attention? Maybe I can't make it to that room immediately, but I can ask another nurse to pass that pain medication for me, or ask an aide to explain to the patient that I will get to them as soon as possible.
No matter where we work or what patient population we serve, we are a team. We have to work together to provide the best care possible for our patients. We have to look out for each other and recognize when our coworkers need a hand. We have to talk each other up instead of sniping about the shortcomings of another unit or provider. Even though I might not work directly with Dietary or Environmental Services, patients view all of us as a unit: The Hospital. If they hear me grumbling about how Pharmacy never sends my meds on time, or how ER always sends up my patients dirty, or how that night shift nurse always leaves extra work for me, it reflects poorly on ME, and on The Hospital as a whole. What's that cheesy saying? Together Everyone Achieves More.
Let's work together and achieve greatness, shall we?
(And in the meantime, lowering nurse to patient ratios sure wouldn't be a bad thing! Ahem, administrators. Each patient is not my only patient, but they deserve to feel like they are!)
Wednesday, November 5, 2014
Expecting the Norm
On the type of units where I work, healthy is the norm. My patients may have pre-existing conditions (such as diabetes or high blood pressure), but most of them choose to be in the hospital. Perhaps it is for an elective procedure, or perhaps it is to deliver a child.
When I take care of my patients, I have certain expectations about their course of treatment.
Sometimes, though, complications develop, and it is my job to be aware and proactive.
I have found that my tendency is to assume that everything will be normal, and to shrug off aberrations as just slight deviations from the norm that will resolve themselves.
I have to make a conscious effort to pay close attention to each detail of each assessment, and to give serious weight to any concerns raised by patients or their loved ones, so that the proper steps can be taken to optimize their health.
I recently had a mother tearfully thanking me for being in tune with her child's condition as it developed, and getting him the interventions he needed.
THAT is why I am a nurse.
To provide for my patients' needs, whether they are physical, emotional, or spiritual.
To provide a listening ear and a sympathetic heart.
To answer questions.
To teach.
To enable.
And if necessary, to delegate to someone with a higher level of expertise, so that all needs can still be met.
When I take care of my patients, I have certain expectations about their course of treatment.
Sometimes, though, complications develop, and it is my job to be aware and proactive.
I have found that my tendency is to assume that everything will be normal, and to shrug off aberrations as just slight deviations from the norm that will resolve themselves.
I have to make a conscious effort to pay close attention to each detail of each assessment, and to give serious weight to any concerns raised by patients or their loved ones, so that the proper steps can be taken to optimize their health.
I recently had a mother tearfully thanking me for being in tune with her child's condition as it developed, and getting him the interventions he needed.
THAT is why I am a nurse.
To provide for my patients' needs, whether they are physical, emotional, or spiritual.
To provide a listening ear and a sympathetic heart.
To answer questions.
To teach.
To enable.
And if necessary, to delegate to someone with a higher level of expertise, so that all needs can still be met.
Sunday, June 1, 2014
Teaching an Old(ish) Nurse New Tricks
Over the last few years, I've developed my beginning-of-shift routine. I generally look at my charts first, then go to each room one by one to medicate and assess simultaneously. The drawback to this is that sometimes I don't make it to my last room before 9am, and that's longer than I'd like to go without seeing my patients!
This week, I decided to try something new for me. As soon as bedside report was completed (so I had a basic knowledge of what each patient was there for, but hadn't looked up specific orders), I went to each of my rooms and did an assessment. By doing that, I was able to see everyone before 8am, so I knew what their baseline was in case they might have a status change mid-shift. Once the assessments were completed, I looked in the charts to fill in details, then began coming around with the morning medications.
I didn't get to start charting any sooner than I would have, but I felt a lot more prepared for the day, and I felt like it went much more efficiently than usual.
So, who says you can't teach an old nurse new tricks?
Tuesday, May 27, 2014
Miscommunication
How's your pain now? Can you rate it on a scale from 0 to 10?
"Well, it was at about a 9, but I repositioned my leg better, so now I'm at a 10."
...Wait a minute. Does that mean you have no pain?
"Yes, no pain. It's at 10."
