Happy Nurses' Week!

In case you missed it, the yearly celebration of nurses has begun. We got the whole week covered at the Hotel with "fun" stuff in between work.

Since the theme for this year's celebration is "healthy nurse, healthy nation", maybe it is time for some nurse-centric play-by-play from yours truly.

Yes, the Hotel has some great facilities, so we are fortunate that a lot of the celebrations occur right by our unit, but the problem: many people don't attend. Why? Because they don't have time.

So consequently, if we could get ANYTHING we asked for this Nurses' Week, here's what would be on the list.

1. Unlicensed staff that actually listen, work, and communicate with the RNs. Too many of them on our unit have a bad habit of dissing the RNs. It needs to stop. Period.

We work together as a team. If you diss the RN you're assigned to on your shift, it's a rubber-glue scenario. You make yourself look bad, too.

2. How about the Captain Obvious question: if you want everyone to document everywhere, why not make it easier at the bedside?

Just saying! If you think logging in after walking 300 feet to the nurses' station, then opening the software, then logging in again, finding the patient, then starting your note is good, you haven't taken care of a bedside patient lately.

No, rehab supposedly has stable patients, but you really need things, like computers that accept the data from the beds, the scales, etc. without double charting.

3. Since I went big on #2, why not on this one. How about a fully stocked cabinet outside each room with the basics, a la TCAB projects of the not so distant past? It would have helped if they had planned this on the last remodel, but here's some food for thought.

Having supply staff actually supply it, would also be nice. If you can't do it outside every room, how about on every wing. Steps do make a difference in a workday (you could be charting, checking labs, etc.)

Finally, no matter where you practice, I wish you a very Happy Nurses' Week. Your work matters and you make a difference.

More to come...

The weekend is here again

Next week is a short one. Dahey returns from his travels. We have a holiday.

Can you say stress? RehabRN hits the road to visit patients in their homes (I occasionally see patients with our super home care team) all by myself. Yes, I'm going in a company car and I'm a nervous wreck. I have to get to the farthest patient first, see the next one (who can be a curmudgeon) and see if I can get the last one in before that day is over, so I don't have to go through the "request a company car" thing all over again.

I admire all of you in home care who do 5-6 visits per day. I don't know how you do it.

However, it's now Friday night. I am off this weekend, which makes me incredibly happy. I'm not going to be stressed about getting ready. I'm just going to do what I can with what I have.

Hope you have a happy weekend too, wherever you are.

'Tis the graduation season

To all of you graduates out there, congratulations! Your four (or more) years are done. You have achieved your goal, or you are on your way to a couple of more graduations, with even more costumes and pomp and circumstance.

There are plenty of graduation speakers this year, but, I've always appreciated this sentiment (even though I'm not a Republican).



Remember, C=RN too, in many schools, so be brave and don't give up. There will always be critics. Do your best every day. You and your patients deserve the best.

I found it a grand coincidence that both my commencement speakers were baseball players. One was a chatty guy who said, "Never take a no from someone who can give you a yes." I lived by that one. It changed my life. The other had a whole collection of maxims from years in baseball.

As they say, when you come to a fork in the road, take it. You never know where it may lead.

More to come...

Things not to do as a nurse, part LVIII

Here's another installment of the popular section on what not to do as a nurse. Listen up, new grads. This is NOT the way to get your 15 minutes of fame.

If you think it is, just remember, NCLEX is getting harder. Here in RehabLand, the pass rate went down, but luckily, the licensing folks are thrilled we are still above the national average pass rate.

Here are a few things that got nurses in RehabLand in trouble lately. Just remember, don't try these at home (or work, either) if you plan on keeping that bright, shiny license.

1. If you're supposed to monitor someone in the ICU, monitor them.

Don't paint your nails, don't go on Facebook, don't blow off the newer nurse you're working with who points out the fact that your patient now has a heart rate of 160 and maybe you should call the doc for orders. Also, when said heart rate goes to 200, don't tell everyone that "I had no idea."

Doesn't work. End of story.

2. If you plead guilty to felony theft, you may lose your license.

Another pretty simple example.

3. Falling in love with a felon could get you in trouble.

No, it's not related to #2, but it could be. Jailhouse Nurse falls for an inmate she's caring for. She goes out and gets him a handcuff key and a gun.  To add to the fun, she smokes some marijuana (a friend brought it in from a legal state) and gets caught doing that while with said inmate/felon. Boundary violations are not a good thing.

4. Oxygen saturation is important for everything.

Remember your ABCs: Airway Breathing Circulation. Yes, those are important. Failing to notice low oxygen sats and to do something about it, can get you into licensure trouble.

5. When you are a private duty nurse, you have to be there (both physically and mentally).

Two examples: one nurse decided to run "personal errands" for almost two hours while caring for her private duty patient, who had hourly vital signs. She also "forgot" to chart that "errand."

Another private duty nurse decided to huff some Dust-Off while her patient's mother fell asleep. The mom found the nurse passed out in the living room on the couch, and when aroused he/she was in no state to work.

