ER Nurse

A Nurse Making A Difference

2006-01-03T17:32:00.000-05:00

Bookmark my friend Nancy's blog: http://nancydunphy.blogspot.com. She's working with Doctors Without Borders for a year in Zimbabwe in a HIV Clinic. Her stories and pictures are amazing and inspiring. I always wanted to do something like that, but didn't have the guts to drop everything and go away for a year, so now I'm living vicariously through her by reading about her adventures on her blog. Check it out!

Turning 35

2005-12-21T18:32:00.000-05:00

Kind of weird to be officially in my mid-30's, but guess you've got to just go with it! Had a great pre-birthday dinner with my family, followed by another dinner at Mie N Yu in Georgetown. Oliver discovered that he really doesn't like lamb and I discovered that I really like French Kisses (a drink!)

One Final to Go....

2005-12-12T14:17:00.000-05:00

I'm so ready to be done! Had my last clinical on Friday; pretty low key.....I was still getting over my cold, so I felt a little out of it. Spent most of the weekend studying for my last final, which is tomorrow--but did manage to squeeze in a little fun. Saturday night went to a Christmas party with Oliver and last night, we saw "Walk the Line," which I thoroughly enjoyed. I'm ready to go out and buy a Johnny Cash CD after seeing it!

Relief

2005-12-07T19:35:00.000-05:00

Just found out I passed Anatomy, in fact I squeaked by with a low A; funny because I was sure that I had bombed the final lab exam. So now, one down and one more to go.
I've been fighting a nasty cold the past few days and woke up at four this morning, feeling crummy. I dowsed myself with medicine and fluids and trudged off to work. Fortunately, my clinical supervisor extraordinaire, Michelle, took pity on me and let me leave at 3. 8 hours is so much more manageable than 12, especially when under the weather. The last four hours can be brutal in the ER; it seems things always seem to deteriorate after 3 pm. So, it was a great relief to head home and turn in for an early night.

Semester End

2005-12-02T16:55:00.000-05:00

Well, the semester is wrapping up; I have two finals, one paper, and one more day at my clinical rotation to go. I enjoyed my clinical rotation at the detox facility so much. The clients were really appreciative of any assistance and I found myself really rooting for them in their efforts to stay clean and sober. I'll miss the staff and clients.
I'm looking forward to a little break from school and my favorite season, Christmas! I can't wait to hang out with my family, decorate the tree, bake Christmas cookies, and listen to Christmas music. My neighborhood in Georgetown is gorgeous at Christmas time and I love looking at all the decorations and lights.

British Royalty on Campus

2005-11-03T15:28:00.000-05:00

Just back from a glimpse of Prince Charles, who came to Georgetown University to give a speech. I didn't get to shake hands with him, but had a pretty good view from where I was standing. It was pretty cool! It was a beautiful day-perfect for hanging out and waiting for the Prince to come.

Cracked

2005-10-17T13:22:00.000-04:00

May I recommend Cracked, by Dr. Drew Pinsky. I'm doing my first rotation at an inpatient detox center and the staff there highly recommended it to me. The book is readable, interesting, and insightful. Dr. Pinksky is candid, compassionate, and committed to helping substance abusers get on the road to recovery. According to his bio, he's the medical director at the Chemical Dependency Services at Las Encinas Hospital in Pasadena, Ca. He's also co-host of the nationally syndicated radio show, Loveline. You can check out his website: www.drdrew.com.

I Never Thought I'd Say This...

2005-09-28T20:18:00.000-04:00

But, it was actually good to get back to work today. It was a good day in the ER, not too crazy, but steady enough to make the day go by quickly. Every Wednesday, we have a fabulous volunteer who brings in homemade goodies for us--cakes, brownies, etc. He usually comes in the last hour of our shift---providing a much needed sugar pick-me up to get through the end. I'm currently precepting a sharp new grad, which is a really nice change from being in charge all the time, and much more rewarding. And in the meantime, I've been tormenting my boyfriend with my newfound health assessment skills and I'm quite sure he'll be as glad as me when I finish the class this weekend!

Helpful Anatomy Website

2005-09-21T08:52:00.000-04:00

For a great refresher, check out www.netanatomy.com. This website has a virtual lab, gross anatomy, cross-sectional anatomy, and radiographic anatomy. It's more fun than cracking open an anatomy book and has great images.