This is the point where I re-explained the pain scale we use, where 0 is no pain and 10 is the worst possible.
(The patient explained that she and her husband used to joke around and rate each other. i.e. You are all dressed up, you're a 10 today! or You've been out working in the yard, you're a 2! In her mind, 10 = good!)
Come to think of it, she did look very relaxed when her pain was a "9"!
Saturday, October 19, 2013
Perspective
My patient unexpectedly developed a serious issue and was rushed off to emergency surgery. Just before he was wheeled off my unit, I caught the eye of two nursing students, who had been watching with awe as the situation developed and was handled.
"So exciting!" one gushed.
Those two words hit me like a punch in the stomach.
Exciting? I could think of many words to describe the situation, but exciting wasn't the first to come to mind.
Terrifying.
Frustrating.
Nervewracking.
Uncertain.
Unifying.
Motivating.
Four years ago, however, I probably would have reacted the same way they did. Here's a chance to see something new! I can totally write about this in my clinical reflection! When else am I going to experience this particular type of case, unless I work in a particular field of nursing? Can't wait to tell my classmates and instructors about this one! Maybe he'll develop some sort of complication to make it even more interesting!
Amazing what a few years in the field can do to your perspective.
"So exciting!" one gushed.
Those two words hit me like a punch in the stomach.
Exciting? I could think of many words to describe the situation, but exciting wasn't the first to come to mind.
Terrifying.
Frustrating.
Nervewracking.
Uncertain.
Unifying.
Motivating.
Four years ago, however, I probably would have reacted the same way they did. Here's a chance to see something new! I can totally write about this in my clinical reflection! When else am I going to experience this particular type of case, unless I work in a particular field of nursing? Can't wait to tell my classmates and instructors about this one! Maybe he'll develop some sort of complication to make it even more interesting!
Amazing what a few years in the field can do to your perspective.
Tuesday, March 19, 2013
We recently dipped a proverbial toe into the waters of pageantry, and have easily come to the decision to pull that toe back out.
Sweet Pea was asking for several months about being in a pageant. I basically ignored the request initially, since many of her passions are fleeting at this age (5). She persisted, so I did some research.
Sweet Pea was asking for several months about being in a pageant. I basically ignored the request initially, since many of her passions are fleeting at this age (5). She persisted, so I did some research.
I found a local pageant that seemed to be less cray-cray than the ones you might see on cable television (no spray tans allowed, makeup/outfits are to be age appropriate, all participants get a crown, etc), so I signed her up.
Sweet Pea was stoked. She strutted around the living room blowing kisses and twirling. She talked nonstop about the pageant. She was disappointed when I told her she wouldn't be on tv.
 |
| Checking herself out pre-pageant. |
And then we got there.
Sweet Pea got overwhelmed.
She was shy.
She kept her fingers in her mouth for about half of her time on stage, and bawled on the way home about not getting a trophy (despite the new tiara on her head).
 |
| Little miss apprehensive |
Needless to say, we are going to stick to pursuing alternate interests, such as gymnastics and soccer. Enjoyment and aptitude go a long way!
 |
| Lined up for their first turn on stage. Spot Sweet Pea! |
 |
| You can take the cray-cray out of the pageant rules, but you can't take the cray-cray out of the parents. These two were more entertaining than their toddler. |
Thursday, December 13, 2012
Unsolicited Advice
On the way out of Library Storytime with a tired toddler, a stranger initiated conversation.
"Before I get on the elevator, I'm going to tell you a secret."
....
"Chamomile tea."
...For what?
Nods in direction of the kids. "Babies."
*puzzled look*
"You can put it in anything. Milk. Whatever. I had four babies, and the last two were twins."
Elevator doors open, ending our brief conversation as awkwardly as it began.
There you have it. The secret to babies is apparently chamomile tea.
"Before I get on the elevator, I'm going to tell you a secret."
....
"Chamomile tea."
...For what?
Nods in direction of the kids. "Babies."
*puzzled look*
"You can put it in anything. Milk. Whatever. I had four babies, and the last two were twins."
Elevator doors open, ending our brief conversation as awkwardly as it began.
There you have it. The secret to babies is apparently chamomile tea.