6. Why you don't want to become Walgreens/CVS/insert favorite drug store here.

This was pretty interesting. Two nurses were  cited related to "collecting medications to give to poor/uninsured patients" Surprisingly, my license does not say MD or registered pharmacist, either.
Some medications just should not be shared (one RN took unused vials to reuse).

7. Don't bring medical records home.

Ever. No matter how behind you are at work. Can you say HIPAA? This RN took home records that affected a patient's care. Very ugly.

And finally...

8. Don't spank your patients.

Even if they are kids who wriggle around and smack you on the nose while doing their dressing.

That is all. Stay tuned for more in our next installment.

Amen, sister!

 From CNN: Quarantined woman to be discharged, Christie's office announces

"It is not a sound public health decision and well-thought out," Hickox said. "Many of the experts in the field have come out to agree with me. So I think that we need to stress the fact that we don't need politicians to make these kinds of decisions. We need public health experts to make these decisions."

Two things:

One: How come Kaci Hickox, RN, a Real Nurse, isn't even noted as one? Sure might have been a different headline if she were an MD.

Two: It's about freaking time: we need more public health people working on this problem than the public health spin doctors, who know absolutely nothing about medical diagnoses.

Too bad, Mr. Christie is not here. Impersonating a medical professional (RN or MD) is a crime in RehabLand.

I'd have been hot, too, with all this c#$p!

Oh, it's Monday

Since I had an earworm the other day, I very well could have had this as one today. It really was a Manic Monday.

When competent (but lazy) RNs refuse assignment, you just have to wonder.

OMG.

Where are the Magliozzi Brothers when we need them?


 
Blame it on the train/But the bus is already there...

Nuggets for July 17

Here are a few goodies I've run across on the internet lately. Enjoy!

A little explosive
Always provocative, Rolling Stone may ignite a few opinions all over the place with their cover photo and story of a Boston Marathon bomber.

Wired up
AHA's survey of Health Care's Most Wired hospitals is out and to no surprise, the Veterans Health Administration made the list.

If you were wondering
How those folks can count all the participants in uprisings, revolutions, etc., the good folks at the BBC have an article about that very topic.

No contest
Maybe if MBAs were licensed like RNs or other healthcare personnel, they'd make the most trusted list, and not appear in an article like this one about writing their own recommendations. I'd love for my old clinical instructor, Nurse Battle Ax (a former Navy nurse) to talk to one of them.

Reading, 'rithing, rejoicing

Right now, I'm reading a book called Heroic Leadership by Chris Lowney. I don't expect to find a lot of it at the Hotel, but what the heck?! Gotta learn about how the other half lives somehow.

We had a few people writhing around. Don't you just hate it when people jump and make putting IVs in a bear, since you tend to blow veins (or go through them) when they're squirming. For some figurative squirming, Marissa (not her real name) finally left the Hotel for a job as a wound RN at World Renown. It's about time. How many years has she b*t&ed about her job? Alas, that writhing IS over, too.

Finally, I am still rejoicing that I managed to get an A for the semester in my grad class. It was, by far, the hardest one I've had so far. Hope the next ones aren't terrible! One class like that is enough.

Back to relaxing the night away...more to come.

Breathe...

It's so simple, but I don't feel like I've done much of that lately. The pace of the day today was a running one, and tomorrow it will be the same.

The weather has been lovely here, so I walked outside on my lunch break. Clear, blue skies and a light wind was beautiful. There's a hint of fall in the air. I strolled over to another building eating my fall apple we picked recently. It was simply heaven.

I have a new RN working with me and she's doing pretty well. The program she's in is helping. I wish they'd have had something like that when I was new. She'll be with me a little while longer before she goes to her next rotation. I got a good report from her previous preceptor, so I think she'll do well. I just hope she applies for an area of interest before her program is over. We have jobs for new grads at Madison and Washington, but they're getting snapped up fast!

The nice thing is that we've had some time to actually talk about our assignment and plan it. I had her take a patient today. We reviewed his orders, then went in and talked to him. He was a bit balky, but Mr. X. eventually cooperated with her. Newbie had worked with him before (when she first came to the unit), so Mr. X. did not have to be oriented to her.  Yes, sometimes orientation includes getting oriented to the patients and the patients oriented to you! Mr. X. was time-consuming, but he provided a lot of learning--learning about motivating people, teaching them how to care for themselves, and teaching them how to direct their own care if they can't do it for themselves.

Our other patients were easy. We set them up, and they did whatever they could themselves, which for a rehab nurse, is sheer, utter joy. I always tell them I'm not going to move into their houses, so they'd better get used to doing as much as they can for themselves.

We got all our paperwork done and even talked to a couple of wound nurses who were doing an in-service on the unit. It was a whole lot of learning rolled up into one day. By the time the day ended, it didn't seem like we did much at all! Time truly flew by, just like those fall winds.

More to come....

Open letter to the soon-to-be "not new" nurses

Dear New Nurses,

Can you believe you've been signing your name with RN behind it for nearly a year? We can't either. It's always nice to have new people on the unit.

Don't forget...