The Life of a NP Student

2005-09-20T16:33:00.000-04:00

To my readers-

My life has gotten busier by the minute, as you may have noticed by my lack of blogging. I've started my second year of my nurse practitioner program and it's going to be challenging, to say the least. I'm taking an intensive four week advanced health assessment course before starting my first clinical rotation this fall. We're going through every system in great detail and I'm learning a ton! I'm also taking a refresher anatomy class, in a cadaver lab, which is most interesting. I didn't have this opportunity as an undergrad, and it's really helpful to actually visualize structures.

I've cut back my hours at work, which has helped to keep my sanity!

Pro-Nursing Book

2005-06-07T14:29:00.000-04:00

Check out: Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care, by Suzanne Gordon. Ms. Gordon, a journalist, co-authored the book that sparked my interest in moving the nursing profession forward: From Silence to Voice: What Nurses Know and Must Communicate to the Public. In her latest book, Ms. Gordon re-visits some of the same themes from Silence to Voice, and looks at how various factors contribute to "undermining nurses and patient care." This is a must-read for any nurse who cares about making positive changes within our profession.

Note to My Readers

2005-05-12T19:16:00.000-04:00

The semester's over ( yeah!!!) and I'm off to Italy next week with my beau!! Stay tuned for more nursing blogging when I return...

NURSES WEEK

2005-05-05T15:13:00.000-04:00

Thanks to everyone who has sent me cards for Nurses Week! At my hospital, we're gearing up for a great week of events to show appreciation for our nurses.....Starbucks freebees, quick chair massages, and more. The week will end with selection of "Nurse of the Year," and a keynote speech by Congresswoman Lois Capps, herself a former nurse.

NATIONAL NURSE ORGANIZING COMMITTEE

2005-04-27T19:40:00.000-04:00

Check out: www.noc.net

The NNOC was established by the California State Nurses Association to take "aggressive action through collective bargaining, professional practice and political issues of concern to both nurses and patients." Recall that California was the first state to pass safe minimum staffing laws, which now Govenor Schwarzenegger is trying to repeal.

The NNOC has an upcoming national conference in Chicago June 10-12, so check out their web site and plan to attend. This group is a powerful advocate for clinical nurses and the first of its kind.

ANA Opposes Minimum Staffing Laws

2005-03-19T12:32:00.000-05:00

California recently passed a law creating a maximum nurse-patient ratio of 1:5. I am dismayed to hear that Organized Nursing, i.e the ANA has opposed such legislation. Numerous studies have shown that lower nurse-patient ratios lead to better patient outcomes. With job dissatisfaction at an all time high in nursing, I would venture to guess that lower nurse-patient ratios would also impact retention. California has withdrawn from the ANA and along with nurse associations in Maine, Massachusetts, Missouri, and Pennsylvania, has formed a new organization called the American Association of Registered Nurses. I am disappointed in the ANA for not supporting such legislation and for not taking a firmer stand with other important issues in nursing, like education. Without laws like these, there will continue to be unsafe patient care environments and a continued mass exodus from the profession.

And We Wonder Why There's A Nursing Shortage....

2005-03-02T15:30:00.000-05:00

I am a 15 year veteran of the Nursing Profession. Twelve and a half of these years have been spent in the Intensive Care Unit, a place where no mortal can survive without the special talents of a good nurse. I have stood on my feet for twelve hours straight anticipating the course of death. I have mocked the Grim Reaper by dragging my patient through a maze of hemodynamic remedies only an expert in this field could imagine. In my time as a nurse I have developed enough self respect to know I deserve more credit than I receive.
Please imagine my disgust when low and behold enters the Chief Surgeon. He is the one I have not spoken to but once in my career. He is making rounds with the Attending Surgeon. The two walk to my patient’s bedside. The Chief Surgeon asks me not to speak when he is at my patient’s bedside. I am stunned because I think, wait a minute: Do you mean ME, the one who anticipated and remedied every dip in blood pressure, every change in filling pressure, and every drop in electrolyte; ME the one who kept his prized patient alive for twelve hours. Certainly he can’t mean ME?!
I look at the Chief Surgeon in utter disbelief. He shoots a glance which is reeking of “Get out of my presence NURSE!” I think to myself, he can’t be serious. Reeling from the misguided order from the Surgeon in Ego Bliss, I tell myself not to worry. Soon he will be retiring and will not get the respect he expects when he cashes his Social Security check.