Monday, December 10, 2012
Irony
Today, I had the potential opportunity to sleep in an hour or two, because I will be going in to work a bit later than usual.
Guess who was up at the usual time?
That's right; the two girls who normally have to bedragged cajoled coaxed carried out of bed were both awake and READY TO BE UP RIGHT NOW long before the sun.
Guess who was up at the usual time?
That's right; the two girls who normally have to be
Wednesday, November 21, 2012
Kid Stories
It's been a while since I've recapped kid stories on here. With the girls getting older, they are both giving me more blog material but less time to blog! Ironic.
Bright Eyes (14 months) moved up to the toddler room at her daycare. One major change from the infant room to the toddler room is the naptime arrangements. Cribs? History. Cots! She doesn't seem big/old enough to be sleeping on a cot, but I hear that she's doing well with it, and has taken great naps for them.
The other day, Sweet Pea laid down on the floor, and Bright Eyes toddled over and started rubbing her back, just like her teachers do for her at naptime.
We've had tear-free dropoffs up until this week; part of the benefit of starting daycare at such a young age. Well, days 1 and 2 in the toddler room broke our streak! On day 3, however, she barely waved at me as I left. The secret? I dropped her off at a mealtime, and apparently a plate of food is interesting enough to engage her so I can slip out!
Bright Eyes is also making progress with her communication skills. She often waves and says, "Hi!" She's recently added "mama" to her reportoire (though sometimes it is MAMAMAMA!) and seems to associate it with me. She is picking up signs pretty quickly now, and uses "more", "milk" (our sign for nursing), "please", and "sit" appropriately.
I asked her one night if she wanted to read, and she looked around, grabbed a book, and sat in my lap and opened the book.
When I hold up a shoe, she holds up her foot for shodding. She also likes trying to put her own socks on.
Silverware is fascinating to her! She once used a spoon to try to eat a saltine cracker.
Sweet Pea (5) has made big strides with reading since just before her birthday. She had known letter sounds for a long time but didn't seem to be able to keep all the pieces of information in her head and put the sounds together into a word. Now she can look at a word, sound it out to herself, and read it to me. So neat to see!
One nice thing about the girls being the ages they are is that the baby/toddler books that Bright Eyes likes are great for Sweet Pea to practice reading. Win-win!
Hmm, how about some quotes? Sweet Pea has had many that have cracked me up. Going to C&P from FB.
"I love you a hundred much, Momma."
(I voted early. Took the kids with me. Once I'd cast my ballot..) "But won't the other one feel bad?"
(While listening to music in the car) "If I could snap, I'd snap to this beat!"
The sun was streaming down from behind some clouds.) "Is that yellow cloud Jesus?"
"Who was the first one to think of cupcakes? You're older than I am. You should know! When were they first invented? 1968?"
(I was explaining that God loves us all the time, no matter what. She was incredulous.) "Even if you say the word 'booty butt?'"
Bright Eyes (14 months) moved up to the toddler room at her daycare. One major change from the infant room to the toddler room is the naptime arrangements. Cribs? History. Cots! She doesn't seem big/old enough to be sleeping on a cot, but I hear that she's doing well with it, and has taken great naps for them.
The other day, Sweet Pea laid down on the floor, and Bright Eyes toddled over and started rubbing her back, just like her teachers do for her at naptime.
We've had tear-free dropoffs up until this week; part of the benefit of starting daycare at such a young age. Well, days 1 and 2 in the toddler room broke our streak! On day 3, however, she barely waved at me as I left. The secret? I dropped her off at a mealtime, and apparently a plate of food is interesting enough to engage her so I can slip out!
Bright Eyes is also making progress with her communication skills. She often waves and says, "Hi!" She's recently added "mama" to her reportoire (though sometimes it is MAMAMAMA!) and seems to associate it with me. She is picking up signs pretty quickly now, and uses "more", "milk" (our sign for nursing), "please", and "sit" appropriately.
I asked her one night if she wanted to read, and she looked around, grabbed a book, and sat in my lap and opened the book.
When I hold up a shoe, she holds up her foot for shodding. She also likes trying to put her own socks on.