Speed will come. It gets even faster as you go along.
You will still learn something new every day. That's why K., the charge nurse, who's been here 30+ years is still here. Never a dull moment.
Your new ideas are still new and fresh. Keep learning and don't forget to share what you know.

Just remember...

This is work. Not an after-school gathering at a watering hole as some people seem to make it. Yes, work is a four letter word. Not a bad one, just happens to have four letters. Work never killed anyone.

Help is also a four letter word. Don't be shy. Ask people if you can help them when you're free (which, incidentally is also four letters). Feel free to do stuff people like, but don't always have time to do--stock supplies, get iced water, empty urinals and report the results.

Don't be a slug. We already have one (two, three...) already. That job is already taken, and will not endear you to management. It may not get you much at all, outside of acquiring a bad habit and an eventual pink slip.

Dream and dream big. Make your plans and go for them, be it climbing mountains, climbing the stairs, or even going into management. This may mean more work and/or school or liberal combinations of both, but don't rely on your youthful looks forever. 

“Focus on the journey, not the destination. Joy is found not in finishing an activity but in doing it.” Greg Anderson

I'm glad you're here to do it with us.

Sincerely,

RehabRN

And to end Nurses' Week...

The Muse, RN is hosting Change of Shift at her place...go check it out!

Thanks for including me in your list, and to start things off, even. Wow!

Back to the final paper....almost over!

Nuggets for April 28 - Media edition

Whew! Thankfully, I've got a break today, so here are a few things out on the 'net worth looking at today.

The WSJ blog discusses the WHO Flu Pandemic scale.

Dr. Val talks about Medbloggers as Press: Second Class Citizens or New Media Elite? I have to say as a peon nurse blogger, I found Dr. Val's article very insightful. Some RNs like myself think they just condescend to nurses and not doctors. Read on for more interesting insights from Dr. Val.

Nurse Ratched's Place is the reason I found this article about real nurses from Edward Norton RN's The Last Nurse Standing. I have to say Ed that the biggest compliment I ever got from a PhD was one who told me when I told her I got a rehab job, "That's real nursing."

Kathy Quan has a really good article on Ultimate Nurse called Nurses Position for Yourselves for Future Opportunities

The LA Times had this article with contributions from three RNs about the current state of nursing, and a great title: Only the strong need apply.

Finally, the Gloucester County Times (NJ) has a great article about male nurses called Male nurses praise job, though still minority.

Nuggets for June 16

Here are a few of the latest finds from various blogs on the internet. Enjoy! Happy Monday!

Get some ed-ju-macation (or educating yourself in the blogosphere)

Spook, RN (aka Drug Pusher) talks about the vocabulary of the medical folks he found out there a while ago, called Gallows Humor.

Lost on the Floor has a link to another slang list you may enjoy, if you're looking for something in the same genre. Someone at Madison just told me about the 3H enema last week.

Although, it's not a nursing blog...

Stories of the Incredibly Stupid blog about life in the pharmacy has some really funny stories lately. My favorites are the Making it Fun series and Karma.

Nuggets for February 23

Here are a few goodies I've found courtesy of the internet and some links in my mailbox.

Cleveland Clinic RN fired due to memoirs (from http://www.nursezone.com/)
No surprise here. I can't wait to read the book. I have been lucky so far...not too many as^&*((les inhabit our rehab unit.

An aside: I have a relative who's a specialist, who's not got the best bedside manner. We joke that his bedside manner is so bad that if he has to spend more than two minutes with a patient, he will self-destruct.

At Hotel Rehab, however, I have encountered some comical and some wonderful specialists. Comical--but not therapeutic--one nephrologist, Dr. T., was in on a weekend to visit one of our elderly dialysis patients. Patient was delusional and told Dr. T he murdered someone. Dr. T. told him he was good--as good as Johnny Corcoran and would get him off on lesser charges. Another one of our docs, Dr. G., saw my preceptor and I taking a patient to a medical unit with his isolation cart. Dr. G. knew the cart wouldn't fit on the elevator with us, so he offered to get it to the patient. We figured he'd corral someone and make them do it. Nope, Dr. G. delivered it himself to the room, just as we had unloaded the patient in his new room.

Another, Dr. B. dropped in on several patients and even took one to use the computer on the unit. Our own Dr. F. one day changed a dressing for me. He usually unravels them and leaves them for the nurses to redress, but this one day, he actually dressed it all the way.

I suspect I've been really, really lucky to have these folks around. I will miss them.

The Dangers of Unmanaged Stress (also nursezone.com)
An interesting article on what stress can do to you.

The Business of Healthcare (from http://www.nytimes.com/)
A very interesting section about healthcare and in particular, this article, Who pays for efficiency?

Family centered care (from http://www.nursesean.com/)
I had a brush with this type of behavior this week when a patient on our unit called her husband at home because her light wasn't answered fast enough. Thankfully, she's not been on my team lately!

That's so wrong (or why I really love Nurse William's posts)
I guessed this by the end of the story, but I loved it, nevertheless. Glad you're back, Nurse William! I love your stuff.

And last but not least, in the ROFL category...
Who's your Dialysis Daddy?
License Pending's take on dialysis patients...somewhere the Viagra folks have yet to go.