Source: The Center for Nursing Advocacy

Everything You Ever Wanted to Know About Health Policy

2005-02-23T14:08:00.000-05:00

Got a health policy question? Check out: Understanding Health Policy: A Clinical Approach, by Thomas Bodenheimer and Kevin Grumbach. This is an excellent reference for anyone interested in health policy or working in the health care field. It provides a decent foundation for understanding the complexities of the US health care system. It gives a great explanation of the evolution of insurance and health care financing in this country and the authors sprinkle the text with interesting case studies. In fact, it's so readable, I could barely put it down long enough to blog about it.

Nursing PhD Student Invited to Lunch With Former President

2005-02-23T13:58:00.000-05:00

One of my dearest friends, Andrea, has been invited to a luncheon with former President Jimmy Carter. This is part of a celebration of the 100th anniverary of Emory University's School of Nursing. Andrea was chosen with seven of her nursing colleagues to attend the luncheon. Andrea states she's looking forward to cracking peanuts with the former pres.

Johnson and Johnson's Campaign for Nurses: Dare to Care

2005-02-16T20:43:00.000-05:00

Check out Johnson and Johnson's Campaign for Nursing's Future. www.choosenursing.com
Johnson and Johnson launched a massive campaign in 2002 to enhance the image of nursing and to recruit and retain nurses. The campaign features television and print advertisements intended to depict positive images of nurses. The campaign has raised over 3 million dollars in nursing scholarships and grants for nursing schools. All the products on the web site are free, including a scrub top, promotional videos, pins, etc. I ordered my kit and am about to embark on a new adventure: nurse ambassador!

Broken Heart Syndrome

2005-02-10T09:33:00.000-05:00

A new study in the New England Journal of Medicine gives further evidence for the effects of stress on the body. According to doctors at Johns Hopkins, sudden emotional stress, such as a traumatic break up or the death of a loved one, can cause a "surge" of adrenaline and stress hormones that "stun" the heart, causing a loss of ventricular function. This sudden stress results in typical heart attack symptoms, including chest pain and shortness of breath. Interestingly, most of the patients studied did not have a prior history of heart problems and the majority of them recovered without sustaining permanent heart damage. Also, most of the patients were women; further evidence that there are real differences in how men and women react to and process stressful events.

Food for Thought

2005-02-07T09:44:00.000-05:00

When you are outraged by somebody's impudence, ask yourself at once, 'Can the world exist without impudent people?' It cannot; so do not ask for impossibilities. That man is simply one of the impudent whose existence is necessary to the world. Keep the same thought present, whenever you come across roguery, double-dealing or any other form of obliquity. You have only to remind yourself that the type is indispensable, and at once you will feel kindlier towards the individual. It is also helpful if you promptly recall what special quality Nature has given us to counter such particular faults. For there are antidotes with which she has provided us: gentleness to meet brutality, for example, and other correctives for other ills. Generally speaking, too, you have the opportunity of showing the culprit his blunder--for everyone who does wrong is failing of his proper objective, and is thereby a blunderer. Besides, what harm have you suffered? Nothing has been done by any of these victims of your irritation that could hurtfully affect your own mind; and it is in the mind alone that anything evil or damaging to the self can have reality. What is there wrong or surprising, after all, in a boor behaving boorishly? See then if it is not rather yourself you ought to blame, for not foreseeing that he would offend in this way. You, in virtue of your reason, have every means for thinking it probable that he would do so; you forgot this, and now his offence takes you by surprise. When you are indignant with anyone for his perfidy or ingratitude, turn your thoughts first and foremost upon yourself. For the error is clearly your own, if you have put any faith in the good faith of a man of that stamp, or, when you have done him a kindness, if it was not done unreservedly and in the belief that the action would be its own full reward. Once you have done a man a service, what more would you have? Is it not enough to have obeyed the laws of your own nature, without expecting to be paid for it? That is like the eye demanding a reward for seeing, or the feet for walking. It is for that very purpose that they exist; and they have their due in doing what they were created to do. Similarly, man is born for deeds of kindness; and when he has done a kindly action, or otherwise served the common welfare, he has done what he was made for, and has received his quittance.