Silverware is fascinating to her! She once used a spoon to try to eat a saltine cracker.
Sweet Pea (5) has made big strides with reading since just before her birthday. She had known letter sounds for a long time but didn't seem to be able to keep all the pieces of information in her head and put the sounds together into a word. Now she can look at a word, sound it out to herself, and read it to me. So neat to see!
One nice thing about the girls being the ages they are is that the baby/toddler books that Bright Eyes likes are great for Sweet Pea to practice reading. Win-win!
Hmm, how about some quotes? Sweet Pea has had many that have cracked me up. Going to C&P from FB.
"I love you a hundred much, Momma."
(I voted early. Took the kids with me. Once I'd cast my ballot..) "But won't the other one feel bad?"
(While listening to music in the car) "If I could snap, I'd snap to this beat!"
The sun was streaming down from behind some clouds.) "Is that yellow cloud Jesus?"
"Who was the first one to think of cupcakes? You're older than I am. You should know! When were they first invented? 1968?"
(I was explaining that God loves us all the time, no matter what. She was incredulous.) "Even if you say the word 'booty butt?'"
I love eavesdropping on the girls' room at night through the monitor. One recent fussy night, I heard, "Bright Eyes, I am going to give you five chances, ok? Now GO TO SLEEP."
(While walking through the grocery store parking lot)
"...And if you step on the yellow lines, they will catch you on FIRE, and then you will have to stop, rock, and roll!"
"...And if you step on the yellow lines, they will catch you on FIRE, and then you will have to stop, rock, and roll!"
"Do you see that orange star over there? It looks like the one they followed when Jesus got born."
"Sweet Pea, that's a street light."
"Well, it looks like a star."
"Sweet Pea, that's a street light."
"Well, it looks like a star."
Thursday, October 4, 2012
Conflicting Values
"I watched my mother go through Alzheimer's," confided my elderly patient. "My dad had some form of dementia, too. I'm already fumbling for words, and that terrifies me. I'm 90 years old and realistically, I only have one or two good years left before I start battling big health problems. Stroke, heart attack, dementia; it's just a matter of time, and I do not want to go through that! Do you know of anyone who can help me with an assisted suicide?"
Well, what do you know? Four years in this place, and this is the first time I have ever been asked that question.
In the few seconds before I answer, I am doing a rapid mental assessment to determine whether this patient is at risk for self-harm. That will affect my next move. My gut says no.
How do I feel about assisted suicide? Is that pertinent to this conversation? I decide my own values and opinions need to go on a back burner. I tell the patient this is a new question for me and that I'm not sure where to go with it, but that I will do a little digging and get back to him.
First step: Document the conversation in the chart and give the charge nurse a heads-up.
Second step: Call the chaplain for ideas.
Third step: Leave a note for the physicians to pass along the chaplain's suggestion.
Fourth step: Return to the patient and let him know what steps have been taken.
Do I have opinions on the issue? Absolutely. I have some strong opinions that would fall under the category "Sanctity of Life," and assisted suicide is no exception. Did my patient ask me to share those opinions? Absolutely not. Should I withhold care, or shy away from researching answers as I would do for any other question asked, just because my patient's values do not line up neatly with my own? Again, I say, absolutely not.
My patients deserve the same level of care no matter who they are, why they are there, how they treat me, or what they believe. That is my duty as a nurse, and it is my honor and privilege as a human being providing care for other humans.
Well, what do you know? Four years in this place, and this is the first time I have ever been asked that question.
In the few seconds before I answer, I am doing a rapid mental assessment to determine whether this patient is at risk for self-harm. That will affect my next move. My gut says no.
How do I feel about assisted suicide? Is that pertinent to this conversation? I decide my own values and opinions need to go on a back burner. I tell the patient this is a new question for me and that I'm not sure where to go with it, but that I will do a little digging and get back to him.
First step: Document the conversation in the chart and give the charge nurse a heads-up.
Second step: Call the chaplain for ideas.
Third step: Leave a note for the physicians to pass along the chaplain's suggestion.
Fourth step: Return to the patient and let him know what steps have been taken.
Do I have opinions on the issue? Absolutely. I have some strong opinions that would fall under the category "Sanctity of Life," and assisted suicide is no exception. Did my patient ask me to share those opinions? Absolutely not. Should I withhold care, or shy away from researching answers as I would do for any other question asked, just because my patient's values do not line up neatly with my own? Again, I say, absolutely not.
My patients deserve the same level of care no matter who they are, why they are there, how they treat me, or what they believe. That is my duty as a nurse, and it is my honor and privilege as a human being providing care for other humans.
Monday, September 10, 2012
Peaks and Troughs
The normal patient load on my particular unit for my shift is 5-6 patients per nurse.
One shift, I started with six patients. Four units of blood, two blown IV sites, one home care set-up, and two late discharges later, it was an hour after the "end" of my shift and I was just beginning my charting. I clocked out about 2.5 hours after shift change.
My next shift (a few days later), I started with four patients. By a few minutes after 9, I had passed all their morning medications and charted all my assessments. When a new patient transferred to my unit, I tucked him in, charted on him, and made the appropriate calls. I had time to eat lunch. I had time to pump.
It's amazing what a difference one or two patients can make!
Another thing that made that latter shift stand out in my mind is that that was the day I was asked to precept a capstone nursing student this semester. (I gladly accepted.) Can't wait!
One shift, I started with six patients. Four units of blood, two blown IV sites, one home care set-up, and two late discharges later, it was an hour after the "end" of my shift and I was just beginning my charting. I clocked out about 2.5 hours after shift change.
My next shift (a few days later), I started with four patients. By a few minutes after 9, I had passed all their morning medications and charted all my assessments. When a new patient transferred to my unit, I tucked him in, charted on him, and made the appropriate calls. I had time to eat lunch. I had time to pump.
It's amazing what a difference one or two patients can make!
Another thing that made that latter shift stand out in my mind is that that was the day I was asked to precept a capstone nursing student this semester. (I gladly accepted.) Can't wait!
Sunday, August 12, 2012
Advice From a Patient
"Listen, honey. Get yourself a boyfriend, and have as many kids as you can. That way, you'll have someone to take care of you when you're old like me."
Sunday, June 10, 2012
Compliments
I round the corner with a patient's breakfast tray, headed to put it with the other dirty ones. A visitor lingers behind me.
"Your hair is really pretty."
I am perplexed by this approach, but thank him, and continue on my way.
He keeps going.
"The color is just, wow, and I like the way you have it up in that ponytail. It looks really nice. I saw it earlier and wanted to make sure I said something."
I excuse myself, head to the nearest med room (which has a lock on the door) and call the charge nurse to find out who he is and whether I should be calling security.
Her verdict: sweet
Mine: creepy
What say you?
"Your hair is really pretty."
I am perplexed by this approach, but thank him, and continue on my way.
He keeps going.
"The color is just, wow, and I like the way you have it up in that ponytail. It looks really nice. I saw it earlier and wanted to make sure I said something."
I excuse myself, head to the nearest med room (which has a lock on the door) and call the charge nurse to find out who he is and whether I should be calling security.
Her verdict: sweet
Mine: creepy
What say you?
Monday, April 16, 2012
Dual Employment
"You have two jobs, Momma. You take care of people, and you take care of us."
She may not have figured out yet what she wants to be when she grows up, but her assessment of what I do is right where I hope to be!
She may not have figured out yet what she wants to be when she grows up, but her assessment of what I do is right where I hope to be!
Friday, April 13, 2012
Process of Elimination
"Oh, no, Momma!" says the 4 1/2 year old.
"What's the matter, darling?"
"I don't know what I want to be when I grow up!"
"Oh, that's ok, honey. You don't have to know that right now." (I was nearly 22 when I figured it out for myself.)
She starts ticking them off on her fingers, "Ice skater? No. Fire fighter? No. Police? No."
Sometimes you have to know what you don't want to figure out what you do want, right? She's on her way!
"What's the matter, darling?"
"I don't know what I want to be when I grow up!"
"Oh, that's ok, honey. You don't have to know that right now." (I was nearly 22 when I figured it out for myself.)
She starts ticking them off on her fingers, "Ice skater? No. Fire fighter? No. Police? No."