From a Meditation by Marcus Aurelius

Question for My Readers

2005-02-06T14:04:00.000-05:00

Should hospitals be for-profit enterprises? Does this increase or decrease quality of care?

Quote of the Week

2005-02-06T06:22:00.000-05:00

My ever-wise older brother, Edward, was quoted in the Health Section of the Washington Post this past week by saying," if you really want to get in shape, look for solutions, not excuses," Described as a "succinct morsel of inspiration," by the Post, the quote was in response to the previous week's query on how people are measuring up to the government's recent recommendation for adults to engage in 60-90 minutes of daily exercise.

Highlight of My Week

2005-02-06T05:54:00.000-05:00

Delivering meals to the elderly/home-bound yesterday with the Junior League was one of the highlights of my week. We do this in conjunction with Iona Senior Services, an organization that administers a variety of great programs to seniors in the District. As part of my work with this committee, I am expected to do 16 Saturday meal deliveries per year. I am assigned a partner and we meet at St. Mary's Court, a seniors' building in Foggy Bottom. We are given a route, with a list of names and addresses and a hot and cold meal for each senior. We can even request a particular route ahead of time. I've ended up by chance with the same route for most of my deliveries; a seniors' building on Conneticut Avenue. Though our contact with each client is brief, I enjoy the short interaction, and the bright smiles that greet us.

Become a Nursing Advocate

2005-02-03T22:00:00.000-05:00

Check out this great site: www.nursingadvocacy.org

The Center for Nursing Advocacy was founded by seven nurses to promote the professional image of nursing. One of the Center's goals is to create an accurate portrayal of nurses in the media. The group monitors shows, such as "ER" to ensure that nurses are portrayed fairly, and lets the producers know when we are not. Their excellent form letter on the web site reminds the producers that nurses are not merely handmaids to physicians and that it is unacceptable to cast nurses in this light, as well as to give physicians credit for the work that nurses perform. The media's inaccurate portrayal of nurses does a great disservice to the profession and ultimately contributes to the nursing shortage by casting nurses in undesirable and inaccurate stereotypical roles. After all, who could forget the line from "Meet the Parents"-"is triage better than being a nurse?" Ouch.

Buresh and Gordon Champion Nurses

2005-02-03T10:09:00.000-05:00

Feeling that you don't have much say or control over your work? Check out From Silence to Voice: What Nurses Know and Must Communicate to the Public," by Bernice Buresh and Suzanne Gordon. Written by two journalists, this book champions the important work of nurses. The authors give sound strategies on how nurses can foster greater respect and authority in the workplace. Often, the strategies are simple: use your full name when introducing yourself to a patient; the theory behind this: being on a first name basis with a patient not only puts us on par with non-professionals, it puts us on uneven ground with physicians, who routinely use their last name and title. Another: let's stop asking physicians and start confering with them; the theory: we work collobratively with them; our input, knowledge, and experience is just as valuable; our work is equally important.
The authors also advocate the importance of reaching out to the media and speaking out about health care issues: through letters to the editor, OpEds, and articles. It's time for the 2.7 million of us to use our collective voice to speak out. After all, who knows more about health care issues than those of us who have actually worked in the field?

Raising the Bar of Nursing Education

2005-01-31T11:26:00.000-05:00

One of the issues that I am most concerned with in nursing is the multiple routes of entry into the profession. Currently, one can be prepared to sit for the registered nurse licensure exam through diploma programs, associate degree programs, or through a four year baccalaureate degree program. Not only do these multiple entry points result in a wide range of nursing knowledge and skills, they lack the standardization of education that characterizes other professions, such as law or medicine. I am a strongly favor in standardizing nursing education to establish the baccalaureate degree as the minimum entry point into the profession. The ANA addressed this issue in a position paper in the mid-1960's. It has still not come to pass, and I would argue is needed now more than ever. The public's perception of nurses and the treatment of nurses by other health care professionals depend upon raising the bar of education. The nursing shortage stems in part from the perception of nursing as a vocational or technical career, and therefore is unattractive to the very people the profession needs. Isn't it time to end this long standing education debate?