Sometimes you have to know what you don't want to figure out what you do want, right? She's on her way!
Wednesday, March 21, 2012
Compassion
I take a deep breath. Exhale slowly.
Comfort care.
New milestone in my nursing career.
Knock softly. Push the door open. Introduce myself to the family.
Patient unresponsive. Introduce myself to him anyway. They say hearing is one of the last senses to go, don't they? Might as well include him as much as possible in his own care.
I have other patients to tend to, but I try to check in on that patient and his family more frequently than I might normally.
What can he sense? Does he know where he is? Does he know his children are by his side? Is he comfortable? Does he feel loved?
I've known the family for six hours, and I already know more about this patient and his relationship with his children than I do about some others I've had all week. He is fiercely independent. He looks out for his children. He is well-prepared. He has a great sense of humor. He will be missed.
I enter the room with small doses of medications to keep him comfortable. I check the identification and clean off the IV site. Before I give it, I notice his breathing has changed. I put aside the syringes and pick up my stethoscope. His peripheral pulses, which had been decent when I first came on shift, are now difficult to detect. His breathing is labored. I don't have to use the stethoscope to realize that his heart is going into ventricular fibrillation.
I make eye contact with his daughter. "He's close," is all I need to say. I quietly step out. As I close the door behind me, I can hear his children sob.
A hug and condolences. Is that all I have to offer this grieving family? I can only hope that my attempts at gentle care of their dying father will help them eventually look back on this time peacefully.
May I not walk away from this experience unchanged. May God grant me the foresight to value my relationships with my own family. May I remember to work a little less, and hug my girls a little more. May my family always know how much I love them, not only in what I say, but in how I treat them. May I treat all my patients with the dignity, compassion, and gentleness they deserve. And someday, when I am on the other side of the equation, may the nurse taking care of me or my family member do the same.
Comfort care.
New milestone in my nursing career.
Knock softly. Push the door open. Introduce myself to the family.
Patient unresponsive. Introduce myself to him anyway. They say hearing is one of the last senses to go, don't they? Might as well include him as much as possible in his own care.
I have other patients to tend to, but I try to check in on that patient and his family more frequently than I might normally.
What can he sense? Does he know where he is? Does he know his children are by his side? Is he comfortable? Does he feel loved?
I've known the family for six hours, and I already know more about this patient and his relationship with his children than I do about some others I've had all week. He is fiercely independent. He looks out for his children. He is well-prepared. He has a great sense of humor. He will be missed.
I enter the room with small doses of medications to keep him comfortable. I check the identification and clean off the IV site. Before I give it, I notice his breathing has changed. I put aside the syringes and pick up my stethoscope. His peripheral pulses, which had been decent when I first came on shift, are now difficult to detect. His breathing is labored. I don't have to use the stethoscope to realize that his heart is going into ventricular fibrillation.
I make eye contact with his daughter. "He's close," is all I need to say. I quietly step out. As I close the door behind me, I can hear his children sob.
A hug and condolences. Is that all I have to offer this grieving family? I can only hope that my attempts at gentle care of their dying father will help them eventually look back on this time peacefully.
May I not walk away from this experience unchanged. May God grant me the foresight to value my relationships with my own family. May I remember to work a little less, and hug my girls a little more. May my family always know how much I love them, not only in what I say, but in how I treat them. May I treat all my patients with the dignity, compassion, and gentleness they deserve. And someday, when I am on the other side of the equation, may the nurse taking care of me or my family member do the same.
Tuesday, January 24, 2012
Spirit of Nursing
This week has helped me remember why I love nursing.
Patients and their family members remembered me (and my name) even when I'd been off for a day or two. They were glad to see me. They vented to me. They reached out for hugs. They called me their angel.
One of the aides told another aide she liked working with me.
Good days at work make it easier to leave the girls in the care of near-strangers at the crack of dawn.
Patients and their family members remembered me (and my name) even when I'd been off for a day or two. They were glad to see me. They vented to me. They reached out for hugs. They called me their angel.
One of the aides told another aide she liked working with me.
Good days at work make it easier to leave the girls in the care of near-strangers at the crack of dawn.
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